Psychopathic Traits in Adolescent Offenders: An Evaluation of Criminal History, Clinical, and Psychosocial Correlates

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1 Behavioral Sciences and the Law Behav. Sci. Law 22: (2004) Published online in Wiley InterScience ( DOI: /bsl.572 Psychopathic Traits in Adolescent Offenders: An Evaluation of Criminal History, Clinical, and Psychosocial Correlates Mary Ann Campbell, Ph.D.,* Stephen Porter, Ph.D., y and Darcy Santor, Ph.D. y Although a large body of research has established the relevance of psychopathy to adult offenders, its relevance to adolescent offenders is far less clear. The current study evaluated the clinical, psychosocial and criminal correlates of psychopathic traits in a sample of 226 male and female incarcerated adolescent offenders. According to an 18-item version of the Psychopathy Checklist Youth Version (PCL-YV; Forth, Kosson, & Hare, 2003), only 9.4% exhibited a high level of psychopathic traits (PCL- YV 25). Consistent with past research, higher PCL-YV scores were positively associated with self-reported delinquency and aggressive behavior and were unrelated to emotional difficulties. Although higher PCL-YV scores were associated with the experience of physical abuse, the only psychosocial factor to predict PCL-YV scores was a history of non-parental living arrangements (e.g. foster care). In terms of criminality, a violent/versatile criminal history was positively associated with psychopathic traits. However, PCL-YV scores were unrelated to *Correspondence to: Professor Mary Ann Campbell, Psychology Department, University of New Brunswick Saint John, PO Box 5050, Saint John, New Brunswick, E2L 4L5, Canada. mcampbel@unbsj.ca y Dalhousie University. This research was part of the first author s dissertation and was supported by a doctoral fellowship from the Social Sciences and Humanities Research Council, a dissertation research grant from the American Psychology and Law Society, and the American Academy of Forensic Psychology. This research would not have been possible without the assistance of numerous volunteers, especially Charlene Lahey, Laura Klingdon, Chris Dodd, Dave Allaby, and Jodie-Lynn Moodie. Special thanks are extended to Michael Woodworth and Naomi Doucette for their invaluable assistance in completing this project and to the Nova Scotia Department of Justice for their support and contribution to this research. In particular, we are grateful for the assistance of Paul Smith and his colleagues with the Department of Policy, Planning and Research and Mr Bill Lonar, Ms Allison Muzzerall, and the staff at the Nova Scotia Youth Detention Centre. Contract/grant sponsors: Social Sciences and Humanities Research Council; American Psychology and Law Society; American Academy of Forensic Psychology. Copyright # 2004 John Wiley & Sons, Ltd.

2 24 M. A. Campbell et al. participants official criminal records for total, nonviolent, violent, and technical violation convictions. In conclusion, the data partially support the construct validity of psychopathy with adolescent offenders, but some inconsistencies with prior adult and adolescent psychopathy research were evident. These issues are discussed. Copyright # 2004 John Wiley & Sons, Ltd. Individuals diagnosed with psychopathy have a marked disregard for societal rules and the rights of others. This personality disorder represents a combination of interpersonal (e.g. manipulativeness, egocentricity), affective (e.g. lack of remorse or guilt), and behavioral (e.g. irresponsibility, criminal behavior) characteristics (Cleckley, 1976; Hare, 1998). Within forensic settings, extensive research indicates that adult psychopaths have a higher risk of violence, are more likely to violate conditional release, and tend not to respond well to traditional intervention programs (see, e.g., Hart & Hare, 1997). Thus, these individuals warrant special consideration when formulating decisions pertaining to case management/supervision, risk assessment, and treatment responsivity. The most widely researched measure of adult psychopathy is the Psychopathy Checklist Revised (PCL-R; Hare, 1991, 2003). However, far less is known about the relevance of psychopathy to adolescent offenders. One reason for this limitation has been a reluctance to assess psychopathy in youths due to such concerns as the weight that the label carries for a poor prognosis and the lack of prospective longitudinal research on psychopathy (Edens, Skeem, Cruise, & Cauffman, 2001; Hare, 1998; Hart, Watt, & Vincent, 2002; Seagrave & Grisso, 2002). Despite these concerns, retrospective studies with adult offenders suggest that psychopathy is a life-long disorder (Hare, 1998; Harpur & Hare, 1994; Hart & Hare, 1997; Vitelli, 1999). In sum, the identification of psychopathic traits in children and adolescents might result in early intervention and the reduction of what could later become a persistent pattern of antisocial and aggressive behavior (see, e.g., Frick, 1998; Lynam, 2002). Within the past decade, measures of psychopathy have been developed for use with children and adolescents. Specifically, the Antisocial Process Screening Device (APSD; Frick & Hare, 2002), the Childhood Psychopathy Scale (CPS; Lynam, 1997), and the Psychopathy Checklist Youth Version (PCL-YV; Forth et al., 2003) have been designed for this purpose. Depending on the nature of the sample and the psychopathy instrument, as many as 15 37% of adolescent offenders present with a high level of psychopathic traits (see, e.g., Brandt, Kennedy, Patrick, & Curtain, 1997; Forth, Hart, & Hare, 1990; Forth & Tobin, 1995; Gretton, Published doctoral dissertation; Kosson, Cyterski, Steuerwald, Neumann, & Walker-Matthews, 2002; Loving & Russell, 2000; Murrie & Cornell, 2002). The higher base rates occur more often in samples of primarily violent and persistently antisocial groups of adolescent offenders. For example, a Swedish study of primarily violent incarcerated adolescents recently found a psychopathy base rate of 59% (Dåderman & Kristiansson, 2003). Despite the relatively high base rate of psychopathic traits in adolescent offender settings, our understanding of the disorder during the adolescent developmental stage is fairly limited. To understand youth psychopathy, most researchers have examined the disorder s construct validity by means of identifying its emotional and behavioral

