Unique and Interactive Associations of Callous-Unemotional Traits, Impulsivity and Grandiosity with Child and Adolescent Conduct Disorder Symptoms

Utility of Multiple Specifiers for Subtyping Oppositional Defiant Problems: Investigating Multiple Psychopathy Dimensions as Specifiers

Past research has speculated that using grandiose-manipulative (GM) and daring-impulsive (DI) traits, rather than solely callous-unemotional (CU) traits, could better inform subtyping youths with behavioral problems. However, this approach remains largely untested. To further enhance our understanding of this matter, the current study utilized self-report (n = 2,381) and parent-report (n = 1,846) data to examine the utility of three psychopathic dimensions as specifiers for oppositional defiant problems (ODP). Findings showed that ODP was a significant predictor of negative outcomes, while the GM, CU, and DI traits emerged as significant predictors of theoretically and clinically relevant external variables (e.g., conduct problems and proactive aggression), independent of ODP (and age, gender, and socioeconomic status), forming the potential foundation for the development of specifiers for ODP. Furthermore, children presenting ODP alongside heightened levels of the three psychopathic traits demonstrated notably higher scores in important external variables compared to other groups, including but not confined to the subgroup of children with ODP and high CU trait levels. Findings provide preliminary support for employing GM and DI traits as specifiers for ODP. However, more comprehensive evaluations of these specifiers' utility would help inform ongoing discussions before definitively concluding they should be included in diagnostic manuals.

The Prognostic Usefulness of Multiple Specifiers for Subtyping Conduct Problems in Early Childhood

OBJECTIVE

To better describe and treat children with conduct problems (CP), grandiose-manipulative and daring-impulsive traits are proposed for subtyping CP, instead of using only a callous-unemotional specifier. However, the acclaimed benefits of having multiple specifiers for CP remain largely untested and therefore highly speculative. To fill this gap, this study tested longitudinal relations between these 3 specifiers and developmental outcomes in childhood and adolescence, independent of early childhood CP.

METHOD

Longitudinal data from 2 community studies were used. Teacher ratings were used to measure CP and the specifiers in 3- to 5-year-olds from Sweden (n = 2,064) and Spain (n = 2,055). Developmental outcomes were assessed by multiple informants (ie, teachers, parents, and children) 1 to 8 years later.

RESULTS

Early childhood CP were predictive of all outcomes. Callous-unemotional traits predicted low levels of social competence and prosocial behavior, independent of CP (and age, sex, and socioeconomic status). Grandiose-manipulative and daring-impulsive traits were predictive of aggression and violent delinquency, respectively, independent of CP, but also of higher levels of prosocial behavior or social competence.

CONCLUSION

The 3 specifiers are predictive of different outcomes, independent of CP, which is thought to form the basis for developing specifiers for CP. Findings tentatively challenge the centrality of callous-unemotional traits for subtyping CP, but it is premature to conclude that grandiose-manipulative and daring-impulsive specifiers are needed in future revisions of DSM and ICD. Efforts to systematically evaluate the utility of these specifiers should be welcomed to inform ongoing debates on this matter.

Emotion Recognition Deficits in Children and Adolescents with Psychopathic Traits: A Systematic Review

Children and adolescents with psychopathic traits show deficits in emotion recognition, but there is no consensus as to the extent of their generalizability or about the variables that may be moderating the process. The present Systematic Review brings together the existing scientific corpus on the subject and attempts to answer these questions through an exhaustive review of the existing literature according to PRISMA 2020 statement. Results confirmed the existence of pervasive deficits in emotion recognition and, more specifically, on distress emotions (e.g., fear), a deficit that transcends all modalities of emotion presentation and all emotional stimuli used. Moreover, they supported the key role of attention to relevant areas that provide emotional cues (e.g., eye-region) and point out differences according to the presence of disruptive behavior and based on the psychopathy dimension examined. This evidence could advance the current knowledge on developmental models of psychopathic traits. Yet, homogenization of the conditions of research in this area should be prioritized to be able to draw more robust and generalizable conclusions.

