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Gepubliceerd in: Journal of Abnormal Child Psychology 7/2013

01-10-2013

Psychopathy as Predictor and Moderator of Multisystemic Therapy Outcomes among Adolescents Treated for Antisocial Behavior

Auteurs: Willeke A. Manders, Maja Deković, Jessica J. Asscher, Peter H. van der Laan, Pier J. M. Prins

Gepubliceerd in: Research on Child and Adolescent Psychopathology | Uitgave 7/2013

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Abstract

Objective

The aim of the present study was to determine whether psychopathic traits act as a predictor and/or moderator of the effectiveness of Multisystemic Therapy (MST).

Method

The sample included N = 256 adolescents (188 boys and 68 girls) referred for conduct problems, randomized to MST or Treatment As Usual (TAU). The mean age was 16 years (SD = 1.31). Assessments were carried out before and immediately after treatment (6 months later). Three psychopathic traits (callous/unemotional traits, narcissism, and impulsiveness) were assessed with parent reports. Adolescents and parents were informants on externalizing problems.

Results

MST was more effective than TAU in decreasing externalizing problems for the “lower callous/unemotional” and “lower narcissism” group, but not for the “high callous/unemotional” and “high narcissism” group (moderators). Impulsiveness was found to predict more post-treatment externalizing problems rated by adolescents (predictor), but not more post-treatment externalizing problems rated by parents.

Conclusions

These findings point out the clinical relevance of adequately assessing psychopathic traits in adolescents referred for treatment of antisocial behaviour, and identifying those adolescents who show high levels of these traits. It is important to tailor MST specifically to meet the needs of juveniles with high levels of callous/unemotional traits and high levels of narcissism to obtain the same level of effectiveness as with juveniles scoring lower on these traits.
Voetnoten
1
Because reliance on sample specific distributions of psychopathic traits may limit the generalizability of the findings, we conducted additional analyses using the results of the only study by Roose et al. (2009) that assessed the APSD and ICU in a Dutch (community) sample of adolescents (n = 455). In these analyses we used a cut off score that was based on the criterion of one standard deviation above the mean provided by this study to indicate the “high psychopathy” group (whereas the rest was the “lower psychopathy” group). Given the fact that this was a convenience sample, these scores cannot be considered norm scores, but the consistency of the results across analyses conducted with different cut off scores would increase confidence in the presented results. The additional analyses indeed showed a similar pattern of findings. More impulsiveness at pretest was found to predict more externalizing problems after treatment as rated by parents as well as adolescents (F = 6.03, p < 0.05 and F = 12.93, p < 0.01, respectively). Callous/unemotional traits and narcissism moderated the effect of intervention on externalizing problems rated by parents as well as adolescents (F = 4.48, p < 0.05 and F = 7.54, p < 0.01 for callous/unemotional traits, respectively; F = 11.95, p < 0.01 and F = 6.01, p < 0.05 for narcissism, respectively). Detailed information regarding these additional analysis is available from the corresponding author.
 
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Metagegevens
Titel
Psychopathy as Predictor and Moderator of Multisystemic Therapy Outcomes among Adolescents Treated for Antisocial Behavior
Auteurs
Willeke A. Manders
Maja Deković
Jessica J. Asscher
Peter H. van der Laan
Pier J. M. Prins
Publicatiedatum
01-10-2013
Uitgeverij
Springer US
Gepubliceerd in
Research on Child and Adolescent Psychopathology / Uitgave 7/2013
Print ISSN: 2730-7166
Elektronisch ISSN: 2730-7174
DOI
https://doi.org/10.1007/s10802-013-9749-5