Book Review: Handbook of Psychopathy. C. J. Patrick (Ed.). New York: Guilford Press, 2005. 651 pp. ISBN 1-59385-212-6

This volume is a scholarly, exhaustive examination of psychopathy, a construct that rears its head ever more frequently in our journals, our posters, our assessment practices, and our courts. It is not intended for the intellectually faint of heart. The authors explicitly eschew any pretense of fulfilling the needs of those who might rely on popular media or breezier venues, such as Without Conscience (Hare, 1999). Patrick has convened an academic faculty that has spent years splicing together data-driven conclusions defining the edges of our understanding of psychopathy from numerous perspectives. It exposes technical and substantive differences of view with research support. The first section introduces several theoretical and empirical foundations of psychopathy, including an introductory chapter by David Lykken that lays the groundwork for several recurrent themes in the book, including curiosity about the noncriminal psychopath. The notion that there is a population of uncaught individuals who have faithlessly conned, cheated, and manipulated their ways to the top of their respective professions, or who have otherwise eluded apprehension, engages our macabre interest in the human dark side, not to mention ensuring advertising revenues for television producers. This section concludes with chapter 4 by Hare and Neumann, misleadingly named “PCL-R Assessment of Psychopathy,” detailing the results of item response theory analysis and evidence in support of the fourfactor model of psychopathy. This chapter has little to do with clinical assessment. It is a substantive description of current research supporting the interpersonal, affective, lifestyle, and antisocial facets underlying the second edition of the PCL-R and the PCL:YV. Controversies and issues relevant to the measurement of psychopathy are introduced by Cooke, Michie, and Hart (ch. 5), who caution that monomeasure bias (overreliance on the PCL-R) may lead us into a conceptual cul-de-sac. They challenge the reader to consider an alternative three-factor structure: impulsive/irresponsible behavioral style, deficient affective experience, and deceitful interpersonal style. They argue that antisocial behavior is a consequence, rather than a symptom, of psychopathy. Lilienfeld and Fowler (ch. 6) provide an engaging argument in favor of self-report methods of assessing psychopathy, including descriptions of three published self-report measures and discussion of the assessment of psychopathy with noncriminal populations. Chapters 7 and 8 are devoted to specific analysis of psychopathy’s relation to personality functions. Lynam and Derefinko argue in favor of understanding psychopathy as a set of personality traits, while Widiger advocates dismantling the construct into specific components, particularly those that contribute to its predictive validity. This section ends (ch. 9) with Poythress and Skeem’s examination of a variety of subtyping strategies to expand traditional distinctions of primary and secondary psychopathy. The Handbook of Psychopathy devotes 180 pages and nine chapters to the etiological mechanisms of psychopathy. This section may be roughly divided into two groupings: the neurological/ physiological research findings and the cognitive, developmental, genetic, and family influences. These chapters are filled with an array of important findings and current science, contributing to a broad understanding of the etiology of psychopathy. Of particular interest is Raine and Yang’s (ch. 14) mixed findings associated with various brain deficits and their relation to psychopathic behavior. Their discussion of neurosurgery and stem cell transplant to mediate psychopaths’ brain deficits is particularly provocative, if speculative. Waldman and Rhee (ch. 11) raise important questions about the heritability of psychopathic traits, including issues related to identifying genes that contribute to