Personality Disorders: Theory, Research, and Treatment © 2013 American Psychological Association

2013, Vol. 4, No. 4, 332–340 1949-2715/13/$12.00 DOI: 10.1037/a0033303

BRIEF REPORT

Criminal Behavior and Cognitive Processing in Male Offenders With

Antisocial Personality Disorder With and Without Comorbid Psychopathy
Rebecca E. Riser and David S. Kosson
Rosalind Franklin University of Medicine and Science

Antisocial personality disorder (ASPD) and psychopathy are 2 important syndromes with substantial
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

utility in predicting antisocial behavior. Although prior studies have identified correlations between
This document is copyrighted by the American Psychological Association or one of its allied publishers.

various factors and the presence of psychopathy or ASPD, most studies have focused on 1 syndrome or
the other. Consequently, it is unclear whether the 2 syndromes reflect similar pathophysiologies, whether
they are in fact 2 distinct syndromes, or whether the correlates of ASPD reflect its high comorbidity with
psychopathy. The present study addressed this issue by examining the impact of ASPD with and without
comorbid psychopathy (as assessed by the Psychopathy Checklist—Revised) on criminal offending and
cognitive processing in 674 adult male inmates at a county jail in Illinois. Participants exhibited either
ASPD and comorbid psychopathy, ASPD but not psychopathy, or neither ASPD nor psychopathy.
Participants with and without comorbid psychopathy were characterized by more criminal behavior than
controls, and inmates with ASPD and psychopathy exhibited more severe criminal behavior than those
with ASPD only. In addition, inmates with ASPD and psychopathy exhibited a different pattern of
cognitive task performance impairment than those with ASPD alone. Results replicate the findings of
Kosson, Lorenz, and Newman (2006) and provide new evidence suggesting that men with ASPD and
comorbid psychopathy are characterized by cognitive processing anomalies different from those seen in
ASPD without comorbid psychopathy.

Keywords: psychopathy, antisocial personality disorder, criminal behavior, personality disorder, cogni-
tion

