The Psychopathy Checklist: Youth Version (PCL:YV) is an assessment that measures psychopathic traits and behaviors in youth aged 12–18 years. The construct of psychopathy has been studied in adults with structured assessment measures developed by Robert Hare since the 1970s using the Psychopathy Checklist (PCL), which later became the PCL–Revised (PCL-R), a measure of psychopathy widely used in research, clinical, and forensic settings. The PCL:YV was adapted from the PCL-R and published in 2003. It has the shared goal among researchers and clinicians of identifying psychopathic traits and their consequences in youth, with the potential to shed light on the developmental precursors of adult psychopathy. Furthermore, it provides a means to discover the persistence of these traits from adolescence to adulthood and to assess the effectiveness of early intervention. Adult psychopathy is related to many negative social and individual outcomes, including violent reoffending, instrumental aggression, substance abuse, and treatment dropout. The PCL:YV was constructed to learn the developmental history of psychopathy and its early manifestation with the goal of ameliorating these negative outcomes. This article describes the structure and administration of the PCL:YV, special considerations when assessing adolescents, its psychometric properties, and its application for understanding the construct of psychopathy in youth.
Structure and Administration
The PCL:YV is a 20-item rating scale completed on the basis of a semi-structured interview and a collateral file review. The rater scores each item on a 3-point scale from 0 to 2, where 2 is definitely present, 1 is somewhat present, and 0 is not present, resulting in a total score ranging from 0 to 40, with higher scores representing more psychopathic traits and behaviors. The file review is typically conducted first to gather and organize information and to help prepare questions for the interview. A rater who typically has an advanced professional or university degree (e.g., MD, MA, PhD) conducts the interview with the youth, which takes approximately 120 minutes. The interview probes different aspects of the youth’s life, including the youth’s history and current functioning, school, work, family background, relationships, substance use, attitudes, emotions, and antisocial behaviors. As a semi-structured interview, its trajectory may change depending on the flow of conversation, cooperation, and types of information shared by the youth. Although not preferable, when an interview is not possible (e.g., youth or parents withhold consent), a PCL:YV assessment can still be conducted with just a file review. File review-only assessments, however, should contain multiple sources of information from varied contexts, should be noted in the assessment report, and its results interpreted cautiously.
The PCL:YV manual provides a detailed description of each item for assessors to minimize rater differences when scoring. In addition to detailed descriptions of each item, the manual provides information on where to find the source of information. These are details and illustrations that give the assessor an indication of what information during the interview and/or file review is relevant and helpful for scoring each item.
PCL:YV items can be grouped according to factor analysis into four clusters of traits and behaviors. Four items comprise an interpersonal traits factor, which include items such as manipulation and impression management. Four items make up an affective traits factor, including items such as lack of remorse or guilt and callousness/lack of empathy. Five items form the behavioral traits factor, including irresponsibility and impulsivity, among others. Five items also comprise an antisocial traits factor, with items such as criminal versatility and poor anger control. The two additional items are stand-alone items that do not load onto one of the four factors. Item scores are summed to produce a PCL:YV total score, with higher scores indicating more psychopathic traits and behaviors.
Considerations for Measuring Psychopathy in Youth
Any measurement of young individuals needs to take into consideration that youth are developmentally unique compared to adults. The PCL:YV incorporated the following age-related considerations into its development.
Nonnormative Behavior
Assessing with the PCL:YV requires a consideration that the degree of normal or average behavior in adolescence is different from that in adults. For instance, risk-taking behavior is more common in youth compared to adults. Therefore, scores on the PCL:YV items must reflect levels of traits and behaviors that are nonnormative for youth.
Age-Appropriate Items
Items should be considered in light of the different expectations, responsibilities, and developmental stages of youth compared to adults. For example, most youth in modern society are not expected to have an extensive work history or have dependents, and they typically have different psychological and emotional concerns compared to adults. Based on this criterion, assessors are expected to be familiar with what is normal adolescent development.
