Psychometric Evaluation of 5- and 7-Year-Old Children's Self-Reports of Conduct Problems

Past research suggests that young children are incapable of reporting information about their own behavior problems. To test this, we examined the validity and the usefulness of children's self-reports in the E-Risk Study, a nationally representative birth cohort of 2,232 children. We used the Berkeley Puppet Interview to obtain children's self-reports of conduct problems when they were 5-years old and the Dominic-R when they were 7-years old. We also collected information about the children and their families by interviewing mothers, sending questionnaires to teachers, and rating examiners' observations during home visits. Results indicate that when children's self-reports are gathered with structured and developmentally appropriate instruments, they are shown to be valid measures: conduct problems reported by the children themselves were associated with known correlates including individual characteristics (e.g., IQ), related behaviors (e.g., hyperactivity), and family variables (e.g., economic disadvantages). Observed correlations closely matched effect sizes reported in the literature using adults' reports of children's behavioral problems. In addition, children's self-reports can be useful: both measures distinguished children meeting DSM-IV criteria for research diagnoses of conduct disorder. Children's reports also contributed unique information not provided by adults. For research and clinical purposes, young children's self-reports can be viewed as a valuable complement to adults' ratings and observational measures of children's behavior problems.     

Interpersonal Relationships and Sex Differences in the Development of Conduct Problems

This article investigates the role of interpersonal relationships in shaping sex differences in the manifestation, etiology, and developmental course of conduct problems and their treatment needs. The review examines whether: (1) Girls conduct problems are more likely than boys to manifest as a function of disrupted relationships with caretakers and peers; (2) For girls more than for boys, the outcomes of conduct problems in adolescence and adulthood, and related treatment needs, are more likely to be a consequence of the quality of interpersonal relationships with others, particularly opposite-sex peers and partners. Evidence reviewed suggests that boys and girls share many similarities in their expression of conduct problems, but that a relational perspective does unify important differences. There is fair evidence that girls with conduct problems are more likely to come to the attention of authorities because of chaotic, unstable family relationships, and to express antisocial behavior in the context of close relationships; there is stronger evidence that the course and outcomes of conduct problems in females versus males pertain to interpersonal relationship impairments. Those sex differences map onto specific differences in treatment needs. Further empirical testing of the proposed relational model is indicated.     

Subfactors of DSM-IV Conduct Disorder: Evidence and Connections with Syndromes from the Child Behavior Checklist

Is conduct disorder (CD) as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) a unitary entity, or do variants of CD exist? We addressed this question, using data collected from the parents of 1,669 Australian boys, aged 6–17. Parents were interviewed to assess DSM-IV Conduct Disorder (DSM-IV CD) criteria. Results revealed 2 subfactors of DSM-IV CD symptoms, made up of overt behaviors (e.g., initiating physical fights) and covert behaviors (e.g., stealing without confrontation). Ordinary least squares regressions showed the 2 CD subfactors to be significantly and uniquely predicted by Child Behavior Checklist (CBCL; T. M. Achenbach, 1991a, 1991b) syndromes labeled Aggressive Behavior and Delinquent Behavior, respectively. The results are discussed in terms of the utility of differentiating these 2 variants of CD in future editions of the DSM.     

The Latent Structure of Psychopathy in Youth: A Taxometric Investigation

Using taxometric procedures, the latent structure of psychopathy was investigated in two studies of children and adolescents. Prior studies have identified a taxon (i.e., a natural category) associated with antisocial behavior in adults as well as children and adolescents. However, features of this taxon suggest that it is not psychopathy but rather a broader class consistent with the construct of life course persistent antisocial behavior. Because the only prior study of youth used a non-clinical sample, the base rate of psychopathy may have been too low to reveal a psychopathy taxon, especially against the background of a broader and more prevalent antisocial behavior taxon. Therefore, this investigation sought to increase the likelihood of finding a psychopathy taxon (should one exist) by increasing its expected base rate through inclusion of clinical cases in the samples studied. Results produced evidence for both a broad antisocial behavior problem taxon consistent with past research and a much lower base rate taxon consistent with prevalence expectations for psychopathy. These findings support the existence of latent taxa for both psychopathy and a broader class of antisocial behavior problems. Further taxometric research appears to be warranted, which should use a broader array of indicators, with greater specificity to psychopathy.     

