It’s likely that many parents have at times questioned—even if it’s for a split second—whether a child’s lack of remorse or empathy might be a sign of a much bigger problem. But no parent ever wants to imagine that their child has psychopathy.
Fortunately, most kids don't have psychopathy—even though they may be uncaring or downright mean at one time or another.
Kids with psychopathy are cruel and unemotional much of the time.
It’s also important to note that kids aren’t either psychopaths or not. Psychopathy is a continuum and some elements will be found to some degree in most children.
Overview
While the term psychopath isn’t an official mental health diagnosis, it is used to describe a cluster of characteristics and behaviors that indicate an individual is callous, uncaring, and deceitful. In the current psychiatric terminology, the pattern is generally known as Antisocial Personality Disorder.
In 2013, the American Psychiatric Association included the condition “conduct disorder with callous and unemotional traits” for children ages 12 and over in its diagnostic manual,DSM-5. It’s a serious condition that reflects interpersonal deficits. It can also be linked to harmful behaviors.
People with psychopathy are often misunderstood, however. They're frequently depicted as mass murderers in movies. The truth is, most people with psychopathy don't become serial killers. In fact, some people with psychopathy go on to become successful entrepreneurs and business leaders.
One study estimates that about 3% of business leaders may actually have psychopathy.
Prevalence
Researchers estimate about 1% of the adult population may meet the criteria for psychopathy. Psychopathy is more common among males than females, but it is not strictly a male disorder.
Because mental health providers don’t use the label psychopath, however, the exact numbers aren’t known. Many of the diagnoses used in mental health treatment overlap with psychopathy, however.
Children who are callous and unemotional are often diagnosed with oppositional defiant disorder at a young age. Then, during their teen years, they may be diagnosed with conduct disorder, which involves a persistent pattern of violating the rights of others and disregarding basic social rules.
As adults, people with psychopathy may be diagnosed with an antisocial personality disorder. And while the conditions overlap, they aren’t synonymous. Antisocial personality disorder is a personality-based diagnosis. Psychopathy is more of a behavior-based condition.
Warning Signs
A 2016 study conducted by researchers at the University of Michigan suggests early signs of psychopathy can be seen in children as young as 2 years old. Even at this age, they show differences in empathy and conscience.
The study asked the primary caregiver, the other parent, and a teacher/daycare provider, to rate callous-unemotional (CU) behavior between ages 2 and 4 on the following items:
- Your child doesn’t seem guilty after misbehaving.
- Punishment doesn’t change your child’s behavior.
- Your child is selfish/won’t share.
- Your child lies.
- Your child is sneaky and tries to get around you.
The researchers followed up with those children again when they were 9. They discovered that the children who exhibited the most conduct issues as a toddler or preschooler were more likely to exhibit behavior problems associated with psychopathy later in childhood.
A child with psychopathy exhibits similar traits to adults who have psychopathy. For instance, they may engage in harming animals or attempting to kill animals for sport and excitement. Tweens, teens, and older kids sometimes engage in harming and killing of animals for sexual gratification. This often occurs in psychopathy/conduct disorder and in antisocial personality disorder.
The telltale signs of psychopathy involve a disregard for others’ feelings and a complete lack of remorse.
Diagnosis
There isn’t a single test that indicates a child may have psychopathy, but psychologists do have several assessments available to help them assess and measure a child’s symptoms.
One of the most commonly used assessments is the Youth Psychopathic Traits Inventory (YPI). It’s a self-report instrument, meaning that adolescents are given the test and asked to answer the questions about themselves. It’s meant to measure personality traits rather than behavior.
When the YPI has been tested on incarcerated and institutionalized youth, it has been shown to be quite reliable.The test assesses for the following symptoms:
- Dishonest charm
- Grandiosity
- Lying
- Manipulation
- Callousness
- Unemotionality
- Remorselessness
- Impulsiveness
- Thrill-seeking
- Irresponsibility
Additionally, adolescents with high callous and unemotional traits are likely to join with antisocial and delinquent peers to commit crimes in groups.
