To Örebro University

Psychopathy is a serious psychiatric phenomenon characterized by a pathological constellation of affective (e.g., callous, unemotional), interpersonal (e.g., manipulative, egocentric), and behavioral (e.g., impulsive, irresponsible) personality traits. Though amygdala subregional defects are suggested in psychopathy, the functionality and connectivity of different amygdala subnuclei is typically disregarded in neurocircuit-level analyses of psychopathic personality. Hence, little is known of how amygdala subregional networks may contribute to psychopathy and its underlying trait assemblies in severely antisocial people. We addressed this important issue by uniquely examining the intrinsic functional connectivity of basolateral (BLA) and centromedial (CMA) amygdala networks in relation to affective, interpersonal, and behavioral traits of psychopathy, in conduct-disordered juveniles with a history of serious delinquency (N = 50, mean age = 16.83 ± 1.32). As predicted, amygdalar connectivity profiles exhibited dissociable relations with different traits of psychopathy. Interpersonal psychopathic traits not only related to increased connectivity of BLA and CMA with a corticostriatal network formation accommodating reward processing, but also predicted stronger CMA connectivity with a network of cortical midline structures supporting sociocognitive processes. In contrast, affective psychopathic traits related to diminished CMA connectivity with a frontolimbic network serving salience processing and affective responding. Finally, behavioral psychopathic traits related to heightened BLA connectivity with a frontoparietal cluster implicated in regulatory executive functioning. We suggest that these trait-specific shifts in amygdalar connectivity could be particularly relevant to the psychopathic phenotype, as they may fuel a self-centered, emotionally cold, and behaviorally disinhibited profile.

BACKGROUND: Reflecting evidence on Callous-Unemotional (CU) traits (e.g., lack of empathy and guilt, shallow affect), the DSM-5 added a categorical CU-based specifier for Conduct Disorder (CD), labeled 'with Limited Prosocial Emotions' (LPE). Theory and prior work suggest that CD youths with and without LPE will likely differ in neural processing of negative socioemotional content. This proposition, however, is mainly derived from studies employing related, yet distinct, operationalizations of CU traits (e.g., dimensional measure/median split/top quartile), thus precluding direct examination of LPE-specific neurocognitive deficits.

METHODS: Employing a DSM-5 informed LPE proxy, neural processing of recognizing and resonating negative socioemotional content (angry and fearful faces) was therefore examined here among CD offenders with LPE (CD/LPE+; N = 19), relative to CD offenders without LPE (CD/LPE-; N = 31) and healthy controls (HC; N = 31).

RESULTS: Relative to HC and CD/LPE- youths and according to a linearly increasing trend (CD/LPE- < HC < CD/LPE+), CD/LPE+ youths exhibited hyperactivity within dorsolateral, dorsomedial, and ventromedial prefrontal regions during both emotion recognition and resonance. During emotion resonance, CD/LPE+ youths additionally showed increased activity within the posterior cingulate and precuneal cortices in comparison to HC and CD/LPE- youths, which again followed a linearly increasing trend (CD/LPE- < HC < CD/LPE+). These effects moreover seemed specific to the LPE specifier, when compared to a commonly employed method for CU-based grouping in CD (i.e., median split on CU scores).

CONCLUSIONS: These data cautiously suggest that CD/LPE+ youths may exhibit an over-reliance on cortical neurocognitive systems when explicitly processing negative socioemotional information, which could have adverse downstream effects on relevant socioemotional functions. The findings thus seem to provide novel, yet preliminary, clues on the neurocognitive profile of CD/LPE+, and additionally highlight the potential scientific utility of the LPE specifier.

A key task in evidence-based case management of youth is the assessment of research-based risk and protective factors. In the present study we compare assessments of social workers using a structured assessment instrument with assessments of social workers not using such an instrument. Assessments of the exact same case—a vignette about a 14-year-old boy—conducted by 30 social workers using a structured assessment instrument and 30 social workers not using such an instrument were compared. The 60 assessments were also rated by independent researchers and senior social services managers, blind to whether an instrument had been used in the assessments or not. As hypothesized, using a structured assessment instrument resulted in the identification of a greater number of research-based risk and protective factors, and the assessments were rated as better in terms of general adequacy, quality, accuracy and potential treatment effectiveness, than when an instrument was not used. The present study demonstrates that social workers’ assessments of youth become more evidence-based, adequate and potentially more treatment effective when a structured assessment instrument is used as compared to when it is not.

