Predictive and incremental validity of the Static-99, Static-99R, and STABLE-2007 for sexual recidivism: A diagnostic test accuracy network meta-analysis (DTA-NMA).

The Static-99, Static-99R, and STABLE-2007 are internationally well-established instruments for predicting static and dynamic risks of sexual recidivism in individuals convicted of sexual offenses. Previous meta-analyses assessed their predictive and incremental validity, but none has yet compared the two Static versions and the Static-STABLE combinations. Here, we implemented diagnostic test accuracy network meta-analysis (DTA-NMA) to compare all tests and identify optimal cutoffs in one comprehensive analysis. The DTA-NMA included 32 samples comprising 45,224 adult male individuals. More information was available on the Static-99 (22 samples; 34,316 individuals) and the Static-99R (13 samples; 27,243 individuals), compared to the Static-99/STABLE-2007 (three samples; 762 individuals), the Static-99R/STABLE-2007 (two samples; 2,972 individuals), and the STABLE-2007 (three samples; 816 individuals). The primary outcome was the area under the receiver operating characteristic curve (AUC). The secondary outcomes were sensitivity and specificity. Optimal cutoffs were determined using the Youden index. The AUC suggested moderate predictive validity for Static-99 and Static-99R, whereas STABLE-2007 had no predictive value. The optimal cutoff of Static-99R was suggested to have higher specificity than that of Static-99, whereas sensitivity was comparable between instruments. The notion of incremental validity for STABLE-2007 could not be confirmed. This work represents the first meta-analysis to compare Static-99, Static-99R, STABLE-2007, and their combinations in one analysis. Static-99R demonstrated the highest specificity in predicting the risk of sexual recidivism, indicating a potential advantage in detecting true nonrecidivists. The findings are discussed, considering the current recommendations for assessing the risk of sexual recidivism in the criminal justice system. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Moderators of Sexual Recidivism as Indicator of Treatment Effectiveness in Persons With Sexual Offense Histories: An Updated Meta-analysis.

The present meta-analysis is an update of the meta-analysis by Schmucker and Lösel [Campbell Syst. Rev. 2017; 13: 1-75], which synthesized evidence on sexual recidivism as an indicator of treatment effectiveness in persons with sexual offense histories. The updated meta-analysis includes 37 samples comprising a total of 30,394 individuals with sexual offense histories, which is nearly three times the sample size reported by Schmucker and Lösel (2017: 28 samples, N = 9781). In line with Schmucker and Lösel (2017), the mean treatment effect was small with an odds ratio of 1.54 [95% CI 1.22, 1.95] (p < .001). A moderator analysis suggested three predictors of importance, i.e., risk level, treatment specialization, and author confounding. Greater treatment effectiveness was suggested in high- and medium-compared to low-risk individuals and in specialized compared to non-specialized treatments. Authors affiliated with treatment programs reported larger effectiveness than independent authors. These findings were overall in line with Schmucker and Lösel (2017), though the effects of risk level and treatment specialization were stronger in the current meta-analysis. The findings of the updated meta-analysis reinforce the evidence for the first and second principle of the Risk-Need-Responsivity model. The results may support researchers and decision-makers in interpreting the current evidence on sexual recidivism as an indicator of treatment effectiveness, and, based on that, implement and carry out informative, methodologically sound evaluations of ongoing treatment programs in persons with sexual offense histories.

The joy of being frightened: Fear experience in psychopathy.

OBJECTIVE: Psychopathic traits are associated with abnormalities in fear processing. While traditional theories focus on a lack of fear, Hosker-Field et al. (2016) provided a new perspective. They suggested that individuals with elevated psychopathic traits may experience threatening situations with appreciation or positivity, resulting in reduced negative fear responses and heightened positive responses (fear enjoyment hypothesis, FEH). METHOD: Our study aimed to refine Hosker-Field et al.'s (2016) study design, addressing methodological limitations and improving the inconsistent operationalization of fear experience in the literature. In an online sample of 353 participants from the general population, we examined the relationship between the FEH and relevant psychopathic traits, specifically those derived from the PCL-R framework (i.e., SRP 4 Factor 1), and from a more trait-based approach to psychopathy with assumed links to fearlessness (i.e., TriPM Boldness). RESULTS: By employing linear mixed effect models, we extended Hosker-Field et al.'s correlational analysis and provided further evidence for the FEH, particularly in relation to psychopathic traits measured using the PCL-R framework. The results regarding Boldness, however, are somewhat inconclusive. CONCLUSION: The present study enhances existing research on fear deficits in psychopathy by assessing the subjective experience of individuals facing threat.

