Psychopathy and treatment outcome: Results from a sexual violence reduction program

The present study examined the association of psychopathy, measured by the Hare Psychopathy Checklist-Revised (PCL-R; Hare, 1991, 2003), to sexual offender treatment completion, change, and recidivism in a Canadian sample of 302 treated sexual offenders followed up in the community 17.6 years post release. Sexual violence risk and treatment change was evaluated via the Violence Risk Scale-Sexual Offense version (Wong, Olver, Nicholaichuk, & Gordon, 2003-2017), and general violence risk via the Sex Offender Risk Appraisal Guide (Quinsey, Harris, Rice, & Cormier, 1998). High-psychopathy men had significantly higher rates of sexual offender treatment noncompletion (30%) than low-psychopathy men (6%), although they did not evidence significantly less therapeutic change. The Affective facet of the PCL-R uniquely, significantly predicted decreased therapeutic progress, and along with the Lifestyle facet, it predicted treatment noncompletion. Examination of recidivism outcomes revealed that treatment completion in and of itself was not significantly associated with decreased sexual or violent recidivism among psychopathic offenders; however, therapeutic change, reflecting risk reduction, was significantly associated with decreased sexual and violent recidivism after controlling for baseline risk and PCL-R score. Results of survival analysis indicated that a subgroup of high-risk psychopathic men who made substantial treatment gains had lower trajectories of sexual and violent recidivism over the follow-up period relative to other high-risk men who demonstrated fewer treatment benefits. The issue of therapeutic pessimism with implications for the treatment and retention of high-psychopathy sexual offenders, per the two-component model, is discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).