Chapter 18: Psychopathy and Pathways to AB in Youth
Benefits of CU I: Advantages of using CU: 1 of 3
Advantages of using CU for subtyping antisocial youth: 1) It explicitly focuses on the affective and interpersonal features that have been critical to defining the construct of psychopathy in adult sample, and more important, for differentiating persons with psychopathy from other antisocial individuals (Cleckley, 1976; Hare, 1998). CU traits but not other dimensions of psychopathy, seem to designate a distinct subgroup of children within severely antisocial youth as well.
Benefits of CU II:: Advantages of using CU: 2 of 3
2) Characteristics of children w/CU traits can be integrated with theories of the normal development of conscience (Frick & Morris, 2004). Such as integration between normal and abnormal development could benefit causal theory by highlighting when and how the normal process of conscience development can go awry.
Benefits of CU III: Advantages of using CU: 3 of 3
3) the use of CU traits could help to integrate and explain some of the findings from research using other methods to designate distinct subgroups of AB youth. Specifically, CU traits seem to designate a subgroup of children w/in the childhood-onset group (e.g., Christian et al., 1997; Viding et al., in press) and w/in the group of children who exhibit both ADHD symptoms and serious conduct problems (e.g., Barry et al., 2999; Frick, Cornell, Barry, et al., 2003) who show characteristics consistent with psychopathy.
Benefits of CU IV: CU aggression: proactive & reactive forms of aggression
CU traits are associated w/severe aggression involving both proactive and reactive forms of aggression (e.g., Frick, Cornell, Barry et al., 2003). The delineation of the core features of CU traits (e.g., Frick et al., 2000) and the explicit link to the adult literature on psychopathy could avoid some of the definitational confusion associated with the under-socialized aggressive method for subtyping AB youth that has been used in past research.
Benefits of CU IX: emotional regulation dysfunction = high reactionary aggression
Difficulty in emotional regulation can also render a child particularly susceptible to becoming angry in response to perceived provocations from peers, leading to aggressive acts w/in the context of high emotional arousal, such as in arguments and fights w/parents, teachers, and peers (Hubbard et al., 2002; Kruh et al., 2002; Loney et al., 2003; Shields & Ciccheti, 1998). Given these problems of behavioral & emotional dys-regulation, such children may require a very different approach to to treatment compared to other children w/CPs (Frick, 1998, 2001).
Benefits of CU V: AB youth w/out CU = features associated w/psychopathy
Another advantage in the use of CU traits to designate a distinct group of AB youth is that it also designates a group of children w/out these traits who show some of the features that are often associated with psychopathy (i.e., narcissism and impulsivity, but who show other characteristics that do not fit with traditional conceptualization of psychopathy (Frick & Morris, 2004). Children w/CPs that are not elevated on CU traits are less aggressive than children high on CU traits, and when they do act aggressively, it is more likely to be reactive in nature (Frick, Cornell, Barry et al., 2003) and in response to real or perceived provocation by others (Frick, Cornell, Bodin et al., 2003).
Benefits of CU VI: AB youth w/out CU = dysfunctional parenting practices
AB children w/out CU traits have CPs more associated with dysfunctional parenting practices (Oxford et al., 2003; Wooton et al., 1997) & w/deficits in verbal intelligence (Loney, Frick,Ellis & McCoy, 1998).
Benefits of CU VII: AB youth w/out CU = emotional regulation problems
AB youth w/out CU traits appear to show problems regulating their emotions. They exhibit high levels of self-reported emotional distress (Frick et al., 1999; Frick,Cornell,Bodin et al., 2003), they are more reactive to the distress of others in social situations (Pardini et al., 2003),and they are highly reactive to negative emotional stimuli (Kimonis et al., 2004; Loney et al., 2003).
Benefits of CU VIII: CPs w/out CU traits can’t regulate emotions
Overall, the findings suggest suggest that different mechanisms are operating in the development of CPs for children with/with-out high levels of CU traits. A significant proportion of children w/CPs who lack CU traits seem to have difficulty regulating their emotions (Frick & Morris, 2004). This difficulty in emotional regulation can lead to a number of problems in adjustment. It can result in the child’s committing implosive and unplanned aggressive acts for which he/she may be remorseful afterwards, but still has difficulty controlling in the future (Pardini et al., 2003).
Benefits of CU X: AB youth = adults AB w/out core psychopathy traits
Many of the characteristics of this group of youth (e.g., lower intelligence, dysfunctional family backgrounds, and high levels of emotional reactivity) appear to be consistent w/adults who show criminal and antisocial behavior but who lack the concomitant affective-interpersonal features of psychopathy (Hare et al., 1991).
Childhood -Adolescent onset of CP I: severe CP V severe AB w/puberty onset
Besides the reactive versus proactive aggression to designating subgroups of children w/severe CP that have been the subject of substantial research (see Moffitt,2003, for a review) and that had been incorporated into the most recent versions of the DSM-IV-TR; American Psychiatric Association, 2000, to classify children with CD that distinguishes between children who begin showing severe CP in childhood versus those whose onset of severe AB w/puberty onset.
Childhood -Adolescent onset of CP II: early child disorders increase over time
Children in the childhood-onset group often begin showing mild oppositional and defiant behaviors early in childhood and defiant behaviors early in childhood (i.e., preschool or early elementary school), Their behavioral problems tend to increase in rate and severity throughout childhood and into adolescence (Lahey, & Loeber, 1994).
Childhood -Adolescent onset of CP III: adolescent-onset group of CP
The adolescent-onset group does not show significant behavioral problems in childhood, but this subgroup does begin showing significant antisocial and delinquent beach during adolescence (Hinshaw, Lahey & Hart, 1993; Moffitt, 1993). In addition to different pattens of onset, there are important differences in the severity of behavior and outcome for the two groups of AB youth.
Childhood -Adolescent onset of CP IV: child-onset of CP = life-long AB
Children in the child-onset group of CP are more likely to show aggressive behaviors in childhood and adolescence and they are more likely to continue to show antsocials and criminal behavior through adolescence and into adulthood (Frick & Loney, 1999; Moffitt & Capsi, 2001).
Childhood -Adolescent onset of CP IX: adolescent-onset of AB
Moffitt (1993), children in the adolescent-onset group engage in adolescent and delinquent behaviors as a misguided attempt to obtain a subjective sense of maturity and adult status in a way that is maladaptive (e.g., breaking societal norms) but encouraged by an antisocial peer group. Given that their behavior is viewed as an extension of a process specific to adolescence, and not due to enduring vulnerabilities, their AB is less likely to persist beyond adolescence. However, they may still have impairments that persist into adulthood due to the consequences of the adolescent AB (e.g., a criminal record, dropping out of school, and substance abuse (Moffitt & Caspi, 2001).
