The Clinical Assessment of Prosocial Emotions (CAPE): Initial tests of reliability and validity in a clinic-referred sample of children and adolescents

Recent changes to diagnostic criteria for serious conduct problems in children and adolescents have included the presence of elevated callous-unemotional traits to define etiologically and clinically important subgroups of youth with a conduct problem diagnosis. The Clinical Assessment of Prosocial Emotions (CAPE) is an intensive assessment of the symptoms of this limited prosocial emotions specifier that uses a structured professional judgment method of scoring, which may make it useful in clinical settings when diagnoses may require more information than that provided by behavior rating scales. The present study adds to the limited tests of the CAPE's reliability and validity, using a sample of clinic-referred children ages 6-17 years of age, who were all administered the CAPE by trained clinicians. The mean age of the sample was 10.13 years (SD = 2.64); 54% of the sample identified as male and 46% identified as female; and 67% of participants identified as White, 29% identified as Black, and 52% identified as another race/ethnicity (i.e., Asian, Hispanic/Latinx, or other). The findings indicated that CAPE scores demonstrated strong interrater reliability. The scores also were associated with measures of conduct problems and aggression, even when controlling for behavior ratings of callous-unemotional traits. Further, when children with conduct problem diagnoses were divided into groups based on the presence of the limited prosocial emotions specifier from the CAPE, the subgroup with the specifier showed more severe conduct problems and aggression. The results support cautious clinical use of the CAPE, its further development and testing, and research into ways to make its use feasible in many clinical settings. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Health Service Utilization in Adolescents Following a First Arrest: The Role of Antisocial Behavior, Callous-Unemotional Traits, and Juvenile Justice System Processing

Previous research indicates that youth exhibiting antisocial behavior are at risk for utilizing a disproportionate amount of health services compared to youth without these problems. The present study investigates whether being processed by the juvenile justice system and showing callous-unemotional (CU) traits independently predict health service utilization (medical and mental health service use and out-of-home placement) over and above the severity of antisocial behavior across adolescence. A total of 766 participants who had been arrested for the first time in adolescence provided data at ten appointments over a period of seven years. Results showed that self-reported antisocial behavior at the time of arrest predicted increased use of most health service use types over the next seven years (i.e. medicine prescriptions, tests for sexually transmitted infections, mental health service appointments, and out-of-home placements). All except prescription medication use remained significant when controlling for justice system processing and CU traits. Further, justice system processing added significantly to the prediction of medical service appointments. Whereas CU traits were associated with mental health service appointments and out-of-home placements, these did not remain significant when controlling for severity of antisocial behavior. These findings are consistent with prior research documenting the health care costs of antisocial behavior.

Callous-Unemotional Traits and Emotion Perception Accuracy and Bias in Youths

This study investigated the associations among conduct problems, callous-unemotional (CU) traits, and indices of emotion recognition accuracy and emotion recognition bias obtained from human faces. Impairments in emotion recognition were considered within broader, impaired emotional and social functioning. The sample consisted of 293 middle-school students (51.19% girls; M age = 12.97 years, SD = 0.88 years). In general, CU traits were associated with less accuracy in recognizing emotions, especially fearful and angry faces, and such deficits in emotional recognition were not associated with conduct problems independent of CU traits. These results support the importance of studying potential deficits in the recognition of emotions other than fear. Furthermore, our results support the importance of considering the role of CU traits when studying emotional correlates of conduct problems. For children scoring high on CU traits, the emotion recognition accuracy of anger was low irrespective of the level of conduct problems, whereas in children scoring low on CU traits, less accuracy in recognizing emotions was related to increases in conduct problems. Finally, our results support the need for research to not only focus on accuracy of emotional recognition but also test whether there are specific biases leading to these inaccuracies. Specifically, CU traits were associated not only with lower accuracy in recognizing fearful faces but also with a tendency to interpret fearful faces as angry. This suggests that the emotional deficit associated with CU traits is not just a deficit in empathic concern toward others distress but also includes a tendency to overinterpret emotions as potential threats to oneself.

Towards Preventative Psychiatry: Concurrent and Longitudinal Predictors of Postnatal Maternal-Infant Bonding

Maternal-infant bonding is important for children's positive development. Poor maternal-infant bonding is a risk factor for negative mother and infant outcomes. Although researchers have examined individual predictors of maternal-infant bonding, studies typically do not examine several concurrent and longitudinal predictors within the same model. This study aimed to evaluate the unique and combined predictive power of cross-sectional and longitudinal predictors of maternal-infant bonding. Participants were 372 pregnant women recruited from an Australian hospital. Data were collected from mothers at antenatal appointments (T0), following their child's birth (T1), and at a laboratory assessment when their child was 5-11-months-old (T2). Poorer bonding at T2 was predicted at T0 by younger maternal age, higher education, and higher antenatal depressive symptoms. Poorer bonding at T2 was predicted at T1 by younger maternal age, higher education, and higher postnatal depressive symptoms. Poorer bonding at T2 was predicted at T2 by younger maternal age, higher education, higher postnatal depression symptoms, higher concurrent perceived social support, and more difficult infant temperament, when controlling for child age at T2. To promote positive maternal-infant bonding, global and targeted interventions in the perinatal period may benefit from targeting maternal psychopathology, perceived lack of social support, and coping with difficult infant temperament.

Oppositional defiant disorder

Oppositional defiant disorder (ODD) is a disruptive behaviour disorder involving an ongoing pattern of angry/irritable mood, argumentative/defiant behaviour and vindictiveness. Onset is typically before 8 years of age, although ODD can be diagnosed in both children and adults. This disorder is associated with substantial social and economic burden, and childhood ODD is one of the most common precursors of other mental health problems that can arise across the lifespan. The population prevalence of ODD is ~3 to 5%. A higher prevalence in males than females has been reported, particularly before adolescence. No single risk factor accounts for ODD. The development of this disorder seems to arise from the interaction of genetic and environmental factors, and mechanisms embedded in social relationships are understood to contribute to its maintenance. The treatment of ODD is often successful, and relatively brief parenting interventions produce large sized treatment effects in early childhood. Accordingly, ODD represents an important focus for research, practice and policy concerning early intervention and prevention in mental health.

