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Dimensions of youth psychopathy differentially predict concurrent pro- and antisocial behavior

Abstract

Objective:

To investigate the unique contribution of narcissism and impulsivity, in addition to callous-unemotional (CU) traits, in explaining concurrent prosocial and antisocial behavior.

Method:

Two hundred and forty-nine schoolchildren (53% female; age 9-12 years) completed the self-report Strengths and Difficulties Questionnaire (SDQ) and the Antisocial Process Screening Device (APSD). Two statistical models were tested, predicting conduct problems (CP) and prosocial behavior (PB). In the first one, CU traits and gender were entered into the equation. The second model added narcissism and impulsivity.

Results:

Gender, narcissism and impulsivity, but not CU, were statistically significant predictors of CP in the second model (F3,226 = 45.07, p < 0.001, R2 = 43.7%; betas: gender = -0.20, narcissism = 0.29, impulsivity = 0.36, CU = 0.06). PB was significantly predicted by all domains except gender (F3,226 = 42.57, p < 0.001, R2 = 42.4%; betas: gender = 0.08, narcissism = -0.16, impulsivity = -0.23, CU = -0.41).

Conclusion:

Our results confirmed that CU traits refer to a distinct manifestation of psychopathy in youth, but we also found that narcissism and impulsivity are equally important when predicting CP. Previous reports of sex differences on APSD and SDQ domains were also corroborated.

Child psychiatry; diagnosis and classification; personality disorders - cluster B (antisocial-borderline-histrionic-narcissistic); violence/aggression; gender differences


Introduction

Children with dysfunctional levels of aggression and antisocial behavior may meet criteria for a diagnosis of conduct disorder (CD). CD is characterized by behavior that violates the rights of others or societal norms11. Jones APJ, Wendt GW. Neuropsychology of psychopathic traits in children. In: Delisi M, Vaughn M. The Routledge international handbook of biosocial criminology. London: Routledge; 2015. p. 218-35. and interferes with typical social and/or academic functioning.22. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Arlington: American Psychiatric Publishing; 2013. The presence of conduct problems (CP) during childhood and adolescence places individuals at risk of serious outcomes such as delinquency, criminal involvement, substance misuse, relationship problems, and severe psychopathy.33. Gumpel TP. Linking psychopathy and school aggression in a nonclinical sample of adolescents. J Sch Violence. 2014;13:377-95. Within the most recent iteration of the DSM-5, the definition of CD has been developed to include a specifier to this diagnosis for those who also display limited prosocial emotions, such as deficits in empathy and in expression of guilt.22. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Arlington: American Psychiatric Publishing; 2013. These characteristics overlap with the concept of callous-unemotional (CU) traits.

CU traits are a category of behavior characterized by persistent, negative acts intended to harm others, as well as the absence of emotional responsiveness and little to no empathy. In this sense, CU traits can be considered as a developmental precursor to psychopathy.11. Jones APJ, Wendt GW. Neuropsychology of psychopathic traits in children. In: Delisi M, Vaughn M. The Routledge international handbook of biosocial criminology. London: Routledge; 2015. p. 218-35. To date, it has been proposed that CU traits may be associated with genetic, brain-based, and environmental factors,44. Viding E, Jones AP, Paul JF, Moffitt TE, Plomin R. Heritability of antisocial behaviour at 9: do callous-unemotional traits matter? Dev Sci. 2008;11:17-22.-55. Fontaine NM, Rijsdijk FV, McCrory EJ, Viding E. Etiology of different developmental trajectories of callous-unemotional traits. J Am Acad Child Adolesc Psychiatry. 2010;49:656-64. which predispose a child to this particular and persistent interpersonal style. CU traits are typically associated with adverse outcomes such as increased CP, substance use, and risk-taking behaviors. Elevated levels of CU traits have been shown to delineate a group of individuals with more severe behavioral difficulties and with very similar rates of CD and oppositional defiant disorder as opposed to those with non-elevated CU traits,66. Frick PJ, Ray JV, Thornton LC, Kahn RE. Can callous-unemotional traits enhance the understanding, diagnosis, and treatment of serious conduct problems in children and adolescents? A comprehensive review. Psychol Bull. 2014;140:1-57. who tend to be more heterogeneous with regards to behavioral symptoms. Additionally, the combination of early psychopathic traits such as impulsivity, CU traits, and aggression has established influences on propensity, situational context, and deterrence of violent offending trajectories.77. McCuish EC, Corrado RR, Lussier P, Hart SD. Psychopathic traits and offending trajectories from early adolescence to adulthood. J Crim Justice. 2014;42:66-76.

