Child and adolescent psychopathy: Assessment issues and treatment needs
Highlights
► We analyze different instruments to assess psychopathy in children and adolescents. ► We review the available treatment modalities to treat child/adolescent psychopathy. ► Research/clinical intervention according to an evolutionary approach is proposed.
Introduction
The first clinical descriptions of psychopathy are attributed to Pinel (1806/1962) and Prichard (1835) who used the terms “manie sans delire” and “moral insanity”, respectively. They described individuals who, without apparent psychopathology, rejected basic social rules and recurrently assumed an antisocial behavior. Brutality, emotional coldness, and callous exploitation of others constitute a set of attributes emphasized in these historical references. Rush (1812) postulated that a deeply rooted “moral depravity” was central in the psychopathic disorder. Schneider (1950) and Kraeplin (1904, 1915) considered these individuals pathologically deceitful and with a tendency to fraudulent behaviors. Kraeplin (1904, 1915) named them “swindlers” and described them as glib, charming, and fascinating, but presenting basic failures in morality or loyalty to others. Schneider (1950) considered these individuals a “self-seeking type” and characterized them as pleasant and affable but egocentric, and superficial in their emotional reactions and in their relationships.
However, it was Hervey Cleckley (1941/1988) who, while studying inpatients at a psychiatric hospital, established a set of specific criteria as the core features of psychopathic personality. Central to his conception, and origin of the title of his book – The Mask of Sanity – is the idea that psychopathy is a severe disorder masked by an outward appearance of robust mental health.
According to Cleckley (1941/1988), antagonistic, aggressive, predatory, vindictive or cruel behaviors were not crucial in the conceptualization of psychopathy. He considered that the deeply rooted impairment of emotional processing among psychopaths (like aphasia or color-blindness), weakened enraged or cruel reactions. Thus, all the harm inflicted to others (as well as to themselves) was a result of their superficiality, boldness, and capricious nature.
In spite of the efforts by Cleckley (1941/1988) to focus the construct of psychopathy upon affective and interpersonal features, the inclusiveness of the anti-social/deviant life-style factor, as a trait inherent to psychopathy or its product, is still questionable (Cooke and Michie, 2001, Cooke et al., 2007, Hare, 2003, Lester et al., in press, Salekin et al., 2006, Skeem and Cooke, 2010).
Regardless of these divergences, because of the impact of psychopathy on society, many authors state that the best time to prevent and intervene is early in life. To make prevention a possibility, it is mandatory to study the construct in early childhood (Lynam, 1996, Lynam et al., 2007, Salekin and Frick, 2005).
Section snippets
Child and adolescent psychopathy
In the 40s, Cleckley (1941/1988) already recognized that psychopathy was a disorder with roots in childhood and adolescence. In the same decade, Karpman, 1949, Karpman, 1950 organized and chaired two consecutive round table discussions about the applicability of the construct to childhood. About 10 years later, McCord and McCord (1964), in the book — The psychopathic: An essay on the criminal mind, stressed the importance of identifying and treating psychopathy in younger populations. These
Assessment of psychopathy
From the works of Lykken (1957), until the early 80s, Cleckley's diagnostic criteria were frequently used in sample selection for the study of psychopathy. Research was conducted mainly on adult male offenders. In the 80s, there was a turning point in the study of the disorder, when Robert Hare (1980) developed a systematic method to assess psychopathy, based on Cleckley's criteria, but presenting some significant differences — the Psychopathy Checklist (PCL; Hare, 1980) and its revised edition
Treatment
Cleckley (1941/1988) contended that psychopathy is essentially a non-treatable condition. Other authors also support this position, including Sueldfeld and Landon (1978) who stated that “no demonstrably effective treatment has been found” (p. 347). Harris and Rice (2006) even argued that “no clinical interventions will ever be helpful” (p. 563). Others have more favorable opinions, pointing out that significant improvements can happen (e.g., psychopathy traits and risk of recidivism), after
Discussion
In the last two decades, there has been a great development in the study of psychopathy in adults and, particularly, in the study of children and adolescents. However, it is important to understand that more research is needed, namely: (a) in the improvement of instruments to assess the disorder (e.g., Johnstone & Cooke, 2004), and (b) to establish and evaluate therapeutic programs (Salekin and Lynam, 2010, Vitacco and Salekin, in press, Vitacco et al., 2010).
In the assessment of child and
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Psychopathic traits in children and youth: The state-of-the-art after 30 years of research
2020, Aggression and Violent BehaviorCitation Excerpt :Several authors have now argued that the best time to prevent and intervene with personality conditions like psychopathy is early in life. Consequently, it seems crucial to study psychopathic traits in children and youth and use the information to build consensus on how to better assess and treat the condition (Colins & Andershed, 2018; Ribeiro da Silva et al., 2012, 2013; Salekin, Andershed, & Clark, 2018). The construct of child and adolescent psychopathy derived from the study of adult psychopathy (Kotler & McMahon, 2010) and can be found in the works of Cleckley (1941/1988), Karpman (1949), Schneider (1950), McCord and McCord (1964), Quay (1965), and even Robins (1966), although Robins' work focused more on the behavioral aspects of psychopathy than the personality traits.
Attachment and psychopathic traits in inpatient female and male adolescents
2018, Comprehensive PsychiatryThe different faces of impulsivity as links between childhood maltreatment and young adult crime
2016, Preventive MedicineCitation Excerpt :Therefore, young adults with a history of childhood emotional abuse may be prone to committing crime in part because they are unlikely to inhibit behavior under the influence of psychological distress. Along the same lines, our findings regarding emotional abuse and property crime, particularly vandalism, could be explained through the development of uncontrollable negative emotionality such as anger and hostility that is built up as a result of emotional abuse and could foster a desire to destroy property (Ribeiro da Silva et al., 2013). Victims of emotional abuse who have urgent personality traits may be stealing and vandalizing property to release and regulate emotional negativity.
The prevalence of psychopathic personality disturbances among incarcerated youth: Comparing serious, chronic, violent and sex offenders
2015, Journal of Criminal JusticeCitation Excerpt :Very few studies have examined psychopathic disturbances in JSO despite its apparent theoretical relevance. The empirical literature is fairly clear in explaining that psychopathy is characterized by interpersonal, affective and behavioral/lifestyle deficits (e.g., Ribeiro da Silva, Rijo, & Salekin, 2013) that are related to a wide range of maladaptive outcomes, including serious and violent offending in youth (e.g., DeLisi, Neppl, Lohman, Vaughn, & Shook, 2014). How these deficits are related to juvenile sex offending is less clear.
The evolutionary roots of psychopathy
2015, Aggression and Violent BehaviorCitation Excerpt :This means, that like other psychiatric conditions, psychopathy is probably a multicausal phenomenon (e.g., DeLisi & Piquero, 2011; Ribeiro da Silva, Rijo, & Salekin, 2012; Viding & Larson, 2010). Other researchers also highlight the importance of an evolutionary approach to explain the development and maintenance of psychopathic traits (Ferguson, 2010; Gilbert, 2005; Glenn, Kuzban, & Raine, 2011; Ribeiro da Silva et al., 2012, 2013; Salekin & Lynam, 2010). Evolutionary sciences expanded very quickly over the past two decades and, despite some criticism (e.g., Gould, 1991), these models offer a great potential in the comprehension of human nature (Gangestad & Simpson, 2007; Gilbert, 2010; Krebs, 2007).
The utility of self-reported psychopathic traits in predicting recidivism among a sample of incarcerated female youths
2020, International Journal of Law and Psychiatry