Untangling Intelligence,Psychopathy, Antisocial Personality Disorder,and Conduct Problems: A Meta‐analytic Review

Substantial research has investigated the association between intelligence and psychopathic traits. The findings to date have been inconsistent and have not always considered the multidimensional nature of psychopathic traits. Moreover, there has been a tendency to confuse psychopathy with other closely related, clinically significant disorders. The current study represents a meta‐analysis conducted to evaluate the direction and magnitude of the association of intelligence with global psychopathy, as well as its factors and facets, and related disorders (i.e. antisocial personality disorder, conduct disorder, and oppositional defiant disorder). Our analyses revealed a small, significant, negative relationship between intelligence and total psychopathy (r = ?.07, p = .001). Analysis of factors and facets found differential associations, including both significant positive (e.g. interpersonal facet) and negative (e.g. affective facet) associations, further affirming that psychopathy is a multidimensional construct. Additionally, intelligence was negatively associated with antisocial personality disorder (r = ?.13, p = .001) and conduct disorder (r = ?.13, p = .001) but positively with oppositional defiant disorder (r = .06, p = .001). There was significant heterogeneity across studies for most effects, but the results of moderator analyses were inconsistent. Finally, bias analyses did not find significant evidence for publication bias or outsized effects of outliers. © 2019 European Association of Personality Psychology     

Significance of Childhood Conduct Problems to Later Development of Conduct Disorder Among Children With ADHD: A Prospective Follow-Up Study

This study investigates whether low to moderate levels of childhood oppositional defiant disorder (ODD) and conduct disorder (CD) behaviors contribute to the development of clinically diagnosed CD in adolescence, in children with attention deficit hyperactivity disorder (ADHD). Participants were 207 White boys (ages 6-12) with ADHD free of conduct disorder diagnoses. Parent and teacher ratings were obtained. Participants were assessed at mean age 18 by clinicians blind to childhood status. A non-ADHD group (recruited in adolescence) was also studied. ODD behavior ratings did not predict CD in adolescence, whereas CD behavior ratings did. No single ODD or CD behavior predicted adolescent outcome. ADHD probands with very low ratings (Not at all, Just a little) by parents and teachers on all CD behaviors were still at significantly increased risk for CD in adolescence, compared to non-ADHD controls. The same relationships were found between childhood ODD and CD behaviors, and antisocial personality disorder in adulthood (mean age, 25). We conclude that childhood ADHD is a developmental precursor of later antisocial disorder, even in the absence of comorbid ODD or CD in childhood. However, low levels of CD-type problems are not innocuous, because they predict later CD among children with ADHD without comorbid CD.     

Conceptualizing Psychopathy: A Psychodynamic Approach

Drawing from analytic theory and clinical conceptualization, three major types of psychopathy are detailed: Superego deficit, aggression driven, and sadism. The types of psychopathy are discussed in terms of their overlap with personality disorders. The range of sadism is charted from the enjoyment of inflicting pleasure to the borderline manifestations in compulsive reenactments in psychopathic patients. Two categories of antisocial behavior— low social intelligence and poor impulse control—are elaborated clinically as inconsistent with the psychodynamic formulation of characterological psychopathy. The divergence between psychodynamic and behavioral approaches to antisocial behavior is discussed, and unresolved enigmas in the formulation of psychopathy are outlined.     

