Never thought you would see the day, did you? Well, it occurred to me after a long back and forth over on Quora that there are aspects of Hare’s work that deserves defending… much to my chargrin.
Now, let me be clear, my arguments about the PCL-R and Hare’s overall demeanor that I covered in the previous segments (linked below for those that haven’t read them but are interested) still stand. I have not changed my mind about that at all. However, Hare has standards that apparently are not only not being adhered to as I covered in that series, but they are being so blatantly ignored, that it annoys me.
Hare has stipulations on who the PCL-R is meant to be used on. It is meant for people in a forensic hospital setting and in prisons. What this individual informed me of in this exchange is that they have used it on children when studying conduct disorder. They are also using it in settings that are neither of the appropriate ones listed above.
You’ve read my take on Hare, and it isn’t a very flattering one. However, I do think that if he is going to be considered the most knowledgeable researcher in psychopathy (of course a contention that I disagree with totally), then at the very least, use his tools correctly.
The PCL-R has a litany of problems when it is used exactly correctly. It is overreaching, overinclusive of criminal traits, is equally applied to antisocial personality disorder as well as psychopathy, and it only becomes massive more unreliable and problematic when the basic rules can’t be followed.
In this exchange, the individual was assessed on three separate occasions with the PCL-R but had never been in a prison, or in a forensic hospital. They were none too happy with my disagreement with this assessment being valid. They were also displeased that I pointed out that brain scans, which he had at a pay-to-play clinic, were not in any way considered diagnostic of psychopathy.
Let me be very clear. I am not challenging their diagnosis. That isn’t my place, I don’t have the expertise to do so, and frankly, in speaking with them, it may well be fairly accurate. The claim was that they were assessed three separate times in various outpatient facilities, with the PCL-R, and confirmed with a brain scan at one of these clinics that you are basically paying them to tell you what they see, not people that are qualified to assess what psychopathy appears like on a brain scan.
However, in discussions, it seems that they are quite similar to me, albeit seemingly more emotional than I would expect as they got offended quite quickly when I pointed these things out. What the exchange gave me was a clear picture of the landscape out there currently.
We are talking about ground-up research here. They are attempting to investigate “psychopathy”, or ASPD in children, which is what the PCL-R is supposed to be used for. There is a tool, a checklist, that is meant to be used in these situations. Hare made it a point to create one, and while I vehemently disagree with the notion that you can assess children for such things, the checklist still exists.
The PCL: YV, or psychopathy checklist-youth version, is a checklist devised by Hare to be used in these situations. It is far shorter than the PCL-R and is tooled for these circumstances. Let’s take a look at the PCL: YV’s traits.
1 Glibness/superficial charm*
A lot of teenagers have this. Some are awkward, some are obnoxiously confident.
2 Grandiose sense of self-worth*
One word. Entitlement. You own them everything because you decided to have them.
3 Need for stimulation*
Underdeveloped frontal lobes, emotional reasoning center, and executive suite account for this, and pretty much all teenagers are very prone to boredom.
4 Pathological lying*
Kids lie. Teenagers are not an exception to this, and in fact, they are far more likely because they’re trying to separate themselves from their parent’s control.
All humans are manipulative. Teenagers may seem to be more so because of that underdeveloped brain thing.
6 Lack of remorse or guilt*
Back to the brain thing. It’s not developed, and the areas that are not developed are those responsible for remorse and guilt.
7 Shallow affect*
Sigh… getting tired of mentioning it, and I am guessing you are tired of reading it, but the brain… it’s underdeveloped.
8 Callous/lack of empathy*
Just see 3, 5, 6 & 7
9 Parasitic lifestyle*
All teenagers are parasites. Not to be mean… but they usually don’t have jobs, they eat all your food, and leave all the lights on. When you have a kid, they have to be parasitic, but that’s what you signed up for when you had them.
10 Poor anger control*
Please see 3, 5, 6, 7, & 8
11 Impersonal sexual behavior
Welcome to the world of all you can watch porn on your smartphone.