The bidirectional effects of antisocial behavior, anxiety, and trauma exposure: Implications for our understanding of the development of callous-unemotional traits

The association of anxiety and trauma with antisocial behavior in children and adolescents has long been the focus of research, and more recently this area of research has become critical to theories of the development of callous-unemotional (CU) traits. Research suggests those with elevated CU traits and anxiety (i.e., secondary CU variant) seem to show more severe externalizing behaviors and are more likely to show histories of trauma, compared to those with elevated CU and low anxiety (i.e., primary CU variant). These findings have typically been interpreted as being indicative of distinct etiological pathways to the development of CU traits. We test an alternative explanation that the higher rates of anxiety and trauma exposure in some youth with elevated CU traits are largely a consequence of their higher levels of antisocial behavior. The current study recruited a sample of 1,216 justice-involved adolescents (M_age = 15.28, SD = 1.28) from three distinct regions of the United States, who were assessed at 6, 12, 18, 24, 30, 36, 48, and 60 months following their first arrest. Using random-intercept cross-lagged models, both antisocial behavior and CU traits predicted changes in future anxiety and CU traits predicted increases in future victimization. Further, using longitudinal parallel mediation models, antisocial and aggressive behavior largely accounted for the predictive association between CU traits and anxiety and CU traits and victimization. These results support a model in which anxiety and trauma histories may be a marker of the severity of antisocial behavior displayed by youth with elevated CU traits. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Characterizing trajectories of anxiety, depression, and criminal offending in male adolescents over the 5 years following their first arrest

Youth in the juvenile justice system evince high rates of mental health symptoms, including anxiety and depression. How these symptom profiles change after first contact with the justice system and - importantly - how they are related to re-offending remains unclear. Here, we use latent growth curve modeling to characterize univariate and multivariate growth of anxiety, depression, and re-offending in 1216 male adolescents over 5 years following their first arrest. Overall, the group showed significant linear and quadratic growth in internalizing symptoms and offending behaviors over time such that levels decreased initially after first arrest followed by a small but significant upturn occurring a few years later. Crucially, multivariate growth models revealed strong positive relationships between the rates of growth in internalizing symptoms and offending behaviors such that improvements in mental health related to greater decreases in offending, and vice versa. These results highlight the reciprocal nature of internalizing and externalizing problems in adolescence, underscoring the importance of considering mental health alongside offending in the juvenile justice system.

A commentary on Perlstein et al. (2023): the past and future of treating youth with limited prosocial emotions

Perlstein, Fair, Hong, and Waller (Journal of Child Psychology and Psychiatry, 2023) meta-analysis provides a critically important summary of the research on the treatment of children and adolescents with elevated callous-unemotional (CU) traits, 10 years after they were added to diagnostic criteria in the "with Limited Prosocial Emotions" specifier for conduct disorder. Their meta-analysis provides clear and convincing evidence that many treatments that reduce conduct problems in youth are also effective for children with elevated CU traits. However, their findings also indicate that CU traits are a severity indicator, in that youth high on these traits start treatment with more severe behavior problems and, despite improving with treatment, often leave treatment with more severe behavior problems. Such findings provide a clear focus for future research to adapt existing treatments to be more effective for youth with elevated CU traits. Further, the findings from the meta-analysis suggested that while treatments overall were not effective in reducing callous-unemotional traits, high-quality parenting interventions show promise for improving this outcome.

Proactive and reactive aggression: Developmental trajectories and longitudinal associations with callous-unemotional traits, impulsivity, and internalizing emotions

Research on proactive and reactive aggression has identified covariates unique to each function of aggression, but hypothesized correlates have often not been tested with consideration of developmental changes in or the overlap between the types of aggression. The present study examines the unique developmental trajectories of proactive and reactive aggression over adolescence and young adulthood and tests these trajectories' associations with key covariates: callous-unemotional (CU) traits, impulsivity, and internalizing emotions. In a sample of 1,211 justice-involved males (ages 15-22), quadratic growth models (i.e., intercepts, linear slopes, and quadratic slopes) of each type of aggression were regressed onto quadratic growth models of the covariates while controlling for the other type of aggression. After accounting for the level of reactive aggression, the level of proactive aggression was predicted by the level of CU traits. However, change in proactive aggression over time was not related to the change in any covariates. After accounting for proactive aggression, reactive aggression was predicted by impulsivity, both at the initial level and in change over time. Results support that proactive and reactive aggression are unique constructs with separate developmental trajectories and distinct covariates.

The Brief Adolescent Depression Screen: A Brief Screening Tool for Depression and Suicidal Behavior in Inpatient Adolescents

Background

In clinical settings, there is significant need for brief, easily-administered assessment tools for adolescent depression that can be used by mental health clinicians from a variety of training backgrounds. Existing depression screening tools do not assess for duration and consistency of symptoms, two key indicators of pathological depression.

Objective

The Brief Adolescent Depression Screen (BADS) was developed to screen for major and persistent depressive disorders in adolescents in order to meet the assessment needs in an inpatient setting, and the validity of this tool was tested.

Method

The current study used a sample of 396 inpatient adolescents to assess the screening utility of the BADS for detecting whether the adolescent meets criteria for a depressive diagnosis according to a well-validated semi-structured interview, as well as detecting a positive history of suicidal behavior. Further, the screening utility of this measure was compared to the utility of an established depression rating scale.

Results

Analyses first determined the duration of depressive symptoms on the BADS that optimally screened for the presence of Major Depressive Disorder and Persistent Depressive Disorder. Findings indicated that, using these optimal screening cut-offs, the BADS showed a strong screening utility, resulting in a sensitivity and specificity for identifying full depressive diagnoses and a positive history of suicidal behavior with similar or greater accuracy than an established rating scale.

Conclusions

These findings provide initial evidence to suggest that the BADS may be a helpful screening tool for adolescent depressive disorders in inpatient settings.

Perceived sleep quality predicts aggressive offending in adolescence and young adulthood

BACKGROUND

There are profound consequences when developing youth do not get adequate sleep. Adolescents who experience poor sleep may be more likely to engage in offending behavior. While there is a documented association between the number of hours youth sleep and their likelihood of offending, it is unclear how youths' perceptions of their sleep quality contribute to offending. Further, scholars have yet to rigorously examine the relation between sleep problems and offending in young adulthood, a developmental stage, which is both critical for desistance and in which sleep may play an important role.

