Fearlessness as an Underlying Mechanism Leading to Conduct Problems: Testing the INTERFEAR Model in a Community Sample in Spain.

Conduct problems (CP) in childhood and adolescence have a significant impact on the individual, family, and community. To improve treatment for CP, there is a need to improve the understanding of the developmental pathways leading to CP in boys and girls. Prior research has linked the child's fearlessness and callous-unemotional (CU) traits, as well as experiences of parental warmth and punitive parenting, to CP. However, few studies have tested the interplay of these factors in contributing to future CP development. The present study aimed to test the InterFear model, which suggests that fearlessness in early childhood leads to CP through an indirect pathway involving low positive parenting, high negative/punitive parenting, and callous-unemotional (CU) traits. The sample included 2467 Spanish children (48.1% girls; Mage = 4.25; SD = 0.91), followed up across a five-year period. Besides a direct association between fearlessness in early childhood and future CP, the results found an indirect pathway whereby fearlessness reduces positive parenting and increases punitive parenting, which contributes to the development of CU traits and sets the stage for CP in later childhood. The specific indirect effect from fearlessness to CP via CU traits accounted for most of the variance, suggesting the existence of a temperamental pathway independent of parental variables. Further, two additional indirect pathways, exclusive of fearlessness, were identified, which started with low parental warmth and positive parenting, leading to CP via CU traits. These findings support the InterFear model, demonstrating multiple pathways to CP with the involvement of fearlessness, parenting practices, and CU traits. This model might play a pivotal role in the development of targeted prevention and intervention strategies for CP.

In Search of Conceptual Clarity About the Structure of Psychopathic Traits in Children: A Network-Based Proposal.

Psychopathic traits in childhood have been revealed as potential identifiers of risk, being predictive of later forms of behavioral maladjustment. Yet, it is still under debate how psychopathic traits in children should be best conceptualized and which are the core dimensions for construct definition and prediction. The present study aims to examine the structure of psychopathic traits in childhood, and its predictive value, by using a combination of traditional factor analysis and more recent network-based methods. Data on psychopathic traits, as measured by the Child Problematic Traits Inventory (CPTI), were collected in a large sample of children (n = 2454; 48.2% girls), aged 3 to 6 at the onset of the study (Mage = 4.26; SD = 0.91), who were followed-up one and two years later using parent- and teacher-reports. Results showed that psychopathic traits measured via CPTI are best conceptualized as five latent factors encompassing grandiosity, deceitfulness, callousness, impulsivity and need of stimulation, a result that converged across informants and time. Callousness and grandiosity emerged as central traits using network analysis of parent-reports, while deceitfulness was most central using teacher-reports. Finally, callousness, impulsivity and deceitfulness emerged as the best predictors of concurrent, prospective and stable conduct problems. These results provide a refined structure of psychopathic traits in children that better accounts for the core elements of the construct. Additional theoretical and practical implications will be discussed in terms of assessment, diagnostic classification and tailored prevention/intervention.

The Prognostic Usefulness of Multiple Specifiers for Subtyping Conduct Problems in Early Childhood.

OBJECTIVE: To better describe and treat children with conduct problems (CP), grandiose-manipulative and daring-impulsive traits are proposed for subtyping CP, instead of using only a callous-unemotional specifier. However, the acclaimed benefits of having multiple specifiers for CP remain largely untested and therefore highly speculative. To fill this gap, this study tested longitudinal relations between these 3 specifiers and developmental outcomes in childhood and adolescence, independent of early childhood CP. METHOD: Longitudinal data from 2 community studies were used. Teacher ratings were used to measure CP and the specifiers in 3- to 5-year-olds from Sweden (n = 2,064) and Spain (n = 2,055). Developmental outcomes were assessed by multiple informants (ie, teachers, parents, and children) 1 to 8 years later. RESULTS: Early childhood CP were predictive of all outcomes. Callous-unemotional traits predicted low levels of social competence and prosocial behavior, independent of CP (and age, sex, and socioeconomic status). Grandiose-manipulative and daring-impulsive traits were predictive of aggression and violent delinquency, respectively, independent of CP, but also of higher levels of prosocial behavior or social competence. CONCLUSION: The 3 specifiers are predictive of different outcomes, independent of CP, which is thought to form the basis for developing specifiers for CP. Findings tentatively challenge the centrality of callous-unemotional traits for subtyping CP, but it is premature to conclude that grandiose-manipulative and daring-impulsive specifiers are needed in future revisions of DSM and ICD. Efforts to systematically evaluate the utility of these specifiers should be welcomed to inform ongoing debates on this matter.

