DSM-5 vs. PCL-R

A reader comments about the differences between the proposed DSM-5 and the PCL-R:

As far as sociopathy goes, the DSM-IV diagnosis was woefully inadequate. It provided no real insight into the disorder and lacked strong empirical evidence; that is why scholars such as Robert Hare and Theodore Millon have said that sociopathy and antisocial personality disorder are two independent constructs and why Hare went further to create the psychopathy checklist. While the psychopathic checklist is a much more accurate diagnostic tool, it also lacks empirical evidence. For one, it looks at personality as a binary construct. You either you have it or not and if not. It says psychopaths are both quantitatively and qualitatively different from non-psychopaths. But personality is not that clean cut. Everyone has psychopathic traits to a greater or lesser degree. It also doesn’t take into account the heterogeneity within psychopathy. According to Hare for and individual to receive a diagnosis in psychopathy they would have to score relatively high on factor 1 and 2, but that is far from true. Some patients would score high on the disinhibited component others on the antagonistic component and while some score high on both. There is abundant evidence that the impulsive-antisocial (disinhibited-externalizing) and affective-interpersonal (boldness-meanness) components of psychopathy differ in terms of their neurobiological correlates and etiologic determinants according to the work group of the DSM 5. So as far as the DSM and sociopathy researchers go, yes, there has been a disagreement between the two and up until now I think the PCL-R was the most useful when comparing it to antisocial personality disorder, but in all honesty, the DSM 5 seems to have a stronger scientific and empirical basis to not only psychopathy but personality as a whole. 

The DSM 5 seems to have a stronger scientific and empirical basis to not only psychopathy but personality as a whole. In contrast to the PCL-R, the DSM 5 derived its criteria from scientific data not theory. In a contested article by Skeem and Cooke, "Is Criminal Behavior a Central Component of Psychopathy? Conceptual Directions for Resolving the Debate," the two colleagues posit that the field of forensic psychology has prematurely embraced Hare's Psychopathy Checklist-Revised (PCL-R) as the gold standard for psychopathy, due in large part to legal demands for a tool to predict violence. Yet the PCL-R's ability to predict violent recidivism owes in large part to its conflation of the supposed personality construct of psychopathy with past criminal behavior, they argue: 

“[T]he modern justice context has created a strong demand for identifying bad, dangerous people…. [The] link between the PCL and violence has supported a myth that emotionally detached psychopaths callously use violence to achieve control over and exploit others. As far as the PCL is concerned, this notion rests on virtually no empirical support…. [T]he process of understanding psychopathy must be separated from the enterprise of predicting violence.” 

Criminal behavior weighs heavily in the PCL's 20 items because the instrument emerged from research with prisoners. But using the PCL-R's consequent ability to predict violence to assert the theoretical validity of its underlying personality construct is a tautological, or circular, argument, claim Skeem and Cooke. Or, as John Ellard put it more directly back in 1998: 

"Why has this man done these terrible things? Because he is a psychopath. And how do you know that he is a psychopath? Because he has done these terrible things." 

All in all, the PCL- R tends to do a better job measuring criminality. Not psychopathy, which is a personality disorder and can’t be adequately recognized by a set of twenty criteria combined with an arbitrary diagnostic threshold. (That threshold being 30).