Childhood -Adolescent onset of CP IX: chilhood- V adolescent-onset AB not across all samples
It is important to note that the clear differences between the chilhood-onset AB and adolescent-onset AB groups have not been found in all samples (Lahey et al., 2000) and the applicability of this model to girls requires further testing (Silverton & Frick, 1999).
Childhood -Adolescent onset of CP V: childhood-onset CP
Relevant to causal theory is the finding that the two groups (proactive & reactive aggression) differ on a number of risk factors related to AB. Specifically, most of the dispositional (e.g., neuropsychological abnormalities & low intelligence) and contextual (e.g., family dysfunction and poverty) correlates that have been associated with severe AB seen primarily associated with the childhood-onset subtype (Moffitt, 1993; Moffitt & Caspi, 2001).
Childhood -Adolescent onset of CP VI: adolescent-onset CP
In contrast, youth in the the adolescent-onset CP do not show the these same risk factors. This group primarily differs in showing more affiliation with delinquent peers and in scoring higher on measures of rebelliousness and authority conflict) Moffitt & Capsi, 2001; Moffitt, Caspi, Dickson, Silva & Stanton, 1996).
Childhood -Adolescent onset of CP VII: child-onset group
The different characteristics of children in the two groups (child-onset versus adolescent-onset) of AB youth have led the theoretical models that propose very different causal mechanisms across the 2-groups. For example, Moffitt (1993, 2003) has proposed that children in the child-onset group develop their problem through a transactional process involving a difficult and vulnerable child (e.g., impulsive, with verbal deficits and a difficult temperament) who experiences an inadequate rearing environment (e.g., poor parental supervision and poor quality schools). This dysfunctional transactional process disrupts the child’s socialization leading to poor social relations with persons both inside (e.g., parents and siblings) and outside the family (e.g., peers and teachers). These disruptions lead to enduring vulnerabilities that can negatively affect the child’s psychosocial adjustment across multiple developmental stages (see also Hinshaw et al., 1993; Patterson, Reid & Dishion, 1992).
Childhood -Adolescent onset of CP VIII: adolescent-onset pathway
Moffitt (1993, 2003) has proposed a causal model to explain the development of conduct problems for children in the adolescent-onset pathway. Because children in this subgroup are more likely to have their problems to adolescence, and because they fell fewer contextual and dispositional factors, this group is conceptualized as showing an exaggeration of the normative process of adolescent rebellion. That is, most adolescents show some level of rebelliousness to parents and other authority figures. This behavior is part of a process by which the adolescents begins to develop his/her autonomous sense of self and his/her unique identity.
Childhood -Adolescent onset of CP X: chid-onset of CP = construct of psychopathy: 1-of-2 studies
The child-onset group shows number of characteristics that would be consistent w/the construct of psychopathy, such as showing a severe chronic, and aggressive pattern of AB that is likely to persist into adulthood. Two studies have directly tested the association between age of psychopathy: 1) Moffitt et al., (1996) reported that boys who showed a preadolescent onset to their conduct problems and showed a continuous level of conduct problems and showed a continuous level of conduct problems behavior across development (i.e., life-course persistent) were more likely to show a personality style characterized by a suspicious and cynical stance toward others and cold and callous behavior toward others than boys whose conduct problems started in adolescence.
Childhood -Adolescent onset of CP X: child-onset of CP = construct of psychopathy: 2-of-2 studies
2) In an adjudicated sample, Silverthorn, Frick & Reynolds (2001) reported that boys who showed serious CP prior to adolescence (prior to age 10) showed higher rates of impulsivity, narcissism, and callous and unemotional traits than boys whose AB emerged after age 11.
Childhood -Adolescent onset of CP XI: childhood-onset: psychopathic V nonpsychopathic traits
Taken together, research suggests that the childhood-onset group shows a number of characteristics that are consistent with the construct of psychopathy. But, this group also shows a number of features that are non consistent with psychopathy, such as verbal intelligence deficits (Moffitt, 1993), high levels of family dysfunction (Frick, 1998), and high levels of anxiety (Walker et al., 1991).
Childhood -Adolescent onset of CP XII: early-onset delinquency not always life-course persistent offenders
And, not all children with early-onset delinquency show a chronic patterns of antisocial deviance that extends into adulthood (Frick & Loney, 1999). For example, only 43% of the sample of boys with an early onset to their conduct problems self-reported severe violent behavior as an adult, and only 55% had a conviction in adult court by the age of 26-years (Moffit, Caspi, Harrington & Milne, 2002). Therefore, the childhood-onset category may be too broad of a category to represent the developmental precursor to psychopathy.
Comorbidity: CD & ADHD I: comorbidities & CP
Past research on CP in children has consistently shown that these problems co-occur with a large number of other disorders and problems in adjustment (Frick, 1998). Furthermore, the presence of certain comorbidities has been a common criterion for designing important subgroups of youth with conduct problems (Loeber & Keenan, 1994).
Comorbidity: CD & ADHD II: CP & ADHD = childhood-onset group
One of the most common overlapping disorders (comorbidities) in children with CD in ADHD for which rates of disgnosis range from 36% in community samples (Waschbusch, 2002) to as high as 90% in some clinic-referred samples of children with CD (Abikoff & Klein, 1992). This ovelap between CP and ADHD seems to be particularly strong for children in the childhood-onset group (Moffitt, 2003).
Comorbidity: CD & ADHD III: research investigating CP & ADHD overlap
There have been a number of the number of reviews of the extensive body of extensive body of research investigating the overlap between CP & ADHD (Hinshaw, 1987; Lilienfeld & Waldman, 1990; Newcorn & Halperin, 2000; Waschbusch, 2002). The reviews have documented a number of consistent problems with ADHD compared to those w/CP alone.
Comorbidity: CD & ADHD IV: higher offending in youth & adulthood
Research has consistently shown that youth w/CD and ADHD show a more severe and aggressive pattern of AB than youth w/CD alone (Waschbusch, 2002). Children with ADHD and CD have poorer outcomes than children with CD alone, such as showing higher rates of police contact, delinquency, theft and overall offending in adolescence (Loeber, Printout & Green, 1990), as well higher rates of arrests and convictions in adulthood (Babinski, Hartsough & Lambert, 1999; Magnusson, 1987).
