Child Psychopathy: Theories,Measurement, and Relations with the Development and Persistence of Conduct Problems

To develop more accurate explanatory and predictive models of child and adolescent conduct problems, interest has grown in examining psychopathic traits in youth. The presence or absence of these traits may help to identify unique etiological pathways in the development of antisocial behavior. The current review provides a detailed summary and analysis of (a) the conceptualization and measurement of child and adolescent psychopathy, (b) research on relations between psychopathic traits and a range of conduct problems and associated variables, (c) efforts to utilize data on child and adolescent psychopathy to delineate a subgroup of youth whose conduct problems share a relatively homogenous etiology and developmental trajectory, and (d) current challenges and limitations in the study of youth psychopathy and directions for future research efforts. Specific sections include the origins of the youth psychopathy construct, conceptualization and measurement, relations between psychopathic traits and conduct problems, relations between measures of psychopathy and measures of individual and contextual variables, efforts to identify a unique subgroup of children with conduct problems using psychopathic traits, and finally, challenges that face the field and goals for the next generation of research.     

Reconstruing the "reconstruction" of psychopathy: a comment on Cooke, Michie, Hart, and Clark

In this comment we highlight critical problems in the estimation of parameters for their hierarchical three-factor model of psychopathy, as assessed with the Hare Psychopathy Checklist, and their interpretation of these factors as causally related to socially deviant behavior. We argue that there is nothing "causal" about a model in which cross-sectional data are used to assert that antisocial tendencies are consequences of other more fundamental psychopathic traits. We present an equally viable model, based on the PCL-R four-factor solution, in which antisocial tendencies play a fundamental role in the construct of psychopathy, consistent with previous research and clinical tradition.     

Psychopathic traits in adolescent offenders: an evaluation of criminal history, clinical, and psychosocial correlates

Although a large body of research has established the relevance of psychopathy to adult offenders, its relevance to adolescent offenders is far less clear. The current study evaluated the clinical, psychosocial and criminal correlates of psychopathic traits in a sample of 226 male and female incarcerated adolescent offenders. According to an 18-item version of the Psychopathy Checklist-Youth Version (PCL-YV; Forth, Kosson, & Hare, 2003), only 9.4% exhibited a high level of psychopathic traits (PCL-YV>/=25). Consistent with past research, higher PCL-YV scores were positively associated with self-reported delinquency and aggressive behavior and were unrelated to emotional difficulties. Although higher PCL-YV scores were associated with the experience of physical abuse, the only psychosocial factor to predict PCL-YV scores was a history of non-parental living arrangements (e.g. foster care). In terms of criminality, a violent/versatile criminal history was positively associated with psychopathic traits. However, PCL-YV scores were unrelated to participants' official criminal records for total, non-violent, violent, and technical violation convictions. In conclusion, the data partially support the construct validity of psychopathy with adolescent offenders, but some inconsistencies with prior adult and adolescent psychopathy research were evident. These issues are discussed.     

Psychopathic Sexuality: The Thin Line Between Fantasy and Reality

In two studies, we explored the relations between psychopathic traits and sexual fantasy content. In Study 1, we rated content themes in the fantasy narratives of 195 men and women recruited at a Canadian university. In Study 2, we administered a sexual fantasy questionnaire to a sample of 355 Canadian undergraduate students. In Study 1, we found that psychopathic traits predicted themes of anonymous, uncommitted, and nonromantic sexual activity after controlling for participant sex. In Study 2, we found that psychopathy added to the prediction of self‐reported engagement in unrestricted, dominant, submissive, deviant, and adventurous sexual activity, even after controlling for participant sex and level of fantasizing about that activity. Furthermore, an interaction between psychopathy and level of fantasizing was observed for unrestricted and deviant sexual behavior, such that participants who reported high levels of fantasizing about these sexual themes were more likely to engage in that behavior if they also reported high levels of psychopathic traits. These findings suggest that psychopathy is related not only to interest in particular sexual behaviors, but also to whether individuals will translate these fantasized behaviors into reality.     

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.     

