Relation between parenting stress and psychopathic traits among children

Parenting stress was examined as a correlate of psychopathic traits, specifically narcissism, callous/unemotional traits, and impulsivity, among school-aged children while controlling for the variance explained by aggressive behavior. Participants included 212 children ranging from 6 to 12 years of age (M = 8.3 years) who were admitted to an acute child psychiatric inpatient unit for treatment. Parents completed standardized measures of aggression (Child Behavior Checklist; CBCL), psychopathic traits (Antisocial Process Screening Device; APSD), and parenting stress (Parenting Stress Index; PSI) at the time of the child's admission. Multiple regression analyses revealed that high levels of the PSI dimension attachment difficulties were associated with high levels of narcissism and callous/unemotional traits among the children while statistically controlling for aggression. The PSI dimension role restriction was also found to be negatively related to narcissism. These findings suggest that specific aspects of parenting stress may be related to child psychopathic traits and might aid with conceptualizing and developing treatment approaches for childhood behavior problems.     

Psychopathic Traits and Delinquency Trajectories in Adolescence

The utility of psychopathic traits predicting various forms of antisocial behavior has been demonstrated extensively. However, there are mixed results concerning which of the three psychopathic personality dimensions—callous and unemotional traits, grandiose and manipulative interpersonal style, impulsive-irresponsible behavior—is the best predictor of antisocial behavior in adolescence. In this study, we examined developmental trajectories of antisocial behavior over four years in adolescence and psychopathic traits as predictors of these trajectories. Participants were 811 adolescents from a longitudinal community sample (M _age = 14). Results showed that four trajectories described the development of antisocial behavior from early to middle adolescence in the current sample. Both grandiose-manipulative traits and impulsive-irresponsible behavior were significant predictors of the high and elevated trajectories whereas callous-unemotional traits were not. Our findings underline the importance of studying the dimensions of the psychopathy constructs uniquely and independently of each other.     

Psychopathic Traits of Dutch Adolescents in Residential Care: Identifying Subgroups

The present study examined whether a sample of 214 (52.8% male, M age = 15.76, SD = 1.29) institutionalized adolescents could be classified into subgroups based on psychopathic traits. Confirmatory Factor Analyses revealed a relationship between the subscales of the Youth Psychopathic traits Inventory (YPI) and the three latent constructs of the original model on which it is based. Latent Class Analyses showed that adolescents showing psychopathic traits could be classified into three subgroups. The first group showed low scores on the grandiose/manipulative dimension, the callous/unemotional dimension, and the impulsive/irresponsible dimension (normal group). The second group scored moderate on the grandiose/manipulative dimension and the callous/unemotional dimension and high on the impulsive/irresponsible dimension (impulsive, non-psychopathic-like group). The third group scored high on all three dimensions (psychopathy-like group). The findings revealed that the impulsive, non-psychopathic like group scored significantly higher on internalizing problem behavior compared to the normal group, while the psychopathy-like and the impulsive, non-psychopathic-like group both scored higher on externalizing problem behavior compared to the normal group. Based on a self-report delinquency measure, it appeared that the psychopathy-like group had the highest delinquency rates, except for vandalism. Both the impulsive and psychopathy-like group had the highest scores on the use of soft drugs.     

The Indirect Effects of Adolescent Psychopathic Traits on Aggression Through Social-Cognitive Factors

Psychopathic traits have been shown to designate youth who are at-risk for varied forms of aggression. The present study examined the indirect effects of social-cognitive factors (i.e., hostility and general approval of aggression) in the association between psychopathic traits (i.e., callous-unemotional traits, narcissism) and two functions of adolescent aggression (i.e., reactive, proactive). Participants were 209 (178 males, 31 females) adolescents aged 16 to 19 attending a residential program for youth who have dropped out of high school. Using a cross-sectional design, participants completed self-report measures of callous-unemotional traits (i.e., callousness, uncaring, unemotional), narcissism, aggression, hostility, and approval of aggression. Results indicated significant indirect effects of callousness on both functions of aggression through hostility. Similarly, there were significant indirect effects of narcissism on both functions of aggression through hostility. Significant indirect effects were also evident for general approval of aggression in the relations between callous-unemotional traits (both callous and uncaring dimensions) and both functions of aggression, and between narcissism and both functions of aggression. These results suggest the importance of examining social-cognitive processes insofar as they may contribute to the relation between psychopathic traits and aggression in youth and serve as possible targets of intervention.     