Comorbidity: CD & ADHD IX: adult psychopathic traits
In adolescence & adulthood, the psychopathic deficit can result in the manipulative and callous behaviors that are characteristic of adults who show psychopathic traits. In a test of this model, Lynam (1998) found that children with both ADHD symptoms and CPs by showing greater deficits on laboratory tasks assessing response modulation, delay of gratification, and executive functioning. These characteristics of children with co-occurring CPs & ADHD are similar to those found for adults with psychopathic traits (Brinkley, Newman, Widiger & Lynam, 2004).
Comorbidity: CD & ADHD IX: CPs & CU = greater levels of aggression & delinquency w/out ADHD
In a sample of nonreferred, elementary-age school children, those w/CPs and CU traits who showed greater levels of aggression and self-reported delinquency (Frick, Cornell, Barry et al., 2003). The group w/CU traits also showed higher rates of ADHD symptoms. However, The higher rates of aggression and delinquency could not be accounted for by the ADHD symptoms. In fact, those children high on CU traits and CPs but w/out significant ADHD symptoms showed the highest levels of aggression and delinquent behaviors.
Comorbidity: CD & ADHD IX: developmental precursors to psychopathy
Lynam’s model could explain why children with childhood-onset CPs are more likely to show the cold and callous features associated with psychopathy. Children with both ADHD and CPs are more common among this subgroup of AB youth. Lynam’s model (1996) model provides Even greater specificity by suggesting that within the childhood-onset group, those w/co-occurring ADHD are most likely to develop these traits. Furthermore, this theory, makes use of a great deal of excising research by imbedding its model of developmental precursors to psychopathy within the existing diagnostic definitions of disruptive behavior disorders for youth (Burns, 2000).
Comorbidity: CD & ADHD V: ADHD & CP = neuropsychological deficits
Youth w/co-occurring ADHD and CP exhibit a number of distinct problems neuropsychological deficits. For example, antisocial youth w/ADHD are more impaired on tasks measuring verbal and auditory memory (Moffitt & Silva, 1988), show greater deficits in verbal intelligence (Moffitt, 1990), show greater deficits in executive functioning (Moffitt & Henry, 1989), and have more problems inhibiting a dominant response (Halperin, O’Brien & Newcorn, 1990).
Comorbidity: CD & ADHD VI: conceptualize this co-occurrence in causal theories
This evidence clearly suggests that the combination of ADHD and CPs designates an important subgroup of subgroup of antisocial and aggressive youth. However, there is considerable disagreement as to the best way to conceptualize this co-occurrence in causal theories. For example, it has been proposed that the symptoms of ADHD (or more specifically, the impulsivity or hyperactivity symptoms) may be the primary causal factor leading to the development of serious CPs for many children with childhood-onset CPs (Burns & Walsh, 2002).
Comorbidity: CD & ADHD VII: severe & impairing pattern of behavior
It has been suggested that the comorbidity of ADHD and CPs represents an additive combination of two separate domains that, when combined, leads to a particularly severe and impairing pattern of behavior (Waschbusch, 2002).
Comorbidity: CD & ADHD VIII: ADHD & CPs =s distinct disorder or psychopathic deficit
It has been proposed that the combination of ADHD and CPs designates a distinct disorder that is qualitatively different from either disorder alone (Lynam, 1996). Lynam’s model is perhaps important because Lynam has proposed that the combination of symptoms of ADHD and CPs may represent a disorder in children similar to psychopathy in adults. Lynam has suggested that the combination of these behavioral problems arises from a “psychopathic deficit” that consists of difficulty incorporating feedback from the environment and using this information to modulate responses when pursuing rewards. This deficit purportedly leads to hyperactive, inattentive, and impulsive behaviors in early childhood, which develops into oppositional and defiant disorder as the child acquires verbal and motor skills.
Comorbidity: CD & ADHD X: impulsive-antisocial behavior = ASP not= psychopathy
The focus on ADHD and CPs places primary emphasis on an impulsive-antisocial dimension of behavior, which has not proven to be specific with adults with psychopathy. That is, impulsive-antisocial tendencies appear to be elevated in most adults with significant criminal histories and/or diagnosis of ASP (Hare, 1985).
Comorbidity: CD & ADHD XI: adult psychopathy = affective & interpersonal
What has been critical to adult definitions of psychopathy is the presence of a specific affective (e.g., lack of guilt or empathy) and interpersonal (e.g., using others for own gain and manipulating others) style that may accompany this impulsive and antisocial lifestyle (Hare, 2003).
Comorbidity: CD & ADHD XII: conscience & inhibitory control very early in development
It is possible that, as suggested by Lynam (1996), the affective and interpersonal features emerge later in development and are secondary to the problems in inhibitory control. But, there is evidence that the effective components of conscience and inhibitory control represent separable dimensions very early in development (Kochanska, 1995, 1997; Kochanska, Gross, Lin & Nichols, 2002).
Comorbidity: CD & ADHD XIII: children with CU traits
It is possible that a specific focus on the affective and interpersonal features of psychopathy may provide greater specificity for development models of psychopathy. In support of this contention, Barry, Frick, DeShazo, McCoy, Ellis and Loney (2000) divided clinic referred children (ages 6-13) with both ADHD and CPs into those elevated and not evaluated on a measure of CU traits. Only those children who also showed CU traits showed higher levels of thrill-seeking behaviors and deficits in response modulation compared to a control group with ADHD alone or a group w/out behavior problems.
CU Traits & Developmental pathways to CPs I: CU dimension of psychopathy
Another attempt to extend the construct of psychopathy to youth has focused on using the CU dimension of psychopathy to designate a distinct subgroup of antisocial and aggressive youth. The interpersonal-affective dimension, which involves a lack of guilt, lack of empathy, and a basic poverty of emotional reaction, is just one of several dimensions that have emerged as being related to psychopathy in adult samples (Cooke & Michie, 20011; Hare, 2993).
CU Traits & Developmental pathways to CPs II: separate CU dimension emerge
Factor analysis of psychopathic features in youth have typically resulted in two (Frick, O’Brien, McBurnett & Wootton, 1994) or three dimensions (Frick, Bodin & Barry, 2000). For example, Frick et al., 2000, conducted a factor analysis of teacher and parent ratings of psychopathic traits in a community sample of 1,136 elementary school-age and 160 clinic-referred children. In both samples, a separate CU dimension emerged. In the community sample, there was clear evidence for two other dimensions, one involving narcissistic traits (e.g., thinks he/she is more important than others; brags excessively) and the other involving impulsive behaviors. But, there was less evidence for a divergence between the narcissism and impulsivity dimensions in this sample (see Frick et al., 1994).