Male Mental Health Problems, Psychopathy, and Personality Traits: Key Findings from the First 14 Years of the Pittsburgh Youth Study

This paper reviews key findings on juvenile mental health problems in boys, psychopathy, and personality traits, obtained in the first 14 years of studies using data from the Pittsburgh Youth Study. This is a study of 3 samples, each of about 500 boys initially randomly drawn from boys in the 1st, 4th, and 7th grades of public schools in Pittsburgh. The boys have been followed regularly, initially each half year, and later at yearly intervals. Currently, the oldest boys are about 25 years old, whereas the youngest boys are about 19. Findings are presented on the prevalence and interrelation of disruptive behaviors, ADHD, and depressed mood. Results concerning risk factors for these outcomes are reviewed. Psychological factors such as psychopathy, impulsivity, and personality are described. The paper closes with findings on service delivery of boys with mental health problems.     

The Association between Anxiety and Psychopathy Dimensions in Children

Although several theoretical models posit that low levels of anxiety are a risk factor for psychopathy and antisocial behavior, a number of studies have reported elevated levels of anxiety among antisocial individuals. Nevertheless, most investigators in this literature have not distinguished between fearfulness and trait anxiety or attempted to separate the antisocial lifestyle dimension from the callous and unemotional dimension of psychopathy. In a study of clinically referred children (N = 143), we found that (a) measures of trait anxiety and fearlessness (low fearfulness) exhibited low correlations; (b) conduct problems tended to be positively correlated with trait anxiety, whereas callous and unemotional traits tended to be negatively correlated with trait anxiety; and (c) controlling statistically for the effects of one dimension increased the divergent correlations of the other dimension with both trait anxiety and fearful inhibition. These findings bear potentially important implications for the diagnosis and etiology of psychopathy and antisocial behavior and suggest that distinctions between trait anxiety and fearful inhibition, as well as between the two dimensions of psychopathy, may help to clarify longstanding confusion in this literature.     

Treatment of Comorbid Conduct Problems and Depression in Youth: A Pilot Study

The purpose of this study was to pilot a cognitive behavioral treatment protocol for adolescents with co-occurring conduct problems and depression. A non-concurrent multiple baseline design was used to assess the effectiveness of the intervention. A sample of five adolescents, aged 11 to 14 years, participated; all five families completed the protocol. Results indicated that symptoms of oppositionality were significantly reduced. Moreover, maternal ratings suggested significant improvements in emotion regulation in their children and cohesion in the family. However, symptoms of depression showed little improvement. Results of this study have implications for improving treatment outcomes for youth with these comorbid conditions and may lead to increased conceptual understanding of these comorbid problems.     

Predicting the Stability of Conduct Problems in Children with and Without Callous-Unemotional Traits

We tested predictors of persistence in conduct problems for children with and without callous-unemotional (CU) traits. Participants were 79 children of an original 98 children recruited from a community-wide screening to oversample children with conduct problems and to ensure equal numbers of children high and low on CU traits. The sample was reassessed at four yearly intervals and the 79 children (81%) were those with data at all four assessments. Children within each conduct problem group were divided into those with more and less stable patterns of conduct problems based on structured interviews with parent and child. Stability in conduct problems for children without CU traits was more strongly related to level of impulsivity and socioeconomic status, whereas children high on CU traits showed more stable conduct problems if they experienced higher rates of life stressors.     

Relation of Age of Onset to the Type and Severity of Child and Adolescent Conduct Problems

In a cross-sectional household sample of 9-through 17-year-old youths from 4 U.S. communities, youths with earlier ages of onset of conduct problems engaged in more conduct problems than youths with later ages of onset when current age and gender were controlled. Specifically, youths with earlier ages of onset were more likely to engage in several types of physical aggression, frequent lying, theft, and vandalism and were less likely to engage in only truancy. There also was an inverse relation between age of onset and level of functional impairment, mental health service use, and meeting diagnostic criteria for conduct disorder, attention-deficit hyperactivity disorder, and oppositional defiant disorder. Within the limits of cross-sectional data, these results support the hypothesis that key aspects of the heterogeneity of conduct problems among youths are related to the age of onset of conduct problems.     