Young Offenders’ Emotion Recognition Dysfunction Across Emotion Intensities: Explaining Variation Using Psychopathic Traits,Conduct Disorder and Offense Severity

Antisocial individuals have problems recognizing negative emotions (e.g. Marsh & Blair in Neuroscience and Biobehavioral Reviews 32:454–465, 2009); however, due to issues with sampling and different methods used, previous findings have been varied. Sixty-three male young offenders and 37 age-, IQ- and socio-economic status-matched male controls completed a facial emotion recognition task, which measures recognition of happiness, sadness, fear, anger, disgust, and surprise and neutral expressions across 4 emotional intensities. Conduct disorder (YSR), and psychopathic and callous/unemotional traits (YPI) were measured, and offenders’ offense data were taken from the Youth Offending Service’s case files. Relative to controls, offenders were significantly worse at identifying sadness, low intensity disgust and high intensity fear. A significant interaction for anger was also observed, with offenders showing reduced low- but increased high-intensity anger recognition in comparison with controls. Within the young offenders levels of conduct disorder and psychopathic traits explained variation in sadness and disgust recognition, whereas offense severity explained variation in anger recognition. These results suggest that antisocial youths show specific problems in recognizing negative emotions and support the use of targeted emotion recognition interventions for problematic behavior.     

Callous-Unemotional Traits Only Versus the Multidimensional Psychopathy Construct as Predictors of Various Antisocial Outcomes During Early Adolescence

The aim of this study was to compare callous-unemotional (CU) traits versus the multidimensional psychopathy construct in their ability to predict future and stable antisocial behavior. At baseline, a community sample of 996 Cypriot 12-year old adolescents (52% girls) completed measures that tap conduct problems (CP) and psychopathic traits, including CU. CP, aggression, and substance use were self-reported at 1–3 year follow-ups. Youths were assigned to six mutually exclusive groups based on their baseline levels of CP and psychopathic traits. Youth with CP scoring high on all three psychopathic traits dimensions (Psychopathic Personality?+?CP) showed the most robust and highest risk for future and stable CP, aggression, and substance use, followed by youth who were high on all three psychopathic traits dimensions but displayed no concurrent CP (Psychopathic Personality Only) and CP youth with low levels of psychopathic traits (CP Only). Youth with CP who merely manifested callous-unemotional traits (Callous-Unemotional?+?CP) were only at risk for future CP. The findings suggest that the CU traits-based approach for subtyping children with CP is less informative compared to a subtyping approach using various psychopathic traits dimensions in predicting future and stable forms of various antisocial outcomes. These findings and their consistency with prior work indicate the need for additional research to examine the various psychopathic traits dimensions rather than focusing solely on CU traits, especially for CP subtyping purposes.     

Gender, Somatization, and Psychopathic Traits in a College Sample

The structure of psychopathic traits and their association with somatization symptoms were investigated in a sample of 199 undergraduate college students enrolled in introductory psychology classes. Using multiple measures of psychopathic traits, an iterated principal axis (IPA) analysis revealed two dimensions of psychopathy that were similar to ones typically found in forensic samples. One dimension focused on a cold, callous, and unemotional interpersonal style and the second dimension focused on an impulsive and antisocial lifestyle. These two dimensions emerged for both men and women, although the correlation between the two was somewhat higher for men than women. Also, the callous and unemotional dimension was negatively correlated with somatization symptoms, and the impulsive and antisocial dimension was positively associated with somatization symptoms. This pattern of associations was similar for both men and women and it suggests that somatization symptoms may be one aspect of the high rate of negative affectivity experienced by antisocial individuals.     

