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Aggression and Violent Behavior 18 (2013) 71–78

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Aggression and Violent Behavior

Child and adolescent psychopathy: Assessment issues and treatment needs
Diana Ribeiro da Silva a,⁎, Daniel Rijo a, Randall T. Salekin b
a
Research Unit of the Cognitive-Behavioral Research and Intervention Center, Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, Apartado 6153,
3001-802 Coimbra, Portugal
b
Department of Psychology, University of Alabama, P.O. Box 870348, Tuscaloosa, AL 35487-0348, United States

a r t i c l e

i n f o

Article history:
Received 14 May 2012
Received in revised form 10 October 2012
Accepted 16 October 2012
Available online 22 October 2012
Keywords:
Psychopathy
Child and adolescent psychopathy
Assessment
Treatment

a b s t r a c t
The identification of psychopathic traits in childhood and adolescence is a topic of growing interest for scientific research. The development of models to predict violent behavior, together with efficient preventive and
therapeutic programs, is a major goal when assessing youths with psychopathic traits. This paper focuses on
the construct of child and adolescent psychopathy, while approaching historical and conceptual issues. By
discussing the “state of the art” of the construct, we will analyze different instruments to assess psychopathy
in children and adolescents, as well as the available treatment modalities. Finally, we will present possible
lines for research and clinical intervention according to an evolutionary approach to anger and antisocial
behavior.
© 2012 Elsevier Ltd. All rights reserved.

Contents
1.
2.
3.

Introduction . . . . . . . . . . . . . . . . . . . . .
Child and adolescent psychopathy . . . . . . . . . . .
Assessment of psychopathy . . . . . . . . . . . . . .
3.1.
Assessment of child and adolescent psychopathy
3.2.
Comorbidity. . . . . . . . . . . . . . . . . .
3.3.
Psychopathy and gender . . . . . . . . . . . .
4.
Treatment . . . . . . . . . . . . . . . . . . . . . .
5.
Discussion . . . . . . . . . . . . . . . . . . . . . .
References . . . . . . . . . . . . . . . . . . . . . . . .

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1. 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)
⁎ Corresponding author at: Centro de Investigação do Núcleo de Estudos e Intervenção
Cognitivo-Comportamental (CINEICC) da, Faculdade de Psicologia e de Ciências da
Educação da Universidade de Coimbra, Rua do, Colégio Novo, Apartado 6153, 3001-802
Coimbra, Portugal. Tel.: +351 239 851 464; fax: +351 239 851 462.
E-mail addresses: diana.rs@fpce.uc.pt (D. Ribeiro da Silva), drijo@fpce.uc.pt
(D. Rijo), rsalekin@bama.ua.edu (R.T. Salekin).
1359-1789/$ – see front matter © 2012 Elsevier Ltd. All rights reserved.
http://dx.doi.org/10.1016/j.avb.2012.10.003

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71
72
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75
76

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.

Lander. The overrepresentation in childhood and adolescence of some characteristics of the disorder. aggressive. affective. Murrie. 1 = item may or may not apply. This instrument is a full-scale assessment tool. By the same time. the malleability of personality during development. Until 1990. and emphasizing the need for multi-domain and multi-source information . Schwalb. As a result of these efforts. it is mandatory to study the construct in early childhood (Lynam. weakened enraged or cruel reactions. by adapting the Psychopathy Checklist (PLC. 1999). / Aggression and Violent Behavior 18 (2013) 71–78 According to Cleckley (1941/1988). although not being a direct adaptation of it. About 10 years later. 2010). in press). Cox. 2005). 2010). P-SCAN. and other instruments to assess psychopathy in forensic populations (e. but rather that the concept be used in a constructive manner to understand better the various types of youth as well as to chart ways to help youth lead more prosocial. & Cornell.. Research was conducted mainly on adult male offenders. To make prevention a possibility. He considered that the deeply rooted impairment of emotional processing among psychopaths (like aphasia or color-blindness).. In spite of the efforts by Cleckley (1941/1988) to focus the construct of psychopathy upon affective and interpersonal features. Leistico. (e. 3. Besides PCL-R. includes a thorough record review and a structured interview. 1991) in a study with adolescent offenders. & Hare. as it happens in the adult version. 1996. and Hare (1990) became pioneers. but presenting some significant differences — the Psychopathy Checklist (PCL. 2002. Frick & Hare. 2001. Patrick. Kotler & McMahon. After 30 years of research. Lester et al. 1995). based on Cleckley's criteria. until the early 80s. and self-report. and meaningful lives” (p. 2006).. the Self-Report Psychopathy Scale (SRP. Fowles.72 D. Table 1 shows different results from studies on the dimensionality of PCL. Salekin and Lynam (2010) underline that the term psychopathy “should not be used in a damaging way. Brannen. Child and adolescent psychopathy In the 40s. thus increasing research in this area. The clinician rates the PCL: YV 20 items on a 3-point scale (0= definitely does not apply. and risk management (DeLisi & Piquero. 2003). the debate about PCL factorial structure still persists. 2003. In the same decade. the last decade has witnessed an exponential increase in the number of publications about child and adolescent psychopathy (Salekin & Lynam. few works about child psychopathy were published. 2007. This paper addresses child and adolescent psychopathy assessment and treatment. and little attention was given to psychopathic traits in children and adolescents (Salekin. teachers. Zalot.1. APSD is a 20-item questionnaire. The most frequently employed is the Psychopathy Checklist: Youth Version (PCL: YV. Later. 2010). Forth. in press. showing that psychopathy could be assessed in youth. 1950) organized and chaired two consecutive round table discussions about the applicability of the construct to childhood. Salekin. Hare.g. Vitacco & Neumann. 2007. McCoy. The PCL: YV (Forth et al. stressed the importance of identifying and treating psychopathy in younger populations. DeCoster. Polaschek. 2008. Edens & Vincent. available in three formats: parents/educators. and its implications in legal contexts. is similar to the conceptualization of psychopathy in adulthood (see Table 2). 1985. 2005. 2011. The Antisocial Process Screening Device (APSD. and the Triarchic Psychopathy Measure (TriPM. predatory. 2010. Forth.. other screening measures of psychopathy in youths are available. Patrick. Assessment of psychopathy From the works of Lykken (1957). 2 = definitely apply). Salekin. 2005). 2003). lifestyle and antisocial — Hare & Neumann. 2010. three factors (interpersonal. Hare. Lynam. Understanding the development of aggression in childhood in general and of psychopathic traits in particular has received a growing interest by the scientific community. in the book — The psychopathic: An essay on the criminal mind. & Sellbom. The need for new and adequate treatment programs will be outlined. Patrick. Cleckley's diagnostic criteria were frequently used in sample selection for the study of psychopathy.. requiring trained raters. & Stouthamer-Loeber. risk assessment. reviewing: (a) the assessment of psychopathy in an historical perspective. 2011). 2. 2001) is the most widely used and tested youth psychopathy screening measure. 1991. & Skeem. Michie.g. 2008). Kosson. the derogatory connotation of the term. Lilienfeld & Widows. productive. & Fitzpatrick. & DaMatteo. Salekin. The version of PCL assesses adolescents aged 13 or more. Boccaccini. 1980) and its revised edition (PCL-R. Instruments of this type include: the Screening Version of PCL-R (PCL: SV. Kotler & McMahon. 2003). Thus. 2006. 2001. Loeber. & Rogers. antagonistic. Karpman (1949. 1965) tried to define subtypes for juvenile delinquency. Hare. the Psychopathic Personality Inventory (PPI. Hare. Levenson. 2005. or by creating new measures adjusted from a developmental point a view (Forth et al. 2008). 2008. Caspi. 1991.g. (b) the most frequently used instruments in the assessment of child and adolescent psychopathy. Silk. is still questionable (Cooke & Michie. boldness. compared to the ones who had not that same disorder. Hart. mainly in violence risk prediction research (e. These authors emphasized the importance of early intervention. 3. 2006. Extension of the construct of psychopathy to childhood and adolescence is a controversial issue. In the 80s. apparently. many authors state that the best time to prevent and intervene is early in life. Hemphill. Heilbrun. all the harm inflicted to others (as well as to themselves) was a result of their superficiality. Salekin & Frick. 2006. Salekin & Lynam. psychopathy in adulthood is a valued construct. the Levenson Primary and Secondary Psychopathy Scale (LPSP.. Salekin et al. 2007. Hare & Hervé. 1995). 2003). Assessment of child and adolescent psychopathy The instruments used in the assessment of child and adolescent psychopathy capture a construct that. McCord and McCord (1964). 2008. Salekin. considering a psychopathic category that he called “under socialized aggressive”. because of the impact of psychopathy on society. Kiehl. as a trait inherent to psychopathy or its product. or four factors (interpersonal. and capricious nature. 2006). either by adapting instruments used in adults. other authors developed instruments to assess psychopathy in children and adolescents. vindictive or cruel behaviors were not crucial in the conceptualization of psychopathy. Seagrave & Grisso. noting that youths who presented signs of psychopathic personality disorder showed their behavior problems in a different way. Concerning its factorial structure. 2007. the inclusiveness of the anti-social/deviant life-style factor. 2003.. & Lilienfeld. Ribeiro da Silva et al. the potential stigmatization of youths. Salekin & Frick. Moffitt. Salekin et al. 2003) is an adaptation for adolescents of the PCL-R (Hare. there are divergent research outcomes: two factors (interpersonal-affective and sociallydeviant lifestyle — Forth et al. there was a turning point in the study of the disorder. most of them draw from PCL: YV. there are different self-report measures designed to assess psychopathy in noncriminal samples. 2006. 8). As stated previously. Marczyk. & Neumann. Scoring for each .. Nevertheless. Skeem & Cooke. and the triggering of iatrogenic effects are some of the problems under intensive debate. & Hare. 2007). the validity and stability of psychopathy. Lester. Hart.. the heterogeneity of minors with anti-social behavior. Leistico. Regardless of these divergences. 1990. 2009). affective and behavioral — Cooke & Michie. when Robert Hare (1980) developed a systematic method to assess psychopathy. Chanen & McCutchenon. relevant for violence prediction. Quay (1964. Cleckley (1941/1988) already recognized that psychopathy was a disorder with roots in childhood and adolescence. 1997. Hare. Skeem. & Krueger. and (c) available treatment approaches to youths with psychopathic traits. Cooke. Lynam.

