Psychopathy and Anxiety in Children and Adolescents: New Insights on Developmental Pathways to Offending

Proposed Specifiers for Conduct Disorder (PSCD) scale: A Latent Profile Analysis with At-Risk Adolescents

The Proposed Specifiers for Conduct Disorder (PSCD; Salekin in Pers Disord: Theory Res Treat 7:180-191, 2016) scale was designed to assess interrelated psychopathic trait domains in conjunction with symptoms of Conduct Disorder (CD) in children and adolescents (i.e., grandiose-manipulative, callous-unemotional, daring-impulsive). Variable-centered studies have provided support for a four-factor PSCD structure (Salekin et al. in Psychol Assess 34(10):985-992, 2022) in line with other adolescent and adult studies. The current person-centered study used latent profile analysis of the PSCD domains to examine whether theoretically meaningful and empirically robust PSCD subtypes emerged from a diverse sample (70.9% White, 20.1% Black, 3.6% Hispanic, and 5.4% other) of adolescents (modal age = 17) in a military style residential facility (N = 409; Males = 80.6%). As hypothesized, a four-class solution was best, consistent with adult psychopathy subtyping research (Hare et al. in Handbook of Psychopathy 39-79, 2018; Roy et al. in Pers Disord: Theory Res Treat, in press). The PSCD subtype profiles were uniform across sex and race/ethnicity. Adolescents evincing a psychopathic trait propensity profile (elevated on all four PSCD domains) displayed the greatest number of arrests and higher overall externalizing psychopathology, compared to the other three latent classes, as well as higher internalizing psychopathology compared to adolescents with general delinquency. The PSCD provides a sound measure of psychopathic trait propensities in youth and our results offer investigators and clinicians a means for understanding person-centered psychopathic traits versus antisocial profiles among at-risk adolescents. Taken together, the current results may offer a viable approach for examining specific treatment targets based on PSCD subtype profiles.

Skin Conductance Responses to a Discrete Threat in Virtual Reality: Associations with Psychopathy and Anxiety

People with high levels of psychopathic traits are often described as fearless and lacking in emotional depth, particularly when evaluating threats in their environments. Skin conductance responsivity (SCR) to negative emotional stimuli represents a robust autonomic correlate of conduct problem behavior in children (Fanti et al., in Neuroscience and Biobehavioral Reviews, 100, 98-107, 2019). However, studies that have examined threat-related processing in youth with conduct problems have tended to use a variety of negative stimuli that might induce various and unspecific negative emotions. Few studies have taken in to account the moderating effects of anxiety on the relationship of distinct psychopathic traits (e.g., narcissism, callousness, impulsivity) with SCR to a fear inducing stimulus. In this study, we examined SCR to a virtual reality rollercoaster drop - that is, a discrete fear inducing event - in a sample of 75 youths (61 males; M = 14 years, SD = 1.4) enrolled in a non-mainstream school. The rollercoaster drop was used to more clearly examine an event-related response to a discrete threat, rather than examining SCR throughout the rollercoaster ride. We used the teacher-reported Antisocial Process Screening Device (Frick & Hare, in Antisocial process screening device: APSD. Toronto: Multi-Health Systems, 2001) to examine the relations of distinct psychopathic traits with SCR and self-reported anxiety. Lower anxiety was associated with higher callousness, but only in youths with low SCR to discrete threat. These findings suggest that fear and anxiety show complex and interactive relations with distinct psychopathic traits.

Fearless but anxious? A systematic review on the utility of fear and anxiety levels to classify subtypes of psychopathy

Psychopathic traits have been linked to anomalies in experiencing fear and anxiety. It remains unclear, however, to what extent fear and anxiety levels are useful parameters to effectively distinguish between subtypes of psychopathy. Therefore, we aimed to elucidate whether different psychopathic phenotypes (primary and secondary psychopathy) can be delineated based on fear/anxiety levels. To investigate associations between psychopathic traits and conscious experiences of fear and/or anxiety a systematic qualitative review of studies was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Seventeen studies were included in the review. We found some evidence for attenuated fear/anxiety levels in primary psychopathy. In secondary psychopathy, the experience of fear/anxiety seemed rather intact. Moreover, primary psychopathy might be associated with a more positive appraisal of the conscious feeling of fear. We reason that consciously experienced fear and anxiety are distinctly related to primary and secondary psychopathy. Due to a lack of consistent and comprehensive operationalizations of fear and anxiety, however, conclusions about their potential to differentiate psychopathic subtypes should be drawn with caution.