3 Psychopathic traits in adolescent offenders 25 correlates in youth samples (see, e.g., Brandt et al., 1997; Forth et al., 1990). In general, these studies identify some apparent commonalities between youth and adult psychopathy (see Forth & Mailloux, 2000; Frick, Barry, & Bodin, 2000). Specifically, psychopathic youths are more likely to be diagnosed with childhoodonset Conduct Disorder and present with a greater variety and seriousness of delinquent and antisocial behaviors (e.g. fighting causing serious injury, stealing, vandalism, and purposely killing animals; Gretton, unpublished doctoral dissertation; Murrie & Cornell, 2000; Myers, Burket, & Harris, 1995; Rogers, Johansen, Chang, & Salekin, 1997; Smith, Gacono, & Kaufman, 1997). Although there are a few exceptions (Brandt et al., 1997; Gretton, unpublished doctoral dissertation), most studies also point to the higher risk of substance abuse, earlier onset for drug use, and experimentation with a greater variety of drugs among psychopathic adolescents (Mailloux, Forth, & Kroner, 1997; Murrie & Cornell, 2000; Toupin, Mercier, Déry, Côte, & Hodgins, 1996). Moreover, adolescent psychopathy is associated with a higher number and annual rate of prior violent offences (Forth et al., 1990; Forth & Tobin, 1995; Gretton, unpublished doctoral dissertation; Smith et al., 1997), a higher number of institutional misbehaviors and aggression while incarcerated (see, e.g., Edens, Poythress, & Lilienfeld, 1999; Murdock Hicks, Rogers, & Cashel, 2000; Rogers et al., 1997), a higher escape and conditional release risk (Gretton, unpublished doctoral dissertation), and a greater tendency toward violent recidivism (Brandt et al., 1997; Gretton, McBride, Hare, O Shaughnessy, & Kumka, 2001; Gretton, McBride, O Shaughnessy, & Hare, 1997). Recent data also suggests that psychopathic adolescents anticipate positive rewards from the use of aggression (Pardini, Lochman, & Frick, 2003). In contrast, the presence of youth psychopathy has been frequently associated with the absence of or low levels of emotional/internalizing problems (e.g. anxiety, depression; Brandt et al., 1997; Frick, Lilienfeld, Ellis, Loney & Silverthorn, 1999; Frick, O Brien, Wooton, & McBurnett, 1994; Toupin et al., 1996). In summary, a number of similarities exist between youth and adult psychopathy, which generally supports the construct validity of psychopathy within this younger age group. Despite the consistencies identified above, there are some findings that call into question the appropriateness of directly applying the construct of psychopathy, as understood in adults, to children and adolescents. Specifically, some notable differences exist in terms of the relationship between psychopathy and certain types of criminal behavior. For example, the presence of a high level of psychopathic traits has not generally proved to be a reliable risk factor among adolescents for sexual recidivism (Gretton, unpublished doctoral dissertation; Gretton et al., 2001; Långström & Grann, 2000). Further, the predictive validity of adolescent psychopathy for non-violent recidivism is more limited than it is among adults (Forth et al., 1990; Gretton, unpublished doctoral dissertation). Such findings stress the importance of clearly identifying possible developmental variations in the relationship between psychopathy and various forms of criminal activity. Therefore, an objective of the current study was to clarify the link between psychopathy and criminal behavior among adolescent offenders. Given the nature of psychopathy, there has been extensive debate regarding its origins. Some have argued in favour of biological or evolutionary causes (e.g. Mealey, 1995; Raine, Lencz, Bihrle, LaCasse & Colletti, 2000), while others have pointed to environmental influences (e.g. Porter, 1996). Although the etiological

4 26 M. A. Campbell et al. roots of psychopathy remain unclear, a better understanding of the potential environmental correlates of this disorder might offer significant insights regarding areas to target for intervention. The few studies concerned with the identification of environmental correlates have largely focused on family factors (i.e. parenting quality, abuse). In a classic early review, McCord and McCord (1964) argued that psychopathy-like traits were associated with early emotional deprivation (i.e. parental neglect, erratic punishment). More recently, Weiler and Widom (1996) found that adults who had been abused/neglected as children scored significantly higher than non-victimized matched controls on a modified version of the PCL-R. In addition, Marshall and Cooke (1995, 1999) compared adult psychopathic and non-psychopathic criminals on a number of early environment-related variables. The childhoods of psychopaths contained more problematic family dynamics (i.e. poor discipline/supervision, parental antipathy, child antipathy to parents, emotional abuse/neglect) and school difficulties (i.e. negative school experience and performance) than the non-psychopaths. Moreover, familial influences were more relevant to Factor 1 (core interpersonal and affective features of psychopathy), while societal influences were more relevant to Factor 2 (antisocial lifestyle and behavior features). Notably, a curvilinear relationship was found between PCL-R scores and family factors, suggesting that familial influences are weaker among high scoring psychopaths than they are for lower scoring individuals. Thus, data from adult studies support the possibility that childhood exposure to a negative family environment and societal influences is related to psychopathic traits, at least to a degree. However, there are various methodological concerns that limit the interpretation of the above findings. For example, Weiler and Widom (1996) significantly modified the PCL-R and omitted core features of psychopathy (e.g. callous/ lack of empathy, lack of remorse or guilt, poor behavioral controls). Hence, the study may not have adequately measured psychopathy and their results may be more reflective of a link between child abuse and antisocial behavior, rather than psychopathy per se. Further, although informative, the review conducted by McCord and McCord (1964) pre-dates the existence of reliable and valid methods of diagnosing psychopathy and its conclusions may be outdated. Some research has specifically focused on the role of environmental factors in youth psychopathy. These studies have largely focused on familial and child maltreatment factors, but their results are inconclusive. Generally, some studies have failed to find significant differences in the prevalence of childhood abuse or maltreatment (physical, sexual, and emotional) between psychopathic and nonpsychopathic adolescents (e.g. Forth & Tobin, 1995; Gretton, unpublished doctoral dissertation), while others report such differences (e.g. McBride, unpublished doctoral dissertation). For example, physical abuse and maternal social deviance predicted PCL-YV scores in a sample of adolescent sex offenders (McBride, unpublished doctoral dissertation, Experiment 1). Likewise, physical abuse by the father and maternal psychopathic traits were low to moderate predictors of PCL-YV total sores in another sample of adolescent offenders (McBride, unpublished doctoral dissertation, Experiment 2). In terms of other family factors, the quality of parenting that a youth receives is associated with certain aspects of psychopathy. Wooton, Frick, Shelton, and Silverhorn (1997) found that poor quality parenting was related to the presence of impulsivity and conduct problems, but not to the callous and unemotional traits of psychopathy as measured by an earlier version of

