Predicting Risky Sexual Behavior: the Unique and Interactive Roles of Childhood Conduct Disorder Symptoms and Callous-Unemotional Traits

Conduct disorder (CD) symptoms and callous-unemotional (CU) traits have been shown to be uniquely associated with risky sexual behavior (RSB) in adolescence and early adulthood, yet their interactive role in predicting RSB remains largely unknown. This study aimed to investigate the predictive value of CD symptoms and CU traits, as well as their interaction, on several RSB outcomes in adolescence and early adulthood. A total of 683 participants (41.7 % female, 47.4 % African American) were followed annually and self-reported age of first sexual intercourse, frequency of condom use, pregnancy, contraction of sexually transmitted infections, and engagement in sexual solicitation from grade 7 to 2-years post-high school. CD symptoms predicted age of first sexual intercourse, condom use, and sexual solicitation. CU traits predicted age of first sexual intercourse and pregnancy. Their interaction predicted a composite score of these RSBs such that CD symptoms positively predicted the composite score among those with high levels of CU traits but not among those with low levels of CU traits. The current findings provide information regarding the importance of both CD symptoms and CU traits in understanding adolescent and early adulthood RSB, as well as the benefits of examining multiple RSB outcomes during this developmental period. These findings have implications for the development and implementation of preventive efforts to target these risky behaviors among adolescents and young adults.     

Callous-unemotional traits and conduct problems in the prediction of conduct problem severity,aggression, and self-report of delinquency

The role of callous-unemotional (CU) traits and conduct problems in predicting conduct problem severity, severity and type of aggression, and self-reported delinquency at a 1-year follow-up was investigated in a sample of 98 children (mean age 12.43; SD = 1.72) recruited from a community-wide screening. Children with both CU traits and conduct problems had a greater number and variety of conduct problems at follow-up than children who at the screening had high levels of conduct problems alone. However, this poorer outcome for children with CU traits could largely be accounted for by differences in initial level of conduct problem severity. Children with CU traits and conduct problems were also at risk for showing higher levels of aggression, especially proactive aggression, and self-reported delinquency. Importantly, these outcomes could not be solely explained by initial level of conduct problem severity. Finally, CU traits predicted self-reported delinquency in some children who did not initially show high levels of conduct problems and this predictive relationship seemed to be strongest for girls in the sample who were high on CU traits but who did not show significant conduct problems.     

Can a Laboratory Measure of Emotional Processing Enhance the Statistical Prediction of Aggression and Delinquency in Detained Adolescents with Callous-unemotional Traits?

In this cross-sectional study, we investigated whether the combination of the presence of callous-unemotional (CU) traits and emotional deficits to distressing stimuli, assessed by a computerized dot-probe task, enhanced the statistical prediction of aggression and delinquency in a sample of 88 detained and predominantly African-American (68%) adolescents (M age = 15.57; SD = 1.28). Overall, self-reported CU traits were associated with self-report measures of aggression and delinquency, but not with official records of arrests. However, there was an interaction between CU traits and emotional deficits for predicting self-reported aggression, self-reported violent delinquency, and a record of violent arrests. Youth high on CU traits and who showed a deficit in their responses to visual depictions of distress showed the highest levels of aggression and violent delinquency.     

Early Language Impairment and Young Adult Delinquent and Aggressive Behavior

Clinic and forensic studies have reported high rates of language impairments in conduct disordered and incarcerated youth. In community samples followed to early adolescence, speech and language impairments have been linked to attention deficits and internalizing problems, rather than conduct problems, delinquency, or aggression. This study examines the young adult antisocial outcomes of speech or language impaired children. Language impaired boys had higher levels of parent-rated delinquency symptoms by age 19 than boys without language impairment, controlled for verbal IQ and for demographic and family variables. Language impaired boys did not differ from controls in self-reported delinquency or aggression symptoms on a standardized checklist; however, language impaired boys reported higher rates of arrests and convictions than controls. Language impairment was not related to aggression or delinquency in girls. We examine alternate models of the interrelationships between language, academics, and behavior, at ages 5, 12, and 19.     

Callous–Unemotional Traits in Predicting the Severity and Stability of Conduct Problems and Delinquency

The current study tests whether the presence of callous–unemotional (CU) traits designates a group of children with conduct problems who show an especially severe and chronic pattern of conduct problems and delinquency. Ninety-eight children who were selected from a large community screening of school children in grades 3, 4, 6 and 7 were followed across four yearly assessments. Children with conduct problems who also showed CU traits exhibited the highest rates of conduct problems, self-reported delinquency, and police contacts across the four years of the study. In fact, this group accounted for at least half of all of the police contacts reported in the sample across the last three waves of data collection. In contrast, children with conduct problems who did not show CU traits continued to show higher rates of conduct problems across the follow-up assessments compared to non-conduct problem children. However, they did not show higher rates of self-reported delinquency than non-conduct problem children. In fact, the second highest rate of self-reported delinquency in the sample was found for the group of children who were high on CU traits but without conduct problems at the start of the study.     