Further Evaluation of the Associations Between Psychopathic Traits and Symptoms of PTSD and Depression in a Nonclinical Sample

Examining psychopathic traits at the factor or facet level has revealed that various aspects of psychopathy may be differentially related, even in opposing directions, to important outcomes (e.g., intelligence, emotion regulation). Empirical work on relations between psychopathy and internalizing disorders, such as posttraumatic stress disorder (PTSD) and depression, has provided evidence for a positive association with antisocial traits. However, findings for the affective domain have been more equivocal. The current study (N = 732) sought to replicate past findings of the positive association of antisocial psychopathic traits with higher levels of PTSD and depressive symptoms, and to further explore associations between affective traits of psychopathy and these disorders using two measures of psychopathy. Results confirmed prior findings of a positive correlation between antisocial features and self-reported PTSD/Depression symptom severity, but they did not provide evidence for any association with affective traits. Future research using longitudinal designs is needed to begin establishing temporal ordering of the psychopathy-internalizing relationship.

The Validity of the Personality Assessment Inventory-Adolescent in Assessing Callous-Unemotional Traits in At-Risk Adolescents

This study examines the validity of the Personality Assessment Inventory-Adolescent (PAI-A; Morey) in assessing callous-unemotional (CU) traits within two independent samples of at-risk adolescents from a residential intervention program. The study tests the extent to which CU traits are represented within PAI-A scales with respect to empirically- or theoretically-related indicators, such as antisociality, aggression, low warmth, low social connectedness, and subdued internalizing psychopathology. The PAI-A substantive scales statistically accounted for an average of 55.0% of the variance in total scores on the Inventory of Callous-Unemotional Traits (ICU; Frick) across samples. Broadly, PAI-A substantive scales evinced theoretically-consistent relations with CU traits. Consistent with expectations, CU traits were broadly related to PAI-A-assessed constructs of antisocial features, aggression, low warmth and social disconnection, but not to subdued internalizing symptoms. Moreover, some of the PAI-A clinical, treatment consideration, and interpersonal scales or subscales demonstrated differential relations across the traits. Implications for assessment of CU traits using the PAI framework are discussed. Overall, this research adds to the literature on CU traits in broadband personality assessment and provides a foundation for future research on CU traits using the PAI-A.

Psychopathy and Corticostriatal Connectivity: The Link to Criminal Behavior in Methamphetamine Dependence

Methamphetamine use and psychopathy are associated with criminal behavior; however, it is unclear how methamphetamine use and psychopathy interact to promote violent, economic and drug offenses. Abnormalities in corticostriatal functional connectivity are exhibited in both psychopathic and methamphetamine dependent individuals, which may contribute to criminal behavior through maladaptive and impulsive decision-making processes. This study shows that psychopathic traits contribute to weaker corticostriatal connectivity in methamphetamine dependence and contributes to an increase in criminal behavior. As the propensity to engage in criminal activity is dependent on a number of factors, a hierarchical regression identifies the contribution of the impulsive antisocial domain of psychopathy, anxiety, years of methamphetamine use and corticostriatal connectivity on different types of criminal offenses. Methamphetamine use and psychopathic traits reduce treatment responsiveness and increase the likelihood of recidivism, and it is therefore important to understand the factors underlying the propensity to engage in criminal behavior.

An Evolutionary Model to Conceptualize Psychopathic Traits Across Community and Forensic Male Youth

Psychopathy has been historically associated with a lack of emotion. However, some authors argue that psychopathy may represent a tendency to externalize the experience of unpleasant emotions, including shame, what could be seen as an adaptive strategy within an evolutionary framework. Nevertheless, empirical research investigating this hypothesis is scarce. Using community (n = 295) and forensic (n = 300) male youth samples and a set of self-report measures, this study tested an evolutionary model involving pathways linking the impact of harsh rearing experiences (traumatic shameful experiences and warmth and safeness experiences) to psychopathic traits, as well as the indirect effects of external shame and shame coping strategies in that association. In addition, this study tested the invariance of this model across samples. Results indicated that the impact of harsh rearing experiences was directly and indirectly (through external shame and shame coping strategies) linked with psychopathic traits. The model explained psychopathic traits in forensic and community samples, though differences in some of the pathways were found across groups. Findings offer support for conceptualizing psychopathic traits as an adaptive strategy to cope with the impact of harsh rearing experiences, opening new pathways to prevention and intervention efforts.

