Assessment of PCL-R

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In most cases, psychiatric patients exhibit insufficiently motivated activities. They may represent an inability to feel remorse or guilt, as well as a lack of emotional connection with people. As a result, their actions may have an emotional, psychological, and even bodily impact on others with whom they interact.

The PCL-R is a reliable assessment of psychopathy for academics and clinicians. The PCL-R is based on an interview with 20 Cleckley criteria times that are evaluated as 0, 1, and 2. O signifies "not present," 1 represents "may be present," and 2 represents "certainly present." The psychopathic individuals have been categorized as having a cut score of 30. PCL-R is composed of two main factors that are highly correlated.

The first factor assesses the disregard of the psychiatric patient to the rights and feelings of others (Hare et al., 2000). This factor integrates other items such as lack of remorse, empathy, guilt and even callousness. The second factor assesses the presence of persistent antisocial behavior such as criminal versatility and juvenile delinquency.

Validity and reliability of PCL-R

The validity of this method is based on the increased knowledge on the psychiatric characteristics of the individuals. For this reason, the knowledge may play a role in clarifying the process that underlay various disorders. Another factor that may explain the validity of PCL-R is the fact that the PCL-R scores are considerably related. To determine validity the correlation between the two factors in addition to different scales of the method (Hare et al., 2000).

Strength of PCL-R

The method facilitated the assessment of psychopathy as per the guidelines by Hare (1991). Additionally, the assessment of the patient was founded on the results of the interview carried out on the patient with a semi-structured method as designed by Hare. In most cases, the interviews are videotaped and the patient has to give their written consent before the beginning of the study. Those that did not agree to a written consent were given the option of a joint interview approach. An independent rater was present at the interview while a second rater was present as an observer (Blois, Forth & Hare, 2017). The method has been chosen so as to enhance the accuracy of scoring. The scores were verified by at least one rater who in most cases appeared to be excellent (Blais, Forth & Hare, 2017). Also, the interrator results were also consistent that further depicted validity of the method. The results of the study were consistent with earlier research in relation to the assessment based on semi-structured interviews regarding of DSM-III-R Axis I and II disorders.

The Population

The population that the study was normed on was 98 male psychiatric men. The men had been admitted to the hospital between January 1, 1996, and December 1, 2001. The PCL-R was administered and the results based on the interview obtained. Additionally, there was a collection of extensive collateral information. The sample was a representative of approximately 75% of all the available male participants admitted to the hospital within the same period. The rest of the population was either not examined or did not consent to the interviews. Others were referred to other hospitals according to their clinical symptoms. The mean age of the patients admitted was 31.5 years with the majority of the patients being white (Hildebrand & de Ruiter, 2004). The rest of the group were Surinamese, Mediterranean and people from other descent. 67.3% of the sample group have never been married and have never been in a common law marriage. Half of the group has been convicted of homicide or murder. Another 24.5% have been convicted of sexual offenses such as rape, assault or child molestation (Hildebrand & de Ruiter, 2004). The remaining from had been convicted of other crimes such as arson, violence, robbery, assault, and others threat.

Strengths and Weaknesses of the Measure

The strength of the PCL-R is that it demonstrated a clear and predictable pattern particularly in association with the DSM axis II disorders. For instance, there was a strong association of PCL-R diagnosis with the diagnosis of antisocial personality disorder. The same finding is consistent with the existing research that supports the validity of PCL-R in various populations. However, there are various limitations concerned with the use of the method for the study. For instance, the methodology was faced by limitations that led to the conclusion that the diagnoses could not have been reliable as per the expectations (Hildebrand & de Ruiter, 2004). It would have been more appropriate to use the semi-structured interview in conjunction with a record review. Also, the methodology of the study also faces a limitation in the number of staff that facilitated axis I and axis II. However, the criteria for the selection of the Axis II were the presence of too much information on the patient files.

Evaluation Using a Person

Upon conducting the PCL-R test on Stella (not her real name), the score was 17. Only scores above 30 are indicators of psychopathy. It is considered as a diagnostic tool in gauging person psychopathic and antisocial tendencies. The psychopathic individuals demonstrate characters such as deceit, violence, lack of guilt lack of remorse, and several violations of the social norms (Storey et al., 2016). This method has been accepted by many as a method of determining the presence and level of psychopathy in an individual (Hildebrand & de Ruiter, 2004). The interview part of the test covers the various areas of the individual life such as the background incorporating items such as work, family status, marital status, educational background, and the criminal background.

The questions have to be confirmed through a review of the documents as the information provided by the psychopath may not be truthful. When completed by a professional, the test shows how close or far the individual's score matches that of the perfect score of verified psychopath. Each of the 20 scores has to be assigned a score of either 0, 1 or 2 based on how well it fits the question being asked. A maximum score which is the perfect score for a psychopath is 40. Likewise, a person with zero likelihood of psychopathy would ideally score zero. As a result, all the scores above 30 can qualify one as a psychopath.

Conclusion

As much as this method is considered as the gold standard in the determination of psychopathy, it is evident that it consists of some evident limitations. One weakness is that the method appears to be labor-intensive requiring a lot of work, particularly when administering and scoring the individuals. Additionally, since it is only on the measure of Psychiatry, some researchers have pointed out that the antisocial features used are not central to the disorder rather they are only the behavioral manifestations, further reducing the validity of the method in assessing psychiatry. All in all, PCL-R has been recommended to use by psychiatrists in assessing psychiatry in various healthcare settings.

References

Blais, J., Forth, A. E., & Hare, R. D. (2017). Examining the interrater reliability of the Hare Psychopathy Checklist-Revised across a large sample of trained raters. Psychological Assessment, 29(6), 762.

Hare, R. D., Clark, D., Grann, M., & Thornton, D. (2000). Psychopathy and the predictive validity of the PCL‐R: An international perspective. Behavioral sciences & the law, 18(5), 623-645.

Hildebrand, M., & de Ruiter, C. (2004). PCL-R psychopathy and its relation to DSM-IV Axis I and II disorders in a sample of male forensic psychiatric patients in the Netherlands. International Journal of Law and Psychiatry, 27(3), 233-248.

Hildebrand, M., De Ruiter, C., & Nijman, H. (2004). PCL-R psychopathy predicts disruptive behavior among male offenders in a Dutch forensic psychiatric hospital. Journal of interpersonal violence, 19(1), 13-29.

Storey, J. E., Hart, S. D., Cooke, D. J., & Michie, C. (2016). Psychometric properties of the Hare Psychopathy Checklist-Revised (PCL-R) in a representative sample of Canadian federal offenders. Law and human behavior, 40(2), 136.

April 19, 2023
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Health Psychology

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Illness Child Development

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