CU Traits & Developmental pathways to CPs III: high CU = severe AB
Although all 3-dimensions (CU, narcissism, impulsivity) emerged in these samples of youth, in clinic-referred samples of youth, in clinic-referred samples of children (e.g., Christian, Frick,Hill,Tyler & Frazer, 1997) and adjudicated samples of adolescents (e.g., Caputo et al., 1999), the narcisstic and impulsivity dimension do not appear to differentiate within severely antisocial youth. For example, a cluster analysis of psychopathic traits and conduct problems in a clinic-referred sample of children ages 6-13 revealed two distinct conduct problem clusters (Christian et al., 1997). Three clusters did not differ on their level of impulsivity and narcissism, but they did differ in their level of CU traits, with the group high on CU traits showing more severe patterns of antisocial behavior.
CU Traits & Developmental pathways to CPs IV: high CU traits = high impulsivity & narcissism
In a sample of adjudicated adolescents, narcisstic and impulsive traits did not differentiate among nonviolent offenders, violent offenders, and violent sex offenders (Caputo et al., 1999). In contrast, the violent sex offenders did show significantly higher levels of CU traits. Across both studies (Christian et al., 1997; Caputo et al., 1999) children who were high on CU traits also tended to be high on the impulsive and narcissistic dimensions. But, there were some children w/child-onset CPs who showed high levels of impulsive and narcissistic traits but/w/out CU traits (see Frick et al., 2000, for similar findings in a community sample).
CU Traits & Developmental pathways to CPs V: stability of CU, narcissism & impulsivity
It is important to consider the stability of CU, narcisstic and impulsive traits in youth (Seagrave & Grisso, 2002). It is important to test whether these traits designate a stable pattern behavior that would warrant them being considered “personality traits.”
CU Traits & Developmental pathways to CPs VI: parent ratings of CU traits over a 4-year study
Frick, Kimonis,Dandreaux and colleagues (2003) examined the stability of parent ratings of CU traits over a 4-year study period in a sample of 98-children who were in grades 3, 4, 6 and 7 at the time of initial assessment. The interclass correlation coefficients across 2 (.76), 3 (.86), and 4-years (.71) were quite high, indicating a substantial degree of stability in parent ratings of these traits.
CU Traits for Defining Groups of AB Youth I: CU traits = distinct AB youth group
The utility of CU traits for designating a distinct group of AB youth has been supported by number of studies. Specifically, in juvenile forensic facilities (Caputo et al., 1999; Silverthorn et al., 2001), in outpatient mental health clinics) (Christian et al., 1997; Frick et al., 1994), and in school based samples (Frick, Cornell, Barry et al., 2003; Frick, Stickle, Dandreaux, Farrell & Kimonis, in press), AB youth with CU traits seem to show an especially severe, aggressive, and stable pattern of CPs. For example, clinic-referred youth who met criteria for a CP diagnosis showed a more severe and varied pattern of CPs & were more likely to have CPs and were more likely to have contact w/police prior to adolescence if they also were high on CU traits (Christian et al., 1997)
CU Traits for Defining Groups of AB Youth II: CPs & CU traits = proactive/instrumental aggression
In a sample of nonreferred community children in which children who showed both CPs and CU traits exhibited more aggression overall and were more likely to show proactive and instrumental patterns of aggression versus children with CPs but not CU traits (Frick, Cornell, Barry et al., 2003).
CU Traits for Defining Groups of AB Youth III: youth psychopathy from cross-sectional studies
One of the key findings supporting the importance of psychopathy in adult samples is its ability to predict later AB (Gendreau et al., 2002; Hemphill et al., 1998; Walters,2003). Unfortunately, research extending the structure of psychopathy to youth has largely been cross-sectional in nature (Edens, Skeem, Cruise & Cauffman, 2001).
CU Traits for Defining Groups of AB Youth IV: predictive validity of psychopathic adolescent traits
The predictive validity of psychopathic traits has been tested in samples of institutionalized adolescents. These studies have documented that psychopathic features predict subsequent delinquency, aggression, number of violent offenses, and a shorter length of time to violent reoffending in AB youth. (Brandt, Kennedy, Patrick & Curtin, 1997; Forth, Hart & Hare, 1990; Topping, Mercier, Dery, Cote & Hodgins, 1995).
CU Traits for Defining Groups of AB Youth IX: high impulsivity & low CU V High CPs and low CU
Adjudicated youth who were high on impulsivity but not CU traits showed evidence for High CPs and low CU on the lexical-decision task. Similarly, in a sample of non-referred children between the ages of 6-and-13, those w/CPs and CU showed reduced reactivity to pictures involving distressing content (e.g., a child in pain and a hurt animal) using a dot-probe paradigm, whereas children high on a measure of CPs but low on CU traits showed showed a heightened level of reactivity to these stimuli (Kimonis, in press).
CU Traits for Defining Groups of AB Youth V: CU predictive validity
In one of the only studies to test the predictive validity of CU traits in a nonreferred sample of children, Frick and colleagues (in press) reported that children w/CPs who also showed CU traits exhibited the highest rates of CPs, self-reported delinquency, and police contacts across a 4-year study period. In fact, this group with the CU traits accounted for at-least-half of all of police contacts reported in the sample across the last three waves of data collection. In contrast, Children w/CPs who were low on CU traits did not report higher rates of self-reported delinquency than nonCP children. In fact, he 2nd highest rate of self-reported delinquency in the sample was found for the group who were high on CU traits but w/out CPs at the start of the study. The latter findings suggest that CU traits may designate a group of children at risk for delinquency, even in the absence of significant CPs.
CU Traits for Defining Groups of AB Youth VI: high CU & high CPs highly inheritable
AB youth w/CU traits may have different causal processes underlying their behavior problems compared to other AB youth. One of the strongest pieces of evidence for potential differences in causal processes across the 2-groups from a study of 6,330 7-year old twins (3,165) twin pairs; Viding, Blair, Moffitt & Plomin, in press). In this study, children scoring in the top 10% of a measure of CPs were further divided into those with (N = 359) and w/out (N = 333) significant levels of CU traits. Estimates of the genetic and environmental effects on variations in CPs were very different for the two groups. Specifically, the heritability estimate for the group high on both CPs and CU traits (.81) was over twice that for the group low on CU traits (.30). This finding is consistent w/research from adult samples showing significant heritability for measures of psychopathic traits (Blonigen, Carlson, Krueger & Patrick, 2003). While this finding suggests that genetic factors may play a larger role in the development of CU traits, it does not provide clues as to the mechanism by which heredity may exert its effects.
