A Systematic Review of Primary and Secondary Callous-Unemotional Traits and Psychopathy Variants in Youth
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A Systematic Review of Primary and Secondary Callous‑Unemotional Traits and Psychopathy Variants in Youth S. G. Craig1,2 · N. Goulter2 · M. M. Moretti2 Accepted: 21 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Two variants of callous-unemotional (CU) traits and psychopathy have been proposed, referred to as primary and secondary. Whereas primary variants are thought to be underpinned by insufficient arousal to emotional cues, secondary variants are thought to develop as a coping mechanism in response to trauma exposure. Compared with adult samples, research on primary and secondary variants in children and adolescents under the age of 18 has only emerged in the past decade, and there is ongoing debate with regards to the identification, defining characteristics, and distinct correlates of these variants. The present systematic review synthesizes the current literature on primary and secondary variants in relation to: (1) constructs used to distinguish and define primary and secondary variants; (2) study population characteristics; (3) data analytic techniques to differentiate variants; and (4) differential associations with theoretically relevant indices related to emotional processing, maltreatment, biomarkers, and behavioral outcomes (e.g., substance use, aggression). This is the first systematic review to examine the growing literature on primary and secondary CU and psychopathy variants among youth. Findings support the distinction between youth with primary versus secondary variants and demonstrate that this distinction is related to unique clinical correlates. Recommendations are made for future research in the field. Keywords Children · Adolescents · Callous-unemotional traits · Psychopathy · Maltreatment
Introduction Elevated callous-unemotional (CU) traits (e.g., lack of empathy, shallow affect, and uncaring attitude) are associated with a more severe and chronic trajectory of aggressive antisocial behavior. Children and adolescents with high levels of CU traits tend to be less emotionally responsive (e.g., Kimonis et al. 2006), and show indifference to others’ emotions, particularly fear (Dadds et al. 2008; Marsh et al. 2011). These core CU traits are considered to be analogous to the affective dysfunction factor of psychopathy as assessed by the Psychopathy Checklist-Revised (PCL-R; Hare 1991), or the youth version of the PCL-R (PCL-YV; Forth and Kosson 2003). The construct of psychopathy is comprised of two or three further dimensions; interpersonal style (e.g., arrogant * S. G. Craig [email protected] 1
Department of Psychology, York University, 4700 Keele St, Toronto, ON M3J 1P3, Canada
Department of Psychology, Simon Fraser University, 8888 University Dr, Burnaby, BC V5A 1S6, Canada
2
and deceitful, narcissistic view of self, and manipulative behavior), and impulsive and irresponsible behavior (Cooke and Michie 2001; Forth and Kosson 2003). The importance of CU traits in predicting future maladaptive outcomes is highlighted by the recent addi
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