A matter of measure? Assessing the three dimensions of narcissism.

The Trifurcated Model of Narcissism (TriMN) has received growing attention in the scientific study of narcissistic traits, as it provides a clear and clinically useful distinction of the three core elements of narcissistic personalities: agentic extraversion (AE), narcissistic antagonism (NA), and narcissistic neuroticism (NN). So far, the Five-Factor Narcissism Inventory (FFNI) and its abbreviations-for example, the recently introduced brief form (FFNI-BF)-represent the only measures that allow for a direct and simultaneous assessment of these traits. Distinct parts of the TriMN have also been measured by other narcissism scales, however, including the Narcissistic Admiration and Rivalry Questionnaire (NARQ) or the Hypersensitive Narcissism Scale (HSNS). It remains unclear to what extent trait estimates provided by these alternative measures overlap and under which circumstances they can be used interchangeably. Here, we present a model-driven combination of NARQ and HSNS items that may serve as a valuable, economic tool to assess the three narcissism dimensions. In two studies (accumulated N = 2,266, 1,673 female, 580 male, 13 diverse), we show that the NARQ/HSNS and the FFNI-BF access virtually the same presentations of AE, NA, and NN, whereby the combined NARQ/HSNS outperforms the FFNI-BF in terms of structure, theory-consistent relations among (latent) narcissistic traits, and predictive validity with respect to personality pathology. Our research provides new insights on the assessment of narcissistic traits according to the increasingly popular TriMN and can inform future research on its dimensions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Deep Learning in the Identification of Electroencephalogram Sources Associated with Sexual Orientation.

INTRODUCTION: It is unclear if sexual orientation is a biological trait that has neurofunctional footprints. With deep learning, the power to classify biological datasets without an a priori selection of features has increased by magnitudes. The aim of this study was to correctly classify resting-state electroencephalogram (EEG) data from males with different sexual orientation using deep learning and to explore techniques to identify the learned distinguishing features. METHODS: Three cohorts (homosexual men, heterosexual men, and a mixed sex cohort), one pretrained network on sex classification, and one newly trained network for sexual orientation classification were used to classify sex. Further, Grad-CAM methodology and source localization were used to identify the spatiotemporal patterns that were used for differentiation by the networks. RESULTS: Using a pretrained network for classification of males and females, no differences existed between classification of homosexual and heterosexual males. The newly trained network was able, however, to correctly classify the cohorts with a total accuracy of 83%. The retrograde activation using Grad-CAM technology yielded distinctive functional EEG patterns in the Brodmann area 40 and 1 when combined with Fourier analysis and a source localization. DISCUSSION: This study shows that electrophysiological trait markers of male sexual orientation can be identified using deep learning. These patterns are different from the differentiating signatures of males and females in a resting-state EEG.

Neuroelectric Correlates of Human Sexuality: A Review and Meta-Analysis.

Many reviews on sexual arousal in humans focus on different brain imaging methods and behavioral observations. Although neurotransmission in the brain is mainly performed through electrochemical signals, there are no systematic reviews of the electrophysiological correlates of sexual arousal. We performed a systematic search on this subject and reviewed 255 studies including various electrophysiological methods. Our results show how neuroelectric signals have been used to investigate genital somatotopy as well as basic genital physiology during sexual arousal and how cortical electric signals have been recorded during orgasm. Moreover, experiments on the interactions of cognition and sexual arousal in healthy subjects and in individuals with abnormal sexual preferences were analyzed as well as case studies on sexual disturbances associated with diseases of the nervous system. In addition, 25 studies focusing on brain potentials during the interaction of cognition and sexual arousal were eligible for meta-analysis. The results showed significant effect sizes for specific brain potentials during sexual stimulation (P3: Cohen's d = 1.82, N = 300, LPP: Cohen's d = 2.30, N = 510) with high heterogeneity between the combined studies. Taken together, our review shows how neuroelectric methods can consistently differentiate sexual arousal from other emotional states.