8. Corrado RR, McCuish EC, Hart SD, DeLisi M. The role of psychopathic traits and developmental risk factors on offending trajectories from early adolescence to adulthood: a prospective study of incarcerated youth. J Crim Justice. 2015;43:357-68.
-99. Corrado RR, McCuish EC, Hart SD, Delisi M. The role of symptoms of psychopathy in persistent violence over the criminal career into full adulthood. J Crim Justice. 2015;43:345-56.

Although CU traits may play a key role in youth psychopathy, there is no consensus as to whether the presence of CU traits is sufficient to classify this subgroup of youth. To date, researchers have repeatedly neglected the contribution of traits such as narcissism and impulsivity to the development of psychopathy – realms that are equally important in determining potential prospects of future psychopaths.1010. Kerig PK, Stellwagen KK. Roles of callous-unemotional traits, narcissism, and Machiavellianism in childhood aggression. J Psychopathol Behav Assess. 2010;32:343-52.,1111. Feilhauer J, Cima M. Youth psychopathy: differential correlates of callous-unemotional traits, narcissism, and impulsivity. Forensic Sci Int. 2013;224:1-7. This is alarming, since early treatment is imperative to attenuate the numerous consequences related to psychopathy along the lifespan. For instance, longitudinal research has shown that narcissism, impulsivity, and CU traits as measured by the Antisocial Process Screening Device (APSD) significantly predicted the “meanness” (e.g., lack of empathy, callousness, cruelty) domain of the Triarchic Psychopathy Measure (TriPM) later on, in young adulthood (β = 0.39, 0.24, and 0.44, respectively).1212. Kyranides MN, Fanti KA, Sikki M, Patrick CJ. Triarchic dimensions of psychopathy in young adulthood: associations with clinical and physiological measures after accounting for adolescent psychopathic traits. Personal Disord. 2017;8:140-9. In addition, data from a child sample highlights the role of narcissism as an important predictor of aggression above and beyond CU traits.1010. Kerig PK, Stellwagen KK. Roles of callous-unemotional traits, narcissism, and Machiavellianism in childhood aggression. J Psychopathol Behav Assess. 2010;32:343-52. Nevertheless, no studies have investigated the magnitude to which impulsivity and narcissism would explain concurrent pro- and antisocial behaviors in school children. To shed some light on this topic, the present study aimed to investigate the unique contribution of narcissism and impulsivity – in addition to CU traits – in explaining those behaviors, while also taking into account the role of gender.

Methods

Participants and procedures

A total of 249 schoolchildren (aged 9 to 12 years, 54.9% girls) participated in this research. All participants attended mainstream primary schools in the London area. This study was approved by the ethics committee of the Department of Psychology, Goldsmiths, University of London. Informed consent was obtained from the parents or guardians of each participant. The data presented in this study were collected as part of a larger study of child behavioral difficulties. All measures were completed by the participants, and there were no a priori exclusion criteria.

Measures

Antisocial Process Screening Device (APSD)1313. Frick PJ, Hare RD. The Antisocial Process Screening Device (APSD). Toronto: Multi-Health Systems; 2001.

The APSD is one of the most widely used measures to assess psychopathic traits in youth. It is a 20-item rating scale that can be completed by a parent or teacher, or self-rated. It comprises three subscales (CU, narcissism, and impulsivity). In the present study, self-reported APSD yielded adequate indices of internal consistency (Cronbach’s α = 0.71; Guttman’s λ6 = 0.79).

Strengths and Difficulties Questionnaire (SDQ)1414. Goodman R. Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatry. 2001;40:1337-45.

The SDQ assesses five dimensions: peer relations (PR), conduct problems (CP), emotional problems (EP), prosocial behaviors (PB), and hyperactivity. It comprises 25 items on a three-point Likert-type scale (0 = not true, 1 = somewhat true, and 2 = certainly true). Again, the self-reported SDQ presented adequate indices of internal consistency in the present study (Cronbach’s α = 0.75; Guttman’s λ6 = 0.82).

Data analysis

The dataset was coded and analyzed using SPSS version 20 and JASP version 0.8. To characterize the sample, frequencies, correlations, means, and standard deviations were calculated for the variables of interest. Inferential t-tests were used for comparisons between means for boys and girls. Hierarchical regression analyses were performed to understand the unique contributions of the predictors CU traits, narcissism, and impulsivity to pro- and antisocial behaviors defined as outcomes.