In Search of Conceptual Clarity About the Structure of Psychopathic Traits in Children: A Network-Based Proposal

Psychopathic traits in childhood have been revealed as potential identifiers of risk, being predictive of later forms of behavioral maladjustment. Yet, it is still under debate how psychopathic traits in children should be best conceptualized and which are the core dimensions for construct definition and prediction. The present study aims to examine the structure of psychopathic traits in childhood, and its predictive value, by using a combination of traditional factor analysis and more recent network-based methods. Data on psychopathic traits, as measured by the Child Problematic Traits Inventory (CPTI), were collected in a large sample of children (n = 2454; 48.2% girls), aged 3 to 6 at the onset of the study (Mage = 4.26; SD = 0.91), who were followed-up one and two years later using parent- and teacher-reports. Results showed that psychopathic traits measured via CPTI are best conceptualized as five latent factors encompassing grandiosity, deceitfulness, callousness, impulsivity and need of stimulation, a result that converged across informants and time. Callousness and grandiosity emerged as central traits using network analysis of parent-reports, while deceitfulness was most central using teacher-reports. Finally, callousness, impulsivity and deceitfulness emerged as the best predictors of concurrent, prospective and stable conduct problems. These results provide a refined structure of psychopathic traits in children that better accounts for the core elements of the construct. Additional theoretical and practical implications will be discussed in terms of assessment, diagnostic classification and tailored prevention/intervention.

The Proposed Specifiers for Conduct Disorder (PSCD) in Iranian School-Attending Adolescents: A Multi-Informant Validation Study of the PSCD Parent- and Youth Self-Report Versions

The Proposed Specifier for Conduct Disorder (PSCD) was developed to measure the broad psychopathy construct with grandiose-manipulative, callous-unemotional, daring-impulsive, and conduct disorder subscales. This study tested the psychometric properties of Persian parent-and-child self-report PSCD versions with 974 parents (86% mothers) and children/adolescents (46.5% boys) dyads. Results showed that with some modifications the proposed hierarchical four-factor structure for both PSCDs was confirmed and was found to be invariant across gender. Across versions, all PSCD scores were internally consistent and demonstrated expected correlations with parent-reported externalizing problems, anxiety/depression, and poor school performance, supporting the PSCDs scores' validity. This study also is the first to examine and establish acceptable to excellent parent-child agreement of PSCD scores. Finally, all PSCD child-report scores offered small though significant incremental validity over their corresponding PSCD parent-version scores in predicting parent-reported conduct problems and proactive aggression. Findings indicated that both Persian PSCDs may hold promise for assessing psychopathy components in Iranian school-attending adolescents and generating additional research on this topic.

Proposed Specifiers for Conduct Disorder-Short Version (PSCD-SV): Psychometric Properties, Concurrent Correlates and Parenting Predictors

The present study aims to further examine the four-factor model of psychopathy in adolescence with a new alternate model for the assessment of psychopathic traits and conduct disorder (CD): The Proposed Specifiers for Conduct Disorder-Short version (PSCD-SV). Data were collected in a sample of 414 adolescents (49.2% females) aged 12-15 at the first assessment who were then followed-up 2 years later. Results supported the usefulness of the PSCD-SV to assess the broader construct of psychopathy showing good psychometric properties, including adequate reliability and validity, while accounting for all its dimensions. In addition, the study showed close associations between psychopathic traits and adolescent behavioral, emotional and psychosocial maladjustment. Finally, the findings elucidated the PSCD's connection to parental support and psychological control, and reinforced the potential role of parenting practices as predictors that can act as mechanisms of change in the development of psychopathy. Overall, current findings shed light on conceptual and developmental models of psychopathy that may have implications for assessment, diagnostic classification, prevention, and intervention.

Sexual development in ADHD and internet pornography consumption

Development of sexual identity during adolescence is a major process of transition in individual life which in cases of ADHD specifically interacts with other ontogenetic, pathological and psychosocial conditions. According to recent findings growing consumption of internet pornography mainly in male ADHD population is closely related to compulsive sexual behavior and hypersexuality. Recent findings also indicate that consumption of internet pornography in ADHD individuals and other sexual activities may serve as a mood-altering "self-medication" which may help to cope with stressful events and decrease depression and anxiety. Taken together recent findings indicate that internet pornography consumption mainly in ADHD individuals is closely related to stressful experiences, anxiety, depression and identity problems in partnerships which significantly increase their vulnerability to the so-called "problematic pornography use" and other forms of addictive sexual behavior. From this developmental perspective "problematic pornography use" in ADHD individuals represents significant epidemiological problem which requires further research mainly with focus on clinical diagnostics and treatment.