Psychopathic and autistic traits differentially influence the neural mechanisms of social cognition from communication signals.

Psychopathy is associated with severe deviations in social behavior and cognition. While previous research described such cognitive and neural alterations in the processing of rather specific social information from human expressions, some open questions remain concerning central and differential neurocognitive deficits underlying psychopathic behavior. Here we investigated three rather unexplored factors to explain these deficits, first, by assessing psychopathy subtypes in social cognition, second, by investigating the discrimination of social communication sounds (speech, non-speech) from other non-social sounds, and third, by determining the neural overlap in social cognition impairments with autistic traits, given potential common deficits in the processing of communicative voice signals. The study was exploratory with a focus on how psychopathic and autistic traits differentially influence the function of social cognitive and affective brain networks in response to social voice stimuli. We used a parametric data analysis approach from a sample of 113 participants (47 male, 66 female) with ages ranging between 18 and 40 years (mean 25.59, SD 4.79). Our data revealed four important findings. First, we found a phenotypical overlap between secondary but not primary psychopathy with autistic traits. Second, primary psychopathy showed various neural deficits in neural voice processing nodes (speech, non-speech voices) and in brain systems for social cognition (mirroring, mentalizing, empathy, emotional contagion). Primary psychopathy also showed deficits in the basal ganglia (BG) system that seems specific to the social decoding of communicative voice signals. Third, neural deviations in secondary psychopathy were restricted to social mirroring and mentalizing impairments, but with additional and so far undescribed deficits at the level of auditory sensory processing, potentially concerning deficits in ventral auditory stream mechanisms (auditory object identification). Fourth, high autistic traits also revealed neural deviations in sensory cortices, but rather in the dorsal auditory processing streams (communicative context encoding). Taken together, social cognition of voice signals shows considerable deviations in psychopathy, with differential and newly described deficits in the BG system in primary psychopathy and at the neural level of sensory processing in secondary psychopathy. These deficits seem especially triggered during the social cognition from vocal communication signals.

The Elemental Psychopathy Assessment (EPA): Factor structure and construct validity across three German samples.

Psychopathy is deemed an important construct in forensic settings. Consequently, its theoretical basis and measurement are relevant to researchers but also to criminal justice administrators and decision-makers. The Elemental Psychopathy Assessment (EPA) is a recently developed self-report scale designed to measure psychopathic traits based on the five-factor model, one of the most comprehensive frameworks of general personality. Recent research provided initial support for the reliability and construct validity of the EPA, and exploratory factor analyses yielded a four-factor structure across different samples from the United States. Independent and confirmatory assessments of the construct validity and factor structure of the EPA are, however, pending. Across three independent, non-American samples (accumulated N = 1,803), we examined its content and factorial validity. We corroborated the proposed four-factor structure by means of both exploratory and confirmatory factor analyses (CFA). Item-based CFA further indicated that the EPA items adequately measure the scales that they were initially assigned to. Taken together, the EPA is a psychometrically sound assessment tool for psychopathy. Given its substantial overlap with basic units of personality, the EPA represents a valid instrument to investigate psychopathy from a dimensional, trait-based perspective. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Automaticity of Early Sexual Attention: An Event-Related Potential Study.

A promising line of research on forensic assessment of paraphilic sexual interest focuses on behavioral measures of visual attention using sexual stimuli as distractors. The present study combined event-related potentials (ERPs) with behavioral measures to investigate whether detection of a hidden sexual preference can be improved with ERPs. Normal variants of sexual orientation were used for a proof-of-concept investigation. Accordingly, 40 heterosexual and 40 gay men participated in the study. Within each group, half of the participants were instructed to hide their sexual orientation. The results showed that a match between sexual orientation and stimulus delays responses and influences ERP before motor responses. Late ERP components showed higher potential in differentiating hidden sexual preferences than motor responses, thereby showing how ERPs can be used in combination with reaction time measures to potentially facilitate the detection of hidden sexual preferences.

