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Assessing the Psychopathy Checklist assessments for female offenders in

Canada: A systematic review
Thesis · February 2021

DOI: 10.13140/RG.2.2.18544.38409
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Running head: THE PSYCHOPATHY CHECKLIST ASSESSMENTS FOR FEMALES 1
Assessing the Psychopathy Checklist assessments for female offenders in Canada: A
systematic review
Jessica L. Brown
Dr. Robert Di Fazio, MSc., Ph.D.
A thesis submitted to the School of Community Services in partial fulfillment of the
requirements for the Honours Bachelor of Behavioural Psychology
St. Lawrence College,
Kingston, Ontario,
Canada
February 22, 2021.

THE PSYCHOPATHY CHECKLIST ASSESSMENTS FOR FEMALES 2
Abstract: Psychopathy is characterized by detrimentally high levels of impulsive or risk-taking,
deceptive and grandiose behaviours and low levels of empathy or remorse; psychopathy has a
strong correlation with criminal and aggressive behaviour. The Hare Psychopathy Checklist-
Revised (PCL-R) is the premiere diagnostic tool for psychopathy and it assesses 20
characteristics or behaviours. Hare created this to use in his research with male inmates in
Vancouver, British Columbia. It was not intended for clinical or forensic use but due to the
success of his work, Hare continued to adapt this measure into a revised checklist, screening
version, and youth version. While Hare and his colleagues routinely assess these measures, they
frequently do not include female participants, or the female participant pool is not representative.
This systematic analysis examined gender as a factor in the symptomology of psychopathy in
inmates and determined whether female inmates require an adjusted version of the PCL
measures in order to accurately assess psychopathy. Important differences were noted in
psychopathy across gender. Women with psychopathic traits are less likely to display criminal
behaviour or physical violence and more likely to engage in verbal violence or social network
manipulation. Male psychopaths are more likely to have grandiose or impulsive behaviour
whereas female psychopaths have higher rates of emotional reactivity and drug abuse. Women
are more likely to inflict harm on themselves than others. Psychopathic women were more likely
to be sex workers and/or use sex for manipulation than men. Most notably, psychopathic
behaviour related more strongly to BPD in women and ASPD in men. Gender moderates the
symptoms, assessment, and diagnosis of psychopathy. The current measures are not effectively
diagnosing psychopathy or assessing risk in women, which they claim to do.
Keywords: psychopath, gender, female, borderline personality disorder, antisocial personality
disorder, the Psychopathy Checklist, corrections

THE PSYCHOPATHY CHECKLIST ASSESSMENTS FOR FEMALES iii
Table of Contents
Chapter I: Introduction 5
Key Terms 5
Factor 1: Interpersonal-Affective Features 5
Factor 2: Impulsive-Antisocial Lifestyle Characteristics 6
Rationale 7
Research Statement 8
Overview 8
Chapter II: Method 9
Inclusion and Exclusion Criteria 9
Information Categories 9
Chapter III: Literature Review 11
Gender Differences in Mental Illness 11
The Psychopathy Checklist 12
Revised and Screening Versions 13
Youth Version 13
Alternative Measures 14
Function of a Psychopathy Diagnosis 15
Impulse Control/Risk Taking 16
Violent/Criminal Behaviour 17
Sexual Deviance 18
Anti-Social Behaviour 19
Factor-Specific Differences 22
Defending the PCL for Female Populations 23
Canadian Female Offenders 25
Mental Illness 25
Violent and Sexual Offending 25
Risk Factors and Security Classification 26
Summary 27
Chapter IV: Results 29
Gender Differences in Psychopathy 29
The PCLs and Female Populations 30
Chapter V: Discussion 32
Implications of Results 32
THE PSYCHOPATHY CHECKLIST ASSESSMENTS FOR FEMALES iv
Strengths and Limitations 33

Strengths 33
Limitations 34
Contribution to Behavioural Psychology Field 34
Suggestions and Recommendations 35
Recommendations for Future Research 35
References 37
Appendix A 45
Prisma Chart 45
Appendix B 46
Empirical Articles Analysis Table 46
Assessing the Psychopathy Checklist assessments for female offenders in Canada: A
Systematic Review
Chapter I: Introduction
An estimated 300,000 people in Canada meet the criteria for psychopathy (Hercz, 2001).
Psychopathy has been a fascination of both the academic world and popular media. Those with
psychopathy are likely to have a lack of emotional reactions coupled with a normal appearance
(Brown, Serin, Forth, Nunes, Bennell, & Pozzulo, 2017). Characterized by detrimentally high
levels of impulsive or risk-taking, deceptive and grandiose behaviours and low levels of empathy
or remorse, psychopathy has a strong correlation with criminal and aggressive behaviour (Brown
et. al., 2017).
Key Terms
Psychopathy is defined by the Diagnostic and Statistical Manual of Mental Health, 5th
edition (DSM-5) as a synonym of anti-social personality disorder, sociopathy, or dissocial
personality disorder (American Psychiatric Association [APA], 2013).
For the purpose of this study, the symptomology of psychopathy will be defined as it is in
the Hare Psychopathy Checklists. These symptoms and their definitions are as follows:
Factor 1: Interpersonal-Affective Features
Deceitfulness. In order to achieve personal goals, the individual lies, deceives, or
manipulates others (Hart et al., 1999). They usually feel no anxiety or remorse about deceiving
others and can take pride in being a ‘con artist’(Hart et al., 1999).
Grandiosity. Hart et al. also report grandiosity when the individual displays an inflated
view of themselves and their abilities and appears self-assured or opinionated. The individual
blames their negative circumstances on external forces such as bad luck. They do not worry
about the future (Hart et al., 1999).
Lack of Empathy. Different from lacking remorse, a lack of empathy is demonstrated by
limited or no affective bonding with others (Hart et al, 1999). The individual fails to understand
emotional consequences of their actions, either positive or negative (Hart et al., 1999).
Lack of Remorse. The individual does not feel guilt (Hare et al., 1999).
Lack of Responsibility. Hare et al. define a lack of responsibility as the avoidance of
taking personal responsibility for the consequences of their actions. This can be by rationalizing
their behaviour, minimizing the effect it had on others, or denying their behaviour outright (Hart
et al., 1999).
Superficiality. This is defined as glibness and ‘putting on a show’ for others; they often
tell stories of their real or fabricated achievements. The individual also makes excuses for
undesirable behaviour and they appear to perform more desirable emotions and actions (Hart,
Cox, & Hare, 1999).
Factor 2: Impulsive-Antisocial Lifestyle Characteristics
Adolescent Antisocial Behaviour. The individual has a history of conduct problems in
their youth in more than one setting and were not the result of abuse or neglect (Hart et al.,
1999).
Adult Antisocial Behaviour. The individual has had criminal charges or convictions;
they repeatedly break formal rules and regulations (Hart et al., 1999).
Irresponsibility. The individual frequently behaves in a way that creates hardship for
themselves or others or puts others at risk (Hart et al., 1999). This also looks like poor job
performance or trouble paying bills (Hart et al., 1999).

Impulsivity. This is defined as an individual that acts without considering the
consequences of the action, often as the result of excitement or desire (Hart et al., 1999).
Lack of Goals. The individual might lack plans or commitments for the future, or they
may make unrealistic or fantastical goals (Hart et al., 1999). They rely on family or friends for
financial support (Hart et al., 1999).
Poor Behavioural Controls. This describes an individual that is quick to anger or
become frustrated and may be physically or verbally abusive, sometimes unprovoked (Hart et al.,
1999).
Rationale
In the general male population, psychopathy can be found in one to two percent, but in
male offenders the prevalence can range from 24 to 47 percent but this prevalence is
significantly lower in all female populations (Brown et al., 2017). Additionally, in 2012, Neuman
et al. found significantly higher rates of psychopathy in male subjects after studying the self-
reports of 33,016 people, including 13,833 males and 19,183 females.
The DSM-5 expresses concern that psychopathy could be under-diagnosed in the female
population “particularly because of the emphasis on aggressive items in the definition” (APA,
2013, p. 662). Psychopathy is more than just aggression; the Hare Psychopathy Checklist-
Revised (PCL-R) is the premiere diagnostic tool for psychopathy and it assesses 20
characteristics or behaviours (Kiehl, 2014). The PCL-R was created based on a study that
included 143 Caucasian, male inmates who were incarcerated in British Columbia, Canada
(Brazil & Forth, 2016). If the main assessment tool was created by only examining male
behaviour, it is likely that it overlooks any differences that are influenced by sex or gender roles.
Currently there is research that argues that the differences between psychopathy in male
and women are not significant enough to warrant gender-specific assessments but there is a
similar amount of research that suggests the differences warrant changes in assessment and
diagnosis of psychopathy in females. This paper seeks to analyze the literature from both sides of
this argument in order to determine whether psychopathy in females presents differently than in
males and subsequently address the implications of the result.
Research Statement
This systematic analysis of the current literature will examine gender as a factor in the
symptomology of psychopathy in inmates and determine whether female inmates require an
adjusted version of the PCL measures in order to accurately assess psychopathy.
Overview
The literature review will summarize the main findings of the last decade, on the
relationship between gender and psychopathy. The methods section will outline how the research
was conducted. Main differences in symptomology between male and female psychopathic
inmates will be explained using peer-reviewed literature.
In the results section, sources will be further analyzed in an empirical articles table and
conclusions will be drawn so the discussion section can determine where assessment and
diagnosis of psychopathy in women can be improved.
Word count: 971