Psychopathy and the ability to read the “language of the eyes”: Divergence in the psychopathy construct

The capacity to interpret others people's behavior and mental states is a vital part of human social communication. This ability, also called mentalizing or Theory of Mind (ToM), may also serve as a protective factor against aggression and antisocial behavior. This study investigates the relationship between two measures of psychopathy (clinical assessment and self‐report) and the ability to identify mental states from photographs of the eye region. The participants in the study were 92 male inmates at Bergen prison, Norway. The results showed some discrepancy in connection to assessment methodology. For the self‐report (SRP‐III), we found an overall negative association between mental state discrimination and psychopathy, while for the clinical instrument (PCL‐R) the results were more mixed. For Factor 1 psychopathic traits (interpersonal and affective), we found positive associations with discrimination of neutral mental states, but not with the positive or negative mental states. Factor 2 traits (antisocial lifestyle) were found to be negatively associated with discrimination of mental states. The results from this study demonstrate a heterogeneity in the psychopathic construct where psychopathic traits related to an antisocial and impulsive lifestyle are associated with lower ability to recognize others' mental states, while interpersonal and affective psychopathic traits are associated with a somewhat enhanced ability to recognize others' emotional states.     

The inclusion of antisocial behavior in the construct of psychopathy: A review of the research

The psychopathic personality, or the construct of this disorder, has a long and contentious history. Psychopathy has been identified anecdotally for centuries; however, the ability to accurately define this construct continues to challenge researchers and clinicians. Of preliminary concern is the relevance of antisocial behavior to this disorder. Theoretical conceptualizations of psychopathy have changed over the past 65 years. Some have stressed the interpersonal and affective deficits of psychopathy [Cleckley, H. (1941). The mask of sanity (1st ed.). St. Louis, MO:C.V. Mosby.], while later conceptualizations have included both personality traits as well as antisocial behavior as criteria of psychopathy [Hare, R. D. (1991/2003). The Hare Psychopathy Checklist—Revised. Toronto, Canada: Multi-Health Systems]. This article will review the literature, particularly the relevance of antisocial behavior to the core personality structure of the psychopath. In doing so, historical theories will be reviewed, followed by later theoretical and empirical research. A great deal of this research has been conducted over the past 15 years, since the publication of the Psychopathy Checklist (PCL) and the Psychopathy Checklist-Revised (PCL-R; [Hare, R. D. (1991/2003). The Hare Psychopathy Checklist—Revised. Toronto, Canada: Multi-Health Systems]). The PCL-R has provided the field of psychopathy research with a consistent measurement device, and, therefore will be discussed at length. The limitations of the psychopathy construct will be discussed as well as needed future research and the policy implications of such research.     

Treatment and psychopathy in forensic settings

People commonly question whether highly psychopathic offenders are treatable. Little scientific research has addressed this question despite key developments in the last 20 years in two relevant areas: reliable measurement of psychopathy, and effective treatments for reducing criminal and antisocial behavior in offenders. One obstacle to progress is confusion about defining psychopathy; a necessary preliminary step to advancing intervention. After outlining the principal definitional issues, we review past and recent research on psychopathy and treatment, concluding that a handful of newer, well-designed studies suggest grounds for optimism about psychopathy and treatability. Although psychopathy characteristics—along with other indices of criminal risk—signal responsivity challenges, well-conceived programs for higher risk offenders can reduce recidivism in highly psychopathic offenders and appear to do so by reducing dynamic risk factors. There are no clear indications yet of whether PCL-psychopathic offenders differ from other high-risk offenders in their ability to respond to such treatments. The questions of whether psychopathy itself responds to treatment, and if so, what forms such treatment might take have not yet been addressed. We conclude by suggesting that advances will come from the use of more divergent measures of psychopathy, and in particular, dynamic measures of psychopathy traits that will allow us to document whether change is occurring.     

Autismus oder „Psychopathy“?

According to the concept of Hare autism spectrum disorders and psychopathy are associated with a strong deficit in empathy. However, empathy deficits in patients suffering from autism spectrum disorders and empathy deficits in individuals with psychopathic personality traits appear to be different. Some authors described the comorbid occurrence of psychopathic personality traits/psychopathy in individuals with autism spectrum disorders. The following article aims to approach this differential diagnostic problem by a brief review of the literature on a casuistic basis. This article reports the case of a highly remarkable 17-year-old adolescent. The case will be discussed according to the construct of psychopathy with reference to the concept of Hare.     

