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Hare Worried About Misuse of PCL-R

posted 18 Jun 2011, 04:15 by Robert Forde   [ updated 24 Jun 2011, 04:33 ]
The PCL-R seems to be running into yet more problems. Increasingly these problems are being aired not only in academic journals but also in the popular press. A recent article examined the case of Robert Dixon, a man who was caught up in a murder perpetrated by someone else, and who in 2009 was refused parole apparently on the basis that he was a psychopath according to the PCL-R. Leaving aside the fact that risk reduces greatly with age even for psychopaths, the idea that someone could be refused parole simply on the basis of their rating on the psychometric instrument is (or should be) anathema to any responsible forensic psychologist.

The article also cites comments by Robert Hare, the developer of the PCL-R. He is quoted as expressing concern about the way the PCL-R is actually being used in forensic practice, or rather misused. It was originally developed as a research instrument, and not as a clinical instrument at all. Hare only released it for use in forensic and clinical practice after some pressure from criminal justice authorities. Unfortunately, it has now become an extremely lucrative instrument. The publication of structured interview booklets, scoring sheets, and the licensing of training courses all generate a considerable income stream. At my own training course in the PCL-R Hare joked that the instrument was his "pension plan". Clearly the comment was meant to be jocular, but there is a serious point here: once money enters into the equation in a big way, it creates a pressure of its own which is nothing to do with either the truth or scientific evidence and practice.

To be fair to Prof Hare, he has himself been expressing these misgivings since at least 1998, when he published an article about them in the journal "Legal and Criminological Psychology". (This has recently been made available online, although anyone wanting to download it will have to pay a fee unless they are a subscriber to the journal).

This should be a concern anywhere the PCL-R is used. I know from my own experience that PCL-R scores are often raised in parole hearings in England and Wales. However, in the United States it is common that the PCL-R is raised in sentencing deliberations. In some American states, a person may be convicted of murder and then a jury is asked to decide whether they should suffer the death penalty or be sentenced to life without parole. There have been arguments in which conflicting prosecution and defence "experts" have defended their own scoring of a person on the PCL-R and attacked that of the opposing expert. The convicted person's life can literally depend upon a few points on a rating scale. For this reason, the PCL-R has become known as "the kiss of death" in some states.

It cannot be stated too strongly that neither the PCL-R nor any other psychometric instrument is a sufficient basis for making detailed predictions about a person's future behaviour. Generalised statements about the relationship between PCL-R scores and risk in a population of offenders may be acceptable, but using such scores as an indicator of how an individual will behave goes far beyond any reasonable application. Even amongst those with high scores, as any experienced practitioner knows, there is a huge variation in attitudes, habits, and reasoning ability. And, as always, age is a crucial moderator of risk. Any experienced practitioner knows these things, but too many practitioners do not have the experience and can only quote the fact that they have done the training course.

That is not enough.