City University of New York (CUNY) CUNY Academic Works All Dissertations, Theses, and Capstone Projects Dissertations, Theses, and Capstone Projects 9-2015 The Sensitive Psychopath: Assessing Construct Overlap Between Secondary Psychopathy and Borderline Personality Disorder Trevor H. Barese Graduate Center, City University of New York How does access to this work benefit ou?y Let us know! More information about this work at: https://academicworks.cuny.edu/gc_etds/851 Discover additional works at: https://academicworks.cuny.edu This work is made publicly available by the City University of New York (CUNY). Contact: [email protected] THE SENSITIVE PSYCHOPATH: ASSESSING CONSTRUCT OVERLAP BETWEEN SECONDARY PSYCHOPATHY AND BORDERLINE PERSONALITY DISORDER By TREVOR H. BARESE A dissertation submitted to the Graduate Faculty in Clinical Psychology in partial fulfillment of the requirements for the degree of Doctor of Philosophy, The City University of New York 2015 CONSTRUCT VALIDITY OF SECONDARY PSYCHOPATHY ii © 2015 TREVOR BARESE All Rights Reserved CONSTRUCT VALIDITY OF SECONDARY PSYCHOPATHY iii This manuscript has been read and accepted for the Graduate Faculty in Clinical Psychology in satisfaction of the Dissertation requirement for the degree of Doctor of Philosophy Michele Galietta_____________________ _____________________ ___________________________________ Date Chair of Examining Committee Maureen O’Connor___________________ _____________________ ___________________________________ Date Executive Officer Patricia A. Zapf_____________________ Andrew A. Shiva____________________ Barry Rosenfeld_____________________ Stephen D. Hart______________________ Supervisory Committee THE CITY UNIVERSITY OF NEW YORK CONSTRUCT VALIDITY OF SECONDARY PSYCHOPATHY iv Abstract THE SENSITIVE PSYCHOPATH: ASSESSING CONSTRUCT OVERLAP BETWEEN SECONDARY PSYCHOPATHY AND BORDERLINE PERSONALITY DISORDER By Trevor H. Barese Adviser: Professor Michele Galietta The literature suggests substantial overlap between secondary psychopathy and Borderline Personality Disorder (BPD). The current study evaluates the degree of construct overlap between BPD and secondary psychopathy within a sample of offenders mandated to treatment in the community. Diagnostic overlap and associations with clinically relevant correlates were assessed to estimate the degree of convergence between the two disorders and divergence from primary psychopathy. The goal of this study was to evaluate the pragmatic utility of maintaining discrete diagnostic categories for secondary psychopathy and BPD rather than identifying secondary psychopaths as offenders with BPD. The Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II) was used to assess borderline and other personality disorder traits. The Psychopathy Checklist: Screening Version (PCL:SV) was used to assess both primary and secondary psychopathic traits. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) was used to assess a variety of clinical correlates including symptoms of mental illness and substance abuse. In addition, self-report measures were used to assess anger (State-Trait Anger Expression Inventory, STAXI), aggression (Aggression Questionnaire, AQ), rumination (White Bear Suppression Inventory, WBSI), and empathy (Questionnaire Measure of Emotional Empathy, QMEE). Potential construct overlap was supported through significant symptom correlations and similarities in participant classification. Substantial parallels in CONSTRUCT VALIDITY OF SECONDARY PSYCHOPATHY v constellations of clinical correlates were supported through a series of multiple regression analyses. The findings indicate that despite a few key differences BPD and secondary psychopathy share many clinical features. More importantly, these commonalities are in general contrast to features of primary psychopathy. CONSTRUCT VALIDITY OF SECONDARY PSYCHOPATHY vi Acknowledgements I would like to take this opportunity to acknowledge some of the individuals who made this project possible. First, I would like to express my gratitude to Dr. Michele Galietta who served as my committee chair and supported me in the development of this study. This project would not have been possible without her assistance. I would also like to thank Patricia Zapf and Andrew Shiva for their contributions to the study. Dr. Zapf’s integrity, generosity, and passion for the field have motivated me to be a better mentor to my students. Dr. Shiva has been an invaluable mentor and reminded me to persevere and be true to my values. I would also like to express my deep gratitude to doctors Stephen Hart and Barry Rosenfeld for agreeing to act as external readers. Dr. Hart has not only encouraged me to pursue my research, but has been a true mentor and continual source of inspiration. Dr. Rosenfeld has provided ongoing encouragement and support in my clinical and academic pursuits. His extensive knowledge in the area of research design and personality assessment were invaluable to the development of this project. I would also like to recognize two close friends Doctors Nathan Cook and Wen Gu. These gentlemen have not only served as colleagues but have also provided the support and encouragement needed to facilitate my academic and professional development. In addition, I would like to express my gratitude to my parents Evelyn and Joseph Barese, my siblings Joseph Barese and Paige LaBelle, and the rest of my family for their patience and support. Finally, I would like to thank Kajal Bhatt who has provided her unwavering emotional support over the last six years. I would not have been able to complete my graduate training without her and the love and support of my friends and family. CONSTRUCT VALIDITY OF SECONDARY PSYCHOPATHY vii Table of Contents Abstract .......................................................................................................................................... iv Acknowledgements ........................................................................................................................ vi List of Tables .................................................................................................................................. x List of Figures ................................................................................................................................ xi Chapter I: Introduction .................................................................................................................... 1 Construct Overlap ....................................................................................................................... 5 Parsimony of theory. ............................................................................................................................. 7 Impediments to research. ...................................................................................................................... 7 Impediments to diagnosis...................................................................................................................... 8 Impediments to treatment.................................................................................................................... 11 Discriminant Validity ................................................................................................................ 11 Operationalization of constructs. ........................................................................................................ 11 Etiology. .............................................................................................................................................. 23 Physiology........................................................................................................................................... 29 Concurrent validity. ............................................................................................................................ 36 Predictive validity. .............................................................................................................................. 49 Limitations & Considerations ................................................................................................... 55 Summary ................................................................................................................................... 56 Possible origins. .................................................................................................................................. 56 Conclusions. ........................................................................................................................................ 61 Chapter II: Method ........................................................................................................................ 64 Rational ..................................................................................................................................... 64 Participants ................................................................................................................................ 64 Procedures ................................................................................................................................. 65 Measures.................................................................................................................................... 67 Personality disorder traits...................................................................................................................