Triarchic Psychopathy Measure: Convergent and discriminant validity in a correctional treatment setting.

The standard measure of assessment of psychopathy in forensic and correctional settings is the Hare Psychopathy Checklist-Revised (PCL-R), an observer-rating instrument assessing 4 facets of psychopathy: Interpersonal, Affective, Lifestyle, and Antisocial. The relatively new triarchic model of psychopathy, in contrast, consists of 3 factors: Boldness, Meanness, and Disinhibition measured with a self-report questionnaire, Triarchic Psychopathy Measure (TriPM). The evidence for the utility of the TriPM questionnaire in forensic or correctional settings is still scarce. Therefore, the current study was conducted to examine the convergence of the TriPM questionnaire with the PCL-R and interpersonal psychopathic behavior ratings based on the Interpersonal Measure of Psychopathy in a sample of German adult male prison inmates undergoing a correctional treatment (N = 152). To test the construct validity with external criteria, measures for impulsiveness and self-efficacy were used. Overall, the results were rather equivocal regarding the validity of the TriPM. The TriPM Boldness scale was not significantly correlated with the PCL-R but only with the Interpersonal Measure of Psychopathy Grandiosity and Self-Efficacy. The TriPM Meanness scale and Disinhibition were strongly correlated and showed a similar correlative pattern with the PCL-R Lifestyle and Antisocial facets. Thus, the construct coverage of the TriPM and the added value for measuring psychopathic traits using the TriPM in correctional settings remains inconclusive. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Fearless but anxious? A systematic review on the utility of fear and anxiety levels to classify subtypes of psychopathy.

Psychopathic traits have been linked to anomalies in experiencing fear and anxiety. It remains unclear, however, to what extent fear and anxiety levels are useful parameters to effectively distinguish between subtypes of psychopathy. Therefore, we aimed to elucidate whether different psychopathic phenotypes (primary and secondary psychopathy) can be delineated based on fear/anxiety levels. To investigate associations between psychopathic traits and conscious experiences of fear and/or anxiety a systematic qualitative review of studies was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Seventeen studies were included in the review. We found some evidence for attenuated fear/anxiety levels in primary psychopathy. In secondary psychopathy, the experience of fear/anxiety seemed rather intact. Moreover, primary psychopathy might be associated with a more positive appraisal of the conscious feeling of fear. We reason that consciously experienced fear and anxiety are distinctly related to primary and secondary psychopathy. Due to a lack of consistent and comprehensive operationalizations of fear and anxiety, however, conclusions about their potential to differentiate psychopathic subtypes should be drawn with caution.

Rational, emotional, or both? Subcomponents of psychopathy predict opposing moral decisions.

Recent research has documented a small but significant correlation between psychopathic capacities and utilitarian moral judgment, although the findings are generally inconsistent and unclear. We propose that one way to make sense of mixed findings is to consider variation in perspective-taking capacities of psychopathic individuals. With this in mind, we had criminal offenders (n = 60), who varied in their psychopathy levels according to the Psychopathy Checklist-Revised (PCL-R), respond to common sacrificial moral dilemmas (e.g., trolley dilemmas) under different conditions. In a baseline condition, participants simply responded to the sacrificial moral dilemmas as is typically done in previous research. In an "emotion-salient" condition, participants had to reason about the emotions of another person after solving moral dilemmas (deliberative processing). In the "emotion-ambiguous" condition, participants saw images of people in distress, after solving moral dilemmas, but did not have to explicitly reason about such emotions (spontaneous processing). The four PCL-R facets predicted distinct interference effects depending on spontaneous versus deliberative processing of hypothetical victim's emotions. The findings suggest that the use of a multi-faceted approach to account for cognitive and moral correlates of psychopathy may help address previously mixed results. Implications and future directions for theory and research are discussed.

Psychopathy checklist: Screening version: A bifactor structure for forensic and community samples.

