Creator Of Psychopathy Test Worries About Its Use

Psychologist Robert Hare created a test that measures whether someone is a psychopath. The test is used extensively in our criminal justice system to help decide whether inmates should get parole — and even to determine whether or not someone should be put to death. But Hare is now worried that his test isn't being properly used.

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MICHELE NORRIS, host:

From NPR News, this is ALL THINGS CONSIDERED. I'm Michele Norris.

There's a man in prison in California named Robert Dixon. He's been denied parole in large part because he took a test. It found he might be a psychopath. Dixon points out, that's a hard label to get rid of.

Mr. ROBERT DIXON: How do I convince somebody that I'm not a psychopath? I don't know.

NORRIS: The test that gave Dixon that label is called the PCL-R. It's used all over our criminal justice system to help make decisions about parole, sentencing, even whether someone should be put to death.

Yesterday, we heard Robert Dixon's story. Today, NPR's Alix Spiegel introduces us to the psychologist who created the test. He says he's now worried the test is not being used properly.

SPIEGEL: For decades, the Canadian psychologist Robert Hare worked to understand psychopathic personalities. Hare did everything. He analyzed their language. He measured their sweat glands. He even videotaped their songs.

Unidentified Man #1: (Singing)

SPIEGEL: The prisoner in this video sits in a bare room. Across the table is a graduate student. The student is there to conduct an interview but suddenly the prisoner starts to grill him. How does the prisoner know that the student is a real student? He could be a cop.

Unidentified Man #1: You could be a cop, right?

SPIEGEL: There's a pause.

Unidentified Man #1: I don't think you're a cop. I checked out the boots to see if they're black and shiny, but then that would be too easy.

SPIEGEL: This is one of more than a thousand videos recorded by psychologist Robert Hare over the course of his research. All of the interviews are with prisoners. And many, like this man, were eventually judged to be psychopaths.

Unidentified Man #1: Anyway, I was going on about justifiable murder. Someone rapes your wife, molests your kid, and then a guy's got to do that. If he doesn't, you know, that's just the way it goes. An eye for an eye, a tooth for tooth. Yea, though I walk through the valley of the shadow of death, I will fear no evil for I pack a .357 Magnum.

(Soundbite of laughter)

SPIEGEL: Hare began collecting these interviews in the 1960s, at a time when research on psychopaths was considered both obscure and basically irrelevant to understanding crime. You see, at that point, Hare says, there was a very clear consensus about where crime came from. Criminals were made, not born.

Dr. ROBERT HARE (Psychologist; Creator, PCL-R): In those days, social factors, environmental factors were the explanation for all crime. When you're born, just a blank - you're a blank slate and I can train you to be anything you want.

SPIEGEL: But Hare didn't really buy this. He thought inborn personality was important. He says, as a psychologist, when he looked at people he just saw these incredible differences in temperament.

Dr. HARE: Differences in impulsivity, differences in the capacity for empathy, for feeling guilt. As, you know, we have individual differences in intelligence, well, we should have individual differences in the personality traits that are responsible or related to crime.

SPIEGEL: And so, Hare set out to dissect the personality traits that might predispose people to criminality. For example, as we watched one of the videos he'd recorded, he pointed out how the prisoner was talking about his own capacity for remorse.

Unidentified Man #2: Remorse for me is a very distant word, because - me and remorse is more like a kick-myself-in-the-stomach word, where I've been there and done that and didn't like it.

Dr. HARE: He's trying to make sense out of something he really doesn't understand. What is remorse?

SPIEGEL: Now, Hare didn't just interview prisoners in order to understand psychopathic personality. He also experimented on them. For example, he recruited dozens of prisoners, put them in chairs and told them that in 30 seconds he was going to zap them with an electrical shock. Then he measured their heart rate to see if that information bothered them. And he found that the behavior of the psychopaths was different.

Dr. HARE: Most people show lots of emotional arousal - anticipatory fear, anxiety - while they're waiting for the shock to occur; psychopaths, hardly any.

Unidentified Man #1: (Singing) Look away, look away, look away, Dixieland.

SPIEGEL: In another experiment, Hare showed prisoners both highly emotional and totally neutral pictures. A picture of a rape, say, versus the picture of a table, and again measured their physical response. He found that for most prisoners, the emotional pictures prompted a very different reaction than the pictures of a table or chair.

Dr. HARE: But with psychopaths there's no difference. They treat these horrific pictures as if they were neutral pictures, no difference whatsoever between them.

SPIEGEL: This work led Hare to the conclusion that psychopaths are essentially emotionally deaf, simply do not have the capacity to feel, in a firsthand way, emotions like empathy, remorse and love.

Dr. HARE: It's sort of like trying to explain to a colorblind person what the color red is. Can we teach a colorblind person how to see red, what red is? You can have all the dictionary definitions you want, but this person will never quite get it.

SPIEGEL: Now, while Hare was making progress on understanding psychopaths, his work was still regarded as marginal, in part because the field of psychopath research in general was missing something really, really important. You see, there was simply no good way for researchers involved in this work to figure out who was a psychopath and who wasn't. The field had no way to measure. And Hare says this was a huge problem.

Dr. HARE: The science cannot progress without reliable and accurate measurement of what it is they're trying to study. Simple as that.

SPIEGEL: And so, Hare decided to make a test for psychopaths. He sat down with his research assistant and together they wrote down all of the personality traits they'd consistently seen in the psychopaths they studied. Hare reads from their list.

Dr. HARE: (Reading) Lack of sincerity, lack of remorse or guilt, lack of affect, lack of empathy, egocentricity, grandiose sense of self-worth.

