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Aggression and Violent Behavior 15 (2010) 422–429

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Aggression and Violent Behavior

Female offenders: Assessment of risk in forensic settings Annette McKeown ⁎ Primrose Programme DSPD (Dangerous and Severe Personality Disorder), Tees Esk and Wear Valleys NHS Foundation Trust, HMP & YOI Low Newton, Durham, DH1 5SD, UK

a r t i c l e

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Article history: Received 23 December 2008 Received in revised form 13 July 2010 Accepted 20 July 2010 Available online 25 July 2010 Keywords: Women Violence Risk Psychopathy HCR-20 PCL-R

a b s t r a c t Assessment of risk within forensic settings is central to ascertaining suitability for treatment, progress following treatment, and informing decision making regarding progression through the criminal justice system within these settings. Assessment of risk is also vital to address risk towards the public. This applies equally to male and female populations. Therefore, it is crucial that assessments employed to inform conceptualization of risk reflect risk factors within the given population. Violence risk assessments such as the HCR-20 and VRS-2 are increasingly being employed with female offenders. The Psychopathy Checklist—Revised (PCL-R) is not a violence risk assessment per se; however it is increasingly being employed with female offenders to inform assessment of risk. The volume of research exploring the application of violence risk assessments to female offender populations has begun to increase but there are still uncertainties regarding application of these assessments with female offenders. In this review, the impact of gender upon pathways into the criminal justice system is outlined. Differing factors relevant to the assessment of male and female offenders are discussed. Research employing the HCR-20 and PCL-R with female populations is also reviewed, and pertinent issues regarding utilizing these assessments with female populations are discussed. Whether more complex assessments are required to wholly capture women's risk of future violence will also be explored. © 2010 Elsevier Ltd. All rights reserved.

Contents 1. 2.

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . Theoretical perspective . . . . . . . . . . . . . . . . . . . . . . . 2.1. Criminal pathways: does gender matter? . . . . . . . . . . . 2.2. Gender and offense characteristics . . . . . . . . . . . . . . 2.3. Existing risk assessments . . . . . . . . . . . . . . . . . . . 2.4. Use of existing risk assessments with female offenders . . . . . 2.4.1. Implications for risk assessments with females . . . . 3. Structured risk assessments: empirical findings with female offenders . 3.1. HCR-20 . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.2. Utilizing the HCR-20 with female offenders . . . . . . . . . . 3.3. Violence Risk Scale (VRS-2). . . . . . . . . . . . . . . . . . 4. Psychopathy in females . . . . . . . . . . . . . . . . . . . . . . . 4.1. Psychopathy Checklist—Revised (PCL-R) . . . . . . . . . . . . 4.2. Gender differences in factor structure of PCL-R . . . . . . . . 4.3. Empirical findings . . . . . . . . . . . . . . . . . . . . . . 4.4. Utilizing the PCL-R with female offenders . . . . . . . . . . . 5. Conclusions and recommendations . . . . . . . . . . . . . . . . . Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

⁎ Tel.: + 44 191 3764161; fax: + 44 191 376 4160. E-mail address: [email protected]. 1359-1789/$ – see front matter © 2010 Elsevier Ltd. All rights reserved. doi:10.1016/j.avb.2010.07.004

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1. Introduction The Corston Report: Review of Women with Particular Vulnerabilities in the Criminal Justice System (Corston, 2007) highlights the importance of reservation of custodial sentences for serious and violent female offenders who pose a threat to the public. It also reflects recommendations outlining the importance of a holistic and woman-centered approach to working with female offenders (Department of Health, 2002). Identifying the risk of female offenders while also adopting a woman-centered approach is premised on the use of risk assessment measures appropriate to the population in question. This leads to fundamental questions about the application of existing risk assessments to female offenders and whether they indeed capture the risk factors of women. Further questions arise regarding the reliability and validity of current risk assessment measures with female populations. One of the aims of this review is to summarize some of the available literature to help elucidate some of these areas. It is hoped this information will help guide use of risk assessments with female offenders. Assessment of psychopathy forms a component of many risk assessments. Therefore, whether the construct of psychopathy varies across gender warrants consideration (Forouzan & Cooke, 2005). The Psychopathy Checklist—Revised (PCL-R) is the most widely used measure of psychopathy employed for both males and females. Given its increasing application within assessment and formulation of risk of female offenders, examination of existing research findings with this population is crucial. The aim of this review is to consider whether the use of existing risk assessment measures with female offenders is appropriate. This exploration begins with examination of existing knowledge on female pathways into offending behavior. Gender differences in risk factors for offending behavior are also summarized in this context. Differences in the offense characteristics of both men and women are considered. Implications of existing theories and research findings upon the application of existing risk assessments with female offenders are then discussed. This is followed by examination of empirical findings applying use of structured risk assessments with female offenders. Next, the construct of psychopathy in females is discussed, followed by examination of the empirical findings linked to use of the Psychopathy Checklist—Revised (PCL-R, 2nd Edition, Hare, 2003) with women. Finally, conclusions and recommendations will be outlined. 2. Theoretical perspective 2.1. Criminal pathways: does gender matter? Bloom, Owen, and Covington (2003) project exploring the most effective methods of treating and rehabilitating female offenders articulated the first of six guidelines was to “acknowledge that gender makes a difference” (p. 76). This initiates consideration of whether indeed gender impacts upon the pathways into offending behavior. If there is gender differences evident in criminal pathways this would tend to provide support for propositions of differences in risk factors for males and females which would therefore impact upon assessment of risk with female offenders. There has been much research suggesting the development of women's criminal behavior differs from that of men. Sexual and physical abuse, financial difficulties and substance use have consistently been demonstrated to characterize the backgrounds of female offenders (Belknap, 2007; Chesney-Lind & Shelden, 2004; Daly, 1992, 1994; Gilfus, 1992; Holsinger, 2000). The prevalence of sexual abuse reported among female offenders varies, although generally appears higher than figures reported in male offenders. Disability Action Inc. (1997) found 85% of a sample of female