12 Early behavior problems
All right, maybe. However, lots of kids have early behavioral problems due to a slew of reasons. So, not particularly indicative of psychopathy.
13 Lacks goals*
Really? Most kids right now, according to a poll, want to be YouTube stars when they grow up. Does that seem to be very realistic or grounded in the goal department?
Please see 3, 5, 6, 7, 8, & 10
Please see 3, 5, 6, 7, 8, 10, & 14
16 Failure to accept responsibility*
Please see 3, 5, 6, 7, 8, 10, 14, & 15
17 Unstable interpersonal relationships*
Please see 3, 5, 6, 7, 8, 10, 14, 15 & 16
18 Juvenile delinquency
This tends to have a lot to do with environment, not necessarily wiring. Granted, I was in this category, and I had a great environment, but it does tend to be more on the antisocial scale because it is going to be more commonly affected by environment.
19 Serious violations of conditional release
Again, environment. Again, usually, not always, but more to do with environment.
20 Criminal versatility
This one has a lot to do with environment. What a kid is exposed to is what they pick up.
PCL: YV 20 items Total
PCL: YV 13 items Total
These are pretty hard to find, and my guess as to why is because they don’t want a bunch of kids self-assessing on the internet. However, you can see two things with this list.
It differs quite a bit from the PCL-R and with good reason as a lot of the things on the PCL-R would never apply to kids, and…
That if you think about a lot of teenagers, this pretty well successfully described them, which is why it is never a good idea to try and assess psychopathy in children or teenagers. The asterisks that I placed next to certain traits have to do with ones that seem to correlate with being a pretty typical teenager in my estimation.
Maybe it was just the kids I was around when I was younger, but nearly all of them had a good number of these traits.
Something else to know about this particular checklist. You see on the bottom where it says PCL: YV 20 items total, and PCL: YV 13 items total? That is because they have found that the best way to use the PCL: YV is with only thirteen of the twenty items. The rest were found to not be particularly indicative of anything.
There is a reason that Hare has his standards for the use of the PCL-R, and there are some that Hare may not acknowledge, but certainly have merit when it comes to the use of the PCL-R in inappropriate places.
Psychopathy is not a label to give to kids. It should never be considered when dealing with kids. It should be reserved for those that have passed the age that they have that fully developed brain, and they can be accurately assessed. I don’t think that assessment should include the PCL-R as a large part of it.
During this discussion, it was made clear that in a number of outpatient facilities where they are treating kids, they are using the PCL-R as a diagnostic tool, and labeling kids as “psychopathic”. This is not the intention of these tools. They are not meant to be used in this way, and I can’t help but think that there is a tremendous amount of damage being done by violating Hare’s standards.
Can you imagine being fifteen and determined to be a psychopath? Your life is over. You are never going to get a fair shot, if you are in jail, you aren’t getting out, and if you do something over the age of eighteen, you are likely getting life simply because you carry that label.
In adults, the PCL-R is not a great tool. I have gone over this in detail, but we aren’t talking about adults. We are talking about kids that have brains that cannot comprehend a good amount of the consequences for the decisions that they make.
There are ample examples of teenagers doing horrific things, and when they reach the age of 23-25, their empathy and remorse kick in, and they can understand what they have done. It’s devastating for them. There was a girl that hired her boyfriend to murder her entire family so she could go live with him. Why murder them and not just run away? Because she was mad that her parents told her to break up with them. Her name was Erin Caffey, and she was sixteen years old at the time of the murders.
The night of the murders, Erin, her boyfriend Charlie Wilkinson, his friend Charles Waid, and Waid’s girlfriend met outside the house. Erin and Waid’s girlfriend waited outside, while Wilkinson and Waid were supposed to break in, steal a jewelry box, murder her siblings and parents, and then burn the house down.
Her father, Terry Caffey, survived this attack. He was shot multiple times, as he was considered the primary threat to the two boys who were attacking them. Unable to move or speak he watched his wife Penny be shot twice. Wilkinson’s gun jammed, so Waid pulled out a sword and decapitated her right next to her gravely injured, but still conscious husband.
