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http://cjb.sagepub.com/content/38/10/965The online version of this article can be foundat:

DOI: 10.1177/0093854811418048

2011 38: 965Criminal Justice and BehaviorDaliah L. Bauer, Lindsay A. Whitman and David S. Kosson

Among Incarcerated Adolescent GirlsReliability and Construct Validity of Psychopathy Checklist: Youth Version Scores

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CRIMINAL JUSTICE AND BEHAVIOR, Vol. 38 No. 10, October 2011 965-987

DOI: 10.1177/0093854811418048

2011 International Association for Correctional and Forensic Psychology

AUTHORS NOTE:The data for this study were collected by Daliah L. Bauer in 1998 and 1999 in partial

fulfillment of the doctoral degree requirements of the Finch University of Health Sciences/Chicago Medical

School (Rosalind Franklin University) and was supported in part by Grants MH49111 and MH57714 from the

National Institute of Mental Health to David S. Kosson. The study was approved by the institutional review

board. We thank Glenda Blakemore and the Illinois Youth Center in Warrenville, Illinois, for their support of

this research. We also thank Diane Goldstein, Seoni Llanes, and Jasmin Vassileva for conducting interviews.

David S. Kosson is one of the coauthors of the Psychopathy Checklist: Youth Version: Technical Manual and

earns a small amount of money annually from sales of the manual. However, his work on the manual had no

influence on the research questions asked or interpretations of the research findings. Correspondence should

be addressed to David S. Kosson, Department of Psychology, Rosalind Franklin University of Medicine andScience, 3333 Green Bay Rd., North Chicago, IL 60064; e-mail: [email protected].

RELIABILITY AND CONSTRUCT VALIDITY OF

PSYCHOPATHY CHECKLIST: YOUTH VERSION

SCORES AMONG INCARCERATEDADOLESCENT GIRLS

DALIAH L. BAUERJefferson Parish Human Services Authority

LINDSAY A. WHITMANNew York University

DAVID S. KOSSONRosalind Franklin University of Medicine and Science

Although recent studies have demonstrated the utility of assessing psychopathic traits in adolescent males, there is

substantially less evidence on the utility of assessing psychopathic traits in adolescent females. This study investigated the

reliability and construct validity of the Psychopathy Checklist: Youth Version (PLC:YV) among a sample of 80 incarcerated

adolescent females. Reliability analyses indicated high interrater agreement and internal consistency for PCL:YV scores.

Consistent with research on adults and adolescent male offenders, psychopathic traits were associated with a greater number

of conduct disorder and alcohol dependence symptoms, earlier onset of criminal behavior, a propensity toward institutional

violence, and interpersonal behaviors associated with psychopathy. Consistent with some prior studies of youth, there were

no negative relationships between PCL:YV scores and internalizing disorder diagnoses and some positive associations

between psychopathy ratings and negative affectivity. Results suggest that assessing psychopathic traits in adolescent females

provides meaningful information regarding criminal behavior, patterns, and personality traits in youth.

Keywords: adolescent psychopathy; female inmates; adolescent psychopathology; construct validity

Although the bulk of the research establishing the importance of psychopathy has beenconducted on adult samples, there is now substantial evidence that the psychopathyconstruct is applicable to adolescents (Rutter, 2005; Vasey, Kotov, Frick, & Loney, 2005).

Psychopathy has many of the same correlates in adolescents as in adults (Kosson, Cyterski,

Steuerwald, Neumann, & Walker-Matthews, 2002; Salekin, Leistico, Trobst, Schrum, &

Lochman, 2005; Vitale, Newman, Bates, Goodnight, Dodge, & Pettit, 2005). Among

adolescents, psychopathic traits predict violence and recidivism (Falkenbach, Poythress, &

Heide, 2003; Salekin, 2008) and psychopathic traits in adulthood (Lynam, Caspi, Moffitt,

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966 CRIMINAL JUSTICE AND BEHAVIOR

Loeber, & Stouthamer-Loeber, 2007). In addition, there is preliminary evidence for

effective treatment of youth with psychopathic traits (Caldwell, McCormick, Umstead, &

Van Rybroek, 2007).

Because most research on adolescent samples has focused primarily on males, there is

relatively little evidence on the utility of assessing psychopathic traits in adolescent

females. This issue is relevant given that growth rates for criminal offenses among

adolescent females are higher than among adolescent males (Puzzanchera, Stahl, Finnegan,

Tierney, & Snyder, 2003), and adolescent females represent a growing proportion of forensic

populations (Porter, 2000). Consequently, the issue of whether indices of psychopathy are

valid and reliable among females is a crucial question in the context of forensic evaluations.

In fact, some theories suggest that psychopathy may be expressed differently in females

than in males. For these reasons, it is important to address the construct validity of

psychopathy instruments in an exclusively female sample. The current study is designed to

address this issue by examining the reliability and validity of psychopathy in adolescentfemales as measured by the Psychopathy Checklist: Youth Version (PCL:YV; Forth,

Kosson, & Hare, 2003). The PCL:YV is an expert rater measure of psychopathic traits

based on the widely validated Psychopathy Checklist Revised (PCL-R; Hare, 2003) but

adapted for use with adolescents.

BACKGROUND

PSYCHOPATHIC TRAITS IN FEMALES

Some researchers have raised the possibility that gender role socialization or biological

sex differences may lead to differences in the expression of psychopathic features in

females versus males (see Cale & Lilienfeld, 2002; Forouzan & Cooke, 2005). Several

studies have identified adult female offenders with psychopathic traits (Salekin, Rogers,

Ustad, & Sewell, 1998; Vitale, Smith, Brinkley, & Newman, 2002; Warren et al., 2003).

