Research Review: What do we know about psychopathic traits in children?

Primary and Secondary Variants of Psychopathic Traits in at-Risk Youth: Links with Maltreatment, Aggression, and Empathy

The current study examined whether two variants of psychopathic traits (PT) were identifiable in high-risk youth who had not yet been identified as antisocial, some of whom had documented histories of maltreatment (N = 167, M_age = 14.84), and then whether the variants differed in levels of aggression and empathy. High-PT youth with low anxiety and trauma (i.e., primary variant PT) and high anxiety and trauma (i.e., secondary variant PT) were differentiated. The secondary variant group was comprised largely of youth with documented histories of maltreatment. This group of youth also reported higher levels of proactive and reactive aggression than did the primary variant youth and low-PT youth. All youth reported similar levels of affective empathy and only small differences in cognitive empathy emerged: Primary variant youth reported lower cognitive empathy than low-PT youth. Findings support generalization of two variant groups of youth with psychopathic traits to diverse, high-risk samples not already identified as antisocial and have important implications for policy and practice.

Validation of the Proposed Specifiers for Conduct Disorder (PSCD) Scale in a Sample of Italian Students

This study aimed to further validate the self-reported version of the Proposed Specifiers Conduct Disorder (PSCD) scale, testing the associations between the PSCD with a scale that measures emotional/behavioral difficulties and prosocial behaviors (Strength and Difficulties Questionnaire, SDQ). A total of 536 Italian students (47.76% male; 11-14 years) completed the PSCD, while their caregivers and teachers completed the SDQ. A series of confirmatory factor analyses to test the best fitting model were run. The internal consistency of the PSCD was evaluated, and the correlations between the PSCD self-reported scores and SDQ Parent and Teacher report scores were examined. A bi-factor model was fitted with a refined 19-item version of the scale, which showed adequate fit indices. The PSCD total score was strongly associated with higher parent- and teacher-rated conduct problems, hyperactivity, and lower prosocial behavioral symptoms. In conclusion, this study indicated that the self-report PSCD shows preliminary promise as a reliable, easy-to-use tool, for measuring psychopathic traits in Italian children and young adolescents.

Validation of the Proposed Specifiers for Conduct Disorder (PSCD) Scale in a Sample of Italian Students

This study aimed to further validate the self-reported version of the Proposed Specifiers Conduct Disorder (PSCD) scale, testing the associations between the PSCD with a scale that measures emotional/behavioral difficulties and prosocial behaviors (Strength and Difficulties Questionnaire, SDQ). A total of 536 Italian students (47.76% male; 11-14 years) completed the PSCD, while their caregivers and teachers completed the SDQ. A series of confirmatory factor analyses to test the best fitting model were run. The internal consistency of the PSCD was evaluated, and the correlations between the PSCD self-reported scores and SDQ Parent and Teacher report scores were examined. A bi-factor model was fitted with a refined 19-item version of the scale, which showed adequate fit indices. The PSCD total score was strongly associated with higher parent- and teacher-rated conduct problems, hyperactivity, and lower prosocial behavioral symptoms. In conclusion, this study indicated that the self-report PSCD shows preliminary promise as a reliable, easy-to-use tool, for measuring psychopathic traits in Italian children and young adolescents.

Interaction of Psychopathic Traits Dimensions in the Prediction of Psychological and Physical Child-to-Parent Violence in Adolescents

This study examined the longitudinal relationships between three psychopathic trait dimensions (callous-unemotional, CU; grandiose-manipulative, GM; and impulsive-irresponsible, II) and their interaction in the prediction of psychological and physical child-to-parent violence (CPV). Furthermore, the study examined whether the predictive relationships were different for boys and girls. A total of 765 adolescents (463 girls), with a mean age of 15.28 years (SD = 1.04), completed measures of the psychopathic trait dimensions (CU, GM, and II) and psychological and physical CPV at the beginning of the study and six months later. At the cross-sectional level, all the psychopathic trait dimensions were related to psychological and physical CPV, although the effect sizes were small. At the longitudinal level, II predicted increased psychological CPV. A significant three-way interaction between the three psychopathic trait dimensions (CU, GM, and II) indicated that the longitudinal association between II and physical CPV was higher for adolescents with high CU and low GM. However, the predictive model did not differ for boys and girls.

Studying Configurations of Psychopathic Traits: Exploring the Viability of Psychopathic Personality in Early Childhood

The idea that very young children can manifest a constellation of personality traits that looks like psychopathy has rarely been explored. To fill this void, data from 2,247 children, aged 3-6 years (M = 4.25; SD = 0.91), from the Estudio Longitudinal para una Infancia Saludable (ELISA) were utilized. Parents and teachers completed questionnaires at baseline and at 1-year follow-up. Using three parent-rated psychopathy dimensions as indicators, the authors conducted latent profile analysis and arrived at five latent classes: Control (39.2%), Impulsive-Need for Stimulation (34.8%), Grandiose-Deceitful (16.5%), Callous-Unemotional (6.2%), and Putative Psychopathic Personality (PP, 3.3%). Children in the PP class, overall, engaged in higher levels of concurrent, future, and stable conduct problems and reactive and proactive aggression, and lower levels of prosocial behavior, as rated by parents or teachers. Findings also revealed meaningful differences between the remaining four classes. Person-oriented analyses seem to offer a fruitful avenue to identify 3-to 6-year-olds who exhibit a putative psychopathic personality and are at risk for future maladjustment.