Psychopathy and antisocial personality disorder (ASPD) are two
constructs that have proven useful in identifying dangerous subsets
of criminal offenders (Salekin, Rogers, & Sewell, 1996; Serin,
1991). Despite an abundance of research demonstrating the costs
of ASPD and psychopathy, the extent of the commonalities and
differences in the correlates of ASPD and psychopathy are seldom
examined in the same study. Clarifying the relationship between
ASPD and psychopathy is essential to both the criminal justice and
mental health systems.
ASPD is characterized by pervasive disregard for the rights of
others, beginning in childhood and continuing into adulthood
(Diagnostic and Statistical Manual of the American Psychiatric
Rebecca E. Riser and David S. Kosson, Department of Psychology,
Rosalind Franklin University of Medicine and Science.
We express our gratitude to Megan Mercado, Richard Riddle, and the
entire Lake County Jail staff for their consistent support of this research.
Preparation of this article was supported in part by the National Institute of
Mental Health, Grant MH57714: R-01, Cognitive Processing Deficits of
Criminal Psychopaths, Principal Investigator: D. S. Kosson, 1999 –2004.
Correspondence concerning this article should be addressed to Rebecca
E. Riser or David S. Kosson, Department of Psychology, Rosalind Franklin
University of Medicine and Science, 3333 Green Bay Road, North
Chicago, IL 60064. E-mail: rebecca.riser@my.rfums.org, david.kosson@
rosalindfranklin.edu
332
Association, Treatment Revision; DMS-IV–TR; American Psychi-
atric Association, 2000). Psychopathy is a syndrome of personality
pathology characterized by lack of empathy, emotional shallow-
ness, superficial charm, and impulsivity (Cleckley, 1988). The
Psychopathy Checklist (PCL; Hare, 1980) and its revision
(PCL–R; Hare, 2003) are the most widely used and best validated
instruments for the clinical assessment of psychopathy.
Although the DSM-IV–TR (American Psychiatric Association,
2000) states that ASPD is “also known as psychopathy” (p. 645),
ASPD diagnostic criteria focus primarily on behavioral deviance,
whereas psychopathy encompasses a wide range of affective,
interpersonal, and behavioral disturbances. The ASPD criteria do
not include many of these interpersonal and affective features, and
the category has been criticized for overreliance on behavioral
indicators.
Nevertheless, the distinction between ASPD and psychopathy is
sometimes blurred. Lee (1999) reviewed studies conducted with
patients who “displayed the core features of psychopathy, as
defined in the ICD-10, DSM-IV, or in Hare’s Psychopathy Check-
list” (p. 17). Lewis (1991) wrote that chronic antisocial behavior is
termed psychopathy in the psychological literature and antisocial
personality in the psychiatric literature but goes on to refer to
chronic antisocial behavior and psychopathy interchangeably.
Kirkman (2008) and Gurley (2009) noted that even today many,
including the American Psychiatric Association, view the two
labels as referring to the same disorder.
 EFFECTS OF COMORBID PSYCHOPATHY
The two syndromes share important correlates. Both are asso-
ciated with substance abuse (Messina, Wish, Hoffman, & Nemes,
2001; Smith & Newman, 1990) and predict treatment failure
(Bucholz, Hesselbrock, Health, Kramer, & Schuckit, 2000; Cun-
ningham & Reidy, 1998; Hare, Clark, Grann, & Thornton, 2000;
Rice, Harris, & Cormier, 1992) and recidivism (Harris, Rice, &
Cormier, 1991; Serin & Amos, 1995). Psychopathy and ASPD are
also highly comorbid within criminal populations (Coid, 2002;
Hare, 2003), raising the possibility that the pathophysiology of the
underlying disorders may be the same.
Others argue that the differences between ASPD and psychop-
athy are important. Most psychopathic individuals meet diagnostic
criteria for ASPD; however most individuals with ASPD are not
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
psychopathic (Hare, 1996). Whereas ASPD has a reported preva-
This document is copyrighted by the American Psychological Association or one of its allied publishers.
lence rate of 50 –75% among prison inmates, only 20 –30% of
inmates meet PCL–R diagnostic criteria for psychopathy (Hare,
2003; Hare, Hart, & Harpur, 1991). Consequently, Stevens (1993)
argued that psychopathy is important for identifying a more ho-
mogenous group of offenders.1
Psychopathy also predicts antisocial behavior (including recid-
ivism) over and above ASPD, including success versus failure
during conditional releases from prisons (Hart, Kropp, & Hare,
1988) and postdiction of substance use disorder symptoms after
controlling for ASPD symptoms (Walsh, Allen, & Kosson, 2007).
Psychopathy and ASPD also differ in regards to the impact of
environmental factors. Whereas some studies suggest that quality
of family environment is unrelated to age of onset or severity of
antisocial behavior in individuals with psychopathic traits, family
environment is a crucial factor for onset of antisocial behavior in
general (Devita, Forth, & Hare, 1990; Wootton, Frick, Shelton, &
Silverthorn, 1997; but see Edens, Skopp, & Cahill, 2008). Simi-
larly, the environment to which ASPD offenders return after prison
is strongly correlated with their reoffending; psychopathic offend-
ers have a high risk of reoffending regardless of the environment
to which they return (Hemphill, Hare, & Wong, 1998).2
Limited evidence also suggests differences in cognitive and
affective correlates. Psychopathy is associated with reduced affec-
tive facilitation of lexical decision, but ASPD is not (Lorenz &
Newman, 2002a, 2002b; Williamson, Harpur, & Hare, 1991).
Deficits in startle potentiation for aversive stimuli have also been
linked to psychopathy and not to ASPD (Vaidyanathan, Hall,
Patrick, & Bernat, 2011). Conversely, general verbal deficits have
been linked to ASPD (Malloy, Noel, Rogers, Longabaugh, &
Beattie, 1989), whereas language anomalies and left hemisphere
(LH) impairments in psychopathy appear more specific (Hare,
Williamson, & Harpur, 1988; Suchy & Kosson, 2006). Sargeant,
Daughters, Curtin, Schuster, and Lejuez (2011) reported that
ASPD and psychopathy differ with respect to their association
with persistence in goal-directed behavior during an aversive sit-
uation: The ASPD diagnosis was associated with lower distress
tolerance, but psychopathic traits were associated with higher
distress tolerance. Taken together, such findings suggest the pos-
sibility that distinct emotional and cognitive mechanisms may
underlie these disorders.
Alternatively, the disorders could reflect the same underlying
mechanisms with psychopathy representing a more severe form of
ASPD (Reid, 2001). From this perspective, the two disorders
might differ in the degree of their association with external criteria
with no difference in the pattern of cognitive or affective corre-
333
lates. For example, both syndromes might be associated with
recidivism and cognitive and affective performance, but effect
sizes might be larger for psychopathy. Consistent with this per-
spective, both syndromes do predict treatment failure and recidi-
vism with psychopathy a better predictor than ASPD (Cacciola,
Alterman, Rutherford, & Snider, 1995; Hare et al., 2000; Kranzler,
Del Boca, & Rounsaville, 1996; Harris et al., 1991; Hemphill et
al., 1998).
Much more research has examined the mechanisms underlying
and correlates of psychopathy than ASPD. Compared with non-
psychopaths, psychopaths exhibit numerous affective and cogni-
tive anomalies, including deficient performance in classifying and
reduced physiological reactivity to affective stimuli (Hare, 2003;
Patrick, Cuthbert, & Lang, 1994; Williamson, Hare, & Wong,
1987); deficient passive avoidance learning (Lykken, 1957; New-
man & Kosson, 1986); and poorer performance than nonpsycho-
pathic offenders on neuropsychological tests of orbitofrontal func-
tion (Lapierre, Braun, & Hodgins, 1995; Mitchell, Colledge,
Leonard, & Blair, 2002). No body of systematic laboratory re-
search addresses these processes in ASPD individuals.
Studies of cognitive function have also yielded substantial evi-
dence that individuals with psychopathy display intact cognitive
function under baseline conditions but display relatively poorer
performance on a variety of cognitive tasks under conditions placing
substantial demands on left hemisphere (LH)-specific attention, mo-
tor, language, and perceptual systems, as predicted by the LH activa-
tion (LHA) hypothesis (Kosson, 1998; Llanes & Kosson, 2006; Suchy
& Kosson, 2006). Given that this has not been examined in ASPD, it
remains possible that ASPD individuals also exhibit LHA deficits.
Because approximately 90% of those inmates classified as psy-
chopathic have comorbid ASPD, it is not feasible to examine
behavior, cognition, and affect in individuals with only ASPD,
only psychopathy, and both psychopathy and ASPD. A more
practical alternative is to study groups of individuals characterized
by ASPD with and without comorbid psychopathy.
To examine whether ASPD with comorbid psychopathy was
distinct from ASPD without psychopathy, using the PCL–R to
assess psychopathy and DSM-IV criteria for the assessment of
ASPD, Kosson et al. (2006) divided individuals into those who
met criteria for ASPD but not psychopathy (ASPD without psy-
chopathy), those who met criteria for both ASPD and psychopathy
(ASPD with comorbid psychopathy), and those who did not meet
diagnostic criteria for either ASPD or psychopathy (controls).
Although both ASPD groups were characterized by more criminal
1
Furthermore, previous studies illustrating the predictive utility of
ASPD in regards to substance abuse and treatment outcomes (Bucholz,
Hesselbrock, Health, Kramer, & Schuckit, 2000; Messina, Wish, Hoffman,
& Nemes, 2001) have more commonly drawn from psychiatric than from
forensic samples (where the prevalence rate of ASPD is much lower and
ASPD may have more discriminating power). Despite evidence signaling
the need for caution regarding the predictive utility of ASPD in prison
settings, the predictive utility of psychopathy has been demonstrated re-
peatedly in offender samples.
2
