Ask the Psychopathy Assessment Expert: Dr. Martin Sellbom

Martin Sellbom, PhD., is a Professor in Clinical Psychology at the University of Otago in Dunedin, New Zealand.  He is the current Membership Chair for the Society for the Scientific Study of Psychopathy and has served on its board for several years. His research interests focus on the diagnosis and assessment of personality disorders, including psychopathy, and the structure of mental health disorders more generally. He is also an expert on clinical personality assessment, including the MMPI instruments. For more information about Dr. Sellbom, see here: http://www.otago.ac.nz/psychology/staff/martinsellbom.html

 

1. How did you get involved in the area of psychopathy research? 

I had always been interested in offender behavior, but did not know I wanted to explicitly focus on psychopathy until I had started my Master’s program. While working in a prison, I found it quite striking how those offenders with high levels of affective/interpersonal psychopathy traits seemed to behave quite differently from other offenders. When I applied for PhD programs, I was interested in both forensic assessment (assessments done for individuals referred by the court system or to aid in treatment planning) and psychopathy, so I applied to programs with faculty who did either (or both). I decided to go to Kent State to study assessment (with an emphasis on forensic applications) using the Minnesota Multiphasic Personality Inventory (MMPI). Once I was there, I decided that my first project would be on using the MMPI to assess psychopathic traits. My mentor, Yossi Ben-Porath, knew Scott Lilienfeld from graduate school at Minnesota, and put us in touch so I could seek explicit psychopathy assessment advice, which started a long collaboration. Also, Edelyn Verona had just started her first position at Kent State before she moved to Illinois, and I worked with her on a project on psychopathy and thinking and reasoning processes. So, in the end, I was fortunate to be able to pursue both my assessment and psychopathy-related interests in graduate school.

 

2. You have examined the usefulness of several self-report scales to assess psychopathic traits.  What are the strengths and limitations of using this methodology to assess for psychopathic traits? 

In brief, self-report questionnaires are quite useful in research because they are efficient, reliable, and useful for a range of people, including community members and offenders. Also, self-report questionnaires allow for the assessment of response bias (the tendency for individuals to respond inaccurately or falsely to questions), which can be quite useful with this population. Disadvantages include the fact that those high on psychopathic traits tend to be dishonest, so their scores on the scales might not be accurate. In addition, individuals with psychopathic traits often lack insight into their own maladaptive traits, and that might make it difficult for them to report accurately. It is also difficult to assess the absence of emotional states, such as guilt, in individuals if these emotional states are rarely experienced. But, I do think there are good self-report measures that have carefully worded items to get around these challenges. Finally, there is a widespread belief that self-report psychopathy questionnaires are less valid than clinical rating scales (i.e., scales that require a clinician to interpret responses). There is hardly any good research on ‘head-to-head’ comparisons of clinician ratings versus self-report assessments of psychopathy in predicting meaningful outcomes, and those few studies that do exist have shown no clear differences.

 

3. Are there gender differences in the manifestation of psychopathy?

This is a tough question to answer. The literature has been quite inconsistent on this topic. Part of the issue is that we have not really sufficiently examined whether psychopathy is the same in men and women. For instance, one very recent study from The Netherlands (Klein Haneveld et al., 2021 in Journal of Personality Assessment), found that the Psychopathy Checklist-Revised (PCL-R) did not perform in the same way for male and female forensic psychiatric patients. If psychopathy is not represented in an equivalent manner in men and women, then it is difficult to study differential manifestations. That said, such studies using the PCL-R have shown some evidence for differences in antisocial conduct for men and women with high scores (for example, men with high PCL-R scores engage in more antisocial behavior, more physical aggression/violence; women with high scores engage in more relational aggression). However, research (some coming from my lab) using a variety of self-report questionnaires, in different contexts, and in the prediction of a range of outcomes, have consistently failed to show evidence for gender differences.

 

4. What are the attachment styles of adults with psychopathic traits? 

There is not as much research in this area as one might think. There has been great variability in the quality of this literature as well, including questionable ways to measure both psychopathy and attachment styles. My former PhD student Dr Elliott Christian published a series of studies on this topic along with me and an attachment expert, Dr. Ross Wilkinson. The answer to the question appears to be different depending on which traits of psychopathy are being examined. The traditional affective-interpersonal psychopathy traits (e.g., callousness, interpersonal manipulation) are consistently associated with an avoidant attachment style, and, in some studies, with both high attachment avoidance and low attachment anxiety. The behavioral aspects of psychopathy, however, tends to be positively associated with anxious attachment. The boldness domain tends to be correlated with secure attachment in general. Moreover, there is some evidence that the findings are a bit different, depending on the kind of relationship (i.e., romantic, friend, mother, father) we examined. However, I would say high attachment avoidance across different kinds of relationships seems to be the attachment style most commonly observed in adult psychopathy.

 

5. Considering research is generally ahead of application in the field, what is one improvement in the field of psychopathy that you hope to see take place over the next five to ten years?

I think we need to do much better at connecting research on psychopathy traits with findings on the broader spectra of psychopathology and personality disorder. Psychopathy is not a unitary concept; it’s a particular constellation of traits (regardless of whose theoretical perspective is considered) that are not unique to psychopathy. These traits exist in all personality models, especially those that emphasize maladaptive traits. Tom Widiger, Don Lynam, and Josh Miller, for instance, have argued for decades now that psychopathy can be (and should be) better connected to basic personality theory. Contemporary models of psychopathology, such as the Hierarchical Taxonomy of Psychopathology (a system that describes psychiatric problems on a continuum), provide for these integrative frameworks as well. If we consider psychopathy from the perspective of common personality traits such as reflecting high levels of antagonism and disinhibition, and low levels of fear/anxiety, then the research on these personality traits could also help us to understand psychopathy, and vice versa.

 

Note: For readers interested in a more in-depth examination of the use of self-report measures to assess psychopathic traits, Dr. Sellbom recommends this chapter he co-authored:

Sellbom, M., Lilienfeld, S. O., Fowler, K. A., & McCrary, K. L. (2018). The self-report assessment of psychopathy: Challenges, pitfalls, and promises. In C. J. Patrick (Ed.) Handbook of psychopathy (2^nd ed., pp. 211 – 258). Guildford