Fearlessness as an Underlying Mechanism Leading to Conduct Problems: Testing the Intermediate Effects of Parenting, Anxiety, and callous-unemotional Traits

This study investigates whether the longitudinal association between fearlessness and conduct problems (CP) is mediated by warm and harsh parenting, parent-child conflict, anxiety, and callous-unemotional (CU) traits. The constructs under investigation were assessed at five different time points, spanning a period of eight years. A multi-informant approach was followed, collecting data from parents and teachers (N = 2,121; 47% girls). The structural equation model pointed to both direct and indirect pathways between fearlessness and CP. Specifically, findings suggested that Time 1 fearlessness (age 3-5 years) increased the likelihood of Time 2 (age 4-6 years) harsh parenting and Time 3 (age 5-7 years) parent-child conflict. Further, fearlessness was positively associated with Time 4 (age 8-10) callous-unemotional traits and Time 5 (age 11-13) CP. The total indirect effect from fearlessness to CP through these variables was significant, although the specific indirect effect from fearlessness to CU traits to CP accounted for most of the variance. Warm parenting and anxiety did not mediate the association between fearlessness and CP. In addition to the identified pathways connecting fearlessness to CP, findings pointed to the existence of multiple developmental pathways to future CP, as well as gender differences in longitudinal associations.

The Proposed Specifiers for Conduct Disorder - Parent (PSCD-P): Convergent Validity, Incremental Validity, and Reactions to Unfamiliar Peer Confederates

Youth who experience psychopathy display multiple impairments across interpersonal (grandiose-manipulative [GM]), affective (callous-unemotional [CU]), lifestyle (daring-impulsive [DI]), and potentially antisocial and behavioral features. Recently, it has been acknowledged that the inclusion of psychopathic features can offer valuable information in relation to the etiology of Conduct Disorder (CD). Yet, prior work largely focuses on the affective component of psychopathy, namely CU. This focus creates uncertainty in the literature on the incremental value of a multicomponent approach to understanding CD-linked domains. Consequently, researchers developed the Proposed Specifiers for Conduct Disorder (PSCD; Salekin & Hare, 2016) as a multicomponent approach to assess GM, CU, and DI features in combination with CD symptoms. The notion of considering the wider set of psychopathic features for CD specification requires testing whether multiple personality dimensions predict domain-relevant criterion outcomes above-and-beyond a CU-based approach. Thus, we tested the psychometric properties of parents' reports on the PSCD (PSCD-P) in a mixed clinical/community sample of 134 adolescents (M_age = 14.49, 66.4% female). Confirmatory factor analyses resulted in a 19-item PSCD-P displaying acceptable reliability estimates and a bifactor solution consisting of GM, CU, DI, and CD factors. Findings supported the incremental validity of scores taken from the PSCD-P across multiple criterion variables, including (a) an established survey measure of parent-adolescent conflict; and (b) trained independent observers' ratings of adolescents' behavioral reactions to laboratory controlled tasks designed to simulate social interactions with unfamiliar peers. These findings have important implications for future research on the PSCD and links to adolescents' interpersonal functioning.

Psychopathic Traits and Parental Practices in Greek-Cypriot Community and Dutch Clinical Referred Samples