5 Psychopathic traits in adolescent offenders 27 the APSD. Similarly, in a sample of clinic-referred children, Frick et al. (1994) found that while a history of parental arrest and parenting quality were associated with behavioral problems of Oppositional Defiant Disorder and Conduct Disorder, these parent variables were unrelated to callous and unemotional psychopathic-like traits. Thus, although parenting quality may not affect the interpersonal and affective features of psychopathy, it may moderate the development of conduct problems manifested by psychopathic-like children. On another level, there is partial evidence that early separation from caregivers may be related to the manifestation of youth psychopathy. Gretton unpublished doctoral dissertation) found that psychopathic adolescent offenders were more likely to have been separated from their biological mother at an earlier age than adolescents with low to moderate psychopathic traits. A similar pattern of early separation was found for biological fathers. Given the correlational nature of these data, the causal role of environmental factors in psychopathy can not be inferred. Nonetheless, there is reason to argue that family and child maltreatment-related factors may, at least partially, influence the manifestation of psychopathy. Further research is required to replicate the above findings and elucidate this possibility. Therefore, an aim of the current study was to explore the potential association of psychopathy with familial and abuse-related factors. In summary, there is a sub-group of adolescents who display a certain pattern of affective, interpersonal, and behavioral traits characteristic of adult psychopathy. However, much remains to be understood about the manifestation and correlates of psychopathy during the adolescent developmental period. To contribute to this understanding, the present study was designed to investigate the criminal, as well as the psychosocial (family, social, clinical) correlates of psychopathic traits in a sample of incarcerated adolescent offenders. Consistent with prior research, it was expected that higher psychopathic traits would be associated with a greater severity of behavioral problems and criminal history, particularly aggression. In contrast, psychopathic traits were expected to be negatively or not associated with measures of emotional difficulties. Given the inconsistencies in the research regarding family and maltreatment correlates of youth psychopathy, no specific hypotheses were made. METHOD Participants The case records of 226 male and female adolescents (M age ¼ 16.24, SD ¼ 1.43, years old), either remanded or incarcerated in one of two youth detention centres, were used. These records were obtained from the Nova Scotia Department of Justice. The specific youths evaluated included those who participated in an epidemiological mental health study conducted through the partnership of Dalhousie University with the Nova Scotia Departments of Justice and Health (see Santor & Kusumakar, unpublished manuscript). This original sample represented the majority of young offenders detained or incarcerated in the province of Nova Scotia. The ethnic composition of the sample was predominately Caucasian (83%), while 7% were African Canadian, 4% were First Nations, and 6% were of unknown ethnicity. Only 17% were female. The majority of youths were serving custodial sentences (90%), while 10% were remanded to await trial or sentencing.

6 28 M. A. Campbell et al. Time in custody ranged from 1 to 2192 days (Mdn ¼ 123 days). Most offenders had prior criminal records (86%). Of these youths, the most frequent prior convictions were for non-violent offenses (86%, M number of non-violent convictions ¼ 5.40, SD ¼ 5.91). About 15% had prior convictions for violence (M number of violent convictions ¼ 1.20, SD ¼ 2.34) and only six youths had previously been convicted of a sexual offence (M number of sexual convictions ¼ 0.03, SD ¼ 0.20). Additional descriptive statistics are shown in Table 1. Measures Psychopathy Checklist Youth Version (PCL-YV; Forth et al., 2003) The version of the PCL-YV used was similar to the one adopted by Gretton (unpublished doctoral dissertation). It represented an 18-item adolescent modified version of Hare s Psychopathy Checklist Revised (PCL-R; Hare, 1991). As with its adult counterpart, each item of the PCL-YV is scored by an objective evaluator based on a review of file information or combined with an interview. The rating scheme for each item is 0 (item is definitely absent), 1 (item maybe/possibly present), or 2 (item is definitely present). This version of the PCL-YV omitted two items; Impulsivity (item 14) and Juvenile Delinquency (item 18). Impulsivity was eliminated given its overlap with the general impulsivity of adolescence, while Juvenile Delinquency was omitted because of its overlap with Criminal Versatility during adolescence. Other subtle modifications to the PCL-R were made to yield more age appropriate scoring and item descriptions. Specifically, the maximum age to which the item of Early Behavior Problems applied was dropped from 12 to 10 years of age. Further, the adult-based item pertaining to many short-term marital relationships (item 17) was modified to include non-marital relationships in order to capture the quality of intimate relationships in adolescence. The evaluation of behavior on conditional release (item 19) was altered to permit consideration of violations committed as an adolescent. Finally, the assessment of criminal versatility (item 20) was modified to prohibit double counting of offense categories for such offenses as Assault with a Weapon. In its various forms, the PCL-YV has demonstrated acceptable levels of validity and reliability (see, e.g., Brandt et al., 1997; Forth et al., 1990; Toupin et al., 1996). Brandt et al. (1997) reported an acceptable level of internal consistency (0.85) and the mean item total correlation (0.23) was similar to that reported for the PCL-R (Hare, 1991). Forth et al. (1990) reported an internal consistency of 0.90, a mean item total correlation of 0.55, and a mean inter-item correlation of For the purposes of the current study, the PCL-YV was scored on the basis of a review of justice department file information. The PCL-R (Grann, Långtröm, Tengström, & Stålenheim, 1998; Wong, 1988) and its modified youth versions (see, e.g., Brandt et al., 1997; Dåderman & Kristiansson, 2003; Gretton, unpublished doctoral dissertation) have been validly scored for research purposes using file information in the absence of an interview. PCL-YV scores were pro-rated to adjust for the two omitted items and to allow for comparison with other studies using the 20-item version of the PCL-R or YV. Pro-rating was in accordance with the guidelines provided by Hare (1991). As such, the maximum pro-rated