Stable Characteristics
When assessing youth with the PCL:YV, it is essential to consider a range of ages from childhood to the time of the assessment when scoring items. This will prevent the undue influence of any transitory problems in a youth’s life on the youth’s score. For example, an adolescent whose parents have recently divorced may be acting more antisocially since the divorce. It is also important to consider many contexts (e.g., school, home, community) over the youth’s lifetime when assessing stability of a characteristic.
Multiple Sources
The file review must contain multiple sources of information about the youth to avoid undue influence of one or a few perspectives that may have limited social interaction with the youth. Having many sources allows for a comparison between observers of the youth and the youth’s perspective during the interview. Sources may include parent and teacher reports, mental health records, and criminal and court records.
Labeling
As an offender in the criminal justice system, the label psychopath can have negative consequences on severity of sentencing, probability of parole, and access to institutional programming and treatment. Therefore, the PCL:YV developers stress that anyone using the PCL:YV must not interpret any score as evidence that the youth is a psychopath. Furthermore, they stress that the PCL:YV should not be the sole assessment used in clinical and forensic decision-making.
Psychometric Properties
Overall, the PCL:YV demonstrates strong psychometric properties. The interrater reliability of PCL:YV Total scores is high within research settings (single-rater intraclass correlation coefficients of .90–.96). However, it is not clear if the same interrater reliability is evident within real-world contexts. The internal consistency of PCL:YV Total scores is also high, with α coefficients ranging from .85 to .94. The factor scores have more variable reliabilities, with interrater reliability ranging from acceptable to excellent (.70–.90) and internal consistency ranging from questionable to excellent (.22–.86).
Research has been conducted with institutionalized young offenders, young offenders on probation, psychiatric inpatient youth, and youth in the community. PCL:YV Total scores do not appear to be unduly influenced by youths’ age, gender, or ethnicity. The PCL:YV is standardized on these samples, with 2,438 youth from Canada, the United States, and the United Kingdom. After a PCL:YV assessment, the youth’s score (Total and/ or Factor) is compared to percentile and T-score tables, which compare the relative level of psychopathic traits of that individual to other youth in similar circumstances (institutionalized, probation, or community) and of the same gender. For example, youth scoring in the 90th percentile will have 90% of youth from the same circumstance and gender score less than them on the PCL:YV. This indicates a high level of psychopathic traits for that youth.
Applications and Uses
The PCL:YV is used in various research, clinical, and forensic settings to help determine the presence of psychopathic traits in youth, including the differences and similarities between youth and adult psychopathy and between youth with high compared to low psychopathic traits. Much of this research has confirmed the validity and utility of the PCL:YV as a measure that is similar to psychopathy in adults as assessed with the PCL-R.
The PCL:YV has been used to determine whether higher psychopathic traits exist more in adolescents who have experienced adverse childhood environments. Higher PCL:YV scores have been associated with separation from mothers or fathers at earlier ages, maternal criminality and number of nonviolent offenses, and lack of parental supervision. There has been no established relationship, however, between PCL:YV and parental substance abuse or whether the youth was adopted. Some researchers have found no relationship between higher PCL:YV scores and parental abuse generally, but others have reported a relationship between higher PCL:YV scores and physical abuse from the father specifically.
Another important use of the PCL:YV is to better understand developmental differences in social, neurocognitive, and intelligence traits of youth who are high compared to low in psychopathy. Higher PCL:YV scores are associated with a diminished empathic response and moral reasoning capabilities on neurocognitive tests. Higher scores are also associated with making more errors on a go/no-go task that is mediated by the orbitofrontal/ventromedial areas of the brain but not with errors on tasks mediated by the frontal/ dorsolateral areas of the brain. In addition, some evidence has shown that the volume of some brain areas is identifiably different based on PCL:YV Factor scores. Intelligence appears to manifest differently in youth scoring higher on the first factor of the PCL:YV (interpersonal traits) compared to youth with lower scores. Youth with higher PCL:YV interpersonal traits may have higher verbal IQ and show more creativity, practicality, and analytic thinking based on standardized measures. PCL:YV Total scores have been positively associated with performance IQ in some studies, but others have shown that youth scoring high on the PCL:YV have comparable IQ scores to those scoring low. Researchers and clinicians often consider these strengths and weaknesses when formulating intervention programs to promote effective change.