Investigations have found PCL-R scores to be reliable and valid in samples of female

methadone patients (Rutherford, Cacciola, Alterman, & McKay, 1996) and female inmates

(Vitale et al., 2002; see also Widom, 1978). As in male substance abusers, PCL-R and

Psychopathy Checklist: Screening Version scores predict poor treatment response among

incarcerated female substance abusers (Richards, Casey, & Lucente, 2003). However,Salekin, Rogers, and Sewell (1997) reported that PCL-R scores were less predictive of staff

ratings related to violence among females than was expected on the basis of prior studies

of male offenders.

PSYCHOPATHIC TRAITS AND AGGRESSION IN JUVENILE POPULATIONS

Several studies have reported that relationships between psychopathic traits and aggression

and delinquency were generally similar for girls and boys (Marsee, Silverthorn, & Frick, 2005;

Penney & Moretti, 2007; Salekin, 2008). In contrast, both Vincent, Odgers, McCormick,and Corrado (2008) and Odgers, Repucci, and Moretti (2005) reported different relationships

between psychopathy and aggression in girls than is typically reported in boys (Falkenbach

et al., 2003). Furthermore, Marsee et al. (2005) noted that the association between



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Bauer et al. / PCL:YV VALIDITY AMONG GIRLS 967

psychopathic features and relational aggression was stronger in girls than in boys. These

findings suggest that the relationship between psychopathy and aggression might be more

complex in girls than in boys.

ASSESSING PSYCHOPATHIC FEATURES IN CHILDREN AND ADOLESCENTS

Several measures have been developed for assessing psychopathic features in younger

populations. The PCL:YV (Forth et al., 2003) is an expert-rater measure of psychopathic

traits based on the best-validated measure of psychopathic traits in adults, the PCL-R (Hare,

2003). Other validated measures, such as the Antisocial Processes Screening Device (Frick

& Hare, 2001) and the Childhood Psychopathy Scale (Lynam, 1997) differ from the PCL:YV

in that they rely solely on information provided by parents or staff. Assessments of the

psychopathy construct in youth using these measures have generated a nomological net quite

similar to that surrounding the psychopathy construct in adults (Salekin et al., 2005).

Nevertheless, the study of psychopathic traits in youth has led to some controversies.

Several researchers have expressed concern that some of the traits associated with

psychopathy are relatively common in adolescence and may not reflect the severe pathology

that they indicate in adults or that, in youth, such traits are not stable across time. In

addition, researchers have recommended caution about the use of youth psychopathy

measures in court proceedings, given the potentially grave consequences of labeling an

adolescent psychopathic (Edens, Skeem, Cruise, & Cauffman, 2001; Seagrave & Grisso,

2002). In addition, there are questions about the specificity and sensitivity of specific

measures of psychopathy. Nevertheless, extant studies suggest that ratings of psychopathy

are relatively stable (Frick, Kimonis, Dandreaux, & Farell, 2003) and reliable across raters.Moreover, evidence suggests that individual differences in psychopathic traits are not

attributable to base rates of psychopathic traits during adolescence (Kosson, 2008) and that

scores on measures based on downward extensions of the adult psychopathy construct

converge with scores based on other approaches (Lynam, Derefinko, Caspi, Loeber, &

Stouthamer-Loeber, 2007).

Because the current investigation employed the PCL:YV to assess psychopathic traits,

we briefly review current knowledge regarding the reliability and validity of PCL:YV

ratings.1Studies indicate that PCL:YV scores are comparable in internal consistency and

interrater agreement to PCL-R scores (e.g., Edens et al., 2001; Forth et al., 2003). Skeem

and Cauffman (2003) reported that the PCL:YV possesses adequate 1-month testretest

reliability. Total scores on the PCL:YV correlate moderately with scores on other measures

of psychopathy and related syndromes, including the Interpersonal Measure of Psychopathy

(IM-P; Kosson, Steuerwald, Forth, & Kirkhart, 1997) and the Antisocial Processes

Screening Device (McBride, 1998; Murrie & Cornell, 2002) and with total scores on self-

report measures as well as with number of conduct disorder symptoms (Forth et al., 2003)

in adolescent male samples.2 In addition, PCL:YV scores correlate with violent and

nonviolent criminal behavior, instrumental violence, institutional violence, and recidivism

(Corrado, Vincent, Hart, & Cohen, 2004; Flight & Forth, 2007; Gretton, Hare, & Catchpole,

2004; Murrie, Cornell, Kaplan, McConville, & Levy-Elkon, 2004). Moreover, PCL:YVscores evidence unique correlations with antisocial behavior criteria after controlling for

other disruptive behavior disorder symptoms (Salekin, Neumann, Leistico, DiCicco, &

Duros, 2004). Although findings are less consistent than in adult samples, psychopathic



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features in male adolescents are reportedly associated with several other forms of

psychopathology, including alcohol and drug use (Epstein, Douglas, Poythress, Spain, &

Falkenbach, 2002), attention-deficit/hyperactivity disorder (ADHD; Colledge & Blair,

2001; Kaplan & Cornell, 2004; Kosson et al., 2002), and externalizing behaviors in general

(Schmidt, McKinnon, Chattha, & Brownlee, 2006).

In contrast, differences between adults and youth with psychopathic traits have been

reported with respect to indices of internalizing psychopathology. Whereas psychopathy

scores in adult samples have correlated negatively with indices of depression and anxiety

disorders (Lovelace & Gannon, 1999; Stalenheim & von Knorring, 1996), PCL:YV scores

have been reported to be uncorrelated with diagnoses and self-reports of depression

(Epstein et al., 2002; ONeill, 2001). Moreover, relations between PCL:YV scores and self-

reported anxiety have been discrepant across samples, ranging from positively correlated

(Kosson et al., 2002) to uncorrelated (Epstein et al., 2002; ONeill, 2001) to negatively

correlated (Dolan & Rennie, 2007; Murrie & Cornell, 2000). A recent community studyreported that PCL:YV scores were positively correlated with ratings of internalizing

behavior problems (Schmidt et al., 2006). However, these relationships have not previously

been investigated in female youth.