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offenders reported suffering childhood sexual abuse, and there have been other findings of 80% (Jordan, Schlenger, Fairbank, & Cadell, 1996; Miller-Warke, 2000) of a sample female offender suffering ‘child–adult victimization’. Lower rates of childhood sexual abuse have been reported in male offenders including 40% in one male offender sample (Fondacaro, Holt, & Powell, 1999) and 59% in another sample of male offenders (Johnson et al., 2006). Johnson et al. (2006) acknowledged they found a higher prevalence of childhood sexual abuse in their sample of male offenders in comparison to previous studies. Research has also suggested female prisoners are three times more likely to have a history of abuse than male prisoners (Bureau of Justice Statistics, 1999). Belknap and Holsinger (2006) compared 281 incarcerated boys and 163 incarcerated girls, finding girls reported significantly higher levels of virtually all abuse variables. This included higher levels of sexual abuse (3/5 of girls vs. 1/5 of boys) and repeated physical abuse (3/5 of girls vs. 2/5 boys). These findings suggest experience of abuse may be particularly relevant risk factor in females' pathways into offending behavior. Gilfus (1992) also demonstrated patterns of repeat victimization in a female offender sample. Gilfus (1992) found despite attempts to avoid re-victimization this was nevertheless relatively common. These re-victimization findings are consistent with findings of Belknap and Holsinger (2006), who found half incarcerated girls reported one or two sexual abusers as opposed to one sixth of boys. In the same sample, one eighth of girls reported three or more sexual abusers as opposed to 3% of boys. Thus, it appears re-victimization is particularly prevalent in female offenders. The relative importance of sexual abuse in the criminal pathways of females was further explored by a prospective study (Siegel & Williams, 2003); finding women who had been a victim of sexual abuse were significantly more likely to be arrested for a violent juvenile offense and an offense as an adult. The contextual factors that tend to characterize the child abuse of females as opposed to males includes an increased likelihood to be abused by someone close to them, and a greater likelihood of the abuse occurring over a long period of time (Browne & Finkelhor, 1986). The greater the severity of abuse in terms of frequency and duration, the greater the level of trauma (Chesney-Lind, 1997). This can in turn lead to greater levels of psychological distress. Thus, sexual abuse may impact upon pathways into offending behavior for females in a somewhat different way than for males. Chesney-Lind (1997, 2000) outlines suggestion of links between abuse, depression, and substance use in female pathways into offending. She argued women often employ survival strategies including running away, prostitution and involvement in relationships which can heighten likelihood of involvement with the criminal justice system. Comparisons of male and female offenders have found 40% of female offenders were under the influence of substances at the time of their index offense as opposed to 32% of male offenders (Bureau of Justice Statistics, 1999). This is further supported by findings that 89% of female offenders reported regular substance use as opposed to 76% of men (Bureau of Justice Statistics, 1999). Higher levels of Axis I clinical syndromes have also been found in female prisoners in comparison to male prisoners. Research has demonstrated higher levels of schizophrenia (19.4% vs. 7.8%), delusional disorder (3.9% vs. 2.7%), lifetime depression (67.8% vs. 30.4%), drug dependence (60.1% vs. 38.7%) and alcohol disorder (27.8% vs. 20.4%) in female prisoners compared to male prisoners (Coid, Yang, Ullrich, Zhang, Sizmur, Roberts, Farrington, & Rogers, 2009). These research findings are further supportive of links between mental illness and substance use to female pathways to offending behavior. Generally, the overarching findings tend to support the impact of gender upon pathways into the criminal justice system, which raises important considerations for the assessment of risk, and treatment of female offenders within criminal justice settings.

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2.2. Gender and offense characteristics Offense characteristics also tend to differ depending on gender. Drug offenses are highly prevalent in the female prison population. Drug offenses accounted for 29% of female prisoners in the England and Wales in January 2008 (Prison Reform Trust, 2008). Females are also more highly represented in the crimes of theft, fraud, and offenses by prostitutes (Home Office, 2006). Females are significantly less likely to be convicted of sexual offending with literature suggesting females perpetrate about 5% of sexual offenses against children (Bunting, 2005). With regard to an index offense of murder, females are more likely to murder an intimate partner and less likely to murder a stranger in comparison to male counterparts (Bloom et al., 2003; Greenfeld & Snell, 1999). This supports the suggestion that the violence of women is more likely to be reactive as opposed to instrumental (Verona & Carbonell, 2000). In addition, for parents who have murdered their children, mothers were noted to be more likely to kill their children during infancy, whereas fathers were more likely to have killed children over the age of seven (Greenfeld & Snell, 1999). Motivational similarities have been noted for males and females in respect of non-familial homicide whereas motivational factors have been noted to diverge with respect of intimate homicide (Belknap, 2001; Daly & Wilson, 1988; Kruttschnitt, 2001; Wilczynski, 2005). Research literature suggests when females murder intimate partners it is often following a large amount of previous domestic abuse (Belknap, 2001); jealousy, infidelity, desertion, and control often underlie motivations with males who murder their intimate partners (Daly & Wilson, 1988). Differences have also been observed regarding non-familial crime with women found to be less violent when committing robbery (Miller, 1998). Women have also been noted to be less likely to use a weapon than males (Greenfeld & Snell, 1999). There is growing evidence, however, that girls are becoming more likely to engage in weapon use and are increasingly becoming involved in gangs (Chesney-Lind & Pasko, 2004). Thus, although there is some suggestion that violence is less prevalent in females, there is evidence this may not indeed be the case. Indeed, it is often thought that intimate partner violence is predominated by male perpetrators, although there is a plethora of research suggesting females perpetrate similar if not greater levels of domestic violence (Archer, 2000, 2002; Bookwala, 2002). 2.3. Existing risk assessments Traditionally, actuarial scales or risk assessment measures focused on static, historical variables and were accepted as the most accurate method of assessing for future risk of violence (Harris, Rice, & Quinsey, 1993; Monahan, 1981). The Violence Risk Appraisal Guide (VRAG: Quinsey, Harris, Rice, & Cormier, 1998) and STATIC 99 (Hanson & Thornton, 1999) are examples of actuarial risk assessment measures premised upon the use of static variables. Many authors criticized this approach to risk assessment, however, suggesting actuarial measures over-emphasize static variables to the detriment of individual clinical variables and eradicate the role of professional judgment (Hart, 1998a). It is notable, however, that clinical judgment alone has been described as overwhelmed by unreliability (Monahan, 1981), and limited by difficulty in predicting probability accurately (Kahneman & Tversky, 1973). Dynamic risk factors are those which may be described as changeable or amenable to change through intervention and treatment (Quinsey et al., 1998). It is acknowledged that dynamic variables do not outperform static variables. However, it is also clear that they are a crucial component to treatment planning and intervention and simultaneously provide greater levels of hope for the prisoner or patient (Raynor, 1997). Structured clinical risk assessments assess both static and dynamic risk factors and act as a guide or ‘aide memoir’ for clinical assessment of risk. The HCR-20 (Webster, Douglas, Eaves, & Hart, 1997), Violence