Several recent studies also suggest apparent associations between
environmental factors and psychopathic traits (Kimonis, Frick, Munoz, &
Aucoin, 2008; Krischer & Sevecke, 2008; Schraft, Kosson, & McBride, in
press). However, most of these studies do not address the possibility that
conduct disorder or ASPD symptoms may account for the apparent asso-
ciation.
 334 RISER AND KOSSON
behavior than controls, those with ASPD and psychopathy exhib-
ited greater criminal activity and weaker emotion facilitation than
those with ASPD only. Furthermore, the degree of affective facil-
itation correlated inversely with criminal activity in participants
with ASPD plus psychopathy, but correlated nonsignificantly with
criminal activity in ASPD-only participants. These findings pro-
vide preliminary evidence for a qualitative distinction between
ASPD with versus without comorbid psychopathic features, and
suggest the possibility that different psychological mechanisms
may characterize these two subgroups of ASPD offenders. How-
ever, until these findings are replicated in an independent sample,
the generality of these distinctions cannot be evaluated. Further-
more, emotional processing was the only mechanism examined in
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
this study. Given the evidence for performance differences con-
This document is copyrighted by the American Psychological Association or one of its allied publishers.
sistent with theories positing specific cognitive deficits in psycho-
pathic offenders, it is important to examine whether individuals with
ASPD alone exhibit performance deficits on neurocognitive tasks
similar to those seen in individuals with ASPD and psychopathy.
The Current Study
The primary purpose of the current study was to investigate the
generalizability of prior findings that offenders with ASPD with-
out psychopathy differ in important ways from those with ASPD
comorbid with psychopathy. We examined whether the differences
in criminal behavior reported in Kosson et al. (2006) would rep-
licate in an independent sample and whether the reported differ-
ences in emotional processing would generalize to cognitive pro-
cessing mechanisms associated with psychopathy. By using the
global-local processing task, it was possible to test whether the
LHA deficits associated with psychopathy are specific to psycho-
pathic offenders with ASPD or generalize to offenders with ASPD
but not psychopathy. Prior studies have shown that LH perceptual
systems are more active in processing local visual stimuli, and
right hemisphere (RH) perceptual systems are more active in
processing global visual stimuli. Because the LHA hypothesis
posits that psychopaths display general cognitive inefficiency
when LH processing systems are substantially and differentially
activated, it predicts that psychopaths will respond more slowly
than nonpsychopaths to both global and local targets in a local bias
condition that presents most targets at the local level and activates
primarily LH perceptual processing systems. The LHA hypothesis
predicts no performance differences in a global bias condition that
activates RH systems differentially.
We evaluated three perspectives: that ASPD with and without
psychopathy reflect the same underlying disorder, that the two
reflect distinct underlying mechanisms, and that the two are
distinct but only in severity. If the two syndromes reflect the
same underlying pathophysiology, then both groups should
manifest similar tendencies on measures of both criminal be-
havior and cognitive processing. If ASPD with and without
psychopathy reflect distinct mechanisms, analyses should re-
veal different patterns of performance in cognitive processing
and differences in criminal behavior. If psychopathy is only a
more severe version of ASPD we should see similar associa-
tions with criminal behavior and cognitive task performance
impairments that differ only in degree. Clarifying the nature of
the behaviors and mechanisms associated with ASPD with
versus without psychopathy has important implications for in-
forming assessment strategies and may ultimately prove impor-
tant in developing interventions to target the psychopathology
underlying these syndromes.
Method
Participants
The sample was comprised of 674 males incarcerated at a
county jail in Illinois between the ages of 18 and 45 (M ⫽ 26.10,
SD ⫽ 6.69) who met all inclusion criteria (see below). The sample
was 45% Caucasian, 49.3% African American, and 4.7% Latino,
with 1% reporting other ethnic backgrounds. Exclusion criteria
included current use of medication with neurocognitive side ef-
fects, presence of psychotic symptoms, inability to read English,
left-handedness (for analyses of cognitive processing only), esti-
mated IQ below 70 (using the Shipley Institute of Living Scale—
Revised), and lack of information about prior criminal charges.
Inmates were classified into one of three groups: ASPD plus
psychopathy (ASPD ⫹ PSY; n ⫽ 145), ASPD without psychopa-
thy (ASPD-only; n ⫽ 201), and neither psychopathy nor ASPD
(controls; n ⫽ 328). The ASPD ⫹ PSY group consisted of inmates
who met diagnostic criteria for ASPD and also met PCL–R criteria
for psychopathy (PCL–R total scores of 30 or above). The ASPD-
only group consisted of inmates who met diagnostic criteria for
ASPD but had PCL–R total scores below 30. Controls consisted of
inmates with PCL–R scores below 30 who did not meet diagnostic
criteria for ASPD. Of the 674 inmates, 156 men comprised the
sample used in analyses for cognitive processing; they met all of
the above inclusion criteria and had completed the global-local
task. The overall sample appeared representative of offender sam-
ples in prior psychopathy studies in the United States. (M age ⫽
27.54, SD ⫽ 6.57; M years of education ⫽ 11.52, SD ⫽ 2.03; M
estimated WAIS–R full scale ⫽ 93.10, SD ⫽ 12.59). The mean
PCL–R score of 23.8 (SD ⫽ 6.9) was similar to that previously
reported for inmate samples (Hare, 2003).
Classification Measures
PCL–R. The PCL–R is a 20-item expert-rater measure of the
interpersonal, affective, and behavioral features of psychopathy
that is typically completed following an in-depth semistructured
interview and a review of available file and/or other collateral
information. The PCL–R items are rated on a 3-point ordinal scale
from 0 (definitely does not apply) to 2 (definitely applies) based on
the extent to which information about an individual’s behavior in
multiple domains and from multiple sources (self-reports, behav-
ioral observation, collateral sources) matches specific item de-
scriptions. Total scores range from 0 to 40, and adults scoring 30
and above are traditionally classified as psychopaths (Hare, 2003).
As in Kosson et al. (2006) and several other studies (e.g., see
Brinkley, Schmitt, Smith, & Newman, 2001; Kosson, Smith, &
Newman, 1990), PCL–R scores were modified to reduce overlap
between psychopathy scores and indices of antisocial behavior.
Scores on two items directly related to criminal conduct (Juvenile
Delinquency and Criminal Versatility) were deleted, and scores on
remaining items were prorated. Good interrater agreement for
PCL–R total scores has been reported across settings. Internal
consistency is high as indicated by alpha coefficients of .84 for
 EFFECTS OF COMORBID PSYCHOPATHY
total scores across samples and item-total correlations of .30 or
higher for most individual items across samples. The PCL–R is
considered a homogenous scale with mean interitem correlations of
.22 (Hare, 2003). Interrater agreement for PCL–R total scores in the
current sample was also good as indicated by an average intraclass
correlation between interviewer and observer ratings of .87.
Assessment of ASPD. The diagnosis of ASPD was deter-
mined based on interview questions addressing DSM-IV criteria
and a review of available file material. In most cases, ASPD
information was explicitly recorded at the time of the interview.
For 83 cases in which ASPD information was assessed but not
coded at the time of the interview, existing interviews were re-
viewed to code ASPD symptoms for this study. Interrater agree-
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
ment on assessments of ASPD from prior interviews based on
This document is copyrighted by the American Psychological Association or one of its allied publishers.
30.0% of the sample was good, k ⫽ .87.
Criminal History Measures
Three indices of criminal activity were utilized to compare the
ASPD-only, ASPD ⫹ PSY and control groups on participation in
violent crime, nonviolent crime, and criminal versatility.
In accordance with prior studies (Hare & McPherson, 1984;
Kosson et al., 1990; Kosson et al., 2006), violent offenses con-
sisted of robberies, murders, assaults, sexual assaults, kidnappings,
and weapons offenses. Nonviolent offenses consisted of burglaries
and thefts, frauds and forgeries, drug offenses, negligence and
major driving offenses, escapes, arsons, obstructions of justice,
and miscellaneous minor crimes. Criminal versatility was opera-
tionalized as the number of different categories in which inmates
were charged with or reported committing offenses.
Laboratory Measure of Cognitive Processing
Data on the global-local task were collected as part of a prior
study (Kosson, Miller, Kosson, Byrnes & Leveroni, 2007). Partic-
ipants sat in front of a 14-inch Dell computer screen and viewed
centrally located stimuli. During each trial, participants were pre-
sented with one hierarchical stimulus consisting of the target letter
H or S at either the local or global level and the distractor letter A
or E at the opposite level for a duration of 150 ms. Participants
were asked to respond by pressing a key on the keyboard to
indicate the target letter presented (H or S). Large global letters
measured 30 mm ⫻ 45 mm (approximately 2.86° ⫻ 4.30°), and
the 12–14 smaller individual letters that comprised each global
stimulus were local letters measuring 6 mm ⫻ 8.5 mm (.57° ⫻
.81°). Participants completed eight practice trials and 64 trials per
Table 1
Demographic Characteristics for Inmate Groups
Education
Inmate group Sample size M SD
a
Control 328 11.80 1.63
ASPD only 201 11.07b 1.71
