Megan J. Rutherford
Alcohol and Drug Abuse Institute, University of Washington

Arthur I. Alterman
John S. Cacciola
Treatment Research Center, University of Pennsylvania/
Philadelphia Veterans Administration

Until recently, the majority of studies on antisociality in substance
abusers have focused not on psychopathy as conceptualized by Cleckley
and operationalized by Hare, but on the Diagnostic and Statistical Manual
of Mental Disorders (DSM) measures of antisocial personality disorder
(ASPD; Alterman, Rutherford, Cacciola, McKay, & Woody, 1996 ; Alterman
, Rutherford, Cacciola, McKay, & Boardman, 1997; Brooner, Schmidt,
Felch, & Bigelow, 1992 ; Cottler, Price, Comptom, & Mager, 1995 ). Studies
on the relationship of psychopathy and substance abuse have mainly
been conducted with male offenders and are limited in number. Some of
these studies measured psychopathy with the Minnesota Multiphasic
Personality Inventory (MMPI; Dush & Keen, 1995; Rogers & Bagby, 1994 )
or other measures of psychopathy ( Fishbein & Reuland, 1994 ). These
studies do not necessarily include truly psychopathic individuals, how-
ever, because measures of psychopathy such as the MMFI typically have
strong correlations with antisocial behaviors but weak correlations with
the personality traits associated with psychopathy (see chap. 3).

The Psychopathy Checklist-Revised (PCL-R) yields a global rating of
psychopathy, the total score, and two factor scores. Factor 1 assesses psy-
chopathic personality traits with items such as glibness/superficial charm,
grandiose sense of self-worth, pathological lying, lack of remorse or guilt,
shallow affect, and failure to accept responsibility for own actions. Factor
2, Chronically Unstable and Antisocial Lifestyle, includes items such as
need for stimulation, parasitic lifestyle, poor behavioral controls, early

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