Are Callous Unemotional (CU) Traits Enough?

A guiding question for this special section, sparked by the increasing number of studies on callous –unemotional traits (CU traits) and the DSM-5 Limited Prosocial Emotion (LPE) specifier, is whether CU traits are enough to identify a clinically meaningful subgroup of youth with conduct problems or whether other psychopathic traits contribute. Seven empirical papers and two commentary papers address this question to varying degrees and in different ways with some papers “competing” various models against one another along with other papers investigating distinct correlates of the psychopathy factors. Findings across the papers suggest that there could be benefits to examining the broader construct of psychopathy in addition to examining its underpinning dimensions rather than CU traits alone. Two commentary papers also shed light on the importance of psychopathic traits in children with Conduct Disorder (CD) and provide insights for future work on this topic. It is hoped that the articles and commentary will generate new ideas for research and practice that could have implications for the treatment of those individuals with CD and psychopathic traits.     

„Rocken statt Ritzen“

Background

Non-suicidal self-injury (NSSI) starts in adolescence and decreases during young adulthood. Despite a high prevalence among adolescents only a few therapeutic interventions directly addressing adolescents exist.

Aim

By connecting music therapy with elements from behavioral therapy an attempt was made to create a therapeutic program which is attractive to adolescents.

Material and methods

A pilot trial of the program “Stop cutting - rock!” was conducted with 12 adolescent females with a mean age of 15.15 years (standard deviation SD ±1.34). The study aimed to compare the frequency of NSSI throughout the treatment phase as well as a pre-post comparison of depression scores.

Results

The results showed a trend towards a decreasing frequency of NSSI. Depression scores decreased significantly between the assessment before therapy and at a 3-month follow-up after the end of the therapy.

Conclusion

The positive feedback concerning music therapeutic elements points to the attractiveness of the approach. By integrating multimodal therapeutic strategies it seems possible to create an individually tailored intervention for adolescents with NSSI.     

Callous-Unemotional Traits and Autonomic Functioning in Toddlerhood Interact to Predict Externalizing Behaviors in Preschool

Callous-unemotional (CU) traits are one meaningful risk factor which helps to explain heterogeneity in the emergence of externalizing behavior problems. While the extant literature demonstrates links between early CU traits and later externalizing problems, there is a dearth of research examining for whom early CU traits confer risk. Data from a longitudinal study (n?= 108) were used to examine the extent to which parasympathetic functioning moderated links between CU traits in toddlerhood (m _age ?=?24.99 months) and externalizing behavior problems at preschool-age (m _age ?=?51 months). Neither CU traits nor parasympathetic functioning at age 2 directly predicted later externalizing behaviors. However, results show that high levels of CU traits predict elevated externalizing behavior problems, but only for toddlers exhibiting either high baseline respiratory sinus arrhythmia (RSA) or little to no RSA suppression in response to a fear stimulus.     

Patienten- und Elternzufriedenheit bei intensiver,klinikvernetzter Zu-Hause-Behandlung

Background

Due to the increasing importance of effective, patient-oriented treatment options for mentally ill children and adolescents, new alternatives to established inpatient and outpatient care in child and adolescent psychiatry have to be found. Intensive cross-sectoral treatment settings may be an alternative but have not yet been evaluated or implemented in routine care.

Aim

The objective of this randomized study was to compare and assess satisfaction with a new model of care within the underlying BeZuHG (“behandelt zu Hause gesund werden”, treated at home become healthy) study with regular inpatient care (TAU). Patients in BeZuHG received early discharge from inpatient care followed by 3 months of intensive home treatment enhanced by clinical elements.