Associations Between Parental Psychopathic Traits, Parenting, and Adolescent Callous-Unemotional Traits

Callous-unemotional (CU) traits (i.e., callousness, low empathy, shallow affect) have been conceptualized as a downward extension of the interpersonal and affective components of adult psychopathy and are associated with stable and severe antisocial behavior. Research suggests that CU traits are moderately heritable, but also influenced by environmental factors, particularly parenting. We examined associations among mother and father psychopathic traits, parenting practices, and offspring CU traits in a community sample of 550 adolescent twins (Mean age = 13.99 years; SD 2.37; 56.4% male), incorporating multiple informants (mothers, fathers, child). Parental interpersonal-affective psychopathic traits were associated with adolescent CU traits and negative parenting (increased harshness, reduced warmth). Moreover, increased parental harshness and reduced warmth partially explained associations between parental interpersonal-affective traits and adolescent CU traits. There was also a significant direct effect specifically between mother interpersonal-affective traits and adolescent CU traits. Finally, using a twin difference design, we confirmed that adolescent CU traits were significantly impacted by non-shared environmental parenting influences (increased harshness, reduced warmth). These results suggest that mother and father interpersonal-affective traits appear to impact parenting practices and serve as risk factors for adolescent CU traits. However, many of the findings did not replicate when using cross-informant reports and were only present within single informant models, highlighting a role for shared informant variance as well. The results suggest the importance of accounting for parent personality in the development of effective parenting interventions for CU traits.

Selfish parents, parenting practices, and psychopathic traits in children

Parental personality and parenting behavior have been associated with the development of psychopathic traits in offspring. However, no study has examined the effect of parental dispositional selfishness on the development of psychopathic traits in offspring, and the potential mechanism underlying this relationship. To address this issue, parents' reports on their dispositional selfishness, negative and positive parenting behavior, and child's psychopathic traits were collected for a group of children from the community (n = 118, 47% male, mean age = 14.1 years). Results showed that parental selfishness was associated with grandiose-manipulative (GM), daring-impulsive (DI), and callous-unemotional (CU) traits in children. In addition, the egocentric selfishness-GM relationship was indirectly mediated by parenting behavior including lack of involvement, poor monitoring, and inconsistent discipline, whereas the association with CU traits was directly mediated by lack of involvement. These effects remained significant after controlling for child's sex, age, race, social adversity, and a prior measure of psychopathic traits. Findings provide initial empirical evidence on the effect of parental selfishness on a child's psychopathic traits, and further support to the proposition that distinct etiology may underlie different dimensions of psychopathic traits.

The startle reflex as an indicator of psychopathic personality from childhood to adulthood: A systematic review

The startle reflex has been suggested to operate as a psychophysiological marker of psychopathic personality, based on findings from studies using a range of different methodologies and participant samples. The present review aims at synthesizing existing evidence of the relationship between psychopathy and the startle reflex across task paradigms, psychopathic personality subtypes and subdimensions, participant samples (i.e., incarcerated/ clinical or non-offenders), and age groups using the triarchic model of psychopathy as a frame of reference. Systematic literature searches were conducted up until the 24th of March 2020 in PubMed, PsycINFO, and Web of Science. A total of 2311 potential studies were identified, out of which 40 met relevancy and quality criteria. Results indicate that reduced aversive startle potentiation is associated with psychopathic personality in general, but clusters of traits relating to the triarchic model constructs of boldness and meanness in particular. Available evidence suggest that startle paradigms could be meaningful for differentiating individuals with and without psychopathic personality. Findings support suggestions of psychopathic personality as a multifaceted, rather than a unitary construct. Reduced aversive startle potentiation has also been found in relation to psychopathic features in child-aged samples but work of this kind is limited and more research is needed. Future studies should focus on greater consistency in task paradigms and analytic strategies to enhance the capacity to compare and integrate findings across studies.

Subnormal short-latency facial mimicry responses to dynamic emotional facial expressions in male adolescents with disruptive behavior disorders and callous-unemotional traits

Using still pictures of emotional facial expressions as experimental stimuli, reduced amygdala responses or impaired recognition of basic emotions were repeatedly found in people with psychopathic traits. The amygdala also plays an important role in short‐latency facial mimicry responses. Since dynamic emotional facial expressions may have higher ecological validity than still pictures, we compared short‐latency facial mimicry responses to dynamic and static emotional expressions between adolescents with psychopathic traits and normal controls. Facial EMG responses to videos or still pictures of emotional expressions (happiness, anger, sadness, fear) were measured. Responses to 500‐ms dynamic expressions in videos, as well as the subsequent 1500‐ms phase of maximal (i.e., static) expression, were compared between male adolescents with disruptive behavior disorders and high (n = 14) or low (n = 17) callous‐unemotional (CU) traits, and normal control subjects (n = 32). Responses to still pictures were also compared between groups. EMG responses to dynamic expressions were generally significantly smaller in the high‐CU group than in the other two groups, which generally did not differ. These group differences gradually emerged during the 500‐ms stimulus presentation period but in general they were already seen a few hundred milliseconds after stimulus onset. Group differences were absent during the 1500‐ms phase of maximal expression and during exposure to still pictures. Subnormal short‐latency mimicry responses to dynamic emotional facial expressions in the high‐CU group might have negative consequences for understanding emotional facial expressions of others during daily life when human facial interactions are primarily dynamic.

During human interactions, short‐latency facial mimicry responses occur to dynamic emotional facial expressions of others. These are preconscious, automatic responses which cannot be voluntarily controlled. They may be important for emotional understanding of others and appear to be subnormal in male adolescents with psychopathic traits.

