The importance of callous–unemotional traits for extending the concept of psychopathy to children.

This study focused on the use of callous–unemotional (CU) traits to identify a subgroup of children with both attention deficit/hyperactivity disorder (ADHD) and a conduct problem diagnosis (oppositional defiant disorder [ODD] or conduct disorder [CD]) who show characteristics similar to adults with psychopathy. In a clinic-referred sample of children aged 6 to 13 years (N?=?154), those with diagnoses of both ADHD and ODD/CD were divided on the basis of teacher ratings of CU traits. Children high on these traits showed features typically associated with psychopathy, such as a lack of fearfulness and a reward-dominant response style. Furthermore, children with CU traits seemed less distressed by their behavior problems. These findings are consistent with research on adults showing that impulsivity and antisocial behavior alone are insufficient to document persons who fit the construct of psychopathy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictors and outcomes of joint trajectories of callous–unemotional traits and conduct problems in childhood.

Callous–unemotional (CU) traits are associated with antisocial and delinquent behaviors in children and represent a potential risk factor for adult psychopathy. However, there is a paucity of longitudinal research that explores the development of these traits, their longitudinal association with conduct problems (CP), and their psychosocial predictors and outcomes. Using a large sample of children followed longitudinally from the Twins Early Development Study (N = 9,578), we described the joint developmental trajectories of CU traits and CP during childhood (between ages 7 and 12) and examined the child- and family-level predictors (4 years old) and concomitant outcomes (12 years old) associated with the trajectories. The developmental trajectories were characterized with teachers' ratings of CU traits and CP from ages 7 to 12. Using general growth mixture modeling, we identified four trajectories of CU traits (stable high, increasing, decreasing, and stable low) and two trajectories of CP (high and low). Compared with the children who followed a low trajectory of CU traits and CP, those who followed a high trajectory of CU traits and CP had more negative child- and family-level predictors at 4 years (including CP, hyperactivity, negative parental discipline, and chaos in the home). Children with high or increasing levels of CU traits and concomitant high levels of CP presented the most negative outcomes at 12 years (including hyperactivity, peer problems, emotional problems, and negative parental feelings). Children with high CU traits and concomitant high levels of CP in childhood should be prioritized for targeted intervention. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Disentangling the Underlying Dimensions of Psychopathy and Conduct Problems in Childhood: A Community Study.

The psychometric and predictive validity of callous-unemotional (CU) traits as an early precursor of conduct disorder and antisocial behavior were assessed. A community sample of children (4-9 years of age) were tested 12 months apart with the Antisocial Process Screening Device (APSD; P. J. Frick & R. D. Hare, 2002), a measure of early signs of psychopathy in children. Factor analysis supported the structure of the APSD. Given controversy surrounding construct overlap between psychopathy and conduct problems, a factor analysis was conducted on pooled items from the Strengths and Difficulties Questionnaire and APSD. A 5-factor solution resulted: antisocial, hyperactivity, CU traits, anxiety, and peer problems. CU traits added small but significant improvements in the 12-month prediction of antisocial behavior for boys and older girls, after controlling for Time 1 measures. These results indicate that although the dimensions of the APSD overlap with dimensions of the disruptive behavior disorders, CU traits have unique predictive validity in childhood. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Callous-unemotional traits and developmental pathways to severe conduct problems.

One method for defining pathways through which children develop severe conduct problems is based on the presence or absence of callous-unemotional (CU) traits. This study investigated potential differences between nonreferred children (mean age = 12.36 years; SD = 1.73) with and without CU traits (n=98). Children with conduct problems, irrespective of the presence of CU traits, tended to have significant problems in emotional and behavioral regulation. In contrast, CU traits, irrespective of the presence of conduct problems, were associated with a lack of behavioral inhibition. Hostile attributional biases were associated with conduct problems but only in boys and in the absence of CU traits. These findings suggest that the processes underlying deficits in emotional and behavioral regulation in children with conduct problems may be different for children with CU traits. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ineffective parenting and childhood conduct problems: The moderating role of callous-unemotional traits.