ASPD ⫹ PSY 145 11.21b 1.97
Note. Education is years completed. IQ is estimated WAIS-R from the Shipley Institute of Living Scale-Revised. Age is in years. Means with different
subscripts differ significantly, p ⬍ .05. Control ⫽ neither antisocial personality disorder (ASPD) nor psychopathy; ASPD -only ⫽ ASPD met but not
psychopathy; ASPD ⫹ PSY ⫽ ASPD met in addition to psychopathy; AA ⫽ African American; C ⫽ Caucasian; L ⫽ Latino; O ⫽ Other.
335
condition using the right hand. Median response latencies and
accuracy were calculated.
Target frequency was varied to manipulate LH versus RH
processing. In the neutral condition (N), targets appeared at the
local and global level equally often. In the global condition (G),
targets appeared at the global level 80% of the time and at the local
level 20% of the time. Conversely, in the local condition (L),
targets appeared at the local level 80% of the time and at the global
level 20% of the time. The presentation of one kind of target (e.g.,
local targets) four times as often as the other kind (e.g., global targets)
was designed to differentially activate the relevant hemisphere-
specific perceptual system (Fink et al., 1997; Van Kleeck, 1989).
Participants received the conditions either in the order global bias-
neutral-local bias (GNL), or in the order local bias-neutral-global bias
(LNG). As in Kosson et al. (2007), principal analyses of the local bias
and global bias conditions included only men administered that con-
dition first to ensure that the impact of each hemispheric activation
condition was not diluted by other conditions (see Kosson et al., 2007,
for additional details). Neutral condition performance comparisons
collapsed across the two orders.
Results
Overview and Preliminary Analyses
Analyses of variance (ANOVAs) and follow-up t tests were
used to compare groups on indices of criminal behavior and
cognitive processing. In cases of heterogeneity of variance, the
Welch F’ and t’ tests were used in comparing group means. There
were no group differences in estimated IQ or age, F(2, 672) ⫽
1.03, p ⫽ .36, F(2, 672) ⫽ 2.42, p ⫽ .09, respectively, and no
relationship between ethnicity and group membership, ␹2(6) ⫽
6.20, p ⫽ .40 (see Table 1). The groups differed in education, F(2,
672) ⫽ 9.87, p ⬍ .001, with the control group averaging more
education (M ⫽ 11.72, SD ⫽ 1.66) than the ASPD-only group
(M ⫽ 11.07, SD ⫽ 1.64) but not the ASPD ⫹ PSY group (M ⫽
11.43, SD ⫽ 1.76). These demographic variables were considered
as possible covariates; however, none of these demographic vari-
ables were associated with indices of criminal behavior or cogni-
tive performance in any condition.
Of the 674 inmates in the criminal activity analyses, outliers
were identified for 12 control, 9 ASPD-only, and 4 ASPD ⫹ PSY
inmates. To reduce their influence, extreme values were trans-
formed to one unit greater than the most extreme value within 3
SDs of the group mean (Tabachnick & Fidell, 2007). Of the 156
IQ Age Ethnicity
M SD M SD AA–C–L–O
92.76 11.06 26.91 7.07 152–163–10–3
92.13 10.16 25.62 6.48 87–103–8–3
92.15 11.27 27.22 6.79 81–57–6–1
 336 RISER AND KOSSON
inmates completing the global-local cognitive task, there were 4
outliers identified. Because one inmate obtained an extreme score
for only one of six indices, that value was modified as noted above.
The remaining three inmates had outlying values on at least three
of six indices and were excluded from analyses, yielding a final
sample of 153 inmates for cognitive analyses: 72 control inmates,
41 ASPD-only inmates, and 40 ASPD ⫹ PSY inmates.
Primary Analyses
Analyses of criminal behavior. The groups differed in crim-
inal versatility, F(2, 671) ⫽ 53.41, p ⬍ .001. Both ASPD-only
inmates and ASPD ⫹ PSY inmates were charged with more types
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
of offenses than controls: t(527) ⫽ ⫺4.83, p ⬍ .001, d ⫽ .42, for
This document is copyrighted by the American Psychological Association or one of its allied publishers.
ASPD-only inmates versus controls, and t’(242) ⫽ ⫺9.60, p ⬍
.001, d ⫽ 1.23, for controls versus ASPD ⫹ PSY. Moreover,
ASPD ⫹ PSY inmates were charged with more types of crimes
than ASPD-only inmates, t(344) ⫽ ⫺5.35, p ⬍ .001, d ⫽ .58 (see
Table 2).
The groups differed in charges for violent offenses,
F’(2, 305) ⫽ 28.64, p ⬍ .001. As shown in Table 2, ASPD-only
inmates and ASPD ⫹ PSY inmates were charged with more
violent offenses than controls: t’(357) ⫽ ⫺2.97, p ⫽ .003, d ⫽ .31,
t’(192) ⫽ ⫺7.42, p ⬍ .001, d ⫽ 1.07, respectively. In addition,
ASPD ⫹ PSY inmates were charged with more violent crimes than
ASPD-only inmates, t’(253) ⫽ ⫺4.89, p ⬍ .001, d ⫽ .61.
The groups differed in charges for nonviolent offenses, F’(2,
295) ⫽ 24.23, p ⬍ .001. Again, ASPD-only inmates and ASPD ⫹
PSY inmates were charged with more nonviolent offenses than
controls: t’(317) ⫽ ⫺4.65, p ⬍ .001, d ⫽ .52, t’(189) ⫽ ⫺5.91,
p ⬍ .001, d ⫽ .86, respectively. Finally, ASPD ⫹ PSY inmates
were charged with more nonviolent crimes than ASPD-only in-
mates, t’(279) ⫽ ⫺2.05, p ⫽ .04, d ⫽ .25 (see Table 2).
Additional analyses of relationships between group classifi-
cation and criminal behavior. Because it could be argued the
greater antisociality of the ASPD ⫹ PSY group resulted from
using a more strict selection criteria for psychopathy than ASPD
(PCL–R score of 30/40 ⫽ 75% of maximum criteria vs. 3/7 adult
ASPD criteria ⫽ 42.85% of maximum criteria), as in Kosson et al.
(2006), we repeated the above analyses using an ASPD cutting
score more comparable to that used to classify psychopathy. These
analyses compared a severe ASPD-only group (meeting at least
five of seven ASPD symptoms, or at least 71.4% of criteria) to the
other groups.
Results were similar to those reported above. There were group
effects for criminal versatility, F(2, 531) ⫽ 54.68, p ⬍ .001,
violent changes, F’(2, 135) ⫽ 30.14, p ⬍ .001, and nonviolent
charges, F’(2, 132) ⫽ 25.43, p ⬍ .001. Independent t tests repli-
cated the pattern of differences reported above for criminal versa-
tility and violent charges.3 The only exception was that the differ-
ence between ASPD-only and the ASPD ⫹ PSY group for
nonviolent offenses dropped to a statistical trend, t(205) ⫽ .440,
p ⫽ .06, d ⫽ .661, suggesting that the difference in severity of
diagnostic criteria contributed to the group difference for nonvio-
lent charges.
Analyses of cognitive processing.
Local bias condition trials. The groups differed in response
latencies for local targets in the local bias condition, F(2, 67) ⫽
3.69, p ⫽ .03. Replicating results of Kosson et al. (2007) for
psychopathic offenders versus controls, the ASPD ⫹ PSY group
responded more slowly than the control group, t(48) ⫽ 12.28, p ⫽
.03, d ⫽ 3.54. The ASPD ⫹ PSY inmates were also slower than
ASPD-only inmates, t’(36) ⫽ 2.36, p ⫽ .02, d ⫽ .79. However, the
ASPD-only group did not differ from controls, t(50) ⫽ .16, p ⫽
.87, d ⫽ .04 (see Table 3).
The groups also differed in response latencies for global targets
in the local bias condition, F(2, 67) ⫽ 3.75, p ⫽ .03. As for local
targets, ASPD ⫹ PSY inmates were slower than ASPD-only
inmates in responding to global targets, t(36) ⫽ 2.65, p ⫽ .01, d ⫽
.88 (see Table 3). Controls were also slower than ASPD-only
inmates, a difference that approached significance, t(50) ⫽ 1.82,
p ⫽ .07, d ⫽ .51. However, ASPD ⫹ PSY inmates were not slower
than controls, t(48) ⫽ ⫺1.33, p ⫽ .19, d ⫽ .38.
Global bias condition trials. There were no significant group
differences in response latencies in the global condition at either
the local target level, F(2, 78) ⫽ .31, p ⫽ .73, or at the global
target level, F(2, 78) ⫽ .20, p ⫽ .82 (see Table 3).
Neutral block trials. There were no significant group differ-
ences in response latencies in the neutral block to either local targets,
F(2, 153) ⫽ .05, p ⫽ .952 or to global targets, F(2, 153) ⫽ 2.10, p ⫽
.13 (see Table 3).
Discussion
Although substantial research has examined psychopathy and
ASPD, the relationships between the two are seldom examined in
the same study. Replicating Kosson et al. (2006), the current study
demonstrated that ASPD in the absence of psychopathy is an
important clinical construct but that psychopathy makes a unique
contribution to the prediction of criminal behavior and cognitive
functioning. Inmates with only ASPD were charged with more
violent and nonviolent charges and characterized by greater crim-
inal versatility than control inmates. These findings provide evi-
dence that the correlates of ASPD do not solely reflect its comor-
bidity with psychopathy. Removing the subset of individuals with
many psychopathic features from a large sample of ASPD inmates
did not eliminate relationships between ASPD and criminality.4
Moreover, even after deleting scores on the two PCL–R items
most directly associated with antisociality (Juvenile Delinquency
and Criminal Versatility), the ASPD ⫹ PSY group displayed more
criminal behavior than controls and, despite the substantial crim-
inality exhibited by ASPD-only inmates, APSD ⫹ PSY inmates
averaged more violent and nonviolent charges and a greater variety
of charges compared with ASPD-only inmates. The difference in
3
The severe ASPD-only group was charged with more different types of
crimes than controls, t(387) ⫽ ⫺4.87, p ⬍ .001, d ⫽ .495, and fewer
different types of crimes than the ASPD⫹PSY group, t(204) ⫽ ⫺2.19, p ⫽
.029, d ⫽ .306. For violent charges, the severe ASPD-only group was
charged with more violent crimes than controls, t’(71) ⫽ ⫺3.14, p ⫽ .002,
d ⫽ .745, and fewer violent charges than the ASPD⫹PSY group, t(205) ⫽
⫺2.09, p ⫽ .038, d ⫽ .29. The severe ASPD-only inmates were also
charged with more nonviolent offenses than controls, t’(69) ⫽ ⫺4.54, p ⬍
.001, d ⫽ 1.09.
4
Because the psychopathy construct appears to be dimensional, the
exclusion of individuals with PCL-R scores of 30 or higher from the
ASPD-only group does not entirely remove all variance due to psycho-
pathic traits. It remains possible that moderate levels of psychopathic traits
account for some of the variance in criminal activity that appears to
characterize individuals with ASPD only.
 EFFECTS OF COMORBID PSYCHOPATHY 337