In this article the authors present a review of previous reviews and meta-analyses, identifying and summarizing the empirical research base on risk and protective factors for future psychosocial problems-specifically externalizing and internalizing problems-among preschool children. The authors also discuss risk and protective factors in the framework of concepts such as evidence-based practice, risk-focused prevention and treatment, and the Risk, Need, and Responsivity principles. They conclude that there is an extensive amount of research on risk and protective factors for preschool children that could and should be used by well educated professionals to help children to a better life.

The SOFIA-study is a prospective longitudinal study of approximately 2,000 children in a mid-sized Swedish community. SOFIA is the acronym of Social and Physical Development, Interventions and Adaptation in Swedish, and the main focus of the study is on understanding developmen-tal trajectories of norm breaking, criminal behavior, and the risk and pro-tective factors for the various trajectories. The aim is to answer question such as Which risk factors are the most important in the development of norm breaking behavior? What protects children from a negative devel-opment? Which interventions are given to children with difficulties? The study was initiated in 2010 by professors H. Andershed and A-K. Ander-shed, and has since then assessed the participants in four data collection waves, in 2010, 2011, 2012 and 2015. At base-line, the children were 3-5 years old, attending public preschools in the community. Questionnaires have been completed by caregivers, preschool and elementary school teachers, as well as principals and headmasters. The purpose has been to collect information both on the children – their behaviors and charac-teristics, the families – parent-child relationships, caregiver attributes, as well as preschool/school relationships, environment, and conditions. The papers presented in this panel are examples of papers using data from the SOFIA-study.

Purpose: Risk and protective factors for antisocial behavior have been shown to act in a cumulative manner. The purpose of this article is to examine the predictive power of risk factors and protective indices predicting violent offending.

Methods: We used longitudinal data across 25 years to predict violent offenses for 475 males. Cumulative childhood risk factors (age 10), and-cumulative individual, family, peer and school protective factors (ages 13, 15) were analyzed.

Results: The likelihood for a conviction for violent offenses showed a fivefold increase with an increase in risk factors from 0 to 3. This increase was markedly reduced when controlling for protective factors. Similarly, controlling for risk factors, the likelihood for a conviction was almost ameliorated, showing a tenfold decrease, with an increase in protective factors from 0 to 10. Interactions between cumulative risk and protective factors were also found. Total number of protective factors significantly decreased the likelihood of violent offenses for those with and without childhood behavioral risk factors, however the decrease was significantly greater for those with no childhood risk factors.

Conclusions: Analyses of antisocial behavior should not be restricted to risk factors, but include protective factors, if the purpose is to better tailor interventions. (C) 2016 Elsevier Ltd. All rights reserved.

The main aim of this dissertation is to investigate whether traits on the level of the individual are important in understanding violent, frequent antisocial behavior among adolescents. The first of the four studies included in this dissertation asks whether individual-level explanations are going to be a fruitful approach at all. The other three studies speak to the question which particular individual characteristics are related to violent, frequent antisocial behavior.

Two different large samples of 14 to 16-year-old male and female non-referred adolescents were assessed. The adolescents were mainly assessed with self-report questionnaires but information from parents and teachers was also incorporated in one of the samples.

Results show that aggressive, antisocial behavior for a subgroup of adolescents cuts across social contexts, indicating that their aggressive behavior is largely dependent on individual characteristics, more than on situational factors. It is further shown that a constellation of personality traits involving a grandiose, manipulative interpersonal disposition, callous, unemotional affective traits, and an impulsive, irresponsible behavioral style, characterizes a subgroup of antisocial adolescents who have more violent, frequent antisocial behavior than antisocial adolescents without this personality constellation. This same subgroup also shows more pronounced problem behaviors of other kinds — early behavioral problems, problems with inhibiting aggressive behaviors, and problems with hyperactivity, impulsivity, and attention.

Moreover, the results show that the affective facet of this particular personality constellation, involving callous, unemotional traits, plays an important role in violent, frequent antisocial behavior independently of other antisocial-related dimensions such as impulsivity, hyperactivity, and sensation seeking traits. Importantly, the main findings were similar for males and females.

It is concluded that specific personality traits are important to consider when moving further toward an understanding of violent, frequent antisocial behavior and that research on non-referred, community samples of youths can be particularly helpful for this purpose. Implications for prevention and intervention and directions for future research are discussed.

Addresses the question of whether it is possible to use a self-report measure of psychopathic traits on non-referred youth samples to identify a subgroup of problematic youths who are particularly problematic and different from other problem youths. A large sample of 1,279 eighth-grade, non-referred adolescents (mean age 14.42 yrs), and their parents were assessed. Students completed self-report measures that assessed personality, conduct problems, and family functioning. Parents responded by completing and mailing in a questionnaire. Results show that the adolescents exhibiting a low-socialized psychopathy-like personality constellation had a more frequent, violent, and versatile conduct-problem profile than other low-socialized and well socialized adolescents. The psychopathy-like adolescents also differed from other poorly socialized adolescents in ways that suggested that their etiological background was different from adolescents with non-psychopathy-like conduct problems. The authors conclude that self-report measures can indeed be useful for research purposes in subtyping youths with conduct problems.