A sample of 6- to 13-year-old clinic-referred (n?=?136) and volunteer (n?=?30) participants was investigated for a potential interaction between the quality of parenting that a child receives and callous–unemotional traits in the child for predicting conduct problems. Ineffective parenting was associated with conduct problems only in children without significant levels of callous (e.g., lack of empathy, manipulativeness) and unemotional (e.g., lack of guilt, emotional constrictedness) traits. In contrast, children high on these traits exhibited a significant number of conduct problems, regardless of the quality of parenting they experiences. Results are interpreted in the context of a model that proposed that callous–unemotional traits designate a group of children with conduct problems who have distinct causal factors involved in the development of their problematic behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Early identification of the fledgling psychopath: Locating the psychopathic child in the current nomenclature.

This research attempted to test D. R. Lynam's (1996) hypothesis regarding the developmental relation between adult psychopathy and children with symptoms of hyperactivity. impulsivity, and attention problems (HIA) and concurrent conduct problems (CP). In a large sample of adolescent boys, 4 groups (non-HIA–CP, HIA only, CP only, and HIA–CP) were compared on measures found to discriminate between psychopathic and nonpsychopathic offenders. In line with predictions, the HIA–CP boys most closely resembled psychopathic adults. HIA–CP boys scored higher than HIA-only and non-HIA–CP boys on a measure of psychopathic personality. As with their adult counterparts, HIA–CP boys were the most antisocial, were the most disinhibited, and tended to be the most neuropsychologically impaired of all the groups. Implications for treatment, research, and the study of comorbidity are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychophysiology of Aggression, Psychopathy, and Conduct Problems: A Meta-Analysis.

A meta-analysis of 95 studies was conducted to investigate the relations of heart rate (HR) and electrodermal activity (EDA) with aggression, psychopathy, and conduct problems. Analyses revealed a complex constellation of interactive effects, with a failure in some cases of autonomic patterns to generalize across antisocial spectrum behavior constructs. Low resting EDA and low task EDA were associated with psychopathy/sociopathy and conduct problems. However, EDA reactivity was positively associated with aggression and negatively associated with psychopathy/sociopathy. Low resting HR and high HR reactivity were associated with aggression and conduct problems. Physiology-behavior relations varied with age and stimulus valence in several cases. Empirical and clinical implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychopathy and suicide: A multisample investigation.

Evidence suggests that behavioral aspects of psychopathy are associated with suicidal behavior, whereas the affective and interpersonal aspects are not. The authors tested the robustness of this bifurcated association across 1,711 persons and 12 samples of adult and juvenile criminal offenders, forensic psychiatric patients, and civil psychiatric patients. The authors observed a small but significant partial correlation (.13) between the behavioral/impulsive lifestyle features of psychopathy and suicidality, but no effect for affective/interpersonal features. Several method and sample features (mental disorder; psychopathy and suicidality measurement format) significantly strengthened or weakened this association. The authors conclude that it is not possible to speak of "the" association between psychopathy and suicide, but that this relationship appears to be partially dependent on methodological (i.e., self-report vs. clinician-administered psychopathy measures) and sample composition (i.e., age; mental illness) factors. Recommendations for practice are provided, including that clinicians should not consider psychopathy a buffer against suicidal behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Multimethod assessment of psychopathy in relation to factors of internalizing and externalizing from the Personality Assessment Inventory: The impact of method variance and suppressor effects.