Table 2
Group Means and Standard Deviations for Criminal Conduct

Inmate group
Control (n ⫽ 328) ASPD only (n ⫽ 201) ASPD ⫹ PSY (n ⫽ 145)
Criminal variable M SD M SD M SD
a b c
Number of charges for violent offenses 2.10 3.03 3.03 3.75 5.47 5.10
Number of charges for nonviolent offenses 9.28a 9.03 14.18b 13.19 17.43c 15.50
Number of different types of charges 3.61a 1.69 4.35b 1.73 5.41c 1.96
Note. Means with different subscripts differ significantly, p ⬍ .05. Control ⫽ neither antisocial personality disorder (ASPD) nor psychopathy; ASPD
only ⫽ ASPD met but not psychopathy; ASPD ⫹ PSY ⫽ ASPD met in addition to psychopathy.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

the number of nonviolent charges reflected a relatively small effect the local level was expected to substantially and differentially
This document is copyrighted by the American Psychological Association or one of its allied publishers.

size (d ⫽ .25). However, the differences between ASPD-only
versus ASPD ⫹ PSY inmates in number of violent charges (d ⫽
.61) and criminal versatility (d ⫽ .58) represented medium effect
sizes, suggesting that ASPD plus comorbid psychopathy has
unique predictive utility in understanding criminal behavior.
Furthermore, most of these relationships replicated when reex-
amined using stringent criteria to form a group of offenders with
severe ASPD. Analyses yielded identical findings for versatility
and violent charges and remained marginally significant for non-
violent criminal activity. Accordingly, although the severity of
diagnostic criteria for psychopathy may have contributed to the
group difference for nonviolent charges, it did not account for
group differences in criminal versatility and violent charges. In
short, among inmates with ASPD, the contribution of comorbid
psychopathy to understanding real world criminal behavior is not
attributable to the severity of criteria used to diagnose psychopa-
thy. This pattern of findings is not consistent with the view that
psychopathy is simply a more severe form of ASPD.
The group differences in cognitive processing are also incon-
sistent with the view that the two syndromes reflect different levels
of the same underlying construct. There were significant group
effects for responses to both the global and local targets in the local
bias condition. The ASPD ⫹ PSY inmates were much slower than
controls in responding to local bias and local targets (d ⫽ 3.54) and
were slightly but nonsignificantly slower than controls for local
bias and global targets (d ⫽ .38). This pattern of results is con-
sistent with the LHA hypothesis as responding to most targets at
activate LH perceptual and motor systems. However, the ASPD-
only group did not exhibit a similar pattern of cognitive processing
impairments. Not only did ASPD-only inmates fail to differ from
controls in response latencies to local bias condition targets, but
they were also faster than inmates with ASPD plus comorbid
psychopathy in responding to both global and local targets in this
condition, and the effect sizes for these differences were quite
large (d ⫽ .79 for local targets; d ⫽ .88 for global targets). In
contrast, no differences were found among the three groups for
either target type in the global bias condition. This pattern is
consistent with the LHA hypothesis because the global bias con-
dition does not differentially activate LH processing systems.
Because this study was the first to examine the LHA hypothesis
using ASPD-only and APSD plus psychopathy groups, results not
only provide evidence of a distinction between ASPD-only and
ASPD ⫹ PSY groups, but also offer the first evidence that LHA
performance impairments are specific to inmates with psycho-
pathic traits; there was no evidence for poor performance in LHA
conditions among inmates with ASPD only. Of course, it remains
important to examine the specificity of impairments predicted by
the LHA hypothesis and other cognitive perspectives (e.g., New-
man, Schmitt, & Voss, 1997) using other paradigms. However, in
general terms, current findings are in accord with those of Kosson
et al. (2007) in suggesting that mechanisms underlying psychop-
athy appear to be specific rather than general. This study was also
the first to demonstrate cognitive processing differences between

