Juvenile Psychopathy

Issues in Juvenile Psychopathy

The impressive body of research supporting the construct of psychopathy in the assessment of adult offenders (Hare, 1991; Salekin et al. 1996) has incited great interest in measuring psychopathy in children and adolescents (Seagrave & Grisso, 2002). The Psychopathy Checklist-Revised (PCL-R, Hare, 1991) has been well-established as the gold standard for measuring psychopathy in adults (Edens, Skeem, Cruise, & Cauffmann, 2001), and the more recent Psychopathy Checklist: Youth Version (PCL:YV; Forth, Kosson, & Hare, 2003) is emerging as the prime candidate for assessing juvenile psychopathy traits (Forth & Mailloux, 2000). Core features of psychopathy, such as lying, disregard of others, and manipulativeness, are usually first present in childhood (Hare, 1970; Millon, 1981). These personality features and behaviors may become increasingly prevalent in adolescence, and may culminate in psychopathy as a stable personality disorder in adulthood. Some authorities have raised serious misgivings about applying the construct of psychopathy to juveniles (Edens et al., 2001; Seagrave and Grisso, 2002). For example, there is no longitudinal research to demonstrate that youth who exhibit psychopathic-like traits continue to engage in antisocial behavior in adulthood, and moreover, most juvenile delinquents desist in their criminal behavior as they mature into adulthood. There could be serious detrimental consequences to falsely identifying a juvenile as a "young psychopath."

Despite the fact that there are gaps in our current knowledge of juvenile psychopathy, there is a great deal of research supporting the reliability and validity of the PCL:YV, summarized in the new manual (Forth, Kosson, & Hare, 2003). Despite their misgivings, Seagrave and Grisso (2002) predict that juvenile psychopathy instruments will inevitably be introduced into forensic clinical practice, and the PCL:YV is likley to become the gold standard for the assessment of psychopathy in juveniles. For these reasons, and because the PCL:YV is now published and readily available to clinicians, it is particularly important to gain a better understanding of juvenile psychopathy and to examine the validity of measures of juvenile psychopathy such as the PCL:YV. Research that explores psychopathic-like traits in youth has the potential to provide information of value for early intervention and public safety. While clinicians are cautioned to be mindful of its limitations and to recognize the potential for misuse, it is important that researchers continue to try to understand this disorder due to the tremendous social, psychological and economic costs of psychopathy (Hart, 1998).

The Youth Violence Project has been conducting research on psychopathy, including juvenile psychopathy, for more than ten years. Below are summaries of some of our work.

Our Psychopathy Research

Boccaccini, M.T., Murrie , D.C. , Clark , J. & Cornell, D.G. (in press). Describing, diagnosing, and naming Psychopathy: How do youth psychopathy labels influence jurors? Behavioral Sciences and the Law.

In light of increasing efforts to assess psychopathy features among youth, scholars have conducted several studies to examine how describing a young offender as manifesting psychopathic traits, diagnosing him with psychopathy, or naming him “a psychopath,” may influence juvenile-justice decision-makers. This study sought to clarify some of the apparently discrepant results from these earlier studies. Jury-pool members (N = 891) reviewed expert testimony that manipulated three variables: history of antisocial behavior (substantial vs. minimal), psychopathic personality traits (present vs. absent), and diagnostic label (no diagnosis, conduct disorder, psychopathy, or “psychopath,”). As in prior research, effects for the antisocial behavior and psychopathic personality traits underlying diagnoses tended to be stronger than the effects of diagnostic labels (i.e., psychopathy or conduct disorder). However, labeling a juvenile as “a psychopath” led jurors to believe that he was at an increased risk for future crime and deserved more severe punishment compared to juveniles described as meeting diagnostic criteria for psychopathy or conduct disorder.

Amato, J., Cornell, D., Fan, X. (2008). Adolescent psychopathy: Factor structure and correspondence with the Millon Adolescent Clinical Inventory (MACI). Criminal Justice & Behavior, 35, 294-310.

This study compared five proposed factor models of psychopathy in a sample of 227 adolescent incarcerated offenders and psychiatric inpatients. Results of CFA indicated that both Cooke and Michie’s three-factor model and a four-factor parceled solution (Neumann, Kosson, & Salekin, 2007) using Hare’s (2003) four factors provided excellent fit. The original two-factor model and the three-and four-factor models from the PCL:YV manual ( Forth, Kosson, & Hare, 2003) provided inadequate fit. Correlational analyses revealed a meaningful pattern of statistically significant relationships between psychopathy factor scores and several factor scores on the Millon Adolescent Clinical Inventory (MACI). Regression analyses indicated Hare’s Antisocial factor (F4) provided incremental validity beyond other psychopathy factors in predicting scores on the MACI Antisocial-Delinquent factor.