Chapter II: Method
Research was collected using several databases. Through the St. Lawrence College and
Queen’s University access points, several databases were search for relevant literature. These
included APA PsycInfo (via PsycNET and Ovid), AccessScience, and Health and Psychosocial
Instruments (HAPI). Correctional Service Canada’s online, public research archives were also
searched.
Several key terms were used to conduct searches within these databases. They are as
follows: psychopathy, gender, female, psychopath, difference, female offenders, PCL-R,
corrections, sex differences.
Inclusion and Exclusion Criteria
The research done on psychopath is extensive and was narrowed down using specific
search criteria. This process is outlined in the Prisma chart in Appendix A.
Research from the last 10 years was examined, with the exception of sources authored by
Robert Hare during the creation of the PCL measures. Two systematic literature reviews were
included to summarize the findings prior to 2010. Any articles in languages other than English
are excluded.
Due to a lack of research involving female inmate participants, community samples will
also be considered and evaluated for their generalizability to a forensic setting. Main-stream
news articles will not be included in the search as literature must be reliable. Youth inmates will
also be included in the search and the PCL-YV to get a clear picture of male and female inmates.
Information Categories
As seen in the empirical articles analysis table (Appendix B), articles were summarized
on several key themes. Most importantly are the sample, interventions/trait assessed, and
relevant findings columns. The sample column outlines the participants in each study and breaks
down the gender ratios studied. In the intervention column, key psychopathic traits as defined in
the introduction are listed to compare differences between factors efficiently. Relevant findings
explain what differences were found across gender in psychopathic traits and behaviour and why
the authors saw this relationship. The results section of this paper will analyze and summarize
the findings of both the empirical articles analysis table and the literature review to determine if
there is a significant difference in psychopathic traits across gender and if this directly impacts
the assessment of psychopathy using PCL measures.
Word count: 347

Chapter III: Literature Review
In order to systematically review the use of the PCLs for use with women in a
correctional setting, this literature review will focus on several topics and their relationships to
one another. First, it will review the literature regarding gender differences within mental
illnesses, and then the creation and adaptations of the PCL, from both an adult and youth
offender perspective. It will then compare these measures to alternatives used for psychopathic
traits and outline why the PCL is used and where. The function of a psychopathy diagnosis both
in a correctional setting and in the community will be explained. Next, the differences moderated
by gender within psychopathic characteristics will be assessed to determine the significance of
gender’s impact on psychopathy. In order to address females in a correctional setting, this review
will then address violent behaviour and sexual deviance across gender and their relationships to
psychopathy. Antisocial personality disorder and borderline personality disorder will be
compared to determine if borderline personality disorder is more common in female psychopaths
than antisocial personality disorder. This could be critical for assessment and diagnosis of
psychopathy in women. The two-factor system used in the PCLs will also be analyzed as it
relates to women. The literature defending use of the PCL with female populations will be
addressed next. Finally, an extensive look at the female forensic population in Canada and their
demographics to address needs and risk factor that vary from male inmates. Findings will be
summarized at the end.
Gender Differences in Mental Illness
Gender differences are present physically and psychologically, but recently these
differences are being examined more closely in the presentation of mental illnesses. Notably
‘male’ disorders are being reexamined under a feminist lens. There has been growing evidence
that autism presents differently across gender and that many common assessment measures
frequently miss autism in females (Ratto et al., 2018). This hole in the assessment is present in
young girls and adult women looking for answers about symptomology that fits closest with an
autism diagnosis (Rattoo et al., 2018). Murray et al. (2017) report many females may be
excluded from an attention deficit with hyperactivity disorder due to a later age of onset than
their male peers.
This issue is seen in the diagnosis of psychopathy, a disorder common among violent
offenders (Kent, 2014). Many studies have demonstrated a positive relationship between
psychopathy and instrumental violence, making psychopathy and its assessment relevant in
correctional and forensic settings (Walsh et al., 2009). If the PCL is not accurate screening
female offenders for violent recidivism, an alternative measure must be considered.
The Psychopathy Checklist
Robert Hare developed the original version of the Psychopathy Checklist in the 1970s to
use in his research with male inmates in Vancouver, British Columbia (Hare, 2020). It was not
originally intended for clinical or forensic use but due to the success of his work, Hare continued
to adapt and perfect this measure (Hare, 2020). Hare then fathered a revised checklist (PCL-R)
that was published in 1991 as well as a screening version (PCL:SV) and a youth-specific version
(PCL-YV) (Hare, 1999). Assessments of these measure are done routinely by Hare and his
colleagues; they frequently do not include female participants, or the female participant pool is
not representative (Cooke et al., 1999; Hare, 1999; Harpur et al., 1988).
The PCL is used across the world in places like North America, Europe, and Australia in
forensic and community settings (Hare, 2020). It is frequently used for research on psychopathy
diagnosis, prognosis, significance, and treatment (Hare, 2020).