Unmasking the Association between Psychopathic Traits and Adaptive Functioning in Children

The appearance of positive adjustment is a theoretically relevant element of psychopathy, and is valuable for demonstrating its incremental validity over a broader antisocial orientation. We examined associations between psychopathic-like features and two measures of adaptive functioning: psychometric intelligence and (immunity to) internalizing problems. Ratings of psychopathy and behavioral problems were obtained in a community sample of children (N=1210). A bifactor model was fit to the psychopathic personality items to capture the underlying variance common to all traits (i.e., general factor) and to isolate a unique cluster of interpersonal traits. We hypothesized that the general psychopathy factor and specific interpersonal factor would exhibit opposing patterns of associations with external criteria. As expected, the general psychopathy factor was associated with greater anxiety/depression and lower cognitive ability. Contrary to hypothesis, the interpersonal factor was not associated with adaptive functioning (i.e., reduced internal distress or superior cognitive ability), although the predicted relations emerged after controlling for antisocial behavior. Hence, in a large representative sample of children, there is limited support for the premise that psychopathic traits are associated with positive adjustment and enhanced intelligence. Implications regarding the construct validity of psychopathy are discussed, including the role of heterogeneity in sample characteristics and instrument.

Psychopathic Personality Works Better than CU Traits for Predicting Fearlessness and ADHD Symptoms among Children with Conduct Problems

Children with early-onset conduct problems (CP) are at great risk for future behavior problems, and this risk seems to increase when CP co-occur with psychopathic traits. Even though studies are indicating that the entire psychopathic personality construct may be more useful in designating a meaningful subgroup of children with CP, research on psychopathic traits and CP in childhood have mainly focused on the role of callous unemotional (CU) traits. Prospective longitudinal data of 1867 3- to 5-year-olds (47% girls) followed annually for two years was used to compare groups of children with different combinations of CP and psychopathic traits on fearlessness and Attention-Deficit Hyperactivity Disorder (ADHD) symptoms. Children with CP and psychopathic personality had higher baseline and stable levels of ADHD symptoms than children with CP only or children with CP and concurrent CU traits, while baseline levels of fearlessness did not differ. They were also more likely to display stable levels of the risky combination of CP and ADHD symptoms. Results were similar for boys and girls. Findings indicate that there are reasons to consider other traits and behaviors as specifiers for subgroups of children with CP over and above CU traits, in order to optimize both diagnostic practice and treatment outcomes.

Attention-deficit/hyperactivity disorder and callous-unemotional traits as moderators of conduct problems when examining impairment in emerging adults

This study examines attention-deficit/hyperactivity disorder (ADHD) and callous-unemotional (CU) traits as moderators of the association between conduct problems (CP) and young adult functioning. Young adults (n = 283; Mage = 20.82 years; 53.4% female), oversampled for attention and behavior problems, provided self-ratings of ADHD, CP, and CU, and adaptive functioning and psychopathology. ADHD and CU simultaneously moderated relationships between CP and family functioning, tobacco use, and internalizing symptoms. In addition, ADHD moderated the relation between CP and job functioning, and main effects of ADHD in the expected direction were found for educational performance and drug use. CU was associated with poorer educational outcomes. Interestingly, no ADHD, CU, or CP effects were observed for reported alcohol use. Our results highlight the importance of considering ADHD and CU in understanding the impact of CP on young adult functioning and psychopathology, and point to the importance of continued work on this topic.

Troubled or Traumatized Youth? The Relations Between Psychopathy, Violence Exposure, Posttraumatic Stress Disorder, and Antisocial Behavior Among Juvenile Offenders

The current study examined how psychopathy, exposure to violence, and posttraumatic stress disorder (PTSD) are associated with antisocial behavior among 1,354 serious delinquent adolescents from the Pathways to Desistance study. Results showed that psychopathy, violence exposure, and PTSD are independently linked to self-reported involvement of delinquency, even after controlling for respondents' demographic characteristics. However, the effect of PTSD on antisocial behavior was small. Differential associations were observed between the 2 factors of psychopathy, interpersonal/affective and social deviance, and PTSD symptoms. Specifically, the effect of social deviance characteristics on delinquency was above and beyond that of interpersonal/affective features. In addition, exposure to violence as a victim or witness were uniquely associated with increased delinquent behavior. Findings clarified the relations among psychopathy, violence exposure, PTSD, and antisocial behavior, and highlighted the differential links between psychopathy factors and delinquency.