Risk Scale (VRS; Wong & Gordon, 1999, 2000), Spousal Assault Risk Assessment Guide (SARA; Kropp, Hart, Webster, & Eaves, 1994), Stalkers Assessment and Management (SAM; Kropp, Hart, & Lyon, 2006) and Risk of Sexual Violence Protocol (RSVP; Hart et al., 2003) are examples of some widely used structured clinical risk assessments. The HCR-20 (Webster et al., 1997a) is a violence risk assessment that has been employed in a variety of forensic settings to determine risk of violence. The HCR-20 aligns variables into past, present, and future. The 10 ‘Historical’ factors concern the past and are static risk factors. The five ‘Clinical’ factors refer to current dynamic variables that are associated with violence. The five ‘Risk Management’ items reflect situational or ‘future’ factors which may mitigate or exacerbate risk. The HCR-20 is an attempt to amalgamate science and practice through devising an instrument that is easily employed in practice but also empirically testable and defensible. The link between psychopathy and violent behavior has been the subject of much research, and the use of the Psychopathy Checklist— Revised (PCL-R; Hare, 1991) has become increasingly widespread in forensic settings. Psychopathy is a discrete personality disorder and is defined by behavioral, affective and interpersonal symptoms. While the PCL-R was not designed as a risk assessment measure for violence, there is a range of research findings suggesting a link between psychopathy and institutional misconduct (e.g., Edens, Petrila, & Buffington-Vollum, 2001), general offending (Loucks & Zamble, 2000), sexual offending (Firestone et al., 1998; Porter, Woodworth, Earle, Drugge, & Boer, 2003), and future violence (Cooke, Forth, & Hare, 1998; Hart, 1998a,b, Hemphill, Hare, & Wong, 1998). Psychopathy as measured by the PCL-R also forms part of risk assessment tools including the HCR-20, VRAG, SAM, SARA, and RSVP. 2.4. Use of existing risk assessments with female offenders The risk assessment measures previously outlined were without exception developed from research on male offenders, albeit subsequently applied to female offenders. This is a contentious issue as it is premised on the assumption that risk factors for both males and females are comparable. Although some researchers argue there is little difference between both populations (Hare, 2003; Loucks & Zamble, 1999; Simourd & Andrews, 1994), other research suggests several more relevant risk factors for females including victimization, childcare, self-esteem, poverty, women's unique health, substance abuse, and mental health issues (Bloom et al., 2003). Additional risk factors including parenting, dysfunctional intimate relationships and self-esteem have also been argued to significantly upon women's likelihood to engage in criminal behavior (Salisbury, 2007). These risk factors are not always included in the aforementioned tools. There is also a growing amount of empirical research suggesting links between the aforementioned factors and risk of women. Research has found associations between child abuse, self-efficacy, and dysfunctional relationships with prison misconducts (Salisbury, Van Voorhis, & Spiropoulos, 2009). Links have also been demonstrated between likelihood of re-arrest and low self-esteem, low selfefficacy, parenting difficulties, victimization, financial difficulties, mental illness, lack of family support, and substance use (Salisbury, Van Voorhis, & Wright, 2006). Thus, there appears to be growing support for gender-specific risk factors although the nature and strength of association with risk of reoffending requires further exploration. 2.4.1. Implications for risk assessments with females The implications of these findings are that risk assessment measures derived from male offender samples may not be accurate in the classification of risk for women (Van Voorhis & Presser, 2001). While it would be preferable that risk assessment procedures informed by gender were constructed based on samples of female offenders, no such measures currently exist. Therefore, while

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recognising the potential limitations of existing risk assessment measures, forensic practitioners wish to employ risk assessment measures that have demonstrated reliability and validity with female offenders. Some of the more commonly employed risk assessments within female forensic settings include the HCR-20 and VRS-2. Although the PCL-R was not specifically designed as a measure of risk, it is also becoming increasingly used with female populations to inform conceptualization of risk. In light of previous observations concerning gender differences in risk factors associated with offending behavior, exploration of the strengths and weaknesses of such measures as applied to female forensic populations seems warranted. 3. Structured risk assessments: empirical findings with female offenders 3.1. HCR-20 Strand and Belfrage (2001) compared the difference between male and female forensic patients on item and subscale scores of the HCR-20. Using the Swedish translation of the HCR-20, 63 female patients who entered a Swedish forensic facility over 10 years were compared to 85 male patients admitted to two Swedish forensic hospitals in 1998. There were no differences in scale or total scores across gender, although there were differences identified between some of the items. Males scored higher on Previous Violence (H1), Young Age (H2), Substance Use Problems (H5), and Negative Attitudes (C2). Females scored higher on Personality Disorder (H9), Impulsivity (C4), and Stress (R5). These findings are likely to reflect gender differences in risk factors linked to offending behavior, and also support propositions that female offenders tend to score lower on risk factors linked to anti-social behavior than males (Nicholls & Petrila, 2005). That females tended to score higher on the Personality Disorder (H9) also highlights personality disorder as a pertinent risk factor for females. The particularly high prevalence of Borderline Personality Disorder within female prisoners (Singleton, Meltzer, Gatward, Coid, & Deasy, 1998) requires further exploration regarding its explicit links to risk of engaging in offending behavior. There are a number of studies exploring the predictive validity of the HCR-20 in female populations. Nicholls, Ogloff, and Douglas (2004) explored the utility of the HCR-20 as a violence screening measure of civil psychiatric inpatient and community violence. Predictive analysis using ROC (Receiver Operating Characteristics) AUC values which evaluate predictive accuracy of variables demonstrated the HCR-20 did not predict inpatient violence for males; however, it showed moderate to large effect sizes for females. For post-release violence moderate to large effect sizes were demonstrated for both males and females. While prediction of community violence was comparable across genders, it is noteworthy that the HCR-20 performed better in the prediction of inpatient violence of females than males. Douglas, Ogloff, Nicholls, and Grant (1999) used a combined sample of 193 detained men (61%) and women (39%) to explore the predictive ability of the HCR-20 in predicting community violence over an average of 626 days post-release. They found similar findings to Nicholls et al. (2004) with the HCR-20 demonstrating moderate to large effect sizes for different categories of violence including physical violence, threatening violence, criminal violence, and any violence for both males and females. de Vogel and de Ruiter (2005) examined the predictive validity of the HCR-20 in a sample of 42 personality disordered female patients admitted to a Dutch forensic psychiatric hospital. The findings were compared with those for a matched sample of 42 male personality disorder forensic psychiatric patients. de Vogel and de Ruiter (2005) found significant differences between item scores across gender, but the subscale scores (Historical, Clinical, Risk Management) were comparable. For male patients, the HCR-20 total score demonstrated good to excellent predictive validity for violent outcomes (violent