lifestyle. grandiose self-worth. Frick. YPI is a self-report instrument that can be answered by children aged 12 or more. aged between 4 and 18 years old.. The Inventory of Callous-Unemotional Traits (ICU. dishonest charm. No. as Johnstone and Cooke (2004) point out. affective. They are composed of 20 and 16 items respectively (true/false answer). Measure Informants Age range No. Larrea. affective. of factors Authors Factors Two factors Hare (1991) Three factors Cooke and Michie (2001) Four factors Neumann. This instrument was designed to assess 10 core personality traits associated with psychopathy (grandiosity. Other available measures include the Psychopathy Content Scale and the Inventory of Callous-Unemotional Traits.g. Items are grouped in three distinct factors: callousness. grandiose-manipulative. and failure to accept responsibility) Factor 3 — Lifestyle (stimulation seeking. 1997) is an instrument composed by 12 brief scales (with a minimum of 3 and a maximum of 7 items each one). early behavioral problems. Hare. in press. being the items adapted from the Child Behavioral Checklist (CBCL. shallow affect. “I can make people believe almost anything”).. there is still a need for more precise instruments. and behavioral) Four factors (interpersonal. APSD predictive validity for anti-social behavior problems was studied by Frick and Hare (2001) thus showing a parallelism with adult psychopathy. 2010). 2001) CPS Child Psychopathy Scale (Lynam.D. callous/lack of empathy. parasitic orientation. 2008). thrill seeking.. and impulsivity/irresponsibility Informal for 16 item version: interpersonal. Achenbach. unemotionally. glibness/superficial charm and callous/lack of empathy) Factor 2 — Social deviance (e. uncaring and unemotional. Factor 2 — Affective (lack of remorse or guilt. grandiose sense of worth. pathological lying. impulsivity. assessing externalizing tendencies. . Adapted from Neumann. 1= somewhat true. teacher. 2010). 1991) and/or the California Child Q-Set (CCQ. remorselessness. The measures can be applied to adolescents aged between 12 and 18. grouped in three facets: callous-unemotional. A version of the YPI is available for children aged between 9 and 12 years old: the Youth Psychopathic Traits Inventory — Child Version (YPI-CV. Ziegler. some of these instruments are frequently used by researchers and clinicians. Van Baardewijk et al. and lack of realistic goals) Factor 4 — Antisocial (poor behavioral controls. and conning/manipulative). Impulsivity and behavioral problems dimensions are mainly associated with factor 2 of the PCL-R for adults. 2003). narcissism. Kerr. & Levander. Salekin. & Barry. Regardless of the growing number of measures developed in the last decades to assess psychopathy in children and adolescents. 5 for each of 10 trait scales (1–4) True–false a Total score only Grandiose/manipulative. Lynam. and impulsive-irresponsible (classification similar to the proposal of Cooke & Michie. Although it should be noted that there do appear to be differences between the APSD and PCL-YV (see Dillard. shallow affect. 2005. parasitic lifestyle. and youth self-report form. 2003). 1997) YPI Youth Psychopathic Traits Inventory (Andershed et al. 2003) APSD Antisocial Process Screening Device (Frick & Hare. and lack of realistic long-term goals) Factor 1 — Interpersonal (glib/superficial. P-16.. Bodin. The lack of agreement on the dimensionality of the psychopathy construct is a major issue that should be addressed in order to better compare results from different studies.. 2008). and juvenile delinquency) item ranges from 0 (not at all true) to 2 (definitely true). criminal versatility and impulsivity) Factor 1 — Arrogant and deceitful interpersonal style (glibness/superficial charm. manipulation. callous/lack of empathy. teacher. and youth 4–18 years 20 items (0–2) Two factors (interpersonal–affective and socially deviant lifestyle) Three factors (interpersonal. Research on its dimensionality indicates a two factor (impulsivity-conduct problems and callous-unemotional — Frick et al. deficient emotional reactivity. 2001). Salekin. As stated before. in a way that minimizes the possibility of deceitful answers by individual with psychopathic traits (e. narcissism and callous-unemotional — Frick. and Newman (2007) Factor 1 — Interpersonal/Affective (e. It can be used with youths between 4 and 18 years old. lifestyle Version for children (9–12 years): Youth Psychopathic Traits Inventory — Child Version (YPI-CV. and failure to accept responsibility for own actions) Factor 3 — Impulsive and irresponsible behavioral style (need for stimulation/proneness to boredom. The Psychopathy Content Scale and the P-16 are two psychopathy scales that can be used when administering the MACI (PCS. The Child Psychopathy Scale (CPS. 2000) structure. The Youth Psychopathic Traits Inventory (YPI. 2002) PCS Psychopathy Content Scale (Murrie & Cornell. impulsivity. callousness.. & Bennett. Van Baardewijk et al. lying.g. impulsivity. One of its advantages is the carefully formulated items. 1980).. 2000) Skilled rater 13+ years 20 items (0–2) Parent. Ribeiro da Silva et al. Barker. irresponsibility. 2000. The diversity of psychopathy assessment instruments (namely when assessing Table 2 Child and adolescent psychopathy measures (adapted from Kotler & McMahon. 2003) assesses the CU factor (consistent with factor 1 of PCL-R) of psychopathy. 2= very true. Murrie & Cornell. Factor 2 — Deficient affective experience (lack of remorse or guilt. criminal versatility. Kotler & McMahon. 2002) includes 10 different scales (each one with 5 items to be answered according to a 4-point Likert-like scale). Andershed. Anthony. and callous-unemotional) Three factors (impulsivity. and 3= definitely true). Hare. while others are much less known. and conning/manipulative). irresponsibility. The ICU can be used to assess children and adolescents.. affective. and thrill seeking). The ICU is a 24-item questionnaire available in parent/caregiver. and Newman (2007). 2003) or a three factor (impulsivity.g. pathological lying. callous-unemotional. of items/scale Factors PCL: YV Psychopathy Checklist: Youth Version (Forth et al. Stattin. This instrument is to be answered by parents of children aged 12 or more. and proactive aggression. Scoring is based on a 4-point scale (0 =nor all true. Block & Block. irresponsibility. / Aggression and Violent Behavior 18 (2013) 71–78 73 Table 1 Factor structure of PCL-R (Hare. and callous-unemotional) Parent 12+ years Youth 12+ yearsa Youth 12–18 years 12 items (multiple questions for each item) 50 items. The callous-unemotional (CU) factor is consistent with factor 1 of the PCL-R and it is associated with low anxiety. and antisocial) Two factors (impulsivity/conduct problems. & Grimes.