Table 3
Group Means and Standard Deviations for Cognitive Processing

Inmate group
Control ASPD only ASPD ⫹ PSY
Response latency variable M SD M SD M SD
b c
Local bias, global trials 812.31 232.03 700.52 184.02 914.44 304.62
Local bias, local trials 579.48a 158.76 572.75a 120.59 694.81c 193.66
Global bias, global trials 592.65 147.45 591.50 109.02 613.02 113.79
Global bias, local trials 732.87 244.64 706.73 207.04 763.38 222.32
Neutral block, global trials 650.73 160.52 637.00 124.39 703.24 184.32
Neutral block, local trials 643.84 190.12 643.95 154.65 654.28 195.65
Note. Sample sizes were 32, 40, and 73 for control groups in the local bias condition, global bias condition, and neutral blocks respectively; 20, 20, and
41 for the ASPD-only groups in the local bias, global bias, and neutral blocks respectively; 18, 21, and 42 for the ASPD ⫹ PSY groups in the local bias
condition, global bias condition, and neutral block respectively. Means with different subscripts differ significantly, p ⬍ .05. Control ⫽ neither antisocial
personality disorder (ASPD) nor psychopathy; ASPD-only ⫽ ASPD met but not psychopathy; ASPD ⫹ PSY ⫽ ASPD met in addition to psychopathy.
 338 RISER AND KOSSON
the two ASPD groups and extends the findings of Kosson et al.
(2006) beyond the domain of emotional processing.
Current results differed slightly from those of Kosson et al.
(2007). Whereas that study had suggested that psychopathy was
associated with relatively general performance impairments under
local bias conditions, the deficits observed in this study in offend-
ers with ASPD ⫹ PSY appear somewhat more specific. The
ASPD ⫹ PSY inmates performed differently than the ASPD-only
inmates for both local and global targets under local bias condi-
tions, however they differed significantly from non-ASPD/non-
psychopathic offenders only with respect to local targets. Although
the effect size for the difference in response latencies to global
targets was not trivial (d ⫽ .38), it was much smaller than the
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
effect size for the difference in response latencies to local targets
This document is copyrighted by the American Psychological Association or one of its allied publishers.
(d ⫽ 3.54) and suggests the possibility that only the performance
difference for local targets may reflect a true neurocognitive def-
icit. However, no conclusions about whether relative performance
impairments reflect true neuropsychological deficits can be drawn
until the performance of psychopathic individuals can be com-
pared directly to performance norms for nonclinical participants.
Consequently, although the group difference for global targets
might also prove reliable given a larger sample, it appears that
requiring the presence of both ASPD and psychopathic traits
results in a more homogeneous group of offenders with more
specific performance impairment under LHA conditions than re-
quiring only psychopathic traits. Further studies examining the
cognitive performance of offenders with ASPD plus psychopathy
may be important not only for resolving the relationship between
ASPD and psychopathy but for understanding mechanisms under-
lying offenders with psychopathic personality.
In summary, current findings add to earlier evidence for impor-
tant distinctions between ASPD versus ASPD plus psychopathy
based on antisocial behavior and emotional processing. Future
studies should address the replicability of the group differences
now reported in both cognitive and emotional processing as well as
the possibility of additional differences between these ASPD
groups in physiological, emotional, and cognitive processing. In
fact, a number of other recent studies suggest additional important
distinctions between ASPD with versus without psychopathy. In
particular, Rogers and Rogstad (2010) reported that offenders with
ASPD plus psychopathy were characterized by more severe alex-
ithymia than offenders with ASPD alone. In addition, Gregory et
al. (2012) recently argued that there are structural differences
between the brains of violent offenders with ASPD-only versus
ASPD plus psychopathy.
Taken together such findings do not appear consistent with
proposed personality disorder revisions for the upcoming DSM-V.
Although designed to capture the psychopathy syndrome more
effectively than DSM–IV, current proposals continue to treat
ASPD as a single diagnostic category (http://www.dsm5.org/
proposedrevision/Pages/PersonalityDisorders.aspd). Although the
aim of including psychopathy in the DSM-V is laudable, merging
the two constructs into one syndrome would result in a consider-
able reduction in diagnostic specificity. If one goal of the DSM-V
revision is to increase the validity and utility of diagnoses, current
and other recent findings suggest that allowing for classification of
individuals with ASPD both with and without comorbid psychop-
athy would help to identify specific groups of individuals charac-
terized by distinct underlying neural, cognitive, and emotional
mechanisms (see also Sargeant et al., 2011).
Several limitations of this study are noteworthy. First, the sam-
ple was restricted to county jail inmates. However, because crimes
resulting in a sentence to a state prison require a felony conviction
and because prisons only include inmates already convicted of
offenses, it is sometimes argued that prison samples are less
representative of offenders than samples that include many arrest-
ees (Blumstein, Cohen, Roth, & Visher, 1986). The replication of
prison sample findings with a county jail sample suggests that the
criminal behavior findings are relatively robust. Nonetheless, fu-
ture studies should attempt to replicate the cognitive findings
reported here in other kinds of correctional settings and outside of
correctional settings. In addition, it is unknown whether the cog-
nitive differences reported here will generalize to other cognitive
tasks. Moreover, because some relationships between psychopathy
and emotional processing impairment do not replicate across dif-
ferent emotional processing paradigms (Brook, Brieman, & Kos-
son, 2013), future studies should examine ASPD-only individuals
and ASPD ⫹ PSY individuals on a variety of cognitive and
emotional processing tasks. Although we corrected PCL–R scores
for two items to reduce the impact of criminal behavior on psy-
chopathy ratings, it remains possible that criminal conduct could
have contributed to PCL–R scores on several other items. Though
many studies of psychopathy-crime relationships do not correct for
scores on any PCL items (e.g., Hemphill et al., 1998; Porter, Birt,
& Boer, 2001), correcting for scores on several additional items
could further protect against predictor-criterion confounds but
risks eliminating substantive variance in the assessment of psy-
chopathic traits.
Alternative approaches to conducting the analyses are worth
consideration. Given the evidence that psychopathy appears to be
continuous, examining these relationships using a dimensional
approach might also prove informative.5 In addition, because we
subdivided offenders with ASPD into groups based on whether
PCL–R scores were at or above versus below 30, our ASPD ⫹
PSY and ASPD-only groups overlap somewhat with the older
distinction between psychopathic, middle, and nonpsychopathic
groups. More concretely, most of our ASPD-only participants
(83%) had PCL–R scores between 20 and 30, but only about half
(49%) of our control group participants had PCL–R scores below
20. In short, although there is some overlap between the ASPD-
only group and the group sometimes referred to as the middle
group in older studies, it is not clear whether an analysis based
solely on traditional PCL–R cutoffs would yield results similar to
or different from the results of the current study. Finally, given the