CU Traits for Defining Groups of AB Youth VII: CPs & CU traits = distinct temperamental style
There is a growing body of research to suggest that children w/CPs & CU traits exhibit a temperamental style that is distinct from from other CP youth. Specifically, in both mental health (Frick, Lilienfeld, Ellis, Loney 7 Silverthorn, 1999) and school-based (Frick, Cornell, Bodin et al., 2003) samples, children w/CPs who also show CU traits exhibit a preference for novel, exiting and dangerous activities. Also, children w/CU traits and CPs have been shown to be less reactive to threatening and emotionally distressing stimuli than other AB youth (Blair, 1999; Frick, Cornell, Bodin et al., 2003; Kimonis, Frick, Fazekas & Loney, in press; Loney, Frick, Clements, Ellis & Kerlin, 2003)
CU Traits for Defining Groups of AB Youth VIII: CU = reduced emotional reactivity
In a sample of adolescents referred to a diversion program for delinquent behavior, youth high on CU traits showed reduced emotional reactivity on a lexical decision task that assessed facilitation in the speed of a child’s recognition of words with negative emotional content compared to emotional neutral words (Loney et al., 2003).
CU Traits for Defining Groups of AB Youth X: emotional deficit w/CPs & CU = adult psychopathic traits
The deficit in emotional processing for children w/both CPs and CU traits is very similar to findings w/AB adults who are high on psychopathic traits (Levenston, Harpur & Hare, 1991). Another finding that is consistent with adult findings on psychopathy (e.g.,Newman, Patterson & Kosson, 1997) is that children w/ CU traits and CPs show response perseveration in computer tasks in which a reward-oriented response set is primed (Barry et al., 2000; Fisher & Blair, 1998; Frick,Cornell,Bodin et al., 2003; O’Brien & Frick, 1996). That is, on tasks in which responding leads to a high rate of rewards initially but then leads to a high rate of punishment (e.g., loss of points) later in the task, children w/CPs and CU traits continue to respond despite the increasing rate of punishment.
CU Traits for Defining Groups of AB Youth XI: CU positive aspects
The reward oriented set not only appears in computerized laboratory tests but also in social situations. In a sample of adjudicated adolescent samples, CU traits were also related to a tendency to emphasize the positive aspects (e.g., obtaining rewards and gaining dominance) of solving peer conflicts w/aggression and to de-emphasize the negative aspects (e.g., getting punished, Pardini et al., 2003).
Developmental Models to Explain CU I: CU/psychopahic temperamental style
The preference for novel and dangerous activities, the lack of emotional responsiveness to negative emotional material, and the lack of sensitivity to cues to punishment are all consistent w/a temperamental style that has been variously labeled as “low fearfulness” (Rothbart & Bates, 1998), “low behavioral inhibition” (Kagan & Snidman, 1991), “low harm avoidance” (Cloninger, 1987), or “high daring” (Lahey & Waldman, 2003).
Developmental Models to Explain CU II: CU/psychopathic temperamental style
Several studies of normally developing children have linked this temperamental style (See: Developmental Models to Explain CU I: CU/psychopathic temperamental style article) to lower scores on measures of conscience development in both concurrent studies (Asendorpf & Nunner-Winkler, 1992; Kochanska et al., 2002) and prospective studies (Rothbart, Ahadi & Hershey, 1994).
Developmental Models to Explain CU III: lack of conscience development
These findings (SEE: Developmental Models to Explain CU I & II…) have led to a number of theories as to how this temperamental disposition may be involved in conscience development (See Frick & Morris, 2004, for a review). For example, some theories suggest that the moral socialization and the internalization of parental and social norms are partly dependent on the negative arousal evoked by potential punishment for misbehavior (e.g., Fowles & Kochanska, 2000; Kagan, 1998; Kochanska, 1993).
Developmental Models to Explain CU IV: negative arousal to punishment cues is attenuated
Guilt and anxiety associated w/actual or anticipated wrong doing can be impaired if the child has a temperament in which the negative arousal to cues of punishment is attenuated, resulting in a diminished experience of anxiety (Kagan, 1998; Kochanska, 1993).
Developmental Models to Explain CU IX: CPs & CU = psychopathic affective deficits
CU & CP emphasis on impairments in the affective components of conscience is consistent with many theories of psychopathic behavior in adults (Hare, 1993).
Developmental Models to Explain CU V: temperamental deficit in negative-emotional arousal
Blair & colleagues (Blair, 1995; Blair, Colledge,Murray & Michael, 2001; Blair, Jones, Clark & Smith, 1997) have proposed a model of socialization that also emphasizes the importance of negative emotional arousal. This model focuses more specifically on the development of empathetic concern in response to the distress in others. This model focuses on early negative emotional reactivity to the distress of others becomes conditioned to behaviors on the part of the child that prompted the distress in others (Blair, 1995). Through the process of conditioning, the child learns to inhibit such behaviors as a means of avoiding this negative arousal. This process of avoidance learning can be impaired by a temperamental deficit in negative-emotional arousal.
Developmental Models to Explain CU VI: parental socialization strategies w/out punishment
The primacy of negative emotional arousal in the development of conscience has been questioned by a number of theorists (Grusec & Goodnow, 1994; Hoffman, 1994). The primary criticism is that it ignores the importance of parental socialization strategies that do not rely on punishment to evoke negative emotions.
Developmental Models to Explain CU VII: emotional arousal = conscience development
The model by Kochanska and colleagues (Kochanska, 1993, 1995, 1997; Kochanska et al., 2002) focuses on emotional arousal as key to conscience development. It proposes that the optimal level of arousal for moral socialization is achieved through an interaction between the child’s temperament and the type of parenting he or she receives. Kochanska and colleagues reported that relatively fearful toddlers showed enhanced scores on measures of conscience development later in childhood if they experienced gentle, consistent and nonpower assertive parenting (Kochanska, 1995, 1997). In contrast, relatively fearless children did not respond w/improved scores on conscience development when they experienced gentle discipline at home. Presumably, such discipline did not lead to optimal conscience development.
Developmental Models to Explain CU VIII: CPs & CU = psychopathy
Children w/CPs & CU appear to be less responsive to typical parental socialization practices than other children w/CPs (Oxford, Cavell & Hughes, 2003; Wootton, Frick, Shelton & Silverthorn, 1997), they are less distressed by the negative effects of their behavior on others (Blair et al., 1997; Frick et al., 1999; Pardini et al., 2003), and they are less able to recognize expressions of sadness in the faces and vocalizations of other children (Blair et al., 2001; Stevens, Charman & Blair,, 2001).