METHODS

Using a sample of 1,216 justice-involved male youth, this study uses within-individual longitudinal methods (fixed-effects Poisson regression models) to examine the relation between changes in perceptions of sleep quality and changes in offending behavior from ages 13 to 24.

RESULTS

Increases in sleep problems are associated with increases in offending, particularly aggressive/person-related offenses, for both adolescents and young adults. This holds true even after controlling for time-varying anxiety, substance use, and violence exposure.

CONCLUSIONS

Improving sleep quality may be critical for reducing aggressive behavior in at-risk adolescents and young adults. Interventions that address sleep quality, and not just quantity, may be particularly beneficial.

The Mood Disorder Assessment Schedule: Initial validation of a new measure for early identification of bipolar spectrum disorders in inpatient adolescents

Due to the significant impairment associated with subthreshold bipolar symptomatology and the harmful effects of delayed diagnosis, there is a great need for diagnostic tools that can facilitate early identification of bipolar spectrum disorders. The Mood Disorder Assessment Schedule (MDAS) is a newly developed measure that focuses on autonomous changes in mood and energy, a key indicator of bipolar spectrum problems which is not included in current diagnostic tools for bipolar disorders. The current study tested the ability of the MDAS to identify individuals at risk for bipolar spectrum disorders. In a cross-sectional sample of 396 inpatient adolescents, the MDAS identified a group of individuals with several bipolar spectrum disorder (BSD) indicators, including greater manic and depressive symptoms, affective lability, suicidal behavior, adverse reactions to antidepressants, and a family history of bipolar disorder and suicidal behavior. When compared to a standard diagnostic interview for bipolar disorders (i.e., Kiddie Schedule for Affective Disorders and Schizophrenia [KSADS]), the MDAS yielded stronger clinical utility in its ability to identify individuals with BSD indicators. Therefore, the MDAS appears to be a promising diagnostic tool for identifying adolescents at risk for BSDs and may help facilitate earlier diagnosis and prevent harmful effects of improper treatment.

A Comparison of Parent, Teacher, and Youth Ratings on the Inventory of Callous-Unemotional Traits

The current study compared the validity of self-, parent-, and teacher-report versions of the Inventory of Callous-Unemotional Traits (ICU), a widely used measure of callous-unemotional (CU) traits, at several different ages. Participants (N = 236, 60.6% girls) were children in Grades 3, 6, and 8 (Mage = 11.55, SD = 2.23) from a public school system in the southern United States. We tested the association of all three ICU versions with several validators: parent- and teacher-reported conduct problems, peer nominations of characteristics associated with CU traits, and sociometric peer nominations of social preference. Results revealed an interaction between the ICU version and grade in the overall level of CU traits reported, with teacher-report leading to the highest ratings in sixth grade and being higher than parent-report in third grade. Furthermore, the validity of the different versions of the ICU varied somewhat across grades. Specifically, findings support the validity of both teacher- and self-report in third grade, but self-report was the only version to show strong validity in the eighth grade.

Inventory of Callous-Unemotional Traits (ICU) Factor Structure and Measurement Invariance in an Adolescent Multinational Sample

OBJECTIVE

The Inventory of Callous-Unemotional Traits (ICU) is a widely used, comprehensive measure of callous-unemotional (CU) traits. While the ICU total score is used frequently in research, the scale's factor structure remains highly debated. Inconsistencies in past factor structure research appear to be largely due to the use of small non-representative samples and failure to control for method variance (i.e., item wording direction).

METHOD

The current study used a multitrait-multimethod (MTMM) confirmatory factor analysis (CFA) approach that considers both trait and method variance to test the factor structure of a 22-item version of the self-report ICU in a multinational community sample of 4,683 adolescents (ages 11-17).

RESULTS

Results showed that a hierarchical four-factor model (i.e., one overarching CU factor, four latent trait factors) that controlled for method variance (i.e., by allowing residuals from positively worded items to covary) provided the best fit (χ2 = 2797.307, df = 160, RMSEA=.059, CFI=.922, TLI=.888, SRMR=.045).

CONCLUSIONS

After controlling for method variance, the best-fitting factor structure is consistent with how the ICU was developed and corresponds to the four symptoms of Limited Prosocial Emotions (LPE) specifier in the DSM-5 criteria for Conduct Disorder (CD). In addition, measurement invariance of this factor structure across age (i.e., younger versus older adolescents) and sex was supported. As a result, mean differences in ICU total score across age and sex can be interpreted as reflecting true variations in these traits. Further, we documented that boys generally scored higher than girls on the ICU, and this sex difference was larger in later adolescence.

The reciprocal relations between well‐being and maternal and peer warmth in adolescents involved in the juvenile justice system

INTRODUCTION

Although justice system involvement increases the risk of negative outcomes for adolescents, many justice-involved youth desist from crime as adults (Sampson & Laub, 2005). There are few studies examining predictors of positive development in justice-involved adolescents. In the current study, we assess the influence of maternal and peer warmth on the development of well-being in adolescents involved in the US justice system over the course of 5 years.

METHODS

Participants included 1216 adolescent males who experienced their first arrest. Interviews were given every year for 5 years. Well-being was measured using the EPOCH questionnaire (Kern et al., 2016) and relationship warmth was measured using a scale adapted from Conger et al. (1994). Hypotheses were tested using latent curve models with structured residuals.

RESULTS

Baseline levels of well-being were associated with maternal (β = 0.49, p < .001) and peer warmth, β = 0.52, p < .001. When an individual's maternal warmth was higher than predicted given their maternal warmth trajectory, their subsequent well-being was higher than expected given their well-being trajectory, b = 0.07, p < .001. When an individual's peer warmth was higher than predicted, their subsequent well-being was higher than expected, b = 0.06, p < .001. These relations were reciprocal, such that well-being also predicted increased maternal and peer warmth.

CONCLUSIONS

These findings suggest that increasing maternal or peer warmth may have cascading effects on the well-being of justice-involved adolescents. Interventions for justice-involved youth may benefit from targeting factors that increase positive development for these youth.