7 Table 1. Descriptive statistics of the sample Psychopathic traits in adolescent offenders 29 Variable Mean (SD) % Externalizing behavior problems YSR externalizing behavior problems total (11.35) YSR attention problems total (11.14) YSR delinquent behavior problems total (10.59) YSR aggressive behavior problems total (10.66) Aggression questionnaire total (36.28) SSS total (5.11) Substance use Age of onset: drug use (1.90) Number of different drugs used 6.98 (3.97) Age of onset: alcohol use (1.90) School behavior Grade level 8.05 (1.32) History of academic achievement 0.54 (0.66) 0 ¼ Significant academic difficulties ¼ Some academic difficulties ¼ Good academic performance 9.4 History of academic behavior problems 0.33 (0.57) 0 ¼ Significant problem behavior at school ¼ Some problematic behavior at school ¼ No problematic behavior at school 5.2 History of school expulsion (yes) 73.3 Internalizing behavior problems YSR internalizing problems (12.53) YSR withdrawn (7.81) YSR somatic problems (10.08) YSR anxious/depressed problems (10.77) YSR social problems (7.24) YSR thought problems (9.65) BDI-II total (11.81) DEQ-A total (41.86) History of suicidal behavior (n ¼ 63; yes) 50.8 History of self-harm behavior (n ¼ 63; yes) 49.2 Family factors Raised by Single parent 51.4 Two parents 48.6 Quality of paternal relationship 1.18 (0.76) 0 ¼ No relationship ¼ Unstable poor relationship ¼ Adequate/good relationship 39.6 History of foster care 0.71 (0.83) 0 ¼ No history of alternate caregiver arrangement ¼ Youth stayed with relative/friend for >3 months ¼ Youth was placed in foster care at some point 25.9 Number of disruptions in living situation 2.67 (1.74) Number of siblings in conflict with law 0.50 (0.77) Abuse factors History of sexual abuse (yes) 24.3 History of physical abuse (yes) 32.5 Abusive experiences questionnaire overall mean 1.06 (0.64) Social factors Presence of many peer relationships (yes) 96.6 Currently in an intimate relationship (yes) 76.1 Number of prior intimate relationships 8.18 (9.42) Number of sexual partners (20.39) History of unprotected sexual behavior (yes) 78.6

8 30 M. A. Campbell et al. total PCL-YV score was 40. Hart and Hare (1997) argue that the ideal PCL-R total cut-off score rests between 28 and 32 for the diagnosis of psychopathy, and studies with adolescents have used cut-offs ranging from 22 to 30 (e.g., Brandt et al., 1997; Forth et al., 1990; Långström & Grann, 2000; Murrie & Cornell, 2000). Given the lack of an established criterion for adolescent psychopathy and the risk of underestimation of high-scorers with the use of file-only information (Wong, 1988), a less stringent criterion was used to capture youths presenting with high psychopathic traits. For classification purposes, youths scoring 25 or greater on the pro-rated PCL-YV total score represented the high psychopathic traits group, while youths scoring between 20 and 24 represented the moderate psychopathic traits group, and those scoring 19 or less were classified as the low psychopathic traits group. This categorical cut-off was not meant to reflect a diagnostic category for psychopathy, but rather was intended to capture youths presenting with a high level of psychopathic traits. The selection of a cut-off score of 25 also has been used by Lee, Hart, and Corrado (2002) and Murrie and Cornell (2002). Further, Loving and Russell (2000) used similar PCL-YV cut-off scores selected for the current study to categorically classify adolescents as presenting with moderate and low psychopathic traits. General Information Questionnaire At the time of their participation in the Santor and Kusumakar (unpublished manuscript) study, adolescents completed a questionnaire requesting demographic information (age, gender, ethnicity), educational history (highest grade level achieved, whether they ever repeated a grade level, history of expulsion from school), history of romantic relationships (seriousness of current relationship, duration of longest relationship, and number of sexual partners), history of substance use (age of onset of experimentation with alcohol and drugs, the types of drug used), and the history of physical and sexual abuse (nature, severity, and frequency of abuse). Youth Self-Report Form (YSR; Achenbach & Edelbrock, 1987) The YSR is a well standardized self-report questionnaire administered to year old male and females. Respondents rate 112 items reflecting a wide range of internalizing and externalizing problem behaviors on a three-point scale, with anchors of 0 (not true) to 2 (very/often true), in terms of whether they had been experienced within the past 6 months. Within the YSR are two broad dimensions of internalizing and externalizing problem behaviors. The internalizing dimension includes subscales of Withdrawal, Somatic Complaints, and Anxiety/Depression, whereas the externalizing dimension includes the sub-scales of Delinquency and Aggressive problems. The construct validity of the YSR externalizing and internalizing scales has been established for year old psychiatric patients (Thuber & Hollingsworth, 1992). In addition, the YSR contains additional sub-scales measuring psychotic symptoms (Thought Disorder), attention problems (Attention Problems) and social difficulties (Social Problems). The reliability and validity of the YSR and its factor structure has been well documented and normed (Achenbach, 1991; Achenbach & Edlebrock, 1987).