Extending Psychopathy to Youth I: considerations: number of factors differ
There is still debate on considerations: number of factors differ, from two (Harpur, Hare & Hakstian, 1989) to eight (Lilienfeld & Andrews, 1996) factors underlying these traits (See: Hare & Neumann, Chapter 4: PCL-R assessment of psychopathy; and Cooke, Michie & Hart, Chapter 5: Facets of Clinical Psychopathy)
Extending Psychopathy to Youth II: psychopathy construct dimensions debated
Disagreement about which of these dimensions are core to the definition of psychopathy (Cooke & Michie, 2001) and even whether any of these dimensions is either necessary or sufficient for defining the construct of psychopathy (Brinkley et al., 2004; Skeem, Poythress, Edens, Lilienfeld & Cale, 2003).
Extending Psychopathy to Youth III: fearfulness & AB in psychopathy?
There is disagreement as to whether fearfulness (Lilienfeld & Andrews, 1996) and AB (Hare, 2003) should be considered part of the defining features of the construct or whether they should be considered as a temperamental risk factor for psychopathy or one possible outcome for individuals with psychopathy (Cooke & Michie, 2001; Frick, Bodin & Barry, 2000; Frick, Cornell, Bodin et al., 2003).
Extending Psychopathy to Youth IV: operational definition challenges
An operational definition of child psychopathy are likely to meet w/significant disagreement as to whether what is specified to be “core” to psychopathy is sufficiently covered or covered in a way that is developmentally appropriate (Johnstone & Cooke, 2004).
Extending Psychopathy to Youth V: PCL-R = preadolescent samples questioned
The most common methods of assessing psychopahy have been based from techniques developed for use in adult incarcerated samples. For example, the most common measure used to assess adults, PCL-R (Hare, 2003), employ data from a semi-structured interview and from institutional files to assign rating of psychopathy. But, when studying youth in non-incarceration samples, the availability of extensive historical data may be limited. And, the reliability and validity of child (i.e., preadolescent) self-report for assessing most forms of psychopathology has been questioned, especially when assessing AB attitudes and behaviors (Kamphaus & Frick, 2002).
Extending Psychopathy to Youth VI: risks of extending psychopathy to youth
Concern has been raised that some levels of psychopathic traits (e.g., irresponsibility, egocentricism, lack of planning and forethought) may be normative in youth and that extending the construct of psychopathy to youth runs the risk of labeling as disordered some youth who show a transient and normative pattern of behavior (Seagreave & Grisso, 2002; Skeem & Cauffman, 2003).
Extending Psychopathy to Youth VII: misuse of measures of youth w/psychopathic traits
The validity of existing measures of psychopathic traits in youth for making such decisions has not been established and, thus, there is great potential for misuse of such measures in many applied settings (Edens et al., 2001).
Subtypes of Aggressive Behavior I: aggressive & nonaggressive forms of conduct problems
Aggressive behavior that is intended to hurt to harm others (Berkowitz, 1993), is an important dimension of childhood conduct problems in most classification systems (American Psychiatric Association,2000). Specifically, many approaches to subtyping children with conduct problems make a distinction between children with aggressive and nonaggressive forms of conduct problems (American Psychiatric Association, 1980; Loeber,Keenan, Zhang, 1987; Quay, 1987).
Subtypes of Aggressive Behavior II: child aggression stable across lifespan
subtyping children with conduct problems make a distinction between children with aggressive and nonaggressive forms of conduct problems (American Psychiatric Association, 1980; Loeber,Keenan, Zhang, 1987; Quay, 1987). The importance of this distinction is supported by research showing that aggressive behavior in children is often quite stable across the lifespan (Huesmann, Eron, Lefkowitz & Walder, 1984) and is very difficult to treat (Kazdin, 1995; Quay, 1987).
Subtypes of Aggressive Behavior III: adult psychopaths = violent-aggressive AB
Aggressive behavior in children is often quite stable across the lifespan (Huesmann, Eron, Lefkowitz & Walder, 1984) and is very difficult to treat (Kazdin, 1995; Quay, 1987). Research in adult samples has shown that adults with psychopathy show a particularly violent and aggressive pattern of antisocial behavior (Gendreau et al., 2002; Hemphill et al., 1998; Walters, 2003; Porter & Woodworth, Chapter 24, this volume.)
Subtypes of Aggressive Behavior IV: child patterns of aggression
Research has shown that there are several distinct patterns of aggressive behavior that may be displayed by children. The distinctions among aggressive behaviors have typically focused on differences in the form (i.e., overt and relational aggression) and the function (i.e., reactive and proactive aggression) of aggressive behavior (see Dodge & Petit, 2003; Little, Jones, Henrich & Hawley, 2003; Poulin & Boivin, 2000, for reviews). Overt and relational forms of aggression can be descriptively distinguished by 1) their method of harm and 2) the goals they serve.
Subtypes of Aggressive Behavior IX: aggressive children = child reactive & instrumental aggression
Factor analysis has consistently identified separate dimensions of aggression related to reactive or instrumental aggression to these 2-categories in children and adolescents (Brown, Atkins, Osborne & Milnamow, 1996; Dodge & Coie 1987; Poulin & Bouvin, 2000; Salmivalli & Nieminen, 2002). Still, these studies have shown that dimensions of reactive and proactive aggression are highly correlated, with estimates ranging from .40 to .90 and typically being about .70 (e.g., Brown et al., 1986). These substantial correlations suggest that a large number of aggressive children show both types of aggression.
Subtypes of Aggressive Behavior V: Overt aggression & Relational aggression
Overt aggression harms others by damaging their physical well-being and verbally aggressive behaviors such as hitting, pushing, kicking and threatening (Coie & Dodge, 1998). Relational aggression harms others through damage to their social relationships, their friendships, or their feelings of inclusion and acceptance in the peer group (Crick et al., 1999). Relational aggression consists of behaviors such as gossiping about others, excluding target children from the group, spreading rumors, or telling others not to be friends with a target child (Crick & Grotpeter, 1995).
Subtypes of Aggressive Behavior VI: boys’ v girls’ aggression
Research has shown that boys are significantly more overtly aggressive than girls, whereas girls may be more relationally aggressive (Crick, Casas & Mosher, 1997; Crick & Grotpeter, 1995). Regardless of gender, however, both relational and overt aggression have been shown to predict social, psychological, and school-related adjustment problems in children and adolescents (Crick, 1996; Crick et al., 1997; Prinstein, Boergers & Vernberg, 2001).