冷酷无情特质：一种易于暴力犯罪的人格倾向

冷酷无情特质(callous unemotional trait, CU)是指对他人冷漠、缺乏罪责感、低共情的一种人格倾向, 伴随有高频率和高破坏性的反社会行为甚至暴力犯罪。CU特质者在情感上表现为对负性情绪加工不敏感, 缺乏共情; 在认知上表现出追求奖赏、忽视惩罚; 在生物学方面, CU特质者生理唤醒水平低、皮质醇水平低、杏仁核和腹内侧前额叶活动异常。未来研究的方向是修订发展本土化CU特质量表、探析CU特质者的性别差异、梳理CU与品行障碍等其他精神障碍的关系、为暴力犯循证矫正的方案设计提供科学依据。     

Callous-Unemotional Traits as Unique Prospective Risk Factors for Substance Use in Early Adolescent Boys and Girls

Youth with elevated conduct disorder (CD) symptoms who also have callous-unemotional (CU) traits exhibit more antisocial behavior than youth without CU traits. However, evidence regarding whether CU traits increase risk of substance use over and above CD symptoms, and whether these associations differ for boys and girls, is scarce. Using the Developmental Pathways Project sample of 521 middle school students, we examined whether adolescent- and parent-reported CU traits measured in 6th grade prospectively predicted the onset and recurrence of substance use and use-related impairment by 9th grade. We also examined the degree to which CU traits uniquely predicted substance use and impairment over and above CD symptoms, as well as whether gender moderated these associations. Results indicated that adolescent-reported CU traits increased the likelihood of substance use and impairment onset and recurrence by 9th grade. Analyses revealed that CD symptoms accounted for prospective associations between adolescent-reported CU and substance use, but gender moderated these associations. Boys with elevated CU traits and CD symptoms were not more likely to report alcohol use onset or recurrence, but they were at highest risk of recurrent marijuana use, use of both alcohol and marijuana, and use-related impairment by 9th grade. Girls with low CU traits and high CD symptoms were most likely to report onset and recurrent use of alcohol, as well as recurrent marijuana use, use of both substances and impairment. Study findings highlight the importance of accounting for CD symptoms and gender when examining links between CU traits and substance use in early adolescence.     

Low Maternal Warmth Mediates the Relationship Between Emotional Neglect and Callous-Unemotional Traits Among Male Juvenile Offenders

Callous-unemotional traits (CU) are thought to be the developmental precursor to adult psychopathy, and identify antisocial youth at risk for persistent, aggressive conduct problems. Accumulating research supports the importance of parenting factors in the development of CU traits. The overlapping but distinct constructs, parental neglect and low warmth, are both associated with CU/psychopathic traits; however, research is yet to examine the relative contribution of these constructs. The purpose of the present study was to examine the unique contributions of parental neglect and low warmth to CU traits among 227 incarcerated male juvenile offenders (M?=?15.73, SD?=?1.27 years). Results indicated that low levels of maternal warmth were more strongly associated with CU traits than emotional and physical neglect. Maternal warmth also significantly mediated the association between emotional neglect and CU traits. Findings from this cross-sectional study suggest that parental neglect influences CU traits at least partly through experiences with unresponsive and emotionally “cold” parenting. The findings also support a movement within the field towards addressing parental warmth as a treatment target for antisocial youth with CU traits.     

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.     

Young adult follow-up of hyperactive children: self-reported psychiatric disorders,comorbidity, and the role of childhood conduct problems and teen CD

We report on the psychiatric disorders present at young adult follow-up (Mean age 20–21 years; 13 + year follow-up) and the comorbidity among them for a large sample of hyperactive (H; N = 147) and community control (CC; N = 71) children. The H group had a significantly higher risk for any nondrug psychiatric disorders than the CC group (59% vs. 36%). More of the H group met criteria for ADHD (5%); major depressive disorder (26%); and histrionic (12%), antisocial (21%), passive–aggressive (18%), and borderline personality disorders (14%) at follow-up than the CC group. Severity of childhood conduct problems contributed to the risk for passive–aggressive, borderline, and antisocial personality disorders. But it only affected risk for antisocial personality after controlling for severity of teen conduct disorder (CD), which also contributed to the risk for these same 3 disorders. Examination for comorbidity among these disorders indicated that presence of either borderline or antisocial personality disorder significantly increased the risk for major depression and the other significant personality disorders. More of the hyperactive group had received various forms of mental health treatment during and since leaving high school than the control group. Results suggest that hyperactive children are at significant risk for at least 1 nondrug disorder in young adulthood, principally major depression and several personality disorders, and that this risk is largely mediated by severity of CD at adolescence.     