Konsekvenser och riskfaktorer rörande normbrytande beteende i barndomen, samt behandlingsstrategier.

This paper introduces ESTER, a research based and computerized risk-need assessment system for youths (0-18 years) with or at risk for conduct problems. The ESTER-system includes a screening tool/questionnaire (ESTER-screening) and a professional structured risk-need assessment instrument (ESTER-assessment). This article briefly presents the background and purpose of ESTER, and the risk and protective factors assessed. It also illustrates how the computerized system effectively helps in presenting results of single as well as repeated assessments, assisting the practitioner in tailoring suitable interventions.

I Normbrytende atferd hos barn er internasjonal forskning gjort tilgjengelig for et bredt publikum. Forfatterne gir en oversikt over nordisk praksis, forskningsfeltet forøvrig og de vurderer validiteten i ulike forskningsresultater. Risikofaktorer og beskyttende forhold hos barnet selv, i familien og i det sosiale nettverket påvirker barns atferdsutvikling, og forfatterne har fokuset rettet mot forebygging og behandling av normbrytende atferd hos barn under 12 år.På lengre sikt kan alvorlige atferdsproblemer hos barn og unge føre til misbruk av alkohol og andre rusmidler, depresjon, lovbrudd, ekteskapskonflikter og arbeidsledighet. Kvaliteten i utdanningen av dem som skal jobbe med disse barna må sikres, og denne boken gir både et godt grunnlag for videre studier og forskning, samtidig som den gir et kunnskapsgrunnlag for å forbedre praksis i hjelpetjenester som barneverntjenesten, psykisk helsevern og pp-tjenesten.

The aim of this study was to compare callous-unemotional (CU) traits versus the multidimensional psychopathy construct in their ability to predict future and stable antisocial behavior. At baseline, a community sample of 996 Cypriot 12-year old adolescents (52% girls) completed measures that tap conduct problems (CP) and psychopathic traits, including CU. CP, aggression, and substance use were self-reported at 1-3 year follow-ups. Youths were assigned to six mutually exclusive groups based on their baseline levels of CP and psychopathic traits. Youth with CP scoring high on all three psychopathic traits dimensions (Psychopathic Personality + CP) showed the most robust and highest risk for future and stable CP, aggression, and substance use, followed by youth who were high on all three psychopathic traits dimensions but displayed no concurrent CP (Psychopathic Personality Only) and CP youth with low levels of psychopathic traits (CP Only). Youth with CP who merely manifested callous-unemotional traits (Callous-Unemotional + CP) were only at risk for future CP. The findings suggest that the CU traits-based approach for subtyping children with CP is less informative compared to a subtyping approach using various psychopathic traits dimensions in predicting future and stable forms of various antisocial outcomes. These findings and their consistency with prior work indicate the need for additional research to examine the various psychopathic traits dimensions rather than focusing solely on CU traits, especially for CP subtyping purposes.

ESTER-assessment is a new assessment instrument for youths (0-18 years), and includes 19 empirically-derived risk and protective factors for conduct problems. This study tests the inter-rater reliability of the five-point rating scale used to assess the 19 factors in ESTER-assessment on 30 institutionalized girls and their file information. Exact agreement between raters varied from 38 to 72 percent on the 19 individual factors, a result much better than chance. Intra-class correlations of the two independent raters on the majority of the 19 individual factors were fair to good. In conclusion, the results lend support to the inter-rater reliability of ESTER-assessment.

Children with early-onset conduct problems (CP) are at great risk for future behavior problems, and this risk seems to increase when CP co-occur with psychopathic traits. Even though studies are indicating that the entire psychopathic personality construct may be more useful in designating a meaningful subgroup of children with CP, research on psychopathic traits and CP in childhood have mainly focused on the role of callous unemo-tional (CU) traits. Prospective longitudinal data of 1,867 3- to 5-year-olds (47% girls) followed annually for two years was used to compare groups of children with different combinations of CP and psychopathic traits on fearlessness and Attention-Deficit Hyperactivity Disorder (ADHD) symp-toms. Children with CP and psychopathic personality had higher baseline and stable levels of fearlessness and ADHD symptoms than children with CP only or children with CP and concurrent CU traits. They were also more likely to display stable levels of the very risky combination of CP and ADHD symptoms. Results were similar for boys and girls. Findings indicate that there are reasons to consider other traits and behaviors as specifiers for subgroups of children with CP over and above CU traits, in order to optimize both diagnostic practice and treatment outcomes.

