Psychopathy and dangerousness: An umbrella review and meta-analysis

Clin Psychol Rev. 2023 Mar:100:102240. doi: 10.1016/j.cpr.2022.102240. Epub 2022 Dec 13.


Psychopathy has traditionally been linked with heightened criminality, but the relationship of psychopathy with increased risk for dangerousness is contested. To address this debated issue, we conducted an umbrella review (PROSPERO CRD42020214761) of all available meta-analyses of psychopathy and indices of 'dangerousness' (e.g., violent or sexual recidivism, self-reported aggression). We searched PsycINFO, Web of Science, PubMed, and Scopus from inception to August 19, 2022, to identify systematic reviews and meta-analyses on psychopathy and dangerousness. Our review included 33 studies, with the quantitative synthesis including 17 effect sizes extracted from 10 studies (N = ∼77,000 participants). Overall, we observed a pooled correlation coefficient r = 0.284 [95% CI = 0.233, 0.336] for the association of psychopathy with dangerousness (equivalent to Cohen's d = 0.592). Despite considerable heterogeneity (I2 = 89.9%), leave-one-out analyses had minimal impact. The effect was robust to examination of potential moderators such as study quality and sample ages. However, the relationship was stronger when psychopathy was assessed using self-report compared to clinical rating scales. The association should be interpreted as meaningful in both the short-term and the long-term and suggests that psychopathy is one of the strongest predictors of dangerousness in the realm of psychopathology.

Keywords: Aggression; Crime; Psychopathic personality; Recidivism; Sexual offending; Violence.

Publication types

  • Meta-Analysis
  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aggression
  • Antisocial Personality Disorder* / diagnosis
  • Humans
  • Recidivism*
  • Self Report
  • Sexual Behavior