FACTOR STRUCTURE OF THE PCL:YV

Preliminary evidence suggests that the factor structure of the PCL:YV is similar to that

reported for the PCL-R. Adult samples have demonstrated good fit for both a three-factor

model comprising interpersonal, affective, and impulsive and irresponsible lifestyle

dimensions and a four-factor model that also includes unusual and prodigious antisocialbehavior (Cooke & Michie, 2001; Neumann, Hare, & Newman, 2007; Vitacco, Rogers,

Neumann, Harrison, & Vincent, 2005). Recent studies of adolescents have indicated that

both the three- and four-factor models provide good fit in large samples of incarcerated

adolescent males assessed with the PCL:YV (Neumann, Kosson, Forth, & Hare, 2006).

Jones, Cauffman, Miller, and Mulvey (2006) also suggested that, with slight modifications,

the three- and four-factor models provided equally good fit in both girls and boys. Although

Sevecke, Pukrop, Kosson, and Krischer (2009) reported that neither model provided

consistently good fit in a sample of female German adolescents, Kosson et al. (2011)

reported acceptable fit for both the three- and four-factor models in a large sample of

adolescent females.

THE CURRENT STUDY

The current study was designed to assess the reliability and validity of psychopathy as

assessed by the PCL:YV in a sample of incarcerated female adolescent offenders. The study

had several goals. First, the reliability of the instrument was examined. Specifically, the

internal consistency and interrater reliability of PCL:YV scores were calculated. Second,

the construct validity of PCL:YV scores was assessed by examining relationships between

psychopathic features and external criteria in several domains. We examined correlationsbetween PCL:YV ratings and scores on the IM-P and number of conduct disorder (CD)

symptoms. We examined correlations between PCL:YV scores and several measures of

antisocial behavior: criminal activity, violence proneness, age of onset of criminal behavior,



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and institutional misconduct. On the basis of prior research with adolescent males, we

expected PCL:YV scores to be positively associated with IM-P scores, number of CD

symptoms, and violent and nonviolent criminal activity but negatively correlated with age

of onset of criminal behavior.

Construct validity was also addressed by examining relations between PCL:YV scores

and symptoms of other forms of psychopathology and pathological personality traits. We

predicted that PCL:YV scores would correlate positively with number of ADHD symptoms

and alcohol and substance use disorder symptoms but would be uncorrelated or negatively

correlated with scores on measures of depression (Hare, 1991; Hare, Hart, & Harpur, 1991;

Harpur, Hare, & Hakstian, 1989; Hart, Forth, & Hare, 1990; Schmitt & Newman, 1999).

We predicted positive correlations between PCL:YV scores and scores on measures of

narcissism (Harpur et al., 1989; Shine & Hobson, 1997). We also examined fearlessness

(Levenson, Kiehl, & Fitzpatrick, 1995; Lykken, 1995). Although two studies with

adults suggested that fearlessness scores should correlate negatively with psychopathictraits (Levenson et al., 1995;Verona, Patrick, & Joiner, 2001), not all studies have replicated

this association (Schmitt & Newman, 1999). As noted above, prior studies of adolescent

males have reported a wide variety of findings with measures of anxiety and fear. Thus, no

predictions were made with regard to relationships between PCL:YV scores and anxiety or

fearlessness scores.

The third goal of the study was to examine whether the associations between psychopathic

traits and the aforementioned criteria could be attributed to overlap between psychopathic

traits and disruptive behavior disorder symptoms. Consequently, we examined whether these

relationships were evident even after controlling for symptoms of ADHD and CD. If the

relationships between psychopathic traits and antisocial behavior and psychopathology

are as robust among females as among males, then PCL:YV scores should be uniquely

predictive of the pattern of antisocial behavior and psychopathology. Finally, given that

prior studies have yielded generally good fit for the three-factor model in independent

samples of adolescent females, we also reported correlations between these PCL:YV factor

scores and external criteria in supplementary analyses.

METHOD

PARTICIPANTS

Participants were 80 females incarcerated at an Illinois correctional facility for youth

offenders. Participants ranged in age from 14 to 19. Fifty-two of the girls (65%) were

European American, 20 (25%) were African American, 6 (7.5%) were Latina, and 2 (2.5%)

were classified as Other. Socioeconomic status information was unavailable at the time of

assessment. The mean age of the participants was 16.2. (See Table 1 for demographic data.)

MATERIALS

The PCL:YV.The PCL:YV (Forth et al., 2003)was used to assess psychopathic traits.

The PCL:YV differs from the PCL-R in that item content and scoring procedures were

modified to reflect the contexts in which adolescents function and the differences in the



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expression of relevant dispositions at different ages and to direct raters to compare each

participants behaviors with norms for her or his age or peer group. Like the PCL-R, the

PCL:YV was designed to assess the behavioral, interpersonal, and affective components ofthe psychopathy construct on the basis of a semistructured interview and collateral

information from institutional files. Each item is scored on a 3-point scale (0 to 2), where

2 indicates that the disposition or trait generally applies to the participant, 1 indicates that

the disposition applies to some extent, and 0 indicates that the disposition does not apply.

Item scores are summed to yield total scores ranging from 0 to 40. Prior studies have

indicated good internal consistency and interrater agreement for PCL:YV total (and factor)

scores (Forth et al., 2003). Raters for this measure included several graduate students given

intensive PCL:YV training by one of the authors (DSK). Where interrater agreement was

computed, it was based on independent observation of the same interview and an independent

review of the participants file information.

The Kiddie Schizophrenia and Affective Disorders ScaleEpidemiological Version

(K-SADS-E).The K-SADS-E (Kaufman, Birmaher, Brent, Rao, & Ryan, 1994) is the child

and adolescent version of the Schizophrenia and Affective Disorders Scale (Endicott &

Spitzer, 1978), a measure of major psychiatric illness. The K-SADS-E interview was

modified to be compatible with diagnostic criteria listed in the Diagnostic and Statistical

Manual of Mental Disorders(3rd ed., rev.;DSM-III-R; American Psychiatric Association,

1987), which was the latest DSM version published at the beginning of this study. The

interview assesses the following disorders: ADHD, anxiety disorders, CD, oppositionaldefiant disorder (ODD), major depressive disorder, dysthymia, eating disorders, and

substance use disorders. Prior studies have reported high interrater agreement for diagnoses

based on the K-SADS-E (Ambrosini, 2000).