Parent Training Adapted to the Needs of Children With Callous-Unemotional Traits: A Randomized Controlled Trial

Callous-unemotional (CU) traits designate a distinct subgroup of children with early-starting, stable, and aggressive conduct problems. Critically, traditional parenting interventions often fail to normalize conduct problems among this subgroup. The aim of this study was to test whether parent-child interaction therapy (PCIT) adapted to target distinct deficits associated with CU traits (PCIT-CU) produced superior outcomes relative to standard PCIT. In this proof-of-concept trial, 43 families with a 3- to 7-year-old child (M age = 4.84 years, SD = 1.12, 84% male) with clinically significant conduct problems and elevated CU traits were randomized to receive standard PCIT (n = 21) or PCIT-CU (n = 22) at an urban university-based research clinic. Families completed five assessments measuring child conduct problems, CU traits, and empathy. Parents in both conditions reported good treatment acceptability and significantly improved conduct problems and CU traits during active treatment, with no between-group differences. However, linear mixed-effects models showed treatment gains in conduct problems deteriorated for children in standard PCIT relative to those in PCIT-CU during the 3-month follow-up period (ds = 0.4-0.7). PCIT-CU shows promise for sustaining improvements in conduct problems for young children with conduct problems and CU traits, but requires continued follow-up and refinement.

Assessing general versus specific liability for externalizing problems in adolescence: Concurrent and prospective prediction of symptoms of conduct disorder, ADHD, and substance use

This study explored the generality versus specificity of two trait-liability factors for externalizing problems-disinhibition and callousness-in the concurrent and prospective prediction of symptoms of conduct disorder, attention-deficit/hyperactivity disorder (ADHD), and substance use (i.e., alcohol use disorder and history of illicit substance use). Disinhibition involves an impulsive, unrestrained cognitive-behavioral style; callousness entails a dispositional lack of social-emotional sensitivity. Participants were European adolescents from the multisite IMAGEN project who completed questionnaires and clinical interviews at ages 14 (N = 1,504, Mage = 14.41, 51.13% female) and 16 (N = 1,407, Mage = 16.46, 51.88% female). Disinhibition was related concurrently and prospectively to greater symptoms of conduct disorder, ADHD, and alcohol use disorder; higher scores on a general externalizing factor; and greater likelihood of having tried an illicit substance. Callousness was selectively related to greater conduct disorder symptoms. These findings indicate disinhibition confers broad liability for externalizing spectrum disorders, perhaps due to its affiliated deficits in executive function. In contrast, callousness appears to represent more specific liability for antagonistic (aggressive/exploitative) forms of externalizing, as exemplified by antisocial behavior. Results support the utility of developmental-ontogenetic and hierarchical-dimensional models of psychopathology and have important implications for early assessment of risk for externalizing problems. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Some critical considerations in applying the construct of psychopathy to research and classification of childhood disruptive behavior disorders

The recent inclusion of callous-unemotional traits in the diagnostic criteria for serious conduct problems has led to renewed interest in more comprehensive integrations of the construct of psychopathy into research and clinical classification of childhood disruptive behavior disorders. There have been a number of recent reviews of research focusing the many potential benefits for this integration. However, there are also a number of issues that could reduce these benefits and even potentially lead to harmful effects. The current paper focuses on several of these issues, some of which are common when attempting to integrate research findings across areas that have been conducted independently of each other. Other issues are more specific to the construct of psychopathy. Specifically, the current paper focuses on the lack of agreement on the necessary and sufficient dimensions needed to define psychopathy, the need to consider developmental relationships among these dimensions, the implications of the different associations among the dimensions of psychopathy with conduct problems in children and adolescents, the need to consider how these dimensions relate to existing constructs used in the classification of disruptive behavior disorders, and the potential harmful effects of labeling something "a dimension of psychopathy". These issues have several clear implications for using the construct of psychopathy to guide research on and diagnostic classification of childhood disruptive behavior disorders.

Understanding the Social Relationships of Youth with Callous-Unemotional Traits Using Peer Nominations

OBJECTIVE

The current study investigated the social and interpersonal correlates of callous-unemotional (CU) traits using peer nominations.

METHOD

Participants (N = 289) were children in Grades 3, 6, and 8 (Mage = 11.47 years, 40.1% male, 64.7% self-identified racial/ethnic minority) from two public school systems in the southern United States. Participants were asked to identify peers they believed fit a number of different characteristics hypothesized to be related to CU traits, in addition to individuals they "liked most" and "liked least." We also obtained self- and teacher ratings of CU traits and parent and teacher ratings of conduct problems (CP).

RESULTS

Factor analyses extracted three dimensions from peer nominations developed from past research describing social characteristics related to CU traits-being mean and aloof (Mean/Cold), untrustworthy and not nice (Not Nice), and dominant and manipulative (Desire for Dominance). Results indicated that CU traits were significantly associated with fewer "liked most" and greater "liked least" nominations, but not after controlling for CP. In contrast, both CP and CU traits were significantly independently associated with Mean/Cold nominations, and only CU traits were associated with Not Nice nominations when controlling for CP.

CONCLUSIONS

The findings from the current study suggest that CU traits are largely associated with traditional indices of peer rejection because of their level of CP. However, they contribute independently to perceptions of being mean, aloof, and untrustworthy. Thus, interventions focused on strengthening the social skills of children with elevated CU traits should consider ways to change these negative peer perceptions.

The Moderating Role of Maternal CU Traits in the Stability of Justice-Involved Adolescents' CU Traits

OBJECTIVE

Callous-unemotional (CU) traits are associated with chronic and severe antisocial behavior. Although previous research has found that parents play an important role in the etiology and maintenance of youth CU traits, little research has examined the extent that parents' own CU traits impact the stability of their children's CU traits. The present study investigated the moderating role of maternal CU traits on developmental changes in youth CU traits.

METHOD

A sample of 346 mother-son dyads, in which all youth were justice-involved males (Mage = 15.81; 57.80% Latino, 20.52% White, 18.21% Black, 3.47% other race/ethnicity), across three states (California, Louisiana, and Pennsylvania) completed a semi-structured interview.

RESULTS

Youth exhibited a decrease in CU traits over 30 months. Mothers' CU traits moderated this relation, such that high maternal CU traits were associated with a smaller decrease in CU traits than low or average maternal CU traits, both when considering youth CU traits continuously and using a clinically significant cut score. The findings remained for continuous CU traits even after accounting for environmental factors (i.e., maternal warmth, maternal hostility, victimization, and witnessing violence), and these environmental factors did not vary over time.

