Psychopathic traits in children and adolescents are increasingly getting attention in both the scientific literature as well as clinical practice. Psychopathic traits tend to be associated with an earlier onset of delinquent behavior, higher levels of delinquent behavior, and higher rates of recidivism (Leenarts et al., 2017). This interest in psychopathic traits is also reflected in the newly added limited prosocial emotion (LPE) specifier to the Conduct Disorder (CD) diagnosis in the Diagnostic and Statistical Manual (DSM)-5 (American Psychiatric Association, 2013), in order to better capture the small group of youth who are more likely to persist in antisocial behavior and might, therefore, be diagnosed with an antisocial personality disorder in adulthood. Nevertheless, there is little research regarding the stability of psychopathic traits in adolescents and young adults.
The stability of psychopathic traits is a long-standing discussion in the adults literature with opposing opinions on the efficacy of therapeutic interventions (Salekin, 2002). This is not surprising given the common belief that treatment might have even a negative effect on psychopathic traits (D'Silva, Duggan, & McCarthy, 2004). A systematic review on the empirical evidence regarding untreatability of psychopathic characteristics in adults, however, reported that only one study suggested high psychopathic traits being associated with less favourable treatment outcomes and that individuals with higher levels of psychopathic traits could demonstrate similar therapeutic progress compared to others (Larsen, Jalava, & Griffiths, 2020). Other research suggested possible modest changes of psychopathic traits in the life course of adults even without therapeutic interventions (Polaschek, 2014).
These findings in adults may not inevitably be translated to juveniles, as adolescence is an important neuro-developmental phase, with the brain still maturing and developing (Sisk & Romeo, 2019). Literature suggests that increases in psychosocial maturity (among others responsibility, social perspective and temperance) are more pronounced in adolescents than in adults (Cauffman, Skeem, Dmitrieva, & Cavanagh, 2016). Hence, there is evidence that the transition from adolescence to young adulthood is marked by continuity of lower and higher order levels of personality trait hierarchy and growth toward greater maturity (Roberts, Caspi, & Moffitt, 2001). The dimensions of psychopathy might be considered variants of normal personality traits, i.e. with some having more, and others having less psychopathic traits. Given the developmental nature of adolescence, one might argue that psychopathic traits in adolescents are less stable over time as suggested and possibly more changeable than in adulthood.
Research in juveniles published mixed results regarding the stability of psychopathic traits. On the one hand, studies support the idea that psychopathy is relatively stable across adolescence (Lynam, Caspi, Moffitt, Loeber, & Stouthamer-Loeber, 2007; Lynam & Gudonis, 2005). One study regarding more than 1,500 boys in the public school system showed no age-related fluctuations in reliability, stability and predictive utility of psychopathy across childhood and adolescence suggesting that concern about large changes in personality pathology across childhood and adolescence may be overstated (Lynam et al., 2009). Psychopathic features in adolescents (Loney, Taylor, Butler, & Iacono, 2007) and aggressive children (Barry, Barry, Deming, & Lochman, 2008) were found to be moderately to stable in transition from adolescence to adulthood.
Other findings, on the other hand, support change and variability of psychopathic traits in adolescence and in transition to adulthood with results from mean- and individual-level analyses revealing a decline of Impulsive Antisociality (e.g. social deviance) from late adolescence to early adulthood (Blonigen, Hicks, Krueger, Patrick, & Iacono, 2006). A longitudinal study over a 2 to 4-year time frame demonstrated a regression to the mean (Frick, Kimonis, Dandreaux, & Farell, 2003). Identification of psychopathy using the Psychopathic Checklist (PCL) in adolescents was found less reliable over a 2-year period than in adults and increases in psychosocial maturity over time predicted decreases in PCL scores for adolescents (Cauffman et al., 2016).
Repeated assessments of changes in Callous/Unemotional, Narcissism, and Impulsivity scores indicate that personality features associated with psychopathy in youth can be reduced through institutional treatment, even in severely behaviorally disordered adolescents (M. F. Caldwell, McCormick, Wolfe, & Umstead, 2012). Nevertheless, it has to be noted that literature on the different dimensions of psychopathy and its course over time in adolescents is still scarce.