The Importance of Assessing Impairment Associated With Limited Prosocial Emotions

Limited prosocial emotions (LPE) are characterized by a lack of remorse or guilt, callousness/lack of empathy, being unconcerned about performance, and shallow/deficient affect. While previous research has largely focused on the presence or absence of LPE in youth, there is considerable evidence that symptom presence/absence and symptom impairment are separable dimensions, where impairment often is found to play a significant, unique role in assessing child psychopathology. The current study utilized a newly developed questionnaire with the purpose of exploring its psychometric properties and better understand the dual and potentially differential role LPE symptom presence and LPE-related impairment have in youth. Mothers (n = 265) of children (M_age = 8.04, SD = 2.07) completed questionnaires assessing LPE impairment, LPE symptoms, externalizing disorder symptoms, and functional impairment. Results demonstrated strong support for the psychometric properties of the newly developed measure of LPE impairment. Importantly, LPE-related impairment uniquely predicted all impairment domains above-and-beyond the effects of LPE symptoms, oppositional defiant disorder, and CD symptoms (as well as child age and sex covariates). Moreover, youth in the top 25th percentile on both LPE symptoms and LPE-related impairment (compared to youth only in the top 25th percentile in LPE symptoms) had greater mean externalizing symptoms and functional impairment. The preliminary evidence provided suggests researchers and clinicians may benefit from assessing both LPE symptoms and LPE-related impairment when attempting to identify youth with high levels of conduct problem symptoms and/or psychosocial impairment. Future research should aim to replicate and expand our findings to other clinical populations.

Aggression subtypes relate to distinct resting state functional connectivity in children and adolescents with disruptive behavior

There is increasing evidence for altered brain resting state functional connectivity in adolescents with disruptive behavior. While a considerable body of behavioral research points to differences between reactive and proactive aggression, it remains unknown whether these two subtypes have dissociable effects on connectivity. Additionally, callous-unemotional traits are important specifiers in subtyping aggressive behavior along the affective dimension. Accordingly, we examined associations between two aggression subtypes along with callous-unemotional traits using a seed-to-voxel approach. Six functionally relevant seeds were selected to probe the salience and the default mode network, based on their presumed role in aggression. The resting state sequence was acquired from 207 children and adolescents of both sexes [mean age (standard deviation) = 13.30 (2.60); range = 8.02-18.35] as part of a Europe-based multi-center study. One hundred eighteen individuals exhibiting disruptive behavior (conduct disorder/oppositional defiant disorder) with varying comorbid attention-deficit/hyperactivity disorder (ADHD) symptoms were studied, together with 89 healthy controls. Proactive aggression was associated with increased left amygdala-precuneus coupling, while reactive aggression related to hyper-connectivities of the posterior cingulate cortex (PCC) to the parahippocampus, the left amygdala to the precuneus and to hypo-connectivity between the right anterior insula and the nucleus caudate. Callous-unemotional traits were linked to distinct hyper-connectivities to frontal, parietal, and cingulate areas. Additionally, compared to controls, cases demonstrated reduced connectivity of the PCC and left anterior insula to left frontal areas, the latter only when controlling for ADHD scores. Taken together, this study revealed aggression-subtype-specific patterns involving areas associated with emotion, empathy, morality, and cognitive control.

Heterogeneity Within Youth With Childhood-Onset Conduct Disorder in the ABCD Study

The purpose of this study was to examine if personality traits can be used to characterize subgroups of youth diagnosed with childhood-onset conduct disorder (CD). Participants were 11,552 youth from the Adolescent Brain Cognitive Development study. Data used in this report came from doi: 10.15154/1504041 (M age 9.92; 45.3% female, 49.6% white, 19.0% Hispanic). A subset of this sample (n = 365) met criteria for CD. Latent profile analyses (LPA) were performed on this subgroup (n = 365) to define profiles of individuals with CD based on self-report measures of impulsivity, punishment sensitivity, reward response, and callous-unemotional traits. Follow up analyses determined if these groups differed on clinically relevant variables including psychopathology, environmental risk factors, social risk factors, and neurocognitive functioning. Participants with a CD diagnosis scored significantly higher on psychological, environmental, social, and neurocognitive risk factors. The LPA revealed three unique profiles, which differed significantly on liability for broad psychopathology and domain-specific liability for externalizing psychopathology but were largely matched on environmental and social risk factors. These unique configurations provide a useful way to further parse clinically relevant subgroups within youth who meet criteria for childhood-onset CD, setting the stage for prospective longitudinal research using these latent profiles to better understand the development of youth with childhood-onset CD.

Psychopathic Traits in Childhood: Insights from Parental Warmth and Fearless Temperament via Conscience Development

The role of psychopathic traits in predicting more serious and persistent patterns of child conduct problems has been well documented. The jointly presence of interpersonal (grandiose-deceitful), affective (e.g., callous-unemotional), and behavioral psychopathic traits (impulsive-need of stimulation) identifies a group of children at increased risk of psychosocial maladjustment. The present study aims to disentangle the underlying mechanisms by examining how early parenting (i.e., warmth) and child temperament (i.e., fearlessness) predict later psychopathic traits, via conscience development (CD). Data were collected in a large sample of children (n = 2.266; 48.5% girls), aged 3 to 6 at the onset of the study (Mage = 4.25; SD = 0.91), who were followed up one and two years later. The results showed direct effects from fearlessness to interpersonal and behavioral psychopathic traits. Parental warmth, fearless temperament, and their interaction, predicted CD, which, in turn, showed a negative effect on psychopathic traits. The indirect effects indicated significant negative mediation effects of warmth through CD on psychopathic traits, which seem to be stronger when children present lower levels of fearlessness. Overall, these results contribute to better understand the development of child psychopathic traits and provide additional insight on effective strategies that will help to restrain the potential development of a high-risk profile in early childhood.

Neurocognitive abilities associated with antisocial behavior with and without callous-unemotional traits in a community sample

OBJECTIVE

Antisocial behavior (aggression, rule breaking) is associated with lower intelligence and executive function deficits. Research has not clarified whether these associations differ with the presence of callous-unemotional (CU) traits, particularly within levels of antisocial behavior observed in the community.

METHOD

We examined whether antisocial behavior and CU traits were differentially associated with intelligence and executive function metrics in 474 adolescent twins (Mean age = 14.18; SD = 2.20) sampled from birth records to represent youth in the community living in neighborhoods with above average levels of poverty. Intelligence was assessed using standardized scores from the Shipley-2. Executive function was assessed using Go/No-Go and Stop Signal tasks.