9 Psychopathic traits in adolescent offenders 31 Beck Depression Inventory II (BDI-II: Beck, Steer, & Brown, 1996) The BDI-II is a 21-item self-report scale designed to measure the presence and severity of depressive symptoms. Normally, items are rated on a four-point scale according to their severity during the past two weeks (e.g. the sadness item range from 0 I do not feel sad to 3 I am so sad or unhappy that I can t stand it ). However, for the purposes of the original study, the time frame of reference was increased to four weeks. The BDI-II yields a total score indicative of the severity of depression. According to clinical cut-off guidelines, scores of 20 or above reflect moderate depression and scores of 29 or above suggest severe depression (Beck et al., 1996). The BDI-II is applicable to clinical and non-clinical populations years old (Beck et al., 1996). Among adolescents, the psychometric properties of the original BDI have been established in a non-clinical sample (Barrera & Garrison- Jones, 1988) and in adolescents with developmental and educational delays (Beck, Carlson, Russell, & Brownfield, 1987). The BDI-II is internally consistent among adolescent psychiatric outpatients, while the factor structure of this scale has been inconsistent among adolescents (Bennett et al., 1997; Steer, Kumar, Ranieri, & Beck, 1998). Therefore, only the total BDI-II score was used. Depressive Experiences Questionnaire for Adolescents (DEQ-A; Blatt, Schaffer, Bers, & Quinlan, 1992) The DEQ-A is a 66-item self-report questionnaire designed to measure experiences commonly associated with depression in adolescents, but which are not typically considered symptoms of depression (e.g. concerns about being rejected, feeling selfcritical). Respondents endorse each item on a seven-point scale ranging from 1 (strongly disagree) to 7 (strongly agree). The DEQ-A consists of two major dimensions of depression, Dependence and Self-criticism. However, only the total DEQ-A score was used in the current study. The DEQ-A has acceptable internal consistency, test retest reliability, and validity (Blatt et al., 1992; Frank, Poorman, Van Egeren, & Field, 1997). Aggression Questionnaire (Santor & Kusumakar, Unpublished Measure) This 30-item scale was designed for the purpose of the study by Santor and Kusumakar (unpublished manuscript). It captures the frequency of perpetrating various types of aggression within the past six months. Categories of aggression include verbal aggression, aggression against objects, provoked physical aggression, unprovoked physical aggression, and use of weapons. Respondents indicate the frequency of each item in the past six months on a seven-point Likert type scale ranging from none to more than 20 times. Total score ranges from 30 to 210, with higher scores indicating a greater frequency of aggressive behavior. In the current sample, the internal consistency of the Aggression Questionnaire was very good (Chronbach s ¼ 0.94) with a mean inter-item correlation of This scale also demonstrated reasonable construct validity in that it was moderately correlated with the Aggression sub-scale of the Youth Self-Report (r ¼ 0.53, p < 0.001) and the Hostility sub-scale of the Symptom Checklist-90-R (r ¼ 0.54, p < 0.001) in the present sample.

10 32 M. A. Campbell et al. Sensation Seeking Questionnaire (SSS, Form V; Zuckerman, Eysenck, & Eysenck, 1978) This measure is an abbreviated 40-item version of the original SSS (Zuckerman, Kolin, Price, & Zoob, 1964). The SSS (Form V) assesses the degree to which the respondent seeks new and varied sensations as manifested by participation in dangerous sporting activities, a non-conventional lifestyle, disinhibited behavior, and rejection of monotony. Each item on the SSS has a forced choice response in which two response options are presented. The respondent indicates the option that best describes him or her (e.g. I like uninhibited parties or I prefer quiet parties with good conversation ). Responses that reflect sensation seeking are scored 1, while those that do not are scored 0. Thus, higher scores indicate greater sensation seeking. Although there are four sub-scales in the SSS (Disinhibition, Thrill and Adventure Seeking, Experience Seeking, and Boredom Susceptibility), this factor structure was not suitable for a sample of adolescents (Michel et al., 1999). However, the total score of an adolescent version of the SSS demonstrated acceptable test retest reliability over one year (Michel et al., 1999). Therefore, only the total SSS score was used. Abusive Experiences Questionnaire (Santor & Kusumakar, Unpublished Measure) This self-report measure includes 44 items pertaining to positive and negative parenting practices relevant to physical abuse and neglect by parents/parental figures. It was designed for the purposes of the Santor and Kusumakar (unpublished manuscript) study. Respondents rated the frequency of occurrence for each item in a typical month on a five-point Likert-type scale ranging from 0 (never) to 4 (seven or more times a month). Examples of items from this scale include my parents make me feel unwanted and my parents hit, kick, or slap me. The total score was calculated by obtaining the mean frequency rating across items, with a higher mean score reflecting a greater overall frequency of abuse from caregivers (items reflecting positive caregiver practices were reverse scored). The mean inter-item correlation of the Abusive Experiences Questionnaire in the current sample was This measure also demonstrated good internal consistency (Chronbach s ¼ 0.94) within the present sample. File-Based Psychosocial Variables Several items were coded from the justice department files to obtain additional information on the overall quality of each adolescent s family background. The following items were rated according to a three-point Likert-type scale that varied depending on the item coded. In general, coders noted whether the item was definitely present/serious concern, sometimes/moderate concern, or was not a concern for a particular youth. Specifically, the quality of parental supervision/ discipline, parental substance use, paternal/maternal/sibling criminality, a history of foster care/alternate caregiver arrangements, and the quality of relationship with mother and father figures were coded. In a similar fashion, raters coded the quality of each youth s social relationships in terms of the degree of association with