Externalizing Behaviors and Alzheimer's Disease and Any Dementia: A Multigeneration Cohort Study in Sweden.

Background and Objectives: We examined the extent to which externalizing behaviors such as violent and nonviolent criminal behavior, and substance use disorders (SUD) are associate with the onset of Alzheimer's disease (AD) and any dementia in prior generations. Research Design and Methods: A nationwide cohort of 2,463,033 individuals born between 1973 and 1997 (index persons) were linked to their biological relatives (parents, grandparents, and uncles/aunts) using Swedish national registers. Cox regression models were used to examine the association between each measure of externalizing behaviors with AD and any dementia in each of the relative cohorts. Results: Parents of index persons with externalizing behaviors had an increased risk for AD compared with parents of index persons without externalizing behaviors-nonviolent criminal behavior: Hazard Ratio (HR) = 1.16, 95% Confidence Intervals (CI) 1.10-1.22; violent criminal behavior: HR = 1.32 (95% CI: 1.19-1.45); SUD: HR = 1.28 (95% CI: 1.17, 1.40). The associations attenuated with decreasing familial relatedness. Relatives of individuals with externalizing behaviors compared with relatives of individuals without, showed an increased risk of having both early-onset and late-onset AD but the strength of the associations was higher for early-onset AD than for late-onset AD. A similar pattern of results was observed for the association with any dementia. Discussion and Implications: Externalizing behaviors are associated with AD and any dementia in prior generations. The associations were stronger for parents in comparison with grandparents and uncles/aunts, suggesting shared familial risks between conditions. This warrants further studies examining common genetic and family-wide environmental factors that may contribute to identifying common underlying mechanisms to the development of externalizing behaviors, AD, and any dementia.

Fearlessness as an Underlying Mechanism Leading to Conduct Problems: Testing the Intermediate Effects of Parenting, Anxiety, and callous-unemotional Traits.

This study investigates whether the longitudinal association between fearlessness and conduct problems (CP) is mediated by warm and harsh parenting, parent-child conflict, anxiety, and callous-unemotional (CU) traits. The constructs under investigation were assessed at five different time points, spanning a period of eight years. A multi-informant approach was followed, collecting data from parents and teachers (N = 2,121; 47% girls). The structural equation model pointed to both direct and indirect pathways between fearlessness and CP. Specifically, findings suggested that Time 1 fearlessness (age 3-5 years) increased the likelihood of Time 2 (age 4-6 years) harsh parenting and Time 3 (age 5-7 years) parent-child conflict. Further, fearlessness was positively associated with Time 4 (age 8-10) callous-unemotional traits and Time 5 (age 11-13) CP. The total indirect effect from fearlessness to CP through these variables was significant, although the specific indirect effect from fearlessness to CU traits to CP accounted for most of the variance. Warm parenting and anxiety did not mediate the association between fearlessness and CP. In addition to the identified pathways connecting fearlessness to CP, findings pointed to the existence of multiple developmental pathways to future CP, as well as gender differences in longitudinal associations.

Risk of dementia and mild cognitive impairment in older adults with a criminal background: a population-based register study in Sweden.

Criminal behaviour has previously been associated with an increased risk for several mental health problems, but little is known about the association between criminal behaviour and dementia. We aimed to examine how the criminal background (type of crime, number of convictions, length of the sentence) is associated with dementia and mild cognitive impairment (MCI), and how mental and physical health disorders and educational attainment influenced these associations. A nationwide cohort of 3,617,028 individuals born between 1932 and 1962 were linked with criminal and medical records using Swedish national registers. We used Cox regression models to examine the associations. Increased risks for dementia (Hazard ratios (HRs) 1.54, 95% confidence interval (CI) 1.50-1.57) and MCI (1.55, 1.50-1.61) were found in individuals with criminal background, particularly among those who committed violent or several crimes, or with long sentences. After full adjustment of covariates, the associations attenuated but remained statistically significant for dementia (1.25, 1.22-1.28) and MCI (1.27, 1.22-1.32). The attenuation was mostly explained by mental health problems -depression, anxiety, schizophrenia spectrum disorders, substance use disorder (SUD), and bipolar disorder- (dementia: 1.34, 1.31-1.37; MCI: 1.35, 1.30-1.40). SUD contributed the most to attenuate the associations. Our results may provide important insights to health and penal systems by showing the importance of considering the severity of the criminal background and life-course mental health when assessing the risk of neurodegenerative disorders.

