FAQ: What about psychopathy?
Probably the most Frequently Asked Question about HCR-20 V3 is whether users must still consider psychopathy and, if so, whether they must use the PCL-R or PCL:SV. The short answer is that symptoms (traits) of psychopathy should be considered, as should symptoms of other personality disorders, but that users are no longer required to administer the PCL-R or PCL:SV. In Version 2, symptoms of psychopathy were considered when coding H7, and symptoms of other personality disorder were considered when coding H9. In Version 3, all personality disorder symptoms are considered when coding H7, now titled “History of Problems with Personality Disorder.” Users may also make sub-item ratings to distinguish H7 (a), “Antisocial, Psychopathic, and Dissocial” personality disorder symptoms from H7 (b), “Other” personality disorder symptoms. The criteria for coding H7 encourage the use of diagnostic procedures with established validity, including but not limited to the PCL-R and PCL:SV.
These changes in V3 are intended to encourage best practice, but also maximize clinical utility. The scientific literature continues to highlight the potential importance of personality disorder symptoms generally, and psychopathic personality disorder symptoms more specifically, as risk factors for violence. But not all HCR-20 users are trained to administer the PCL-R or PCL:SV. In addition, the PCL-R and PCL:SV may not be validated or appropriate for use with specific sub-groups of patients, and users may deem it more appropriate to use other diagnostic criteria, such as those in the DSM or ICD.
Stay tuned for more FAQs and answers.