Revised and Screening Versions
In 1999, wanting to generalize the PCL for use in clinical and forensic settings, Hare
analyzed the literature that had accumulated evaluation and using his measures. He found the
PCL-R and the PCL:SV to be predictive of aggression and violence with forensic samples. He
also determined these measures accurately predicted violent recidivism (Hare, 1999). At this
point in time, Hare expressed there was insufficient research done with the PCL measures being
on female participants, a problem that still occurs today. Many of the studies conducted using the
PCL measures have insufficient numbers of female participants. Coid et al. (2009) only had 12%
of their sample identify as female. Several more modern studies had only approximately 30%
female participants (Cook et al., 1999; Strand et al., 2006; Thomson et al., 2019; Warren et al.,
2018). These studies draw conclusions for both genders in various populations but do not have
representative samples being studied.
Cut-off scores for diagnosing psychopathy in females were lower than men in most of the
studies included in Efferson and Glenn’s review (2018) in order to have psychopathic women
included at all. This is not how the PCL measures are used clinically and Hare (1999) notes that
any research done using his measures could be affected by improper administration. A case law
review indicated the PCL-R being used in Canadian courts had a much higher standard error of
measurement than 2.90 as the measure reports (Edens et al., 2015). Edens et al. ruled out any
other reasons for this finding other than some form of error.
Youth Version
Intended for use with individuals ages 12-18, the PCL: YV was adapted from the revised
version of the checklist in 2003 (Forth & Brazil, 2019). Due to the changing nature of youth
personalities, Forth and Brazil emphasize that youth assessed with the PCL: YV should never be
referred to as a ‘psychopath’ and it should not be the only assessment used in clinical or forensic
settings.
Violent reoffending does have a positive relationship with PCL: YV scores, but this
relationship is found only on male youth (Forth & Brazil, 2019; Vincent et al., 2008). Using a
longitudinal study of youth offenders, Vincent et al. determined the PCL: YV could not be used a
risk assessment for violent or non-violent reoffending by female juveniles. Comparatively, it was
a significant predictor of these behaviours in boys (Vincent e al., 2008). Additionally, Schmidt
and McKinnon (2006) also found the PCL: YV to predict general and violent recidivism in male
native-Canadian and Caucasian youth; it had significantly weaker concurrent and predictive
validity with girls. They report that the PCL: YV failed to predict recidivism in all female
subgroups (Schmidt & McKinnon, 2006).
Alternative Measures
In 2019, Vaughan et al. conducted a cross-sectional study assessing several measures of
psychopathy while looking at psychopathic traits in athletes. When they compared the PCL:SV,
the Short Dark Triad (SD3), the Narcissistic Personality Inventory, and the Machiavellianism
Scale (Mach-IV), they found significant invariance across measures (Vaughan et al., 2019).
Although this may be explained by misspecification of concepts across groups, Vaughan et al.,
caution practitioners using any of these measures with female populations. The definition of
psychopathy is muddied with a Hollywood perspective and the understanding of psychopathic
traits varies from person to person. Even with significant under-representation, females being
assessed for psychopathy in recent studies still show important differences from their male
counterparts.
Function of a Psychopathy Diagnosis
Individuals of both genders with psychopath designations require the most metal health
and rehabilitation services within Canadian prisons (Hicks et al., 2010; Shipley & Arrigo, 2001).
Determining which individuals are high risk is a top priority at Correctional Services Canada in
order to protect inmates and staff within prison systems and the community (Government of
Canada, GC, 2020). This process also includes planning programming for each inmate; inmates
quickly diagnosed with the PCL: SV, which was designed to be a quick screening tool, can move
to more secure institutions and begin rehabilitation programming as soon as they are able (GC,
2020).
Individuals determined to be psychopaths after interacting with the criminal justice
system face many obstacles because they are considered the highest risk to the community with
little consideration for other important factors (Shipley & Arrigo, 2001). Shipley and Arrigo also
report that most mental illnesses can facilitate ‘not criminally responsible due to mental illness’
defense or mitigate responsibility, but psychopathy is often an aggravating feature of crime. The
determination of psychopath has serious implications in jury court cases, due to the negative
connotation of the disorder (Shipley & Arrigo, 2001).
Many of the studies done on psychopathy in juvenile delinquents emphasize the need for
early intervention (Efferson & Glenn, 2018; Lindberg et al., 2016; Schmidt & McKinnon, 2006;
Umbach et al., 2015). The literature has suggested the PCL: YV is not valid among female
youth inmates as an assessment tool or a risk assessment; many young female offenders may
miss the treatment they need in order to reduce recidivism and will be released from institution
programming without skills to manage psychopathic traits (Schmidt & McKinnon, 2006; Vincent
et al., 2008).
Treatment for psychopathy is still in research phases, most namely by Robert Hare in
Vancouver, Canada (Hare, 2020). There is significant argument between researchers as to the
best approach to treating these offenders; many believe a biological or pharmaceutical
intervention is critical to treat chemical and physical brain deficits (Kent, 2014; Umbach et al.,
2015). Correctional programming focuses on main risk factors, including substance abuse and
interpersonal affectiveness skills (Brown et al., 2018). Though some sources report psychopathy
being impossible to treat or increasing in severity with treatment, Caldwell et al. (2006) found
treatment slowed or reduced recidivism among juvenile inmates.
Impulse Control/Risk Taking
Impulse control is one of the traits that is most similar across gender but still has several
factors that vary. This section includes grandiosity, impulsivity, and poor behavioural controls as
they are defined in the introduction.
Drug use is a risk taken by many individuals with other mental illnesses (APA, 2013).
Gender moderates drug use in people with psychopathic traits (Schulz et al., 2016). With a
forensic sample, Schulz et al. determined a significant correlation between antisocial behaviour
and drug use in women; this was not seen in male participants.
Furthermore, Grandiosity is a trait associated with psychopathy through the PCL but in
2010, Visser et al. found women who scored high on the PCL: SV reported low self-esteem and
reported high body shame and anxiety. These women scored high on the PCL in sections
unrelated to grandiosity or superficiality; these traits occur less frequently in women than men
and may result in female psychopaths scoring lower in PCL measures (Visser et al., 2010).
In a look at more modern antisocial behaviour, Duncan and March (2019) looked at the
antisocial uses of the dating application Tinder across gender. They characterized three types of
antisocial behaviours happening on the application: general, to enhance reputation, manipulate
social relationships, or for sadism; esteem, to increase ego and self-worth; and sexual, to gain
access to casual sex. Women were more likely to use Tinder for esteem related antisocial
behaviours and men were more likely to have sexual motivation (Duncan & March, 2019).
Women are taking less risks when online dating to access casual sex, regardless of the scores on
psychopathic measures (Duncan & March, 2019). These results were found in their psychopathic
sample as well as their control, indicating also women are less likely to show grandiose ideas of
their own self-worth.
Hecht et al. (2016) assessed impulsivity in terms of reactive versus proactive aggression.
They found psychopathy had behavioural manifestations that varied across gender. Women with
high PCL-R scores had elevated levels of reactive aggression, indicating they had higher levels
of emotional reactivity (Hecht et al., 2016). Men with high PCL-R scores had elevated levels of
proactive aggression, indicating more impulsivity (Hecht et al., 2016). This could alter female
scores in impulsivity in the PCL measures.
Violent/Criminal Behaviour
Although violent or criminal behaviour is not defined within the PCL measures, Hare
advertises that they are accurate predictors of recidivism and violent behaviour (Hare, 1999). The
literature reports violent and/or criminal behaviour in both genders, often exacerbated by the
presence of psychopathic symptoms or traits. These behaviours look different depending on the
gender performing them.
Self-harm is moderated by gender in psychopathic populations (Verona et al., 2012).
Verona et al. assessed factor-specific differences between genders in inmates using the PCL:SV
and found a correlation between psychopathic traits and self-directed violence in only women
(Verona et al., 2012). Similarly, Mededovic et al. (2018) women with psychopathic traits are
more likely to have somatization, depression, stress, or suicidal behaviours than men with similar
traits. Women at risk for violence are more likely to have a history of suicide ideation or attempts
than males (Bottos, 2007). In maximum security settings, 71% of women and 21% of men have a
previous suicide attempt (Blanchette & Motiuk, 1997).
Women who score high on the PCL-R and commit murder are more likely to have a
mental illness, act impulsively, and choose victims from within the family (Carabellese et al.,
2019).
Conversely, intimate partner violence (IPV) is commonly perpetrated by men with
psychopathic traits, but there does not appear to be a relationship between these traits in women
and the perpetration of IPV (Mager et al., 2014).
Wynn et al. (2012) report women with psychopathic traits are less likely to display
criminal behaviour or physical violence than men and more likely to engage in verbal violence or
social network manipulation indicating they may have less interaction with the justice system.
Sexual Deviance
Sexual deviance and sexual offending are significant concerns for Correctional Service
Canada (Government of Canada, GC, 2020). Within higher security institutions, sex offenders
receive specific rehabilitation programming in order to reduce the risk of reoffending violently or
sexually (GC, 2020). Antisocial traits as defined by the PCL: SV were found to be predictive of
sexual deviance including sadism, pedophilia, exhibitionism, and rape-like content in women but
not men, indicating female psychopaths maybe more likely to offend sexually than males
(Bommel et al., 2018).