substantial and asymmetric overlap between ASPD and psychop-
athy, ASPD ⫹ PSY, ASPD-only and psychopathy-only groups
could not be directly compared on external criteria. Although the
direct comparison of these groups would require very large sam-
ples, such comparisons would be particularly informative.
Despite limitations, findings corroborate the hypothesis that
ASPD with and without comorbid psychopathic features are syn-
5
However, the substantial correlation between psychopathy scores and
dimensional measures of ASPD would result in a loss of substantial
variance in the measure of each construct and render interpretation of
unique associations difficult (Lynam, Hoyle, & Newman, 2006).
 EFFECTS OF COMORBID PSYCHOPATHY
dromes characterized by distinct mechanisms and challenge the
perspective that the two reflect the same underlying pathophysi-
ology. Further studies that take into account the asymmetric over-
lap between psychopathy and ASPD are needed to establish the
generality of the distinctions reported here and in Kosson et al.
(2006) and in order to examine other correlates of these two costly
syndromes associated with antisocial behavior.
References
American Psychiatric Association. (2000). Diagnostic and statistical man-
ual of mental disorder: Text revisions (4th ed.). Washington, DC:
Author.
Blumstein, A., Cohen, J., Roth, J., & Visher, C. A. (1986). Criminal
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
careers and career criminals (vol. 1). Washington, DC: National Acad-
This document is copyrighted by the American Psychological Association or one of its allied publishers.
emy Press.
Brinkley, C. A., Schmitt, W. A., Smith, S. S., & Newman, J. P. (2001).
Construct validation of a self-report psychopath scale: Does Levenson’s
SRPS measure the same construct as Hare’s PCL-R? Personality and
Individual Differences, 31, 1021–1038. doi:10.1016/S0191-
8869(00)00178-1
Brook, M., Brieman, C., & Kosson, D. S. (2013). Emotional processing in
Psychopathy Checklist-assessed psychopathy: A review of the literature.
Manuscript submitted for publication.
Bucholz, K. K., Hesselbrock, V. M., Health, A. C., Kramer, J. R., &
Schuckit, M. A. (2000). Research report. A latent class analysis of
antisocial personality disorder symptom data from a multi-centre family
study of alcoholism. Addiction, 95, 553–567. doi:10.1046/j.1360-0443
.2000.9545537.x
Cacciola, J. S., Alterman, A. I., Rutherford, M. J., & Snider, E. C. (1995).
Treatment response of antisocial substance abusers. Journal of Nervous
and Mental Disease, 183, 166 –171. doi:10.1097/00005053-199503000-
00007
Cleckley, H. (1988). The mask of sanity. St. Louis, MO: Mosby.
Coid, J. (2002). Personality disorders in prisoners and their motivation for
dangerousness and disruptive behaviour. Criminal Behaviour and Men-
tal Health, 12, 209 –226.
Cunningham, M. D., & Reidy, T. (1998). Antisocial personality disorder
and psychopathy: Diagnostic dilemmas in classifying patterns of anti-
social behavior in sentencing evaluations. Behavioral Sciences & the
Law, 16, 333–351. doi:10.1002/(SICI)1099-0798(199822)16:3⬍333::
AID-BSL314⬎3.0.CO;2-N
Devita, E., Forth, A., & Hare, R. D. (1990). Family background of male
criminal psychopaths [Abstract]. Canadian Psychology, 31, 346.
Edens, J. F., Skopp, N. A., & Cahill, M. A. (2008). Psychopathic features
moderate the relationship between harsh and inconsistent parental dis-
cipline and adolescent antisocial behavior. Journal of Clinical Child and
Adolescent Psychology, 37, 472– 476. doi:10.1080/15374410801955938
Fink, G. R., Halligan, P. W., Marshall, J. C., Frith, C. D., Frackowiak,
R. S. J., & Dolan, R. J. (1997). Neural mechanisms involved in the
processing of global and local aspects of hierarchically organized visual
stimuli. Brain: A Journal of Neurology, 120, 1779 –1791. doi:10.1093/
brain/120.10.1779
Glenn, A. L., Raine, A., Mednick, S. A., & Venables, P. (2007). Early
temperamental and psychophysiological precursors of adult psycho-
pathic personality. Journal of Abnormal Psychology, 116, 508 –518.
doi:10.1037/0021-843X.116.3.508
Gregory, S., ffytche, D., Simmons, A., Kumari, V., Howard, M., Hodgins,
S., & Blackwood, N. (2012). The antisocial brain: Psychopathy matters:
A structural MRI investigation of antisocial male violent offenders.
Archives of General Psychiatry, 69, 962–972. doi:10.1001/archgenpsy-
chiatry.2012.222
Gurley, J. R. (2009). A history of changes to the criminal personality in the
DSM. History of Psychology, 12, 285–304. doi:10.1037/a0018101
339
Hare, R. D. (1980). A research scale for the assessment of psychopathy in
criminal populations. Personality and Individual Differences, 1, 111–
117.
Hare, R. D. (1996). Psychopathy and Antisocial Personality Disorder: A
Case of Diagnostic Confusion. Psychiatric Times, 13(2), 39 – 40.
Hare, R. D. (2003). The Hare Psychopathy Checklist—Revised (2nd ed.).
Toronto, Canada: Multi-Health Systems.
Hare, R. D., Clark, D., Grann, M., & Thornton, D. (2000). Psychopathy and
the predictive validity of the PCL-R: An international perspective.
Behavioral Science and the Law, 18, 623– 645. doi:10.1002/1099-
0798(200010)18:5⬍623::AID-BSL409⬎3.0.CO;2-W
Hare, R. D., Hart, S. D., & Harpur, T. J. (1991). Psychopathy and the
DSM–IV criteria for antisocial personality disorder. Journal of Abnor-
mal Psychology, 100, 391–398. doi:10.1037/0021-843X.100.3.391
Hare, R. D., & McPherson, L. M. (1984). Violent and aggressive behavior
by criminal psychopaths. International Journal of Law and Psychiatry,
7, 35–50. doi:10.1016/0160-2527(84)90005-0
Hare, R. D., Williamson, S. E, & Harpur, T. J. (1988). Psychopathy and
language. In T. E. Moffitt & S. A. Mednick (Eds.), Biological contri-
butions to crime causation (pp. 68 –92). Dordrecht, the Netherlands:
Martinus Nijhoif.
Harris, G. T., Rice, M. E., & Cormier, C. A. (1991). Psychopathy and
violent recidivism. Law and Human Behavior, 15, 625– 637. doi:
10.1007/BF01065856
Hart, S. D., Kropp, P. R., & Hare, R. D. (1988). Performance of male
psychopaths following conditional release from prison. Journal of Con-
sulting and Clinical Psychology, 56. 227–232. doi:10.1037/0022-006X
.56.2.227
Hemphill, J. F., Hare, R. D., & Wong, S. (1998). Psychopathy and
recidivism: A review. Legal and Criminological Psychology, 3, 139 –
170. doi:10.1111/j.2044-8333.1998.tb00355.x
Kimonis, E. R., Frick, P. J., Munoz, L. C., & Aucoin, K. J. (2008).
Callous-unemotional traits and the emotional processing of distress cues
in detained boys: Testing the moderating role of aggression, exposure to
community violence, and histories of abuse. Development and Psycho-
pathology, 20, 569 –589. doi:10.1017/S095457940800028X
Kirkman, C. A. (2008). Psychopathy: A confusing clinical construct.
Journal of Forensic Nursing, 4, 29 –39.
Knight, R. A., & Prentky, R. A. (1990). Classifying sexual offenders: The
development and corroboration of taxonomic models. In W. L. Marshall,
D. R. Laws, & H. E. Barbaree (Eds.), Handbook of sexual assault:
Issues, theories, and treatment of the offender (pp. 23–52). New York,
NY: Plenum Press.
Kosson, D. S. (1998). Divided visual attention in psychopathic and non-
psychopathic offenders. Personality and Individual Differences, 24,
373–391. doi:10.1016/S0191-8869(97)00176-1
Kosson, D. S., Lorenz, A., & Newman, J. P. (2006). Effects of co-morbid
psychopathy on criminal offending and emotional processing male of-
fenders with antisocial personality disorder. Journal of Abnormal Psy-
chology, 115, 798 – 806. doi:10.1037/0021-843X.115.4.798
Kosson, D. S., Miller, S. K., Byrnes, K. A., & Leveroni, C. L. (2007).
Testing neuropsychological hypotheses for cognitive deficits in psycho-
pathic criminals: A study of global-local processing, Journal of the
International Neuropsychological Society, 13, 267–276. doi:10.1017/
S1355617707070294
Kosson, D. S., Smith, S. S., & Newman, J. P. (1990). Evaluating the