„Psychopathy“ im Kindes- und Jugendalter

The term psychopathy is defined as a severe personality pathology, which is characterized by extreme aggressive, antisocial and violent behavior as well as affective and interpersonal deficits. In recent years, research into the construct of psychopathy has often focused on the incidence and detection of such pathologies in children and adolescents. In this context, a point of interest is to explore the course and stability of psychopathic personality dimensions throughout youth. Results demonstrate clear evidence for the occurrence of personality traits characteristic for psychopathy in early childhood and adulthood, which facilitates early detection with the aid of age-specific diagnostic instruments.The distinct correlation between psychopathy and severe, repeated and largely treatment refractory violence, which results in substantial public damage, calls for further research in children and adolescents in order to define the construct of psychopathy more precisely, to further illuminate underlying pathologies and consequently develop more specific typologies and effective treatment strategies. To that end, it is of particular importance to correctly capture dimensional factors of psychopathy in youth and to examine their stability throughout stages of adolescent development.     

Assessment of "juvenile psychopathy" and its association with violence: a critical review

Interest in the construct of psychopathy as it applies to children and adolescents has become an area of considerable research interest in the past 5-10 years, in part due to the clinical utility of psychopathy as a predictor of violence among adult offenders. Despite interest in "juvenile psychopathy" in general and its relationship to violence in particular, relatively few studies specifically have examined whether operationalizations of this construct among children and adolescents predict various forms of aggression. This article critically reviews this literature, as well as controversies regarding the assessment of adult psychopathic "traits" among juveniles. Existing evidence indicates a moderate association between measures of psychopathy and various forms of aggression, suggesting that this construct may be relevant for purposes of short-term risk appraisal and management among juveniles. However, due to the enormous developmental changes that occur during adolescence and the absence of longitudinal research on the stability of this construct (and its association with violence), we conclude that reliance on psychopathy measures to make decisions regarding long-term placements for juveniles is contraindicated at this time.     

Psychopathic traits and externalizing behaviors: a comparison of self- and informant reports in the statistical prediction of externalizing behaviors

It has long been assumed that features associated with psychopathy, such as a lack of insight and deceitfulness, may compromise the utility of self-report measures, particularly for understanding the relations between these traits and important outcomes (e.g., offending). Unfortunately, little research has explicitly examined the relations between self- and informant reports of psychopathy and their relations to these outcomes. The current study examined the incremental validity of self- and informant reports of psychopathic traits, assessed with 3 validated psychopathy measures, in the statistical prediction of externalizing behaviors (EBs). To reduce shared method variance, self- and informant reports of EBs (i.e., substance use, antisocial behavior, gambling, and intimate partner violence) were examined separately. Results indicate that both self- and informant reports of psychopathy are related to EBs and provide some degree of incremental validity, although self-reported psychopathy scores proved slightly more useful than other-reported psychopathy scores. These findings suggest that, in nonforensic settings, psychopathy data derived from both self- and other-reported psychopathy measures have utility in understanding the relations between psychopathic traits and EBs.     

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

Although psychopathy usually is treated as a unitary construct, a seminal theory posits that there are 2 variants: Primary psychopathy is underpinned by an inherited affective deficit, whereas secondary psychopathy reflects an acquired affective disturbance. The authors investigated whether psychopathy phenotypically may be disaggregated into such types in a sample of 367 prison inmates convicted of violent crimes. Model-based cluster analysis of the Revised Psychopathy Checklist (PCL-R; R. D. Hare, 2003) and trait anxiety scores in the psychopathic subgroup (n = 123; PCL-R > or = 29) revealed 2 clusters. Relative to primary psychopaths, secondary psychopaths had greater trait anxiety, fewer psychopathic traits, and comparable levels of antisocial behavior. Across validation variables, secondary psychopaths manifested more borderline personality features, poorer interpersonal functioning (e.g., irritability, withdrawal, poor assertiveness), and more symptoms of major mental disorder than primary psychopaths. When compared with the nonpsychopathic subgroup (n = 243), the 2 psychopathic variants manifested a theoretically coherent pattern of differences. Implications for etiological research and violence prevention are discussed.     