Murrie, D., Boccaccini, M., McCoy, W., & Cornell, D. (2007). Diagnostic labeling in juvenile court: How do descriptions of psychopathy and conduct disorder influence judges? Journal of Clinical Child and Adolescent Psychology, 36, 228-241.

When child psychologists in forensic contexts assign youth diagnostic labels such as psychopathy or conduct disorder, are judges more punitive towards the labeled youth? Or, are judges more influenced by the criteria underlying such diagnostic labels? A national sample of juvenile and family court judges (N = 326) rendered hypothetical dispositions based on one of twelve mock psychological evaluations. The evaluations varied the presence of two sets of diagnostic criteria (antisocial behavioral history and psychopathic personality traits) and three diagnostic labels (conduct disorder, psychopathy, no diagnosis) in order to distinguish criterion effects from labeling effects. Results revealed substantial effects (Cohen's d's of .33 to 1.27 on six of nine variables) for having a history of antisocial behavior. Psychopathic personality features also appeared influential, albeit on fewer variables. Surprisingly, there were no negative effects associated with either the conduct disorder or psychopathy label. We conclude that researchers should attend as much to criterion effects as to simple labeling effects, and that child psychologists working in forensic contexts should consider carefully the ways in which they describe the criteria underlying their diagnoses.

Murrie, D., Cornell, D., & McCoy, W. (2005). Psychopathy, conduct disorder, and stigma: Does diagnostic labeling influence juvenile probation officer recommendations? Law and Human Behavior, 29, 323-342.

This study investigated the potential influence of labeling a juvenile as psychopathic. Juvenile probation officers (JPOs; N = 260 ) rendered hypothetical recommendations based on eight mock psychological evaluations. The evaluations varied the presence of two diagnostic criteria (antisocial behavioral history and psychopathic personality traits) and diagnostic labels (psychopathy, conduct disorder, no diagnosis) in order to distinguish criterion effects from labeling effects. The diagnostic criteria of antisocial behavior had a substantial effect on JPO recommendations (effect sizes .50–.79), while the diagnostic criteria of psychopathic personality traits had a more limited effect. Surprisingly, diagnostic labels had little effect, and there were no appreciable differences between conduct disorder and psychopathy diagnoses. These findings illustrate the importance of distinguishing diagnostic criterion effects from diagnostic labeling effects. Download PDF File

Kaplan, S.G., & Cornell, D.G. (2004). Psychopathy and ADHD in Adolescent Male Offenders. Youth Violence and Juvenile Justice, 2, 148-160.

What is the relationship between psychopathy traits and attention deficit/hyperactivity disorder (ADHD) in juvenile offenders? The authors examined psychopathy scores, as measured by the Psychopathy Checklist: Youth Version and three indices of ADHD in 122 incarcerated male juvenile offenders. In addition, we investigated whether psychopathy and ADHD predicted violent behavior. Psychopathy Checklist: Youth Version Total and Factor 1 scores did not correlate with measures of ADHD, although Factor 2 scores were weakly associated with two of three ADHD indices. Psychopathy Checklist: Youth Version scores, but no ADHD indicators, were correlated with violent behavior.

McConville, D.M. (2004). The Millon Adolescent Clinical Inventory in the Assessment of Juvenile Offenders. Unpublished Doctoral Dissertation. University of Virginia.

This study examined the utility of the Millon Adolescent Clinical Inventory (MACI) in the assessment of 135 incarcerated juvenile offenders. The three primary research questions were: (1) What is the MACI profile for juvenile offenders? (2) Are there distinctive characteristics in the MACI profiles of aggressive offenders, chronic offenders, or sex offenders? (3) Do juvenile offenders with mood disorder, conduct disorder, or substance abuse disorder have distinguishing MACI profiles? This study also investigated the factor structure of the MACI and compared results using factor scores versus individual MACI scales. Participants in this study were 135 volunteer adolescents admitted to a centralized intake facility for the state juvenile correctional center in Richmond, Virginia. The participants ranged in age from 13 to 18, with a mean age of 16 years. Each participant completed the MACI during their initial intake period. MACI results were compared with clinical data gathered by the institution’s Behavioral Services Unit staff, including psychiatric diagnosis, history of drug and alcohol use, and offense history. Researchers also coded violent offense history and institutional infractions for violent behavior. Clinical staff members completed a modified version of the Observed Aggression Scale. An exploratory factor analysis of MACI scales revealed a three-factor solution for Personality Patterns, and two factor solutions for Expressed Concerns and Clinical Syndromes scales. The factors accounted for 82, 66, and 78% of the variance respectively. Theoretically related factors were correlated with outcome criteria related to mental health problems (.18 to .39) and offense history characteristics (.18 to .28). MACI factors were able to classify offenders with mood disorders, conduct disorders, and substance abuse problems with moderate accuracy (65 to 78%). Factors adequately discriminated between violent offenders, sex offenders, and chronic offenders (58 to 82%). The results of this study support the MACI as a useful instrument for clinicians working in juvenile offender institutions.