Parental practices are associated with psychopathic traits across several developmental stages. However, the majority of available studies focused mainly on the affective dimension of psychopathy, namely callous-unemotional traits, disregarding the grandiose-deceitful and impulsivity-need for stimulation dimensions. The current study examines the distinct associations between all three dimensions with parental practices (parental involvement, poor monitoring, inconsistent discipline, and corporal punishment) after considering the effect of conduct problems (CPs) and sex in a Greek-Cypriot primary school sample (N = 792, Mage = 6.93, SD = 0.72) and a Dutch clinical-referred sample (N = 217, Mage = 9.55, SD = 1.79) of children. In the community sample, hierarchical multiple regression analysis revealed that parents of children with high levels of callous-unemotional traits were more likely to engage in inconsistent discipline but less in positive parental practices. In contrast, high levels of impulsivity-need for stimulation were related to inconsistent discipline. In the clinical sample, callous-unemotional traits were associated with less parental involvement and grandiose-deceitful dimension with high levels of inconsistent discipline. These findings suggest that the three psychopathy dimensions have unique relations with parental practices above and beyond CPs, proposing that parental practices may be influenced more strongly by psychopathic traits than by antisocial behavior.

The Relative Importance of Psychopathy Features as Predictors of Externalizing Behaviors in Youth: A Multimethod Examination

Research in youth psychopathy has focused heavily on the affective features (i.e., callous-unemotional [CU] traits) given robust links to severe and chronic forms of externalizing behaviors. Recently, there have been calls to expand the scope of work in this area to examine the importance of other interpersonal (i.e., antagonism) and behavioral (i.e., disinhibition) features of psychopathy. In the present study, we apply an under-utilized statistical approach (i.e., dominance analysis) to assess the relative importance of CU traits, antagonism, and disinhibition in the prediction of externalizing behaviors in youth, cross-sectionally and at 9-month follow-up. Using a multi-informant (youth- and parent-report), multi-method (questionnaire, ecological momentary assessment [EMA]) preregistered approach in a diverse sample of clinically referred youth (Mage = 12.60 years, SD = .95 years, 47% female; 61% racial/ethnic minority), we found youth- and parent-reported psychopathy features accounted for a significant proportion of variance in externalizing behavior cross-sectionally and longitudinally. However, results provided limited support for our preregistered hypotheses. While antagonism and disinhibition had larger general dominance weights relative to CU traits for both youth- and parent-report, most differences were non-significant. Thus, the interpersonal, affective, and behavioral psychopathy features could not be distinguished from one another in terms of their importance in the prediction of externalizing behavior, assessed cross-sectionally or longitudinally. Taken together, the results highlight promising avenues for future research on the relative importance of youth psychopathy features.

The Underlying Mechanisms in the Association Between Traumatic Brain Injury in Childhood and Conduct Disorder Symptoms in Late Adolescence

The present study examined i) the direct association between traumatic brain injury (TBI) in childhood and conduct disorder symptoms in adolescence, ii) whether this effect is mediated by impulsivity and/or callous unemotional traits (CU traits), and iii) whether these indirect effects are moderated by childhood family adversity and adolescent substance use. Utilising data from the Avon Longitudinal Study of Parents and Children (ALSPAC), participants with head injury information up to 12 years (4.5 years, 5.4 years, 6.5 years, 8.6 years, 11.7 years) were identified and categorised into a TBI (n = 409), orthopaedic injury (n = 1469) or non-injury group (n = 5685). Psychosocial factors such as impulsivity at 13 years, CU traits at 13 years, childhood family adversity (between birth to 4 years) and substance use at 14 years were collated for moderated mediation analyses. Conduct disorder symptoms were assessed at 16 years of age. TBI and conduct disorder symptoms were positively associated, and this association was mediated by impulsivity but not CU traits. The indirect effects were higher in magnitude for individuals with higher levels of childhood family adversity. Adolescent substance use was not found to moderate the indirect effects between TBI and conduct disorder symptoms. These results were specific to TBI individuals, and not in participants with orthopaedic injury and no reported injuries. Targeting impulsivity and early family adversity may alleviate the risk of conduct disorder symptoms following TBI in childhood. These findings have important implications for informing neuro-rehabilitative and preventative measures in clinical and community settings.

Does Conduct, Oppositional Defiant, and Panic Disorder Symptoms Associate with Suicidal Ideations Among African American Adolescents?

