Measuring psychopathy in children and teenagers

Questionnaire measures of childhood and teenage psychopathy should not be used in clinical or forensic settings because their legitimacy has yet to be established.

That's the message from Carla Sharp and Sarah Kine who assessed four youth psychopathy questionnaires: The Antisocial Process Screening Device, The Child Psychopathy Scale, The Psychopathy Content Scale and The Youth Psychopathic Traits Inventory.

The closest thing to a gold standard in this field is the youth version of Hare's Psychopathy Checklist, but this requires lengthy interviews with children and their parents, hence the appeal of self-report questionnaires.

Sharp and Kine found the current batch of questionnaires had many strengths – for example, different items that are meant to gauge the same thing tended to correlate with each other, and high scores on the questionnaires tended to correlate with arrests or other measures of antisocial behaviour, as you'd expect.

However, there was a severe lack of longitudinal research with the measures, which is particularly important for distinguishing between typical teenage characteristics and genuine psychopathy. There was also a lack of consensus over whether child psychopathy is made up of two factors (callous plus antisocial) or three (arrogant/deceitful interpersonal style; irresponsible behaviour; plus emotional deficiencies).

The idea that psychopathy can be identified in childhood is a controversial and sensitive issue. In theory it could allow treatment to be targeted early on when it is most likely to be effective, but on the other hand, children labelled as psychopathic could see their liberties curtailed based on a clinical diagnosis. Given these concerns, and in the context of the current state of knowledge, Sharp and Kine advised that, right now, using youth psychopathy questionnaires in clinical and forensic settings may be "considered unethical".

Instead, they recommend the questionnaires may best be suited "for screening purposes that may lead to more comprehensive clinical interview, file review and the gathering of collateral information."

Further reading

Sharp, C., Kine, S. (2008). The Assessment of Juvenile Psychopathy: Strengths and Weaknesses of Currently Used Questionnaire Measures. Child and Adolescent Mental Health, 13(2), 85-95. DOI: 10.1111/j.1475-3588.2008.00483.x