They then went to the younger siblings’ room where Erin’s brothers recognized Wilkinson and begged him not to kill them. One of her brothers was shot, the other, the two intruders took turns using the sword. Wilkinson and Waid then set the house on fire. Terry managed to crawl from the house, to the neighbors, and the police were called. He was rushed to the hospital and into surgery. He was very fortunate to not have lost his life.
Why did I tell you this story? Well, for a couple of reasons. One is because none of these people were psychopaths. It isn’t pleasant to understand this, but most crimes like this committed by teenagers, are committed by fully neurotypical teenagers hampered by an underdeveloped brain. In the article that I gathered most of the information about this case, this passage appeared at the bottom:
After learning about Erin Caffey, read about another teen murderer, Zachary Davis, who bludgeoned his mother to death and tried to set his brother on fire. Then, read about the heinous murder of a nine-year-old at the hands of her 15-year-old neighbor, Alyssa Bustamante.
There are so many examples of this, and I could list them for another twenty pages without scratching the surface. They aren’t psychopaths just because they did something terrible. However, due to the shoddy work in research, it is almost guaranteed that they would be the first contenders for a “psychopathy in teenagers” study.
Now they are using the PCL-R on kids in outpatient settings? I may not like the man, but that is an egregious abuse of Hare’s work.
Back to the person that gave me this information. A great deal of his gripe with me was my insistence that psychopaths do not feel guilt, anxiety, or empathy. We went back and forth for a time, and I disagree with his contentions, but I can see how he might arrive at his conclusions based on the dreadful way that these studies on kids are being done.
It is almost as though they are dismissing that teenagers are not in possession of a fully functional brain. Years ago I used to be of the mindset that teenagers, when they do something like Erin Caffey, or any of the others that committed heinous acts, that they should be in prison for life.
I have since revised my stance on this. After learning about the development stages of the brain, I really had no choice in the matter. They do not have the ability to understand the acts in which they participated, or planned. That is my position as a layman, but the people running these studies, these are the people that should know better. Understanding human development should not be on the back burner if you are constructing studies and labeling kids.
If you are going to build studies on the PCL-R it is my belief that at the very least you have to use it properly. If you don’t, then the study is garbage and should be immediately dismissed. I am not the one that elevated Hare to the position of authority that he currently sits in. The people that do the research did that, and as such, it should be well within their ethical boundaries to use his tools correctly. Clearly, this is not the case, and that is a problem.
This doesn’t even touch on the fact that pay-for-play brain scans are not diagnostic, nor can they be used to support a clinical diagnosis, because the people working in these clinics are not educated in the brain formation of psychopathy. That still exists solely in the research realm, and if they are selling a diagnosis of ASPD, my guess is that it is to make money. I happen to know of the clinic that they went to, and they do not have a good reputation due to the fact that their techniques are not grounded in research. They also do not use fMRIs, they use a different scan entirely that is not used in research surrounding psychopathy.
It seems that psychopathy is getting a bit fashionable to be able to claim, and there will always be a market for this to occur. So long as clinicians are willing to use tools outside of their realm of application, there will be more of these conversations. As I said, I am not questioning their diagnosis, but I am definitely criticizing the methodology. There is no excuse for acting so far outside the boundaries of reason.
I dislike defending Hare, or his work, but will do so when I see it being abused.
What makes Erin Caffey different from the many other teenagers whose parents made them break up with their sweethearts and didn't murder their whole families?
I think most kids shouldn’t be diagnosed with MANY things, as they are literally forming into adults, and m erroneous or perhaps simply early correct diagnoses can alter how that person forms into an adult. For most kids, diagnoses like these don’t help, but hurt. If something is going to ruin a kid - save it until it won’t. Labels, when you’re an adult, are so hard - imagine what damage they can do to a kid.
(To be clear, I’m not talking about “medical” diagnoses, for the most part, and even then, many things can change as a child grows, and labels taken to heart can become self-fulfilling prophecies.)