Previous studies suggest that mental illness symptoms among adolescents, such as conduct disorder, oppositional defiant disorder, and panic disorder symptoms often associate with suicidal ideations. Despite this, few studies have examined whether these mental illness symptoms associate with suicidal ideations among African American adolescents. To address these limitations, the current study examined whether conduct disorder, oppositional defiant disorder, and panic disorder symptoms associated with suicidal ideations (N = 261). Using binominal logistic regression, results suggest that conduct disorder symptoms were associated with a higher likelihood of endorsing suicidal ideations than oppositional defiant disorder symptoms. Finally, panic disorder symptoms and gender differences were not associated with suicidal ideations. Preventive efforts and psychotherapy implications are discussed.

Parental Antisocial and Psychopathic Traits Influence Adolescent Psychopathology

The role of parental antisocial behavior in the development of adolescent psychopathology is well established in the literature. However, less is known about the role of parental psychopathic traits in offspring psychopathology. Adolescents (N = 210; boys = 107) and their parents participated in a study measuring parental antisocial behavior, psychopathic traits (i.e., callous-unemotional traits, impulsive-irresponsibility, and grandiosity), and adolescent psychopathology, including depression, anxiety, attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD). Results from the structural equation model suggested that maternal antisocial acts, but not anger propensity, positively predicted adolescent CD, ODD, and depressive symptoms. Paternal anger propensity mainly predicted internalizing problems, whereas paternal impulsive-irresponsibility predicted anxiety and ADHD symptoms. In addition, findings pointed to several indirect effects from maternal and paternal psychopathic traits to adolescent psychopathology, with the strongest one being between maternal impulsive-irresponsibility to maternal antisocial acts to adolescent ODD. The findings suggest that parental antisocial behaviors and psychopathic traits, and especially impulsive-irresponsibility, should be considered in interventions aiming to reduce adolescent psychopathology.

Validation of the Proposed Specifiers for Conduct Disorder (PSCD) Self-Report Version in Iranian School-Attending Adolescents

The Proposed Specifiers for Conduct Disorder (PSCD) scale was developed to advance the study of child and adolescent psychopathy, especially as it relates to conduct disorder. This study is the first to test the factor structure, measurement invariance, internal consistency, and validity of the Persian PSCD self-report version in a gender-mixed sample of 1,506 school-attending 11 to 18 years old youth (M age = 15.23; SD = 1.83; 49.60% boys). Confirmatory factor analysis supported the proposed four-factor hierarchical structure of the PSCD, though with 19 items loaded on grandiose-manipulative, callous-unemotional, daring-impulsive, and conduct disorder components. This factor structure was also invariant across gender. The PSCD total and four components scores were internally consistent and exhibited the expected relations with proactive aggression, externalizing problems, anxiety and depression, and poor school performance, supporting the PSCD scores' convergent, discriminant, and criteria validity. The findings indicated that with some modifications, the Persian PSCD might hold promise for assessing psychopathy components in Iranian school-attending adolescents and may spark additional research in a variety of settings.

The Proposed Specifiers for Conduct Disorder (PSCD) Scale: Factor Structure and Validation of the Self-Report Version in a Forensic Sample of Belgian Youth

This is the first study to test the psychometric properties of the self-report version of the Proposed Specifiers for Conduct Disorder (PSCD) in detained youth. The PSCD is a measure of the broad psychopathy construct, with grandiose-manipulative, callous-unemotional, daring-impulsive, and conduct disorder (CD) components. Participants (227 males) completed the PSCD along with other measures, including a diagnostic interview to assess Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) CD. Results support the PSCD's proposed hierarchical four-factor structure. Correlations with an alternate measure of psychopathy and symptoms of CD support the convergent validity of PSCD scores. PSCD scores showed positive associations with criterion variables of emotional and regulatory functioning, aggression, substance use, and school problems. Finally, PSCD scores were unrelated to anxiety and depression, supporting the PSCD's discriminant validity. Findings indicate that the PSCD is a promising measure for assessing psychopathic traits in detained male adolescents, though its incremental validity is in need of further scrutiny.

