BACKGROUND: Offenders with personality disorder can be challenging to engage and retain in treatment. The UK Offender Personality Disorder (OPD) pathway aims to proactively and responsively identify and engage offenders with personality disorder. However, a subpopulation of offenders on the pathway have been found to not be accepted into any OPD service and therefore fail to progress.
OBJECTIVE: This study aims to identify and describe offenders on the OPD pathway who fail to progress and to understand the causal drivers by which individuals fail to progress in the pathway.
METHODS: A sample of 50 offenders on the OPD pathway who had been refused from at least two OPD services (nonprogression group) were compared to 100 offenders accepted into OPD services (control group). Partial least squares structural equation modeling was used to model the causal factors involved in not being accepted into OPD services.
RESULTS: The path coefficients in the structural model showed that the most influential factor in nonprogression was attitude toward treatment (β=.41; P<.001; f2=0.25) alongside those with psychopathology (β=.41; P<.001; f2=0.25), specifically, psychopathy, psychosis, and co-occurring personality disorder.
CONCLUSIONS: The findings of the study provide a basis of how to work with this population in the future to increase the likelihood of acceptance into OPD services.

A prevailing view among researchers and mental health clinicians is that symptoms of antisocial personality disorder (ASPD)/psychopathy decrease as affected individuals reach middle age. In the current investigation, informants were surveyed about the behavior of individuals who they believed showed traits of ASPD/psychopathy and were over the age of 50. A final sample of 1,215 respondents rated the index individuals according to the ASPD/psychopathy traits derived from the pre-publication first draft of the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, revealing high endorsement of traits associated with ASPD. Survey respondents reported their observations that individuals who met a threshold for putative ASPD/psychopathy continued to engage in antisocial behavior after age 50, and as a result the respondents endured significant harm, including material losses, financial losses, and various self-reported mental health problems. Those who knew the index individuals both before and after the age of 50 were specifically asked whether there was a change in the individual\'s engagement in manipulation, deceit, and antisocial behavior; 93% of respondents reported that the behavior was just as bad or worse after age 50. Other researchers have suggested that the DSM diagnostic criteria do not accurately describe ASPD/psychopathy symptoms and behavior in older adults, and that the disorder remains stable, but its manifestation changes with age. This study supports those conclusions.

There are some distinct methodological challenges, and possible pitfalls, for neuroethics when it evaluates neuroscientific results and links them to issues such as moral or legal responsibility. Some problems emerge in determining the requirements for responsibility. We will show how philosophical proposals in this area need to interact with legal doctrine and practice. Problems can occur when inferring normative implications from neuroscientific results. Other problems arise when it is not recognized that data about brain anatomy or physiology are relevant to the ascription of responsibility only when they are significantly correlated with the psychological capacities contemplated by the legal formulations of responsibility. We will demonstrate this by considering two significant cases concerning psychopathy. Some paradigms that aim at measuring higher-order capacities, such as moral understanding, have limited validity. More robust paradigms for the study of learning in restricted controlled conditions, on the other hand, have limited ecological validity across individuals and context to be of any use for the law.

Personality disorders have long been bedeviled by a host of conceptual and methodological quandaries. Starting from the assumption that personality disorders are inherently interpersonal conditions that reflect folk concepts of social impairment, the authors contend that a subset of personality disorders, rather than traditional syndromes, are emergent interpersonal syndromes (EISs): interpersonally malignant configurations (statistical interactions) of distinct personality dimensions that may be only modestly, weakly, or even negatively correlated. Preliminary support for this perspective derives from a surprising source, namely, largely forgotten research on the intercorrelations among the subscales of select MMPI/MMPI-2 clinical scales. Using psychopathic personality as a case example, the authors offer provisional evidence for the EIS hypothesis from four lines of research and delineate its implications for personality disorder theory, research, and classification. Conceptualizing some personality disorders as EISs elucidates long-standing quandaries and controversies in the psychopathology literature and affords fruitful avenues for future investigation.

In response to a crisis of confidence, several methodological initiatives have been launched to improve the robustness of psychological science. Given its real-world implications, personality disorders research is all too important to not follow suit. The authors offer a plea for preregistration in personality disorders research, using psychopathic personality (psychopathy) as a prominent case example. To suit action to word, the authors report on a preregistered study and use it to help refute common misconceptions about preregistration as well as to illustrate that the key strength of preregistration: transparency outweighs its (perceived) disadvantages. Although preregistration will not conclusively settle the many debates roiling the field of psychopathy and other personality disorders, it can help to verify the robustness of empirical observations that inform such debates.

The current study investigated original case descriptions of psychopathy (Cleckley, 1941) in relation to current conceptualizations and general personality traits. Attorneys, forensic psychologists and clinical faculty members completed ratings of psychopathy and personality after reading vignettes based on Cleckley\'s descriptions of a psychopath. The results suggest that professionals\' ratings are consistent with current conceptualizations of psychopathy. Furthermore, the five-factor model (FFM) personality traits of the vignettes aligned with the current literature on the FFM and psychopathy (i.e. low neuroticism, conscientiousness and agreeableness). The results further supported that a general trait model, like the FFM, may be well suited to describe the underlying personality traits of psychopathy. Gender differences were also examined.

Neonaticide is an infant murder occurring on the day of birth. The case reports found in the literature are often focused on the mother as the agent in the context of pregnancy denial, dissociative symptoms, or psychosis. However, this report describes a rare case of attempted serial neonaticides, in which the acts were committed by a nurse at the nursery of a referral hospital in Brazil. The authors describe a forensic psychiatric evaluation for criminal responsibility and correlate the information from this particular case with relevant forensic themes, namely neonaticide, Munchausen by proxy syndrome, and serial healthcare killers.