Research to date has revealed divergent relations across factors of psychopathy measures with criteria of internalizing (INT; anxiety, depression) and externalizing (EXT; antisocial behavior, substance use). However, failure to account for method variance and suppressor effects has obscured the consistency of these findings across distinct measures of psychopathy. Using a large correctional sample, the current study employed a multimethod approach to psychopathy assessment (self-report, interview and file review) to explore convergent and discriminant relations between factors of psychopathy measures and latent criteria of INT and EXT derived from the Personality Assessment Inventory (Morey, 2007). Consistent with prediction, scores on the affective–interpersonal factor of psychopathy were negatively associated with INT and negligibly related to EXT, whereas scores on the social deviance factor exhibited positive associations (moderate and large, respectively) with both INT and EXT. Notably, associations were highly comparable across the psychopathy measures when accounting for method variance (in the case of EXT) and when assessing for suppressor effects (in the case of INT). Findings are discussed in terms of implications for clinical assessment and evaluation of the validity of interpretations drawn from scores on psychopathy measures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Early identification of chronic offenders: Who is the fledgling psychopath?

In this article, the author highlights the need for early intervention for chronic offenders. He reviews evidence suggesting that children who manifest symptoms of hyperactivity–impulsivity–attention problems (HIA) and conduct problems (CP) are at the greatest risk for chronic offending. He reviews existing theories of the relations among constructs: (1) HIA increases risk in those already at risk and (2) HIA leads to symptoms of CP. In addition, he advances a third theory that children with symptoms of HIA and CP are afflicted with a virulent strain of conduct disorder best described as fledgling psychopathy. The author discusses treatment implications and supporting evidence for each model. Finally, he recommends that the subtype theory receive further consideration and examination. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Subtyping pathological gamblers on the basis of affective motivations for gambling: Relations to gambling problems, drinking problems, and affective motivations for drinking.

Pathological gamblers who drink when gambling (n=158; 77% men; mean age=36.0 years) completed the Inventory of Gambling Situations (IGS) and gambling and drinking criterion measures. Principal components analysis on the IGS subscales revealed negative (e.g., Unpleasant Emotions) and positive (e.g., Pleasant Emotions) gambling situation factors. Subjecting IGS factor scores to cluster analysis revealed three clusters: (a) enhancement gamblers, with low negative and high positive factor scores; (b) coping gamblers, with very high negative and high positive factor scores; and (c) low emotion regulation gamblers, with low negative and positive factor scores (59%, 23%, and 18% of the sample, respectively). Clusters were validated with a direct measure of gambling motives. Additional validity analyses showed that coping gamblers scored higher than the other groups on a variety of different gambling activities, gambling problems, drinking frequency, drinking problems, and coping drinking motives, whereas low emotion regulation gamblers scored lower than the other groups on gambling frequency, gambling problems, drinking quantity, and enhancement drinking motives. The findings validate this empirical approach to subtyping gamblers and suggest consistency of motives across addictive behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Treatment of Conduct Problems in Children With Callous-Unemotional Traits.

The aim of this study was to examine the impact of callous-unemotional (CU) traits on treatment outcomes and processes in a 10-week behavioral parent-training intervention with young boys referred for conduct problems (N = 56; mean age 6.29 years). CU traits were associated with greater conduct problems at pretreatment and with poor outcomes at 6-month follow-up. CU traits uniquely predicted clinical outcomes when analyzed in relation to conduct-problem severity, other predictors of antisocial behavior, and parents' implementation of treatment. Boys with high CU traits were less responsive to discipline with time-out than boys without CU traits and reacted to this discipline with less affect. These findings present important implications for the role of child temperament in intervention for conduct problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Callous-Unemotional Traits and Delinquent Peer Affiliation.

Association with a deviant peer group is a robust correlate of juvenile antisocial behavior. The current study focused on whether this association differed for antisocial youth with and without callous-unemotional (CU) traits and whether potential mediators of this association differed for the 2 groups. Deviant peer group association was examined in a community sample (N = 98) of high-risk youth. The sample was assessed at 4 yearly intervals. Across all assessment points, children with conduct problems and CU traits showed the highest level of affiliation with deviant peers. At the first 2 assessment points, this effect was largely mediated by dysfunctional parenting and problems in the child's social relationships. In contrast, the mediational role of these variables was much weaker at the last 2 assessment points. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictive validity of callous–unemotional traits measured in early adolescence with respect to multiple antisocial outcomes.