SPIEGEL: And so on. Then Bob Hare designed, basically, an interview given by a psychologist that would find out whether someone had these traits. And he even made a way to score whether the traits were strong or weak or not there at all. Any score over 30 on his test certified the person as a psychopath. Voila, the test was born.

(Soundbite of flipping pages)

SPIEGEL: So this is literally - this is literally it.

Dr. HARE: This is it. This is the first thing that people saw - 17 pages, double-spaced.

SPIEGEL: Then one of Hare's students, an undergraduate named Randy Kropp, had an idea for another way to use the test.

Dr. RANDY KROPP (Forensic Criminologist): I just sort of posed the idea for him. I said, you know, do you think it would be a good idea to maybe follow up psychopaths?

SPIEGEL: What Kropp did was select a group of prisoners with high, low and moderate scores on the test. Then he followed what those prisoners did after they were released from prison. He wanted to figure out if people with high scores were more likely to commit crimes than people with low scores. Turns out, they were. Bob Hare.

Dr. HARE: Those who had low scores on the PCL-R, about 20 or 25 percent would be reconvicted within four or five years. The high group was 80 percent.

SPIEGEL: So, score high and there was an 80 percent chance you would re-offend; low, 20 percent. In other words, Hare's test...

Dr. HARE: Did an excellent job of predicting who would commit another offense within the next couple of years.

SPIEGEL: This was incredible. Now remember earlier, I pointed out that Hare was working at a time when people believed criminal behavior was really the result of poor environments. Then suddenly, here was this test of personality that seemed to identify the world's most serious chronic criminals.

Steve Hart, a former student of Bob Hare, who's now a leader in the field, says his colleagues were stunned.

Dr. STEVE HART (Psychologist): Here we are using a diagnosis of personality disorder to predict criminal behavior, and it's working.

SPIEGEL: Steve Hart remembers that shortly after the paper went public in the mid-'80s, Hare's lab got a visit from Canada's National Parole Board. They wanted the test.

Dr. HART: They said quite literally: What we want to do is give everybody this test and then have the test score written in big red numbers on the front of the file. No parole board should be able to make a decision without having some knowledge about whether or not somebody is psychopathic.

SPIEGEL: But at least initially, Bob Hare was deeply worried about letting people in the criminal justice system use his test - worried that this test he'd made for pure research purposes might be used incorrectly in the real world and hurt people.

So Steve Hart says Robert Hare told his students he would not give it out to certain people.

Dr. HART: I'm never giving the checklist to somebody who works in the criminal justice system. I'm just going to give it to scientists who do nothing.

SPIEGEL: But Hart says Hare's students argued with him, until ultimately Hare reconsidered, which is how the test ended up being used all over the criminal justice system in America, to help decide what kind of sentence a criminal should get, to help make parole decisions, for all kinds of decisions that radically affect people's lives.

But as use of his test has spread, Robert Hare has come to feel that some of his initial fears about how it might be misused have actually come to pass.

Dr. HARE: I feel ambivalent about it.

SPIEGEL: You see, while Hare is a strong believer that his test works well for the kind of basic lab research that it was originally designed for, he, like others, have begun to wonder if it does as good a job outside the lab.

Mr. DANIEL MURRAY (Professor, University of Virginia): Once you get into the real world, there does seem to be some lessening of reliability.

SPIEGEL: This is Daniel Murray, a professor at the University of Virginia, and about four years ago, Murray decided to study the real-world reliability of the test. Reliability is really important. It's when two people testing the same person get the same result.

So to do this study, Murray found court cases where a psychologist working for the prosecution tested the same person as a psychologist working for the defense. Then he looked at whether or not those psychologists got the same score. The answer: definitively no.

Mr. MURRAY: Ten-, 15- even 20-point score difference we found. And overall, there was about an eight-point difference in scores.

SPIEGEL: The question was why. One possibility, says Murray, is that the psychologists using the tests in prisons and courts might not be well-trained.

Mr. MURRAY: You know, we don't know if people giving it in the field have received formal, rigorous training or if they've just sort of bought the manual and maybe read a couple papers and decided they're going to start using it.

SPIEGEL: But Murray thinks it's also something else. He says that in his study, psychologists hired by the prosecution consistently scored higher than psychologists employed by the defense, probably, Murray says, because they're being paid for those opinions, and that money influences them.

As for Robert Hare, he sees both this bias and the lack of training as serious problems. He says it really bothers him.

Mr. HARE: I'm very concerned about the inappropriate use of this instrument for purposes that have serious implications for the individual and for society.

SPIEGEL: Still, use of the test continues to spread. It's now even mandated in several states. And the test has helped cause a shift in our ideas about where crime comes from, as well.

The idea that criminal behavior is primarily a product of poor environments has much less power today, in part because Hare's work seemed to teach us that crime resides inside the person, that inborn personality traits like empathy can influence whether people participate in crime. Bob Hare.

Mr. HARE: Empathy is highly genetic in origin, modified and shaped by the environment, of course. But if you've got an adult who has virtually no empathy in the normal sense of the term, you're not going to send him to school to learn empathy, Empathy 101. It's just not going to work.

SPIEGEL: And when you think about criminals in this way, as people who are almost genetically predisposed to crime, you are much less likely to invest in their rehabilitation than if you saw their acts as a product of unfortunate environmental circumstances.

This is why it's so important to figure out if bias and bad training are affecting Hare's test to the point that it is potentially mislabeling people. After all, once someone is labeled as a psychopath, what can you do with him? Nothing but lock him away.

Alix Spiegel, NPR News, Washington.

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