The role of psychopathic personality disorder in violence risk assessments using the HCR-20.

Antisocial and psychopathic traits are essential to evaluate when assessing risk for violence using the HCR-20. The role of the PCL-R on the HCR-20 was investigated using a series of meta-analytic tests. Across 34 samples in which both tools were rated, AUCs for violence were similar (∼.69), and exclusion of the psychopathy item (H7) did not reduce the HCR-20's accuracy. Quantitative synthesis of results from multivariate analyses conducted in 7 raw datasets that used both tools demonstrated that the average probability of observing violence for every point increase on the HCR-20 (without H7), while controlling for the PCL-R, was 23%, whereas for the PCL-R it was -1%. The HCR-20 (without H7) added incremental validity to the PCL-R, whereas the converse was not true, and only the HCR-20 (without H7) possessed unique predictive validity. Results suggest the HCR-20's predictive validity was not negatively impacted by excluding the PCL-R. Areas for future study are discussed, including research on various ways to assess and incorporate into risk assessment personality traits related to violence.