CONCLUSION

The results highlight the importance of maternal influence in understanding how youth CU traits change over time, and have important implications for the use of parenting and family-level interventions among justice-involved youth.

Impact of recreational cannabis legalization on cannabis use, other substance use, and drug-related offending among justice-system-involved youth

The present study assessed whether cannabis use, other types of substance use, and drug-related offending changed among 1216 justice-system-involved youth after recreational cannabis legalization. Using generalized estimating equation population-averaged models, we compared youth in California, where recreational cannabis is legalized, and Pennsylvania, where recreational use is still prohibited. Results indicated that cannabis use, cannabis selling, and driving under the influences (DUIs) increased more among Pennsylvanian than Californian youth. We found no changes in alcohol or noncannabis drug use after legalization. Cigarette use did not change significantly among Pennsylvanian youth, but Californian youth exhibited decreased cigarette use after legalization. Although not directly tested in the present analysis, it is possible that changes in state-level recreational cannabis policies throughout the U.S. may contribute to more permissive attitudes toward cannabis, which leads to higher use and use-related outcomes. Future research should continue to consider the potential impacts of legalization on other types of risky and illegal behavior.

Triarchic Model Traits as Predictors of Bullying and Cyberbullying in Adolescence

The triarchic model of psychopathy includes a disinhibition dimension related to externalizing outcomes, a meanness dimension pertaining to callous-unemotional traits, and a boldness dimension referring to emotional stability and high confidence in peer relationships. Some dimensions of psychopathy have been extensively investigated in samples of children and adolescents; in particular, the callous-unemotional (meanness) dimension has been associated with aggression and bullying in numerous studies. However, the other dimensions of the triarchic model have been relatively unexplored in samples of adolescents. Thus, we tested for associations between the triarchic dimensions and bullying and cyberbullying behaviors (i.e., proactive, goal-directed, and repetitive aggressive behaviors) in a sample of 580 high school students aged 14 to 19 years. Logistic regression analyses showed that (a) meanness and disinhibition scores were uniquely associated with traditional bullying, whereas only meanness was uniquely associated with cyberbullying; (b) boldness scores moderated the relationship between disinhibition and cyberbullying, such that disinhibition was related to cyberbullying only at low levels of boldness; and (c) these patterns were maintained when accounting for overall levels of conduct problems and were not moderated by the experience of victimization. Our findings suggest that the triarchic model of psychopathy can contribute to an understanding of youth engagement in bullying and cyberbullying.

The associations of maternal warmth and hostility with prosocial and antisocial outcomes in justice-involved adolescents

Parental warmth and hostility are two key dimensions of parenting for child development, but the differential effects of these parenting dimensions on child prosocial and antisocial development has not been adequately investigated. The current study hypothesized that parental warmth would be uniquely related to child callous-unemotional traits and prosocial behavior, whereas parental hostility would be uniquely related to child delinquency and aggression. These hypotheses were investigated in a diverse sample of 1,216 adolescent males (13 to 17 years old, 46% Latino, 37% Black) with justice-system involvement in the 5 years following their first arrest. Hybrid models estimated within- and between-individual associations over time, while controlling for the overlap between parental warmth and hostility and between child prosocial and antisocial outcomes. Results indicated that maternal warmth showed consistent associations with callous-unemotional traits and prosocial behavior over time, whereas maternal hostility showed consistent associations with delinquency and aggression over time. Further, the findings were similar across racial and ethnic groups. Implications for developmental models of antisocial behavior, particularly for those including the role of callous-unemotional traits, are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Still connecting the dots: An investigation into infants' attentional bias to threat using an eye-tracking task

An attentional bias toward threat has been theorized to be a normative aspect of infants' threat and safety learning, and an indicator of risk for internalizing psychopathology in older populations. To date, only four studies have examined this bias using the dot-probe task in infancy and the findings are mixed. We extended the literature by examining patterns of attention to threat in a culturally and linguistically diverse sample of infants aged 5-11 months old (N = 151) using all measures previously employed in the infant dot-probe literature. Given that an attentional bias toward threat is associated with higher risk of developing anxiety disorders later in life, we also examined how negative affect-an early correlate of later anxiety disorders-is related to attentional bias toward threat in infancy. This study was the first to use a consistent measure of negative affect across the whole sample. An eye-tracking dot-probe task was used to examine attentional bias toward threat (i.e., angry faces) relative to positive (i.e., happy faces) stimuli. Results showed that an attention bias to threat was not characteristic of infants at this age, and negative affect did not moderate the putative relationship between attention and emotional faces (angry, happy). These findings therefore suggest that attention biases to socio-emotional threat may not have emerged by 11 months old.

A Within-Individual Examination of the Predictors of Gun Carrying During Adolescence and Young Adulthood Among Young Men

Although prior studies have identified several risk factors for gun carrying, no prior longitudinal studies have examined a comprehensive set of explanatory factors together in within-individual change models or examined whether the predictors of gun carrying change across adolescence and early young adulthood. The present study fills these gaps by examining the predictive utility of several risk factors for gun carrying, and by examining whether any of the associations vary by age. The sample included 1216 young men who were arrested for the first time during adolescence (approximately 15 years old) and interviewed regularly for 5 years (until approximately 20 years old) after the first arrest. The outcome was youth-self-reported gun carrying and the risk factors included several variables consistent with various explanations for gun carrying (psychosocial maturity deficits; antisocial behavioral style; socialization; victimization). Research questions were addressed with fixed effects dynamic panel models (within-individual change models). Results showed that the most robust predictors of gun carrying were increased exposure to guns and gun-related violence and increased engagement in other antisocial and illegal behavior. The results emphasize the specific etiology of gun carrying and the potential social contagion effect of gun-related events. Overall, the study points to the need for prevention and intervention programs to specifically target the reduction of the real and perceived prevalence of gun-related events in young men's lives.