It’s important to note that the children who rank high in psychopathy aren’t likely to be pressured into breaking laws. Instead, they’re more likely to be the ringleaders who influence the other members of their group to engage in antisocial behavior.
How to Tell If Your Teen Is Lying to You
Link to Substance Abuse
In both adults and teens, research has found that individuals who rank high in psychopathic traits are more likely to abuse substances.
Researchers suspect that the relationship is reciprocal, meaning that individuals who tend to be impulsive and irresponsible are more likely to abuse substances. And substance abuse is more likely to lead to an increase in impulsive and irresponsible behavior.
Adolescent males who rank high in psychopathy traits tend to begin using substances at an earlier age. They are also more likely to use a wider variety of drugs and more likely to struggle with substance abuse issues into adulthood.
Teen Health and Safety
Stability of Symptoms
Some researchers suggest that psychopathy traits remain stable across the lifespan, meaning that a child who exhibits signs of psychopathy is likely to grow up to exhibit those same traits.
Other researchers suggest that psychopathy scores are likely to be inflated during adolescence. Sensation seeking and impulsivity are highest during this stage of life and it may a developmental issue, not necessarily a pathological one.
Studies indicate children who tend to be callous and unemotional are more likely to become aggressive later in life. They’re also more likely to commit crimes.
Without treatment, it’s unlikely that psychopathy will improve over time.
Causes
There are a lot of debates about whether psychopaths are born or made. But researchers suspect it isn’t such a clear-cut issue. Instead, psychopathy results from a complex relationship between genetics, family dynamics, and life experiences.
Early exposure to a dysfunctional environment is likely a factor in the development of psychopathic traits.
Children who have been physically abused, neglected, and separated from their parents are more likely to develop psychopathy.
Poor bonding with a parent is also thought to be a factor. A parent with mental health issues or substance abuse problems, or one with little contact with an infant, for example, may never bond with a child. Children who have inconsistent caregivers may also be unable to successfully attach to an adult.
Studies show that male adolescents with psychopathy are most likely to have been victimized at a young age. Adolescent females with psychopathy, on the other hand, are more likely to have come from a dysfunctional background, such as frequent changes in foster homes.
Some studies suggest that children with callous and unemotional traits may be hardwired a little differently. Their brains react differently to fear, sadness, and negative stimuli. They also have difficulty recognizing other people’s emotions.
Peer victimization may also play a role. Children who are victimized by their peers are more likely to become callous and unemotional at older ages.
Treatments
For many years, it was thought that people with psychopathy were untreatable. But more recent studies suggest that symptoms can improve with intensive treatments, tailored to the unique emotional, cognitive, and motivational styles found in children who rank high in psychopathy.
Children who exhibit psychopathy traits require specialized treatment. They don’t respond well to usual methods of discipline since they seem to be unfazed by consequences and they don’t care if others are disappointed in their choices.
Some residential treatment programs offer reward-based interventions, meaning that children must earn every privilege based on good behavior. Studies show these types of interventions can have a positive impact on children’s behavior.
Children may benefit from learning pro-social behavior, empathy, problem-solving skills, and emotion recognition. Treatment often focuses on improving a child’s ability to cope with anger and frustration.
If you’re seeing signs that cause you to question whether your child might have psychopathy, it’s important to seek professional help. A pediatrician or mental health professional can assist in assessing, diagnosing, and treating your child.
While there isn’t a specific medication that treats the symptoms of psychopathy, medication may be part of the treatment plan. Antipsychotic medication, such as risperidone, has been found to decrease aggression in children with conduct disorder. Mood stabilizers and other medications may also be administered to help a child improve emotional dysregulation.
How to Get Help
If your child seems to lack empathy for others sometimes or lies once in a while, they probably don't have psychopathy. Instead, they're probably just a normal child who is learning new skills and developing a better understanding of the world.
If, however, their callousness and lack of remorse seemto be getting worse, or it isn’t just an isolated incident, talk to your pediatrician. Your doctor may want to refer your child for a more comprehensive evaluation to determine if there are any other mental health issues, personality problems, or behavior disorders at play as well.