Beck Depression Inventory (BDI).The BDI (Beck & Ward, 1972) is a widely used self-

report instrument designed to assess symptoms of depression, and BDI scores are internally

consistent (coefficient alpha of .86 for psychiatric patients and .81 for nonpsychiatric

patients) and correlate highly with diagnoses of depression in various samples (Subramaniam,

Harrell, Huntley, & Tracy, 2009). It has been reported to be valid for use in adolescent

samples (Krefetz, Steer, Gulab, & Beck, 2002) and appears to perform better at screeningdepressive symptoms than some other self-report measures (Atlas & DiScipio, 1992).

Harm Avoidance Scale (HAS). The HAS (Tellegen, 1982) is a self-report fearfulness

subscale from the Multidimensional Personality Questionnaire (Tellegen, 1982). It was

TABLE 1: Sample Characteristics

Measure n M SD

PCL:YV total score 80 25.18 5.88

Number of charges for any offense 79 6.23 3.39

Number of charges, violent offenses 79 1.67 1.65

Age of first charge, any offense (years) 79 13.34 1.55

Age of first charge, violent offense (years) 57 12.53 4.06

Number of institutional infractions 79 9.92 21.27

Number of violent institutional infractions 79 1.10 2.80

Note. PCL:YV =Psychopathy Checklist: Youth Version (Forth, Kosson, & Hare, 2003).

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designed to assess fearfulness, as opposed to neuroticism, and is related to a lack of risk

taking. HAS scores correlate highly with indices of fear proneness and behavioral inhibition

but are independent of trait anxiety (Watson & Clark, 1984; White & Depue, 1999). Levenson

et al. (1995) reported high internal consistency of HAS scores (alpha coefficient = .87)

among college students.

Welsh Anxiety Scale (WAS). The WAS of the Minnesota Multiphasic Personality

Inventory (Welsh, 1956) is a self-report scale that has been widely used to measure

anxiety in studies of adult psychopathy. Although originally interpreted as a measure of

trait anxiety, it is typically considered a measure of neuroticism or negative affectivity

(Watson & Clark, 1984). The measure assesses five dimensions of anxiety-related symptoms,

including poor mental efficiency, negative affect, pessimism and anhedonia, interpersonal

oversensitivity, and schizoid mentation (Welsh, 1956). Split-half reliability coefficient

of the assessment was .88 (Welsh, 1956).

Anxiety Sensitivity Index (ASI). The ASI (Reiss, Peterson, Gursky, & McNally, 1986) is

a self-report scale designed to measure the tendency to react negatively to the experience

of anxiety symptoms. ASI scores exhibit good psychometric properties (Reiss et al., 1986).

Although no prior studies have examined relationships between psychopathy and ASI

scores in youth, Hale, Goldstein, Abramowitz, Calamari, and Kosson (2004) reported that

PCL-R and ASI scores are not correlated in adults. High internal consistency and acceptable

test-retest reliability across 2-week (Reiss et al., 1986) and 3-year intervals (Maller &

Reiss, 1992) has been reported. The internal consistency of the ASI for the present sample

was high (=.86).

Intellectual functioning. The Wechsler Intelligence Scales for ChildrenThird Edition

(Wechsler, 1991) and the Wechsler Adult Intelligence ScaleRevised (WAIS-R; Wechsler,

1981) are well-established measures of intelligence used to assess cognitive functioning in

children ages 6 to 16 and ages 16 and older, respectively. The current study used only the

Vocabulary and Block Design subtests. Previous investigations have used WAIS-R subtest

standard scores to estimate intelligence in adult offenders (e.g., Weizman-Henelius,

Viemero, & Eronen, 2004).

The Peabody Picture Vocabulary TestRevised (PPVT-R).The PPVT-R (Dunn & Dunn,

1981) is a 10- to 15-min measure of receptive vocabulary skills for standard English and

screens for verbal ability in persons ages 2.5 to 40. The PPVT-R requires no reading or

writing. The PPVT-R has been used in previous investigations with adjudicated youth (e.g.,

Linz, Hooper, Hynd, Isaac, & Gibson, 1990). Although there appear to be no prior studies

of the relation between PPVT-R scores and psychopathic traits, PPVT-R scores are

correlated with measures of achievement (Naglieri & Pfeiffer, 1983; Smith, Smith, &

Dobbs, 1991).

Narcissistic Personality Inventory (NPI).The NPI (Raskin & Hall, 1981) is a widelyused self-report measure of narcissism. It has been reported to exhibit adequate reliability

and moderate correlations with other self-report and interview measures of narcissistic

personality disorder (Emmons, 1987; Raskin & Terry, 1988). It is a 40-item forced-choice

measure. Scores on the NPI are internally consistent (=.87).



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CD symptoms. Symptoms of CD, according to DSM-IVcriteria (American Psychiatric

Association, 1994), were assessed via semistructured interview as well as a comprehensive

review of each participants institutional file.

Violence proneness and criminal activity.Interviews and institutional file reviews wereused to code three aspects of violence proneness: number of charges for violent offenses,

age at first charge for a violent offense, and number of violent institutional infractions.

Consistent with prior studies, robbery, assault, murder, sexual assault, and kidnapping

were classified as violent offenses (Hare & McPherson, 1984; Kosson et al., 2002). Drug

offenses, burglary or theft, fraud, escape, arson, obstruction of justice, and miscellaneous

minor offenses were classified as nonviolent offenses. With respect to institutional

infractions, threats and assaults were considered violent; the remainder of infractions

consisted of rule violations, insubordination, theft, and lying to officials. The age at which

participants were first officially charged with any criminal act was also coded frominstitutional files.