This study investigates the relationship between the self-report Youth Psychopathic Traits Inventory (YPI) and the clinician-rated Psychopathy Checklist: Youth Version (PCL:YV). A representative sample of 92 girls and 70 boys, 12 to 20 years of age (mean age, 17 years), who received services at a clinic for adolescents with substance misuse problems, was studied. Moderate correlations (r =30-.51) were found between conceptually corresponding YPI and PCL: YV factor scores among both boys and girls, whereas correlations between individual subscales of the YPI and items of the PCL: YV were not as consistent. A cross-tabulation of groupings based on the three-factor models of the two instruments largely supported the categorical convergent validity of the YPI, particularly for low and high scorers. Although more studies with larger samples are needed, results indicate that the YPI is a cost-effective measure of psychopathic traits in adolescents in research settings.

Examined the relationship between bullying in school and street violence. 2,915 adolescents (aged 14-15 yrs) completed questionnaires concerning street violence, weapon carrying, violence victimization, loitering, bullying, and nights away from home. Results show that bullying others in school was strongly linked to violent behavior and weapon-carrying on the streets, both among males and females. Bullying others in school was also related to being violently victimized on the streets. Findings suggest that school bullying is in many cases a part of a more general violent and aggressive behavior pattern, and that preventive efforts targeting individuals with bullying behavior in school may decrease violence among adolescents in the community as well.

Objective:  In the present paper we ask whether it is meaningful to study psychopathic traits in non-referred youths and whether this kind of research can be used to understand the development of criminal full-blown psychopathy.

Method:  We review studies that have investigated the utility of assessing psychopathic traits in non-referred samples of youths.

Results:  Research shows that psychopathic traits in non-referred youths manifest similarly to how they are manifested among incarcerated offenders, as indicated by similarities in factor structures. Also, psychopathic traits relate similarly to frequent, violent antisocial behavior in non-referred youths as among adult and adolescent institutionalized criminal offenders. Thus, the differences between the non-referred conduct-problem youths exhibiting a psychopathic personality pattern and the incarcerated, criminal youths identified as psychopathic seem to be quantitative rather than qualitative.

Conclusion:  It is concluded that research on non-referred youth samples can provide important knowledge about the processes that underlie the development of psychopathic traits and how this development can be prevented. Implications for future research and intervention and prevention are discussed.

The present study tests the utility of the personality-based three-factor model of psychopathy according to the Hare Psychopathy Checklist: Screening Version (PCL:SV). This model of psychopathy excludes aspects of criminal behavior as opposed to other models of psychopathy. The main research question was to what extent the three-factor model of psychopathy can identify a problematic subgroup of young offenders. The sample consisted of 148 incarcerated young male criminal offenders, between 15 and 25 years of age (mean=19.07, SD=2.11) who were recruited from a central detention center for young offenders in a northern German county. Model-based cluster analysis of the three psychopathy factors showed that three different clusters labeled: (i) Unemotional/Impulsive-Irresponsible, (ii) Low traits, and (iii) Psychopathic personality, had the best fit to the data. The psychopathic personality cluster with high scores on all three factors of the PCL:SV exhibited, as expected, a significantly higher prevalence of conduct disorder and substance use problems, but was not significantly different from the other clusters on past criminality and previous incarcerations. In conclusion, the results showed that the three-factor model of psychopathy can be useful in identifying a problematic subgroup of young offenders. (C) 2008 Published by Elsevier Inc.

The purpose of this chapter is to review what is currently known about the conceptualization and assessment of psychopathy in childhood, and to offer perspective on where investigative work in this area can proceed from here using the aforementioned questions as a guide. In the service of this broad goal, the chapter is organized around five specific aims. First, we consider how psychopathy relates to conditions listed in the “Disruptive Behavior Disorders” section of DSM-5, devoting special attention to the diagnosis of conduct disorder with limited prosocial emotions (CD+LPE) as a means to capture child psychopathy. Second, we review findings from developmental studies testing the extent to which psychopathic tendencies can be identified reliably and effectively, in terms of predicting meaningful outcomes, at early ages. Third, to further address the question of how applicable the diagnosis is to youth, we summarize existing evidence regarding the structural properties and criterion-related validity of differing established measures of child/adolescent psychopathy. Fourth, we review etiological theories and relevant research findings, including data from neuroscience. Fifth, we outline directions for future research, with an emphasis on ways to improve investigative approaches and interpretability of findings in this crucial area of study. In this latter section of the chapter, we also address issues such as the need for continuing research directed at clarifying relations between child psychopathy and the childhood diagnoses in the DSM.