One hundred forty-nine inpatients within a maximum security psychiatric facility were assessed with the Psychopathy Checklist: Screening Version (PCL:SV; S. D. Hart, D. N. Cox, & R. D. Hare, 1995). Within the total sample, 68% had a psychotic disorder and 30% met criteria for psychopathy. Using confirmatory factor analysis, the authors tested the 2-factor PCL:SV model of psychopathy and recent 3- and 4-factor models. Results indicated good fit for each model, with the 4-factor model showing best overall fit. Structural equation modeling was used to determine which psychopathy factors predicted 6-month follow-up of inpatient aggression. The 2-, 3-, and 4-factor models, respectively, accounted for 16%.27%. and 3l% of the variance in aggression.