In 2017, Puri et al. studied 692 sex workers in Vancouver and 48.8% reported a prior
mental health diagnosis. Although the majority of these participants had depression (35.1%) or
anxiety (19.9%), personality disorders are also present that could relate to psychopathy (Puri et
al., 2017). Unfortunately, Puri et al. did not examine this relationship. Edwards and Verona
(2016) determined antisocial and impulsive traits as defined by the PCL: SV correlated to a
history of prostitution in women. This relationship was not present in male participants (Edwards
& Verona, 2016). Their results indicated women with psychopathy were more likely to engage in
sexually risky behaviour than male psychopaths, but men were more likely to engage in other
impulsive behaviours (Edwards & Verona, 2016).
Alternatively, in a review of the literature Beryl et al. (2014) reported female psychopaths
were more likely to use sexual promiscuity for manipulation whereas males used it for risk-
taking. Several difference motivations behind sexual risk taking have been presented; no
literature has directly addressed the function of sexually risky behaviour and whether this differs
across gender. The studies thus far indicate there is a relationship between types of promiscuity
and gender (Beryl et al., 2014; Edwards & Verona, 2016).
Anti-Social Behaviour
This section will analyze antisocial symptomology as it relates to the PCL. The traits
included are adult and adolescent behaviour, deceitfulness, lack of empathy, lack of
responsibility, lack of goals, and lack of remorse as they are defined in the introduction.
Almost half of the 20 items on the PCL related to an antisocial personality or lifestyle
(Hare, 1999). Often antisocial personality disorder (ASPD) is diagnosed before or with
psychopathy, especially in males (Harpur et al., 1988). In popular culture, many of the traits
associated with psychopathy are antisocial traits: namely deceitfulness, lack of empathy, and lack
of remorse (Kent, 2014).
Differences in psychopathy as it relates to ASPD are well documented and best described
using the use of concise literature reviews. Beryl et al. (2014) reviewed 261 publications with
data on 2545 participants and reported that antisocial behaviour was not crucial to a female
psychopath diagnosis. The research has indicated these traits are not typical of women who
exhibit many other psychopathic traits and this finding has been replicated several times
(Efferson & Glenn, 2018).
Efferson and Glenn systematically reviewed the even more recent literature outlining the
differences between male and female psychopaths. They looked at any research dating before
January of 2018 and focused on emotional, cognitive, and morality constructs. Results indicated
males with high PCL-R scores had higher deficits in emotional processing, including deficits in
empathy and remorse (Efferson & Glenn, 2018). Men were also more likely to endorse causing
harm which is an antisocial behaviour (Efferson & Glenn, 2018).
Both literature reviews indicated antisocial behaviour linking men and not women to
psychopathy, invalidating a large section of the PCL measures for female populations. Strand
(2000) found the PCL: SV underestimated psychopathy in females due to differences in
antisocial behaviour across gender.
Borderline Personality Disorder
Borderline personality disorder (BPD) is defined as a pattern of unstable interpersonal
relationships, identity, and affect marked by impulsivity (APA, 2013). Psychopathy is diagnosed
when deficits in emotional processing, interpersonal relationships, and self-regulation are present
(Sprague et al., 2012). Arguably, BPD meets these criteria slightly differently than ASPD which
is also a cluster B personality disorder (APA, 2013).
Where ASPD presents as deceitful in interpersonal relationships, BPD is evident by
frantic attempt to avoid abandonment that is real or imagined (APA, 2013). ASPD can lead
individuals to fail to plan ahead and set goals; BPD causes an unstable sense of self (APA,
2013). The most dramatic difference is in affect; ASPD presents as low reactivity, limited or no
empathy, and a lack of remorse (APA, 2013). BPD is characterized by increased or dramatic
reactivity and suicidal behaviour (APA, 2013).
These two disorders have two criteria that are very similar. Impulsivity is a trait for both
BPD and ASPD but in ASPD it is often a reckless disregard for others’ safety, whereas BPD
impulsivity is usually self-detrimental (APA, 2013). The second similarity is defined as
irritability and aggressiveness for ASPD and intense, uncontrollable anger for BPD, both
characterized by a lack of control leading to a violent outburst (APA, 2013).
Whereas ASPD is more common in males, BPD diagnoses are 75% female (APA, 2013).
Where psychopathic men show high levels of antisocial personality disorder (ASPD) symptoms
(risk-taking, impulsivity, poor behaviour control, criminal versatility, and irresponsibility)
psychopathic women have shown higher rates of borderline personality disorder (BPD)
symptoms (instability with emotions, goals, and relationships) (Lindberg et al., 2016). This
perspective, linking BPD to psychopathic females, is new to the literature and many other studies
suggest this direction for future research (Beryl et al., 2014; Efferson & Glenn, 2018; Lindberg et
al., 2016).
Hicks et al. (2010) attempted to validate primary and secondary subtypes of psychopathy
across female populations and assess gender differences across subtypes. Primary psychopaths
are incapable of emotions (empathy and guilt), appear callous, cold, and lack anxiety, relative to
ASPD (Hicks et al., 2010). Secondary psychopaths have a normal capacity of emotion but have
an excess of negative emotions which can lead to high levels of anxiety, emotional distress,
hostility, aggression, and impulsive behavior, relative to BPD (Hicks et al., 2010). Females
displaying secondary psychopathic traits are more likely to disrespect institutional rules and
engage in violent behavior with staff and other inmates, exhibit greater mental health problems,
and require greater mental health services or correctional planning than primary psychopaths
(Hicks et al., 2010). Alternatively, male primary psychopaths require more mental health
services and correctional planning than secondary psychopaths (Hicks et al., 2010). The
psychopathic individuals that cause the most problems criminally and require the most
rehabilitation are male psychopaths displaying ASPD symptoms and female psychopaths
displaying BPD symptoms and the most common screening tool for psychopathy, the PCL: SV,
only addresses antisocial traits and behaviours.
In offenders released back into the community, a diagnosis of BPD or ASPD significantly
predicts time to re-offence (Howard et al., 2013).
Factor-Specific Differences
In 1988, Harpur, Hakstian, and Hare factor-analyzed data from six samples of male
inmates to determine if the factor structure of the PCL was replicable in order to address the
argument that the diagnoses of ASPD and psychopathy needed to be discriminated from one
another. The PCL was able to assess personality traits that underlie ASPD that a diagnosis of
ASPD may not reference (Harpur et al.). They also determined splitting personality and
behavioural traits into two factors generalized the PCL to noncriminal and non-antisocial
populations. The factors and their associated psychopathic traits were outlined in the
introduction.
Edwards and Verona (2016) found factor two traits predicted prostitution in only women.
Factor two traits also relate positively to drug abuse in women whereas factor one relates
negatively to drug abuse in women (Shulz et al., 2016). These relationships were not seen in
male samples.
Factor two traits also have positive associations with BPD symptoms (Mededovic et al.,
2018). Sprague et al. (2012) conducted two studies to examine the relationship between the
features of psychopathy and BPD. They found high scores in both factor one and factor two traits
were associated with BPD in only women. Factor one traits alone present as a protective factor
against negative emotionality associated with BPD for only male participants (Sprague et al.,
2012). Mededovic et al. (2018) also report factor one traits being protective for male participants
in their study.
Defending the PCL for Female Populations
Several sources claim the PCL is replicable and reliable among female participants. It is
important to note before the delivery of this data that much of this information has large
limitations that greatly impact the results they are discussing. The quality of research defending
the PCL for use with women in both community and forensic settings is significantly lower than
the literature requesting more analysis of this measure and a female population. The most
common limitation was the lack of female participants in any study taking place in a correctional
facility. A limitation present throughout the literature was the severe lack of longitudinal
studies; many results are just cross-sectional and do not look at development of psychopathy
over time. In addition to studies with more female participants, studies that look at longer periods
of time are also necessary to this field of research.
When Cooke et al. evaluated the PCL: SV in 1999 in order to reason it interchangeable
with the PCL-R. They had a 31% female participant pool but still cautioned more research was
needed before either the PCL: SV or PCL-R were used with female forensic populations. Hare
was a researcher on this study, and he has mentioned within most of his papers, the need for
more sampling with female subjects. His research involved mostly adult, male inmates and does
not work with females frequently enough (Hare, 2020). Hare also notes on his website that he
does not make clinical assessments but has consulted for CSC and the RCMP.
In 2009, Coid et al. used a longitudinal study to directly compare the PCL-R; the
Historical, Clinical, Risk Management–20 (HCR-20); the Risk Matrix 2000–Violence; the
Violence Risk Appraisal Guide; the Offenders Group Reconviction Scale (OGRS); and the total
previous convictions among prisoners, assessed pre-release in predicting violent recidivism. The
PCL-R and the HCR-20 were the highest ranked among female populations and the OGRS was
the highest ranked among men; the 3143 individual subject pool was 12% women.
In 2018, Warren et al., attempted to examine the association between the Historical,
Clinical, Risk-Management-20: Version 2 (HCRM-20), the PCL-R, the Violence Risk
Assessment Guide (VRAG), and violence perpetrated by inmates. They also endorse the
predictive validity or accuracy of all three measures as risk assessment tools. Warren et al. had
39% female participants, but the study was cross-sectional, not longitudinal and they only saw a
response rate of 37%. Both factors may reduce the accuracy of their results.
Canadian Female Offenders
The PCL was created by a Canadian working in Vancouver and in order to assess its
practicality as an assessment tool in female correctional facilities, the Canadian female prison
population will be addressed. Approximately six percent of the incarcerated population in
Canada is female, inside five institutions and a healing lodge (Correctional Services Canada, GC,
2019). Like in the male inmate population, indigenous people are overrepresented (GC, 2019).
Mental Illness
In 2018, Brown et al. (R-420) assessed the mental health of this population. They
determined three quarters of the sample had a current or lifelong mental disorder and one third of
women had severe impairment in psychological and social functioning. Within Canadian female
inmates, 49.4% have a lifetime diagnosis of ASPD and 33.3% have a lifetime diagnosis of BPD
(Brown et al., 2018, R-406). Six percent of female inmates have an IQ below 70, compared to
2.8% of male inmates; these inmates will require additional programming (Stewart et al., 2016).
Violent and Sexual Offending
The majority of violent crime is perpetrated by male offenders in Canada (Bottos, 2007).
Bottos determined female violence was often the result of substance abuse or the inability to
manage strong, negative emotions and take place most commonly in a relational context, which
is different than male violence. There is a small group of female offenders who commit violence
to achieve control over the victim (Bottos, 2007). Motivations driving offending differ across
gender as well as community reposnse and consequences of the crime (Bottos, 2007). These
differences must be considered with creating intervention plans in order to address how they
impacted the crime committed. The treatment of females who commit violent offenses must
consider woman’s status in a gendered society, as many of the difficulties faced are a direct
result of their status as females (Bottos, 2007). Bottos draws attention to gender roles and social
norms that differ across gender. Understandably, these differences impact mental illness, crime,
and the criminal justice system. All of these must take gender into consideration of each unique
corrections case.
When looking at Canadian women who have committed sexual offences, fifty percent
were coerced into offending by a co-offender, twenty-nine percent pre-planned their offence, and
seven percent offended impulsively (Lutfy & Derkzen, 2014).
Risk Factors and Security Classification
Security classification is one of the first steps in planning the rehabilitation of offenders
and is guided by the assessment of risk factors (Wanamaker, 2018). Some risk factors men and
women present the same or similarly: age, criminal history, criminal associates, lower IQ,
substance abuse, education, and employment (Wanamaker, 2018). Brown (2017) listed “criminal
history, criminal peers, criminal attitudes, employment, marital/family, community functioning”
as predictive of recidivism in both genders.
Several risk factors are moderated by gender: history of abuse/trauma, mental illness,
dysfunctional relationships, and parent responsibilities (Wanamaker, 2018). Brown (2017) adds
criminal intimate partners, parental stress, and unsafe housing as women-salient factors. GC
indicates they require more research to determine how significant these gender-responsive
factors may be to over-classifying women’s risk (Wanamaker, 2018).
Brown (2017) reports the antisocial or psychopathic pattern of traits and behaviour may
not be predictive of recidivism for female offenders. Where male psychopaths are likely to
commit multiple offences, female psychopaths are not; they may have less interaction with the
justice system overall (Brown 2017). Brown stresses the need for additional evidence to confirm
psychopathy overestimates recidivism in females.
Women are more likely to offend while serving time in a medium security prison than
male inmates in the same security and are more likely to offend earlier in their sentence (Harris
et al., 2014). They are also three times more likely than men to commit a minor offence while in
custody (Harris et al., 2014). Harris et al. found age to be predictive of these offences in both
genders, but high criminogenic need was predictive of institutional offences for females.
A history of trauma is more prevalent in female offenders than in male offenders (Brown,
2007). Tam and Derkzen (2014) also emphasize that women are more like to develop
posttraumatic stress disorder (PTSD) and experience higher intensity symptoms than men in
Canada. They discovered a strong link between trauma and female offending behaviour and
determined treatment of PTSD symptoms in female offenders could have meaningful positive
impact on recidivism, substance abuse, and institutional adjustment (Tam & Derkzen, 2014).
In Canada, inmates’ needs to protect both themselves and the community are moderated
by the gender of the offender.
Summary
The PCL and its versions, used to assess psychopathy and risk to the community, have
been evaluated consistently with insufficient female samples. Originally designed only for use in
research with male inmates, the PCL has become widely used in North America to assess
recidivism in inmates of both genders (Kent, 2014).
Many differences exist between males and females that engage in psychopathic
behaviour and this affects the assessment and treatment of psychopathy in Canadian women,
especially within the corrections system. The literature indicates psychopathic women may fail
to report grandiosity, superficiality, impulsivity. They may report additional psychopathic traits
such as sexual deviance, sexual risk taking, self-directed violence, and borderline personality
disorder traits which are not assessed on the PCL. Borderline personality disorder may be a more
accurate assessment for violent recidivism in women and is currently be considered alongside
ASPD when diagnosing psychopathy in most populations. GC is acutely aware that Canadian
female inmates have risk factors and needs that are unique to their population and differ from the
male population. The indigenous female forensic population has significantly more unique issues
than other races (Brown et al., 2017).
There has been evidence indicating the PCL is valid among female populations, but all of
these studies did not have representative female populations or were unable to operationally
define psychopathy in a way it could be consistently assessed. Hare reports the PCL needing
significantly more research done with female populations before it is used to assess risk or
recidivism (Hare, 1999).
All of the literature calls for much more research into female psychopathy, usually
suggesting specific directions including looking at the relationship to BPD, addressing gender
roles in behavioural presentation, and evaluating measures of psychopathy with larger female
populations. That being said, the negative connotations of being diagnosed a psychopathy are
very detrimental to youth populations and have significant disadvantages among adult
populations as well which must be weighed against the benefits of this designation.
Word count: 5011