Material and methods

Youths and parents were asked to fill in a patient satisfaction questionnaire (BesT) at completion of treatment. Participants in the study were evaluated between April 2012 and January 2013.

Results

Neither BeZuHG nor inpatient care was clearly superior. Youths in the control group stated a higher satisfaction with the overall treatment than youths in the BeZuHG group (p?=?0.031), while youths in the BeZuHG group named a significantly higher satisfaction with the home treatment component than with the inpatient component of treatment (p?=?0.007).

Conclusion

Patient satisfaction could be shown for inpatient and BeZuHG treatment at discharge. Data may change at follow-up. A long-term follow-up should be implemented to confirm these results or to allow other conclusions.     

Does Dispositional Aggression Feed the Narcissistic Response? The Role of Narcissism and Aggression in the Prediction of Job Attitudes and Counterproductive Work Behaviors

Purpose

The purpose of this study was to extend the personality and work-related outcomes literature by examining: (1) the effects of narcissism on job satisfaction, organizational commitment, and counterproductive work behaviors and (2) the moderating effects of dispositional aggression on the narcissism–counterproductive work behaviors relationship.

Design/Methodology/Approach

Multi-wave data were collected from 381 workers employed in a variety of work settings within the United States.

Findings

Narcissism had consistent main effects on job satisfaction, organizational commitment, and counterproductive work behaviors after controlling for the personality characteristics agreeableness, conscientiousness, neuroticism, and aggression. Aggression moderated the relationship between narcissism and counterproductive work behaviors, such that the positive relationship between narcissism and counterproductive work behaviors was stronger when dispositional aggression was high.

Implications

This study provides greater clarity regarding the role of narcissism within job attitudes and behaviors, shows that dispositional aggression strengthens or amplifies the narcissistic response for counterproductive work behaviors, and provides a platform to further explore narcissism and aggression within the workplace.

Originality/Value

This study found that narcissism consistently predicted unique variance in work-related criteria after the effects of agreeableness, conscientiousness, neuroticism, and aggression were controlled. It also found evidence that aggression moderates the effects of narcissism on counterproductive work behaviors. This study is the first to directly examine these effects.     

Eltern und Patienten als Subjekt der Behandlung

Background

There are hardly any alternatives to inpatient treatment for children and adolescents in need of intensive psychiatric treatment. In the randomized study BeZuHG (“behandelt zu Hause gesund werden”, treated at home become healthy), equality of treatments could be shown in the outcome parameters when comparing TAU (inpatient treatment) and the new treatment module BeZuHG (early discharge followed by intensive home treatment enhanced by clinical elements). Patient satisfaction with each treatment module was evaluated at follow-up.

Material and methods

In this study 144 parents and patients of the intervention group (n?=?79) and the control-group (n?=?65) were interviewed after an average of 8 months. Information on expectations, experience with BeZuHG, changes in communication and interaction within the family as well as problem solving strategies (and sustainability of the changes), overall satisfaction and treatment suggestions for modification of the BeZuHG treatment were collected in semistructured telephone interviews.

Results

The following aspects in the BeZuHG treatment were rated as important by parents and patients: support and help with transfer problems, single sessions, a trusting therapeutic relationship as well as treatment setting at home. Enhanced problem solving skills as well as improved family communication were noticed. In the intervention group 70?% would prefer the BeZuHG setting to inpatient care and 46?% in the control group.

Conclusion

The BeZuHG concept is a good and functional alternative to inpatient treatment. Continuity in treatment and therapeutic relationships are essential for successful treatment at home. Positive treatment results within the family as well as the patient remain stable at follow-up after 8 months.     