Gilbert. Verona et al. DeLisi & Piquero. The same problems and inherent conceptual difficulties are evident with regard to ethnicity (Skeem et al. Salekin. 2003). also presenting CU traits. White & Frick. different methodologies adopted (Skeem et al. both phenomena may be the result of a common causal process (e. 2010). Casey. 2009).. / Aggression and Violent Behavior 18 (2013) 71–78 youths) may also be the cause for misunderstandings and mistakes. parental neglect. Dandreaux.. Verona. less parental supervision and greater contact with deviant peers) factors occur together with certain dispositional vulnerability factors (e. 2009). 2000. although this may be the result of a shortage of studies. 2003..8% to 16% vs. Sadeh. 2006). There are highly consistent data about the prevalence of psychopathic traits in boys and girls. it seems that the impulsivity/conduct problems factor identifies above all a group of anti-social youth whereas the presence of CU traits is typical of a group of children whose anti-social behavior comes from low fear levels and shallow affect (Frick. Mishonsky & Sharp. Anti-Social Personality Disorder (APD). genetic predisposition) (Sevecke & Kosson.g. and from a type of immediate reward based response (Forth et al. Salekin. Johansson. Sevecke et al.. 2002. Vermeiren. mostly composed by men (Odgers & Moretti. which can help in the identification of subtypes (Sevecke & Kosson. are the same. Jones. 2011. Glenn. Mitchell. Johansson et al.2% in girls). with greater prevalence in boys (1. in terms of antisocial behavior and emotional processing (Barry et al..g. it is included a specifier for CD. 2006). but they show. 2011. Recent studies have pointed out the need to make a differential diagnosis between psychopathy/behavior problems and autism spectrum disorders (Blair. with 82% of male prison inmates fulfilling the criteria for at least one DSM-IV personality disorder (Baião & Rijo. 2002). & Javdani. Frick et al. mainly for two reasons: (a) the correlation between psychopathic features and symptoms of other disorders is high. A considerable amount of research suggests that personality disorders have a high prevalence in forensic contexts (40% a 60%) (e. 2002. 2009. Boivin.g. cognitive. Barry. 2010). & Viding. but not in adults (Hofmann. the onset of symptomatology is postponed to adolescence. Adolescent onset — after 10 years old) and to symptomatic severity (mild. Verona & Vitale. & Iselin.8% to 9.. defending that the CD component is primary in relation to ADHD (Lahey.. and. 2000). we must be careful when evaluating the relationship between personality disorders and psychopathy. Vaughn et al. 2011. 2010. Lee. . the prevalence of CD in the universe of delinquent adolescents ranges between 31% and 100% (e.3. They suggest that this association confers a specific vulnerability towards the development of psychopathy (e. Cornell.. 2011).g. 2000). Lynam. hormonal) and psychosocial (e. & Blair. However. Rathouz. & Andershed. 2009). Some data also suggest that genetic factors contributing to alcohol and other substances abuse or dependence. Burnett. Ribeiro da Silva et al. 2006). McCrory.. 3. & Lilienfeld. Vitale et al.g. Sevecke & Kosson.74 D. Korte. Sylvers. & Barker. 2010). & Buitelaar.. according to the onset of the first symptoms (Childhood onset — before 10 years old. Lynam. Fontaine. Loeber. 2011. Odgers & Moretti. 2010). 2005). & Werner.. There may also be some links to negative affect (Price. 2011. 2000). Burke. However. Although behavioral disinhibition is considered a dimension of psychopathy (impulsivity/conduct problems). 2011. some authors contend that girls tend to present a “delayed-onset” pattern. The prevalence of ADHD is also high in anti-social adolescent/adult prison inmate samples (e. & Suvak. Recent studies have documented that early behavioral problems usually precede the development of severe anti-social behavior (e. some authors defend the existence of a common genetic factor that contributes to externalizing problems and to psychopathy (Larsson et al.. 1996. social context. Thus. In Portugal. Kerr. Contrary to what Cleckley (1941/1988). 1996). Some authors (e. 2000.. Glenn et al. CU traits). 2006). Raine. 2005. 2010). In community samples. Colledge.g. Available data also suggest that children with CD. Sevecke. & Krisher. Sevecke et al. Scheepers. and Conduct Disorder (CD) of DSM-IV-TR (American Psychiatric Association. Some researchers defend that an early onset of CD is a strong predictor of future involvement in criminal activities (DeLisi... and the lack of instrumentation specifically adapted to assess psychopathy in females (Kotler & McMahon. 2010). On the one hand. 1995. understanding the relationship between psychopathy and other disorders is simultaneously complex but of major interest. Barry et al.g. On the other. even if we know that in criminal settings this phenomenon is more prevalent in males (Cale & Lilienfeld. 2006. Blair. In summary. Further.g. an ongoing research study suggests higher prevalence rates. DeLisi. Happé.. often persisting in adulthood. 2003. there are studies that stress a direct relationship between anxiety and psychopathy in children and adolescents (Kubak & Salekin.. Bons..g. Psychopathy and gender Research on gender differences in adults has been biased since the majority of the studies are conducted in forensic samples. Newhill. Wilson. 2005. & Porter. when using the construct in forensic or clinical evaluations.. 2008). According to this perspective. and motor). 2005). by studying the dimensions of empathy (emotional. it is difficult to isolate the role personality disorders play in the causes or pathways of psychopathy. Murray. Other theories suggest that girls tend to present more relational aggressiveness.. among others. With regard to comorbidity with internalizing problems. Lykken. ADHD is one of the most widely diagnosed problems in childhood and adolescence. and severe). DeLisi et al. Farrell. & Mendnick.2. studies indicate that although psychopathy rates are similar in both genders. 2001. that is. 2010. 2011. 2009. 2010). the factorial structure of psychopathy seems different in males and females (Vaughn. 2010. 2005. this factor tends to overlap with symptoms of Attention Deficit Hyperactivity Disorder (ADHD). and other types of externalizing psychopathology. the internalizing problems seem to represent an important area of discontinuity in youth psychopathy (more internalizing disorders). in press). 2011).. 0.. In DSM-IV (1994) and DSM-IV-TR (APA. moderate. versus adult psychopathy (less internalizing disorders). research is required because this may be a central point in the explanation of developmental pathways. 1996) — the so called “comorbid subtype hypothesis” (Lynam. Venables.. Klinger. 2009). & Mitchell.. Frick. however. Other studies do not confirm this connection. In youth. which may indicate a common or overlapping etiology. 2008. & Howard. a less notorious type of aggression. 2003. they start presenting symptoms of the disorder generally during adolescence (Frick & Dickens. CD. Comorbidity Some studies examined the relationship between psychopathic traits and other psychiatric disorders. a greater sexual promiscuity (Loeber et al. giving the disorder a façade of late-onset (Crick. 2007. Thus.. & Kimonis. Stickle. & Moffitt. although there are just a few comprehensive and wide-raging reviews (Sevecke & Kosson. Oppositional Defiant Disorder (ODD). data suggest that the beginning of the disorder in childhood is rare in girls (Moffitt & Caspi. 2009. Rommelse. & McBurnette. Beaver. display features similar to adults with psychopathy. Ostrov. 1997) offer that the connection between children with disruptive behavior and psychopathy in adulthood is especially high in minors diagnosed with both ADHD and CD. Bodin.g. 2010). (b) psychopathy apparently comprises heterogeneous group of individuals with distinctive but related symptoms and different patterns concerning comorbidity. Juodis. 2005. 2007). 3. when other biological (e. Also worth noticing. 2007). DeLisi et al. Behavior tends to be less violent in women.. 2001). These differences among adults and adolescents with psychopathic traits also suggest that positive treatment outcomes are possible in the early stages of the disorder. & Dane. Brennan. CD can be diagnosed in youth. Lehmkuhl. 2010..

