Psychopathy and comorbidity in a young offender sample: taking a closer look at psychopathy's potential importance over disruptive behavior disorders

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

Do college students drink more than their non-college-attending peers? Evidence from a population-based longitudinal female twin study

The association of college attendance with alcohol use and alcohol use disorders was examined in a population-based young adult female twin sample identified from a systematic search of birth records. College-attending women consumed a larger overall volume of alcohol than did their non-college-attending peers, but they were not more likely to be diagnosed with an alcohol use disorder. Significant associations between college attendance and alcohol involvement were probed using 3 different complementary research designs: multivariate cross-sectional analyses, longitudinal analyses of the precollege and college years, and cotwin-control analyses of twin pairs discordant for attending college. Although demographic and lifestyle characteristics accounted for most or all of the association between college attendance and alcohol involvement, there was 1 aspect of drinking behavior, occasionally consuming large quantities of alcohol, that remained significantly associated with college attendance even after controlling for these characteristics or for genetic and family background factors. These results are consistent with the conclusion that some aspect of the college experience may be an important environmental risk factor for this pattern of drinking among young adults.     

Lying to insurance companies: the desire to deceive among physicians and the public

This study examines the public's and physicians' willingness to support deception of insurance companies in order to obtain necessary healthcare services and how this support varies based on perceptions of physicians' time pressures. Based on surveys of 700 prospective jurors and 1617 physicians, the public was more than twice as likely as physicians to sanction deception (26%versus 11%) and half as likely to believe that physicians have adequate time to appeal coverage decisions (22%versus 59%). The odds of public support for deception compared to that of physicians rose from 2.48 to 4.64 after controlling for differences in time perception. These findings highlight the ethical challenge facing physicians and patients in balancing patient advocacy with honesty in the setting of limited societal resources.     

School-year employment among high school students: effects on academic, social, and physical functioning

This study describes the effects of different weekly work intensity levels on adolescent functioning in a sample of 3,083 high school students in rural South Texas, where economically disadvantaged and Hispanic youth are heavily represented. Anonymous surveys were conducted in 10th- and 12th-grade students' classrooms in 1995. The following effects were associated with long hours of weekly employment during the school year: (1) decreased performance/engagement in school and satisfaction with amount of leisure time, and (2) increased health risk behaviors and psychological stress. The effects of school-year work on academic factors and health behaviors differed by grade, but not by race/ethnicity, parent education, or race/ethnicity and parent education considered together. It was concluded that parents and professionals should continue to monitor the number of weekly hours that students work during the school year.     

Cognitive behaviour therapy for eating disorders: a "transdiagnostic" theory and treatment

This paper is concerned with the psychopathological processes that account for the persistence of severe eating disorders. Two separate but interrelated lines of argument are developed. One is that the leading evidence-based theory of the maintenance of eating disorders, the cognitive behavioural theory of bulimia nervosa, should be extended in its focus to embrace four additional maintaining mechanisms. Specifically, we propose that in certain patients one or more of four additional maintaining processes interact with the core eating disorder maintaining mechanisms and that when this occurs it is an obstacle to change. The additional maintaining processes concern the influence of clinical perfectionism, core low self-esteem, mood intolerance and interpersonal difficulties. The second line of argument is that in the case of eating disorders shared, but distinctive, clinical features tend to be maintained by similar psychopathological processes. Accordingly, we suggest that common mechanisms are involved in the persistence of bulimia nervosa, anorexia nervosa and the atypical eating disorders. Together, these two lines of argument lead us to propose a new transdiagnostic theory of the maintenance of the full range of eating disorders, a theory which embraces a broader range of maintaining mechanisms than the current theory concerning bulimia nervosa. In the final sections of the paper we describe a transdiagnostic treatment derived from the new theory, and we consider in principle the broader relevance of transdiagnostic theories of maintenance.     

The effects of extinction,noncontingent reinforcement and differential reinforcement of other behavior as control procedures

Several techniques have been used in applied research as controls for the introduction of a reinforcement contingency, including extinction, noncontingent reinforcement (NCR), and differential reinforcement of other behavior (DRO). Little research, however, has examined the relative strengths and limitations of these "reversal" controls. We compared the effects of extinction with those of NCR and DRO in both multi-element and reversal designs, with respect to (a) rate and amount of response decrement, (b) rate of response recovery following reintroduction of reinforcement, and (c) any positive or negative side effects associated with transitions. Results indicated that extinction generally produced the most consistent and rapid reversal effects, with few observed negative side effects.     

Functional analysis and treatment of self-injurious behavior in young children a summary of 30 cases

The assessment and treatment of self-injurious behavior (SIB) has received much attention in the literature; however, few studies have focused on early intervention for this behavior. In the current study, functional analyses with developmentally appropriate modifications were conducted in an outpatient clinic with 30 children (aged 10 months to 4 years 11 months) to assess SIB and problem behavior in its early stages. The reported mean age of SIB onset was 17 months, and head banging was the most prevalent topography. Functional analyses identified sources of reinforcement for SIB in 62.1% of cases; with the inclusion of all forms of problem behavior, sources of reinforcement were identified for 87.5% of cases. Function-based treatments were developed for 24 cases, with functional communication training prescribed most often (70.8% of cases). Implications of these findings for the development of early intervention programs for SIB are discussed.     

Personality and the predisposition to engage in risky or problem behaviors during adolescence

Longitudinal data from a representative sample of 1,978 Black and White adolescents were used to examine the role of personality in multiple risk or problem behaviors. Results indicate that covariation among diverse behaviors (educational underachievement, delinquent behavior, substance use, sexual behavior) can be adequately modeled by a single higher order factor, and that impulsivity and avoidance coping serve as generalized risk factors for involvement in these behaviors. Whereas none of the personality variables examined explained change in problem behaviors once established, avoidance coping prospectively predicted involvement among a subgroup of adolescents with little or no prior involvement. Results suggest that dysfunctional styles of regulating emotions and emotionally driven behaviors are core features of risky or problem behaviors during adolescence.     

Knowing in advance: the impact of prior event information on memory and event knowledge

We examined the influence of newly acquired information on children's memory and general representation of a personally experienced event. Thirty-five children between the ages of 5 and 7 years participated in the novel event (Visiting the Pirate). The day before participating, children were: (1) provided with new information specific to the up-coming event; (2) engaged in a discussion generally related to the event topic based on existing knowledge; or (3) discussed an unrelated topic. Advance information specific to the event led to better recall and, in particular, to better integration of the experience into a general event representation both soon after the event and at a follow-up interview 4 months later, whereas general discussion of the topic without the event specific information neither enhanced memory reports nor facilitated the integration of event information. Providing information in advance can have significant effects on memory and knowledge acquisition although many variables, including those relating to the specific content of the information, will affect this relation.     

Age constraints on first versus second language acquisition: evidence for linguistic plasticity and epigenesis

Does age constrain the outcome of all language acquisition equally regardless of whether the language is a first or second one? To test this hypothesis, the English grammatical abilities of deaf and hearing adults who either did or did not have linguistic experience (spoken or signed) during early childhood were investigated with two tasks, timed grammatical judgement and untimed sentence to picture matching. Findings showed that adults who acquired a language in early life performed at near-native levels on a second language regardless of whether they were hearing or deaf or whether the early language was spoken or signed. By contrast, deaf adults who experienced little or no accessible language in early life performed poorly. These results indicate that the onset of language acquisition in early human development dramatically alters the capacity to learn language throughout life, independent of the sensory-motor form of the early experience.