Editorial Statement About JCCAP's 2023 Special Issue on Informant Discrepancies in Youth Mental Health Assessments: Observations, Guidelines, and Future Directions Grounded in 60 Years of Research

Examining profiles of convergence and divergence in reports of parental warmth: Links to adolescent developmental problems

Parental warmth during the transition from childhood to adolescence is a key protective factor against a host of adolescent problems, including substance use, maladjustment, and diminished well-being. Moreover, adolescents and parents often disagree in their perceptions of parenting quality, and these discrepancies may confer risk for problem outcomes. The current study applies latent profile analysis to a sample of 687 mother-father-6th grade adolescent triads to identify patterns of adolescent-parent convergence and divergence in perceptions of parental warmth. Five profiles were identified, and associations with adolescent positive well-being, substance use, and maladjustment outcomes in 9th grade were assessed. Patterns of divergence in which adolescents had a pronounced negative perception of parental warmth compared to parents, as well as those wherein pronounced divergence was present in only one adolescent-parent dyad, were associated with diminished positive well-being compared to adolescents who had more positive perceptions of warmth than parents. Having more negative perceptions of warmth compared to parents was also associated with elevated risk for alcohol and marijuana initiation, but only when the divergence was pronounced rather than more moderate. These findings add nuance to findings from previous between-family investigations of informant discrepancies, calling for further family-centered methods for investigating multiple perspectives.

Daily Interplay of Positive and Negative Events with Adolescents' Daily Well-Being: Multilevel Person-Centered and Variable-Centered Approaches

INTRODUCTION

This study examined associations between adolescents' daily negative and positive events and their coping efficacy, an understudied topic but pivotal to adolescent thriving.

METHODS

The sample included 153 parent-adolescent triads; adolescents' mean age, 15.71 years (SD = 1.53), 51% girls. Parents were in their midlife (Mage mother = 47.82, SD = 4.90; Mage father = 50.39, SD = 5.80). The study used a daily diary methodology to test within-person links to establish a temporal order of effects. Over seven consecutive days, adolescents reported on 14 daily negative and positive events. Adolescents, mothers, and fathers reported on adolescents' daily coping efficacy.

RESULTS AND CONCLUSIONS

Multilevel latent profile analysis (MLPA) identified 4 day-level event profiles: "low event day" (34% of days), reflecting low levels of both positive and negative events and low coping efficacy and positive and negative mood; "positive day" (44%), reflecting dominance of intense positive events and corresponding high coping efficacy and positive mood; "mixed day," reflecting a combination of intense positive and negative events with average coping efficacy and positive mood despite high negative mood and impaired coping. Multilevel path analysis showed adolescents reported increased coping efficacy a day after increased academic load, and parents reported increased adolescent coping efficacy a day after positive parent-adolescent interactions. Fathers reported decreased adolescent coping efficacy a day after peer disappointment. Findings suggest positive events predominate in adolescents' lives, and their coping efficacy is sensitive to dynamic changes in the valence of context.

Assessing Whether Negative Parenting Cognitions Bias Parent Report of Preschoolers' Externalizing Symptoms: A Regularized Moderated Non-Linear Factor Analysis Approach

Parent report is frequently used to assess children's psychopathology, however, researchers have expressed concerns about the validity of parent reports. Some parental characteristics, attitudes, or beliefs may systematically bias a parent's report of their child's behaviors and functioning. Informed by social information processing models of parenting risk, parents with more difficulties reflecting on and interpreting their children's behavior may be at risk for less accurate reports. The present study conducted two regularized moderated non-linear factor analyses with LONGSCAN data to examine how parents' self-reported negative parenting cognitions were associated with structural parameters of parent-reported child aggression and attention problems. While differential item functioning (DIF) was present on the aggression and attention problems subscales as a function of negative parenting cognitions, the DIF was small in magnitude, inconsistent in directionality and did not significantly alter factor-level parameters. Negative parenting cognitions did demonstrate a small but significant negative impact on all latent externalizing factors (aggression and attention problems), such that caregivers with fewer negative parenting cognitions endorsed fewer items, and this was associated with a lower mean of each latent variable. Given that accounting for DIF did not contribute to meaningful differences in impact parameters or improve criterion validity, findings suggest that the aggression and attention subscales are functionally invariant to negative parenting cognitions, suggesting that externalizing symptoms can be reliability compared across parents of varying parenting cognitions.

