The role of psychopathy in assessing risk for violence: Conceptual and methodological issues

Purpose . There is growing evidence that psychopathic (dissocial) personality disorder is associated with violence. The purpose of this paper is to consider the role of psychopathy in clinical assessments of risk for violence. Arguments . Risk assessments are conducted for the purpose of preventing, not predicting, violence. Yet, most research on risk for violence is conducted and interpreted within the framework of a simplistic prediction paradigm, thus underestimating the practical importance of risk factors. Despite this bias, violence predictions based on psychopathy are only slightly less accurate than predictions that cognitive behavioral therapy will reduce symptoms of depression or cardiac bypass surgery will reduce angina pain; and more accurate than predictions that smaller class sizes will lead to improved academic achievement or cardiac bypass surgery will reduce mortality. Conclusion . Information about psychopathy can be used to make relatively accurate predictions of violence. Of course, decisions concerning if and how such information should be used are another matter. The paper concludes with recommendations concerning the appropriate role of psychopathy in violence risk assessments and avenues for future research.