Sexuality in Adults With ADHD: Results of an Online Survey

Establishing a secure sexual identity is a major developmental goal of an individual's transition from childhood to adolescence and the years that follow. Attention deficit/hyperactivity disorder (ADHD) as a neurodevelopmental disorder defined by the core symptoms of inattention, hyperactivity, and impulsivity, but also with emotional dysregulation, oppositional behaviors, or disorganization appearing early in life, can affect several areas of an individual's personal and social development, including sexual health. Yet, the scientific knowledge about the relationship between ADHD and sexual functioning is still scarce. Using an anonymous online survey, we compared different sexual behaviors including risky sexual behaviors, hypersexual behaviors, and sexual dysfunctions between 206 individuals with (n = 139) and without (n = 76) ADHD. Individuals with ADHD reported significantly more hypersexual behaviors than non-ADHD individuals, whereas no differences were found concerning risky sexual behaviors or sexual dysfunctions. In women with ADHD, hypersexual behaviors, sexual risk-taking as well as sexual dysfunctions were closely related to symptoms of emotional dysregulation, impulsivity, and oppositional symptoms. In men with ADHD, the associations between ADHD symptomatology and the sexuality-related measures were less clear, however, signs of emotional dysregulation seemed to be relevant as well. Since individuals with ADHD seem to be at an increased risk of some peculiarities in sexual behavior, sexuality-related issues should be routinely addressed during clinical consultations to provide more holistic treatment in order to enhance individual well-being and quality of life.

Understanding Emotion Regulation and Humor Styles in Individuals with Callous-Unemotional Traits and Alexithymic Traits

Alexithymia is a personality trait which is characterized by impairments in identifying and describing emotions. Both psychopathic and alexithymic personality traits have been associated with impairments in emotion processing. This study aims to clarify the conceptual overlap between psychopathic traits (focusing on callous-unemotional traits) and alexithymic traits, with emotion regulation strategies and humor styles using a community sample. A battery of self-report measures was distributed through an online platform to 538 male and female participants between the ages of 18 to 65. Hierarchal linear regression analyses demonstrated that emotion regulation strategies were the strongest predictors and accounted for the largest variance of callous-unemotional traits and alexithymic traits. More specifically, expressive suppression arose as a positive predictor while cognitive reappraisal arose as a negative predictor for both personality traits. Aggressive humor (maladaptive) arose as a positive predictor while self-defeating humor (maladaptive) and affiliative humor (adaptive) arose as negative predictors for callous-unemotional traits. In contrast, self-defeating humor arose as a positive predictor for alexithymic traits while affiliative humor and self-enhancing humor arose as negative predictors. Findings indicate that there are similarities and differences between these personality traits. The implications regarding tailoring interventions that target specific deficits associated with each personality trait are discussed.

Why Do Students Become Cyberbullies? Elucidating the Contributions of Specific Developmental Risks to Cyberbullying

Cyberbullying is currently considered as a widespread problem among children and adolescents; in particular, the risks of cyberbullying have recently been examined. The empirical analyses of the present work are based on data from a German longitudinal study. The self-reports of adolescents from Dortmund and Nuremberg on both cyberbullying and individual and contextual characteristics were taken into account. The two-wave panel encompasses N = 871 adolescents (44.5% male); the average age was M = 15.1 years (SD = 0.83) at t1. Data on cyberbullying refer to sending insults or threats to others via the Internet, spreading rumours or talking badly about others via the Internet, and sending private e-mails, photos or similar from others in order to embarrass or ridicule the persons concerned. Other characteristics relate to single aspects of psychopathy (egocentric egotism, low self-control, empathy deficits), acceptance of violence, and delinquent peers. The path analytical findings illustrate the predictive relationships between both individual and contextual risks and cyberbullying in adolescence. The empirical results are discussed, among others, from the perspective of developmental and life-course criminology.

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

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

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

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

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

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

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

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

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

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

Adult attachment and psychopathic traits: Investigating the role of gender, maternal and paternal factors

Individuals with psychopathic traits have been identified to display insecure attachment. However, it is not clear which attachment dimension contributes more to high psychopathic traits, and more specifically to callous-unemotional (CU) traits, which parental relationship is more influential and if this differs across gender. This study examined the associations of adult attachment dimensions (avoidance and anxiety) and parental factors (regard, responsibility and control) with CU traits (N = 1149) using Hierarchical Linear Regression. The relationship with both parents was assessed separately to identify their unique contribution to CU traits in males and females respectively. The avoidant attachment positively predicted while the anxiety attachment dimension negatively predicted CU traits and this was the case for both male and female participants. Interestingly, maternal regard was a negative predictor of CU traits in males only, whereas paternal responsibility arose as a positive predictor of CU traits in females only. Attachment dimensions explained the largest variance in both males and females. Findings point to the importance of attachment dimensions contributing to CU traits even in an adult sample. Parental variables were less influential on CU traits compared to attachment related variables and findings suggest that there are differences between males and females. These findings have important implications for gender differentiated attachment based interventions for individuals with CU traits.