Subtypes of Aggressive Behavior VII: Reactive aggression
Aggressive behavior is separated into reactive and proactive dimensions (Dodge & Petit, 2003; Poulin & Boivin, 2000). Reactive aggression also referred to as hostile or impulsive aggression, is generally defined as aggression that occurs as an angry response to provocation or threat (Dodge & Petit, 2003; Poulin & Bouvin, 2000). Aggressive acts of this kind often occur in the context of high emotional arousal, such as in an argument or fight, and they are typically not planned.
Subtypes of Aggressive Behavior VIII: deliberate aggression
Proactive aggression or instrumental aggression or premeditated aggression, is generally defined as aggression that is unprovoked and typically involves planning and forethought. Most important, this form of aggression is used for some sort of instrumental gain, such as to obtain goods or services, to obtain dominance over others, or to embrace one’s social status (Dodge & Petit, 2003).
Subtypes of Aggressive Behavior X: Two types of aggression V one type
Research has indicated that there is some asymmetry in the high degree of association between the two types of aggression. Specifically, there appears to be a significant number of children who only show reactive forms of aggression, whereas most children who show high levels of proactive aggression also show high rates of reactive aggression (Brown et al., 1996; Dodge & Coie, 1987; Pitts, 1997). Therefore, there appears to be a group of highly aggressive children who show both types of aggressive behavior and who show only reactive types of aggression (Frick, Cornell, Barry, Bodin & Dane, 2003).
Subtypes of Aggressive Behavior XI: 1-of-2 characteristics of child aggressive subgroups
There is growing evidence for a number of distinct characteristics between children in these aggressive subgroups: 1) children in the two groups have different risk for problems later in adolescence and adulthood. Specifically, children who show proactive aggression are at higher risk for delinquency and alcohol abuse in adolescence, as well as criminality in adulthood (Pulkkinen, 1996; Vitaro, Brendgen & Tremblay, 2002; Vitaro, Gendreau, Tremblay & Oligny, 1998).
Subtypes of Aggressive Behavior XII: 2-of-2 characteristics of child aggressive subgroups
2) The social adjustment of children in these 2-aggressive groups (proactive & reactive aggression) appears to be different. Reactively aggressive children show greater school adjustment problems, higher rates of peer rejection, and more peer victimization than do proactively aggressive children (Dodge, Lochman, Harnish, Bates & Pettit, 1997; Poulin & Boivin, 2000; Schwartz et al., 1998; Waschbush, Willoughby & Pelham, 1998).
Subtypes of Aggressive Behavior XIII: reactive aggression children
These social problems (reactive aggression children) may be related to deficits in social cognition that have been related to reactive aggression, such as a tendency to attribute hostile intent to ambiguous provocations by peers and difficulty developing nonaggressive solutions to problems in problems in social encounters (Crick & Dodge, 1996; Dodge, Price, Bachorowski & Newman, 1990; Hubbard, Dodge, Cillessen, Coie & Schwartz, 2001).
Subtypes of Aggressive Behavior XIV: proactively aggressive children
Proactively aggressive children over-estimate the positive consequences of the aggressive behavior (e.g., the likelihood that it will produce tangible rewards and reduce adverse treatment from others) and are less likely to believe that they will be punished because of their behavior (Dodge et al., 1997; Price & Dodge, 1989; Schwartz et al., 1998).
Subtypes of Aggressive Behavior XIX: violent children & psychopathic traits
Research comparing children with different patterns of aggressive behavior has uncovered a number of important differences between children who show purely reactive aggression and those who show both proactive and reactive aggression. These include many differences in their social, cognitive and affective characteristics. Most important, it appears that the group high on both reactive and reactive aggression shows number of characteristics that are similar to adults with psychopathy, as the severe & persuasive nature of their aggression, such as the severe and persuasive nature of their aggression, their risk for adult criminality, their insensitivity to potential punishment for their aggressive behavior, and deficits in their emotional reactivity.
Subtypes of Aggressive Behavior XV: 3-of-3 characteristics of child aggressive subgroups
3) The 2-patterns of aggressive behavior (prosocial and reactive) have been related to distinct emotional correlates. Reactively aggressive children show high rates of angry reactivity, low frustration tolerance, and a propensity to react with high levels of negative emotion to aversive stimuli (Hubbard et al., 2002; Little et al., 2003; Shields & Ciachetti, 1998: Vitaro et al., 2002).
Subtypes of Aggressive Behavior XVI: reactively aggressive children
Consistent with problems in emotional regulation, reactively aggressive children exhibit high rates of depression and anxiety, and they score higher on measures of impulsivity (Day, Bream & Pal, 1992; Dodge et a., 1997; Vitaro et al., 1998, 2002).
Subtypes of Aggressive Behavior XVII: kids w/proactive aggression high
Children who are high on proactive aggression do not show these problems in emotional regulation (Crick & Dodge; Dodge & Coie, 1987; Dodge et al., 1997; Vitaro et al., 2002). In fact they often show reduced levels of emotional reactivity (Hubbard et al., 2002; Pitts, 1997).
Pitts (1997) reported on a group of 103 boys (grades 3-6) who were placed into 3-groups: 1) nonaggressives (N = 38), 2) reactive aggressives (N = 19), and 3) reactive-progressive aggressive (N = 38). Both groups of aggressive children exhibited lower rates of resting heart rate than did the nonaggressive group. But, in response from a simulated provocation from peers, the heart rate of the reactive group increased significantly compared to control children (nonaggressives), whereas the heart rate of the proactive-reaction group remained low.
Subtypes of Aggressive Behavior XX: pervasive kid aggression = adult psychopathy
The link between the pervasive pattern of aggression in children and characteristics associated with psychopathy is consistent with research on incarcerated adults that has shown that sever patterns of violence that include instrumental & aggressive aggression are associated with psychopathic traits (Cornell et al., 1996; Patrick, Zempolich & Levenston, 1997; Woodworth & Porter, 2002).
Subtypes of Aggressive Behavior XXI: Violent sex offenders = higher psychopathic traits
Violent sex offenders, who tend to show more instrumental and premeditated violence, showed higher rates of psychopathic traits compared to other violent offenders and nonviolent juvenile offenders (Caputo, Frick,& Brodsky, 1999). In a sample of juvenile offenders incarcerated in adult prison, offenders who showed more severe, repeated, instrumental and sadistic violence against their victims scored higher on a self-report measure of psychopathic traits (Kruh, Frick & Clements, 2005).
Subtypes of Aggressive Behavior XXII: psychopathic positive traits = instrumental aggression
In a sample of 169 adjudicated adolescents, psychopathic traits were associated w/a tendency to emphasize the positive aspects (e.g., obtaining rewards & gaining dominance) of aggression and deemphacize the negative (i.e., getting punished)of these acts (Pardini, Lockman & Frick, 2003). This cognitive style is linked specifically to instrumental aggression; SEE: Subtypes of Aggressive Behavior XX: pervasive kid aggression = adult psychopathy).
