Incremental validity of the Psychopathy Checklist-Revised above and beyond the diagnosis of antisocial personality disorder regarding recidivism in sexual offenders

Abstract Purpose The diagnostic criteria of the Antisocial Personality Disorder (ASPD) overlaps greatly with the Lifestyle and Antisocial facets of the Hare Psychopathy Checklist-Revised (PCL-R), whereas the Interpersonal and Affective facets seem to differentiate between antisocial and psychopathic offenders. Previous studies investigated either the ASPD diagnosis or psychopathy measured with the PCL-R, but not the combination of both in sexual offenders. The present study tested three hypotheses that PCL-R scores are incrementally predictive above and beyond the ASPD diagnosis regarding general recidivism, non-sexual violent recidivism, and sexual recidivism. Methods We performed Cox regression modeling with two-fold cross validation, using a training sample (n = 755) and a testing sample (n = 368) of adult male sexual offenders from Austria. Average time-at-risk was 10.13 years. Results The PCL-R scores predicted general and violent recidivism after the diagnosis of the ASPD was controlled for. The Lifestyle and Antisocial facets, in particular, were incremental. Sexual recidivism could not be predicted. Conclusions The current results support the use of the PCL-R in applied sexual offender assessment in addition to general clinical diagnostic procedures due to its incremental validity, despite a large overlap between the diagnostic criteria of ASPD and the PCL-R concept of psychopathy.