Adolescent school experiences and dropout,adolescent pregnancy,and young adult deviant behavior

Outside of the family, schools are the most proximal socializing agent available to convey societal norms and prohibitions to young people. In some cases, a positive school experience can compensate for the antisocial influence of family and community. The present study investigated the predictive ability of school-related factors on later deviancy in a random sample of 452 US adolescents 12-18 years of age attending 150 junior or senior high schools in upstate New York and enrolled in a broader prospective study. A measure of conduct problems, obtained 2 years before measurement of school factors, was used to control for the predisposing effects of problematic behavior on later deviance. Academic achievement, academic aspirations, and a learning-focused school environment had deterrent effects on all deviant outcomes assessed--dropping out of school, adolescent pregnancy, engaging in criminal activities, criminal conviction, antisocial personality disorder, and alcohol abuse--independent of age, gender, intelligence quotient, socioeconomic status, childhood conduct problems, and proportion of deviance-oriented friends in adolescence. Given the persistence of deviant behavioral patterns of adolescence into adulthood, the systems-level influences identified in this study should be given careful attention.     

The prediction of violent and nonviolent criminal behavior in a methadone maintenance population

The utility of traits associated with Antisocial Personality Disorder in making risk assessments of violent and nonviolent crimes was examined in 254 subjects sampled from a methadone maintenance population. A factor analysis of a number of baseline measures resulted in five factors measuring hostility, insecure attachment, impaired reality testing, antisocial personality, and empathy. These factors were used in logistic regression analysis to predict charges for violent and nonviolent crimes over a 2-year period. Individuals with high scores on the antisocial personality factor had an increased risk of both violent and nonviolent criminal charges. Individuals with low scores on the empathy factor were at high risk for violent crimes. In an analysis using the factor components rather than the factors, the measures of perspective-taking and a socialization were associated with violent criminal charges, and the measure of psychopathy, but not antisocial behavior, was associated with nonviolent criminal charges. The results support the use of measures of personality traits in addition to measures of a history of antisocial behavior in making violence risk assessments in substance-dependent patients. The DSM construct and diagnosis of Antisocial Personality Disorder may be enhanced by greater emphasis on personality traits associated with antisocial behavior.     

Ineffective discipline and conduct problems in males: Association, late adolescent outcomes, and prevention

In the current study, social learning theory and findings on the association of ineffective parental discipline and childhood conduct problems was reviewed In addition, the association of ineffective discipline in childhood to arrests and academic achievement in adolescence was tested. The reviewed studies were multi-agent, multimethod passive longitudinal, prevention, and clinical studies conducted at the Oregon Social Learning Center (OSLC). Measurement of childhood discipline included observational data. Analyses predicting to adolescent outcomes were conducted for the Oregon Youth Study sample of approximately 200 males at risk for delinquency. The finding of an association between ineffective discipline and childhood conduct problems was replicated in three OSLC studies. Ineffective discipline at Grade 4, controlling for Grade 4 antisocial behavior, was found to predict to a more serious juvenile arrest record (two or more arrests) and to failure to enter higher education. Prevention efforts need to be directed toward promoting effective discipline skills, especially in parents of young children. Effective discipline includes such skills as structuring situations, redirecting child behavior, encouragement, and also consistent use of a mild to moderate consequence such as time out or privilege loss.     

Adjustment Problems and Emerging Personality Characteristics from Early to Late Adolescence

This 6-year longitudinal study extended earlier findings of contextual influences on adolescent adjustment problems by examining relationships between adolescent emotional and behavioral problems and late adolescent personality among more than 400 youths who were followed from 7th grade to the last year of high school. Results suggest that psychological distress and behavioral problems experienced during the adolescent years (7th–10th grades) are significantly related to personality structure during the final year of high school (12th grade). Psychological distress in adolescence was primarily related to the Multidimensional Personality Questionnaire (MPQ) superfactors of negative and positive emotionality, whereas delinquency and substance use problems were primarily related to the MPQ superfactor of constraint. These relationships remained significant even when personality characteristics in 9th grade were taken into account. That is, emotional and behavioral problems predicted change in personality traits during the adolescent years. Moreover, both initial level and change in distress and problem behaviors were predictive of late adolescent or early adult personality. This finding suggests that personality formation is a dynamic process, dependent on the growth or decline, as well as the magnitude of earlier developmental problems. Because earlier research has shown that these developmental problems are affected by both distal and proximal environmental contexts as well as by the formative nature of adolescence, intervention efforts aimed at the reduction of maladjustment and the enhancement of healthy personality development should target early adolescent social contexts. Other theoretical implications of the findings also are discussed.     