Using Progress Feedback to Enhance Treatment Outcomes: A Narrative Review

We face increasing demand for greater access to effective routine mental health services, including telehealth. However, treatment outcomes in routine clinical practice are only about half the size of those reported in controlled trials. Progress feedback, defined as the ongoing monitoring of patients' treatment response with standardized measures, is an evidence-based practice that continues to be under-utilized in routine care. The aim of the current review is to provide a summary of the current evidence base for the use of progress feedback, its mechanisms of action and considerations for successful implementation. We reviewed ten available meta-analyses, which report small to medium overall effect sizes. The results suggest that adding feedback to a wide range of psychological and psychiatric interventions (ranging from primary care to hospitalization and crisis care) tends to enhance the effectiveness of these interventions. The strongest evidence is for patients with common mental health problems compared to those with very severe disorders. Effect sizes for not-on-track cases, a subgroup of cases that are not progressing well, are found to be somewhat stronger, especially when clinical support tools are added to the feedback. Systematic reviews and recent studies suggest potential mechanisms of action for progress feedback include focusing the clinician's attention, altering clinician expectations, providing new information, and enhancing patient-centered communication. Promising approaches to strengthen progress feedback interventions include advanced systems with signaling technology, clinical problem-solving tools, and a broader spectrum of outcome and progress measures. An overview of methodological and implementation challenges is provided, as well as suggestions for addressing these issues in future studies. We conclude that while feedback has modest effects, it is a small and affordable intervention that can potentially improve outcomes in psychological interventions. Further research into mechanisms of action and effective implementation strategies is needed.

Future Directions for Conduct Disorder and Psychopathic Trait Specifiers

Conduct disorder (CD) is a psychiatric diagnosis characterized by a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate social norms or rules are violated. This article presents information on CD with an emphasis on a new multispecifier personality model that could offer a valuable new perspective on CD by refining the way we specify CD. The multispecifier model may have the potential to clarify the considerable confusion that has occurred over past decades and improve our understanding of prevalence, etiology, course, and treatment of youth with conduct problems. In this paper, we present a new structure for CD designed to inspire new lines of research that may be needed to help the field more fully capitalize on this innovation. With additional research, it is hoped that the new multispecifier model will eventually buy clinicians additional information that cannot be gleaned from current diagnostic criteria and will help clinicians and researchers further uncover the factors that promote or protect against the development of CD. This paper delineates the areas of research that will be needed to fully realize the potential of a multispecifier model and ultimately to improve clinical care for children and adolescents with CD.

Peer Problems and Prosocial Behavior Among Icelandic Children and Adolescents with ADHD and/or Autism: Gender and Age Differences

Children with neurodevelopmental disorders tend to have more social difficulties than typically developing children. The aim of the current study was to examine parent and teacher-reported effects of age and gender on social functioning in a large clinical sample of children and adolescents with ADHD, autism, or co-occurring ADHD and autism using a cross-sectional study design. This nationwide clinical sample included 2132 Icelandic children and adolescents (35% girls, 65% boys) aged 5-18 years referred for a neurodevelopmental diagnostic assessment (ADHD and/or autism) in Iceland. Social functioning was measured using the Prosocial behavior and Peer problem subscales on the Strengths and Difficulties Questionnaire (SDQ) completed by parents and teachers. Results revealed that autistic youth and youth with co-occurring ADHD and autism experienced more peer problems and showed less prosocial behavior than youth with ADHD only. According to parents and teachers, girls were found to experience more social difficulties compared to boys. Interaction for age and gender, although only significant for teacher reports, indicated that younger girls with neurodevelopmental disorders experience more peer problems and show less prosocial behavior than older girls. In contrast, boys with neurodevelopmental disorders experience similar issues at all ages. The results suggest different patterns of social difficulties for boys and girls with neurodevelopmental disorders. Future research should examine different developmental pathways of social challenges for boys and girls. Implications for developing and providing clinical interventions appropriate developmental stages are discussed.