The PCL:YV is related to antisocial behavior in youth. There is a higher preponderance for violent antisocial behavior in both institutions and the community for youth with high PCL:YV scores. Youth in correctional institutions with high PCL:YV scores have more infractions and show more physical violence compared to those with lower scores. Other antisocial indications that distinguish high PCL:YV youth from low PCL:YV youth are a greater presence of instrumental motives for violence (using aggression toward others to get something) and victim injury (the severity and type of injury the victim sustained). Along with preponderance for antisocial behavior, those with higher PCL:YV scores also have an earlier onset of criminal activity, higher frequency of criminal activity, and more versatility in the types of crimes they engage in, even after removing the items within the PCL:YV, which are used to score criminal behavior. These patterns have also been found in some ethnic minorities assessed with the PCL:YV.
There is a well-established positive relationship between PCL:YV scores and violent reoffending, but this relationship has largely been found only with boys. A mean 10-year follow-up study into young adulthood of young offenders assessed with the PCL:YV found that it was a strong predictor of violent, nonviolent, and sexual reoffending, with approximately half the youth later receiving an adult conviction. The relationship between the PCL:YV and sexual reoffending, however, is not well established. Although youth with elevated PCL:YV scores are more likely to reoffend, some researchers have demonstrated that an intensive treatment program for such youth has been successful at reducing violent reoffending rates compared to conventional detainment.
The PCL:YV has extensive research that has investigated psychopathic traits in youth and found that many similarities exist with research from the adult psychopathy literature. This supports the use of the PCL:YV as a valid measure of a similar construct of psychopathy as measured by the PCL-R for adults. There has not been, however, longitudinal studies investigating the concordance between PCL:YV scores and PCL-R scores in the same individual. Furthermore, despite there being a relationship, not all youth scoring high on the PCL:YV go on to have criminal involvement. There may, therefore, be mediating factors that contribute to the traits assessed with the PCL:YV and its association with future criminal behavior. Discovering these mediating factors is the goal of researchers and clinicians to assist with identifying potential variables that might be considered when implementing more effective interventions for youth with high psychopathic traits.
References:
- Caldwell, M., Skeem, J., Salekin, R., & van Rybroek, (2006). Treatment response of adolescent offenders with psychopathy features: A 2-year follow-up. Criminal Justice and Behavior, 33, 571–596. Retrieved from https://doi.org/10.1177/0093854806288176
- Forth, A. E., Bergstrøm, H., & Clark, H. J. (2016). Psychopathic traits in adolescence: Assessment and implications. In C. B. Gacono (Ed.), The clinical and forensic assessment of psychopathy: A practitioner’s guide (2nd ed., pp. 115–136). New York, NY: Routledge.
- Forth, A. E., Kosson, D. S., & Hare, R. D. (2003). The Hare Psychopathy Checklist: Youth Version. Toronto, Canada: Multi-Health Systems.
- Neumann, C. S., Kosson, D. S., Forth, A. E., & Hare, R. D. (2006). Factor structure of the Hare Psychopathy Checklist: Youth Version (PCL:YV) in incarcerated adolescents. Psychological Assessment, 18, 142–154.
- Schmidt, F., Campbell, M. A., & Houlding, C. (2011). Comparative analyses of the YLS/CMI, SAVRY, and PCL:YV in adolescent offenders: A 10-year follow-up into adulthood. Youth Violence and Juvenile Justice, 9, 23–42.