A systematic review of psychopathy in women within secure settings

• This systematic review synthesises data of 2545 participants from 28 studies.
• The PCL-R was the most commonly used measure of psychopathy.
• PCL-R prevalence rates ranged from 1.05% to 31% (using a cut-off criterion of 30).
• The prevalence rates of psychopathy are lower in women than typically found in men.
• The 3-Factor model (Cooke & Michie, 2001) received most support in reviewed studies.

The construct of psychopathy has been comparatively understudied in women, and to date there has been no attempt to systematically review the literature related to psychopathy in women. This review assimilates the existing evidence in relation to the prevalence and factor structure of psychopathy in women within secure settings. An extensive systematic search was performed using 11 electronic databases and four search engines; citation, author and reference list searching was also performed. After removing duplicates and appraising the study’s eligibility by title, 261 publications were appraised against minimum quality and eligibility threshold criteria, resulting in 28 remaining publications with data on 2545 participants. Quality appraisal was conducted by two raters, with excellent inter-rater reliability (kappas = .7−.9). A narrative synthesis was then performed. PCL-R based prevalence rates ranged from 1.05% to 31% (with a cut-off criterion of 30), with variations in multiple factors, such as geographical location and type of sample setting. The factor model with the most support from the reviewed studies was Cooke & Michie’s (2001) 3-Factor model. The apparent gender differences in the prevalence rates, factor structure and item expression of psychopathy, presents implications for the assessment and general conceptualisation of the construct in women within secure settings.