Identifying psychopathic subtypes: combining an empirical personality classification of offenders with the psychopathy checklist-revised.

Mentally disordered offenders who were psychopathic according to the Psychopathy Checklist-Revised (PCL-R) were divided into primary psychopath, secondary psychopath, controlled, and inhibited groups on the basis of a validated empirical classification, using the Antisocial Personality Questionnaire (APQ). They were compared on the factors and facets of the PCL-R, criminal history, Axis I and Axis II psychopathology, experience of child abuse, personality, interpersonal style, and clinical ratings of risk and treatability, to determine the utility of the APQ classification in identifying subtypes of psychopath. Significant differences between APQ primary and secondary psychopaths on several measures support the identification of these groups with the primary and secondary psychopaths hypothesized by Karpman (1948) and others. However, further differences suggest that the controlled and inhibited groups represent additional variants of primary and secondary psychopath, respectively. The results provide further evidence for the heterogeneity of psychopaths, and suggest that the PCL-R encompasses several distinct subtypes of abnormal personality.