PROCEDURES

Eligible females were invited to meet with the experimenter (DLB) to learn about the

study. Females taking psychotropic medication were not eligible to participate in the study,

given concern about the effects of medications on results of neuropsychological tasks

unrelated to the current study. Following an explanation of the protocol by the first author,

each individual was presented with the opportunity to assent to participation. Participation

was voluntary and confidential. If an adolescent agreed, consent from her parent or legal

guardian was requested by telephone, followed by request for written consent through the

mail. Oral consent was witnessed and documented in writing. These procedures were

approved by the institutional review board of Finch University of Health Sciences (now

Rosalind Franklin University of Medicine and Science). Individuals were paid a total of

$10 to $15 for their participation.

During the morning, participants completed a series of neuropsychological tests and an

emotional processing task (see Bauer, 1999, for additional details). The interview and

all questionnaires were administered during the afternoon session. Each participants

institutional file was reviewed after testing was completed to obtain collateral informationabout her criminal history and behavioral history at the institution as well as to assess the

consistency of interview and file material. Fifteen percent of interviews were observed by

the third author or one of three other graduate students trained by the third author.

Statistical procedures.To reduce the number of analyses, the sample prevalence of

each disorder assessed with the K-SADS-E was evaluated prior to conducting analyses.

Relationships between psychopathic features and presence of specific psychiatric

disorders were examined only for disorders with base rates of 10% or higher (Tabachnick

& Fidell, 2001). In addition, relationships between psychopathic features and total

number of psychiatric diagnoses were examined. Because 85% of participants metcriteria for CD, CD was excluded from analyses addressing the total number of psychiatric

illnesses.



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RESULTS

DESCRIPTIVE INFORMATION AND RELIABILITY OF PCL:YV SCORES

The mean PCL:YV total score for the sample was 25.18 (SD=5.88). Neither skewnessnor kurtosis appeared to be evident (skewness =.05; kurtosis =.88). Interrater reliability

for PCL:YV total scores was assessed for 15% of the cases by computing intraclass

correlation coefficients (ICCs) using the one-way random effects model to obtain an

average intraclass r as a measure of absolute agreement between raters. The ICC for

prorated PCL:YV total scores was .95, suggesting good interrater agreement. This value is

slightly higher than that reported in prior PCL-R and PCL:YV studies (Forth et al., 2003;

Hare, 1991). Coefficient alpha for PCL:YV scores was .82, similar to that previously

reported for the PCL-R and PCL:YV (Edens et al., 2001; Hare, 1991; Kosson, Smith, &

Newman, 1990). Corrected item-to-total correlations for each PCL:YV item also suggested

adequate internal consistency: All of these exceeded .20 except that for Item 19, which was.19. All items were retained for further analyses.

CONSTRUCT VALIDITY

To ensure that correlations with external criteria were not inflated by direct overlap

between PCL:YV scores and criterion measures, scores on PCL:YV items likely to overlap

with criterion measures were subtracted before calculating validity correlations. Following

Kosson et al. (2002), scores on PCL:YV Items 12 and 18 (early behavior problems and

serious criminal behavior) were deleted before calculating correlations between PCL:YV

scores and number of CD symptoms and age of onset of criminal and violent behavior.

Analyses of criminal activity and institutional misconduct corrected PCL:YV scores for

Items 10, 18, and 20 (poor anger control, serious criminal behavior, and criminal versatility).

Where observers were present, averages of interviewer and observer PCL:YV scores were

used in calculating correlations between PCL:YV scores and criterion variables.

Psychopathy and related constructs.As expected, PCL:YV scores correlated highly

with IM-P scores, r=.53,p


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the number of violent infractions, r=.38,p=.001, and with the total number of behavioral

infractions, r=.43,p


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the sum total), no relationship between PCL:YV scores and number of diagnoses emerged

(r=.06, ns; see Table 3).

PERSONALITY TRAITS

Total PCL:YV scores and NPI scores were correlated although not significantly, r=.21,

p=. 07 (see Table 2). No relationship between PCL:YV and HAS scores was found (see

Table 2).

INTELLIGENCE AND RECEPTIVE VOCABULARY

Psychopathic traits were unrelated to measures of intelligence. Neither the correlation

with scaled scores for the Vocabulary subtest or that for the Block Design subtest

approached significance, both rs


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institutional infractions, r=.35,p


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TABLE 4: Correlations Between PCL:YV Factor Scores and Measures of Concurrent, Convergent, and

Discriminative Validity

Variable Interpersonal Affective Lifestyle za

Measures commonly associated with psychopathic features

IM-P .51*** .37** .33**

Total number of CD symptoms .38*** .39*** .50***

Number of violent charges .21 .32**a .082 2.20

Total number of charges .22* .22* .23*

Age at first violent charges .03 .23 .14

Age at first charges .23* .30** .18

Number of violent infractions .38***a .32** .11b 2.17

Total number of infractions .39***a .36***a .08b 2.48, 2.58

ADHD .29**a .10a .52***b 2.00, 4.02

ODD .01 .06a .27*b 2.81

Alcohol dependence .15 .03a .32**b 2.641

Drug dependence .17 .02

a

.24*

b

1.99 NPI .20 .20 .12

Measures considered independent of or inversely

associated with psychopathic features

Major depression .12a .06a .33**b 3.49, 3.52

Dysthymic disorder .02 .02 .16

PTSD .14 .03 .06

Psychotic symptoms .10 .00 .20

Beck Depression Inventory .07a .00a .41***b 3.78, 3.77

Harm avoidance .12 .02 .03

Anxiety Sensitivity Index .02 .03 .17

Welsh Anxiety Scale .10a .06a .49***b 3.19, 4.03

Total psychiatr ic disordersb

.12b

.01a

.53***b

3.24, 4.80 PPVT-R .14 .34**a .05b 2.62

BDS .07 .11 .05

VOCS .06 .13 .04

Note. PCL:YV = Psychopathy Checklist: Youth Version (Forth, Kosson, & Hare, 2003); IM-P = InterpersonalMeasure of Psychopathy (Kosson, Steuerwald, Forth, & Kirkhart, 1997); CD = Conduct disorder; ADHD =attention-deficit/hyperactivity disorder; ODD = oppositional defiant disorder; NPI = Narcissistic PersonalityInventory (Raskin & Hall, 1981); PTSD =posttraumatic stress disorder; PPVT-R =Peabody Picture VocabularyTestRevised (Dunn & Dunn, 1981); BDS =Block Design scaled score; VOCS =Vocabulary scaled score (seetext for additional detail).a. Columns with different superscripts denote significant differences between the magnitude of correlations fordifferent PCL:YV factors. Z scores are significant values for the z test for dependent correlations, p


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Douglas, Poythress, & Epstein, 2004) as well as similar to that reported by Odgers et al.

