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)     

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)     

Psychopathy and conduct problems in children.

Factor analysis of a measure of psychopathy was conducted in a sample of 95 clinic-referred children between the ages of 6 and 13 yrs. These analyses revealed 2 dimensions of behavior, one associated with impulsivity and conduct problems (I/CP) and one associated with the interpersonal and motivational aspects of psychopathy (callous/unemotional: CU). In a subset of this sample (n?=?64), analyses indicated that scores on the I/CP factor were highly associated with traditional measures of conduct problems. In contrast, scores derived from the CU factor were only moderately associated with measures of conduct problems and exhibited a different pattern of associations on several criteria that have been associated with psychopathy (e.g., sensation seeking) or childhood antisocial behavior (e.g., low intelligence, poor school achievement, and anxiety). These analyses suggest that psychopathic personality features and conduct problems are independent, yet interacting, constructs in children, analogous to findings in the adult literature. (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)     

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)     

Validation de l'échelle d'évaluation des traits antisociaux.

This study is testing the psychometric properties of the French version of the Antisocial Process Screening Device (APSD, Frick & Hare, 2001). Reliability and validity of the scales (impulsivity/conduct problems, callous/unemotional), as well as the total scale are tested on a sample of 306 children (mean age: 9.9 years) receiving special education services because of behaviour problems. Results indicate psychometric properties consistent with the English version (Frick, O'Brien, Wooton & McBurnett, 1994), as well as some differences. Test-retest reliability, internal consistency, confirmatory factor analysis, and validity (convergent, predictive) are acceptable. Further use of the French version of the APSD is warranted for research purposes but interpretation must remain cautious in the absence of a population based sample used in the validation process. Studies on the factors associated with the precocity and the stability of antisocial traits are recommended. (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)     

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)     

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)     

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)     

Diagnostic labeling in juvenile justice settings: Do psychopathy and conduct disorder findings influence clinicians?

Do provocative diagnostic labels such as psychopathy or conduct disorder influence clinicians who work in juvenile justice settings? Juvenile justice clinicians (N = 109) responded to a mock psychological evaluation of a juvenile, which varied antisocial history, psychopathic personality features, and diagnosis (psychopathy, conduct disorder, or none). Psychopathic personality features and antisocial behavioral history led to higher clinician ratings of the juvenile's risk for future criminality. A psychopathy label also led to higher clinician ratings of risk, but only when there was a minimal history of antisocial behavior. No diagnostic labels influenced clinician ratings regarding treatment. Viewed alongside other research on labeling in the juvenile justice system, clinicians appear to be somewhat more responsive to mention of the psychopathy construct than are nonclinical juvenile justice professionals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychopathy and Comorbidity in a Young Offender Sample: Taking A Closer Look At Psychopathy's Potential Importance Over Disruptive Behavior Disorders.

The authors examined the construct of psychopathy as applied to 130 adolescent offenders using 3 psychopathy measures and a broad range of DSM-TV Axis I diagnoses and psychosocial problems. Measures used in the study included the following: (a) Psychopathy Checklist-Youth Version (PCL- PCLYV; A. E. Forth, D. S. Kosson, & R. D. Hare, 2003), (b) Antisocial Process Screening Device (APSD; YV; P. J. Frick & R. D. Hare, 2002), (c) a modified version of the Self-Report Psychopathy-II scale (SRP-II; R. D. Hare, 1991b), and (d) the Adolescent Psychopathology Scale (APS; W. M. Reynolds, 1998). Results from this study offer incremental support for the construct validity of psychopathy in youth. Psychopathy evidenced better convergent and discriminant validity results than did the disruptive behavior disorders (DBDs) such as oppositional-defiant disorder (ODD) and conduct disorder (CD). Despite this finding, psychopathy scales nonetheless correlated with other forms of psychopathology at a higher rate than was expected, suggesting that comorbidity is high even when psychopathy is used as a classification scheme. Also, hierarchical multiple regression was used to determine whether psychopathy offered an improvement in the prediction of previous violent and nonviolent offenses. The results for the current study were mixed, with only the PCL-YV significantly predicting previous violent and nonviolent offenses beyond the DBDs. The findings indicate that psychopathy may offer incremental improvement over DBDs with regard to level of comorbidity and perhaps even prediction. However, simply extending the adult construct of psychopathy to youth without considering the array of psychopathology that may accompany adolescent psychopathy could be misleading. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A biopsychosocial model of the development of chronic conduct problems in adolescence.

A biopsychosocial model of the development of adolescent chronic conduct problems is presented and supported through a review of empirical findings. This model posits that biological dispositions and sociocultural contexts place certain children at risk in early life but that life experiences with parents, peers, and social institutions increment and mediate this risk. A transactional developmental model is best equipped to describe the emergence of chronic antisocial behavior across time. Reciprocal influences among dispositions, contexts, and life experiences lead to recursive iterations across time that exacerbate or diminish antisocial development. Cognitive and emotional processes within the child, including the acquisition of knowledge and social-information-processing patterns, mediate the relation between life experiences and conduct problem outcomes. Implications for prevention research and public policy are noted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Distinct contributions of conduct and oppositional defiant symptoms to adult antisocial behavior: evidence from an adoption study