Chapter IV: Results
The goal of this thesis was to determine key differences between psychopathy in female
and male inmates. Furthermore, this study sought to evaluate the validity of the PCL measures
in regard to their use with female clients, in terms of diagnosis and risk assessment.
The literature largely supported the research question, indicating the PCL measures are
inadequate for assessing females with psychopathic tendencies.
A total of 54 articles were reviewed to compile this systematic review. Within this
literature, there was a significant gap in the research indicating insufficient studies have been
done using psychopathy checklist assessments on female subjects. Until more studies are done
with female subjects, these measures are not reliable to diagnose psychopathy in females or
indicate the risk of recidivism for violent offenders. Robert Hare, the creator of the psychopath
checklist measures, claims them to be functional as diagnostic tools and risk assessments and
does not emphasize the differences gender could create in psychopathy.
Gender Differences in Psychopathy
Key differences have been observed between male and females who exhibit
psychopathic behaviour throughout the literature including risk taking, violent behaviour,
sexual behaviour, and personality disorder symptoms.
The first major differences related to impulse control and risk taking. Male psychopaths
were found to be more likely to have grandiose or impulsive behaviour whereas female
psychopaths were found to have more emotional reactivity and drug abuse.
In terms of violent behaviour, the literature suggested women with psychopathic
behaviour were more likely to inflict harm on themselves than others; this relationship was
opposite in male psychopathy.
Sexual behaviour varied across gender as well. Psychopathic women were more likely to
be sex workers and/or use sex for manipulation than men, but men with psychopathic
behaviour were more likely to be sexual deviant in order to take risks. Some literature
suggested women with psychopathy were more likely to sexual offend than men with similar
behaviour patterns.
Finally, psychopathic behaviour was examined in relation to ASPD and BPD;
psychopathic behaviour related strongly to BPD in women and ASPD in men throughout the
literature. These differences affect the effectiveness of the psychopathy checklist measure due
to the weight of each symptom and factor as it is weighted on the measure. This could result in
an under diagnosing of psychopathy in female inmates in Canadian corrections.
The PCLs and Female Populations
The literature indicated no research with female participants during the creation and
assessment of the PCL measures. The evidence that supported PCL measures for use with
female populations was not strong and did not use enough female participants to justify the
results. The PCL is frequently used in correctional settings as a risk assessment in North
America; the literature indicated they are not accurate risk assessments for females, especially
juvenile females.
All of these differences and concerns are seen within the Canadian corrections system
as evident in the literature that can be accessed through their website. The current literature
supports that gender moderates the symptoms, assessment, and diagnosis of psychopathy and
the current measures are not sufficiently doing the job for which they claim to perform.
Word count: 511