(2005) for a sample of incarcerated adolescent females (M=24.7, SD=5.2, vs. current

M=25.18, SD=5.88).Consistent with prior studies using the PCL:YV,reliability statistics

indicate that it is possible for trained raters to obtain very high interrater agreement for

PCL:YV total scores in an adolescent female sample.

CONSTRUCT VALIDITY

Regarding convergent validity, PCL:YV scores correlated highly with IM-P scores,

suggesting a link between PCL:YV scores and interpersonal manifestations of psychopathy

analogous to that previously reported in adult males using the PCL-R and in adolescent

males using the PCL:YV. Although more than 80% of the current sample met diagnostic

criteria for CD, PCL:YV scores were highly correlated with number of CD symptoms,

suggesting that female youth with more psychopathic traits demonstrate more severe

conduct problems than do peers with fewer psychopathic traits. Whether psychopathic

traits moderate the persistence of antisocial behavior into adulthood among girls with CD

symptoms is an important question for future studies.

ANTISOCIAL BEHAVIOR AND VIOLENCE

Consistent with evidence suggesting that adults with psychopathic traits begin committing

crimes at earlier ages and commit more crimes than other offenders (Forth et al., 2003),

current findings indicate that among adolescent females, psychopathic traits were associated

with an earlier age of onset of criminal charges and with the total number of charges.Although the zero-order correlation between PCL:YV scores and age of onset of violent

charges was not significant (after correcting for item scores likely to overlap substantially

with measures of violent crime), the corresponding partial correlation was significant after

controlling for disruptive behavior disorder scores. This pattern of findings is largely

consistent with prior findings on adolescent males (Forth et al., 2003; Salekin, 2008).

Interestingly, though, the correlation between psychopathy and number of violent

charges was not significant (after controlling for predictor-criterion overlap) in this sample.

As this result is inconsistent with previous research, it is important to consider possible

reasons for this pattern of results. One possibility is that the significant correlation reported

in some prior studies reflects a failure to correct for predictor-criterion overlap whenexamining relations between psychopathic features and violence proneness. For example,

Penney and Moretti (2007) reported significant correlations between psychopathic features

and self-reported aggressive behavior in both males and females, but they did not correct

PCL:YV scores for overlap with aggression. However, Corrado et al. (2004) did correct for

predictor-criterion overlap and nevertheless reported significant relationships between

psychopathic traits and violent recidivism in a mixed youth sample composed of 79%

males. In contrast, Odgers et al. (2005) found that corrected PCL:YV scores predicted

concurrent but not future aggression; moreover, the relationship for concurrent aggression

was no longer significant after controlling for victimization experiences. Thus, it could beargued that the relationship between psychopathic traits and violent charges is robust in

males but not in females. Alternatively, it could be argued that the absence of a relationship

between PCL:YV scores and number of violent charges in the current sample may reflect



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a lower base rate of violent charges in this sample compared to other samples. Unfortunately,

given the variation in the operationalization of violent acts in different studies (e.g., violent

convictions from file review vs. self-reported violent charges), it is not possible to compare

the base rates of violent acts in prior investigations with those in the current sample. That

said, the base rate for violent infractions in our study was lower than the base rate for

violent charges, and violent infractions were significantly correlated with PCL:YV scores.

Psychopathic features were associated with greater numbers of violent and total

institutional infractions, suggesting that females with psychopathic features continue to

violate rules and expectations, despite the extreme structure and regulation associated with

incarceration. This finding is consistent with prior research on adults with psychopathic

features in prisons (e.g., Edens, Buffington-Volum, Colwell, Johnson, & Johnson, 2002)

and hospitals (Hildebrand, de Rutter, & Nijman, 2004) as well as with some prior findings

with adolescent males (Stafford & Cornell, 2003). This suggests the possibility that such

youth may be less responsive than other adolescent inmates to the interventions anddisciplinary methods employed in correctional settings. However, a recent report that

incarcerated adolescent males with psychopathic traits exhibited poorer behavior during

treatment but benefited from an intervention program suggests the possibility that

proneness to institutional infractions does not necessarily presage poor prognosis (Caldwell

et al., 2007). Nevertheless, it must be noted that prior findings with adolescents have been

inconsistent(Edens & Campbell, 2007), suggesting that there may be more variability to

this relationship in youth than in adult samples.

PSYCHOPATHOLOGY AND INTERNALIZING SYMPTOMS

The relatively high proportion of psychiatric disorders in our sample is consistent with

the high prevalence rates for psychiatric disorders reported previously for incarcerated

adult female samples (Abram, Teplin, McClelland, & Dulcan, 2003; Teplin, Abram, &

McClelland, 1996) as well as for incarcerated adolescents (Odgers, Burnette, Chauhan,

Moretti, & Reppucci, 2005). Considering more specific relationships, PCL:YV scores

were moderately associated with ADHD diagnosis and modestly associated with alcohol

dependency diagnosis. These findings substantiate the commonly reported finding that

psychopathic traits are correlated with externalizing psychopathology in male and mixed-

gender adolescent samples (e.g., Kaplan & Cornell, 2004; Kosson et al., 2002; Schmidt

et al., 2006). The comorbidity of psychopathic traits with psychiatric disorders, such asalcohol dependence and ADHD, may contribute to some of the problems in adjustment to

incarceration associated with psychopathic features.

