Child and adolescent psychopathy: Assessment issues and treatment needs Diana Ribeiro da Silva a, ⁎, Daniel Rijo a , Randall T. Salekin b a Research Unit of the Cognitive-Behavioral Research and Intervention Center, Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, Apartado 6153, 3001-802 Coimbra, Portugal b Department of Psychology, University of Alabama, P.O. Box 870348, Tuscaloosa, AL 35487-0348, United States abstract article info Article history: Received 14 May 2012 Received in revised form 10 October 2012 Accepted 16 October 2012 Available online 22 October 2012 Keywords: Psychopathy Child and adolescent psychopathy Assessment Treatment The identification of psychopathic traits in childhood and adolescence is a topic of growing interest for scien- tific research. The development of models to predict violent behavior, together with efficient preventive and therapeutic programs, is a major goal when assessing youths with psychopathic traits. This paper focuses on the construct of child and adolescent psychopathy, while approaching historical and conceptual issues. By discussing the “state of the art” of the construct, we will analyze different instruments to assess psychopathy in children and adolescents, as well as the available treatment modalities. Finally, we will present possible lines for research and clinical intervention according to an evolutionary approach to anger and antisocial behavior. © 2012 Elsevier Ltd. All rights reserved. Contents 1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71 2. Child and adolescent psychopathy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72 3. Assessment of psychopathy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72 3.1. Assessment of child and adolescent psychopathy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72 3.2. Comorbidity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 3.3. Psychopathy and gender . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 4. Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 5. Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76 1. Introduction The first clinical descriptions of psychopathy are attributed to Pinel (1806/1962) and Prichard (1835) who used the terms “manie sans delire” and “moral insanity”, respectively. They described indi- viduals who, without apparent psychopathology, rejected basic social rules and recurrently assumed an antisocial behavior. Brutality, emo- tional coldness, and callous exploitation of others constitute a set of attributes emphasized in these historical references. Rush (1812) postulated that a deeply rooted “moral depravity” was central in the psychopathic disorder. Schneider (1950) and Kraeplin (1904, 1915) considered these individuals pathologically deceitful and with a tendency to fraudulent behaviors. Kraeplin (1904, 1915) named them “swindlers” and described them as glib, charming, and fascinat- ing, but presenting basic failures in morality or loyalty to others. Schneider (1950) considered these individuals a “self-seeking type” and characterized them as pleasant and affable but egocentric, and superficial in their emotional reactions and in their relationships. However, it was Hervey Cleckley (1941/1988) who, while studying inpatients at a psychiatric hospital, established a set of specific criteria as the core features of psychopathic personality. Central to his concep- tion, and origin of the title of his book – The Mask of Sanity – is the idea that psychopathy is a severe disorder masked by an outward appear- ance of robust mental health. Aggression and Violent Behavior 18 (2013) 71–78 ⁎ Corresponding author at: Centro de Investigação do Núcleo de Estudos e Intervenção Cognitivo-Comportamental (CINEICC) da, Faculdade de Psicologia e de Ciências da Educação da Universidade de Coimbra, Rua do, Colégio Novo, Apartado 6153, 3001-802 Coimbra, Portugal. Tel.: +351 239 851 464; fax: +351 239 851 462. E-mail addresses: diana.rs@fpce.uc.pt (D. Ribeiro da Silva), drijo@fpce.uc.pt (D. Rijo), rsalekin@bama.ua.edu (R.T. Salekin). 1359-1789/$ – see front matter © 2012 Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.avb.2012.10.003 Contents lists available at SciVerse ScienceDirect Aggression and Violent Behavior