Chapter V: Discussion
During this systematic analysis, the literature was examined to determine if gender has a
moderating factor on the presentation, assessment, and diagnosis of psychopathy in female
offenders and looked to determine if the PCL measures accurately assess female populations.
The subsequent section of this systematized literature review develops inferences from the
literature review and result sections. A review of the thesis statement/research goal is provided.
The results are reviewed, and their implications addressed, that is, how this literature review is an
original contribution, and place its importance in context of the current literature and how they
may be applied. Additionally, strengths and limitations of the systematized literature review are
revised and discussed in this section. Furthermore, the strengths and limitations will also be
assessed in order to determine the contribution this thesis makes to the field of Behavioural
Psychology. To conclude, suggestions and recommendations are offered for possible adjustments
to assessment of female offenders and for future directions in research, projects, and programs in
regard to psychopathy in female offender populations.
Implications of Results
Psychopathy has many implications to the public and as a diagnosis. In a correctional
setting, the designation psychopathy is used for risk assessment and designating which offenders
may be more likely to be violent. Currently, PCL measures are used in corrections as a part of
risk assessments for repeat violent offenders (Brown, 2018). The results of this study indicate
this may be an inaccurate gage of risk in female offenders, especially youth female offenders.
Female inmates are likely to score too low on the PCL to indicate psychopathic tendencies, and
therefore are assessed at a lower risk then they actually pose to society.
Additionally, being unable to accurately diagnose offenders of either gender directly
sabotages the treatment and therefore rehabilitation plan. Violent offenders that could be
rehabilitated and reintegrated into society are not getting the most effective treatment because
they have been improperly assessed. Additionally, female offenders with psychopathy who are
not identified by the PCL measures may not receive any treatment while incarcerated. This poses
a significant risk to society as these offenders who should receive treatment are rehabilitated
back into society without coping strategies to reduce recidivism. Considering psychopathy raises
your risk of reoffending, treating psychopaths as early as possibly is imperative to limit risk to
society and strain on public funding of correctional systems.
The results of this review indicate to correctional professionals that supplementary
assessments must be used when looking at risk of violent recidivism and to pay special attention
to women exhibiting psychopathic behaviours or traits as well as females who commit violent
offences.
This systemized review is an original contribution to this field of research because the
consolidation of research on female psychopaths has not been done in the last decade. This study
used older meta-analyses to cover the research from before 2010 and then consolidates the most
recent research in female psychopathy to draw conclusions regarding symptomology,
assessment, and treatment. This systematic analysis evaluates the research and identifies gaps
moving forward in this field of study in order to guide future research.
Strengths and Limitations
Strengths
The methodology of this study is clearly outlined and easy to replicate. Other researchers
or professionals can use key terms and databases to quickly reference sources or learn more.
Additionally, research on female inmates is limited and studies on female psychopaths is
even more limited. This study bridges a gap by consolidating the limited literature on female
psychopaths in terms of assessment, diagnosis, risk factors, and symptomology. This study can
serve as a reference for female psychopathy as it outlines the majority of the research done in the
last 10 years on female inmates with psychopathic traits.
Limitations
Due to COVID-19, access to resources was limited to the internet. Though most sources
are now online, it would have been beneficial to access library collections or speak to experts in
the region.
Almost all the literature on psychopathy does not include representative female
participants; female participation is always less than half the sample. A clear picture is not being
given on the female experience of psychopathy unless representative sample of female inmates is
studied. Female offenders being drastically underrepresented impacts the strength of these
results and suggests further research is needed before conclusions are confirmed.
Contribution to Behavioural Psychology Field
This study contributes to the behavioural psychology field by assessing the behaviours
used to diagnose women with psychopathy. The research indicates the assessment and diagnosis
of psychopathy in women is not accurately operationally defined and as a result woman are
being under assessed and treated. Behavioural psychology emphasizes the more effective
treatment should be used as indicated by the literature; this study indicates female psychopaths
may not be receiving the best treatment, or any treatment at all. The research indicates female
psychopathy is still misunderstood, and much more research is required to accurately diagnose
and treat it.

Suggestions and Recommendations
Correctional professionals should be mindful of these results when assessing female
inmates. In corrections in Canada, several risk assessments are used in tandem; this is the
suggested standard (Government of Canada, 2020). Because the majority of inmates in the
country are male, many assessments are geared towards their gender. Using multiple reliable
assessments and being mindful of gender differences is the best way to accurately assess and
treat female inmates.
It is also recommended professionals working with female inmates are trained to be
aware of the differences between male and female psychopaths, as their attitude to incarceration
and treatment may vary from what they are used to with male inmates.
Finally, much more research is needed with female offender populations. Though there
are significantly more male offenders in Canada, rehabilitating female offenders is just as
important. This study sheds light on the lack of research with female offender participants and
designates a direction for further study.
Recommendations for Future Research
As stated before, more research needs to be done with a representative sample of female
inmates. Many of these findings could be inaccurate due to the lack of female participants in all
the literature. The field of behavioural psychology cannot study male offenders and extrapolate
results to females. Although women have been participants in Hare’s testing of his measures, it
was not a representative sample like most of the other literature. The PCL measures have never
been tested with specifically female participants, and they are still used as an assessment tool
with all genders (Hare, 1999). Correctional research treats women as an afterthought and this can
lead to improper rehabilitation, strain on tax dollars, and an unsafe community.

There is also a deficit of longitudinal studies on psychopathy for any gender. More
longitudinal studies are required to assess psychopathy over time; this systematic review used
only two as they were the only ones accessible in the databases used. The progression or
development of psychopathy is largely not understood for females and examining this disorder
and its progression over time will further help the understanding of the relationship between
gender and psychopathy and its subsequent assessment and treatment of psychopathic females.
Finally, once the scope of gender differences is determined, it is recommended Robert
Hare adapt the PCL further, into a female specific version. That being said, with the growing
understanding of gender identity and expression, further research will be necessary on the
implication on nonbinary individuals.
Word count: 1222

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four-facet model of psychopathy predict physical, verbal, and indirect aggression.
Aggressive Behavior, 45, 265-274. doi: 10.1002/ab.21816
Umbach, R., Berryessa, C.M., & Raine, A. (2015). Brain imaging research on psychopathy:
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Vaughan, R., Madigan, D.J., Carter, G.L., & Nicholls, A.R. (2019). The Dark Triad in male and
female athletes and non-athletes: Group differences and psychometric properties of the
Short Dark Triad (SD3). Psychology of Sport & Exercise, 43, 64-72. doi:
https://doi.org/10.1016/j.psychsport.2019.01.002
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Appendix A
Prisma Chart
Additional records
Identification
Records identified through identified through other

database search sources
N = 3450
N=5
Records after duplicates

removed
N = 2300
Screening
Records screened based on Records Excluded

title and abstract
N = 2300 N = 1950
Full text articles assessed Not relevant to research