Socioeconomic Status and Psychopathic Traits in a Community Sample of Youth

The current study aims to address socioeconomic status (SES) as a moderating variable between psychopathic traits and conduct problems in a sample of 2432 Dutch adolescents (M_age?=?14.50 years, SD?=?1.67, 56% male). Both family and neighborhood SES were measured, with income as a proxy for the level of SES. There were small but significant positive correlations between the behavioral and interpersonal dimensions of psychopathy and family SES, a small but significant negative correlation between the affective dimension and neighborhood SES, and a small and significant positive correlation between neighborhood SES and the behavioral dimension of psychopathy. Results further showed that the relations between youth psychopathic traits were moderated by neither family SES nor neighborhood SES. The results suggest that the relations between psychopathic traits and conduct problems are equally strong for lower and higher SES youth. Taken together, these findings warrant the conclusions that SES does not play a role as a moderator in the relation between psychopathy and conduct problems.     

Multisystemic Therapy and Functional Family Therapy Compared on their Effectiveness Using the Propensity Score Method

Multisystemic Therapy (MST) and Functional Family Therapy (FFT) have overlapping target populations and treatment goals. In this study, these interventions were compared on their effectiveness using a quasi-experimental design. Between October, 2009 and June, 2014, outcome data were collected from 697 adolescents (mean age 15.3 (SD 1.48), 61.9% male) assigned to either MST or FFT (422 MST; 275 FFT). Data were gathered during Routine Outcome Monitoring. The primary outcome was externalizing problem behavior (Child Behavior Checklist and Youth Self Report). Secondary outcomes were the proportion of adolescents living at home, engaged in school or work, and who lacked police contact during treatment. Because of the non-random assignment, a propensity score method was used to control for observed pre-treatment differences. Because the risk-need-responsivity (RNR) model guided treatment assignment, effectiveness was also estimated in youth with and without a court order as an indicator of their risk level. Looking at the whole sample, no difference in effect was found with regard to externalizing problems. For adolescents without a court order, effects on externalizing problems were larger after MST. Because many more adolescents with a court order were assigned to MST compared to FFT, the propensity score method could not balance the treatment groups in this subsample. In conclusion, few differences between MST and FFT were found. In line with the RNR model, higher risk adolescents were assigned to the more intensive treatment, namely MST. In the group with lower risk adolescents, this more intensive treatment was more effective in reducing externalizing problems.     

Using a Videogame Intervention to Reduce Anxiety and Externalizing Problems among Youths in Residential Care: an Initial Randomized Controlled Trial

Residential care is among the most intensive forms of treatment in youth care. It serves youths with severe behavioral problems and is primarily focused on targeting externalizing problems. Despite best efforts, effect sizes remain moderate, which may be due to the disregarding of internalizing symptoms – in particular anxiety - and to limitations regarding the delivery model of interventions. This initial randomized controlled trial (n?=?37) aimed to examine the effectiveness of a biofeedback videogame intervention (Dojo) as an addition to treatment as usual for youths with and without intellectual disability (ID) in residential care with clinical levels of anxiety and externalizing problems. Dojo targets both anxiety and externalizing problems, and incorporates the principles of conventional treatment, while addressing its limitations. Youths were randomly assigned to play Dojo (eight 30-min gameplay sessions) or to treatment as usual (TAU). Measurements of anxiety and externalizing problems were conducted at baseline, posttreatment, and 4-months follow-up through youths’ self-report and mentor-report. Completers-only analyses revealed decreases in self-reported anxiety and externalizing problems, and mentor-reported anxiety at posttreatment for participants in the Dojo condition compared to the control condition. Only mentor-reported anxiety was maintained at follow-up. No effect was found for mentor-reported externalizing problems. These findings provided preliminary evidence that Dojo is a promising, innovative intervention that engages high-risk youths. Practical implications are discussed.     