We evaluated competing measurement models for the Psychopathy Checklist: Screening Version (PCL:SV), one of the most widely used assessment instruments of psychopathy, which applies to clinical, forensic, and community samples. With four all-male community and forensic samples collected in Germany and the United States (nTotal = 853), we evaluated several measurement models of the PCL:SV, including correlated factor models, higher-order models, and bifactor models, on numerous psychometric criteria including model fit, factor saturation, and predictive utility. Across the samples, we found that a bifactor model had better fit to the data and explained comparable or more variance in measures of fluid intelligence, crystallized intelligence, and characteristics of antisocial personality disorder relative to the four correlated factors model. The best bifactor structure model differed between forensic and community samples. With both populations, in addition to a g factor which loaded on all items, a nested factor representing the lifestyle and antisocial facets was also modeled. With the forensic sample, an additional orthogonal nested factor representing the interpersonal facet was needed. We conclude that there is strong communality across the 12 PCL:SV items, which is best captured by a bifactor structure. However, the specific nesting structure differs due to whether or not the sample includes a forensic or community population. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Associations of the MAOA uVNTR genotype and 5-HTTLPR/rs25531 haplotype with psychopathic traits.

Previous studies have linked polymorphisms of the monoamine oxidase A (MAOA uVNTR) and serotonin transporter gene (5-HTTLPR) to individual differences in the expression of psychopathic traits, but findings remain inconsistent. One possible reason is that these studies have treated psychopathy as a unitary construct when there is accumulating evidence that there are variants or subtypes. We used a variable-centered and a person-centered approach by (a) examining putative genetic correlates of psychopathy across individuals and (b) comparing the frequencies of the MAOA uVNTR genotype and 5-HTTLPR/rs25531 haplotype between empirically derived subtypes of psychopathy, respectively. Notably, we included the often neglected rs25531 polymorphism, which is closely connected to the 5-HTTLPR. Based on data from male offenders and community volunteers, structural equation modeling indicated that the 5-HTTLPR/rs25531 haplotype was specifically associated with interpersonal deficits beyond the overarching psychopathy construct. Latent profile analysis revealed four clusters that were labeled non-psychopaths, sociopaths, callous-conning, and psychopaths. The low-activity variant of the 5-HTTLPR/rs25531 haplotype was significantly more frequent in the callous-conning compared to the non-psychopathic subtype. There were no effects for the MAOA uVNTR. The results illustrate that psychopathy should not be treated as a unitary construct but that there are variants with specific profiles of psychopathic traits, and that the 5-HTTLPR/rs25531 haplotype plays a role in the manifestation of interpersonal deficits from a variable-centered as well as from a person-centered view.

Emotion expression abilities and psychopathy.

The ability to express emotion is considered a core socioemotional skill; however, most research is focused on receptive abilities, with little investigation of productive abilities. We present an investigation of individual differences in facial expression of emotion using observational techniques. Given descriptions of highly psychopathic persons as successful liars and manipulators, we investigate the ability to intentionally pose emotional expressions when no emotion is elicited. A mixed sample of adult men (N = 316 community volunteers, prison inmates, and forensic-psychiatric patients) ranging along the psychopathy continuum were asked to facially express a nonfelt emotion, specifically anger, disgust, fear, happiness, sadness, and surprise, through either written instructions or through imitation of a target's facial expression. Through structural equation modeling, we evaluate relations between this emotion expression ability and general mental ability, interpersonal abilities, and psychopathy. We find that psychopathy is moderately associated with poorer emotion expression ability, meaning highly psychopathic individuals are poorer at imitating the expressions of others and poorer at expressing all emotions. However, this deficit is largely attributable to deficits in general mental ability. These results challenge the view that highly psychopathic individuals have the cognitive skills to support a superior ability to deceive or manipulate others. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Triarchic or septarchic?-Uncovering the Triarchic Psychopathy Measure's (TriPM) structure.