Eligibility
for eligibility question’s aims and

objective
N = 350 N = 296
Articles included in
final review
Include
d
N = 54
Appendix B
Empirical Articles Analysis Table
Study
Research Interventions/Trait
Authors and Study Purpose Sample Outcome Measures Relevant Findings Limitations
Design/ Model Assessed
Year
Beryl R. et Review the literature Systematic 261 publications Manipulation PCL-R Prevalence is lower in female Construct of
al. (2014) related to psychopathy in review with data on 2545 Impulsivity populations than male psychopathy in
women narrative participants women is not clearly
synthesis Differences found: defined across the
Adult females from -flirting vs. conning manipulation literature
secure settings -function of sexual promiscuity (risk
taking vs manipulative)
-antisocial behaviour not crucial to
female psychopathy
Bommel R. investigate the Correlational 429 Belgian or Sexual deviance Dutch version of Replicated gender differences in Replication should
et al. (2018) relationship between analyses Dutch participants Psychopathy psychopathy look at gender
psychopathic traits and Checklist: Screening differences such as
deviant sexual interests 76% female version, the antisocial facet more likely to culture and sexual
across gender Multidimensional predict deviant sexual interests among socialization
Assessment of Sex women  especially sadistic,
and Aggression pedophilic, exhibitionistic, and rape-like Relies on self-report
content
Concerns about the
applicability of PCL-
based measures in
women
Deviant sexual interests may be more
prevalent among female psychopaths Measure of sexual
deviance was adapted
for ethical reasons
Mostly highly
educated participants
Coid J. et al. Assess 5 different clinical Longitudinal 3143 inmates Violent recidivism Psychopathy The OGRS ranked highest for Female sample very
(2009) risk assessments over 6-12 serving time for a Checklist—Revised; predicting violent reoffending among small
months sexual or violent the Historical, men
principal offense Clinical, Risk
Management–20; the
Study
Year
from England or Risk Matrix 2000– The PCL–R and HCR-20 H subscale
Wales Violence; the ranked highest for predicting violence
Violence Risk among women
12% female Appraisal Guide; the
Offenders Group
Reconviction Scale;
and the total previous
convictions among
prisoners, assessed
pre-release
Cooke D.J. et Evaluate the Screening Item response 586 participants Assessing the measure PCL:SV The PCL:SV can be considered a short Larger sample of
al. (1999) version of the PCL-R theory analysis from 11 different version of the PCL-R women is needed to
samples in Canada generalize to female
and USA population
Age 16-82
31% female
Duncan Z. & Determine if gender and Cross-sectional 587 participants 3 forms of antisocial Antisocial Uses of General antisocial use of tinder no This measure has
March E. the traits of psychopathy (79% female) behaviours general, Tinder questionnaire gender significance only been used once
(2019) will predict variance of esteem, and sexual  adapted version of
antisocial behaviours Volunteers from Antisocial Uses of Females were more likely to use tinder Gender ratio is not
during online dating social media Facebook measure to increase ego and self-worth close to equal
advertisements
Short Dark Triad, Males were more likely to use Tinder Operationalized
Short Sadistic for casual sex definition of ‘types
Impulse Scale of antisocial
behaviours’ not given
Edwards Examine the effects of Cross-sectional Study 1 Factor 1 versus factor 2 Study 1 Gender moderates interpersonal- Few people of either
B.E. & drug dependence and 171 community in relation to sex work Psychopathy affective traits within sexual exchange gender openly admit
Verona E. psychopathic features in dwelling female Checklist: Screening contexts to sex work or sex
(2016) relation to sex work offenders Version, self- exchange
report/public records Factor 2 Antisocial-impulsive traits
Examine gender Study 2 of sex work correlate with prostitution in women Many sex trades not
differences in 319 participants and not men included in sample:
psychopathy relationships (42% female) with Study 2 pornography
with casual forms of sex history of drug Questionnaire on workers, phone sex
exchange (trading sex for use/violence sexual risk-taking operators, etc.
necessities
Study
Year
Findings are
correlational;
longitudinal studies
need to be done
Efferson Discuss the current Systematic Research from Emotional, cognitive, PCL-R Males show higher deficits in emotional Various samples both
L.M. & research on gender review before January 2018 and morality constructs processing than females  recognizing forensic and not,
Glenn A.L. difference in the and remembering emotional information differing definitions
(2018) correlates of psychopathy Unrelated to Violence vs. and fear reactivity of psychopathy
behaviour manipulation
-correlates of psychopathy Male and not female psychopaths Many studies use
= any construct that was Participants not demonstrate response preservation and lower cut-off scores
not exclusively a reported more passive avoidance errors than non- for women than men
behavioural outcome psychopaths when diagnosing
psychopathy
Males more likely to endorse causing
harm whereas women are more likely to
engage in passive harm i.e.
manipulation
Hare (1999) Presenting psychopathy as Literature Violent offenders Violence/recidivism PCL-R and :SV Hare measures are predictive of Incorrect use of the
a risk factor for violence review both incarcerated aggression and violence in a forensic PCL assessments can
and on parole in the setting as well as violent recidivism effect validity and
community studies may have
used measure
Male & female  incorrectly
majority male
Exact break downs PCL should be used
not provided in combination with
assessment of other
recidivism risk
factors
Little research done

on female
participants at this
time
Study
Year
Harpur T.J. Determine whether the Cross-sectional Six samples of male Factor 1 defined by PCL Factor structure is stable and replicable No female
et al. (1988) PCL has a factor structure inmates from personality traits, among male inmates participants
that is stable and Canada, USA, and -superficiality
replicable England -habitual lying and Old source that has
manipulation; the potential to be
n = 1119 -callousness; outdated included
-lack of affect, guilt, because it is Hare’s
remorse, and empathy defense of his factor
structure on the PCL
Factor 2 unstable and which has been
antisocial lifestyle indicated by the other
research as a
predictor of
recidivism
This article supports

the newer research
Hecht L.K. et Explore the gender Multivariate 1158 adult Impulsivity and Psychopathic Gender has an effect on the relationship Undergraduate
al. (2016) differences in the Analysis undergraduates aggression Personality between the impulsive/behavioral sample  not
relationships between between the ages of Inventory- Revised, features of psychopathy and aggression generalizable to
psychopathy and reactive Cross-sectional 18 and 58 Levenson Self- females exhibit higher levels of forensic samples
(RA) versus proactive 72% female Report Psychopathy emotional distress (i.e. negative affect,
(PA) aggression Scale, Reactive- anxiety, and distress regarding social Does not assess long
Proactive Aggression confrontation) term
Questionnaire Self-report
Behavioral manifestation of
psychopathy varies across gender
Females exhibit higher levels of

impulsive and behavioral dimensions
(higher levels of emotional reactivity)
 elevated levels of RA.
males exhibit higher levels of the

impulsive and behavioral dimensions
psychopathy  elevated levels of PA
Study
Year
Hicks B.M. Validate primary and Cross-sectional 226 female inmate Primary psychopaths PCL-R, Women score higher on measure of Behaviour criteria
et al. (2010) secondary subtypes of volunteers -incapable of emotions Multidimensional stress reaction and impulse control and was main focus
psychopathy across Medium security (empathy and guilt) Personality lower on aggression physiological
female populations. -appear callous, cold, Questionnaire-Brief, responses need to be
Assess gender differences and lacking anxiety. Survey of Alcohol All females scored significantly lower considered
across subtypes. -relative to ASPD and Drug Use, on absorption, a risk factor for
institutional records, dissociative symptoms Recommend
Secondary psychopaths clinical interview longitudinal study
-normal capacity of with a random
emotion Female secondary psychopaths are more sample
-an excess of negative likely to disrespect institutional rules
emotions leads to high and engage in violent behavior with
levels of anxiety, staff and other inmates, exhibit greater
emotional distress, mental health problems (PTSD,
hostility, aggression, and substance abuse, suicidal behaviour)
impulsive behavior
-relative to BPD
Female secondary psychopaths appear

even more psychologically maladjusted
than male secondary psychopaths
Female secondary psychopaths require

greater mental health services and
correctional planning than female
primary psychopaths  the invesrse of
these results is seen with male samples
Lindberg N. Assess psychopathic traits Cross-sectional 25 female Finnish, Violence Hare Psychopathy Equal rates of psychopathic traits across Small sample size
et al. (2016) of girls charged with juveniles were Checklist: Youth gender
violent crimes and compared to 25 Antisocial Version, psychiatric
compare with that of their male participants examination reports,
male counterparts that were typed Instability (of future and file assessments Boys showed higher levels of
matched by offence goals/emotions/etc.) stimulation-seeking, impulsivity, and
irresponsibility, as well as poor anger
Ages 15-17 control, emotional dysregulation early
in childhood, and criminal versatility
Study
Year
consistent with antisocial personality
disorder
Girls showed higher rates of instability

(long-term emotional dyregulation, lack
of goals, and irregular relationships) 
consistent with borderline personality
disorder
Mager K.L. Determine if gender has a Cross-sectional 250 male and Factor 1 versus factor 2 Psychopathy More IPV perpetrated by men Relied on participant
(2014) moderating role on female participants psychopathy: “Factor 1 Checklist: Screening reports of IPV-
intimate partner violence with recent consisted of the version and the Relationship between psychopathy participants may
(IPV) drug/violence interpersonal-affective Revised Conflict factors and IPV differ by over-report their
histories features, such as Tactics Scale genderpsychopathy exacerbates IPV partner’s violence
Examine relationship 43% female callousness, lack of perpetration in men
between IPV, 55% previously remorse, and lack of Did not assess for
psychopathic traits, and incarcerated empathy, whereas Factor gender of partner or
mutual violence 2 involved the impulsive look at same-sex
and antisocial lifestyle partner violence
characteristics” versus opposite sex
Mededovic J. Examine the relationship Canonical 650 University of Adaptiveness of Self-Report Affective psychopathic traits have Self-report
et al. (2018) between psychopathic Correlation Zagreb students psychopathic traits Psychopathy Scale, adaptive potential represent a protective
traits and indicators of Analysis Ages 19-38 The Depression factor for experiencing emotional -recommend
emotional distress across 60% women Anxiety Stress Scale, distress behavioural,
gender biographical and
Women environmental
factors being
considered for future
 somatization, depression, stress, research
suicide behaviours
-Population is not
 positive associations between Factor generalizable
2 traits and BPD disorders
Men
Study
Year
 violence, criminal recidivism,
impulsiveness
Sex had a moderating role in the

relationship between Interpersonal and
Lifestyle traits and distress
Psychopathic traits seem to be more
adaptive in males
Useful in creation of gender specific