. In Salekin (2002) review. Harris and Rice (2006) only included studies using the PCL: YV/PCL-R. With regard to treatment. are not included neither correctly controlled (Salekin. 2012). other positive therapeutic effects. in their review. However. Vitacco & Salekin. They argue that these traits may hinder the success of therapy. 2010). Salekin. In the assessment of child and adolescent psychopathy. Skeem. Lester. Thorton & Blud. questions concerning early intervention still remain. 2012). 5. 2010. & Umstead. the interpersonal and affective features) makes individuals with psychopathic traits inadequate subjects for psychotherapy. Treatment Cleckley (1941/1988) contended that psychopathy is essentially a non-treatable condition. et al. stressing the importance of early intervention efforts (Hawes & Dadds. 2012). Kubak & Salekin. 2009. 2002.. 2012. and also in outcome assessment. These researchers indicate that the complexity of psychopathy (namely. 2008). Salekin et al. 2011.. very complex to put into practice and leads to other issues.. 2012. 2002. Cadlwell.D. namely: (a) in the improvement of instruments to assess the disorder (e. Several authors contend that the construct of psychopathy. 2002). this author sustains that in complex problems.. Other authors also support this position. & Sellers. how would children be screened? Which groups of children would be targeted for assessment (fearless. at least partially.. & Rogers. On the other hand. & Jouriles. must be developed. Kubak & Salekin. 2007) may have some positive outcomes in psychopathy features. and assessment of the disorder. Tippey. and (b) to establish and evaluate therapeutic programs (Salekin & Lynam. Some studies show that an early family intervention (McDonald. treatment efficacy is evaluated based on treatment compliance and recidivism. narcissism or manipulation traits)? This first question is. 2004). Salekin (2002) states that intensive individual psychotherapy can have positive effects not only on the behavioral component. These and other works (e.. Johnstone & Cooke. Salekin.. This suggestion is of unquestionable relevance. group. 2006. 2010. et al. as is the case of psychopathic disorder.. 2007). Frick. That is. and may even worsen the symptomatology (Harris & Rice. maintaining. it is essential for researchers to create more precise assessment instruments. Salekin. there is a considerable gap in treatment programs specifically tailored to psychopathy and specifically geared toward deficits found in the affective and interpersonal features of the disorder (Salekin. in the study of children and adolescents. Worley. raters. 2012). mainly when it is associated with group psychotherapy. 2010.. Tippey. 2010. It should be pointed out that this thesis can only be sustained in theory. Lynam et al. Some authors believe that the attempt to treat psychopathy does not alter the characteristics of the disorder. by itself. & Grimes. in press).g. Skeem et al. 2002. and regardless of these discrepancies. increasing the capacity of feeling remorse and empathy. Some of these studies also present important methodological weaknesses. it is crucial to decide which type of treatment is the most adequate for each case.. Different opinions are. 2005). Salekin. improving interpersonal relationships).. Salekin. Ribeiro da Silva et al. they feel that the training of certain social and emotional skills in individuals with psychopathy may improve their criminal strategies in a way that they become more capable of avoiding legal detention. 347). and mainly with youth. and informants)? If children score high on psychopathy measures. 2011. the authors have tested new models for intervening with youth with psychopathic features (Salekin. which may help to answer several questions: Why do different factorial structures of psychopathy in children and adults emerge? Why is there instability of the factorial structure using the same instrument or among disparate measures? Are the available instruments adequate for female populations and different racial and ethnical groups? (see review by Kotler & McMahon. 2006. Salekin. Salekin. and a diversity of therapeutic outcomes (e. Although further research is needed. besides being very valued and used in risk management (DeLisi & Piquero. Miller. recidivism. In many cases. Dodson. (b) the moderate stability of child and adolescent psychopathy (e. & Van Rybroek. Vitacco. but several questions can be formulated. et al. 2002. pointing out that significant improvements can happen (e. and point out that many of the studies demonstrating positive therapeutic effects are case studies. Salekin. et al. namely in the affective and interpersonal components. Vitacco & Neumann.g. in terms of inclusion criteria (Harris & Rice. / Aggression and Violent Behavior 18 (2013) 71–78 4. samples obtained through different psychopathy assessment instruments (other than PCL-R/PCL: YV). with or without anti-social and/or criminal behavior? .. 2007)..g.. can be crucial if directed to the early identification of children at risk of developing the disorder (e.. as there has been no specific investigation of this issue. Hemphill. In this regard. 2012. Salekin. 2006. Price et al. mainly those associated with affective and interpersonal facets of psychopathy (e. Thorton & Blud. and family). 75 In short. including Sueldfeld and Landon (1978) who stated that “no demonstrably effective treatment has been found” (p. Regardless of these questions. Others have more favorable opinions.g. McCormick. & Henderson. Up to the present.. after certain types of therapies. and fewer experimental studies). and maintaining a job). 2009). That is. Cognitive-Behavioral Therapy (CBT) with motivational based strategies (Hass et al. 563). etiology. 2008. Rosenfield. Bayliss. Salekin. with CU traits.g. 2012. On the other hand. How can we take into account the issue of psychopathic trait stability from childhood to adulthood? How can we take into account protective and/or risk factors capable of reducing. Concerning the early identification of psychopathic traits. in press. especially compared to the considerable amount literature on the description. Lester. 2010. Results concerning treatment efficacy are quite inconsistent in samples of delinquent adolescents scoring in psychopathy measures. 2012. few well designed studies were conducted in order to evaluate the therapeutic outcomes in individuals with psychopathic disorder (Caldwell. but also on the affective component of psychopathy. and that included recidivism as a treatment outcome. 2010) demonstrate that psychopathic traits seem to be flexible mainly if early identified and treated. and (c) greater comorbidity mainly with internalizing problems (e. aggressive. et al. intensive and multimodal programs. Lee et al. psychopathy traits and risk of recidivism). Leistico et al. Salekin & Frick. 2010). and when family members are integrated in the therapeutic program. Lester. 2010. 2006). Salekin. & Allen. quasi-experimental designs. with grandiosity. Wolfe... namely: Who shall be informed of alarm signs and how should this be done? Which is the most adequate assessment method in these cases (measures. or increasing the stability of psychopathy over the course of development? After having answered these two questions. it is important to understand that more research is needed. 2007. there has been a great development in the study of psychopathy in adults and. Thorton & Blud.g. Lynam et al. Discussion In the last two decades... which involve different therapeutic interventions (individual. 2011. the author included different types of studies (case studies. 2010. due to the adoption of different measures and methodologies in these meta-analytic studies (Harris & Rice. particularly. Tippey. 2007. et al.. 2010. Salekin. there is some evidence that children and adolescents are more likely to benefit from therapeutic interventions because of: (a) their inherent developmental idiosyncrasies. Tippey. 2011) have also shown encouraging results. Lynam. In the worst scenario.g. Tippey. They criticize the methodology used by Salekin (2002). 2005. little research has emerged. a more fundamental one persists — How to treat children and adolescents scoring high in psychopathy. Harris and Rice (2006) even argued that “no clinical interventions will ever be helpful” (p. Salekin. Salekin.g. 2009.