Developing Cutoff Scores for the Inventory of Callous-Unemotional Traits (ICU) in Justice-Involved and Community Samples

Objective: The recent addition of the callous-unemotional (CU) traits specifier, "with Limited Prosocial Emotions (LPE)," to major classification systems has prompted the need for assessment tools that aid in the identification of elevations on these traits for diagnostic purposes. The goal of the current study was to use and evaluate multiple methods for establishing cutoff scores for the multi-informant questionnaire, the Inventory of Callous-Unemotional Traits (ICU).Method: The present study compared the clinical utility of various proposed cutoff methods and scores (i.e., empirically derived cutoffs using receiver operating characteristic (ROC), normative cutoffs, and rational scoring approximations of LPE criteria) in both a longitudinal sample of justice-involved male adolescents (N = 1,216; M_age = 15.29, SD = 1.29) and a cross-sectional sample of school children (N = 289; M_age = 11.47 years; SD = 2.26).Results: Methods resulted in a range of cutoff scores with substantial diagnostic overlap and validity. Specifically, they designated justice-involved adolescents at risk for later delinquency, aggression, and rearrests, and they designated school children more likely to be rated by parents and teacher as having conduct problems and rated by peers as being rejected and mean.Conclusions: The results lead to ranges of ICU scores that have support for their validity and can help to guide clinical decisions about children and adolescents who may be elevated on CU traits.

Editorial: Testing the Validity of the Limited Prosocial Emotions Specifier

Colins et al.¹ address a timely and important topic. Specifically, both the DSM-5 and the International Classification of Diseases, 11th edition (ICD-11) for the first time introduced a specifier (ie, with limited prosocial emotions) for the diagnosis of conduct disorder (DSM-5) or for the diagnoses of conduct-dissocial and oppositional defiant disorders (ICD-11) to designate those persons with these disorders who also show elevated levels of callous-unemotional (CU) traits. This change was based on research showing that children and adolescents with significant conduct problems who also show elevated levels of CU traits seem to be an etiologically and clinically important subgroup of persons with these disorders.^2,3 The DSM-5 chose not to conduct field trials to test the validity of new diagnoses (only reliability) and, instead, considers research on new diagnoses as the field trials for future revisions of the manual.⁴ Thus, the work by Colins et al.¹ is critical for this validation process. The study by Colins et al. has a number of methodological features that make their results particularly informative.¹ The most notable feature was the use of a large nonreferred sample that was followed from 3 to 5 years of age to 11 to 13 years of age with a high retention rate. The authors also provide a nice summary of past attempts to validate the LPE specifier, which has provided mixed support at best. However, they also note that most of these studies did not use the full criteria for the LPE specifier and that this is an important limitation that Colins et al. overcome, especially given that the criteria include only 4 symptoms. Thus, the authors' findings that children with the LPE specifier and serious conduct problems exhibited more conduct disorder (CD) symptoms and comorbid problems (ie, fearlessness, symptoms of oppositional defiant disorder, and attention-deficit/hyperactivity disorder [ADHD]) and were at higher risk for future CD symptoms 3 years later are critical advances.

Exploring Disproportionate Minority Contact in the Juvenile Justice System Over the Year Following First Arrest

Minority youth are disproportionately represented in the juvenile justice system. Examining how racial disparities relate to biased entry into and continued involvement with the system, while accounting for past and current offending, can provide context about the mechanisms behind overrepresentation. 1,216 adolescents were examined after first arrest to explore associations between race and history of self-reported offending, likelihood of formal processing, and likelihood of rearrest. Black youth committed fewer offenses prior to arrest than White youth, Black and Latino youth were more likely to be formally processed, and Black youth were most likely to be rearrested (even controlling for postbaseline offending), highlighting that minority youth are overrepresented in the juvenile justice system despite similar or lower levels of criminal behavior.

Neighborhood Disorder and Risk-Taking Among Justice-Involved Youth-The Mediating Role of Life Expectancy

Neighborhood disorder has been linked to perceptions of shorter life expectancies, and shorter life expectancies have been associated with greater risk-taking. Yet, no studies have combined these two pathways. Using data from the longitudinal Crossroads study, the present study assessed whether life expectancy mediates the association between neighborhood disorder and risk-taking-substance use, crime, and risky sex-among 1,093 justice-involved adolescents. Results indicate that neighborhood disorder was linked to lower estimated life expectancy which in turn related to higher rates of cigarette use, binge drinking, illicit drug use, offending, and casual sex. However, life expectancy did not explain the association between neighborhood disorder and marijuana use or inconsistent condom use.

Assessing the Association between Participation in Extracurricular Activities and Delinquent Behavior among Justice-Involved Young Men

Extracurricular activities (ECAs) have been found to promote positive youth development and protect against misconduct and minor delinquency. However, little research has examined whether ECA participation predicts delinquency among at-risk young men or considered how delinquent behavior, in turn, impacts ECA participation. This study examined extracurricular participation over three years in a sample of 1,216 justice-involved young men (M_age  = 15.29). Approximately half of the sample participated in ECA each year. A cross-lagged panel model was used to examine the bidirectional association between ECA participation and two types of delinquency, school misconduct and criminal offending. The results suggest that ECA participation did not consistently predict subsequent delinquency. Rather, justice-involved young men who engaged in more delinquency were less likely to participate in ECAs.

Exposure to Gun Violence: Associations with Anxiety, Depressive Symptoms, and Aggression among Male Juvenile Offenders

Objective: To examine whether at-risk male youth experience increases in anxiety, depressive symptoms, and aggression during years when they are exposed to gun violence, adjusting for relevant covariates.Method: Participants were 1,216 male, justice-involved adolescents who were recently arrested for the first time for a moderate offense. They were interviewed 9 times over 5 years. Fixed effects (within-individual) regression models were used to estimate concurrent associations between exposure to gun violence and three outcomes: depressive symptoms, anxiety symptoms, and aggression (both overall and separately for proactive and reactive aggression). The reverse direction (anxiety, depressive symptoms, and aggression predicting gun violence exposure) was also modeled.Results: After controlling for covariates, exposure to gun violence was significantly associated with increases in reactive aggression and, to a lesser extent, increases in proactive aggression. In addition, gun violence exposure was associated with increased anxiety but not depressive symptoms. We found no support for the reverse direction.Conclusions: At-risk males experienced significant increases in anxiety and aggression (particularly reactive aggression) during years when they are exposed to gun violence, even after accounting for several potential confounding factors. The greater impact on reactive aggression suggests that exposure to gun violence may affect self-regulation and/or social information processing. The analyses shed light on the less-visible damage wrought by gun violence and underscore the importance of mental health screening and treatment for youth who have been exposed to violence - especially gun violence - both to assist individual youths and to disrupt cycles of violence.