RESULTS

Neither antisocial behavior, nor CU traits alone, were associated with cognitive functioning when accounting for demographic factors. However, antisocial behavior and CU traits interacted to predict reaction time variability. At low levels of CU traits, antisocial behavior was associated with higher reaction time variability (traditionally thought to reflect worse sustained attention). At high levels of CU traits, antisocial behavior was associated with lower reaction time variability (thought to reflect better sustained attention).

CONCLUSION

Elevated antisocial behavior and CU traits may be characterized by a distinct neurocognitive profile compared to elevated antisocial behavior in isolation. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Examining Psychopathic Traits in Children Using the Child Psychopathy Scale - Revised

Applying the affective dimension of psychopathy to youth has advanced understanding of conduct problems in youth, leading to suggestions that other aspects of psychopathy may do the same. This was addressed in the present study by examining the structure and validity of psychopathic traits in elementary-age children as rated by mothers and teachers on the Child Psychopathy Scale - Revised (CPS-R). Participants were 222 children (80.2% male; Mage = 8.92), the majority (71.6%) of whom met criteria for both ADHD and conduct problems. Confirmatory factor analysis supported a four-factor model consisting of prosocial-empathic (PE), grandiose-manipulative (GM), emotionally volatile (EV), and attentive-planful(AP) factors. The CPS-R demonstrated good criterion validity with well-established measures of child behavior problems and callousness. The EV and AP factors demonstrate incremental validity by moderating the relation between conduct problems and impairment. Latent profiles supported a three-profile solution for mothers and a four-profile solution for teachers, with profiles consisting of one group low, one group moderate, and one high on all measures for both informants, and a fourth group that was high on all measures except CD and limited PE. Profiles differed significantly from each other on callousness and impairment, with limited PE being the best differentiator of youth highest in antisocial behavior based on mother and teacher report. Findings suggest that mothers and teachers may be able to identify children at risk for a more negative trajectory of antisocial behavior, that it is worthwhile to examine multiple psychopathy dimensions (rather than just the affective dimension), and that the CPS-R may be useful to screen for youth who are most likely to display more severe antisocial behavior and impairment.

Disruptive Behavior Disorders and Psychopathic Traits in Adolescents: Empathy-Related Responses to Witnessing Animal Distress

Cruelty to animals is a symptom of conduct disorder and associated with psychopathic traits in childhood. One of the factors thought to contribute to animal cruelty is reduced empathy and concern for the well-being of animals. A first aim of this study was to examine empathy towards animals in distress in male adolescents with disruptive behavior disorders (DBD) and high or low psychopathic traits, and normal controls (NC). Psychopathic traits were assessed by the Antisocial Process Screening Device (APSD). Respondents were exposed to a short film clip depicting a baby bear in distress. Heart rate (HR) responses were monitored during film exposure. Afterwards, respondents were asked to report the emotions they had observed and experienced. Contrary to expectations based on research on human empathy, no group differences were found in empathy-related responses to witnessing animal distress. Both DBD groups and normal controls observed equal levels of distress in the baby bear, experienced as much empathy and sympathy, and showed similar levels of HR reduction during the most dramatic scene. Results suggest that empathy for humans does not generalize to animals, and vice versa. A second aim was to examine the associations between empathy-related responses and the broad concept of psychopathy as well as its dimensions. The relationships were different and for the most part reversed in the NC and DBD groups. Group proved to be an important moderating factor, indicating that results obtained within a sample of healthy adolescents do not generalize to adolescents with DBD, and vice versa.

Role of Callous and Unemotional (CU) Traits on the Development of Youth with Behavioral Disorders: A Systematic Review

Numerous studies have shown that youth with behavioral disorders (BD) present an increased risk for developing severe and persistent antisocial behaviors in adulthood. Retrospective research notes that not all children and adolescents follow a negative trajectory and explains this heterogeneity in particular by the severity of CU traits. Our study examines how these traits affect the functioning of children and adolescents with BD. Method: A systematic literature review conducted through various databases and using different keywords made it possible to analyze 52 studies published from 2015 to 2020 that measured the bidirectional effects of CU traits on the functioning of young. Results: Out of the 52 studies, 47 analyzed links between CU traits and neurobiological or mental health, 20 examined family and school contexts, eight focused on social adjustment, 10 on social interactions and 19 measured links with cognitive functioning, especially executive functions. Conclusion: Consistent with previous recommendations in the field, our findings emphasize the importance of assessing the presence of UC traits in early childhood to prevent the emergence of comorbid disorders and to target multimodal (early) interventions to influence the life trajectories of youth with high CU traits.

Variants of Psychopathic Traits Follow Distinct Trajectories of Clinical Features Among Children with Conduct Problems

Original definitions of psychopathy suggest the existence of two variants that present with distinct clinical features among antisocial adults, but whether these clinical differences originate early in life or emerge at some point during childhood remains uncertain. We examined if primary and secondary variants follow distinct developmental trajectories of theoretically relevant clinical features among children with conduct problems (CP). Participants were 370 children (40.3% girls) with CP initially aged 8.49 years old in average (s.d. = 0.93). Variants indicators (callous-unemotional [CU] traits and anxiety [ANX]) and clinical features were measured at six yearly assessments. A dual trajectory modelling approach was used to identify groups and group memberships were entered in conditional growth models predicting trajectories of clinical features. Four groups were identified: CP-only, anxious (CP + ANX), primary (CP + CU), and secondary (CP + CU + ANX). Both variants showed higher initial levels of impairment than the CP-only group on most features. Compared to the primary variant, membership to the secondary variant was associated with more stable patterns of CP, oppositional problems, narcissism-grandiosity and impulsivity-irresponsibility traits. Moreover, children from the secondary variant showed higher initial levels of impairment in terms of cognitive abilities, depression, victimization, and dependency to teachers, with non-significant effects on the slope parameters suggesting that these early differences persist across development. In addition to showing distinct clinical features relatively early in childhood, children from the secondary variant of psychopathic traits are at high risk of experiencing an increasing psychopathological burden across childhood. The early identification and treatment of these children therefore appears particularly important.

