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

The relationship between psychopathy and autism: a systematic review and narrative synthesis

Background and methods

The aim of this systematic review was to synthesise research examining the relationship between autism and psychopathy to: (a) better understand the relationship between these two constructs, and (b) describe the clinical manifestation of the two when they co-occur. A systematic search of the literature returned 36 studies.

Results

Across all ages, autistic individuals and those with elevated autistic traits but no autistic diagnoses appeared to have increased callous and unemotional traits or psychopathy relative to the general population. Several studies evidenced that although both constructs are associated with empathetic dysfunction, the underlying mechanisms differ. In adults, psychopathy/psychopathic traits were associated with diminished affective empathy and intact cognitive empathy, whilst the opposite was seen autistic adults and those with elevated autistic traits. In children, those with autistic traits or a diagnosis of autism had diminished cognitive empathy, but not affective empathy, while the relationship between callous and unemotional traits/psychopathy and empathy amongst children was less clear. The co-occurrence of autism and psychopathy was seen to lead to additional empathic and cognitive impairment, but findings were mixed making it challenging to clearly describe the clinical manifestation.

Conclusion

There remains a paucity of research investigating the interaction between autism and psychopathy and included studies were characterised by multiple measurement difficulties. Attention should be directed toward developing better methods for identifying psychopathic traits in autistic individuals to advance our understanding of the relationship between autism and psychopathy to allow for the development of appropriate care pathways for this population.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=413672, identifier CRD42023413672.

Callous unemotional traits mediate the presence of challenging behaviors in adults with autism spectrum disorder and intellectual disability

Background: Callous-unemotional traits (CUT) are an antisocial personality trait, which can be present in people with autism spectrum disorder (ASD), especially in relation to difficulties in empathy. These traits are related to challenging behaviors, such as aggressive behavior, which may occur in people with ASD. Method: This study aimed to expand the understanding of the role of CUT in adults with ASD and intellectual disability (ID). Eighty-three adults with a diagnosis of ASD and ID participated in the study. Results: Mediation analyses found that CUT indirectly mediated the relationship between ASD symptomatology and the frequency of self-injuries and stereotypies, but not aggression. Conclusions: It is considered that CUT may have a protective effect on the presence of individual challenging behaviors in adults with ASD and ID. The apparent relationship between CUT and executive functioning was discussed. CUT traits may be considered as a variable to contemplate in relation to interventions in challenging behaviors in the ASD population, especially in those individuals who show aggression-related behaviors and who have a higher executive level.