Validity of the Youth Psychopathic Traits Inventory-Short Version in Justice-Involved and At-Risk Adolescents

The current study examined the reliability and validity of the Youth Psychopathic Traits Inventory-Short Version (YPI-S) in two different samples of at-risk adolescents enrolled in a residential program ( n = 160) and at a detention facility ( n = 60) in the United States. YPI-S scores displayed adequate internal consistency and were moderately associated with concurrent scales on other self-report psychopathy measures and externalizing behaviors. YPI-S scores were moderately related to interviewer-ratings of the construct using the four-factor model of the Psychopathy Checklist: Youth Version. Findings suggest that the YPI-S may be a clinically useful and valid tool for the assessment of psychopathic traits in juvenile settings. This may be particularly true given the differential predictive utility of each of its dimensions.

Anxiety Symptoms and Coping Motives: Examining a Potential Path to Substance Use-Related Problems in Adolescents With Psychopathic Traits

BACKGROUND

Although the relation between impulsive-irresponsible psychopathic traits and substance use is well-documented, the path to developing substance use problems is less understood in adolescents with these characteristics.

OBJECTIVES

To examine the associations between psychopathy, anxiety, and substance use motives and a mechanism by which anxiety and alcohol and marijuana coping motives mediate the relation between psychopathic traits and substance use-related problems.

METHODS

A sample of 185 at-risk adolescent males from a residential military-style program reporting past alcohol or marijuana use (M age = 16.74) participated in the study.

RESULTS

Impulsive-Irresponsible psychopathic traits were uniquely and incrementally predictive of alcohol and marijuana use-related problems and anxiety. Anxiety and coping motives appeared to partially explain the association between impulsivity-irresponsibility and substance use-related problems.

CONCLUSIONS/IMPORTANCE

Findings suggest that youth expressing impulsive-irresponsible psychopathic traits may engage in problematic substance use at least partly as a function of heightened anxiety and a subsequent desire to alleviate distress by using alcohol or marijuana to cope.

The Social Anxiety Scale for Adolescents: Measurement Invariance and Psychometric Properties Among a School Sample of Portuguese Youths

Over the last decades there has been an increased interest in assessing social anxiety in adolescents. This study aims to validate the Social Anxiety Scale for Adolescents (SAS-A) to Portuguese youth, and to examine its invariance across gender as well as its psychometric properties. The participants were 782 Portuguese youths (371 males, 411 females), with an average age of 15.87 years (SD = 1.72). The results support the original three-factor structure of the SAS-A, with measurement invariance being found across gender, with females scoring higher than males on two subscales. High levels of internal consistency were found. Positive associations with empathy demonstrated that high socially anxious adolescents have elevated empathy tendencies. Mostly null or low negative associations were found with measures of psychopathic traits, callous-unemotional traits and aggression. Study findings provide evidence that the SAS-A is a psychometrically sound instrument that shows measurement invariance between genders, good reliability and positive correlations with empathy.

Psychopathy, depression, and anxiety as predictors of suicidal ideation in offenders

Compared to nonoffenders, offenders are at increased risk for suicidal ideation and psychopathy. However, literature currently lacks sufficient understanding of moderating pathways linking psychopathy to suicidal ideation among offenders. This study investigated anxiety and depressive symptoms as potential moderators using a sample of 162 male offenders in the New Jersey correctional system. Results supported a significant positive correlation between secondary psychopathy and suicidal ideation. In addition, depression and physiological anxiety moderated the association between secondary psychopathy and suicidal ideation. Present findings may assist in determining relevant suicide risk factors (i.e., depression, physiological anxiety, secondary psychopathy) to assess for in offenders.

Moderators of correctional treatment success: an exploratory study of racial differences

An important area in correctional rehabilitation research is to better understand how offenders differentially respond to correctional treatments. Potential treatment moderators forwarded in the literature are gender, race/ethnicity, and personality types. This exploratory study asked whether a group of parolees had demographic and personality moderators of treatment and, if so, were the moderating influences different by race? An experimental design was used to randomly assign a sample of 937 male parolees (n = 658 African American, n = 279 White) to the experimental group that received the cognitive-behavioral treatment program and the control group that did not. Discrete-time event history analysis independently tested the program-moderating effects of demographic and personality characteristics (age, prior employment status, educational attainment, marital status, social class, risk of recidivism, prior violence, IQ, reading level, cognitive maturity, personality type, residential urbanization) on recidivism for African American and White parolees. This study found that the age group and personality type of the parolees interacted with the cognitive-behavioral program in ways that created racially disparate recidivism outcomes.

