Assessing the threat of lone-actor terrorism: the reliability and validity of the TRAP-18

Terrorism, especially lone-actor terrorism, is considered a major national security threat in both North America and Europe. The threat of terrorism has many faces and violence can arise from all ideological extremes. The authors present the theoretical model and current empirical validation of the Terrorist Radicalization Assessment Protocol (TRAP-18), a structured professional judgment instrument for those engaged in risk assessment of persons of concern for acts of terrorist violence. It can be used independently of a particular ideology. The TRAP-18 consists of 8 proximal warning behaviors and 10 distal characteristics, and has been designed to help prioritize the imminency of risk in specific cases, and therefore determine the intensity of monitoring and active management a case requires. Research has demonstrated excellent interrater reliability, and promising content, criterion, discriminant, and predictive validity. More research is in progress. The TRAP-18 is currently used by counterterrorism experts in North America and Europe. It offers a useful approach for professionals who may be assessing and treating individuals of national security concern

Understanding violence: Does psychoanalytic thinking matter?

A coherent psychoanalytic theory of violence has been hindered by the very few psychoanalysts who have actually worked with violent patients, by political allegiance to certain psychoanalytic schools of thought, a naïve belief that all violence is typically not intentional, but rather a problem of impulse control, and the lack of understanding of recent neurobiological findings concerning aggression. Although intensive psychoanalytic treatment is usually not appropriate for violent individuals, the authors assert that a comprehensive understanding of violent behavior from a psychoanalytic perspective is of relevance for all mental health practitioners interested in the nature of human aggression. Actual violence is informed by bodily enactments and regressions to primitive subjective states; the effects of trauma on representation and symbolic functioning; the demarcation between affective and predatory violence; and understanding how all of our mental processes, including cognitions, wishes, memories, unconscious phantasies, ego-defenses, and object relations, are originally rooted in the body. The authors review the historical psychoanalytic literature on violence and critique contemporary psychoanalytic theorizing regarding the etiology of violent behavior in the light of some neurobiological research findings. They conclude with treatment recommendations for those clinicians whose patients have been violent toward others

A clinical investigation of malingering and psychopathy in hospitalised insanity acquitees

This study compares Psychopathy Checklist-Revised (PCL-R) scores, DSM-Ill-R diagnoses, and select behavioral indices between hospitalized insanity acquittees (N = 18) and hospitalized insanity acquittees who successfully malingered (N = 18). The malingerers were significantly more likely to have a history of murder or rape, carry a diagnosis of antisocial personality disorder or sexual sadism, and produce greater PCL-R factor 1, factor 2, and total scores than insanity acquittees who did not malinger. The malingerers were also significantly more likely to be verbally or physically assaultive, require specialized treatment plans to control their aggression, have sexual relations with female staff, deal drugs, and be considered an escape risk within the forensic hospital. These findings are discussed within the context of insanity statutes and the relevance of malingering, psychopathy, and treatability to future policy concerning the disposition of insanity acquittees

The PCL–R and capital sentencing: A commentary on “Death is different” DeMatteo et al. (2020a).

DeMatteo et al. (2020a) published a Statement in this journal declaring that the Psychopathy Checklist-Revised (PCL-R) “cannot and should not” be used in U.S. capital-sentencing cases to assess risk for serious institutional violence. Their stated concerns were the PCL-R’s “imperfect interrater reliability,” its “variability in predictive validity,” and its prejudicial effects on the defendant. In a Cautionary Note, we (Olver et al., 2020) raised questions about the Statement’s evaluation of the PCL-R’s psychometric properties, presented new data, including a meta-meta-analysis, and argued that the evidence did not support the Statement’s declaration that the PCL-R “cannot” be used in high stakes contexts. In their reply, titled “Death is Different,” DeMatteo et al. (2020b) concurred with several points in our Cautionary Note, disputed others, asserted that we had misunderstood or mischaracterized their Statement, and dismissed our new data and comments as irrelevant to the Statement’s purpose. This perspective on our commentary is inimical to balanced academic discourse. In this article, we contend that DeMatteo et al. (2020b) underestimated the reliability and predictive validity of PCL-R ratings, overestimated the centrality of the PCL-R in sentencing decisions, and underplayed the importance of other factors. Most of their arguments depended on sources other than capital cases, including mock trials, Sexually Violent Predator (SVP) hearings, and studies that included the prediction of general violence. We conclude that the rationale for the bold “cannot and should not” decree is open to debate and in need of research in real-life venues

Reliability and validity of the Psychopathy Checklist-Revised in the assessment of risk for institutional violence: A cautionary note on DeMatteo et al. (2020).

A group of 12 authors (GA) shared a statement of concern (SoC) warning against the use of the Hare Psychopathy Checklist-Revised (PCL-R; Hare, 1991, 2003) to assess risk for serious institutional violence in US capital sentencing cases (DeMatteo et al., 2020). Notably, the SoC was not confined to capital sentencing issues, but included institutional violence in general. Central to the arguments presented in the SoC was that the PCL-R has poor predictive validity for institutional violence and also inadequate field reliability. The GA also identified important issues about the fallibility and inappropriate use of any clinical/forensic assessments, questionable evaluator qualifications, and their effects on capital sentencing decisions. However, as a group of forensic academics, researchers, and clinicians, we are concerned that the PCL-R represents a psycholegal red herring, while the SoC did not address critical legislative, systemic, and evaluator/rating issues that affect all risk assessment tools. We contend that the SoC’s literature review was selective and that the resultant opinions about potential uses and misuses of the PCL-R were ultimately misleading. We focus our response on the evidence and conclusions proffered by the GA concerning the use of the PCL-R in capital and other cases. We provide new empirical findings regarding the PCL-R’s predictive validity and field reliability to further demonstrate its relevance for institutional violence risk assessment and management. We further demonstrate why the argument that group data cannot be relevant for single-case assessments is erroneous. Recommendations to support the ethical and appropriate use of the PCL-R for risk assessment are provided

Psychodynamic treatment of antisocial personality disorder

Many psychoanalytic clinicians and researchers experienced in working with severe personality disorders have concluded that patients with a diagnosis of antisocial personality disorder are not treatable with psychodynamic psychotherapy (Gabbard 2005; Kernberg 1984; Kernberg et al. 2008). This pessimism is based on the seeming impossibility of engaging with patients whose pervasive deception and emotional detachment forecloses any possibility of entering into a viable therapeutic relationship, while the focus of therapy is constantly being diverted from exploration of the patient's mind into managing his risky antisocial behaviors. Although there is a lack of systematic controlled empirical evidence to indicate that psychodynamic treatments are effective in these individuals, recent research into the psychopathic patient's abnormal cognitive deficits and emotional responses (Patrick 2006) and awareness that antisocial personality disorder is a disorder of attachment (Meloy 2002) are stimulating a renewed interest in psychodynamic approaches