What do others feel? Cognitive empathy deficits explain the association between callous-unemotional traits and conduct problems among preschool children

Abstract

Callous-unemotional traits (CU) are a risk factor for antisocial behavior, although it is unclear whether deficits in affective or cognitive empathy explain this association. Using a multi-informant approach involving data collection from parents and teachers (N = 167, M age = 4.7 years), the current study aimed to test whether cognitive or affective empathy deficits account for the association between CU traits and antisocial behavior among preschool children. Results revealed that cognitive, but not affective, empathy was associated with both CU and conduct problems, and also mediated the relationship between CU traits and conduct problems. These findings were not replicated for overt and relational aggressive behavior. Our findings suggest that cognitive empathy deficits may be more important than affective empathy in explaining antisocial behavior in preschool children. As a result, interventions aiming to reduce conduct problems early in development may need to target difficulties in understanding what others are thinking or feeling.     

Boys Who Join Gangs: A Prospective Study of Predictors of First Gang Entry

In a representative sample of boys who were in the 7th grade of an urban public school system at the start of a 6-year longitudinal study, more African American boys (23.8%) than non-Hispanic White boys (3.9%) had entered an antisocial gang by age 19. There were too few White gang members to study, but among African American boys, first gang entry was predicted prospectively by both baseline conduct disorder (CD) behaviors and increasing levels of CD behaviors prior to gang entry. This suggests that gang entry may be a further developmental step for some boys who are already on a trajectory of worsening antisocial behavior. Having friends prior to gang entry who engaged in aggressive delinquency increased the risk of gang entry further, but only during early adolescence. Family income and parental supervision also independently predicted gang entry, but the direction of their influences depended on the youth's age.     

Psychopathic Traits in Boys With and Without Attention-Deficit/Hyperactivity Disorder: Concurrent and Longitudinal Correlates

To investigate the role of psychopathic traits in a clinical and comparison sample, we obtained dimensional California Child Q-Set (CCQ) personality profiles for 66 preadolescent boys with attention-deficit/hyperactivity disorder (ADHD) and 56 comparison boys during naturalistic summer programs and correlated each boy's CCQ profile with an expert-derived CCQ psychopathy prototype. These scores, representing each boy's degree of similarity to the prototype, were significantly associated with concurrent externalizing diagnoses and symptoms and, with statistical control of these externalizing features, concurrent measures of objectively observed noncompliance, overt and covert antisocial behavior, and peer sociometric nominations indexing peer rejection. Psychopathic traits were not associated with peer acceptance. CCQ psychopathy dimension scores also predicted severity of delinquency at a 5-7-year prospective follow-up, with statistical control of age, baseline externalizing diagnoses and symptoms, and baseline objective observations of antisocial behavior. Predictions held when overt behavioral items from the CCQ, which may have overlapped with the delinquency outcome criterion, were eliminated. Despite these strong effects, a plethora of false positives were evident in the prospective predictions to delinquency status. We discuss research and clinical implications of measuring psychopathic traits in childhood.     

Sadistic personality disorder in sex offenders: relationship to antisocial personality disorder and sexual sadism.

To investigate the relationship of sadistic personality disorder (SPD), as defined in the appendix of DSM-III-R, to other personality disorders and to sexual sadism, 70 sex offenders (27 child molesters, 33 rapists, and 10 murderers) were assessed by the International Personality Disorder Examination. In 19 subjects (27.2%) from the total sample, SPD was diagnosed. The highest overlap appeared with borderline personality disorder (31.6%) and antisocial personality disorder (42.1%). However, in four cases SPD was the only personality disorder diagnosed. Factor analysis of the antisocial and sadistic criteria resulted in four major factors--one factor with high loadings on the sadistic criteria and the violent criteria of antisocial personality disorder, two factors with different forms of adult and juvenile aggression, and a fourth factor with high loadings on the antisocial criteria covering exploitative behavior. The results do not support SPD as a discrete disorder. Nevertheless, SPD may be seen as an important subdimension of antisocial personality disorder, distinct from more exploitative forms of antisocial behavior with less violence. Of those patients with SPD, 42.1% also had a DSM-III-R diagnosis of sexual sadism, which may be the most dangerous configuration.     

Perceived positive outcomes as a mediator between adolescent callous-unemotional traits and antisocial behavior

This study investigated perceived positive outcomes as a mediator of the relation between callous-unemotional (CU) traits and antisocial behavior (i.e., delinquency, aggression) and the potential moderational influence of anxiety in that model. Participants were 149 adolescents, ages 16–19 years (124 males, 25 females) in a residential setting. Perceived positive outcomes for antisocial behavior mediated the relation between CU traits (callousness and uncaring) and such behaviors. Additionally, anxiety had a moderating effect on the relation between callousness and perception of positive outcomes, and the indirect effect of callousness on antisocial behavior was conditional based on varying levels of anxiety. These results suggest a potential mechanism through which CU traits are associated with adolescent behavioral problems.