BACKGROUND: We conducted an exploratory multivariate analysis of juvenile behavior symptoms in an adoption data set. One goal was to see if a few DSM-interpretable symptom dimensions economically captured information within the data. A second goal was to study the relationships between any such dimensions, biological and environmental background, and eventual adult antisocial behavior. METHODS: The data originated from a retrospective adoption study. Probands with a biological background for parental antisocial personality or alcoholism were heavily oversampled. Symptoms were ascertained by proband and adoptive parent interview. We performed, by gender, orthogonal rotated principal component analyses of juvenile behavior disturbance symptoms (females, n = 87; males, n = 88). We used structural equation modeling to examine the relationships hypothesized above. RESULTS: For both genders, an oppositional defiant disorder (ODD) component and at least 1 conduct component emerged. Regardless of the conduct component scores, the ODD components were significant predictors of adult antisocial behavior. For males, the ODD component was predicted by an antisocial biological background, but not by scores on the Adverse Adoptive Environment Scale. The conduct components were predicted by adoptive environment alone. For females, biological background or biological-environmental interactions predicted each of the components. CONCLUSIONS: There has been little previous distinction between conduct disorder and ODD in studies of genetic and environmental influences on juvenile behavior. The study suggests that adolescent ODD symptoms may be a distinct antecedent of adult antisocial personality. In males, adolescent ODD symptoms may represent early expression of genetic sociopathic personality traits.     

Testing a Four-Factor Model of Psychopathy and Its Association With Ethnicity, Gender, Intelligence, and Violence.

Although a 2-factor model has advanced research on the psychopathy construct, a 3-factor model was recently developed that emphasized pathological personality and eliminated antisocial behavior. However, dropping antisocial behavior from the psychopathy construct may not be advantageous. Using a large sample of psychiatric patients from the MacArthur Risk Assessment Study (J. Monahan & H. J. Steadman, 1994), the authors used confirmatory factor analysis to test a 4-factor model of psychopathy, which included interpersonal, affective, and behavioral impulsivity dimensions and an antisocial behavior dimension. Model fit was good for this 4-factor model, even when ethnicity, gender, and intelligence variables were included in the model. Structural equation modeling was used to compare the 3- and 4-factor models in predicting proximal (violence) and distal (intelligence) correlates of psychopathy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Validating female psychopathy subtypes: Differences in personality, antisocial and violent behavior, substance abuse, trauma, and mental health.

Recent empirical investigations utilizing male prisoners have begun to validate clinical conceptualizations of primary and secondary psychopathy subtypes. We extended this literature by identifying similar psychopathic subtypes in female prisoners on the basis of personality structure using model-based cluster analysis. Secondary psychopaths (n = 39) were characterized by personality traits of negative emotionality and low behavioral constraint, an early onset of antisocial and criminal behavior, greater substance use and abuse, more violent behavior and institutional misconduct, and more mental health problems, including symptoms of posttraumatic stress disorder and suicide attempts. Primary psychopaths (n = 31) exhibited few distinguishing personality features but were prolific criminals especially in regards to nonviolent crime, and exhibited relatively few mental health problems despite substantial exposure to traumatic events. The results support alternative etiological pathways to antisocial and criminal behavior that are evident in personality structure as well as gender similarities and differences in the manifestation of psychopathic personalities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pursuing the psychopath: Capturing the fledgling psychopath in a nomological net.

The present article reports on an attempt to import the concept of psychopathy at the childhood level. Childhood psychopathy was assessed in 430 boys ages 12 and 13 years by using caretaker reports on a translation of an adult psychopathy assessment instrument. A systematic construct validation approach revealed that childhood psychopathy fits into the nomological network surrounding adult psychopathy. Children with psychopathic personalities, like their adult counterparts, were serious and stable offenders, impulsive, and more prone to externalizing than internalizing disorders. Childhood psychopathy also provided incremental validity in predicting serious stable antisocial behavior in adolescence over and above other known predictors and one other classification approach. These results suggest that psychopathy has a childhood manifestation that can be measured reliably. Implications and future directions are outlined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychopathy and violence: The importance of factor level interactions.

The power of scales based on the Psychopathy Checklist (PCL; R. D. Hare, 1980) for prediction of violent behavior is well established. Although evidence suggests that this relationship is chiefly due to the impulsive and antisocial lifestyle component (Factor 2), the predictive power of psychopathy for violence may also reflect the multiplicative effects of this component with interpersonal and unemotional traits (Factor 1). The determination of the extent to which psychopathy subcomponents interact to predict violence has theoretical and practical implications for PCL-assessed psychopathy. However, the relationship between violence and the interactive effects of psychopathy subcomponents remains largely undetermined. The authors used prospective and cross-sectional designs to examine the independent and interactive effects of the factors of PCL-assessed psychopathy in 2 samples: (a) 199 county jail inmates and (b) 863 civil psychiatric patients. The Factor 1 × Factor 2 interaction predicted violence in both samples, such that the predictive power of Factor 2 was attenuated at lower levels of Factor 1. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

When parents have a history of conduct disorder: How is the caregiving environment affected?

Individuals with early-emerging conduct problems are likely to become parents who expose their children to considerable adversity. The current study tested the specificity of and alternative explanations for this trajectory. The sample included 246 members of a prospective, 30-year cohort study and their 3-year-old children. Parents who had a history of conduct disorder were specifically at elevated risk for socioeconomic disadvantage and relationship violence, but suboptimal parenting and offspring temperament problems were common to parents with any history of disorder. Recurrent disorder, comorbidity, and adversity in the family of origin did not fully account for these findings. The cumulative consequences of early-onset conduct disorder and assortative mating for antisocial behavior may explain the long-term effects of conduct disorder on young adult functioning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)