Interestingly, findings with respect to internalizing psychopathology and personality

traits were less consistent with prior adult findings but consistent with several prior studies

of adolescents. Specifically, whereas adult studies suggest negative correlations between

psychopathic features and diagnoses of depressive and anxiety disorders, there were no

significant relationships between PCL:YV total scores and diagnoses for internalizing

disorders. Similarly, PCL:YV scores were not significantly correlated with BDI, ASI, or

HAS scores. However, PCL:YV scores correlated positively with WAS scores, and anonsignificant correlation with BDI scores was positive (r = .16), corroborating the

possibility reported in some other studies of adolescent males that the relation between

psychopathic traits and internalizing psychopathology may be different in adolescents



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compared to adults (Kosson et al., 2002; Schmidt et al., 2006). In contrast, a recent

investigation of adolescent male offenders with CD (Dolan & Rennie, 2007) indicated a

negative correlation between trait anxiety and affective component scores. Although the

inconsistencies in the literature in this field may reflect a lack of consistency with regard

to anxiety measures and/or heterogeneity of samples investigated, the current results

corroborate that additional research with youth samples is necessary to determine the

nature of the relationship between psychopathic traits and negative affectivity in juveniles.

Indeed, it is possible that youth characterized by a greater proportion of psychopathic traits

may experience more distress in general and during their incarceration than their adult

counterparts with more long-standing legal histories. Alternatively, given that several

studies of adults have identified subtypes among offenders described as primary psychopaths

and secondary psychopaths (Hicks, Markon, Patrick, Krueger, & Newman, 2004; Vassileva,

Kosson, Abramowitz, & Conrod, 2005), it is possible that the apparent discrepancies in

findings reflect differences across samples with regard to proportions of youth characterizedby primary psychopathy versus secondary psychopathy syndromes.

Overall, the pattern of relationships between PCL:YV scores and indices of antisocial

behavior was similar before and after controlling for disruptive behavior disorder symptoms.

Similar correlations were observed for IM-P scores, for CD symptoms, for violent and

nonviolent infractions, and for age of onset of criminal behaviors. Findings were somewhat

weaker for relationships between psychopathic traits and indices of externalizing and

internalizing psychopathology, suggesting that the comorbidity between psychopathic traits

and other externalizing disorders may account for some of the relationships between

PCL:YV scores and symptoms of substance use disorders and negative affectivity.

However, unique relationships between psychopathic features and narcissism scores and

age of first violent offense were significant, whereas the zero-order correlations with these

criteria had fallen short of significance.

SUPPLEMENTARY ANALYSES OF FACTOR SCORE CORRELATIONS

The correlations between factor scores and external criteria were also largely consistent

with prior findings on both adolescent and adult males. First, correlations between factor

and criterion scores suggest that both interpersonal and affective dimensions contribute to

the utility of the psychopathy construct. Scores on both dimensions were significant (cross-

sectional) predictors of antisocial behavior and comorbid psychopathology. Consistent with

previous research with males (e.g., Corrado et al., 2004), scores on these two dimensions

predicted scores on different violence indices. Whereas affective dimension scores were

especially associated with the number of charges for violent crimes, consistent with Penney

and Moretti (2007), only interpersonal dimension scores were associated with the number

of violent institutional infractions. Nevertheless, the pattern of correlations was moderately

similar for the affective and interpersonal components of psychopathy, as scores on both

dimensions appear to be related to antisocial behavior. Most of the differences observed in

relationships with specific forms of psychopathology were between the correlation for the

affective or interpersonal factor scores (or both) and the correlation for lifestyle dimensionscores.

For both externalizing and internalizing forms of psychopathology, correlations were

generally stronger for lifestyle dimension scores than for interpersonal and affective



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dimension scores. With respect to externalizing psychopathology, lifestyle scores were

stronger predictors of ADHD, ODD, and alcohol and other drug dependence diagnoses.

Regarding internalizing psychopathology, lifestyle scores were better predictors of major

depression diagnoses, of BDI scores, and of negative affectivity (WAS) scores. These

findings suggest that at least in this sample, lifestyle scores are generally predictive of

psychopathology.

Relevant to the current results, Rutherford, Alterman, Cacciola, and McKay (1998)

reported gender differences in relationships between factor scores and criterion variables in

adult offenders. They noted that the relationship between Factor 1 and a history of CD was

less consistent for women than for men. In contrast, in this sample, relationships between

number of CD symptoms and scores on the interpersonal and affective factors were as

strong as the relationship between CD symptoms and lifestyle scores.

COMMENT ON PREDICTIVE VALIDITY

As noted earlier, Odgers et al. (2005) reported that PCL:YV scores in a female adolescent

sample were not predictive of future violent criminal activity. Similarly, Schmidt et al.

(2006) and Vincent et al. (2008) reported that PCL:YV scores were less predictive of

violent recidivism among female than among male adolescents. Unfortunately, because

prospective data were not available in the current study, this relationship could not be tested

with this sample. However, because the current study is one of only a few investigations to

date that focus exclusively on adolescent female offenders, replication of current findings

in independent samples and extensions to examinations of predictive validity are critical.

Although several recent studies with adolescents included female youth (Andershed,Hodgins, & Tengstrom, 2007; Penney & Moretti, 2007; Salekin et al., 2004), most prior

studies included only males (Corrado et al., 2004; Kosson et al., 2002; Murrie & Cornell,

2002; Spain et al., 2004) or examined mixed samples without addressing gender differences

(e.g., Falkenbach et al., 2003).

LIMITATIONS OF THE CURRENT STUDY

One of the chief limitations of the current study is the relatively small sample size.