Core features of callous-unemotional traits: Network analysis of the inventory of callous-unemotional traits in offender and community samples

OBJECTIVE

Callous-unemotional (CU) traits have been added as a specifier labeled with "Limited Prosocial Emotion" used to diagnose conduct disorder in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. However, little is known about the core features of CU traits. Thus, this study aimed to identify the most central component of CU traits from a network perspective.

METHOD

Network analysis was applied to investigate the network structure of CU traits operationalized by the Inventory of Callous-Unemotional Traits in a sample of juvenile offenders (M_age  = 17.14, N = 609) and community youths (M_age  = 10.82, N = 487).

RESULTS

Our findings showed that items assessing callousness are the most central in the network across both samples. Also, the unemotional items were found to be located at a peripheral position, with fewer links apparent to callousness and uncaring items.

CONCLUSIONS

Callousness might be the key feature of CU traits in youths. Our findings further advance the general understanding about the core features of CU traits in clinical practice.

Frontal alpha asymmetry and emotional processing in youth with psychopathic traits

Emotional processing deficits are often considered central to psychopathy. There is evidence that those high in psychopathy pay less attention to emotional stimuli, and it is possible that these individuals experience diminished withdrawal motivation or heightened approach motivation in response to emotional stimuli. Studying emotional processing abnormalities, especially among youth, may be essential for better understanding psychopathy's development and for informing interventions. However, few studies on psychopathy have experimentally manipulated emotional processing, and despite the growing literature on neuroscience and psychopathy, there are aspects of neural activity that have yet to be investigated. The current study used a sample of 52 justice-involved youth to examine how psychopathy, as measured by the Proposed Specifiers for Conduct Disorder scale, relates to frontal alpha asymmetry (FAA), a neural correlate of approach and withdrawal motivation. Alpha asymmetry was first measured at rest and then while youth were asked to process emotional stimuli spontaneously as well as to increase and decrease their responses to emotional stimuli. Results indicated that total psychopathy was not related to FAA at rest or during task performance. However, youth higher in callous-unemotional traits demonstrated similar patterns of neural activity to youth lower in callous-unemotional traits when instructed to increase their response to emotional stimuli. These findings were not evident for grandiose-manipulative or daring-impulsive traits. These findings may indicate that youth high in callous-unemotional traits are capable of modulating their emotional responding, which could in turn have treatment implications for youth high in psychopathic traits.

A Multi-Informant Study of the Validity of the Inventory of Callous-Unemotional Traits in a Sample of Norwegian Adolescents with Behavior Problems

The Inventory of Callous-Unemotional traits (ICU) is a widely used measure of the affective aspects of psychopathy in children and adolescents. Although a 3-bifactor model of the ICU has often been supported, method-variance effects and mixed results for the Unemotional subscale raise concerns. This study applied a multi-informant design to investigate the structural and concurrent validity of the self-, parent- and teacher-versions of the ICU in a Norwegian at-risk adolescent sample (N = 160, female = 46.3%, mean age = 14.73 years, SD = 1.47). Confirmatory Factor Analysis demonstrated method-variance effects of the standard- and reverse-scored items. The best fitting model was the 12-item 2-factor ICU, comprising a Callousness and an Uncaring factor. The scale reliabilities were acceptable with Cronbach alphas ranging from .810 to .906 across respondent groups. Cross-rater reliability was poor, with Intra Class Correlations ranging from .170 to .226. The concurrent validity of the ICU12 was supported by within-rater associations to externalizing problems, aggression, and problematic alcohol use. Cross-rater associations of ICU12-scores to self-reported delinquency and lower levels of anxiety, provided additional support for the concurrent validity. The unidimensional ICU12 total score was associated both to delinquency and rule-breaking behavior as observed for the Callousness factor and to lack of anxiety and reduced fear sensitivity as observed for the Uncaring factor. The ICU items aimed at capturing lack of prosocial emotions, seem to need revision. Future research should assess the predictive validity and clinical relevance of unidimensional versus factor models of the ICU.

Emotional dysregulation and callous unemotional traits as possible predictors of short-term response to methylphenidate monotherapy in drug-naïve youth with ADHD

BACKGROUND

Emotional dysregulation (ED) and callous unemotional (CU) traits can be associated with ADHD in youth, influencing its natural history and outcome, but their effect on medication efficacy is unexplored. We examined whether two measures of baseline ED and CU traits, the Child Behavior Checklist-Dysregulation Profile (CBCL-DP) and the Antisocial Process Screening Device (APSD), respectively, were predictors of change of ADHD-Rating Scale (ADHD-RS) after a 4-week methylphenidate (MPH) monotherapy.

METHODS

43 patients (37 males, 8-16 years, mean 9.9 ± 2.7 years) were included. Hierarchical linear regression models were used to explore whether CBCL-DP and APSD might predict ADHD-RS score, controlling for baseline severity.

RESULTS

Baseline CBCL-DP predicted higher post-treatment ADHD-RS scores in total and hyperactivity-impulsivity, but not in inattention subscale. Baseline APSD was not significantly related to ADHD-RS scores at the follow-up.

LIMITATIONS

Small sample size, lack of gender diversity, non-blind design and short period of observation.

CONCLUSION

ED, assessed with that CBCL-DP, might be a negative predictor of change of hyperactive-impulsive symptoms after MPH treatment and should be systematically assessed at baseline.