Self-Rated Symptoms of Oppositional Defiant Disorder and Conduct Disorder: Factor Structure, Reliability, and Validity in a Clinical Sample of Adolescents

This study examined the psychometric properties of self-rated symptoms of oppositional defiant disorder (ODD) and conduct disorder (CD). We analyzed symptom ratings from a clinical outpatient sample of 658 adolescents aged 11;0-17;11 years diagnosed with ODD/CD and/or attention-deficit hyperactivity disorder. In two steps, we examined the factor structure of ODD models and an additional CD symptom dimension using confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM). Our preferred three-factor CFA and ESEM models (CFI = 0.937-0.975, TLI = 0.926-0.962, RMSEA = 0.049-0.068, SRMR = 0.045-0.070) demonstrated scalar measurement invariance across age groups (≥ 14;0 years) and metric measurement invariance across informants (parents, teachers). With exceptions, the self-rated symptom scales showed acceptable internal consistencies (α = 0.68-0.84). Convergent (r =.27-.65) and divergent validity (r =.13-.41) were supported using Achenbach's Youth Self Report Form. Our results provide implications for using self-rated ODD/CD symptoms in clinical practice and research.

Intergenerational transmission of comorbid internalizing and externalizing psychopathology at age 11: Evidence from an adoption design for general transmission of comorbidity rather than homotypic transmission

Psychopathology is intergenerationally transmitted through both genetic and environmental mechanisms via heterotypic (cross-domain), homotypic (domain-specific), and general (e.g., "p-factor") pathways. The current study leveraged an adopted-at-birth design, the Early Growth and Development Study (57% male; 55.6% White, 19.3% Multiracial, 13% Black/African American, 10.9% Hispanic/Latine) to explore the relative influence of these pathways via associations between adoptive caregiver psychopathology (indexing potential environmental transmission) and birth parent psychopathology (indexing genetic transmission) with adolescent internalizing and externalizing symptoms. We included composite measures of adoptive and birth parent internalizing, externalizing, and substance use domains, and a general "p-factor." Age 11 adolescent internalizing and externalizing symptom scores were the average of adoptive parent reports on the Child Behavior Checklist (n = 407). Examining domains independently without addressing comorbidity can lead to incorrect interpretations of transmission mode. Therefore, we also examined symptom severity (like the "p-factor") and an orthogonal symptom directionality score to more cleanly disentangle transmission modes. The pattern of correlations was consistent with mostly general transmission in families with youth showing comorbid internalizing and externalizing symptoms, rather than homotypic transmission. Findings more strongly supported potential environmental or evocative mechanisms of intergenerational transmission than genetic transmission mechanisms (though see limitations). Parent-specific effects are discussed.

The Association between Hyperactivity and Suicidal Behavior and Attempts among Children Referred from Emergency Departments

The global prevalence of suicidal behaviors in children is rising, with attention-deficit hyperactivity disorder (ADHD) proposed as a contributing factor. This study examines the association between ADHD facets (hyperactivity and inattention) and suicidal behavior and attempts in children. Additionally, it seeks to compare self-reported ADHD symptoms and suicide-related incidents with parental reports. A cohort of 71 children referred from emergency departments due to suicidal thoughts and behaviors completed self- and parental report questionnaires. The results revealed that elevated hyperactivity scores, surpassing the ADHD diagnosis threshold, were significantly associated with increased rates of suicidal behavior. Hyperactivity demonstrated a stronger association with lifetime suicide attempts compared to inattention. Moreover, children's self-reported ADHD symptoms exhibited a stronger correlation with suicide attempts than parental reports. This study highlights the critical role of hyperactivity in understanding suicidal behaviors among children with ADHD. It underscores the importance of considering hyperactivity-related symptoms in assessment and treatment approaches for suicidal behavior in this population.

Maternal suicide risk predicts preschooler emotional and behavioral problems

Maternal history of suicidal thoughts and behaviors (STBs) has been identified as a robust risk factor for offspring emotional and behavioral problems, including risk for offspring STBs. The impact of maternal history of STBs has been well-documented in adolescent and young adult samples, with emerging research highlighting the need to examine early clinical correlates of risk in young children, prior to the emergence of STBs. In an extension of prior work, the current study examined associations between maternal history of STBs and previously identified emotional and behavioral correlates of STBs (negative affect, internalizing problems, attention problems, aggressive behavior) in young children. These associations were examined in a mother-preschooler sample (n = 158, mean preschooler age=41.52 months) with approximately half of mothers endorsing a history of STBs and 20 % of the sample scoring at the threshold that indicates suicide risk. In multivariate models, maternal history of STBs was significantly associated with preschooler aggressive behavior, assessed via mother- (β=0.19) and teacher-report (β=0.21), as well as mother-reported negative affect (β=0.22). Results document a link between maternal history of STBs and increased risk for heightened negative affect and aggressive behavior at home and school during the sensitive preschool period. Findings are discussed within the context of enhancing models of intergenerational transmission suicide risk.