The Triarchic Psychopathy Measure (TriPM) is based on a 3-dimensional conceptual model, though few studies have directly tested a 3-factor structure. The current study used a large community sample (N = 1,064, 53% males, Mage = 34) to test the structure of the TriPM via exploratory and confirmatory factor analysis, along with 4 community replication samples from North American and Europe (Ns = 511-603, 33-49% males) and 1 European male offender sample (N = 150). Three of these samples were also used to model the correlations between relevant external correlates and the original TriPM factors versus emergent factors to examine the cost of misspecifying TriPM structure. The model analyses did not support a 3-factor model (comparative fit index = .76, root mean square error of approximation = .08), revealing a number of items with limited statistical information, but uncovered a 7-factor structure (comparative fit index = .92, root mean square error of approximation = .04). From the majority of Boldness, Meanness, and Disinhibition scale items, respectively, emerged 3 factors reflecting Positive Self-Image, Leadership, and Stress Immunity; 2 factors tapping Callousness and Enjoy Hurting; and 2 factors involving Trait Impulsivity and Overt Antisociality. Further, the Enjoy Hurting and Overt Antisociality factors were more strongly correlated with one another than with the other scales from their home domains (Callousness and Impulsivity). All 7 emergent factors were differentially associated with the external correlates, suggesting that the 3 original TriPM factors do not optimally represent the conceptual model underlying the TriPM. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Indirect and Neuropsychological Indicators of Pedophilia.

The present study aimed to differentiate pedophilic child sex offenders (CSOs) from nonoffending controls (CTLs), as well as contact from noncontact CSOs. For this purpose, we investigated 21 contact CSOs, 20 noncontact CSOs (child pornography offenders), as well as 21 CTLs on neuropsychological test measures and indirect test measures of sexual interest. Multiple logistic regression models showed that three parameters of indirect tests and two neuropsychological test parameters allowed the differentiation of CSOs from CTLs with a maximum accuracy of 87%. The profile of contact and noncontact CSOs was remarkably similar and the optimal model for this group differentiation had a maximum accuracy of 66%, with slightly increased levels of risk-taking behavior and greater susceptibility for perceptual interference in contact CSOs than in noncontact CSOs. The findings suggest that standardized, objective methods can support the assessment of sexual offenders against children in forensic psychiatry and legal psychology.

The perils of untested assumptions in theory testing: A reply to Patrick et al. (2020).

We respond to a critique by Patrick et al. (2020) of our recent study (Roy et al., 2020) that raised questions regarding the three-factor model of the Triarchic Psychopathy Measure (TriPM). Roy et al. demonstrated that a replicable model involving seven unidimensional factors accounted for the TriPM items across North American and European general population samples, as well as European male offenders. Despite having access to large TriPM datasets, the Patrick et al. critique relied on tangential analyses of general personality traits, using a single college sample with TriPM data as supplemental. Thus, Patrick et al. ignored findings highlighting multidimensional TriPM scales and the uncertainty they introduce with respect to the larger nomological network of psychopathy. In our reply, we demonstrate additional problems with the three-factor TriPM model and show that the seven-factor model out-performs the three-factor model in predicting correlates of psychopathy. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The Effects of Acute Transcranial Direct Current Stimulation on Attentional Bias in Pedophilic Disorder: A Preregistered Pilot Study.

OBJECTIVES: Individuals with pedophilic disorder (PD) experience personal and interpersonal difficulties and are at risk of sexually offending against children. As such, innovative and empirically validated treatments are needed. Recent studies have indicated that men who have sexually offended against children (SOC) with PD display an automatic attention bias for child-related stimuli as well as reduced activity in the dorsolateral prefrontal cortex (dlPFC), a brain area involved in cognitive control, including control over sexual arousal. In this preregistered pilot study, we are the first to investigate whether acutely increasing prefrontal activity could reduce the putative pedophilic attention bias. MATERIALS AND METHODS: We delivered a single 20-min session of active anodal versus sham transcranial direct current stimulation (tDCS) over the left dlPFC to 16 SOC with PD and 16 matched healthy controls, while they performed a task requiring controlled attention to computer-generated images of clothed and nude children and adults. We collected responses unobtrusively by recording eye movements. RESULTS: Our results did not support the presence of the expected automatic attention bias across outcome measures. Nonetheless, we found a response facilitation with child targets in patients and, unexpectedly, in controls, likely due to unwanted salience effects. Active versus sham tDCS reduced this bias across groups, as indicated by a significant group*condition interaction (p = 0.04). However, no attentional bias and no tDCS effects on attentional responses to child and adult images emerged following tDCS. CONCLUSIONS: These results suggest enhanced cognitive control in response to salient stimuli during active tDCS. Thus, to assist future studies on neuromodulation in PD, we provide suggestions for design improvement.