. Salekin.. cannot serve to justify the exclusion of individuals (children. The British Journal of Psychiatry. (2001). & Loney. 2012. 2002. H. Oxford..g. P. Andershed. Salekin. Wolfe. making these individuals use. (2008). Hass et al. (2007). et al. exploitative strategies rather than affiliative ones (Gilbert. 33.. & McCutchenon. (2010). 109–113.. (2000). 131–158). Psychophathic factors and risk for aggressive behavior: A test of the “Threatened Egotism” hypothesis. 2010.g. Aslan (Chair). Murray. 2011. G. Chanen. 2012. Journal of Cognitive Psychotherapy: An International Quarterly. K. Palo-Alto. M. From our point of view. and lack of deep or lasting emotion). S. 2012) show that psychopathic traits can be changeable if identified and treated up to pre-adolescence. R. Criminal Justice and Behavior. Plaschek. In E. Salekin. 2009. Cooke. M. (2011. (2010). 2005. O. For instance. New approaches to treatment. D. M. R. T. L. McCormick. these characteristics should be taken into account when drawing specific therapeutic programs (Salekin. Skeem. response to specifically designed treatments may also inform the theoretical assumptions that persist when trying to explain the roots and course of the psychopathic disorder. 1999.. 2.. et al. Caldwell et al.. Ellis. Lester. 335–340. together with motivational work (Hass et al. manipulation. 2006. p. 190. & Mitchell. grandiosity. Kazdin. A. deception and manipulation. N. and focused on the affective and interpersonal features of the disorder (Salekin. The psychopath: Emotion and brain... which underscores the importance of establishing criteria for early identification of psychopathic traits. R. Burlington: University of Vermont.. Some authors point out that the attempt to treat psychopathy does not change features of the disorder. Rijo.... Department of Psychiatry. 2012). Tippey. H. Kazdin & Wassell.. it must be stressed that some features of the disorder (e. . 29. 491–498. or adults) from treatment. A selective impairment in the processing of sad and fearful expressions in children with psychopathic tendencies. These outcomes give children and adolescents a higher probability of therapeutic change and encourage the development of future intervention programs for youth. V. & Skeem. Also.. how shall we intervene effectively in the affective and interpersonal features of psychopathy (CU traits. & Levander. Blair. seem to bring promising intervention strategies for individuals with psychopathy. Salekin. 2010). S.. Kerr. June). A. Kuzban.. child abuse.. 39–50. The epidemiology of personality disorders. Refining the construct of psychopathy: Toward a hierarchical model. Both of these latter therapies focus on the elicitation of positive human traits and this is why they may be adequate therapeutic approaches to bring about advantages for individuals scoring high on psychopathic traits. D. K. & Salekin. up to the present.. Colledge. Michie. 24.g. (2002). F. can play a major role in the origins and/or exacerbation of psychopathic traits (see review by Ribeiro da Silva. 2010a. or cognitive–behavioral. Personality disorders and self-concept in Portuguese prison inmates. Cognitive Theory of Antisocial Personality Disorder. J. R. Because much attention has been paid to the construct dimensions and assessment issues.. Criminal Justice and Behavior.. when compared to adults. several authors argue that insecure bonds with parental figures and other factors of the psychosocial environment (e. G. Tippey. 2011).. R. CA: Consulting Psychologists Press. may be of interest for treating psychopathy. C. McCoy. C. if the aim is not to prevent and/or treat the disorder. J. Symposium conducted at the meeting of 7th International Congress of Cognitive Psychotherapy. F.. 2012. D. M. Manual for the Child Behavior Checklist/4-18 and 1991 profile. Salekin. Caldwell. low motivation to change. The Netherlands: Elsevier. Stattin.. Treatment-related changes in psychopathy features and behavior in adolescent offenders. Casey. Tyrer (Ed. (2012). The California Child Q-Set. Alternately. London: Arnold. 2010. Louis. Salekin. 51–74. (2000). By the contrary. 71–79). there have been extraordinary advances in the domain of psychotherapies. Hague. There are a number of avenues that researchers may want to consider and explore in the treatment evaluation of youth with psychopathic features. N.. McDonald et al. M. and toxic experience). B. & Rijo. Salekin. and Thorton and Blud (2007) point out. very few studies (frequently associated with important methodological limitations) were conducted to specifically assess the therapeutic efficiency in psychopathic individuals. St. results about treatment effectiveness are more inconsistent. Cale. Psychopaths: Current international perspectives (pp. 2010b). D. 282). Blair. Tippey. Glenn. Since the 40s. R. emotional and cognitive empathic abilities in children with autism and conduct disorder. M.. et al.76 D. 2010).. In short. If one hypothesizes that psychopathy develops from shame then this model might be quite viable as method for treating the disorder as CFT was mainly developed for individuals that “feel deep internal shame and for whom the inner and outer worlds have become cold” (Gilbert & Gerlsma. M. & Raine. & Blair. Caldwell et al. It is worth remembering that. 2009. 2012) can have positive effects upon the behavioral and affective components of the psychopathic disorder. Text rev. 2002). V. Frick. & Van Rybroek. neglect. and/or MMPE. T. 571–596... Of greater concern is the lack of treatment programs specifically designed for psychopathic subjects. J... 2000. Psychopathic traits in non-referred youths: Initial test of a new assessment tool. J. E. Tippey. 2006). 171–188. Psychopathy development and implications for early interventions. 71–80. 2011. et al. Proceeding of Measures Behaviors. H.. et al.. p. J. & Michie. Journal of Abnormal Psychology. 2012)... C. (2006).. Bayliss. Ribeiro da Silva et al. Law and Human Behavior. Lee et al. & Henderson. and from our point of view. 2006.. et al. This may be an important target of prevention or intervention programs that target the bond between parents and children. L. G. Treatment response of adolescent offenders with psychopathy features: A 2-year follow-up. Motor. J. Gilbert. K. Therefore. M. and narcissism)? As stated earlier. References Achenbach. Miller. and as Skeem. there is no point in identifying psychopathic traits in children and adolescents. 2010). (1980). J. MO: Mosby (Original work published 1941). management and course (pp. DeShazo. Personality and Mental Health. Salekin. then such interventions as the mental models intervention for positive emotion may be used (MMPE. 24. and greater response to treatment (Cadlwell et al. 109. Diagnostic and statistical manual of mental disorders (4th ed. Personality disorders: Diagnosis. DC: American Psychiatric Association. J. 2012). The importance of callous-unemotional traits for extending the concept of psychopathy to children.. Hass et al. (2006). and can even worsen the symptoms (Harris & Rice. P. & I. Moreover. Salekin.. D. (2001). Baião. results are less encouraging (Harris & Rice. in their social interactions. & Lilienfeld. when Hervey Cleckley (1941/1988) stated that psychopathy was a non-treatable personality disorder.g. Cadlwell. & Block. 39. 2011).. Istanbul.. Tippey. 2012).. D. (1988). A. such as CFT. M. 2010.). and Manchak (2009). With regard to delinquent adolescents who score high on psychopathic measures (see review by Salekin.). if it is thought that the use of positive psychology interventions to reduce negative affect generally may help with the reduction of psychopathic traits. Blaauw. 2005. Salekin. Personality disorder in adolescence: The diagnosis that dare not speak its name. 1999. / Aggression and Violent Behavior 18 (2013) 71–78 Studies of therapeutic outcomes show that children with behavioral problems can significantly improve with a cognitive–behavioral approach (e. there is some evidence showing that early intervention: family (e. 2009). There are promising studies showing that youths with psychopathic traits present greater comorbidity with internalizing problems (e. Mitchell. D. Bons. (2005). UK: Blackwell. Rommelse.. 30. 288). & Umstead. H. E. D. adolescents. C. in children and adolescents with psychopathy. Cooke. The mask of sanity (6th ed. In P. Psychological Assessment. 2011).. Bayliss et al. 2010. can produce promising results. Cleckley.). S.. Kubak & Salekin.). J. C.g. 144–155. Washington. Barry.. These and other studies (e. in particular Compassion-Focused Therapy (CFT.. American Psychiatric Association (2000). (1991). Sheridan (Eds. Understanding the structure of psychopathy checklist — Revised. Kolko et al. This model for psychotherapy is greatly based in an evolutionary perspective of emotional and relational functioning. E... Data from other researchers show that intensive therapy (Cadlwell et al. T. Block. Scheepers. 13. CFT helps in the activation (for the individual himself and for others) of “potentially dormant affiliative strategies” (Gilbert & Gerlsma.. L. Journal of Abnormal Child Psychology. J.. M.. few comprehensive models explaining the onset and development of psychopathic traits exist.. Lynam. Nevertheless. These interventions might need to be adapted to consider other caregivers and community warmth factors. J. 2006. J. In S. there is the so called 3rd generation of cognitive behavioral therapies. R. 35–41. & Buitelaar. T.g.