11 Psychopathic traits in adolescent offenders 33 delinquent/antisocial peers and coded their academic performance and problematic school behavior. Finally, coders calculated the number of years a youth resided with his or her biological parent/adopted parents. Criminal History Variables Official file information was coded to obtain information about each participant s criminal history, which included the most recent index offense(s) that led to the index incarceration period and pre-index criminal behavior. Specifically, information pertaining to the total number and type of past offenses was obtained for sexual, non-sexual violent, and non-violent convictions. Official records were also coded to obtain information about each youth s history of community release (e.g. probation) in terms of the number of past violations of supervised releases due to recidivism or technical violation. Each offender s dominant offense profile was defined by the offense category in which the youth committed the greatest number of offenses. That is, offenders with only non-violent offenses were classified as having a nonviolent criminal profile, while those who committed more than one violent or sexual offense and had less than two non-violent offenses were classified as having a violent profile. Finally, adolescents who committed more than three violent offenses and more than three non-violent offenses had a versatile criminal profile. Procedure Coder Procedure and Training The PCL-YV and file-based psychosocial variables were coded after a review of available Justice Department records. These records typically contained (i) a report completed by a probation officer for sentencing purposes that documented the social history of the offender, (ii) an Intake Assessment Form that documented the youth s birth date, admittance date, custody status, release date, current charges, and prior incarcerations, and (iii) a sentence plan and monthly review of the youth s progress while he or she was incarcerated. On occasion, these files included a custodial report documenting institutional adjustment and progress. Training in the coding of psychosocial variables consisted of discussions with the first author regarding the operational definitions for each of the variables to be coded, followed by practice and feedback on the use of the coding scheme. These same coders were trained by the first author in the administration and scoring of the PCL-YV. Training on the use of the PCL-YV involved familiarization with the construct of psychopathy and the PCL-YV by means of reading material and an information session conducted by the first author. Coders practiced and received feedback on the use of the PCL-YV before official coding began. Twenty percent of the PCL-YVs and of the file-based coding described above were scored by two of a pool of five raters to establish inter-rater reliability. Interrater reliability was assessed using intraclass correlation coefficients (ICCS; Shrout & Fleiss, 1979; see also McGraw & Wong, 1996). ICCs are used to evaluate the inter-rater reliability of continuous data and to take into account the variance

12 34 M. A. Campbell et al. Table 2. Inter-rater reliability of Psychopathy Checklist Youth Version items as measured by intraclass correlation coefficient (ICC) PCL-YV items ICC (2,1) ICC (2,2) Glibness/superficial 0.86* 0.92* Grandiose sense of self-worth 0.71* 0.83* Need for stimulation/proneness to boredom * Pathological lying 0.76* 0.86* Conning/manipulative 0.83* 0.91* Lack of remorse or guilt * Shallow affect 0.93* 0.97* Callous/lack of empathy 0.76* 0.86* Parasitic lifestyle * Poor anger control 0.77* 0.87* Impersonal sexual behavior 0.86* 0.93* Early behavior problems 0.88* 0.93* Lacks goals 0.76* 0.86* Irresponsibility * Failure to accept responsibility for own actions 0.87* 0.93* Unstable interpersonal relationships 0.70* 0.83* Serious violations of conditional release * Criminal versatility 0.88* 0.94* *Intraclass correlation coefficient (ICC) 0.70, indicating acceptable inter-rater reliability. between raters. A two-way random effects model was used for the calculation of single-rater (ICC (2,1) ) and average-rater (ICC (2,2) ) coefficients because we assume that any two raters were randomly chosen from a population of raters. Single rater represents the reliability estimate for an individual rater and average rater represents an estimate of reliability based on the average score between raters. An absolute agreement definition was applied to the ICC calculation to account for systematic variation between raters. As recommended by Barrett (2001), an ICC 0.70 represented an acceptable level of inter-rater reliability. PCL-YV total scores demonstrated good inter-rater reliability (ICC (2,1) ¼ 0.92, ICC (2,2) ¼ 0.95). The inter-rater reliability for individual PCL-YV items is shown in Table 2. The inter-rater reliability of the psychosocial coding scheme was less successful. As presented in Table 3, only the history of sibling criminality, the quality of relationship with a paternal caregiver, a history of placement in foster care or alternative Table 3. Inter-rater reliability of file coded psychosocial variables in the full sample (N ¼ 226) Coded psychosocial variable ICC (2,1) ICC (2,2) General quality of the caregiver s supervision of youth General quality of caregiver s discipline of youth s behavior History of parental criminality History of sibling criminality 0.85* 0.92* Quality of relationship with dominant maternal figure Quality of relationship with dominant paternal figure * Number of years youth resided with primary caregivers History of placement in alternate home/foster care 0.79* 0.89* Association with delinquent/antisocial peers History of academic achievement 0.77* 0.87* History of academic behavior 0.72* 0.84* *Intraclass correlation coefficient (ICC) 0.70, indicating acceptable inter-rater reliability.