Conduct Problems and Adherence to COVID-19 Guidelines: A Developmental Psychopathology-Informed Approach

COVID-19 underscores the importance of understanding variation in adherence to rules concerning health behaviors. Children with conduct problems have difficulty with rule adherence, and linking early conduct problems with later adherence to COVID-19 guidelines can provide new insight into public health. The current study employed a sample (N = 744) designed to examine the longitudinal consequences of childhood conduct problems (Mean age at study entry = 8.39). The first objective was to link early conduct problems with later adherence to both general and specific COVID-19 guidelines during emerging adulthood (M age = 19.07). The second objective was to prospectively examine how interactional (i.e., callous unemotional traits, impulsivity) and cumulative (i.e., educational attainment, work status, substance use) continuity factors mediated this association. The third objective was to examine differences in sex assigned at birth in these models. Direct associations were observed between childhood conduct problems and lower general, but not specific COVID-19 guideline adherence. Conduct problems were indirectly associated with both general and specific adherence via higher levels of callous unemotional traits, and with specific adherence via higher problematic substance use. No differences in the models were observed across sex assigned at birth. Findings provide insight into both how developmental psychopathology constructs are useful for understanding COVID-19 guideline adherence, and the ways in which conduct problems may shape health outcomes.

A Cross-Sectional and Longitudinal Test of the Low Sensitivity to Threat and Affiliative Reward (STAR) Model of Callous-Unemotional Traits Among Spanish Preschoolers

Despite advances in the theoretical and empirical literature, a better understanding of the etiological determinants of callous-unemotional (CU) traits is needed. In this study, we tested the hypotheses advanced by the Sensitivity to Threat and Affiliative Reward (STAR) model, a theoretical framework, which proposes that individual differences in two temperament dimensions, fearlessness and low affiliation, jointly contribute to the development of CU traits. Specifically, we examined the unique and interactive effects of fearlessness and low affiliation on CU traits, both cross-sectionally and longitudinally and within and across informants (teachers and parents) in a large community sample of Spanish preschoolers (N = 2467, 48.1% girls, M = 4.25 years; SD = 0.91). Both fearlessness and low affiliation were independently related to higher CU traits across models. Consistent with the purported relationships outlined in the STAR model, we also found that a significant interaction between fearlessness and low affiliation explained unique variance in CU traits. The results suggested that main and interactive effects were specific to CU traits and not to other related dimensions of psychopathic traits that are measurable in early childhood (i.e. grandiose-deceitfulness and impulse need of stimulation). Thus, we provide new empirical support to the hypotheses generated by the STAR model in relation to the development of CU traits. Fearlessness and low affiliation are potential targets of future child-focused interventions to prevent or treat the development of CU traits and childhood conduct problems.

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

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

Factorial Structure and Nomological Network of the Inventory of Callous-Unemotional Traits Accounting for Item Keying Variance

The factorial structure of the Inventory of Callous Unemotional Traits (ICU) is currently under dispute. The present study aims to test the factorial structure of a Greek adaptation of the ICU by considering item keying variance and examining alternative theoretical and empirically derived models. Additionally, it aims to investigate the nomological network of the ICU subscales, after controlling for item keying variance. The sample consisted of 1536 Greek-Cypriot adolescents, who completed a battery of questionnaires, including the ICU. Results showed that the consideration of item keying variance improved the overall fit of all the examined models and led to significant changes in the predictive validity of the subscales, while method factors presented distinct patterns of associations with external variables. Overall, results suggest that ICU is contaminated by item keying variance, which can be filtered out to provide clinically useful insight into the factorial structure of the ICU.