Moderators of Psychosocial Intervention Response for Children and Adolescents with Conduct Problems

Objective: The purpose of this Brief Report is to synthesize the current evidence base examining moderators of psychosocial intervention response for children and adolescents with conduct problems (CP). We also provide directions for future research.Method: We focused on four categories of psychosocial interventions for the prevention and/or treatment of CP: (1) parent management training (PMT) for children, (2) other family-based interventions for adolescents, (3) youth skills training, and (4) multicomponent interventions (i.e., family-based intervention plus skills training). Emphasis is placed on findings from meta-analyses.Results: Moderation analyses have occurred more frequently for PMT than for other types of interventions. Variables for which there was consistent evidence for positive moderation included higher initial severity of CP, father engagement, higher maternal depressive symptoms, individual administration (vs. group), and treatment/targeted prevention approaches (vs. universal prevention). Variables where there was evidence for no moderation (demonstrating generalizability) included child diagnostic status and family risk in PMT, and diagnostic status and intervention setting for skills training. However, for some variables, evidence of moderation was dependent on intervention type.Conclusions: Future research should examine multiple moderators in combination; incorporate innovative techniques such as integrative data analyses, individual participant data, and class-based modeling, which may identify moderator effects that are undetected by more traditional variable-oriented moderation analyses; and conduct moderated mediation models for informing developmental theory on the interplay of risk and protective factors.

Commentary: Implications for future research on the genetic and environmental causes of callous-unemotional traits - a commentary on Takahashi et al (2020)

Takahashi et al. (2020) showed that CU traits at age 7 were highly heritable, that the genetic influences underlying the course of CU traits from age 7 to 16 were largely independent from those underlying the initial level, and that the genetic influences on CU traits in early childhood were substantially different from the genetic influences on these traits in adolescence. This commentary on these important and provocative findings focuses on their implications for future research. Specifically, it notes that future studies attempting to find genetic loci related to CU traits need to consider that such loci may differ depending on the age of the sample and this research needs to consider several important considerations when measuring CU traits that can influence the results. Further, the results of Takahashi et al highlight the importance of environmental influences on the stability of CU traits that could play an important role in treatment.

Do callous-unemotional traits moderate the effects of the juvenile justice system on later offending behavior?

BACKGROUND

Research suggests that callous-unemotional (CU) traits, a recent addition to psychiatric classification of serious conduct problems, may moderate the influence of a number of contextual factors (e.g., parenting, deviant peer influence) on an adolescent's adjustment. The current study sought to replicate past research showing that formal processing through the juvenile justice system increases recidivism and tested the novel hypothesis that CU traits would moderate the relationship between processing decision and future antisocial behavior.

METHODS

A diverse sample of first-time male offenders (N = 1,216; M age = 15.12, SD = 1.29) in three regions of the United States was assessed within 6 weeks of their first arrest and then at 6-month intervals for 36 months.

RESULTS

Compared to those who were informally processed (i.e., diverted), adolescents formally processed through the court were at a higher risk of self-reported offending and rearrests as measured by official records, after controlling for preexisting risk factors. However, baseline CU traits moderated this association such that those with high CU traits reported offending at high rates across the subsequent three years regardless of how the juvenile justice system processed their case.

CONCLUSIONS

CU traits are important to psychiatric classification for designating a subgroup of antisocial youth who may respond differently to contextual influences, including being less susceptible to the negative effects of juvenile justice system involvement. The public health significance of this moderation is significant by suggesting that previous estimates of the harmful impact of formal processing by the juvenile justice system may underestimate its impact, given that the majority of arrested adolescents have normative levels of CU traits.

Conduct Disorders and Empathy Development

Childhood conduct disorders, a serious mental health concern, put children at risk for significant mental health problems throughout development. Elevations on callous-unemotional (CU) traits designate a subgroup of youth with conduct disorders who have unique causal processes underlying their problem behavior and are at a particularly high risk for serious impairment relative to others with these disorders. As a result, these traits have recently been integrated into major diagnostic classification systems for conduct disorders. Given that CU traits are partly defined by deficits in empathy, we review research on empathy development in typically developing children and use this research to (a) advance theories on the specific emotional deficits that may be associated with CU traits, (b) explain the severe pattern of aggressive behavior displayed by children with elevated CU traits, and (c) suggest possible ways to enhance prevention and treatment for children with conduct disorders and elevated CU traits.

Callous-Unemotional Traits and Risk of Gun Carrying and Use During Crime

OBJECTIVE

With the addition of the "with limited prosocial emotions" specifier within the diagnosis of conduct disorder (DSM-5) and of conduct-dissocial disorder (ICD-11) to designate those with elevated callous-unemotional traits, the authors examined the role that callous-unemotional traits play in the risk for gun carrying and gun use during a crime in a sample at high risk for gun violence.

METHODS

Male juvenile offenders (N=1,215) from three regions of the United States were assessed after their first arrest and then reassessed every 6 months for 36 months and again at 48 months. Callous-unemotional traits and peer gun carrying and ownership were measured via self-report after the first arrest (i.e., baseline). Gun carrying and use of a gun during a crime were self-reported at all follow-up points.

RESULTS

Callous-unemotional traits at baseline increased the frequency of gun carrying and the likelihood of using a gun during a crime across the subsequent 4 years after accounting for other risk factors. Furthermore, callous-unemotional traits moderated the relationship between peer gun carrying and ownership and participant gun carrying, such that only participants low on callous-unemotional traits demonstrated increased gun carrying as a function of their peers' gun carrying and ownership.

CONCLUSIONS

This study demonstrates the importance of considering callous-unemotional traits in gun violence research both because callous-unemotional traits increase gun carrying and use in adolescents and because the traits may moderate other key risk factors. Notably, the influence of peer gun carrying and ownership may have been underestimated in past research for the majority of adolescents by not considering the moderating influence of callous-unemotional traits.