13 non-parental living situation, history of academic achievement, and history of academic behavior were reliably coded and used in subsequent analyses. Administration of Self-Report Measures Psychopathic traits in adolescent offenders 35 As part of the prior research study (Santor & Kusumakar, unpublished manuscript), the adolescents incarcerated or detained in two facilities located in the province of Nova Scotia (Shelburne Youth Centre and the Nova Scotia Youth Centre) were recruited by facility staff. These staff members were not directly involved in the young offender s case. All adolescents housed in the detention centres were considered for inclusion as long as they provided informed consent, received the consent of their legal guardian, and could read at an age appropriate level. Permission was also obtained from the youth and the Department of Justice to use the information they relayed for research purposes. Among other sources of information used in the original study, participants were administered a variety of self-report questionnaires designed to obtain information about demographics, substance abuse history, externalizing problems (i.e. thrill seeking behavior, aggression, delinquency), internalizing problems (i.e. depression, general psychiatric symptoms), romantic relationships, and abusive experiences (i.e. physical and sexual). The individuals responsible for administering the self-report measures were qualified Department of Justice personnel directly involved in the youth s rehabilitation program and case management. These test administrators were supervised by the program coordinators of each youth facility to ensure that appropriate testing protocols were followed. Testing took approximately 4 h and was spread over a two day period of 2 h sessions each day. No compensation was offered to the youths for their participation. RESULTS The PCL-YV The mean total pro-rated PCL-YV score was (SD ¼ 5.91, range 3 32) and did not differ between males (M ¼ 16.35, SD ¼ 6.09) and females (M ¼ 15.50, SD ¼ 5.60), F(1, 210) ¼ 0.57, p ¼ Using the categorical classification of PCL-YV scores, the majority of youths fell in the low psychopathic (71%, 151/ 212; M ¼ 13.23, SD ¼ 3.92) or moderate psychopathic traits (19%, 41/212; M ¼ 21.64, SD ¼ 1.67) categories. Only 20 youths (9.4%) scored high enough to fall in the high psychopathic traits group (M ¼ 27.58, SD ¼ 1.97), while only three participants reached or exceeded the traditional adult cut-off of 30. The interrater reliability of the PCL-YV categories was high ( ¼ 0.91). PCL-YV categorical classifications were independent of youth gender, 2 (2) ¼ 3.74, p ¼ According to the traditional factor structure of the PCL-YV, Factor 1 (interpersonal and affective psychopathic traits) and Factor 2 (antisocial lifestyle and behavior traits) were moderately correlated, r(212) ¼ 0.46, p < The mean Factor 1 score was relatively low (M ¼ 4.65, SD ¼ 3.13), as was the pro-rated Factor 2 (M ¼ 8.47, SD ¼ 2.93). Male and female offenders did not differ on Factor 1 scores (M ¼ 5.60 and 4.65, SD ¼ 3.38 and 3.31, respectively, F(1, 210) ¼ 2.29, p ¼ 0.132) or Factor 2

14 36 M. A. Campbell et al. scores (M ¼ 8.72 and 8.73, SD ¼ 2.97 and 3.36, respectively), F(1, 210) ¼ 0.00, p ¼ Item total correlations ranged from 0.26 to 0.59 and the internal consistency of the PCL-YV was acceptable (Chronbach s ¼ 0.75). A principal components factor analysis with a Promax rotation for oblique factors was used to identify the underlying factor structure of the PCL-YV within the present sample, Barlett s Test of Sphericity, approx. 2 (153) ¼ , p < A scree plot suggested that a single factor was represented in this sample. This factor appeared to represent global psychopathic traits and accounted for 21% of the variance. Items included in this global factor (coefficients 0.30) measured a combination of affective, egocentric, and behavioral psychopathic characteristics (i.e. Callous/ Lack of Empathy, Poor Anger Controls, Lack of Guilt/Remorse, Shallow Affect, Grandiose Sense of Self-Worth, Early Behavioral Problems, Glib/Superficial Charm, Failure to Accept Responsibility, and Irresponsibility. There were an insufficient number of female offenders to compare the PCL-YV factor structure between male and female offenders. Given the divergence between the factor structure of the current sample and the traditional two-factor model of psychopathy, only the total PCL-YV score was used in subsequent analyses. Correlates of High Psychopathic Traits PCL-YV correlations with measures of clinical variables (externalizing behavior, internalizing problems, substance abuse), psychosocial factors (family background, abuse history, social functioning), and criminal history variables were calculated (see Table 4). To reduce the risk of inflated correlations between the PCL-YV and measures of behavior problems and criminal history, PCL-YV items reflecting overt antisocial behavioral traits were removed prior to calculation of the correlation. Specifically, Early Behavior Problems, Criminal Versatility, Serious Violations of Conditional Release, and Poor Anger Control were collectively removed from the scale. In addition, the Stimulation Seeking/Proneness to Boredom item was omitted when calculating correlations with substance abuse variables and the SSS total score. Although non-adjusted PCL-YV correlations are included in the table for the reader s interest, only the adjusted correlations were interpreted. As indicated in Table 4, higher PCL-YV scores were associated with measures of self-reported delinquency and aggression, while no significant associations were found with substance use variables. Further, there were no significant correlations between PCL-YV scores and measures of internalizing problems. In terms of psychosocial variables, higher PCL-YV scores were not associated with exposure to antisocial influences in the family (i.e. history of sibling criminality), the number of disruptions in the youth s living situation, or whether the youth was raised by a single parent. However, a history of placement in non-parental living arrangements/foster care was associated with high PCL-YV scores. Further, a history of physical abuse and the experience of a greater frequency of abuse by caregivers were positively correlated with PCL-YV scores. Academically, those offenders with higher PCL-YV scores were associated with behavioral problems at school but not with academic underachievement. Socially, psychopathy scores were not significantly related to whether the youth viewed him or herself as having many friends, the number of romantic