This study investigated the predictive validity of youth callous–unemotional (CU) traits, as measured in early adolescence (Grade 7) by the Antisocial Process Screening Device (APSD; Frick & Hare, 2001), in a longitudinal sample (N = 754). Antisocial outcomes, assessed in adolescence and early adulthood, included self-reported general delinquency from 7th grade through 2 years post–high school, self-reported serious crimes through 2 years post–high school, juvenile and adult arrest records through 1 year post–high school, and antisocial personality disorder symptoms and diagnosis at 2 years post–high school. CU traits measured in 7th grade were highly predictive of 5 of the 6 antisocial outcomes—general delinquency, juvenile and adult arrests, and early adult antisocial personality disorder criterion count and diagnosis—over and above prior and concurrent conduct problem behavior (i.e., criterion counts of oppositional defiant disorder and conduct disorder) and attention-deficit/hyperactivity disorder (criterion count). Incorporating a CU traits specifier for those with a diagnosis of conduct disorder improved the positive prediction of antisocial outcomes, with a very low false-positive rate. There was minimal evidence of moderation by sex, race, or urban/rural status. Urban/rural status moderated one finding, with being from an urban area associated with stronger relations between CU traits and adult arrests. Findings clearly support the inclusion of CU traits as a specifier for the diagnosis of conduct disorder, at least with respect to predictive validity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessment of psychopathy as a function of age.

The assessment of psychopathy was examined as a function of age in 889 male prison inmates between the ages of 16 and 69. Ratings of psychopathy were made with the Psychopathy Checklist (PCL), which measures 2 correlated factors. Factor 1 describes a cluster of affective-interpersonal traits central to psychopathy. Factor 2 describes traits and behaviors associated with an unstable, unsocialized lifestyle, or social deviance. Cross-sectional analyses revealed that mean scores on Factor 1 were stable across the age-span; mean scores on Factor 2 declined with age. The prevalence of antisocial personality disorder, and, to a lesser extent of PCL-defined psychopathy, also declined with age. The results are consistent with a conceptualization of psychopathy as encompassing 2 correlated but distinct constructs. They also suggest that age-related differences in traits related to impulsivity, social deviance, and antisocial behavior are not necessarily paralleled by differences in the egocentric, manipulative, and callous traits fundamental to psychopathy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reduced cognitive ability in alcohol dependence: Examining the role of covarying externalizing psychopathology.

Reduced executive cognitive ability is associated with alcohol dependence (AD) and other comorbid externalizing disorders. Working memory capacity, short-term memory, conditional associative learning, and intelligence were assessed in a sample (N = 477) with variation in lifetime histories of externalizing problems (conduct disorder, adult antisocial behavior, substance problems); this included a subsample (n = 285) with a Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) diagnosis of AD. Individuals with both AD and a history of childhood conduct disorder (CCD) scored lower on cognitive measures compared to those with AD and no history of CCD. Structural equation models showed that reduced ability in all cognitive domains was predicted by a latent externalizing factor reflecting covariation among lifetime problems with alcohol, drugs, childhood conduct, and adult antisocial behavior and was not uniquely related to any one problem. Further, for those with AD, the externalizing factor was associated with reductions in all the domains of cognitive ability. The results suggest that the reduced executive cognitive ability observed in AD individuals is partly accounted for by a general latent externalizing factor rather than alcohol-related problems per se. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Destructive sibling conflict and the development of conduct problems in young boys.

