High-Psychopathy Men With a History of Sexual Offending Have Protective Factors Too: But Are These Risk Relevant and Can They Change in Treatment?

• Published in: Journal of consulting and clinical psychology 2021-05, Vol.89 (5), p.406-420
• Main Authors: Olver, Mark E., Riemer, Emily K.
• Format: Article
• Language: English
• Subjects: Antisocial personality disorder; Change agents; Checklists; Clinical assessment; Criminal records; Forensic psychiatry; Forensic Psychology; High risk; Human; Male; Men; Mental health; Mental health services; Offending; Patient History; Personality disorders; Protective Factors; Psychopathology; Psychopathy; Recidivism; Resistance; Risk assessment; Risk Factors; Scores; Sex crimes; Sex offenders; Sexual violence; Treatment; Violence
• ISSN: 0022-006X; 1939-2117
• DOI: 10.1037/ccp0000638

Objective: Psychopathy is a serious personality disorder reputed for resistance to correctional and forensic mental health treatment and synonymous with being high risk for different recidivism outcomes; it is not readily associated with an abundance of positive qualities or protective factors. Research has yet to examine the presence of protective factors as a function of psychopathy in correctional samples and the risk-relevance of protective factors for high-psychopathy men. Method: The present study examined the association of psychopathy and protective factors to recidivism in a Canadian sample of 461 men who attended sexual-offense-specific treatment and followed up nearly 10-year postrelease. The Psychopathy Checklist-Revised (PCL-R; Hare, The Hare psychopathy-checklist-revised, 1991; Hare, Manual for the revised psychopathy checklist, 2003) and the Structured Assessment of Protective Factors (SAPROF; de Vogel et al., The International Journal of Forensic Mental Health, 2011, 10, 171) were rated from institutional files and recidivism data were obtained from official criminal records. Results: PCL-R scores were inversely related to SAPROF scores; however, even men scoring high on the PCL-R made significant pre-post changes on protective factors. PCL-R and SAPROF scores predicted sexual, violent, and general recidivism; treatment-related changes in protective factors, controlling for PCL-R score, were significantly associated with decreased violent recidivism. Conclusions: Protective factors can and do change with purposive change agents (e.g., correctional treatment), even among individuals with substantial psychopathic traits. The role and risk relevance of protective factors in sexual violence risk assessment and management with high psychopathy clientele are discussed. What is the public health significance of this article? The research demonstrates that protective factors can change pre-posttreatment in a sexual violence reduction program and that protective factors can be increased therapeutically with high risk-high need men who have substantial psychopathic traits. Structured assessments of protective factors increment the prediction of recidivism beyond psychopathy and appear to mitigate risk for future recidivism with this client group in correctional settings.