Results from a Pilot Randomized Controlled Trial of a Single-Session Growth-Mindset Intervention for Internalizing Symptoms in Autistic Youth

Autistic youth experience elevated rates of co-occurring internalizing symptoms. Interventions to treat internalizing symptoms in autistic youth are almost uniformly costly and time-intensive, blunting dissemination of intervention and highlighting the need for scalable solutions. One promising option is a relatively new class of evidence-based treatments, single-session interventions (SSIs), however, no study has examined SSIs for depression symptoms in autistic youth. Participants included 40 autistic adolescents ranging in age from 11 to 16 (Mage = 14.22, Nmale = 32). Eligible youth who agreed to participate were randomized to either the active intervention (Project Personality), or an active control designed to mimic supportive therapy. Participants and their caregiver completed questionnaires immediately before, after, and three months post intervention. All participants completed the intervention independently and largely reported enjoying it. The intervention was delivered with 100% fidelity. Findings demonstrated improvements in perceived primary control, malleability of personality, and social competence relative to the active control group immediately post-intervention. Further, results revealed improvements in self-reported depression symptoms and parent reported emotional regulation at 3-month follow up. This study was the first to assess a GM-SSI designed to treat depression symptoms in autistic adolescents. Results indicated improvements in perceived control immediately post-intervention and downstream improvements in depression. Nonetheless, we did not find improvements in symptoms of anxiety, suggesting that autistic adolescents may require modifications to the intervention to maximize benefit. Findings demonstrate the utility of GM-SSI for internalizing symptoms for autistic youth and hold considerable promise as a low-intensity and scalable intervention.

The interaction of family functioning and disease- and treatment-related factors on quality of life for children after cancer

PURPOSE

Children with cancer experience low quality of life (QOL), yet heterogeneity underscores a need to understand how risk and resilience factors interact. This study evaluated if family functioning relates to QOL differentially depending on diagnosis and treatment intensity.

METHODS

Participants included children (ages 8-14) who completed treatment within six months for either brain tumor (BT; n = 42) or non-central nervous system solid tumor (ST; n = 29). Caregivers and children rated QOL and family functioning. Treatment intensity was categorized as low, moderate, or high. Cross-informant moderation models tested hypothesized interactions.

RESULTS

Child-reported family functioning significantly interacted with diagnosis and treatment intensity in models of caregiver-reported QOL. More maladaptive family functioning was associated with reduced QOL for children with BT and moderately-intense treatments.

CONCLUSIONS

Children with BT and moderate treatment intensities are sensitive to family functioning, highlighting an at-risk group to target for family-level intervention. Future work should evaluate these associations longitudinally.

Systematic Integration of Multi-Informant Externalizing Ratings in Clinical Settings

Best practice clinical assessment of externalizing problems often necessitates collection of information from parents, youth themselves, and teachers. The present study tested the predictive validity of a psychometrically-driven scoring procedure to integrate multi-informant, dimensional ratings of externalizing problems. Participants were 2264 clinic-referred youth ages 6-18. Parents, teachers, and youth completed questionnaire ratings of externalizing problems (hyperactivity-inattention, conduct problems, and oppositionality-defiance) prior to an initial clinical appointment. The predictive validity of simple (highest informant rating; and all informant ratings separately) and more complex (latent S-1 bifactor model with specific informant factors; and moderated nonlinear factor analysis accounting for child age and sex) methods of informant integration was tested in predicting impairment, comorbidity, and number of clinical encounters. A simple model, in which all informant ratings were included, showed the best predictive validity across outcomes, performing as well or better than the use of the highest informant ratings or more complex latent variable models. The addition of child age and sex as moderators in the factor model did not improve predictive validity. Each informant (parent, teacher, and youth) contributes important information to the prediction of clinically-relevant outcomes. There is insufficient evidence at present to suggest that complex latent variable models should be favored over simpler models that preserve each informant's ratings.