Psychometric Properties of the Youth Psychopathic Traits Inventory Triarchic Scales and Its Short Version in Chinese Male Juvenile Offenders

The triarchic conceptualization of psychopathy encompasses three distinct dispositional components: boldness, meanness, and disinhibition. The current study aimed to validate triarchic construct scales composed of items from the Youth Psychopathic Traits Inventory (YPI) in a sample of Chinese male juvenile offenders (N = 613, mean age = 17.14 years, SD = 1.09 years). Although the CFA and ESEM models failed to support the three-factor structure for YPI-based triarchic scores, the convergent and criteria validity of the YPI-Tri and YPI-Tri-S were supported as they demonstrated the expected relation with other psychopathic traits or component measures and aggressive behavior measures. The internal consistency of the YPI-Tri and YPI-Tri-S scores ranged from marginal to good. The findings provide preliminary evidence for the YPI-based triarchic scores and support for the utility of the YPI-Tri and YPI-Tri-S in assessing psychopathy in Chinese male juvenile offenders.

Autonomic nervous system activity and callous-unemotional traits in physically maltreated youth

BACKGROUND

Research into callous-unemotional (CU) traits often focuses exclusively on biological risk factors without integrating social factors. This gap exists despite a growing body of research showing that the social environment may actually impact physiological functioning, which could in turn affect behavior.

OBJECTIVE

The current study addresses this limitation by examining physical maltreatment and heart rate stress reactivity as potential risk factors for CU traits.

PARTICIPANTS AND SETTING

This research was conducted in a community sample of Chinese youth (mean age = 11.83 years, 44.3 % female).

METHODS

Each child separately reported frequency of physical maltreatment experiences by his or her mother and father over the past 12 months. Children completed a self-report measure of CU traits.

RESULTS

Frequency of maternal physical maltreatment was associated with uncaring traits in females, but not in males. Paternal physical maltreatment was associated with uncaring traits in both males and females and with callous traits in females only. While paternal physical maltreatment was associated with lower heart rate reactivity in females, maternal physical maltreatment was associated with higher heart rate reactivity in females.

CONCLUSION

Findings provide mixed support for a potential physiological pathway through which child maltreatment may impact callous traits and provide a multilevel, biosocial lens through which to understand CU traits.

Callous-unemotional traits and the attentional bias towards emotional stimuli: Testing the moderating role of emotional and behavioural problems among high-risk adolescents

Former studies demonstrated that antisocial youth with callous-unemotional (CU) traits are impaired in the processing of negative emotional stimuli. The aim of the current study was to explore the moderating role of different behavioural (i.e. conduct problems, hyperactivity-inattention) and emotional problems (i.e. internalizing symptoms) in the relationship between CU traits and attentional bias towards emotional stimuli. Besides using self-report measures, attentional bias was tested by an affective dot-probe task in a high-risk sample of 102 adolescent boys (M age = 16.34 years; SD = 1.32). CU traits were related to reduced attention to emotionally distressing pictures. Furthermore, conduct problems significantly moderated the relationship between CU traits and attention to distress cues. These findings highlight the importance of considering potential moderators to the well-established link between CU traits and deficits in response to negative emotional cues.

Factor Structure and Measurement Invariance of Youth Psychopathic Traits Inventory-Child Version in Chinese Children

The primary goal of the present study was to examine the latent factor structure and measurement invariance (MI) of the Youth Psychopathic Traits Inventory-Child Version (YPI-CV) in a sample of Chinese children. 299 school children (aged 9-12, 47.3% female) completed the Chinese version of the YPI-CV, and their parents completed a different measure of psychopathic traits, as well as ones for other measures: the Child Problematic Traits Inventory (CPTI), the Strength and Difficulty Questionnaire (SDQ), and the Social Competence - Parent Version (SCPV). Results showed that a bifactor model at item level fit the data best and was invariant across gender. Specifically, the general psychopathy factor influenced the 18 items strongly, suggesting that the YPI-CV is unidimensional rather than multidimensional. Overall, findings suggest that the bifactor structure of the YPI-CV should be used when examining relationships with outcome variables in Chinese children, with a focus on the total score of the YPI-CV, while factor scores should explain with caution.

Maladaptive Aggression: With a Focus on Impulsive Aggression in Children and Adolescents

Objective: Aggressive behavior is among the most common reasons for referral to psychiatric clinics and confers significant burden on individuals. Aggression remains poorly defined; there is currently no consensus on the best ways to recognize, diagnose, and treat aggression in clinical settings. In this review, we synthesize the available literature on aggression in children and adolescents and propose the concept of impulsive aggression (IA) as an important construct associated with diverse and enduring psychopathology. Methods: Articles were identified and screened from online repositories, including PubMed, PsychInfo, the Cochrane Database, EMBase, and relevant book chapters, using combinations of search terms such as "aggression," "aggressive behavio(u)r," "maladaptive aggression," "juvenile," and "developmental trajectory." These were evaluated for quality of research before being incorporated into the article. The final report references 142 sources, published from 1987 to 2019. Results: Aggression can be either adaptive or maladaptive in nature, and the latter may require psychosocial and biomedical interventions when it occurs in the context of central nervous system psychopathology. Aggression can be categorized into various subtypes, including reactive/proactive, overt/covert, relational, and IA. IA in psychiatric or neurological disorders is reviewed along with current treatments, and an algorithm for systematic evaluation of aggression in the clinical setting is proposed. Conclusions: IA is a treatable form of maladaptive aggression that is distinct from other aggression subtypes. It occurs across diverse psychiatric and neurological diagnoses and affects a substantial subpopulation. IA can serve as an important construct in clinical practice and has considerable potential to advance research.