The Sensitivity to Threat and Affiliative Reward (STAR) model and the development of callous-unemotional traits

Research implicates callous-unemotional (CU) traits (i.e., lack of empathy, prosociality, and guilt, and reduced sensitivity to others' emotions) in the development of severe and persistent antisocial behavior. To improve etiological models of antisocial behavior and develop more effective treatments, we need a better understanding of the origins of CU traits. In this review, we discuss the role of two psychobiological and mechanistic precursors to CU traits: low affiliative reward (i.e., deficits in seeking out or getting pleasure from social bonding and closeness with others) and low threat sensitivity (i.e., fearlessness to social and non-social threat). We outline the Sensitivity to Threat and Affiliative Reward (STAR) model and review studies that have examined the development of affiliative reward and threat sensitivity across animal, neuroimaging, genetic, and behavioral perspectives. We next evaluate evidence for the STAR model, specifically the claim that CU traits result from deficits in both affiliative reward and threat sensitivity. We end with constructive suggestions for future research to test the hypotheses generated by the STAR model.

Forms, Importance, and Ineffability of Factor Interactions to Define Personality Disorders

The emergent interpersonal syndrome (EIS) approach conceptualizes personality disorders as the interaction among their constituent traits to predict important criterion variables. We detail the difficulties we have experienced finding such interactive predictors in our empirical work on psychopathy, even when using uncorrelated traits that maximize power. Rather than explaining a large absolute proportion of variance in interpersonal outcomes, EIS interactions might explain small amounts of variance relative to the main effects of each trait. Indeed, these interactions may necessitate samples of almost 1,000 observations for 80% power and a false positive rate of .05. EIS models must describe which specific traits' interactions constitute a particular EIS, as effect sizes appear to diminish as higher-order trait interactions are analyzed. Considering whether EIS interactions are ordinal with non-crossing slopes or disordinal with crossing slopes, or entail nonlinear threshold or saturation effects may help researchers design studies, sampling strategies, and analyses to model their expected effects efficiently.

Personality Disorders as Emergent Interpersonal Syndromes: Psychopathic Personality as a Case Example

Personality disorders have long been bedeviled by a host of conceptual and methodological quandaries. Starting from the assumption that personality disorders are inherently interpersonal conditions that reflect folk concepts of social impairment, the authors contend that a subset of personality disorders, rather than traditional syndromes, are emergent interpersonal syndromes (EISs): interpersonally malignant configurations (statistical interactions) of distinct personality dimensions that may be only modestly, weakly, or even negatively correlated. Preliminary support for this perspective derives from a surprising source, namely, largely forgotten research on the intercorrelations among the subscales of select MMPI/MMPI-2 clinical scales. Using psychopathic personality as a case example, the authors offer provisional evidence for the EIS hypothesis from four lines of research and delineate its implications for personality disorder theory, research, and classification. Conceptualizing some personality disorders as EISs elucidates long-standing quandaries and controversies in the psychopathology literature and affords fruitful avenues for future investigation.

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

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

Valence, arousal or both? Shared emotional deficits associated with Attention Deficit and Hyperactivity Disorder and Oppositional/Defiant-Conduct Disorder symptoms in school-aged youth

We examined emotional responses in Attention Deficit Hyperactivity and Oppositional Defiant/Conduct Disorder to affective pictures. Eighty seven children (42 female, M_age = 11.2), with clinical or subclinical symptoms and controls viewed joy, fear, sadness or neutral pictures while heart rate, skin conductance, corrugator and zygomaticus responses were recorded. The moderating role of Callous-Unemotional and anxiety traits was evaluated. Lower resting heart rate and decreased skin conductance across picture types was associated with ADHD symptoms. Decreased heart rate reactivity to fear and sad stimuli was associated with ADHD and ODD/CD. Corrugator and zygomaticus responses were not associated with ADHD or ODD/CD. Findings are mostly consistent with a fearlessness account of disruptive behavior, and seem to also pertain to ADHD, with intact valence systems. Findings are discussed in light of the significance of identifying common pathogenic mechanisms across traditional diagnostic categories, consistent with trans-diagnostic approaches to the study of psychopathology.