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This study compares Psychopathy Checklist-Revised (PCL-R) scores, DSM-III-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.
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PMID:A clinical investigation of malingering and psychopathy in hospitalized insanity acquittees. 884 29

Homicidal sex offenders represent an understudied population in the forensic literature. Forty-eight homicidal sex offenders assessed between 1982 and 1992 were studied in relation to a comparison group of incest offenders. Historical features, commonly used psychological inventories, criminal histories, phallometric assessments, and DSM diagnoses were collected on each group. The homicidal sex offenders, compared with the incest offenders, self-reported that they had more frequently been removed from their homes during childhood and had more violence and forensic psychiatric contact in their histories. On the self-report psychological inventories, the homicidal sex offenders portrayed themselves as functioning significantly better in the areas of sexuality (Derogatis Sexual Functioning Inventory) and aggression/hostility (Buss-Durkee Hostility Inventory). However, on the Psychopathy Checklist-Revised (PCL-R), researchers rated the homiciders significantly more psychopathic than the incest offenders on Factor 1 (personality traits) and Factor 2 (antisocial history). Police records revealed the homicidal subjects also had been charged or convicted of more violent and nonviolent nonsexual offenses. The phallometric assessments indicated that the homicidal sex offenders demonstrated higher levels of response to pedophilic stimuli and were significantly more aroused to stimuli depicting assaultive acts to children, relative to the incest offenders. Despite the homiciders' self-reports of fairly good psychological functioning, DSM-III diagnoses reliably discriminated between the groups. A large number of homicidal sex offenders were diagnosed as suffering from psychosis, antisocial personality disorder, paraphilias, sexual sadism, sexual sadism with pedophilia, and substance abuse. Seventy-five percent of the homicidal sex offenders had three or more diagnoses compared with six percent of the incest offenders. The article addresses the role of "hard" versus "soft" measures in the assessment and treatment of violent sex offenders. In addition, the usefulness of phallometric assessments and the PCL-R and its subscales are considered.
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PMID:Homicidal sex offenders: psychological, phallometric, and diagnostic features. 989 11

The case of Aileen Wuornos, executed in Florida for the serial killing of seven men, is studied to determine her degree of psychopathy and the presence or absence of sexuality or sexual sadism as a motivation or gratification for her crimes. The authors, one of whom evaluated the subject shortly before her death, determined that she evidenced a psychopathic personality (PCL-R score 32). She also met DSM-IV-TR criteria for Antisocial Personality Disorder and Borderline Personality Disorder. While her killings ostensibly were carried out during routine acts of prostitution, there was ambiguous evidence that her crimes were sexually motivated or gratifying. Her articulated motivation was robbery and elimination of the witness/victim. After carefully considering all available data, the authors concluded there was no convincing evidence of sexual sadism in either her personal history or her method of committing serial murder, and it remains unclear whether sexual gratification was to some degree a motivating factor in her commission of these offenses. The confluence of early childhood attachment disruptions, severe psychopathy, other personality disorder pathology, and a traumagenic abuse history likely contributed to her having serially murdered seven victims.
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PMID:The role of psychopathy and sexuality in a female serial killer. 1593 2

The aims of this study were to compare the prevalence of psychiatric disorders and "psychopathy" in homicidal and nonhomicidal sexual offenders and to investigate the specificity of previous studies on psychiatric morbidity of a sample of sexual murderers. Information from court reports of 166 homicidal and 56 nonhomicidal sex offenders was evaluated using standardized instruments (SCID-II, PCL-R) and classification systems (DSM-IV). Sexual murderers were diagnosed more often with a personality disorder (80.1% vs. 50%; p < 0.001), especially schizoid personality disorder (16.3% vs. 5.4%; p < 0.05), as well as with sexual sadism (36.7% vs. 8.9%; p < 0.001) and sexual dysfunctions (21.7% vs. 7.1%; p < 0.05). Additionally, they had more often used alcohol during the offense (63.2% vs. 41%; p < 0.05). The results indicate that sexual murderers have more and a greater variety of psychiatric disorders when compared to nonhomicidal sex offenders.
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PMID:Sociodemographic and diagnostic characteristics of homicidal and nonhomicidal sexual offenders. 2198 47

Sexual sadism and psychopathy have been theoretically, clinically, and empirically linked to violence. Although both constructs are linked to predatory violence, few studies have sought to explore the covariation of the two constructs, and even fewer have sought to conceptualize the similarities of violence prediction in each. The current study considered all four Psychopathy Checklist-Revised (PCL-R) facets and employed well-defined, validated measures of sadism to elucidate the relation between sadism and psychopathy, as well as to determine the role of each in the prediction of non-sexual violence and sexual crime behaviors. Study 1 assessed 314 adult, male sex offenders using archival ratings, as well as the self-report Multidimensional Inventory of Development, Sex, and Aggression (the MIDSA). Study 2 used archival ratings to assess 599 adult, male sex offenders. Exploratory and confirmatory factor analyses of crime scene descriptions yielded four sexual crime behavior factors: Violence, Physical Control, Sexual Behavior, and Paraphilic. Sadism and psychopathy covaried, but were not coextensive; sadism correlated with Total PCL-R, Facet 1, and Facet 4 scores. The constructs predicted all non-sexual violence measures, but predicted different sexual crime behavior factors. The PCL-R facets collectively predicted the Violence and Paraphilic factors, whereas sadism only predicted the Violence factor.
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PMID:Relating sexual sadism and psychopathy to one another, non-sexual violence, and sexual crime behaviors. 2401 44

Sexual sadism and psychopathy are often considered synonymous with sexual homicide, but there is limited research on their associates in sexual homicide offenders. Associates of dimensional measures of sexual sadism (Sexual Sadism Scale; SeSaS) and psychopathy (Psychopathy Check List-Revised [PCL-R] total, Factor 1, and Factor 2) were examined in 51 male Scottish cases. Over a third were DSM-IV (Diagnostic and Statistical Manual of Mental Disorders-IV) sexual sadists, just under a third screened in with the SeSaS, and a quarter were "Hare psychopaths." Sexual sadism and PCL-R measures were moderately associated. Sexual sadism predicted control, sexual deviance, and unusual behaviour at crime scenes; attempted homicide and having a co-accused; and multiple sexual homicides and previous sexual offending. PCL-R Factor 1 predicted violent, exploitative, and evading detection behaviours at crime scenes; completed homicide; and previous violent offending. PCL-R Factor 2 predicted impulsive behaviours at crime scenes, substance misuse, and previous general offending. Psychopathy and sexual sadism play key roles in sexual homicide, interact with each other, and determine different aspects of offences and offenders.
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PMID:Sexual Sadism and Psychopathy in Sexual Homicide Offenders: An Exploration of Their Associates in a Clinical Sample. 3089 82