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recidivism and inpatient violence); however, predictive accuracy for female patients was much lower. In females, only the HCR-20 final risk judgment and not the total score demonstrated significant predictive validity for violent outcomes. It was noted that the three most frequently coded ‘other considerations’ differed for each gender. For men, they were financial problems, lack of prospects for the future, and violent fantasies; for women, they were forming a new relationship, care for children, and prostitution. This supports a previously outlined point by Lowenkamp, Holsinger, and Latessa (2001) regarding the potentially differing risk factors relevant for female offenders. This research also suggests the HCR-20 may be maximized with female offenders when judgments of final risk are employed as opposed to the summation of individual risk factors. A recent large scale prospective study of a cohort of male and female prisoners in England and Wales was undertaken by Coid et al. (2009). The study included 1396 male prisoners and 321 female prisoners with either a violent or sexual index offense. The predictive ability of a number of measures were compared among men and women including the HCR-20 (Webster et al., 1997); PCL-R (Hare, 1991, 2003); VRAG (Quinsey et al., 1998); Risk Matrix 2000—Violence (RM2000 [V]; Thornton et al., 2003) and OGRS—II (Copas & Marshall, 1998; Taylor, 1999). The HCR-20 H subscale demonstrated the highest predictive ability in comparison to other measures for violent reoffending of women in comparison to men. It is notable perhaps that the H subscale of the HCR-20 includes the risk factor Major Mental Illness (H6). Within this study, female prisoners were found to have higher levels of Axis I clinical syndromes in comparison to men. This is in line with previous suggestion of links between mental illness and women's pathway into offending behavior (Chesney-Lind, 2000). 3.2. Utilizing the HCR-20 with female offenders The above findings provide promising preliminary evidence regarding employing the HCR-20 as a risk assessment measure with female offenders. de Vogel and de Ruiter (2005) findings are particularly promising regarding employing the HCR-20 with personality disordered female offenders. Their results also emphasize when employing the HCR-20 with female offenders it is particularly important to employ the final risk judgment in the form of deciding whether a women is of low, medium, or high risk for violence. It is noteworthy, however, that employing final risk judgment as opposed to using HCR-20 scores is the recommendation of the Webster et al. (1997) when applied to both male and female offenders. An interesting point perhaps is whether HCR-20 items used to inform these final risk judgments differ for both males and females and whether the presence of one pertinent factor may influence final risk judgments for females but may not for males and vice versa. Webster et al. (1997) acknowledge it may be reasonable to decide an individual is of high risk on the basis of the presence of one individual item, for example if an individual presents with ‘Active Symptoms of Mental Illness’ (C3) and has expressed intent to commit murder. The findings of de Vogel and de Ruiter (2005) that identify gender differences in ‘other considerations’ coded in the HCR-20 suggest there may be differences in the factors used to reach final risk judgments when applied to female offenders. Perhaps risk factors including abuse, problematic intimate relationships, and parenting style may be more heavily weighted although this requires further investigation. In addition, application of the HCR-20 to female offenders who have perpetrated offenses with a low baseline including sex offenses and child cruelty also warrants further exploration. 3.3. Violence Risk Scale (VRS-2) The VRS-2 (Wong & Gordon, 1999, 2000) utilizes 6 static and 20 dynamic risk factors derived from the research literature identifying risk factors associated with violence. Each factor is scored on a 4-point

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scale with higher scores reflecting greater link with violence. Items receiving a score of zero are indicative of an individual's area of strength. The stages of the change model (Prochaska, DiClimente, & Norcross, 1992) have been integrated into the VRS-2 to assess motivation to change and subsequently measure change following treatment. It has been suggested that the VRS-2 has performed well in descriptive data to date but further research is required to further support its use with female offenders (Logan, 2002). This implies a lack of research exploring the applicability of the VRS-2 with women. There is currently research being undertaken, however, with a large sample of female offenders employing a number of risk assessment measures including the VRS-2 (C. Stewart, Personal Communication, 31 March 2008) and the outcome data of this study will provide further information regarding the applicability of the VRS-2 with women. 4. Psychopathy in females 4.1. Psychopathy Checklist—Revised (PCL-R) There is a demonstrable link between psychopathy and violent behavior and violent recidivism (Hare, 1996; Hart, 1998a,b; Hemphill et al., 1998). The Psychopathy Checklist—Revised (PCL-R, 2nd Edition; Hare, 2003) is currently the most widely accepted measure of psychopathy. The Psychopathy Checklist Screening Version (PCL: SV) is highly correlated with the PCL-R and is often employed as a shorter method of screening for psychopathic disorders. The PCL-R consists of two highly correlated factors, with Factor 1 representing interpersonal and affective characteristics indicative of a callous disregard for others, whereas Factor 2 represents behavioral traits indicative of an anti-social lifestyle and social deviance (Hare et al., 1990). Hare (2003) acknowledged further research is required regarding the applicability of the PCL-R to female offenders although simultaneously stated the descriptive properties and some of the psychiatric and criminal justice correlates are similar to those identified with male offenders. There is a growing amount of research exploring use of the PCL-R with female samples. Forouzan and Cooke (2005) highlighted some issues regarding the applicability of the same criteria for diagnosis of psychopathy within females, the question of whether the PCL-R measures the same construct in females, and whether psychopathy possesses the same forensic utility across genders. Understanding of these issues is crucial for both practical and theoretical reasons. It is generally accepted that prevalence rates of psychopathy are lower in females than males (Jackson, Rogers, Neumann, & Lambert, 2002; Vitale, Smith, Brinkley, & Newman, 2002). Although this may be rephrased to state that PCL-R scores tend to be lower in female populations, in light of questions surrounding whether the PCL-R is tapping the same construct across gender. Thus, prevalence rates become more unclear. 4.2. Gender differences in factor structure of PCL-R It has also been observed that there are gender differences in the factor structure of psychopathy which suggest the PCL-R items may vary in salience across gender (Bolt, Hare, Vitale, & Newman, 2004). Grann (2000) study of 36 female and 36 male Swedish forensic psychiatric patients suggested the PCL-R items assessing a callous lack of empathy and juvenile delinquency were more characteristic of males while promiscuous sexual behavior was found to be more characteristic of females. Forouzan (2003) identified the behavioral expression of psychopathy in females differs from that of males. Expression of manipulation in females was described as flirtatious behavior, whereas conning behavior was more characteristic of males. In addition, impulsivity and conduct disorder were more likely to take the form of self-harm, running away, manipulation, and complying to commit offenses among females. In males, impulsivity and conduct