construct validity of psychopathy in Black and White male inmates: The
preliminary studies. Journal of Abnormal Psychology, 99, 250 –259.
doi:10.1037/0021-843X.99.3.250
Kranzler, H. R., Del Boca, F. K., & Rounsaville, B. J. (1996). Comorbid
psychiatric diagnosis predicts three-year outcomes in alcoholics: A
posttreatment natural history study. Journal of Studies on Alcohol, 57,
619 – 626.
 340 RISER AND KOSSON
Krischer, M. K., & Sevecke, K. (2008). Early traumatization and psychop-
athy in female and male juvenile offenders. International Journal of Law
and Psychiatry, 31, 253–262. doi:10.1016/j.ijlp.2008.04.008
Lapierre, D., Braun, C. M., & Hodgins, S. (1995). Ventral frontal deficits
in psychopathy: Neuropsychological test findings. Neuropsychologia,
33, 139 –151. doi:10.1016/0028-3932(94)00110-B
Lee, J. H. (1999). The treatment of psychopathic and antisocial personality
disorders: A review. Clinical Decision Making Support Unit, Broadmoor
Hospital, Berkshire.
Lewis, C. E. (1991). Neurochemical mechanisms of chronic antisocial
behavior (psychopathy). A literature review. Journal of Nervous and
Mental Disease, 179, 720 –727. doi:10.1097/00005053-199112000-
00002
Llanes, S., & Kosson, D. S. (2006). Divided visual attention and left
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
hemisphere activation among psychopathic and nonpsychopathic of-
fenders. Journal of Psychopathology and Behavioral Assessment, 28,
This document is copyrighted by the American Psychological Association or one of its allied publishers.
9 –18. doi:10.1007/s10862-006-4533-2
Lorenz, A. R., & Newman, J. P. (2002a). Utilization of emotion cues in
male and female offenders with antisocial personality disorder: Results
from a lexical decision task. Journal of Abnormal Psychology, 111,
513–516. doi:10.1037/0021-843X.111.3.513
Lorenz, A. R., & Newman, J. P. (2002b). Deficient response modulation
and emotion processing in low-anxious Caucasian psychopathic offend-
ers: Results from a lexical decision task. Emotion, 2, 91–104. doi:
10.1037/1528-3542.2.2.91
Lykken, D. T. (1957). A study of anxiety in the sociopath personality. The
Journal of Abnormal and Social Psychology, 55, 6 –10. doi:10.1037/
h0047232
Lynam, D. R., Hoyle, R. H., & Newman, J. P. (2006). The perils of
partialling: Examples from aggression and psychopathy. Assessment, 13,
328 –341. doi:10.1177/1073191106290562
Malloy, P., Noel, N., Rogers, S., Longabaugh, R., & Beattie, M. (1989).
Risk factors for neuropsychological impairment in alcoholics: Antisocial
personality, age, years of drinking, and gender. Journal of Studies on
Alcohol and Drugs, 50, 422.
Messina, N., Wish, E., Hoffman, J., & Nemes, S. (2001). Diagnosing
antisocial personality disorder among substance abusers: The SCID
versus The MCMI-II. The American Journal of Drug and Alcohol
Abuse, 27, 699 –717. doi:10.1081/ADA-100107663
Mitchell, D. G. V., Colledge, E., Leonard, A., & Blair, R. J. R. (2002).
Risky decisions and response reversal: Is there evidence of orbito-frontal
cortex dysfunction in psychopathic individuals? Neuropsychologia, 40,
2013–2022. doi:10.1016/S0028-3932(02)00056-8
Newman, J. P., & Kosson, D. S. (1986). Passive avoidance leaning in
psychopathic and nonpsychopathic offenders. Journal of Abnormal Psy-
chology, 95, 252–256. doi:10.1037/0021-843X.95.3.252
Newman, J. P., Schmitt, W. A., & Voss, W. D. (1997). The impact of
motivationally neutral cues on psychopathic individuals: Assessing the
generality of the response modulation hypothesis. Journal of Abnormal
Psychology, 106, 563–575. doi:10.1037/0021-843X.106.4.563
Patrick, C. J., Cuthbert, B. N., & Lang, P. J. (1994). Emotion in the
criminal psychopath: Fear imagery processing. Journal of Abnormal
Psychology, 103, 523–534. doi:10.1037/0021-843X.103.3.523
Porter, S., Birt, A. R., & Boer, D. P. (2001). Investigation of the criminal
and conditional relsease of Canadian federal offenders as a function of
psychopathy and age. Law and Human Behavior, 25, 647– 661. doi:
10.1023/A:1012710424821
Reid, W. H. (2001). Antisocial personality, psychopathy, and forensic
psychiatry. Journal of Psychiatric Practice, 7, 55–58. doi:10.1097/
00131746-200101000-00008
Rice, M. E., Harris, G. T., & Cormier, C. A. (1992). An evaluation of a
maximum security therapeutic community for psychopaths and other
mentally disordered offenders. Law and Human Behavior, 16, 399 – 412.
doi:10.1007/BF02352266
Rogers, R., & Rogstad, J. E. (2010). Psychopathy and APD in non-forensic
patients: Improved predictions or disparities in cut scores? Journal of
Psychopathology and Behavioral Assessment, 32, 353–362.
Salekin, R. T., Rogers, R., & Sewell, K. W. (1996). A review and
meta-analysis of the Psychopathy Checklist and Psychopathy Check-
list—Revised: Predictive validity of dangerousness. Clinical Psychol-
ogy: Science and Practice, 3, 203–215. doi:10.1111/j.1468-2850.1996
.tb00071.x
Sargeant, M. N., Daughters, S. B., Curtin, J. J., Schuster, R., & Lejuez,
C. W. (2011). Unique roles of antisocial personality disorder and psy-
chopathic traits in distress tolerance. Journal of Abnormal Psychology,
120, 987–992. doi:10.1037/a0024161
Schraft, C. V., Kosson, D. S., & McBride, C. K. (in press). Exposure to
violence within home and community environments and psychopathic
tendencies in adolescents. Criminal Justice and Behavior.
Serin, R. C. (1991). Psychopathy and violence in criminals. Journal of
Interpersonal Violence, 6, 423– 431. doi:10.1177/088626091006004002
Serin, R. C., & Amos, N. L. (1995). The role of psychopathy in the
assessment of dangerousness. International Journal of Law and Psychi-
atry, 18, 231–238. doi:10.1016/0160-2527(95)00008-6
Smith, S. S., & Newman, J. P. (1990). Alcohol and drug abuse—
dependence disorders in psychopathic and nonpsychopathic criminal
offenders. Journal of Abnormal Psychology, 99, 430 – 439. doi:10.1037/
0021-843X.99.4.430
Stevens, G. F. (1993). Applying the diagnosis of antisocial personality to
imprisoned offenders: Looking for hay in a haystack. Journal of Of-
fender Rehabilitation, 19, 1–26. doi:10.1300/J076v19n01_01
Suchy, Y., & Kosson, D. S. (2006). Forming, switching, and maintaining
mental sets among psychopathic offenders during verbal and nonverbal
tasks: Another look at the left-hemisphere activation hypothesis. Journal
of the International Neuropsychological Society, 12, 538 –548. doi:
10.1017/S135561770606070X
Tabachnick, B. G., & Fidell, L. S. (2007). Using multivariate statistics (5th
ed.). New York, NY: Harper Collins.
Vaidyanathan, U., Hall, J. R., Patrick, C. J., & Bernat, E. M. (2011).
Clarifying the role of defensive reactivity deficits in psychopathy and
antisocial personality using startle reflex methodology. Journal of Ab-
normal Psychology, 120, 253–258. doi:10.1037/a0021224
Van Kleeck, M. H. (1989). Hemispheric differences in global versus local
processing of hierarchical visual stimuli by normal subjects: New data
and a meta-analysis of previous studies. Neuropsychologia, 27, 1165–
1178. doi:10.1016/0028-3932(89)90099-7
Walsh, Z., Allen, L. C., & Kosson, D. S. (2007). Beyond social deviance:
Substance-specific relationships with PCL-R facets. Journal of Person-
ality Disorders, 21, 273–288. doi:10.1521/pedi.2007.21.3.273
Williamson, S., Hare, R. D., & Wong, S. (1987). Violence: Criminal
psychopaths and their victims. Canadian Journal of Behavioral Science,
19, 454 – 462. doi:10.1037/h0080003
Williamson, S., Harpur, T. J., & Hare, R. D. (1991). Abnormal processing
of affective words by psychopaths. Psychophysiology, 28, 260 –273.
doi:10.1111/j.1469-8986.1991.tb02192.x
Wootton, J. M., Frick, P. J., Shelton, K. K., & Silverthorn, P. (1997).
Ineffective parenting and childhood conduct problems: The moderating
role of callous unemotional traits. Journal of Consulting and Clinical
Psychology, 65, 301–308. doi:10.1037/0022-006X.65.2.292.b