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Popular culture exploits a loose notion of psychopaths as remorseless thugs with intent to harm the rest of us. It’s difficult to get past this, but most so-called psychopaths have never been formally diagnosed and probably wouldn’t meet the criteria. The word has become a lazy way to label those we dislike. It’s almost meaningless, but for one thing: It has a uniformly pejorative force. They are the ultimate bad guys. This filters into the collective mindsets of juries that make life-changing decisions.
A research team from the University of Toronto Mississauga undertook an extensive study of the use in Canadian courts of the standardized assessment, the Psychopathy Checklist-Revised or PCL-R. Rasmus Rosenberg Larsen, the first author, is a professor of forensic epistemology, or the study of knowledge relevant to forensic science. This philosophical discipline examines reasoning skills in such areas as crime scene reconstruction, the setup of experiments, the quality of database information, and methods of real-life application.
The research team examined 3,315 legal cases from 1980 through 2023 that included psychopathy scores, which were most typically derived from the PCL-R. Canadian prison psychologist Robert Hare and his colleagues had created this 20-item checklist based on a specific set of traits and behavior. “Psychopathy is a personality disorder,” Hare wrote in Without Conscience, “defined by a distinctive cluster of behaviors and inferred personality traits, most of which society views as pejorative.” Among its features are a callous disregard for the rights of others and a propensity for predatory behaviors. Without remorse, psychopaths charm and exploit others for their own gain. They lack empathy, honesty, and a sense of responsibility, and they manipulate and con others with little regard for anyone’s feelings. Some become violent.
The checklist generates scores between 0 and 40. Those above 30 (some use 25) indicate a clinically significant manifestation of psychopathy. For a long time, psychopathy was considered untreatable, so it made sense to believe that those with high scores had an increased chance of repeating their crimes. As part of a comprehensive risk assessment study, the PCL-R came to be viewed as one of the best predictors of recidivism.
The assessment was first presented for diagnostic use in 1980 and revised five years later. Hare cautioned against using it in court settings. He understood that the process of scoring the PCL-R could be influenced by whether the clinician was hired for the prosecution or the defense. Yet after 2000, there was a sharp increase in its use in a forensic context, with a gradual decline after 2013. In addition, there were shifts in attitudes about the condition and more efforts to understand and treat it.
In 2020, a group of “concerned experts” published a statement to the effect that “concerns remain, however, about using PCL-R scores to make precise and accurate predictions in certain contexts.” These include the prediction of “serious institutional violence,” especially in the context of high-stakes legal decisions.
Larsen’s team confirms this concern, using a disciplined study to underscore Hare’s initial caution. They determined that psychopathy assessments were used in court primarily as a clinical measure or for risk assessment, with higher scores delivered for the prosecution vs. the defense. Sometimes, these experts failed to stay up to date on such things as neuropsychology, promising treatment plans, and the reliability of predictions for future behavior. Thus, they were presenting misinformation. When the researchers performed a qualitative analysis of 183 examples of expert testimony regarding the risk for recidivism via the PCL-R, they found that many made incorrect claims about treatability, and some had attenuated what is supposed to be a painstaking process.
We see similar trends in popular culture via such books as Jon Ronson’s The Psychopath Test. In addition, Larsen et al. note that the most recent professional manual for the PCL-R doesn’t address treatment programs for psychopathy that have shown positive results.
When jurors get the wrong information from experts and they’re already primed by culture to think the worst, presenting a PCL-R diagnosis can put defendants at an unfair disadvantage. “We’re using a tool that seems to only be harming people,” Larsen states. “We shouldn’t be implementing a tool on a wrongful basis just because we want some sort of ends that cannot be justified.”
He has a point, but he might be overstating one part of the problem and missing another. He published a book, Psychopathy Unmasked: The Rise and Fall of a Dangerous Diagnosis, that suggests his own bias. Did it affect the research interpretation? He offered results from a mock trial experiment that found members of the public tend to associate psychopathy with much higher risk levels than is found in empirical research. So, they overreact to such testimony, based on popular media portrayals. However, this doesn’t necessarily negate the need for a professional assessment. Instead, it seems to support the stance that experts should better explain the condition of psychopathy vs. erroneous media notions.
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Larsen et al. urged the courts to use more caution with PCL-R presentations, as they can have the wrong effect on sentencing and parole decisions. That’s a fair position, but it’s an incomplete fix. Unconscious bias in jurors from the culture at large could still undermine even the most objective presentation.