Although 80 participants appear ample for examining correlations, this sample is smaller

than some samples examined among male adolescents (e.g., Corrado et al., 2004; Murrie

et al., 2004). In spite of the small sample, the pattern of significant relationships was quite

similar to that previously reported in adolescent males.

A related weakness was that to avoid reducing statistical power, we did not correct for

the number of correlations calculated. As a result, it is possible that some of the relationships

noted here reflect alpha inflation. We believe it is important to seek a balance between

statistical power and conservatism. In this context, we note that had we used a more

conservative alpha level of .01, almost all the correlations reported here would have

remained statistically significant. However, the exceptionsrelationships between PCL:YV

scores and WAS scores and alcohol dependencyreflect relatively small effects andshould be viewed as tentative pending replication in other female samples. Even so, it is

noteworthy that similar correlations with alcohol use (Mailloux, Forth, & Kroner, 1997)

and with negative affectivity scores (e.g., Kosson et al., 2002; Sevecke, Kosson, Lehmkuhl,



19/24


& Krischer, 2009; cf. Schmidt et al., 2006) have been reported in prior studies of adolescent

males and females. In fact, because our sample was modest in size, it is possible that some

correlations that were not statistically significant in our sample would have been significant

had we been able to test a larger number of participants. For this reason, further examination

of these relationships appears warranted.

Another salient weakness of this study is its limited generalizability. All participants were

females incarcerated in a medium-security facility. Inclusion of a community sample

(e.g., Forth & Burke, 1998) would have allowed for comparisons between delinquents and

nonadjudicated adolescents. It is crucial that such comparisons be made as well as that

larger, more diverse samples are studied. Moreover, adolescents receiving psychotropic

medications were excluded from analyses. Frequently, youth with frequent irritable mood

states and violent and aggressive tendencies receive medication in the community and in

correctional settings. Excluding youth receiving medication could result in a skewed sample

with fewer of the violent juvenile offenders who may exhibit psychopathic traits in additionto aggressive behaviors and other mental health problems. To assess the generalizability of

these results, future research should examine the construct of psychopathy in samples that

include more mentally ill adolescent offenders.

CONCLUSIONS

Overall, the results of the current study suggest that the construct of psychopathy is

meaningful in the current sample of adolescent female offenders. It is significant that many

of the findings regarding both reliability and construct validity of PCL:YV scores parallel

findings in studies of adult psychopathy and adolescent male offenders. Consistent with

data on adolescent and adult males (Epstein et al., 2002; Hare, 2003; Kosson et al., 1990;

Schmidt et al., 2006), psychopathic traits in the current adolescent female sample were

associated with a pervasive pattern of criminal behavior, interpersonal anomalies associated

with psychopathy, and externalizing psychiatric disorders. Although psychopathic features

were not linked to symptoms of certain psychiatric disorders, such as depression, in the

current sample, psychopathic features were associated with anxiety features, ADHD, CD,

and having more than one psychiatric disorder (after excluding CD). In sum,these data

suggest that the PCL:YV is useful in evaluating adolescent female offenders. Just as malepsychopathic offenders have demonstrated a more pervasive pattern of persistent and

violent criminal behaviors, female participants in the current study demonstrated a similar

pattern of early-onset criminal behaviors and more persistent difficulties adjusting to the

demands of incarceration. From a clinical perspective, these data are relevant in suggesting

that treatment programs informed by psychopathic traits among inmates may well be as

useful for young girls as they are for young boys. The links to early antisocial behavior and

externalizing disorders suggest the possibility that interventions with these youth should

begin at an early age and should target conduct and interpersonal problems. At the same

time, given the concerns that have been raised about the pejorative nature of the label

psychopathy, we believe caution is warranted in generalizing from the results of this studyuntil these findings are replicated in independent samples.

However, additional analyses of the factor structure underlying PCL:YV scores in larger

samples appear warranted (cf. Kosson et al., 2011). In addition, where current findings



20/24


appear inconsistent with those of prior studies (e.g., the absence of correlations between

PCL:YV scores and violent offenses), analyses in independent samples are necessary to

examine the robustness of the findings reported here.

NOTES

1. Several studies have also been conducted in which adolescents were rated on the Psychopathy ChecklistRevised

(PCL-R) or slight modifications of the PCL-R. However, to avoid confusion, we have restricted our literature review to

studies employing measures designed for use with adolescents. Nevertheless, findings from studies with the modified PCL-R

appear consistent with the suggestion that psychopathic features can be assessed in adolescents (e.g., Forth, Hart, & Hare,

1990; Roussy & Toupin, 2000).

2. Self-report measures of psychopathic traits have also yielded findings similar to those for the Psychopathy Checklist:

Youth Version (PCL:YV) in several studies; however, some studies have reported discrepancies between the correlates of

PCL:YV ratings versus scores on self-report measures (Lee, Vincent, Hart, & Corrado, 2003; Spain, Douglas, Poythress, &

Epstein, 2004; Vitacco, Rogers, & Neumann, 2003). It is noteworthy that PCL:YV total and factor scores correlate

significantly with scores on self-report measure, but analogous factor score correlations are generally not very high (e.g.,

Cauffman, Kimonis, Demetrieva, & Monahan, 2009; Spain et al., 2004).

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Daliah Bauer,PhD, is the director of forensic services at Jefferson Parish Human Services Authority in Louisiana. She is

also an adjunct faculty member at the University of New Orleans and Tulane University. Her work focuses on personality

development in adolescence and application of evidence based treatments in community settings.

Lindsay Allen Whitman, PhD, is a neuropsychology postdoctoral fellow at the Comprehensive Epilepsy Center at New York

University. She conducts comprehensive neuropsychological evaluations with children and adults with a variety of neurological

and psychiatric disorders. Her graduate research focused on the cognitive correlates of psychopathy in adolescents.

David S. Kosson, PhD, is a professor of psychology at Rosalind Franklin University of Medicine and Science. He studies

psychopathy and other personality disorders with primary foci on cognitive, affective, physiological, and developmental

mechanisms underlying psychopathy.

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