disorder were more likely to manifest as violent behavior (Forouzan, 2003). This is suggestive of variance in the manifestation of psychopathic traits across gender. Hare (1991) acknowledged that psychopathy may be ‘expressed’ differently in males and females and commented some PCL-R items may require modification when applied to females (p. 64). Although this acknowledgement was made in the first edition of the PCL-R Manual (Hare, 1991) there was little explanation of what was meant in terms of modification and there are no recommendations in the subsequent second edition of the PCL-R (Hare, 2003) regarding what form modification may take with female offenders. 4.3. Empirical findings Research with male samples has generally suggested the anti-social and unstable lifestyle traits consistent with Factor 2 of the PCL-R are a better predictor of institutional violence and recidivism than the affective and interpersonal traits consistent with Factor 1, with a meta-analysis of 42 studies supporting this assertion (Walters, 2003). There is a growing amount of speculation, however, regarding whether Factor 2 is an equally powerful predictor of outcomes in female samples. Salekin, Rogers, Ustad, and Sewell (1998) study of female offenders found that Factor 1 demonstrated a significant association with recidivism whereas the relationship between Factor 2 and recidivism was minimal. This finding is in contrast with studies of male offenders suggesting Factor 2 items are more closely related to general recidivism in comparison to Factor 1 items (Barbaree, Seto, Serin, Amos, & Preston, 1994). Richards, Casey, and Lucente (2003) explored the predictive validity of the PCL-R in an initial sample of 404 incarcerated women in substance abuse treatment. Results indicated a significant correlation between number of charge-free days and total psychopathy score. Results showed that women's PCL-R scores, particularly Factor 1 scores were significant in the prediction of new charges. The significant correlation between Factor 1 scores and general recidivism mirror findings of Salekin and colleagues and suggest Factor 1 as a stronger predictor whereas Factor 2 is less promising. It is also supported by the findings of Strand and Belfrage (2005) who found women who met criteria for psychopathy on the PCL: SV scored significantly lower on the item measuring adolescent anti-social behavior than the comparison sample of males. Coid et al. (2009) also found in their recent large prospective study that Factor 1 showed predictive ability for the violent reoffending of women but not for men. Nicholls and Petrila (2005) suggest adult anti-social behavior may also be less discriminating for diagnosis of psychopathy among females. The link between Factor 1 of the PCL-R and recidivism is consistent with suggestions that interpersonal and affective risk factors are particularly salient factors for women and their risk of reoffending (Odgers, Repucci, & Moretti, 2005). The substantial body of research suggesting the PCL-R is a robust predictor of criminal behavior including violence among males (Hare, 2003), would tend to suggest if the same is true of females, psychopathy scores would show links with levels of institutional violence and aggression. Douglas et al. (1999) demonstrated the PCL: SV predicted four categories of violence including physical violence, threatening violence, criminal violence, and any violence in a combined sample of 193 involuntarily committed Canadian men (61%) and women (39%). In addition, unpublished research supports this association with a positive correlation with PCL-R scores in female offenders and institutional convictions and violence (Loucks, 1995). In a similar vein, Loucks and Zamble (2000) also found a link between women's PCL-R scores and the number of violent criminal convictions, institutional convictions and number of violent institutional convictions. Vitale et al. (2002) reported similar findings to above. A number of unpublished studies on psychopathy in women offenders have also suggested a moderate to strong association with

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official criminal records of general and violent convictions (Loucks, 1995; Strachan, 1993). As a result of reservations regarding the similarity of factor structures and of individual symptoms, it is a highly contentious issue as to whether raw PCL-R total scores represent the same level of psychopathy across gender. Therefore, the question of diagnostic cut-offs remains debatable. As a result, the PCL-R cut-off score of 30 has been employed by some studies (Vitale et al., 2002) whereas others have established a cut-off score based on the results obtained in their sample (e.g., a total score of 20 or more) (Grann, 2000, Rutherford, Cacciola, & Alterman, 1999). This is due to the fact that none, or very few of the women in these studies scored at the traditional cut-off score level. The divergent factor structure demonstrated among males and females suggest the construct measured by the PCL-R may not be equivalent across gender, and some authors have suggested the factor structure of psychopathy may need to be re-worked for female populations (Cooke & Michie, 2001). 4.4. Utilizing the PCL-R with female offenders The contradictory findings of studies on the PCL-R in females suggest there may be misconceptions regarding the underlying dimensions and the nature of psychopathy in women. This is supported by the growing amount of evidence suggesting there may be ‘sex differences in the behavioral manifestations of psychopathy’ and that psychopathy may be ‘expressed’ differently in men and women (Hare, 1991, p. 64). There is a more general concern about whether in female populations the PCL-R captures the construct of psychopathy satisfactorily. The increasing application of the PCL-R within female forensic settings presents contentious issues. To merely assume psychopathy in females is equally predictive to findings among males presents the possibility of human rights issues and potential misconception of level of risk. Although evidence for the PCL-R as a predictor of general recidivism and violence is generally accepted to be less robust than findings with males, there is a growing body of evidence suggesting links between the PCL-R scores of females and aggression, general recidivism, violent recidivism, institutional misconduct and violent misconduct. 5. Conclusions and recommendations This review raises some points relevant to assessment of risk of women in forensic settings. It appears the pathways of females into the criminal justice system differs from that of males where factors including abuse, substance use and mental health problems appear particularly characteristic of female pathways into offending behavior. The differing offense and victim characteristics alongside at times apparently differing motivations underlying the violence of females suggest traditional assessments of risk employed with male offenders may not fully inform conceptualization of risk. There are also some variables including self-esteem, health, parenting difficulties, trauma, and forms of victimization that inform assessment of risk in female offenders that may not be covered in traditional risk assessments. The review of use of the HCR-20 with female samples raised some interesting observations, namely, final risk judgments as opposed to total HCR-20 scores appear to be more predictive of risk for female offenders. This raises questions as to whether other factors besides those covered in the HCR-20 are employed in such a final judgment as HCR-20 scores have been found to predict violent outcomes in males more accurately than with females. For example, in de Vogel and de Ruiter (2005), study forming a new relationship, childcare, and prostitution were found to be relevant for females suggesting they may inform risk judgments. Research exploring factors and the weighting applied to these factors used to inform judgments of risk when employing the HCR-20 would be particularly beneficial. For example, it may be that judgments of parenting difficulties are

