Psychopathy has received a marked increase in attention in the research literature over the past 2 decades since the validation and standardization of assessment tools designed to measure this construct, particularly the Psychopathy Checklist-measures (Hare, 1991/2003; Hart, Cox, & Hare, 1995; and Forth, Kosson, & Hare, 2003). Psychopathy has been identified as the best single predictor of violence among adult offenders (Hart, 1998). Such findings have led some to conclude that "psychopathy is the most important psychological construct for policy and practice in the criminal justice system" (Harris, Skilling, & Rice, 2001). Despite the overwhelming evidence of substantial societal and individual costs attributable to this disorder, little is known about psychosocial precursors of psychopathy. This study examines risk factors related to the development of psychopathy, as measured by the PCL:SV, in a sample of 446 psychiatric patients using structural equation modeling (SEM). The final SEM includes five predictor variables measuring early-life physical abuse, paternal antisocial behavior, and cognitive ability. Severe physical abuse (β = 0.17, p = .043), biological father's alcohol abuse history (β = .16, p =.004), biological father's arrest history (β = 0.13, p = .02), and the subject's cognitive ability (β = -0.18, p < .001) were found predictive of psychopathy in this sample. Post hoc analyses comparing male and female subjects, and black and white subjects, indicate different causal pathways in the development of psychopathy among these groups. Future research designed to assess these potentially different causal pathways are recommended. Implications to clinical theory, practice, and policy are also discussed.