Murrie, D., Cornell, D., Kaplan, S., McConville, S., & Levy Elkon, A. (2004). Psychopathy scores and violence among juvenile offenders: A multi-measure study. Behavioral Sciences & the Law, 22, 49-67.

This study examined the relations between psychopathy scores and violent behavior in 113 incarcerated adolescents. We compared the results of four different instruments designed to assess psychopathy features among juveniles - the Psychopathy Checklist: Youth version (PCL:YV), two versions of the Antisocial Process Screening Device (APSD), and a Psychopathy Content Scale on the Millon Adolescent Clinical Inventory (MACI). We found that PCL:YV scores were significantly correlated with violent offense history, unadjudicated violence, and institutional violence, as well as measures of the severity and instrumentality of prior violence. Receiver operating characteristic analyses generates statistically significant effect sizes (AUCvalues) ranging from .64 to .79. The three other measures generates statistically significant correlations with one or more of the violence criteria, although correlations and effect sizes tended to be smaller in magnitude. Our results offer some support for the validity of these measures of psychopathic features, and the value of the PCL:YV in particular, with respect to short-term measures of violence outcome among juvenile offenders.

Stafford, E., & Cornell, D. (2003). Psychopathy scores predict adolescent inpatient aggression. Assessment, 10, 1-11.

This prospective study found that psychopathy scores predicted aggressive behavior among 72 adolescent psychiatric inpatients. Psychopathy was assessed within three days of hospital admission by clinical raters trained in the use of Hare's Psychopathy Checklist (Revised). Aggressive behavior was recorded by clinical staff who were unaware of psychopathy ratings. Adolescents rated higher in psychopathy exhibited higher frequencies of aggressive behavior, including physical aggression against peers and staff, than adolescents rated lower in psychopathy. Psychopathy scores discriminated high and low aggressive youth with 71% accuracy. Receiver Operating Characteristic (ROC) analysis yielded an effect size of .78. Download PDF File

Murrie, D., & Cornell. D. (2002). Psychopathy screening of incarcerated juveniles: A comparison of measures. Psychological Assessment. 14, 390-396.

How well do brief screening measures correspond with a full-scale assessment of psychopathy among juvenile offenders? This study compared three independent screening measures (Psychopathy Screening Device self-report, Psychopathy Screening Device staff rating, and MACI Psychopathy Content Scale) with the Psychopathy Checklist: Youth Version (PCL:YV) in a sample of 117 incarcerated males. We found modest correlations (.30 to .49) between PCL:YV scores and the three screening measures, and moderate accuracy (67 to 82%) in identifying youth who scored relatively high (>25) on the PCL:YV. Although these results support the construct of adolescent psychopathy, they indicate substantial limitations in the use of psychopathy screening measures with juvenile offenders. Download PDF File

Murrie, D., & Cornell, D. (2000). Adolescent psychopathy and the Millon Adolescent Clinical Inventory. Journal of Personality Assessment, 75, 110-125.

We investigated the ability of the Millon Adolescent Clinical Inventory (MACI) to assess psychopathy as measured by the Psychopathy Checklist-Revised (PCL-R). Participants were 90 adolescents in an inpatient psychiatric unit. The MACI's Substance Abuse Proneness (r = .47), Unruly (r = 43), and Submissive (r = -.42) scales correlated most strongly with the PCL-R. Using a discriminant function analysis, the Substance Abuse Proneness scale correctly distinguished between high and low psychopathy content scale using 20 MACI items. This content scale correlated with the PCL-R (r = .60) and distinguished high and low psychopathy groups in 83% (Kappa = .66) of cases (sensitivity 85%, specificity 81%). Download PDF File