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weighted particularly strongly when the HCR-20 is applied to female offenders who have offended against their own children, or perhaps this may be the case with female offenders more generally. The application of risk assessments to female sex offenders is also an area which requires further research, as it unclear as to what factors are routinely used to conceptualize judgments of risk with this particular offending population. Overall, it was found there is increasing levels of evidence supporting the use of the HCR-20 to inform conceptualization of risk with women when risk judgments as opposed to scores are employed, although further research is required regarding what other factors may further aid the HCR-20 when employed with this population. Research on use of the PCL-R with female samples has demonstrated links between levels of psychopathy and institutional violence, recidivism, and future violence. It seems, however, that the affective and interpersonal traits consistent with Factor 1 may be a better predictor of future offending than the anti-social and unstable lifestyle traits reflected in Factor 2. This is in conflict with the literature on male offenders although further research is required to explore whether this association between Factor 1 is also found with institutional aggression and future violence in female samples. Although the PCL-R is not a risk assessment per se, the findings are generally employed to inform conceptualization and formulation of risk. Therefore, if indeed Factor 1 scores are demonstrated to have stronger correlations with the violence of females this may have a number of potential implications. It may be that the interpersonal and affective characteristics of psychopathy are more predictive of future risk in females and thus overall PCL-R scores may be less informative, although this requires further exploration to elucidate this area. There is also suggestion that the behavioral expression of psychopathy within females may differ and there is primary research supporting this suggestion. The diagnostic cut-off scores for the PCL-R remain contentious and have varied in different studies with females. Jackson et al. (2002) found evidence that employing a cut-off score of 25 or above discriminates well between females meeting criteria for psychopathy and those who do not. The varying evidence available provides tentative support for this assertion and employing a cut-off score of 25 with female offenders. Overall, the research supports the use of the HCR-20 and PCL-R with female populations to inform conceptualization of risk of violent reoffending. Further research is required however to illuminate some of the points raised in this review regarding the use of the HCR-20 and PCL-R. A particular focus on risk factors that may further inform assessment of risk of females when utilizing the HCR-20 would be valuable. With regards the PCL-R further exploration of the construct of psychopathy in females, the behavioral expression of such, and a greater understanding of questions regarding factor structure would also be advantageous to inform its use with female populations. This would better inform decision making with regards to the implementation of cut-off scores with female offenders. Acknowledgements I would like to acknowledge all members of the Primrose DSPD (Dangerous and Severe Personality Disorder) team in particular Dr. Susan Cooper and Dr. Ray Travers for all their support and advice regarding the undertaking of this review. References Archer, J. (2000). Sex differences in aggression between heterosexual partners: A metaanalytic review. Psychological Bulletin, 126, 651−680. Archer, J. (2002). Sex differences in physically aggressive acts between heterosexual partners: A meta-analytic review. Aggression and Violent Behavior, 7, 213−351. Barbaree, H. E., Seto, M. C., Serin, R., Amos, N., & Preston, D. (1994). Comparisons between sexual and nonsexual rapist subtypes: Sexual arousal to rape, offense precursors, and offense characteristics. Criminal Justice and Behavior, 21, 95−114.

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Belknap, J. (2001). The invisible woman: Gender, crime, and justice, 2nd edn. California: Wadsworth Publishing Company. Belknap, J. (2007). The invisible woman: Gender, crime, and justice, 3rd ed. Belmont, CA: Thompson Wadsworth. Belknap, J., & Holsinger, K. (2006). The gendered nature of risk factors for delinquency. Feminist Criminology, 1, 48−61. Bloom, B., Owen, B., & Covington, S. (2003). Gender-responsive strategies: research, practice and guiding principles for women offenders. Washington DC: National Institute of Corrections. Bolt, D. M., Hare, R. D., Vitale, J. E., & Newman, J. P. (2004). A multigroup item response theory analysis of the Psychopathy Checklist—Revised. Psychological Assessment, 16, 155−168. Bookwala, J. (2002). The role of own and perceived partner attachment in relationship aggression. Journal of Interpersonal Violence, 17, 84−100. Browne, A., & Finkelhor, D. (1986). Impact of child sexual abuse: A review of research. Psychological Bulletin, 99, 66−77. Bunting, L. (2005). Females who sexually offend against children: responses of the child protection and criminal justice systems. Executive summary. Bureau of Justice Statistics (1999c). Prior abuse reported by inmates and probationers. Washington, DC: U.S. Department of Justice. Chesney-Lind, M. (1997). The female offender: Girls, women, and crime. Thousand Oaks, CA: Sage. Chesney-Lind, M. (2000). What to do about girls? Thinking about programs for young women. In M. McMahon (Ed.), Assessment to assistance: Programs for women in community corrections (pp. 139−170). Lanham, MD: American Correctional Association. Chesney-Lind, M., & Pasko, L. (2004). The female offender: girls, women, and crime. Newbury Park, CA: Sage Publications, Inc. Chesney-Lind, M., & Shelden, R. G. (2004). Girls, delinquency, and juvenile justice, 3rd ed. Belmont, CA: Thompson Wadsworth. Coid, J., Yang, M., Ullrich, S., Zhang, T., Sizmur, S., Roberts, C., Farrington, D. P., & Rogers, R. D. (2009). Gender differences in structured risk assessment: comparing the accuracy of five instruments. Journal of Consulting and Clinical Psychology, 77(2), 337−348. Cooke, D. J., Forth, A. E., & Hare, R. D. (Eds.). (1998). Psychopathy: Theory, research and implications for society. Dordrecht: Kluwer Academic Publishers. Cooke, D. J., & Michie, C. (2001). Refining the construct of psychopathy: Towards a hierarchical model. Psychological Assessment, 13, 171−188. Copas, J. B., & Marshall, P. (1998). The Offender Group Reconviction Scale: The statistical reconviction core for use by probation officers. Journal of the Royal Statistical Society, 47, 159−171. Corston, J. (2007). The Corston Report: A review of women with particular vulnerabilities in the criminal justice system. Daly, K. (1992). Women's pathways to felony court: Feminist theories of lawbreaking and problems of representation. Southern California Review of Law and Women's Studies, 2, 11−52. Daly, K. (1994). Gender, crime, and punishment. New Haven, CT: Yale University Press. Daly, K., & Wilson, M. (1988). Homicide. New York: Aldine De Gruyter. de Vogel, V., & de Ruiter, C. (2005). The HCR-20 in personality disordered female offenders: A comparison with a matched sample of males. Clinical Psychology and Psychotherapy, 12, 226−240. Department of Health (2002). Women's mental health: Into the mainstream. Strategic development of mental health care for women. London: Department of Health. Disability Action Inc. (1997). Women in prison and disability project. Mile End, South Australia: Disability Action Inc. Douglas, K., Ogloff, J., Nicholls, T., & Grant, I. (1999). Assessing risk for violence among psychiatric patients: The HCR-20 Violence Risk Assessment Scheme and the Psychopathy Checklist. Journal of Consulting and Clinical Psychology, 67, 917−930. Edens, J. F., Petrila, J., & Buffington-Vollum, J. K. (2001). Psychopathy and the death penalty: Can the psychopathy checklist-revised identify offenders who represent a continuing threat to society? Journal of Psychiatry & Law, 29(4), 433−448. Firestone, P., Bradford, J. M., McCoy, M., Greenberg, D. M., Curry, S., & Larose, M. R. (1998). Recidivism in convicted rapists. Journal of the American Academy of Psychiatry and the Law Online, 26(2), 185−200. Fondacaro, K. M., Holt, J. C., & Powell, T. A. (1999). Psychological impact of childhood sexual abuse on male inmates: The importance of perception. Child Abuse and Neglect, 23, 361-169. Forouzan, E. (2003). Psychopathy among women: Conceptualisation and assessment problems. Third Annual International Association of Forensic Mental Health Services (IAFMHS) Conference, Miami, FL (pp. 3). Forouzan, E., & Cooke, D. J. (2005). Figuring out la femme fatale: Conceptual and assessment issues concerning psychopathy in females. Behavioral Sciences and the Law, 23, 765−778. Gilfus, M. E. (1992). From victims to survivors to offenders. Women's routes of entry and immersion into street crime. Women & Criminal Justice, 4, 63−90. Grann, M. (2000). The PCL-R and gender. European Journal of Psychological Assessment, 16, 147−149. Greenfeld, L., & Snell, T. C. (1999). Women offenders. Bureau of Justice Statistics. Hanson, R. K., & Thornton, D. (1999). Static-99: Improving actuarial risk assessments for sex offenders (User Report No. 99-02). Ottawa, Canada: Department of the Solicitor General of Canada. Hare, R. D. (1991). The Hare Psychopathy Checklist—Revised. Toronto, Ontario, Canada: Multi-Health Systems. Hare, R. D. (1996). Psychopathy: A clinical construct whose time has come. Criminal Justice and Behavior, 23(1), 25−54. Hare, R. D. (2003). Hare Psychopathy Checklist—Revised (PCL-R), 2nd ed. Technical manual. North Tonawanda, NY: Multi-Health Systems.