The Importance of Child and Adolescent Psychopathy

In commenting on the five articles in this special issue, this paper discusses (1) the concept of child and adolescent psychopathy, and whether adolescent psychopaths are qualitatively distinct from other young people; (2) the measurement of adolescent psychopathy; (3) the relationship between psychopathy and other personality dimensions; (4) childhood risk factors for psychopathy; (5) psychopathy in the context of risk factors for delinquency; and (6) the prevention and treatment of adolescent psychopathy. It is argued that the three dimensions of an arrogant, deceitful interpersonal style, deficient affective experience, and an impulsive or irresponsible behavioral style are most important at present in the definition of psychopathy. An ambitious research agenda is recommended, investigating the concept of adolescent psychopathy, developing new measures, conducting new longitudinal studies on development and risk factors, and mounting new randomized experiments on prevention and treatment.     

Callous-Unemotional Traits and Subtypes of Conduct Disorder

There has been growing consensus that children with conduct disorder (CD) constitute a very heterogeneous group containing children who vary substantially on the development, course, and causes of the disorder. While many have recognized the importance of this heterogeneity for developing better causal theories and for developing more effective treatments, there has been little consensus as to the best way to subtype children with CD. In this paper, we review a number of approaches to subtyping, each with some evidence for its validity for certain purposes. We focus on two recent approaches that have great potential for integrating past subtyping approaches and for advancing causal theory. The first approach is the division of children with CD into those with a childhood onset to their severe antisocial behavior and those with an adolescent onset to their behavior. The second approach is to designate children within the childhood-onset group who show callous and unemotional traits, which is analogous to adult conceptualizations of psychopathy. Both approaches help designate children who many show different causal processes underlying their severe aggressive and antisocial behavior, and who may warrant different approaches to treatment.     

The interview for antisocial behavior: Psychometric characteristics and concurrent validity with child psychiatric inpatients

The present study evaluated psychometric features and correlates of the Interview for Antisocial Behavior (IAB), a new measure designed to assess antisocial child behavior. Parents of 264 psychiatric inpatients (ages 6–13 years) completed the measure to evaluate antisocial behavior of their children. The investigation evaluated the relation of IAB scores to clinically derived diagnoses and to aggression and externalizing behaviors, as measured by different raters (parents, teachers), across different settings (home, school, hospital), and with different assessment methods (rating scales, behavioral role-play test). The results indicated that the IAB showed acceptable levels of internal consistency. A priori scores (severity, duration, total antisocial behavior) and factor analytically derived scales (Arguing/Fighting, Covert Antisocial Behaviors, Self-Injury) distinguished children with a DSM III diagnosis of conduct disorder, and scores on the IAB were more consistently related to other measures of aggression and externalizing behavior than to measures of internalizing behavior or overall severity of dysfunction. The implications of the results for use of the measure, particularly in relation to evaluation of the overt-covert dimension of antisocial behavior, are discussed.Completion of this research was facilitated by a Research Scientist Development Award (MH00353) and by grants (MH35408, MH39642) from the National Institute of Mental Health and the Rivendell Foundation.     

The Potential Mediating Role of Parenting Practices in the Development of Conduct Problems in a Clinic-Referred Sample

Research has consistently found associations among parenting practices, socioeconomic disadvantage, ethnicity and conduct problems in children. We investigated whether parenting practices might mediate the relation between ethnicity and conduct problems and the relation between socioeconomic status (SES) and conduct problems. The subjects were 141 clinic-referred children between the ages of 6 and 17 and their primary custodial parents. Using multiple indicators for each construct, except ethnicity, the mediational role of parenting was tested using structural equation modeling. The results indicated that the effects of SES on conduct problems was largely mediated by the influence of ineffective parenting practices. In contrast, ethnicity was not associated with conduct problems in this clinic-referred sample, even prior to controlling for SES and parenting practices, suggesting that the link between minority status and conduct problems may be dependent on the demographic characteristics of the sample. Exploratory analyses also revealed that there were ethnic differences in the types of parenting practices that were most strongly associated with conduct problems.     