Friendship Quality in Youth With and Without Disruptive Behavior Disorders: The Role of Empathy, Aggression, and Callousness

Youth with disruptive behavior disorders (DBD; Oppositional defiant disorder and/or conduct disorder) are known to show impaired social relationships. Little is known about positive (PFQ) and negative best friendship quality (NFQ) in youth with DBD, and their relations with DBD specific symptoms such as aggression subtypes, empathic abilities, and callous unemotional (CU)-traits. The current study includes N = 115 youth with and N = 146 without DBD (M_age = 13.98, SD = 2.2). A diagnostic interview and self-rating questionnaires assessed ODD/CD diagnosis, friendship quality, aggression, empathy, and CU-traits. When examined on a categorical level, youth with and without DBD did not differ in friendship quality. On a dimensional level across groups, perspective taking was positively associated with PFQ. Proactive aggression was positively associated with NFQ. CU-traits in females were positively, while CU-traits in males were negatively, associated with NFQ. Results highlight that behavioral and cognitive symptoms, rather than clinical categories, are important to consider when discussing friendship qualities.

Continuity and Change in Psychopathic Traits Among School-Aged Children with Conduct Problems

The three dimensions of psychopathic traits in childhood have been consistently associated with high levels of conduct problems among children. However, little is known about the continuity and change in psychopathic traits among children with conduct problems. This study aimed to examine the homotypic continuity and change of the three dimensions of psychopathic traits from 8 to 14 years old among 370 children (40.3% girls) who were identified at school as having conduct problems at study inception. Results supported the structural continuity of the tridimensional model of psychopathic traits and revealed that the callous-unemotional dimension is more stable than the two other dimensions. However, the levels of the three dimensions of psychopathic traits remained high over time among a substantial number of children with conduct problems. This study has implications regarding the longitudinal assessment of psychopathic traits within this specific population.

Longitudinal measurement invariance of the Child Problematic Trait Inventory in older Chinese children

The Child Problematic Traits Inventory (CPTI) is a newly developed informant-rated instrument to measure psychopathic traits during early childhood. The aim of this study was to examine the longitudinal measurement invariance of the CPTI in a group of Chinese schoolchildren. Mothers of 585 children aged 8 to 12 years (50% girls) completed the CPTI twice with one-year interval. Confirmatory factor analyses showed that the CPTI had strict invariance (i.e., equality of factor patterns, loadings, intercepts, and item uniqueness) across time. Furthermore, the internal consistencies for the CPTI subscales were good at both time points and the stability coefficients over time were moderate. Findings suggest that, in children aged 8 to 12 years old, changes in CPTI scores across time can be attributed to actual changes in the child's psychopathic personality.

Genetic underpinnings of callous-unemotional traits and emotion recognition in children, adolescents, and emerging adults

BACKGROUND

Callous-Unemotional (CU) and psychopathic traits are consistently associated with impaired recognition of others' emotions, specifically fear and sadness. However, no studies have examined whether the association between CU traits and emotion recognition deficits is due primarily to genetic or environmental factors.

METHODS

The current study used data from 607 Caucasian twin pairs (N = 1,214 twins) to examine the phenotypic and genetic relationship between the Inventory of Callous-Unemotional Traits (ICU) and facial emotion recognition assessed via the laboratory-based Facial Expression Labeling Task (FELT).

RESULTS

The uncaring/callous dimension of the ICU was significantly associated with impaired recognition of happiness, sadness, fear, surprise, and disgust. The unemotional ICU dimension was significantly associated with improved recognition of surprise and disgust. Total ICU score was significantly associated with impaired recognition of sadness. Significant genetic correlations were found for uncaring/callous traits and distress cue recognition (i.e. fear and sadness). The observed relationship between uncaring/callous traits and deficits in distress cue recognition was accounted for entirely by shared genetic influences.

CONCLUSIONS

The results of the current study replicate previous findings demonstrating impaired emotion recognition among youth with elevated CU traits. We extend these findings by replicating them in an epidemiological sample not selected or enriched for pathological levels of CU traits. Furthermore, the current study is the first to investigate the genetic and environmental etiology of CU traits and emotion recognition, and results suggest genetic influences underlie the specific relationship between uncaring/callous traits and distress cue (fear/sadness) recognition in others.

Not Just for Adults: Using the Triarchic Model of Psychopathy to Inform Developmental Models of Conduct Problems in Adolescence

The triarchic model of psychopathy was advanced to reconcile differing historic conceptions of this condition and alternative approaches for assessing it. The current study was undertaken to expand the empirical evidence base for the triarchic model by examining its correlates in adolescents, with measures of particular relevance to developmental theories of antisocial behavior. Self-report scales assessing the triarchic constructs were administered along with measures of conduct problems, callous-unemotional traits, attachment style dimensions, negative emotionality, and hyperactivity/inattention to 608 Italian adolescents (272 girls; M age = 16.70 years). The disinhibition dimension of the triarchic model was related most highly to general externalizing outcomes, such as conduct problems and hyperactivity-inattention, in this adolescent sample. The meanness dimension was selectively related to callous-unemotional traits and other measures of limited prosocial emotions and to affiliation motives that emphasize social gain. Triarchic boldness was associated with greater emotional stability and greater confidence in peer relationships. Of interest, an interaction between meanness and boldness was evident in predicting a lower need to understand one's own and others' emotions. These results provide a valuable illustration of the potential of the triarchic model to help advance developmental models of antisocial behavior in youth. Public Significance Statement This study examined how dimensions of psychopathy described by the triarchic model relate to measures of problem behaviors and affective-interpersonal style in an adolescent sample. Scores on the three triarchic dimensions-disinhibition, meanness, and boldness-showed meaningful contrasting relations with conduct problems, hyperactivity/inattention, callous-unemotional traits, emotional proclivities, and attachment style dimensions. This work illustrates how the triarchic model conceptualization can help advance developmental models of the emergence of antisocial behavior.