Results

Descriptive statistics and gender differences

For SDQ PB and CP, mean (SD) values were 7.99 (1.80) and 2.77 (1.99), respectively. Mean (SD) values for APSD CU traits, narcissism, and impulsive behavior were, respectively, 2.99 (1.77), 4.04 (2.67), and 4.18 (2.02). Aside from CU traits, all other variables showed statistically significant differences between boys and girls. Boys scored higher on CP, impulsive behavior, and narcissism than girls (t1,228 = -4.89, p < 0.001, d = -0.65; t1,226 = -2.27, p = 0.02, d = -0.30; t1,226 = -3.53, p < 0.001, d = -0.47, respectively), whereas girls displayed elevated PB scores (t1,225 = 2.89, p = 0.004, d = 0.39).

Correlations and predictors

As expected, CP was negatively linked with PB (r = -0.46), and positively associated with CU traits (r = 0.34), narcissism (r = 0.53), and impulsivity (r = 0.55). PB was negatively associated with CU traits, narcissism, and impulsivity (r = -0.56, -0.45, and -0.46, respectively). CU traits were associated with narcissism (r = 0.39) and impulsivity (r = 0.36). Finally, narcissism was positively linked with impulsivity (r = 0.46). All correlations were significant at p < 0.001.

Hierarchical regression analyses were performed with CU traits and gender as predictors firstly (Model 1). To understand the increment in the model, narcissism and impulsivity were added in the second step (Model 2). Interestingly, when using gender and CU traits alone to predict conduct problems, the model explained 19.4% of the variance. Nevertheless, adding narcissism and impulsivity resulted in a substantial increase in the amount of variance explained by the predictors (from 19.4 to 43.7%), although CU traits failed to retain their statistical significance. For the model exploring predictors of prosocial behaviors, the second model displayed better results when compared to the model that considered CU traits and gender alone. The amount of variance explained increased from 34% (first model) to 42.4% (second model), and gender failed to retain its statistical significance from step one to two (Table 1).

Table 1
Psychopathic personality traits predicting pro- and antisocial behaviors in 9-to-12-year-olds

Discussion

In the current study, we primarily sought to examine the extent to which impulsivity and narcissism predicted concurrent prosocial and antisocial behaviors in schoolchildren over and above CU traits alone. To achieve these goals, hierarchical regression models were used. We found that there are differential predictors of the domains of pro- and antisocial behavior, which should not simply be seen as two sides of the same coin.

For PB, CU traits are the strongest (negative) predictor, although narcissism and impulsivity are also significant negative predictors. On the other hand, for prosocial behavior, when a model including CU traits, narcissism, and impulsivity was tested, CU traits were not a statistically significant predictor of antisocial behavior in this community sample of children. This finding is particularly interesting given the recent addition of the limited prosocial emotions specifier in DSM-5.22. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Arlington: American Psychiatric Publishing; 2013.

One of the key reasons for including this specifier into the DSM-5 is to allow for specialized care, treatment, and research pathways for children who show both negative (i.e., antisocial) and positive behaviors (i.e., display of appropriate prosocial emotions). Our research has shown that early personality features (narcissism) and behavioral features (impulsivity) also make important contributions to child behavioral presentation. It should be noted that impulsivity was a statistically significant variable in all models tested in this study. In this sense, therapies directed at aggressive behaviors may be particularly relevant.1010. Kerig PK, Stellwagen KK. Roles of callous-unemotional traits, narcissism, and Machiavellianism in childhood aggression. J Psychopathol Behav Assess. 2010;32:343-52. A similar pattern was observed for narcissism, which was also a statistically significant predictor of pro- and antisocial behavior, although less strong than impulsivity. Here, implications for clinical treatment might include transferring excessive focus from the individual (i.e., avoidance of fostering egocentricity features) and stressing perspective-taking abilities and empathy.1515. Barry CT, Frick PJ, Killian AL. The relation of narcissism and self-esteem to conduct problems in children: a preliminary investigation. J Clin Child Adolesc Psychol. 2003;32:139-52.,1616. Muñoz Centifanti LC, Kimonis ER, Frick PJ, Aucoin KJ. Emotional reactivity and the association between psychopathy-linked narcissism and aggression in detained adolescent boys. Dev Psychopathol. 2013;25:473-85.

