Incremental validity of the Psychopathy Checklist-Revised above and beyond the diagnosis of antisocial personality disorder regarding recidivism in sexual offenders

Purpose: The diagnostic criteria of the Antisocial Personality Disorder (ASPD) overlaps greatly with the Lifestyle and Antisocial facets of the Hare Psychopathy Checklist-Revised (PCL-R), whereas the Interpersonal and Affective facets seem to differentiate between antisocial and psychopathic offenders. Previous studies investigated either the ASPD diagnosis or psychopathy measured with the PCL-R, but not the combination of both in sexual of-fenders. The present study tested three hypotheses that PCL-R scores are incrementally predictive above and beyond the ASPD diagnosis regarding general recidivism, non-sexual violent recidivism, and sexual recidivism. Methods: We performed Cox regression modeling with two-fold cross validation, using a training sample (n = 755) and a testing sample (n = 368) of adult male sexual offenders from Austria. Average time-at-risk was 10.13 years.Results: The PCL-R scores predicted general and violent recidivism after the diagnosis of the ASPD was controlled for. The Lifestyle and Antisocial facets, in particular, were incremental. Sexual recidivism could not be predicted.Conclusions: The current results support the use of the PCL-R in applied sexual offender assessment in addition to general clinical diagnostic procedures due to its incremental validity, despite a large overlap between the diagnostic criteria of ASPD and the PCL-R concept of psychopathy.