Future Directions: The Phenomenology of Irritable Mood and Outbursts: Hang Together or Hang Separately1

Recognition of the importance of irritable mood and outbursts has been increasing over the past several decades. This "Future Directions" aims to develop a set of recommendations for future research emphasizing that irritable mood and outbursts "hang together," but have important distinctions and thus also need to "hang separately." Outbursts that are the outcome of irritable mood may be quite different from outbursts that are the trigger or driving force that make youth and his/her environment miserable. What, then, is the relation between irritable mood and outbursts? As the field currently stands, we not only cannot answer this question, but we may also lack the tools to effectively do so. Here, we will propose recommendations for understanding the phenomenology of irritable mood and outbursts so that more directed and clinically useful assessment tools can be designed. We discuss the transdiagnostic and treatment implications that relate to improvements in measurement. We describe the need to do more than repurpose our current assessment tools, specifically interviews and rating scales, which were designed for different purposes. The future directions of the study and treatment of irritable mood and outbursts will require, among others, using universally accepted nomenclature, supporting the development of tools to measure the characteristics of each irritable mood and outbursts, understanding the effects of question order, informant, development and longitudinal course, and studying the ways in which outbursts and irritable mood respond to treatment.

Proposed Specifiers for Conduct Disorder (PSCD) self-report: Factor structure and validation in a community sample of Belgian youth

The current study examined the psychometric properties of the Proposed Specifiers for Conduct Disorder (PSCD) in a sample of school-attending adolescent Belgian youth (N = 599; M age = 16.51 years, SD = 1.27). Given the recent interest in the PSCD-Short Version (PSCD-SV), this study focused on the 13-item variant of the PSCD. Study findings showed that the PSCD-SV had a hierarchical four-factor structure including the components of grandiose-manipulative (GM), callous-unemotional (CU), daring-impulsive (DI), and conduct disorder (CD). These interrelated factors were found to be internally consistent. The study also showed that the PSCD-SV total score was positively and significantly related to an alternate measure of psychopathy. Further, the study revealed the PSCD-SV was meaningfully related to the five-factor personality domains (i.e., extraversion, conscientiousness, agreeableness) as well as peer functioning and prosocial behavior. Bivariate correlations demonstrated that the dimensions differed in their associations with external correlates (e.g., peer functioning). Regression analyses showed that the GM, CU, and CD components of the PSCD-SV were uniquely associated to externalizing difficulties, whereas only the GM and CU components of the PSCD-SV were associated with low prosocial behaviors. These findings shed light on the conceptual and developmental models for the consideration of psychopathy and conduct problems. The use of the broader psychopathy condition as well as its underpinning dimensions may have important implications for assessment, treatment, and diagnostic manuals. The implications of the current study are further discussed.

Measurement-based care in an adolescent partial hospitalization program: Exploring treatment progress and predictors using the top problems assessment

This study used measurement-based care (MBC) to examine patient improvement and trajectories of change during treatment in an adolescent partial hospitalization program (PHP). The current study also explored whether youth trajectories in PHP varied based on demographic variables, symptom severity at intake, or presence of an anxiety or depressive disorder diagnosis. Participants included 124 youth (aged 13-18) with primarily anxiety and depression diagnoses who received care in a PHP. The Top Problems Assessment (TPA), an idiographic measure of patients' chief complaints, was administered weekly alongside depression and anxiety symptom questionnaires to incorporate the consumer perspective. Results demonstrated that youth significantly benefitted from PHP treatment across all measures. The rate of TPA improvement slowed down over time whereas the rates of decline for the anxiety and depression questionnaires did not change statistically. Anxiety disorder status and more severe baseline anxiety symptoms were also independently associated with slower rates of improvement on TPA, but not on the symptom measures. Overall, these results suggest youth improved from treatment in this PHP, and that changes in youth-reported top problems may be more prominent at the beginning of treatment. Moreover, providers may want to consider treatment modifications, or perhaps monitor progress more closely, for youth who present with higher anxiety severity at PHP admission. This study demonstrates how incorporating MBC practices and personalized assessment in a PHP can enable exploration of who benefits most, under what conditions, and when.