Factor structure and construct validity of the Self-Report Psychopathy (SRP) scale and the Youth Psychopathic Traits Inventory (YPI) in young men

A large sample (N = 425) of young adult males from the Pittsburg Youth Study (PYS; Loeber, Farrington, Stouthamer-Loeber, & Van Kammen, 1998) was used to test the item-level structure of the short-form version of the Self-Report Psychopathy Scale (SRP; Paulhus, Neumann, & Hare, in press) and the standard version of the Youth Psychopathic Traits Inventory (YPI; Andershed, Kerr, Stattin, & Levander, 2002). Also, structural equation modeling analyses examined how the SRP and YPI factors were linked to external correlates involving criminal offenses and internalizing and externalizing psychopathology. The modeling results indicated acceptable fit for the latent structure of both instruments and the SRP and YPI factor correlations were strong, particularly for conceptually-related scales. Finally, both instruments showed similar patterns in predicting externalizing and internalizing psychopathology, as well as criminal offenses. Taken together, the results provide evidence of convergent and construct validity across the two instruments. New insights into the link between psychopathy and the external correlates in young adult males are discussed.

Under the surface of adolescent psychopathic traits: high-anxious and low-anxious subgroups in a community sample of youths

In this study, we examined subgroups of adolescents based on their levels of psychopathic traits and anxiety. Participants were 914 youths from a community sample, with a mean age of 14.28 (SD = .94) years. We used adolescents' self-reports of psychopathic traits and their parents' reports of the adolescent's anxiety to identify distinct subgroups of youths. Using latent class analysis, we identified five groups that varied in levels of psychopathic traits and anxiety. Two groups were characterized by high levels of psychopathic traits and high or low scores on anxiety. Validation of these subgroups revealed that they differed significantly from each other in theoretically meaningful ways-the low-anxious subgroup reported higher levels of psychopathic traits, lower levels of impulsivity and hyperactivity, and lower levels of aggression than the high-anxious group. These findings are in line with previous empirical research and provide support that anxiety discriminates between two subgroups of adolescents with psychopathic traits.

Salivary cortisol and psychopathy dimensions in detained antisocial adolescents

Previous research revealed hypothalamic-pituitary-adrenal (HPA) axis abnormalities in relation to antisocial and aggressive behavior. Some evidence suggests that low cortisol levels may serve as a biological marker for a severe antisocial subgroup with pronounced callous-unemotional (CU) traits. Children displaying the combination of severe antisocial behavior and CU traits appear to be particularly at risk of developing adult psychopathy. Given the lack of studies on the relationship between cortisol levels and CU traits in antisocial adolescents, the current study investigates whether cortisol levels are uniquely associated with CU traits as compared to other psychopathy dimensions (i.e., narcissism and impulsivity). Detained antisocial adolescents (n=63) and a community comparison group (n=62) completed diaries and collected three saliva samples daily on two days, with compliance monitored electronically. Psychopathy dimensions were assessed through self-report questionnaires. Externalizing symptoms were assessed by structured clinical interview. Multilevel regression analyses indicated no differences in cortisol levels or diurnal slopes between the two groups. Overall, cortisol levels were not significantly related to psychopathy dimensions. However, greater impulsivity was associated with lower cortisol levels in the community sample, but not in the antisocial group.

CONCLUSION

Results cast doubt on the notion of low cortisol levels as a biological marker for CU traits. Low basal cortisol levels appear to be more closely related to a general deficit in behavioral regulation. Implications for future research are discussed.

The role of trait anxiety in reducing the relationship between childhood exposure to violence/victimization and subsequent violent behavior among male delinquent youth

In this project, the authors examined the relationship trait anxiety has on incarcerated male adolescents' progression from childhood exposure to violence/victimization to violent behavior. Self-report survey data were analyzed to determine the youth's levels of trait anxiety, how the degree of childhood trauma was related to their level of anxiety, as well as whether their level of anxiety affected the relationship between trauma and subsequent frequency and severity of their delinquent acts using a moderation analysis. Anxiety significantly decreased the relationship between victimization and the commission of violence (F = 15.93, p < .001).