Hare, R. D., Harpur, T. J., Hakstian, A. R., Forth, A. E., Hart, S. D., & Newman, J. P. (1990). The Revised Psychopathy Checklist: Descriptive statistics, reliability, and factor structure. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 2, 338−341. Harris, G. T., Rice, M. E., & Quinsey, V. L. (1993). Violent recidivism of mentally disordered offenders: The development of a statistical prediction instrument. Criminal Justice and Behaviour, 20, 315−335. Hart, S. D. (1998a). Psychopathy and risk for violence. In D. Cooke, A. E. Forth, & R. D. Hare (Eds.), Psychopathy: Theory, research and implications for society (pp. 355−375). Dordrecht, The Netherlands: Kluwer. Hart, S. D. (1998b). The role of psychopathy in assessing risk for violence: Conceptual and methodological issues. Legal and Criminological Psychology, 3, 121−137. Hart, S. D., Kropp, P. R., Laws, D. R., Klaver, J., Logan, C., & Watt, K. A. (2003). The Risk for Sexual Violence Protocol (RSVP): Structured professional guidelines for assessing risk of sexual violence. Burnaby, British Columbia: Mental Health, Law, and Policy Institute, Simon Fraser University; Pacific Psychological Assessment Corporation; and the British Columbia Institute Against Family Violence. Hemphill, J. F., Hare, R. D., & Wong, S. (1998). Psychopathy and recidivism: A review. Legal and Criminological Psychology, 3, 139−170. Holsinger, K. (2000). Feminist perspectives on female offending: Examining real girls' lives. Women & Criminal Justice, 12, 23−51. Home Office. (2006). Statistics Commision Report No. 30. Crime Statistics: User Perspectives. available online at. http://www.statscom.org.uk/uploads/files/ reports/Crime_Statistics_Review-final.pdf. Jackson, R. L., Rogers, R., Neumann, C. S., & Lambert, P. L. (2002). Psychopathy in female offenders: An investigation of its underlying dimensions. Criminal Justice & Behavior, 29, 692−704. Johnson, R. J., Ross, M. W., Wendell, C. T., Williams, M. L., Carvajal, R. I., & Peters, R. J. (2006). Prevalence of childhood sexual abuse among incarcerated males in county jail. Child Abuse & Neglect, 30, 75−86. Jordan, B. K., Schlenger, W. E., Fairbank, J. A., & Cadell, J. M. (1996). Prevalence of psychiatric disorders among incarcerated women. Archives of General Psychiatry, 53(6), 513−519. Kahneman, D., & Tversky, A. (1973). On the psychology of prediction. Psychological Review, 80, 237−257. Kropp, P. R., Hart, S. D., & Lyon, D. R. (2006). The Stalking Assessment and Management Guidelines (SAM): User manual. Vancouver, Canada: ProActive ReSolutions Inc. Kropp, P. R., Hart, S. D., Webster, C. D., & Eaves, D. (1994). Manual for the spousal assault risk assessment guide. Vancouver, British Columbia: British Columbia Institute on Family Violence. Kruttschnitt, C. (2001). Gender and violence. In C. M. Renzetti, & L. Goodstein (Eds.), Women, crime, and criminal justice: Original feminist readings (pp. 77−92). Los Angeles: Roxbury Publishing Company. Logan, C. (2002). Dangerous and Severe Personality Disorder Women's Services Preassessment Pilot: Unpublished Academic Report. Home Office and HM Prison Service. Loucks, A.D. (1995). Criminal behaviour, violent behaviour, and prison maladjustment in federal female offenders. Unpublished doctoral dissertation. Queen's University, Kingston, Ontario. Loucks, A. D., & Zamble, E. (1999). Predictors of recidivism in serious female offenders. Corrections Today, 61, 26−32. Loucks, A.D. and Zamble, E. (2000). Predictors of criminal behaviour and prison misconduct in serious female offenders. Unpublished manuscript, Queen's University, Kinston, Ontario, Canada. Lowenkamp, C. T., Holsinger, A. M., & Latessa, E. J. (2001). Risk/need assessment, offender classification, and the role of childhood abuse. Criminal Justice and Behavour, 28(5), 543−563. Miller, J. (1998). Up it up: Gender and the accomplishment of street robbery. Criminology, 36, 37−66. Miller-Warke, J. (2000). Prisoners as women: Questioning the role and place of imprisonment. Paper presented at the Women in corrections, staff and clients conference. Adelaide: Australian Institute of Criminology. Monahan, J. (1981). Predicting violent behaviour: An assessment of clinical techniques. Beverly Hills, CA: Sage. Nicholls, T., Ogloff, J., & Douglas, K. (2004). Assessing risk for violence among male and female civil psychiatric patients: the HCR-20, PCL:SV, and McNiel & Binder's screening measure. Behavioral Sciences and the Law, 22, 127−158. Nicholls, T., & Petrila, J. D. (2005). Gender and psychopathy: An overview of important issues and introduction to the special issue. Behavioural Sciences and the Law, 23(6), 729−741. Odgers, C. L., Repucci, N. D., & Moretti, M. M. (2005). Nipping psychopathy in the bud: An examination of the convergent, predictive, and theoretical utility of the PCL:YV among adolescent girls. Behavioral Sciences and the Law, 23, 743−763. Porter, S., Woodworth, W., Earle, J., Drugge, J., & Boer, D. P. (2003). Characteristics of sexual homicides committed by psychopathic and nonpsychopathic offenders. Law and Human Behavior, 27, 459−470. Prison Reform Trust (2008). Bromley Briefings: Prison Factfile. available online at. http:// www.prisonreformtrust.org.uk/temp/FactfilespPROOFspJUNE08small.pdf. Prochaska, J. O., DiClimente, C. C., & Norcross, J. C. (1992). In search of how people change: Applications to addictive behaviours. American Psychologist, 47, 1102−1114. Quinsey, L., Harris, G. T., Rice, M. E., & Cormier, C. A. (1998). Violent offenders: Appraising and managing the risk. Washington D.C.: American Psychological Association. Raynor, P., 1997. Implementing the 'Level of Service Inventory-Revised' (LSI-R) in Britain: Initial results from five probation areas. The Cognitive Centre Foundation, Swansea. Richards, H. J., Casey, J. O., & Lucente, S. W. (2003). Psychopathy and treatment response in incarcerated female substance abusers. Criminal Justice & Behavior, 30, 251−276.

