Based on this review, the author concludes that the use of the PCL-R with women in assessing their risk for violence should be approached with caution. Current research on this issue is limited, and the findings are equivocal at best; consequently, it cannot be assumed that psychopathy predicts aggression in women in the same fashion it does in men. Until more research is conducted with females, evaluations of psychopathic traits in women should be conducted with caution. Rogers (2000), Vitale and Newman (2001), and Hare (1991 suggest that the PCL-R be used only in risk predictions with populations in which its validity has been confirmed, specifically for males in criminal and forensic psychiatric settings. Nicholls et al. (2005) partially agree with this position in acknowledging "complexities and an inherent moral, ethical, and legal quagmire facing clinicians attempting to conduct risk assessments within pragmatic constraints." They do not, however, exclude the use of psychopathy assessments with women, advising that "due care must be taken to consider the implications of psychopathic traits in women." The current article offers similar advice in recommending that if women are assessed for psychopathy with the PCL-R, the evaluators should adhere to the most rigorous standards and consider the consequences of their decisions. In addition, although psychopathy is important in any assessment of risk, it is always inappropriate to base risk decisions on one measure or a single factor. At a minimum, clinicians should use multiple assessments of psychopathic traits when female clients are involved. 44 references