141–172). E. & DaMatteo. Behavioral Sciences & the Law. 151–158. M. J. & Barry. (2010b). 116. (2007). 7. Predictors and outcomes of joint trajectories of callous-unemotional traits and conduct problems in childhood. American Psychiatric Association. H. King. A. H. M. F. The psychopathic delinquent child. MAYSI. Handbook of child and adolescent psychopathy (pp. P. R... The SRP-II as a rich source of data on psychopathy. & Wassell.. T. and children's social–psychological adjustment. Current perspectives on conduct disorder. J. DC: Author. 39. J... Rijsdik.. Heilbrun. R. 28–45. J. (2000). & McCord. N. 1188–1197. (2006). Loeber. The Hare psychopathy checklist — Revised (2nd ed. Florida: Psychological Assessment Resources.. 21.. D. Fontaine. Kiehl. Callousunemotional traits and conduct problems in the prediction of conduct problem severity. P. In C. Fledging psychopathy in classroom: ADHD subtypes. Handbook of psychopathy (pp. L. & Fitzpatrick. J. (2005). Journal of Abnormal Child Psychology. (2005). The antisocial personalities. & Hare. The Hare P-scan: Research version. 471–487. 13. (1950). Evolutionary theory and psychopathy. A. K. Stouthamer-Loeber. Raine. A research scale for the assessment of psychopathy in criminal populations. (2010). 186–197. McCrory. A. DeLisi. Community vs. T. (2005). M. D. P. The antisocial process screening device (APSD). R. Lynam (Eds. D. J. 2000–2011: A state-of-the-art review. 247–253.. Journal of Consulting and Clinical Psychology. New York: Guildford Press.. & Caspi. 1994). Moffitt. 508–518. Loeber. J. & Lichtenstein. Kubak.. Lutz. Are there stable factor in preadolescents girls' externalizing behaviors? Journal of Abnormal Child Psychology.. & Stouthamer-Loeber. Holden. S. 28. L. A study of anxiety in the sociopathic personality. and YLS/CMI. Assessing psychopathic attributes in a noninstitutionalized population. 9–74). Psychopathic personality: The scope of the problem. R. Oakland: New Harbinger Publications. D.. (1980). 209–234. G. (2005). P. Development and Psychopathology. B. 355–375. C.. Moffitt. Jones. research and use in psychotherapy (pp. Lander. E. A. & Neumann. Psychopathy and anxiety in children and adolescents: New insights on developmental pathways to offending. D. Glenn. Assessment of child and adolescent psychopathy. Journal of Abnormal Psychology. Child psychopathy: Theories. Beaver. P. Larsson. In C... G. Psychopathy is the unified theory of crime. (2007). D. M.)... A. (2009). Bodin. A. F. T. Forth. & Cooke. Hare. Salekin. Wexler. S. (1915). International Journal of Forensic Mental Health. 3–13). Lykken.. Juvenile psychopathy: A clinical construct in need of restraint? Journal of Forensic Psychology Practice. Revisiting Lynam's notion of the “fledgling psychopath”: Are HIA-CP children truly psychopathic-like? Child and Adolescent Psychiatry and Mental Health. Salekin. 1013–1023. 414–420. Juvenile psychopathy from a developmental perspective: Implications for construct development and use in forensic assessments. In P. (2003). & Jouriles. 73. D. C. In H. Kazdin. A. Journal of Child Psychology and Psychiatry. C. Journal of Abnormal Psychology. Hofmann. 79–112). Dandreaux..). & Fletcher. New York: Guilford Press. Loeber. R. 555–572). & Hare. & D. Agression and Violent Behavior.. 737–741. Lynam. 22. Hemphill. clinical treatment of children with early-onset ODD or CD: A clinical trial with 3 years follow-up. Hare. 94–101. Psychological Assessment. L. Patrick (Ed.. Hipwell. psychopathy. 541–552. Journal of Abnormal Child Psychology. In R.. Journal of Psychopathology Behavior and Assessment. J. E.). A.. 12.. 179–201). D. Clinical Child and Family Psychology Review. New York: Guildford Press.. R. S. Toronto: Multi-Health Systems. (2006).). & Sellbom. R. A. R. Psychopathic traits and conduct problems in community and clinic-referred samples of children: Further development of the Psychopathy Screening Device. Journal of Abnormal Psychology. R.. Inc.. Dillard. M. P. T. Burnett. J. 51.. T. Frick. Gilbert. (1991). Personality and Individual Differences. Compassion and cruelty. (2008). Cox.. Loeber. Current Psychiatry Reports. D. Handbook of psychopathy (pp. Pursuing the psychopath: Capturing the fledgling. aggression. J. & Sembower.. parents. K. & Hare. G. Childhood predictors differentiate life-course persistent and adolescent-limited antisocial pathways among males and females. G... (1997)... T. J. T. R. R. 34. Law and Human Behavior. Dorn. Diagnostic and statistical manual of mental disorders (4th ed... 291–325. New York: Routledge.). D. D. 357–373. Journal of Cousulting and Clinical Psychology. J. (2003). 7–16. A. R.. Lykken. Journal of Abnormal Psychology.. S. Waschbusch. & Kimonis. S. Harris. 39. E.. Treatment of psychopathy: A review of empirical findings. S. & Gerlsma. psychopath in a nomological net. & Salekin... 342–344. & Hart.. R. Salekin. 256–273. The American Journal of Orthopsychiatry. A longitudinal study of relational aggression. Frick. (2010). K. 2. caring. D. C. Lilienfeld. 2000) American Psychiatric Association. Journal of Social and Clinical Psychology. & J. Recall of shame and favouritism in relation to psychopathology. K. Vaughn. Diagnostic and statistical manual of mental disorders (4th ed. Washington. M. J. M. M. S. Glenn. E. (2001). (2011). M. & Carrey. / Aggression and Violent Behavior 18 (2013) 71–78 Crick. Therapeutic changes in children. T. Gilbert. E. research. (1995). (2009). E. R. & Raine. Barth. (2002). (in press). 