A. McKeown / Aggression and Violent Behavior 15 (2010) 422–429 Rutherford, M. J., Cacciola, J. A., & Alterman, A. I. (1999). Antisocial personality disorder and psychopathy in cocaine-dependent women. American Journal of Psychiatry, 156, 849−856. Salekin, R. T., Rogers, R., Ustad, K., & Sewell, K. W. (1998). Psychopathy and recidivism among female inmates. Law and Human Behavior, 22, 109−128. Salisbury, E.J. (2007). Gendered pathways: An investigation of women offenders' unique paths to crime. Unpublished doctoral dissertation, University of Cincinnati, Cincinnati, OH, Criminal Justice. Salisbury, E. J., Van Voorhis, P., & Spiropoulos, G. V. (2009). The predictive validity of a gender-responsive needs assessment: An exploratory study. Crime & Delinquency, 55, 550−585. Salisbury, E. J., Van Voorhis, P., & Wright, E. (2006). Construction and validation of a gender responsive risk/needs instrument for women offenders in Missouri and Maui. Presented at the Annual Meeting of the American Society of Criminology, Los Angeles, CA. Siegel, J. A., & Williams, L. M. (2003). The relationship between child sexual abuse and female delinquency and crime: A prospective study. Journal of Research in Crime and Delinquency, 40, 71−94. Simourd, D., & Andrews, D. (1994). Correlates of delinquency: A look at gender differences. Forum on Corrections Research, 6, 26−31. Singleton, N., Meltzer, H., Gatward, R., Coid, J., Deasey, D. (1998). Psychiatric morbidity among prisoners in England and Wales. London: The Stationery Office. Strachan, C. (1993). Assessment of psychopathy in female offenders. Unpublished doctoral dissertation, University of British Columbia, Vancouver, British Columbia. Strand, S., & Belfrage, H. (2001). Comparison of HCR-20 scores in violent mentally disordered men and women: Gender differences and similarities. Psychology, Crime, and Law., 7, 71−79.

429

Strand, S., & Belfrage, H. (2005). Gender differences in psychopathy in a Swedish offender sample. Behavioral Sciences and the Law, 23(6), 837−850. Taylor, R. (1999). Predicting reconvictions for sexual and violent offenses using the Revised Offender Group Reconviction Scale (Home Office Research Findings, No. 104). London: Home Office. Thornton, D., Mann, R., Webster, S., Blud, L., Travers, R., Friendship, D., et al. (2003). Distinguishing and combing risks for sexual and violent recidivism. Annals of the New York Academy of Sciences, 989, 225−235. Van Voorhis, P. V., & Presser, L. (2001). Classification of women offenders: A national assessment of current practices. Washington, D.C.: US Department of Justice, National Institute of Corrections. Verona, E., & Carbonell, J. L. (2000). Female violence and personality, evidence for a pattern of over controlled hostility among one-time violent female offenders. Criminal Justice and Behavior, 27, 176−195. Vitale, J. E., Smith, S. S., Brinkley, C. A., & Newman, J. P. (2002). The reliability and validity of the Psychopathy Checklist—Revised in a sample of female offenders. Criminal Justice & Behavior, 29, 202−231. Walters, G. (2003). Predicting institutional adjustment and recidivism with the Psychopathy Checklist factor scores: A meta-analysis. Law and Human Behavior, 27, 541−558. Webster, C. D., Douglas, K. S., Eaves, D., & Hart, S. D. (1997). HCR-20: Assessing the Risk for Violence (Version 2). Vancouver: Mental Health, Law, and Policy Institute, Simon Fraser University. Wilczynski, A. (2005). Child-killing by parents. In R. E. Dobash, R. P. Dobash, & L. Noaks (Eds.), Gender and crime (pp. 167−180). Cardiff: University of Wales Press. Wong, S.C.P. and Gordon, A. (1999, 2000). Violence Risk Scale. Unpublished manuscript, Saskatoon, Saskatchewan, Canada.