Validating the B‐Scan Self: A self‐report measure of psychopathy in the workplace

The surging interest in corporate psychopathy has underscored the need for a reliable and valid measure of psychopathic features that is suitable for research in organizational settings. The B‐Scan Self is a new self‐report measure of corporate psychopathy that was developed with Hare's Psychopathy Checklist‐Revised (PCL‐R) as a framework. Validity studies, using two independent Mechanical Turk samples, were designed to examine its factor structure and validity. Results indicated that B‐Scan Self facets were internally consistent and unidimentional and strongly related to another self‐report measure of psychopathy (SRP‐III). Confirmatory factor analyses supported a reliable fifteen facets and four‐factor model consistent with the PCL‐R four‐factor model of psychopathy. Furthermore, B‐Scan Self facets were positively correlated with the Dark Triad of personality traits and negatively correlated with FFM traits of Agreeableness and Conscientiousness. More importantly, B‐Scan Self facets presented the same pattern of correlations with FFM traits as the SRP‐III and different patterns than the two other Dark Triad measures. Although this constitutes the first validation study of the B‐Scan Self and more research is needed, we believe that these results are encouraging and that the B‐Scan Self provides an opportunity to study psychopathic features through the measure of work‐related 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.     

Secondary psychopathy,but not primary psychopathy,is associated with risky decision-making in noninstitutionalized young adults

Although risky decision-making has been posited to contribute to the maladaptive behavior of individuals with psychopathic tendencies, the performance of psychopathic groups on a common task of risky decision-making, the Iowa Gambling Task (IGT; Bechara, Damasio, Damasio, & Anderson, 1994), has been equivocal. Different aspects of psychopathy (personality traits, antisocial deviance) and/or moderating variables may help to explain these inconsistent findings. In a sample of college students (N = 129, age 18–27), we examined the relationship between primary and secondary psychopathic features and IGT performance. A measure of impulsivity was included to investigate its potential as a moderator. In a joint model including main effects and interactions between primary psychopathy, secondary psychopathy and impulsivity, only secondary psychopathy was significantly related to risky IGT performance, and this effect was not moderated by the other variables. This finding supports the growing literature suggesting that secondary psychopathy is a better predictor of decision-making problems than the primary psychopathic personality traits of lack of empathy and remorselessness.     

Sexually coercive tactics used by university students: a clear role for primary psychopathy

Current research suggests that people with psychopathic traits engage in sexual coercion as an alternative mating strategy. Research overlooks the relation between psychopathic traits and coercive behavior in male and female samples that engage in dating quite frequently. Male and female university students reported on their current relationship styles and their use of minor and severe sexually coercive tactics. Results indicate that primary psychopathy (using the Levenson's SRPS), but not secondary psychopathy, predicts the use of all measures of sexual coercion for both females and males, although males were more likely to exploit an intoxicated partner than females. Additionally, females with high levels of primary psychopathy were more likely to use physical forms of coercion. The findings show that the primary psychopathy features (callousness, charm, and selfishness) predict a shortterm mating strategy that focuses on gaining sex through minor forms of coercion and manipulation.     

Quantifying the psychopathic stare: Automated assessment of head motion is related to antisocial traits in forensic interviews

Clinicians have long noted that individuals with high psychopathic traits exhibit unique interpersonal style often observable during forensic interviews. Here we develop an automated approach for quantifying head dynamics during video-recorded naturalistic clinical interviews. We expected head dynamics would be related to psychopathic traits. As predicted, dwell times indicate that those with higher levels of psychopathic traits are characterized by more stationary head positions, focused directly towards the camera/interviewer, than were individuals low in psychopathic traits. These associations were primarily driven by developmental/antisocial features of psychopathy, indicating that those with severe and life-course persistent antisocial behavior exhibit more rigid and focused orienting of their head during interpersonal communication. These results encourage more research into the automated quantification of behavioral manifestations of personality to support clinical observations that psychopaths exhibit unique qualities in non-verbal interpersonal communication.     

The relationship between psychopathic traits and attachment behavior in a non-clinical population

Attachment processes have been proposed to play a key role in the development of the core features of psychopathy (Fowles & Dindo, 2006). The findings reported in the literature regarding the associations between attachment and psychopathic traits are far from conclusive, especially in non-clinical populations. The present study investigated the relationship between self-reported attachment behavior and psychopathic traits in a college sample. Two-hundred nine participants completed the Experiences in Close Relationships-Revised scale and the Levenson Self-Report Psychopathy scale. Controlling for gender and race, hierarchical multiple regression analyses indicated that individuals high in both attachment avoidance and attachment anxiety had higher primary psychopathy scores. Both individuals high in attachment avoidance and individuals high in attachment anxiety had higher secondary psychopathy scores. Implications of these findings for future research and clinical practice are discussed.