32. (2011).. In C... J. (2003). (2011). H. The Hare psychopathy checklist — Revised. (2009). and reading comprehension in a community sample of adolescents. Psychopathic-like traits in childhood: Conceptual and measurement concerns. (1999). (2005). measurement. T. and self-report of delinquency. Barker. Youth Violence and Juvenile Justice. DeCoster. Journal of Abnormal Child Psychology. J. Hawes. E. J. 38. Text rev.). Moffitt.). R. C. Psychopathy in adolescent offenders: An item response investigation of the Antisocial Process Screening Device Self Report and the Psychopathy Checklist: Youth Version. (2009). Kerr. 9. R. O. Journal of Abnormal Psychology. The psychopath: An essay on the criminal mind. Mahwah. (2007). C. (1995).. G. Pelham. Kotler. S. (2000). and families resulting from treatment of children with conduct problems. Lester. M. G. Johnstone. Yuille (Eds. 371–380. Callous-unemotional traits in predicting the severity and stability of conduct problems and delinquency. Linking adult psychopathy with childhood hyperactivity–impulsivity–attention problems and conduct problems through retrospective self-reports. Child and adolescent psychopathy and personality. & Rice. M. (2006). & Hervé. 39. The Hare Psychopathy Checklist and recidivism: Methodological issues and critical evaluating empirical evidence. J. 38. J. & Moffitt. B.. Journal of Abnormal and Clinical Psychology. Kosson. The British Journal of Clinical Sychology. 271–284. 730–742. Kolko. L. P. J. 39. T. Pardini. 37. Hare. E. and practice (pp. D. Handbook of psychopathy (pp... S. & McBurnette. (2006). D. D. P. Assessment of psychopathy in male offenders. J. Keenan. A.. Salekin. Effects of a parenting interventions on features of psychopathy in children. 7–18. Bodin.. The upside of being socially anxious: Psychopathic attributes and social anxiety are negatively associated. DeLisi. É. 8. (1964). DSM-IV-TR (APA. R. Psychopathic traits in youth: Is there evidence of primary and secondary subtypes? Journal of Abnormal Child Psychology. 289–301. T. physical aggression. Journal of Personality and Social Psychology. J. J. D. 120. 55. New York: Guilford Press. Rosenfield. Edens. Psychological Medicine. T. C. Predicting juvenile recidivism with PCL: YV. Psychiatrie: Ein lehbuch (7th & 8th eds. 381–393. 37. (2011). P. & Stouthamer-Loeber. & Sharp. Development and Psychopathology. Frick.. Caspi. 20. (1999). E. P. 19. Cornell. NJ: Erlbaum. (2010a). Gilbert (Ed. (2000)... & McMahon.. 8. Raine.... (2007). P.. Personality Disorders: Theory Research and Treatment. and new directions. Kotler. Tuvblad. 567. McDonald. (2009). & McMahon.. Andershed. B. R. Frick. M.. 53. & Mendnick. J. F. P.. & Widows..D. The compassionate mind: A new approach to life's challenges. (2009). 223–265. R..). (2008). Leipzig: Barth. 223–272. R. Journal of the American Academy of Child and Adolescent Psychiatry. 591–609. R. D. 1133–1153. Hare. D. The psychopath: Theory. 120. R. Dodson. A. (2011). The Kasdin method for parenting the defiant child. 111–119. R. & Iselin. A common genetic factor explains the association between psychopathic personality and antisocial behavior.. 382–393.. 714–727. Salekin. D. Ostrov. K. New York: Routledge.. (2005). 425–438. & Suvak.. DeLisi. New York: Houghton Mifflin. N. R.. New frontiers in criminal careers research. & Vincent. D. & Andershed. Treatment response in CP/ADHD children with callous/unemotional traits.. 2.. T. Compassion: Conceptualizations. Hare. P. Psychopathic Personality Inventory — Revised: Professional manual.). D. M. (2004). D. B. R. B. N. The University of New Orleans. A. Karpman. Grann. Law and Human Behavior. Pardini.. J.. M. 4. D. 59–72. R.. 31. D. (2010). M. D. Journal of Abnormal Child Psychology.. R. Gilbert. D. T. A. F. (in press).. R. Kazdin. J. Boivin. & Hare.. D. (1949). Patrick (Ed. T.. Frick.. Toronto: Multi-Health Systems. and Allied Disciplines.. DSM-IV (APA. J. K. 43–58. M. A. and relations with the development and persistence of conduct problems. G.. Lee. Journal of Abnormal Psychology. Happé. Mishonsky. D. P. 33. Gilbert. structural proprieties. Levenson. (1990). Feeling. W. DC: Author. A. P. D. M.. In R. Venables. (2003). R. . (1994). & Dadds. H. Leistico. Herve.. Lykken. F. 106. The treatment of conduct problems in children with callous-unemotional traits. P. (2006). Psychological Assessment. D. M. S. Unpublished rating scale. D. M. 21. Journal of Abnormal Child Psychology. Hare. Frick. T.. Early identification of chronic offenders: Who is the fledgling psychopath? Psychological Bulletin. The American Journal of Orthopsychiatry. (2001). E. K. (2010).). Journal of Criminal Justice..... S. knowing: Different types of empathy deficit in boys with psychopathy tendencies and autism spectrum disorder. (1996). Forth. Journal of Personality Disorders. S. Handbook of child and adolescent psychopathy (pp. D. D. M. Mahwah. C. A large-scale meta-analysis related the Hare measures of psychopathy to antisocial conduct. H.. L. -E. E. R. R. R.. C. 68. (2010). 103–125.. S. & Werner. Barry. & Dickens. 31. J. (1957).). M.. 37. Toronto: Multi-Health Systems.. R. & Rogers.. 77 Johansson. D. McCord. Hart. Korte. O. A. (1985).. A. Lynam... Princeton. D.. W. NJ: Erlbaum. R. & Grimes.. Longitudinal evidence that psychopathy scores in early adolescence predict adult psychopathy. 26. H. Ribeiro da Silva et al. Andrade. G. A. Lynam (Eds. R. Toronto: Multi-Health Systems. Psychological Assessment. & Piquero.. Lynam. M. 1. Salekin. Washington. A. 155–165. Gilbert. Lynam. The Psychopathy Checklist: Youth Version. Z. 111(556). S. Bukstein. (2011).. The Inventory of Callous-Unemotional Traits. H. E. Rathouz. Charnigo. Lynam. R. Burke. Karpman. M. R. 1–9. W. & D. (2002). M. Youth Violence and Juvenile Justice. The PCL-R assessment of psychopathy: Development. T. A comparison of procedures for the assessment of psychopathy. A. Psychopathic behavior in infants and children: A critical survey of existing concepts. V. R.. F. 58–90). 8. Patrick (Ed. J. NJ: Van Nostrand. P. 6–10. E. 127–138. (2009). 16. M.. R. Kuzban. R. R. 457–470. R. D. C.. A.. 116. Manual for the psychopathy checklist: Screening. S. The stability of psychopathy across adolescence. M. R. Frick. Toronto: Multi-Health Systems. Hart. Farrell. Waxing and waning in concert: Dynamic comorbidity of conduct disorder with other disruptive and emotional problems over 17 years among clinic-referred boys. A. M. New York: Guildford Press. (1995). 777–791. (2003). A. Early temperamental and psychophysiological precursors of adult psychopathic personality. T. & Dane. Lahey. Compassion focused therapy. T. E.. Hass. E. Marczyk. & Viding. 1–12. Stickle. Kraeplin..