Psychometric Properties of a Semistructured Interview to Assess Limited Prosocial Emotions

Callous-unemotional (CU) traits have recently been added to the diagnostic criteria of Conduct Disorder in the Diagnostic and Statistical Manual of Mental Disorders-Fifth edition and of conduct-dissocial and oppositional defiant disorders in the International Classification of Disease-Eleventh edition as the limited prosocial emotions specifier. This change necessitates the assessment of these traits with validated measures in both research and clinical contexts. The current study sought to validate a semi-structured diagnostic interview method, the Michigan Limited Prosocial Emotion Addendum (M-LPE) to the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version, of assessing CU traits based on a recently developed clinician rating system (Clinical Assessment of Prosocial Emotions, Version 1.1) in a sample of at-risk youth. Results supported the interrater reliability of the M-LPE with moderate agreement and high reliability between raters. The M-LPE demonstrated convergent and incremental validity with CU traits and various measures of antisocial behavior. The results provide preliminary evidence for the use of a semi-structured interview assessment of CU traits in research contexts and build the foundation for further validation.

Marijuana Use Among Justice-Involved Youths After California Statewide Legalization, 2015-2018

Objectives. To determine the impact of California's recreational marijuana legalization on marijuana use among justice system-involved (JSI) adolescents and young adults, and to distinguish whether any changes resulted from legalization (passing the law) or from implementation of the law.Methods. We compared changes in JSI youths' marijuana use in 2 states: California (n = 504), where recreational marijuana use was recently legalized, and Pennsylvania (n = 478), where recreational use is still prohibited. Furthermore, we examined changes in marijuana use across 3 key time periods (October 2015-June 2018): before legalization, after legalization but before implementation, and after implementation.Results. California JSI youths did not demonstrate a significant increase in marijuana use after legalization (b = -0.010; P = .950) or implementation (b = -0.046; P = .846). However, in Pennsylvania, rates of marijuana use increased significantly after legalization (b = 0.602; P = .001) but not after implementation (b = 0.174; P = .533).Conclusions. Although recreational marijuana legalization was not associated with changes in marijuana use among youths in California, we observed increased rates of use in Pennsylvania after legalization in California. Recreational marijuana laws may be indirectly related to youths' marijuana use by supporting more permissive national attitudes toward marijuana.

Mapping the Specific Pathways to Early-Onset Mental Health Disorders: The "Watch Me Grow for REAL" Study Protocol

BACKGROUND

From birth, the human propensity to selectively attend and respond to critical super-stimuli forms the basis of future socio-emotional development and health. In particular, the first super-stimuli to preferentially engage and elicit responses in the healthy newborn are the physical touch, voice and face/eyes of caregivers. From this grows selective attention and responsiveness to emotional expression, scaffolding the development of empathy, social cognition, and other higher human capacities. In this paper, the protocol for a longitudinal, prospective birth-cohort study is presented. The major aim of this study is to map the emergence of individual differences and disturbances in the system of social-Responsiveness, Emotional Attention, and Learning (REAL) through the first 3 years of life to predict the specific emergence of the major childhood mental health problems, as well as social adjustment and impairment more generally. A further aim of this study is to examine how the REAL variables interact with the quality of environment/caregiver interactions.

METHODS/DESIGN

A prospective, longitudinal birth-cohort study will be conducted. Data will be collected from four assessments and mothers' electronic medical records.

DISCUSSION

This study will be the first to test a clear developmental map of both the unique and specific causes of childhood psychopathology and will identify more precise early intervention targets for children with complex comorbid conditions.

Intimate Partner Violence Perpetration and Psychopathy: A Comprehensive Review

Abstract. Intimate partner violence (IPV) is the physical, sexual, and psychological abuse of an intimate partner and is a widespread, international public health crisis. An important proximate risk factor for IPV perpetration is the presence of psychopathic traits but there has not been a systematic review of the research linking psychopathic traits to IPV perpetration. We identified 43 studies using 13,476 participants (9,024 men and 4,452 women) across 10 countries that met our search criteria that led to the following conclusions. First, psychopathy was associated with IPV perpetration with medium effect sizes, even after accounting for various distal and proximate risk factors. Second, the different dimensions of psychopathy did not consistently differ in their prediction of IPV perpetration. Third, within individuals with a history of IPV perpetration, psychopathy did not relate to the frequency or severity of partner violence. Fourth, a few studies have tested the associations among child abuse, psychopathy, and IPV, with one study reporting that the combination of child abuse and psychopathic traits led to especially high risk for IPV perpetration. Lastly, we conclude by making recommendations for how future research and interventions should consider psychopathy to reduce the societal burden of IPV.

Risky Sexual Behavior among Arrested Adolescent Males: The Role of Future Expectations and Impulse Control

The current study evaluates two predictors of adolescent sexual risk-taking, specifically whether impulse control or future expectations predict condom use and casual sex. We examine whether risky sex occurs among youth who tend to act without thinking about the future, or instead, youth who report low future expectations. We consider these relations longitudinally among a sample of sexually active justice-involved adolescent males (N = 752, M age = 15.58) a group at heightened risk for sexual risk-taking. We found that optimistic expectations for the future predict a higher likelihood of engaging in consistent condom use, whereas high impulse control is related to a lower likelihood of casual sex. Implications for intervention and research on positive sexual health are discussed.

ParentWorks: Evaluation of an Online, Father-Inclusive, Universal Parenting Intervention to Reduce Child Conduct Problems

Evidence-based parenting interventions are effective in reducing conduct problems, yet these interventions have limited reach, and few involve the participation of fathers. This paper describes the outcomes of an open trial of ParentWorks, a universal, online, father-inclusive parenting intervention aiming to decrease childhood behavioural problems and promote positive parenting in mothers and fathers. A total of 388 families (456 individual parents; 36.6% fathers) were included in the study. Mixed model analyses showed significant decreases in child emotional/behavioural problems, dysfunctional parenting, interparental conflict, and parental mental health problems. The baseline severity of child behavioural problems significantly moderated the effects on child outcomes so that children with higher levels of problems benefitted more from the program. Participation of both caregivers in two-parent families, as well as parent sex, did not significantly affect the program outcomes. Results provide initial empirical support for the universal, self-directed, online parenting intervention, in addressing both child behavioural problems and parenting outcomes. Trial registration: ACTRN12616001223426, registered 05/09/2016.