Interplay between Attachment to Peers and Parents in Korean Adolescents’ Behavior Problems

The present study investigated the relative contribution of style of peer attachment (secure, anxious, avoidant) and quality of attachment to parents on behavior problems in Korean adolescents. In addition, we examined the role of paternal and maternal attachment separately as a potential moderator in the relationship between style of peer attachment and internalizing and externalizing behavior problems. Middle school students (245 males, 209 females) completed the Korean version of the Adolescent Friendship Attachment Scale, Inventory of Parental and Peer Attachment-Revised, and Youth Self-Report. Attachment to peers and parents as predictors of behavior problems were tested via hierarchical multiple regression analyses. Results revealed that anxious peer attachment remained the strongest predictor of behavior problems among adolescents (internalizing behavior problems β?=?.18, p?<?.01; externalizing behavior problems β?=?.21, p? <?.001), indicating the relative importance of peer relationship compared to attachment to parents. Paternal attachment significantly moderated the relationship between avoidant peer attachment and externalizing behavior problems (β?=?.15, p?<?.05), even when the main effect of avoidant peer attachment on externalizing behavior problems was not significant. Results highlight the role of both attachments to peers and parents on adolescents’ psychological adjustment.     

Internalizing problems and their impact on the relation between callous-unemotional traits,narcissism, and aggression

Narcissism and callous-unemotional (CU) traits have demonstrated relations with youth aggression across studies. However, different forms of narcissism and internalizing problems may exacerbate the relation between CU traits and aggression. To that end, the current study examined the degree to which interactions among internalizing problems, CU traits, and dimensions of narcissism related to aggression in a sample of 219 adolescents (83.1% males), ages 16–19, enrolled in a military-style residential program. Consistent with previous research, psychopathy-linked narcissism significantly moderated the relation between CU traits and aggression. Addtionally, self-reported aggression was highest among adolescents who endorsed high levels of CU traits, psychopathy-linked narcissism, and internalizing problems. The same pattern of results was not evident for other forms of narcissism. These results suggest that internalizing problems further increase the probability of aggression among adolescents with psychopathic tendencies (i.e., CU traits, psychopathy-linked narcissism). Further implications are discussed.     

An exploratory study of the relations between psychopathic traits and depressive symptoms in a non-clinical sample of adolescents

Empirical evidence suggests an association between psychopathic traits, depressive symptoms and delinquent behavior in community samples of adolescents. In this study, a sample of 243 high school students completed questionnaires assessing depressive symptoms and psychopathic traits (callousness and narcissistic traits). There were significant positive correlations between depressive symptoms, callousness and narcissistic traits. Narcissistic traits appeared to be a mediator between depressive mood and callousness while depressive mood was the main predictor of impulsivity/poor behavioral control. These findings are consistent with the hypothesis that impulsivity/poor behavioral control, callous and narcissistic traits are defenses against depressed mood. Narcissistic defenses may prepare the development of callousness. There might be a developmental process from depressive symptoms to psychopathic traits and behavior problems in adolescents.     

Symptomattributionsstile bei Hypochondrie

Background

Somatic symptom attributions are of central importance in cognitive-behavioral models of the development, maintenance and treatment of hypochondriasis. However, the mode of symptom attribution has rarely been systematically investigated in these patients. Is a somatic mode of symptom attribution indeed specific for hypochondriasis and furthermore, how strongly is it associated with “doctor shopping”, a typical behavioral consequence of hypochondriasis?

Patients and methods

In this study 88 hypochondriacal, 52 depressive and 52 healthy persons were asked to complete the symptom interpretations questionnaire and several standardized symptom questionnaires. They also took part in two structured clinical interviews for the diagnosis of hypochondriasis and various other psychological disorders according to DSM-IV.

Results

Somatic symptom attributions were associated specifically with hypochondriasis, while normalizing attributions characterized persons with low health anxiety. When examined as predictors in multiple regression models, in particular somatic attributions and the total of somatoform complaints predicted the intensity of health anxiety (R ²?=?0.69) and “doctor shopping” (R ²?=?0.48).

Conclusion

In the cognitive-behavioral treatment of hypochondriasis, patients should be encouraged to test normalizing explanations as alternatives to habitual somatic attributions of somatic disturbances.