. M. Callous-unemotional traits and their importance to causal models of severe antisocial behavior in youth. 28. D. R. P. D. Handbook of child and adolescent psychopathy (pp. In R. Salekin. (2011). R. In J. L.. (2009).. Salekin. R. C. T. & D. Goodnight.. S. Psychopathy and therapeutic pessimism: Clinical lore or clinical reality? Clinical Psychology Review. D. (2002). P. (2002). Adolescent psychopathy and the law. 343–373). S. International Journal of Forensic Mental Health. M. T. 135–157. Vermeiren. (2010). (2011). 415–436). Learning forensic assessment (pp. Lynam (Eds. (2012). Douglas. Van Baardewijk. R. S. (2008).. (2006).. N.. Newhill. R. H. Wilson. Sevecke. M. bold. Schalling (Eds. 2. Salekin. The influence of psychopathic traits on response to treatment. Scholte. & Vitale. Sevecke. S. Behavioral Sciences & the Law. & Barker. A treatise on insanity (D. New York: Guilford Press. D. K. 283–292.).. Lynam (Eds. In R. H. Criminal Justice and Behavior. J. Pinel.. and meanness. Psychopathic personality: Bridging the gap between scientific evidence and public policy.). Davis.). Lester. M. Youth Violence and Juvenile Justice. Sinnott-Armstrong (Eds. and drug abuse. W. Schwalb. D.). E. Newman. Journal of Personality Assessment.. Handbook of child and adolescent psychopathy (pp. R. 36.. T. Handbook of child and adolescent psychopathy (pp.. & D. H. Andershed. Plaschek. & Grisso. Vitacco. T... & Cooke.. Is criminal behavior a central component of psychopathy? Conceptual directions for resolving the debate. Mahwah. D. Psychological science in the courtroom: Consensus and controversy (pp. Salekin. 75. & Blud. Adolescent development and the measurement of juvenile psychopathy.. 46–48. R. Personality and Mental Health. (2003). R. Patrick. Jacksom (Ed. (2010). An investigation of psychopathic features among delinquent girls: Violence. S. & Vermeiren. A. Fowles. Tippey.. 433–445. D. Conceptualizing the psychopathic personality: Disinhibited. Salekin. Diagnostic labeling in juvenile court: How do descriptions of psychopathy and conduct disorder influence judges? Journal of Clinical Child and Adolescent Psychology.. T.. (2007). (2009).. M. G. Quay. The Millon Adolescent Clinical Inventory and psychopathy. C. In C. P. & Frick. T. Rush. Neumann. P. Bates. R. Lehmkuhl. Skeem. O. Stegge. Brennan. J. Law and Human Behavior. S. London: Sherwood. Vitacco. C. The American Journal of Psychiatry. Treatment of child and adolescent psychopathy: Focusing on change. Salekin.).. Worley. The clinical assessment of psychopathy. (2002). R. J. R. 21. D. R. K. Lynam (Eds. 479–484. J. T. A. Lynam (Eds. & D. K. (2000). Murrie. 154–163.. 22.). (1965). Salekin. (2003).. N. Salekin. & Cornell. & Allen. 110–125. (2008). T. J. R. F.. B. (2010). R. J. Dodge. In H. (1835). 374–397). NJ: Erlbaum. Kiehl & W. 18. A treatise on insanity and other disorders affecting the mind. 403–409. D. & Newman. Psychopathic personalities. T. Deficient behavioral inhibition and anomalous selective attention in a community sample of adolescents with psychopathic traits and low-anxiety traits. In R.. Silk. G. Medical inquiries and observations upon the diseases of the mind. Salekin. Dimensions of personality in delinquent boys as inferred from the factor analysis of case history data. 95–162. Lilienfeld (Eds. 284–317).. Thorton. J. Price. Psychopathy and depression in adolescent offenders.. J. & Manchak. A. Handbook of child and adolescent psychopathy (pp.. & Cornell. R. In R. (2010). 103–119. Trans. Child Development. New York: Guilford Press. 277–318. 122.). In R. Journal of Abnormal Child Psychology.. McCoy. Child and adolescent psychopathy: An introduction. C. T.. R. Forensic issues for child and adolescent psychopathy. 36. J. New York: Routledge/Taylor & Francis. Vaughn. T. & Landon. Child and adolescent psychopathy: A state-of-the art reflection on the construct and etiological theories. L... 30. Thomaes. 33. E. Hare.. (in press). & S.. New York: Wiley. European Journal of Child and Adolescent Psychiatry. London: Cassell. L. E. Yullie (Eds. M.. Ziegler. (2010). Triarchic conceptualization of psychopathy: Developmental origins of disinhibition. D. Journal of Abnormal Child Psychology. & Lilienfeld. R.. 23. 33. Vitacco. In C. C.78 D. (2007). 389–414). T. A. E. Salekin. 1280–1287. Salekin. T. J. Juodis. Polaschek. 199–209. & Grimes. research. Criminal Justice and Behavior. Lynam (Eds. G. C. J. T. Rijo. Examining relations between psychopathology and psychopathy dimensions among female and male offenders. & Moretti. L. 21. New York: Hafner (Original work published 1806). J. Salekin. J. boldness. 26. 6. R. E. A. Handbook of child and adolescent psychopathy (pp. & Krisher. (2010).. Lynam (Eds. S. (1964). (2006). (2005). C. (2010). Psychopathy in children and adolescents: Key issues in conceptualization and assessment. Patrick. J.. Prichard. Skeem. M. (2008). Verona. 228–241. J. & Salekin. & Bennett. Psychopathology and delinquency in adolescents: A descriptive and developmental perspective. New York: Guilford Press.. W. S. V. M. C. Patrick (Ed.. Y. M. R. Salekin. M. Approaches to treatment. & Porter. Factor structure of psychopathy in youth: Testing the applicability of the new four factor model. Journal of Criminal Justice. 505–539). & Neumann. / Aggression and Violent Behavior 18 (2013) 71–78 Murrie. & D. Salekin.. T. 1–12). T. 79–112. Salekin. T. Salekin. … or just plain mean? In R. The development of the Youth Psychopathic Traits Inventory — Child Version. & Javdani. Psychological Science in the Public Interest. 240–255. New York: Guildford Press. 347–378). 31(3). O. 31. 33. J.. T. Skeem.. C. Psychological Science. H. (1962). K. M. Law and Human Behavior. S. Behavioral Sciences and the Law. theft. K. & Neumann. In R. J.. Klinger. & Frick. (1950).. D. & Howard. C. Brannen.). Boccaccini. L. Child and adolescence psychopathy: The road ahead. and practice (pp. L. Patrick (Ed. (2009). A.).. & Krueger. 470–486. Clinical Psychological Review. (1812).. psychopathic. D. Salekin. Development and Psychopathology. (2012). Ribeiro da Silva. Aggressive and antisocial girls: Research update and challenges. Quay. The influences of gender and culture on child and adolescent psychopathy. 1. C. White. & Lynam. (2010). O.. New York: Guilford Press. D. Handbook of psychopathy (pp. Law and Human Behavior. 135–155). L. A. Relationships of child and adolescent psychopathy to other forms of psychopathology. & Rogers. 12. Lynam (Eds. Leistico. Treatment of conduct problem youth with interpersonal callous traits using mental models: Measurement of risk and change. P. L. Salekin. S. 235–266. Psychopathy in youth and mental sets: Incremental and entity theories of intelligence. 15–48). S. International Journal of Law and Psychiatry. Journal of Personality Disorders. Seagrave. New York: Guildford Press. & D. Commentary: Personality disorder in adolescence: The diagnosis that dare not speak its name. & Kosson. Fear and loathing in psychopaths: A metaanalytic investigation of the affect recognition deficit. T. & Salekin. New York: Guilford Press. 40. New York: Guildford Press. 358–384). T. Treatment of psychopathy: A review and brief introduction to the mental model approach for psychopathy. & D. but how? Rehabilitating general. R. P. Measuring psychopathic traits in children through self-report. & Sellers.. S. (2005). & D. B. & Lynam. T. E. In R. J. R. (2006). Handbook of psychopathy (pp. Gilbert & Piper. K. 659–668. Handbook of child and adolescent psychopathy (pp. Sadeh.. K. 85–95. T. 129–152). In R.. A. Philadelphia: Kimber & Richardson. 102–117. R. S. (2008). Larrea. Psychopathic traits and preattentive threat processing in children: A novel test of the fearlessness hypothesis. New York: Guilford Press. C. 80. T. 35. R.. A. Salekin. Sylvers. . P. & J. Handbook of child and adolescent psychopathy (pp. Predicting dangerousness with two Millon Adolescent Clinical Inventory psychopathy scales: The importance of egocentric and callous traits. B. J. Appropriate treatment works. 401–420). DeLisi. In K. E. P. 449–462.). Psychopathy and the law. K. 913–928. R. Risk assessment for juvenile justice: A meta-analysis. Ribeiro da Silva et al. L. New York: Guilford Press. Handbook of child and adolescent psychopathy (pp..).)... The super-ordinate nature of the psychopathy checklist-revised. (2010). R. Patrick. S.. L. D. 219–239. Anthony. R. 22. & Pettit. T. F. manifestations and etiology.. Zalot. Skeem.). (in press). S. R. (2007). Psychopathic personality as pathological stimulation seeking. D. 180–183. S. T. D. 317–342). C. C. M. G. R. New York: Guilford Press.). Psychopathic behavior: Approaches to research (pp. P.). In R.. 461–470. Verona. R. D. M. R. G. K. Psychopathy in children and adolescents: The need for a developmental perspective.. & D. 269–277. and high risk offenders. Sueldfeld. D. D. (2007). & Lilienfeld. New York: Wiley. Salekin. D. D. R... Hare. T... (2012). C. 38. D. D. L. Lynam (Eds. M. Personality Disorders: Theory Research and Treatment.. (2010). (2011). O. R... Schneider. Journal of Personality Assessment.. Psychological Assessment. Herve. Salekin. & D. M. 22. R. Vitale. Beaver.). The psychopath: Theory.. G. (1978). C. Odgers. Psychopathy in woman: Assessment..