Little empirical work has explored the relation between destructive sibling conflict and conduct problems in children. This study used a measure of observed sibling conflict to examine its relations with maternal and teacher report of conduct problems in a low-income sample of 180 five-year-old boys and their close-age siblings. Early report of behavior problems and rejecting parenting were added to the analyses to control for these predictors and to examine interactive effects. The interaction between destructive sibling conflict and rejecting parenting predicted aggressive behavior problems across time and informants such that a rise in aggression scores was evident for children who had high levels of both sibling conflict and rejecting parenting. Sibling conflict was also directly related longitudinally to the Child Behavior Checklist Delinquency factor. Results are discussed in terms of additive risk models and G. R. Patterson's (1984, 1986) theory of coercion. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

ODD dimensions, ADHD, and callous–unemotional traits as predictors of treatment response in children with disruptive behavior disorders.

To answer several questions pertinent to DSM–V, the authors examined the predictive validity of pretreatment oppositional defiant disorder (ODD) dimensions, attention-deficit/hyperactivity disorder (ADHD), and callous–unemotional (CU) traits in relation to several treatment outcomes in 177 children diagnosed with ODD or conduct disorder (CD). Multiple informants completed diagnostic interviews and rating scales at 6 assessment points (pretreatment to 3-year follow-up) to document emotional and behavioral outcomes. After controlling for pretreatment CD, the ODD dimension of hurtfulness was related to treatment-resistant CD, delinquent behaviors, and externalizing problems. In contrast, the ODD dimension tapping irritability was associated with treatment-resistant ODD, internalizing problems, and global functional impairment following treatment. Whereas pretreatment ADHD was associated with posttreatment ODD and social problems, it was unrelated to posttreatment CD symptoms and diagnosis. Contrary to predictions, CU traits were unrelated to any posttreatment outcomes after controlling for other covariates. These findings remained after controlling for measures of pretreatment global functional impairment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Increased testosterone-to-cortisol ratio in psychopathy.

Only a few studies have examined hormones in psychopathy, and results have been mixed. It has been suggested that because hormone systems are highly interconnected, it may be important to examine multiple systems simultaneously to gain a clearer picture of how hormones work together to predispose for a certain construct. In the present study, we attempt to clarify the role of the hormones cortisol and testosterone in psychopathy by examining both hormones in a community sample of 178 adults demonstrating a wide range of psychopathy scores. Results showed that psychopathy scores were associated with an increased ratio of testosterone (baseline) to cortisol responsivity to a stressor. Psychopathy was not associated with either of these measures independently or with baseline cortisol levels. These findings suggest that these highly interconnected hormone systems may work in concert to predispose to psychopathy. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Two subtypes of psychopathic violent offenders that parallel primary and secondary variants.

[Correction Notice: An erratum for this article was reported in Vol 116(4) of Journal of Abnormal Psychology (see record 2007-17062-019). The headings "Primary (n = 74)" and "Secondary (n = 49)" should be reversed in Table 1 on p. 401. In addition, the means for the Psychic Anxiety scale of the Karolinska Scales of Personality should be 0.52 (rather than -0.52) and -0.34 (rather than 0.34).] Although psychopathy usually is treated as a unitary construct, a seminal theory posits that there are 2 variants: Primary psychopathy is underpinned by an inherited affective deficit, whereas secondary psychopathy reflects an acquired affective disturbance. The authors investigated whether psychopathy phenotypically may be disaggregated into such types in a sample of 367 prison inmates convicted of violent crimes. Model-based cluster analysis of the Revised Psychopathy Checklist (PCL-R; R. D. Hare, 2003) and trait anxiety scores in the psychopathic subgroup (n = 123; PCL-R ≥ 29) revealed 2 clusters. Relative to primary psychopaths, secondary psychopaths had greater trait anxiety, fewer psychopathic traits, and comparable levels of antisocial behavior. Across validation variables, secondary psychopaths manifested more borderline personality features, poorer interpersonal functioning (e.g., irritability, withdrawal, poor assertiveness), and more symptoms of major mental disorder than primary psychopaths. When compared with the nonpsychopathic subgroup (n = 243), the 2 psychopathic variants manifested a theoretically coherent pattern of differences. Implications for etiological research and violence prevention are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)