15 Psychopathic traits in adolescent offenders 37 Table 4. PCL-YV total score correlations with clinical, psychosocial, and criminal history measures PCL total Adjusted Measures score PCL total 1 General externalizing behavioral problems YSR externalizing problems 0.23*** 0.18* YSR delinquent behavior sub-scale 0.19** 0.16* YSR aggressive behavior sub-scale 0.20** 0.17* YSR attention problems sub-scale 0.16* 0.14 Sensations seeking scale total score Aggression questionnaire total score 0.21** 0.19* Substance use Age started drinking 0.17* 0.13 Age at first experimentation with drugs Total number of drugs used at least once Criminal history First time offender Length of custody period Total number of pre-release offenses (excluding technical offences) Number of pre-release non-violent offenses Number of pre-release violent offenses 0.15* 0.09 Number of pre-release sexual offenses Number of pre-release technical violations 0.14* 0.08 Internalizing behavioral problems YSR internalizing problems YSR withdrawn sub-scale YSR somatic complaints sub-scale YSR anxious/depressed sub-scale YSR social problems sub-scale YSR though problems sub-scale BDI-II total DEQ-A total History of suicidal behavior? (n ¼ 61) History of self-harm behavior? (n ¼ 47) Family background factors Quality of paternal caregiver relationship History of placement in foster care 0.29*** 0.28* Grew up with two parents? Total number of disruptions in living situation Number of siblings in contact with the law Abuse Abusive experiences questionnaire total 0.20* 0.19* History of sexual abuse? History of physical abuse? * 0.17* Social factors Youth has many friends? Number of intimate relationships Number of sexual partners Ever had unprotected sex? Academic performance Ever repeated a year at school? History of academic achievement History of academic behavior problems *** 0.25** Ever expelled from school? 0.21** 0.17* *p < **p < ***p < The following items were removed from the PCL-YV total score to prevent artificial inflation of correlations; Criminal Versatility, Poor Anger Control, Early Behaviour Problems, and Serious Violation of Conditional Release. 2 In addition to the above noted adjustments, the Need for Stimulation/Proneness to Boredom item was removed from the PCL-YV total score prior to calculation of the correlation. 3 Lower scores represent more problematic behavior.

16 38 M. A. Campbell et al. relationships experienced, the number of sexual partners reported by the youths, or whether they engaged in unprotected sexual activity. A stepwise multiple regression was used to predict the PCL-YV total score using the clinical and psychosocial variables that were correlated with the PCL-YV. In cases where variables were highly inter-correlated, only one variable was included in the prediction model to avoid redundancy and inflation of the model s predictive utility. Demographic (i.e. age and gender) and criminal history characteristics (i.e. total number of prior violent, non-violent, and technical violation convictions) were entered first to statistically control for the influence of these factors. The stepwise regression model was significant (R 2 ¼ 32, F(6, 58) ¼ 4.60, p ¼ 0.001) and accounted for 25% ( adj R 2 ) of the variability in PCL-YV scores. Standardized beta coefficients indicated that while gender did not uniquely predict PCL-YV scores ( ¼ 0.08, t(185) ¼ 0.69, p ¼ 0.491), a younger age at the time of admission to the youth detention centre was predictive of a higher PCL-YV score ( ¼ 0.23), t(185) ¼ 2.04, p ¼ There was a marginally significant trend for a higher number of prior violent convictions to uniquely predict PCL-YV scores ( ¼ 0.21), t(185) ¼ 1.91, p ¼ 0.06). The total number of pre-release non-violent convictions ( ¼ 0.18) and technical violations ( ¼ 0.01) did not add unique information to the model, t(185) ¼ 1.52, p ¼ and t(185) ¼ 0.11, p ¼ 0.909, respectively. The only psychosocial variable to uniquely add to the prediction of total PCL-YV scores was a history of placement in foster care/alternative living arrangement ( ¼ 0.37), t(185) ¼ 3.33, p ¼ The mean Abusive Experiences Questionnaire total score, YSR Attention Problems, Delinquency, and Aggression sub-scales, a history of academic behavior problems, a history of physical abuse, the quality of the paternal relationship, and the age at which the youth starting drinking alcohol were statistically excluded from the model. Psychopathic Traits and Past Criminal Behavior As shown in Table 4, after adjusting PCL-YV scores, psychopathic traits were unrelated to prior convictions (i.e. total, violent, non-violent, sexual, and technical violation convictions). However, in terms of criminal profiles, there was a significant difference in mean PCL-YV total scores across offenders with primarily non-violent, violent, or versatile criminal profiles, F(2, 203) ¼ 8.50, p < Post hoc tests indicate that adolescents with a non-violent profile had a significantly lower mean PCL-YV score (M ¼ 14.36, SD ¼ 5.68) than adolescents with a violent (M ¼ 17.31, SD ¼ 5.85; Tukey HSD ¼ 2.95, p ¼ 0.002) or versatile (M ¼ 18.84, SD ¼ 6.30) profile, Tukey HSD ¼ 4.48, p ¼ However, adolescents with a violent profile had similar PCL-YV scores to those with versatile criminal profiles, Tukey HSD ¼ 1.53, p ¼ DISCUSSION Psychopathy in adolescence has only recently become a point of empirical interest. Much remains to be understood about the manifestation and implications of psychopathic traits in adolescence, particularly in how it applies to adolescent