The Inventory of Callous and Unemotional Traits

The Inventory of Callous and Unemotional Traits (ICU), developed to assess callous/unemotional (CU) traits, has recently experienced increased attention in light of the proposal to add a CU specifier to the conduct disorder diagnosis in DSM-5. In a sample of 70 at-risk adolescents (ages 13-17 years) in the foster care system who received a contemplative intervention program, the present study placed the ICU within a nomological network of correlates, including anxiety, depression, hopefulness, loneliness, and physiological measures of stress (e.g., cortisol). The findings offered some support for the ICU’s construct validity, including significant negative associations with measures of compassion toward others. Nevertheless, unexpected substantial positive correlations emerged with multiple measures of psychological distress, raising questions concerning other aspects of the ICU’s construct validity. Taken together, results of the current study suggest that rather than assessing a dearth of all major emotions as implied by its name and some previous descriptions, the ICU may be heavily saturated with negative emotionality and global maladjustment.

Psychopathy, traumatic exposure, and lifetime posttraumatic stress

This study examined two theoretical models on the interaction between psychopathy, traumatic exposure, and lifetime posttraumatic stress in a sample of 81 male detainees. In Model 1, the interpersonal and affective features of psychopathy were assumed to protect against posttraumatic stress. In Model 2, the lifestyle and antisocial traits of psychopathy were assumed to lead to a lifestyle that increases the risk of traumatic exposure and subsequent posttraumatic stress. The authors found significant negative bivariate associations between Psychopathy Checklist-Revised (PCL-R) total, Interpersonal and Affective facet scores, and posttraumatic stress. Model 1 was confirmed, as they found the interaction between the Affective facet and traumatic exposure had a significant negative effect on posttraumatic stress. Model 2 was rejected. The authors' findings confirm that the interpersonal and affective features of psychopathy are associated with an emotional deficit and that the affective features of psychopathy are crucial for understanding the relationship between psychopathy and anxiety.

Effects of a parenting intervention on features of psychopathy in children

This study examined whether Project Support, a parenting intervention shown to reduce child conduct problems, also exerts positive effects on features of psychopathy in children. Participants were 66 families (mothers and children) recruited from domestic violence shelters who participated in a randomized controlled trial evaluating Project Support. Each family included at least one child between the ages of 4 and 9 who was exhibiting clinical levels of conduct problems. Families were randomly assigned to the Project Support intervention condition or to an existing services comparison condition, and they were assessed on 6 occasions over 20 months, following their departure from the shelter. Children in families in the Project Support condition, compared with those in the comparison condition, exhibited greater reductions in features of psychopathy. Moreover, the changes in features of psychopathy remained after accounting for changes in conduct problems. Project Support's effects on features of psychopathy were mediated by improvements in mothers' harsh and inconsistent parenting. These findings on the effects of an intervention on features of psychopathy are the first from a randomized controlled trial. They inform the debate about whether features of psychopathy in children are responsive to intervention, and hold important implications for clinical practice.

Psychopathic traits of Dutch adolescents in residential care: identifying subgroups

The present study examined whether a sample of 214 (52.8% male, M age = 15.76, SD = 1.29) institutionalized adolescents could be classified into subgroups based on psychopathic traits. Confirmatory Factor Analyses revealed a relationship between the subscales of the Youth Psychopathic traits Inventory (YPI) and the three latent constructs of the original model on which it is based. Latent Class Analyses showed that adolescents showing psychopathic traits could be classified into three subgroups. The first group showed low scores on the grandiose/manipulative dimension, the callous/unemotional dimension, and the impulsive/irresponsible dimension (normal group). The second group scored moderate on the grandiose/manipulative dimension and the callous/unemotional dimension and high on the impulsive/irresponsible dimension (impulsive, non-psychopathic-like group). The third group scored high on all three dimensions (psychopathy-like group). The findings revealed that the impulsive, non-psychopathic like group scored significantly higher on internalizing problem behavior compared to the normal group, while the psychopathy-like and the impulsive, non-psychopathic-like group both scored higher on externalizing problem behavior compared to the normal group. Based on a self-report delinquency measure, it appeared that the psychopathy-like group had the highest delinquency rates, except for vandalism. Both the impulsive and psychopathy-like group had the highest scores on the use of soft drugs.

Treatment of psychopathy: a review and brief introduction to the mental model approach for psychopathy

Psychopathy is thought by many to be an untreatable disorder. This article puts the treatment of psychopathy into historical context and reviews research on the treatment of the disorder with adults (K = 8) and youth (K = 5). Findings indicate that treatment for adults shows low to moderate success with three of eight studies demonstrating treatment gains. Treatment of youth appears to be more promising with six of eight studies showing treatment benefits. Although less than optimal success rates with adults, we suggest that bright line distinctions regarding the treatability of those with psychopathic characteristics from non-psychopathic individuals are inappropriate at this time. We conclude with directions for future research and briefly introduce the mental models approach for the treatment of psychopathy in youths.