Adult Outcomes of Child Conduct Problems: A Cohort Study

The present study assessed the mental health and criminal records of 6,449 males and 6,268 females who presented conduct problems as children by examining an unselected birth cohort followed up to age 30. Conduct problems were defined by teacher ratings of behavior problems and/or antisocial behavior in the community. There was little overlap in the children identified by teachers and by the community. These two groups of children were at differential risk for adult mental disorder. Seventy-six percent of the males and 30% of females with childhood conduct problems had either a criminal record, a mental disorder, or both by age 30. Risk ratios for adult criminality and/or mental disorders, however, were greater for females than for males with a history of childhood conduct problems. Almost all of the mental disorders were severe substance abuse. Mental disorders and crime were strongly associated among males with a history of childhood conduct problems.     

Developmental and Sex Differences in Types of Conduct Problems

Maternal report of types of conduct problems in a high-risk sample of 228 boys and 80 girls (ages 4–18) were examined, using a version of the Child Behavior Checklist, expanded to include a range of covert and overt antisocial items (stealing, lying, physical aggression, relational aggression, substance use, and impulsivity). Age and sex effects were investigated. Boys were significantly more physically aggressive than girls. There were no sex differences for stealing, lying, relational aggression, and substance use. Lying and substance use increased with age, whereas relational aggression and impulsivity peaked during early adolescence. A small group of girls had pervasive conduct problems across multiple domains. For some domains such as stealing, lying, and relational aggression, girls showed at least as many problems as boys. Girls, in general, tended to have fewer conduct problems. On the other hand, when assessed across multiple domains, conduct problems in high-risk girls were possibly more pervasive than in high-risk boys, suggesting the possibility of a gender paradox.     

Psychopathy and structure of primary mental abilities

The Comprehensive Ability Battery (CAB) was used to assess 18 primary mental abilities in 53 white, male prison inmates for whom highly reliable ratings of psychopathy were available. None of the correlations between ratings of psychopathy and scores on the CAB tests was significant, and the overall pattern or structure of abilities was the same for inmates with low and high ratings of psychopathy. The possibility is raised that the personality characteristics of psychopaths make them appear to be brighter and more creative than they actually are. Compared with norms for male high school students, the inmates as a group generally performed well, falling near the 50th percentile on 11 of the tests. The inmates performed significantly better than the normative sample on tests of verbal ability, esthetic judgment, aiming, and representational drawing, and significantly worse on tests of ideational fluency, spontaneous flexibility, and word fluency.This research was supported by Grant MT-4511 from the Medical Research Council of Canada.     

Teacher Ratings of Hyperactivity, Inattention, and Conduct Problems in Preschoolers

Age and sex norms of classroom behavior in preschoolers were established on a standard measure, the Revised Conners Teacher Rating Scale, and the utility of this measure for assessing problem behavior in preschoolers was examined. Teachers provided ratings for 455 nonreferred preschoolers. In addition, ratings were obtained for 12 clinically referred preschoolers diagnosed with attention deficit hyperactivity disorder. The Conduct Problems, Inattention, and Hyperactivity subscales, as well as the Hyperactivity Index, were found to have good internal reliability and were related to each other in predictable ways. Normative data are presented by age and sex. Age was inversely related to scores for the Conduct Problems subscale, the Hyperactivity subscale and the Index. Sex was a significant predictor of subscale scores, with boys receiving higher scores than girls. Subscale scores and nearly all item scores were highly significantly different between clinically referred and nonreferred preschoolers. The results provide a standard upon which to evaluate preschool-aged children in clinical and research settings.