Assessing Psychopathic Traits Among Children: The First Validation Study of the Child Problematic Traits Inventory in a Clinical Sample

This is the first study that tested the psychometric properties of the Child Problematic Traits Inventory (CPTI) in clinic-referred children (ages 6-13 years). Teachers (N = 159) and parents (N = 173) completed the CPTI and various other measures. Confirmatory factor analyses supported the CPTI's three-factor structure when teachers and parents rated the 28 CPTI items. Teacher- and parent-reported CPTI scores showed the expected relations with external correlates (e.g., conduct problems and proactive aggression). Crucially, the validity of the CPTI scores was also supported across informants (i.e., when linking teacher-reported CPTI scores to parent-reported external correlates, and vice versa) and across methods (i.e., regardless if a questionnaire or a diagnostic interview was used to measure external correlates). We conclude that the CPTI holds promise as a research tool for assessing psychopathic traits in clinic-referred children. Until our findings have been replicated and extended, the CPTI should not be used for clinical decision making.

Neural Profile of Callous Traits in Children: A Population-Based Neuroimaging Study

BACKGROUND

Callous traits during childhood, e.g., lack of remorse and shallow affect, are a key risk marker for antisocial behavior. Although callous traits have been found to be associated with structural and functional brain alterations, evidence to date has been almost exclusively limited to small, high-risk samples of boys. We characterized gray and white matter brain correlates of callous traits in over 2000 children from the general population.

METHODS

Data on mother-reported callous traits and brain imaging were collected at age 10 years from participants of the Generation R Study. Structural magnetic resonance imaging was used to investigate brain morphology using volumetric indices and whole-brain analyses (n = 2146); diffusion tensor imaging was used to assess global and specific white matter microstructure (n = 2059).

RESULTS

Callous traits were associated with lower global brain (e.g., total brain) volumes as well as decreased cortical surface area in frontal and temporal regions. Global mean diffusivity was negatively associated with callous traits, suggesting higher white matter microstructural integrity in children with elevated callous traits. Multiple individual tracts, including the uncinate and cingulum, contributed to this global association. Whereas no gender differences were observed for global volumetric indices, white matter associations were present only in girls.

CONCLUSIONS

This is the first study to provide a systematic characterization of the structural neural profile of callous traits in the general pediatric population. These findings extend previous work based on selected samples by demonstrating that childhood callous traits in the general population are characterized by widespread macrostructural and microstructural differences across the brain.

The genetic underpinnings of callous-unemotional traits: A systematic research review

BACKGROUND

Callous-unemotional (CU) traits represent the affective features of psychopathy used to delineate youth at high risk for externalizing pathology. The genetic etiology CU traits is not currently well-understood.

METHODS

The current review surveyed the literature for studies on the genetic underpinnings of CU traits and integrated information from 39 genetic studies.

RESULTS

The results from 24 studies with quantitative data suggest that the heritability for CU traits is likely between 36-67%. A majority of the 16 molecular genetic studies focused on candidate genes in the serotonin and oxytocin systems with results that have not been well replicated. Although two genome-wide association studies have been conducted, no genome-wide significant loci have been discovered.

DISCUSSION

There is some evidence to suggest that the serotonin and oxytocin systems may play a role in CU traits; however, there is currently not enough evidence to implicate specific genetic mechanisms. The authors encourage researchers to continue to apply the most up-to-date and relevant methodology, specifically collaborations and consortiums using genome-wide and polygenic methods.

Shared and unique variances of interpersonal callousness and low prosocial behavior

Although low prosocial behavior (LPB) items have been incorporated into youth measures of callousness, it remains unclear from current factor analytic findings whether callous traits and LPB are best operationalized as a common construct, or distinct dimensions. Using data from a population-representative birth cohort (N = 5,463), this study compared 4 latent factor structures for interpersonal callousness (IC; 6 items) and LPB (5 items) at age 13: (a) unidimensional; (b) two-factor; (c) higher-order (with 2 subfactors); and (d) bifactor (1 general and 2 specific residual factors). Alternative models distinguishing positively and negatively worded items were tested for comparative purposes. To assess the external validity of the factors that emerged from the best-fitting model, associations with early parenting styles and psychiatric comorbidities were examined. A bifactor model, achieving invariance for males and females, offered the best fit for these data. However, additional bifactor-specific indices suggested that the specific IC factor did not offer a unique contribution to the total variance over and above the general factor (IC/LPB). Of the remaining factors, IC/LPB was associated with higher levels of harsh parenting, externalizing and internalizing disorder, and social-cognitive difficulties, and lower levels of warm parenting. The LPB factor, meanwhile, was associated with greater social-cognitive difficulties and externalizing disorder, and lower maternal warmth, evoking a phenotype that may be more indicative of the autism spectrum than IC. These findings suggest that the shared variance underlying IC and LPB taps a severe psychiatric phenotype, while the residual variance for LPB may represent a distinct profile of social-cognitive dysfunction. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Associations Between Conduct Disorder, Neurodevelopmental Problems and Psychopathic Personality Traits in a Swedish Twin Youth Population

Previous research has found a complex relationship between psychopathic traits, neurodevelopmental problems (NDPs), and conduct disorder (CD) in children. This study explores associations between psychopathic traits, assessed with the Child Problematic Traits Inventory-Short Version (CPTI-SV), and CD in children with and without coexisting NDPs (i.e., attention deficit/hyperactivity disorder [ADHD] and autism spectrum disorder [ASD]) in a community-based sample of Swedish twins (n = 8762). Findings indicate weak to moderately strong correlations between psychopathic traits and CD, ADHD, and ASD, respectively. Furthermore, in univariable analyses, both psychopathic traits and NDPs displayed significant positive associations with being screened positive for CD, though only the grandiose-deceitful dimension of CPTI-SV and the ADHD domain concentration and attention deficits remained significantly associated with CD in a multivariable regression model. The results are relevant to screening and assessment in child and youth psychiatry, as a grandiose and deceitful interpersonal style may also be a valid sign of children at risk of developing CD.