A Multi-Method Examination of Peer Functioning in Children with and without Cognitive Disengagement Syndrome

OBJECTIVE

Cognitive disengagement syndrome (CDS) includes excessive daydreaming, mental confusion, and hypoactive behaviors that are distinct from attention-deficit/hyperactivity disorder inattentive (ADHD-IN) symptoms. A growing number of studies indicate that CDS symptoms may be associated with ratings of social withdrawal. However, it is important to examine this association in children specifically recruited for the presence or absence of CDS, and to incorporate multiple methods including direct observations of peer interactions. The current study builds on previous research by recruiting children with and without clinically elevated CDS symptoms and using a multi-method, multi-informant design including recess observations and parent, teacher, and child rating scales.

METHOD

Participants were 207 children in grades 2-5 (63.3% male), including 103 with CDS and 104 without CDS, closely matched on grade and sex.

RESULTS

Controlling for family income, medication status, internalizing symptoms, and ADHD-IN severity, children with CDS were observed during recess to spend more time alone or engaging in parallel play, as well as less time involved in direct social interactions, than children without CDS. Children with CDS were also rated by teachers as being more asocial, shy, and socially disinterested than children without CDS. Although children with and without CDS did not differ on parent- or self-report ratings of shyness or social disinterest, children with CDS rated themselves as lonelier than children without CDS.

CONCLUSIONS

Findings indicate that children with CDS have a distinct profile of peer functioning and point to the potential importance of targeting withdrawal in interventions for youth with elevated CDS symptoms.

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.

Examining Behavioral Approach and Inhibition to Further Characterize Youth With Impulsive Aggression

Objective

Impulsive aggression in youth is a significant clinical and public health concern, spanning multiple diagnostic categories and causing significant psychosocial impairment. To advance its assessment and treatment, recent research has focused on developing an empirically derived nosology that can distinguish impulsive aggression from other common childhood problems. The current study is a secondary analysis examining the associations between this empirically defined form of impulsive aggression, other psychiatric symptom dimensions, and behavioral approach and inhibition motivation of youth.

Method

Participants were 636 youth (61% male; 69% Black/African American; mean age = 11.10) who presented for treatment to a community mental health center or an academic medical center. Dimensions of psychopathology were based on a prior principal component analysis that yielded 5 components: aggression-impulsive/reactive (AIR), mania, depression, self-harm, and rule-breaking. All parents and a subset of youth (n = 363) rated behavioral approach and inhibition motivation of youth.

Results

After controlling for demographic factors (age, sex, race) and other dimensions of psychopathology (mania, depression, self-harm, rule-breaking behavior), AIR was uniquely and positively associated with parent- and adolescent-reported behavioral approach motivation and negatively associated with parent-reported behavioral inhibition.

Conclusion

The results help to further characterize AIR, a clinically relevant and empirically defined construct of impulsive aggression, by showing that AIR is associated with high approach and low inhibition motivational dispositions above and beyond the effects of rule-breaking behavior and mood symptoms. These findings add to a growing literature that shows promise in improving assessment and treatment outcomes for this highly impairing clinical concern.

What is the Best Source of Information for Psychopathic Traits in Youth? A Review and Meta-analysis of Self- and Other-Reported Psychopathic Traits and Their Association with Negative Outcomes

Child psychopathic traits appear to be associated with negative outcomes. Despite the study of youth psychopathy often relying on multiple reporters (e.g., child, caregivers, teachers), there is limited insight into how much information these various sources contribute and moreover, how this information is integrated. The present study sought to address this gap in the literature by examining the magnitude of relationships between self- and other-reported youth psychopathy and negative outcomes (e.g., delinquency, aggression) using a meta-analytic approach. Results revealed a moderate association between psychopathic traits and negative outcomes. Moderator analyses showed a greater relationship for other- than self-reported psychopathy, although not to a substantive extent. Results further indicated the magnitude of the overall psychopathy-negative outcomes association was stronger for externalizing than internalizing outcomes. Study findings can inform improvements in the assessment of youth psychopathy across research and practice, in addition to advancing our understanding of the utility of psychopathic traits in the prediction of clinically relevant outcomes. This review also provides guidance for future multisource raters and source-specific information in the study of psychopathy in youth.