To conclude, it is certainly relevant to consider gender and CU traits as important risk factors for the development of the psychopathic personality. However, a more comprehensive examination including the exploration of narcissism and impulsivity not only gives us a more robust picture – as explained by a significant increase in the variance explained – but also implications in terms of intervention designs aiming to prevent CP and promote prosocial behaviors among at-risk populations.1313. Frick PJ, Hare RD. The Antisocial Process Screening Device (APSD). Toronto: Multi-Health Systems; 2001. In addition, understanding the role of CU traits, alongside narcissism and impulsivity, in predicting CP may help researchers identify homogenous groups with greater accuracy, as well as contribute to capturing a richer picture of etiologies and trajectories of antisociality.1717. Eisenbarth H, Demetriou CA, Kyranides MN, Fanti KA. Stability subtypes of callous-unemotional traits and conduct disorder symptoms and their correlates. J Youth Adolesc. 2016;45:1889-901.,1818. Salekin RT. Psychopathy in childhood: why should we care about grandiose-manipulative and daring-impulsive traits? Br J Psychiatry. 2016;209:189-91.

Acknowledgements

GWW thanks Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) for the support provided through doctoral scholarship BEX 893713-3.

References

  • 1
    Jones APJ, Wendt GW. Neuropsychology of psychopathic traits in children. In: Delisi M, Vaughn M. The Routledge international handbook of biosocial criminology. London: Routledge; 2015. p. 218-35.
  • 2
    American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Arlington: American Psychiatric Publishing; 2013.
  • 3
    Gumpel TP. Linking psychopathy and school aggression in a nonclinical sample of adolescents. J Sch Violence. 2014;13:377-95.
  • 4
    Viding E, Jones AP, Paul JF, Moffitt TE, Plomin R. Heritability of antisocial behaviour at 9: do callous-unemotional traits matter? Dev Sci. 2008;11:17-22.
  • 5
    Fontaine NM, Rijsdijk FV, McCrory EJ, Viding E. Etiology of different developmental trajectories of callous-unemotional traits. J Am Acad Child Adolesc Psychiatry. 2010;49:656-64.
  • 6
    Frick PJ, Ray JV, Thornton LC, Kahn RE. Can callous-unemotional traits enhance the understanding, diagnosis, and treatment of serious conduct problems in children and adolescents? A comprehensive review. Psychol Bull. 2014;140:1-57.
  • 7
    McCuish EC, Corrado RR, Lussier P, Hart SD. Psychopathic traits and offending trajectories from early adolescence to adulthood. J Crim Justice. 2014;42:66-76.
  • 8
    Corrado RR, McCuish EC, Hart SD, DeLisi M. The role of psychopathic traits and developmental risk factors on offending trajectories from early adolescence to adulthood: a prospective study of incarcerated youth. J Crim Justice. 2015;43:357-68.
  • 9
    Corrado RR, McCuish EC, Hart SD, Delisi M. The role of symptoms of psychopathy in persistent violence over the criminal career into full adulthood. J Crim Justice. 2015;43:345-56.
  • 10
    Kerig PK, Stellwagen KK. Roles of callous-unemotional traits, narcissism, and Machiavellianism in childhood aggression. J Psychopathol Behav Assess. 2010;32:343-52.
  • 11
    Feilhauer J, Cima M. Youth psychopathy: differential correlates of callous-unemotional traits, narcissism, and impulsivity. Forensic Sci Int. 2013;224:1-7.
  • 12
    Kyranides MN, Fanti KA, Sikki M, Patrick CJ. Triarchic dimensions of psychopathy in young adulthood: associations with clinical and physiological measures after accounting for adolescent psychopathic traits. Personal Disord. 2017;8:140-9.
  • 13
    Frick PJ, Hare RD. The Antisocial Process Screening Device (APSD). Toronto: Multi-Health Systems; 2001.
  • 14
    Goodman R. Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatry. 2001;40:1337-45.
  • 15
    Barry CT, Frick PJ, Killian AL. The relation of narcissism and self-esteem to conduct problems in children: a preliminary investigation. J Clin Child Adolesc Psychol. 2003;32:139-52.
  • 16
    Muñoz Centifanti LC, Kimonis ER, Frick PJ, Aucoin KJ. Emotional reactivity and the association between psychopathy-linked narcissism and aggression in detained adolescent boys. Dev Psychopathol. 2013;25:473-85.
  • 17
    Eisenbarth H, Demetriou CA, Kyranides MN, Fanti KA. Stability subtypes of callous-unemotional traits and conduct disorder symptoms and their correlates. J Youth Adolesc. 2016;45:1889-901.
  • 18
    Salekin RT. Psychopathy in childhood: why should we care about grandiose-manipulative and daring-impulsive traits? Br J Psychiatry. 2016;209:189-91.
  • Epub Mar 25 2017.

Publication Dates

  • Publication in this collection
    Sept 2017

History

  • Received
    18 Oct 2016
  • Accepted
    25 Mar 2017
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