treatment models
Schmidt F. & Examine the predictive Longitudinal 130 adjudicated Recidivism PCL:YV, RCMP PCL:YV predicts general and violent Criminal records do
McKinnon L. validity of the Canadian youth criminal records, recidivism in male native Canadian and not reflect extent of
(2006) Psychopathy Checklist: Both Caucasian and Child Behavior Caucasian youth violent or criminal
Youth Version (PCL-YV) native, separated Checklist, Youth behaviour
across gender and into groups by Self-Report PCL:YV has weaker concurrent and
ethnicity demographic predictive validity with girls and failed All violent offenses
(Gender & Race) to predict recidivism in all female were given equal
subgroups weight i.e. possession
62% male of a weapon (6% of
sample) and sexual
assault (12% of
sample)
Coding severity of
violent offense could
yield different results
Schulz N. et Examine whether gender Cross-sectional 318 participants Drug use in relation to Psychopathy Factor 2 correlated positively to drug Measures of
al. (2016) moderates psychopathic with illicit drug use factor 1 and 2 Checklist: Screening use substance use and
factors/drug use or criminal histories version and Antisocial factor related to drug use personality traits are
in the past year structured clinical more strongly in women self-reported and
interview for drug may not be objective
Ages 18-62 use Factor 1 negatively related to drug
42% women abuse symptoms  more so in women Longitudinal work is
than men required to draw
more direct
conclusions
Study
Year
Strand S. Validate the Swedish Cross-sectional 655 male and Violence Historical Clinical Both are valid and reliable across -Samples were not
(2006) screening tools for female inmates with and Risk gender randomly selected
violence mental illness Management-20 -Female samples are
& Differences in antisocial behaviour significantly smaller
20% female Psychopathy across gender may underestimate than male
Checklist: Screening psychopathy in females using these -male sample was
version measures mostly from
maximum-security
institutions
Thomson Assess the association Cross-sectional 565 Bulgarian Aggression predicted by PCL-R, PCL:SV, Affective traits are positively correlated Unable to assess
N.D. et al. between corporeal, verbal community psychopathic traits Aggression with physical aggression in only function of
(2019) and indirect aggression members (affective, antisocial, Questionnaire, females aggression (i.e.
and psychopathy across impulsivity, etc.) reactive vs.
gender Age 18-45 Antisocial traits are positively proactive)
32% female correlated with indirect aggression in
only males Community sample
 lower base rate for
Risk factors to aggression vary across psychopathic traits
gender than in clinical or
forensic setting
Vaughan R. Determine whether gender Cross-sectional 1258 participants in Narcissism, Narcissistic Subscale scores (including Hare’s Self- Authors report data
et al. (2019) creates a variance on young adulthood Machiavellianism, and Personality report scale) are not valid predictors of was not collected
Short Dark Triad traits psychopathy Inventory, Mach-IV, recidivism among women participants form intact teams
625 women with and Self-Report
varying athletic Psychopathy Scale Further work needed
ability to confirm results
Verona E. et Study 1 Data analyses Study 1 Factor 1 vs. factor 2 Study 1 Gender does moderate psychopathic Unable to
al., (2012) Determine if gender has a 318 undergrad specific differences Psychopathic traits differentiate between
moderating role on Study 1 students (51% between genders Personality impulsive versus
psychopathic traits and Hierarchical female) between the Inventory—Short Impulsive-antisocial and affective- planed violent
risk of self-harm regression ages of 18 and 21 Self-harm behaviour Form, Self-Report interpersonal factors may indicate behaviours
analysis Psychopathy Scale, higher risk of self-harm in only women
Study 2 Study 2 Suicidal Behaviors Small effect size
Generalize to correctional Study 2 160 women and 299 Questionnaire- Self-directed violence in men serves a
setting Structural male inmates Revised protective role
Addition of borderline equation between the ages of
personality symptoms modeling 18 and 55 Psychopathy links to self-directed
Study 2 violence in women but not men
The Psychopathy
Checklist: Screening
Version, Borderline
Study
Year
Features Scale of the
Personality
Assessment
Inventory, the
Lifetime History of
Aggression
questionnaire
Visser B.A. Examine the effect of Cross-sectional 198 undergraduate Sexual deviance and Self-Report Women that scored high on the Sample was non-
et al. (2010) gender on the students from Brock self-esteem Psychopathy Scale, psychopathy scale reported lower self- clinical, and
relationships between University Appearance Anxiety esteem, greater body shame, and greater generalization of
psychopathy, sexual Age 18-32 Scale, Rosenberg appearance anxiety than men with results is not
behaviour, and esteem 70% female Self-Esteem Scale similar scores recommended
Self-reported: self-
attractiveness, age of
first intercourse and
oral sexual
encounter, number of
sexual partners
Warren J.I. et Examine the association Cross-sectional 471 volunteer Violence, rule infraction Historical, Clinical, Support for the predictive validity or Not longitudinal
al. (2018) between HCRM-20, PCL- inmates from 2 state Risk-Management- accuracy of all 3 risk assessment tools Not equal ratio
R, VRAG and violence prisons 20: Version 2
perpetrated by inmates PCL-R, Violence Response rate of
313 from Ohio Risk Assessment 37%
158 from Texas Guide, institutional
39% female reports
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Assessing the Psychopathy Checklist assessments for female offenders in

Thesis · February 2021

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Assessing the Psychopathy Checklist assessments for female offenders in Canada: A

Dr. Robert Di Fazio, MSc., Ph.D.

A thesis submitted to the School of Community Services in partial fulfillment of the

requirements for the Honours Bachelor of Behavioural Psychology

St. Lawrence College,

February 22, 2021.

Abstract: Psychopathy is characterized by detrimentally high levels of impulsive or risk-taking,

This systematic analysis examined gender as a factor in the symptomology of psychopathy in

measures in order to accurately assess psychopathy. Important differences were noted in

diagnosing psychopathy or assessing risk in women, which they claim to do.

Keywords: psychopath, gender, female, borderline personality disorder, antisocial personality

disorder, the Psychopathy Checklist, corrections

Strengths and Limitations 33

Assessing the Psychopathy Checklist assessments for female offenders in Canada: A

et. al., 2017).

edition (DSM-5) as a synonym of anti-social personality disorder, sociopathy, or dissocial

personality disorder (American Psychiatric Association [APA], 2013).

Factor 1: Interpersonal-Affective Features

Deceitfulness. In order to achieve personal goals, the individual lies, deceives, or

about the future (Hart et al., 1999).

Lack of Empathy. Different from lacking remorse, a lack of empathy is demonstrated by

Lack of Responsibility. Hare et al. define a lack of responsibility as the avoidance of

Cox, & Hare, 1999).

Factor 2: Impulsive-Antisocial Lifestyle Characteristics

Adolescent Antisocial Behaviour. The individual has a history of conduct problems in

performance or trouble paying bills (Hart et al., 1999).

Impulsivity. This is defined as an individual that acts without considering the

financial support (Hart et al., 1999).

Poor Behavioural Controls. This describes an individual that is quick to anger or

reports of 33,016 people, including 13,833 males and 19,183 females.

males and subsequently address the implications of the result.

symptomology of psychopathy in inmates and determine whether female inmates require an

adjusted version of the PCL measures in order to accurately assess psychopathy.

inmates will be explained using peer-reviewed literature.

diagnosis of psychopathy in women can be improved.

Word count: 971

Chapter II: Method

follows: psychopathy, gender, female, psychopath, difference, female offenders, PCL-R,

corrections, sex differences.

Inclusion and Exclusion Criteria

search criteria. This process is outlined in the Prisma chart in Appendix A.

the assessment of psychopathy using PCL measures.

Word count: 347

Chapter III: Literature Review

by gender within psychopathic characteristics will be assessed to determine the significance of

psychopathy. Antisocial personality disorder and borderline personality disorder will be

compared to determine if borderline personality disorder is more common in female psychopaths

summarized at the end.

Gender Differences in Mental Illness

their male peers.

female offenders for violent recidivism, an alternative measure must be considered.

The Psychopathy Checklist

diagnosis, prognosis, significance, and treatment (Hare, 2020).

Revised and Screening Versions

representative samples being studied.

subgroups (Schmidt & McKinnon, 2006).

In 2019, Vaughan et al. conducted a cross-sectional study assessing several measures of

psychopathy is muddied with a Hollywood perspective and the understanding of psychopathic

Function of a Psychopathy Diagnosis

Individuals determined to be psychopaths after interacting with the criminal justice