One possibility to delineate psychopathy in adolescents is the three-dimensional conceptualization of Cooke and Michie (2001) with the underlying dimensions Grandiose-Manipulative (GM), Callous-Unemotional (CU), and Impulsive-Irresponsible (II) with CU seen as the core trait (also in line with the main focus of LPE specifier). This affective facet of psychopathy and the dysfunction thereof involves reduced guilt and empathy, as well as reduced attachment to significant others. CU traits showed a moderate level of stability over three years in a large North-American sample of N = 1,216 adolescents who had been arrested for the first time, similar to what has been reported in community samples, as well as an overall decline at older age (Ray et al., 2019). A longitudinal study on a twin sample confirmed previous research that genetic factors substantially underlie CU traits during childhood, while non-shared environmental factors have considerable, generally age-specific contributions, over and above genetic factors (Henry et al., 2018).
The GM dimension comprises four subscales: Dishonest Charm, Grandiosity, Lying, and Manipulation. A Swedish study investigating the stability of GM traits over four years in 1,068 adolescents from a community sample and reported in summary three profiles with declining levels over time and one profile of adolescents who start with high levels and maintain elevated levels (Salihovic, Özdemir, & Kerr, 2014).
The II dimension includes items regarding Impulsiveness, Thrill-Seeking, and Irresponsibility. The time course of the traits in above mentioned study suggested three profiles of decreasing levels and a moderate-stable profile (Salihovic et al., 2014). Longitudinal analyses seem to suggest a linkage of attachment to parents with the impulsive-irresponsible psychopathic trait and therefore the influence of environmental factors in the time course of this dimension (Vagos, Ribeiro da Silva, & Macedo, 2021).
The differences of stability of psychopathic traits might partly be explained by the use of different instruments and the large variety of samples as stated by Lynam and colleagues (2007). As alternative measures of psychopathy manifest low rates of agreement in classifying youth as psychopathic even at a single time point (Cauffman, Kimonis, Dmitrieva, & Monahan, 2009) there persists the uncertainty if changes of psychopathic scores assessed with different measures reflect instability of psychopathy or measurement errors. The variation of scores on measures of psychopathy might also reflect the method how the components of psychopathy are examined as well as the different developmental stages of the participants (Cauffman et al., 2016). These possible confounding factors were omitted in multiple longitudinal studies on the stability of psychopathic characteristics. One examination of the Psychopathy Checklist: Youth Version (PCL:YV) over a 6-month follow-up period found moderate-to-high stability while the affective factor of the PCL:YV was less stable than the other factors (Z. Lee, Klaver, Hart, Moretti, & Douglas, 2009). In a North-American study over a period of approximately 2 years using parent and self-reports (starting sample age approximately 13 years) the rank-order stability of psychopathic traits was high to very high based on parent reports and lower based on self-reports (Munoz & Frick, 2007). These findings suggest the stability of psychopathic traits in early adolescence (Gacono, 2015). A longitudinal study in Sweden investigated the stability of psychopathic traits from the approximate age of 13 and onwards for a total of 4 years. The most stable subscales in the yearly assessments using the Youth Psychopathic tratis Inventory (YPI) were the impulsive-irresponsible subscale and the grandiose-manipulative subscale indicating that possibly the more behavior-focused dimensions of psychopathic traits are highly-stable across adolescence (Salihovic et al., 2014). A Swedish study on twins examined the importance of genetic and environmental influence for the stability of psychopathic personality between mid- and late adolescence over the course of 3 years measured also using the YPI. Results showed that the three psychopathic personality dimensions were stable at different levels of analysis and linked to a stable higher order general factor (i.e., psychopathic personality factor). Genetic factors contributed substantially to the stability of this general higher order factor, whereas environmental factors were of little importance (Forsman, Lichtenstein, Andershed, & Larsson, 2008).
In short, current research findings indicate that results regarding the stability of psychopathic traits in adolescents are mixed (e.g. due to differences is assessment, different conceptualization, in treatment or not). The aim of the present study was to add empirical knowledge regarding stability of self-reported psychopathic traits, including the underlying dimensions of GM, CU and II. The following results would be informative for treatment approaches and better adherence to therapeutic settings and consecutive improved outcomes and prevention of delinquent recidivism.