Subtypes of Aggressive Behavior XXIII: CD & proactive aggression
In a nonreferred community sample of children, youth with conduct problems and psychopathic traits exhibited more aggression overall, and more proactive aggression specifically than other children with conduct disorders (Frick,Cornell, Bodin et al., 2003).
Subtypes of Aggressive Behavior XXIV: reactive & instrumental aggression = psychopathy
Taken together, the research provides growing support for the contention that children who show a combination of proactive and reactive patterns of aggression show a number of characteristics consistent with the construct of psychopathy.
(SEE: Subtypes of Aggressive Behavior 1- XXIII…)
trait constellation: psychopathy I: affective, self-referential, behavioral
The constellation of affective (e.g., poverty of emotions, lack of empathy, and guilt), interpersonal (e.g., callous use of others for one’s own gain), self-referential (e.g., inflated sense of ones own importance), and behavioral (e.g., impulsivity and irresponsibility) traits associated with the construct of psychopathy have proven to be quite important for designating a distinct group of antisocial adults.
trait constellation: psychopathy II: inmates w/psychopathic traits = severe AB
Research has consistently shown that incarcerated adults who also show psychopathic traits show a more severe and violent pattern of AB, both within the institution and after release (Gendreau, Goggin & Smith, 2002; Hemphill, Hare & Wong, 1998; Walters, 2003).
trait constellation: psychopathy III: high AB & psychopathy commoneness
Incarcerated adults with and without psychopathy features show a number of distinct cognitive (Newman & Lorenz, 2003), affective (Hare, 1998; Patrick, 2001), and neurological (Kiehl et al., 2001), correlates that could implicate different causal processes involved in the development of AB for the 2-groups of individuals (Factors 1 & 2).
trait constellation: psychopathy IV: chronic youth offenders = 50% of crime
As w/Adult AB, research has clearly indicated that AB youth are a very heterogeneous group (Frick & Ellis, 1999). For example, the most persistent 5-6% for youthful offenders account for about 50% of reported crimes (Farrington, Ohlin & Wilson, 1986; Moffitt, 1993).
Undersocialized/Socialized Subgroups of Antisocial Youth I: extend psychopathy construct to youth
One of the earliest attempts to explicitly extend the construct of psychopathy to youth divided juvenile offenders into categories labeled “psychopathic” and “socialized.” (Quay, 1964). The psychopathic group was characterized by such traits as a lack of concern for others, untrustworthiness, a lack of bonding w/others, and a destructive and assaultive behaviors. The socialized delinquent group that was less aggressive and less interpersonally alienated and often committed nonaggressive delinquent acts (e.g., truancy, stealing and drug use) with antisocial peers. In an attempt to avoid the pejorative connotations associated with the label “psychopathy” the former subgroup was later changed to “undersocialized aggressive” (Quay, 1986).
Undersocialized/Socialized Subgroups of Antisocial Youth II: Undersocialized- V Socialized aggressive youth
Undersocialized aggressive youth showed more adjustment problems in juvenile facilities, were less successful in institutional work-release programs, and were more likely to violate probation and be rearrested than socialized aggressive youth (Quay, 1987) P. 360.
Undersocialized/Socialized Subgroups of Antisocial Youth III: like adults with psychopathy
Undersocialized aggressive youth were characterized by low autonomic arousal, diminished serotonergic functioning, response perseveration of laboratory tasks, and stimulation-seeking behaviors (Lahey, Hart, Pliszka, Applegate & McBurnett, 1993; Quay, 1987, 1993; Raine, 2002). These results are all similar to findings for adults with psychopathy (Brinkley et al., 2004).
Undersocialized/Socialized Subgroups of Antisocial Youth IV: “socialized” or “undersocialized” subtypes
The DSM-II (American Psychiatric Association, 1980) included in its diagnosis of CD a distinction between “socialized” or “undersocialized” subtypes.
Undersocialized/Socialized Subgroups of Antisocial Youth V: undersocialized aggressive definition confusion
The change in name from “psychopathy” to “undersocialized aggressive” resulted in considerable confusion as to the core features of this subtype and as to the best way to operationalize these features (Hinshaw et al., 1993; Lahey, Loeber, Quay, Frick & Grimm, 1992). Some definitions focused on the child’s ability to form an maintain social relationships, whereas others focused primarily on the context (alone or as a group) in which the antisocial acts were typically committed (see Frick & Ellis, 1999, for examples). Few definitions focused directly on the interpersonal and affective characteristics that were central to the clinical descriptions of psychopathic individuals on which this method of subtyping was purportedly based.
Undersocialized/Socialized Subgroups of Antisocial Youth VI: new focus: AB acts committed w/antisocial peers
DSM -III-R (American Psychiatric Association, 1987) reversed its criteria (1980) for subtyping CD disorder (Lahey et al., 1992). The criteria for undersocialized subtype were changed to focus solely on whether the antisocial acts were committed alone an whether the pattern included aggressive symptoms. It was renamed the “solitary-aggressive subtype.” The criteria for the second subtype (socialized aggressive subtype) focused solely on whether the antisocial acts were committed w/other antisocial peers, and this subtype was assumed to be primarily nonaggressive in nature. It was named the group subtype: “socialized aggressive subtype.”
Undersocialized/Socialized Subgroups of Antisocial Youth VII: revised criteria for subtyping CD
The rationale for defining subtypes of “undersocialized types” (DSM -III-R: American Psychiatric Association, 1987) revised its criteria for subtyping conduct disorder (Lahey et al., 1992). 1) children of the undersocialized type tended to be highly aggressive, whereas most children identified as falling within the socialized aggressive type tended to show nonaggressive AB symptoms. 2) It was assumed that reliability would be enhanced because there was less ambiguity in measuring physical aggression and in determining who was typically present when a child engaged in AB than in measuring more subjective personality traits related to a child’s emphatic concern for others and feelings of guilt (Hinshaw et al., 1993; Lahey et al., 1992).
Undersocialized/Socialized Subgroups of Antisocial Youth VIII: focus away from core adult psychopathy traits
The rationale for defining subtypes of “undersocialized types” (DSM -III-R: American Psychiatric Association, 1987), while eliminating some of the confusion inherent in assessing the earlier DSM-III criteria (1980), moved this subtype approach away from a focus on the interpersonal and affective dimensions that are considered hallmarks of adult psychopathy (see Hare, Hart & Harpur, 1991, for a similar trend in definitions used to define psychopathy in adults).