Older and feeling unsafe? Differences in underlying vulnerability, anxiety and life satisfaction among older adults.

Objectives: Feeling safe in the daily environment is important in late life. However, research on configuration of vulnerability factors for perceived unsafety in older adults is scarce. The current study aimed to identify latent subgroups of older adults based on their vulnerability for perceived unsafety.Method: We analyzed the data from a cross-sectional survey of residents in senior apartments in a mid-sized Swedish municipality (N = 622).Results: The results of the latent profile analysis based on frailty, fear of falling, social support, perceived neighborhood problems, and trust in others in the neighborhood indicated the presence of three profiles. These profiles were labelled as compromised body and social networks (7.2%), compromised context (17.9%) and non-vulnerable (74.9%). Profile membership was statistically predicted by age, gender, and family status and profiles differed in perceived unsafety, anxiety and life satisfaction.Conclusion: Overall, the study findings suggested the existence of latent subgroups of older people based on patterns of vulnerability.

Psychopathic Personality Configurations in Early Childhood: A Response to Dvoskin et al. (2022).

Dvoskin et al. (2022) offered a cautionary comment on an article published in the Journal of Personality Disorders (López-Romero et al., 2021). This comment was focused on the scientific and policy grounds of our study, and cautioned against the use of the "putative psychopathic personality" label for applied purposes. While we agree with most of their concerns and cautions, we aim to provide additional clarification on the raised concerns, noting that the purpose of our study is purely exploratory, and that its findings are not intended for applied purposes. We do expect that our study and this commentary will further clarify the importance of examining psychopathic personality from a developmental perspective, opening new ways of discussion regarding how to best conceptualize and study a construct that, while waiting for additional longitudinal research, has been shown as relevant in identifying a group of children and adolescents at increased risk for maladjustment.

The Persian version of the Youth Psychopathic Traits Inventory-Short Version (YPI-S): A psychometric evaluation.

Studies on the psychopathy construct are mostly limited to Western cultures, and there is a lack of research in this area in non-Western countries, specifically in Iran. The present study aimed to examine the factor structure, internal consistency, and convergent validity of the Persian version of the Youth Psychopathic Traits Inventory-Short Version (YPI-S) with a sample of 668 school-attending adolescents in Iran (46% girls; Mage = 16.35). Confirmatory factor analysis supported the proposed three-factor model. While the internal consistency of some YPI-S scores was unsatisfactory, the YPI-S scores showed the expected relations with external correlates (e.g., aggression, hyperactivity), supporting the validity of YPI-S scores. The authors' results supported the YPI-S for assessing psychopathic traits in Iranian adolescents. The modification of the YPI-S factor structure, the low factor loadings of some YPI-S items, and the inadequate internal consistency of some YPI-S dimensions indicate cultural influences on the assessment of cross-cultural traits.

Presence of Meaning in Life in Older Men and Women: The Role of Dimensions of Frailty and Social Support.

Presence of meaning in life is an important component of eudemonic wellbeing while aging. While subjective health and interpersonal relationships are among important sources of meaning for older adults, less research has explored the gender differences in the potential contribution of these sources to the presence of meaning in late life. The current study aims to examine the associations of frailty dimensions (daily activities, health problems, and psychosocial functioning) and social support with the presence of meaning in late life, and whether these associations differ for older men and women. The study employs the data from the 65+ and Safe Study - a cross-sectional survey of residents of senior apartments. The data were collected in 2019 in a mid-sized Swedish municipality (N=618; age range from 64 to 106years, 60.5% female). Results showed significant associations of health problems, psychosocial functioning, and social support with the presence of meaning in life. Further, the results demonstrated no statistically significant gender differences in the associations between frailty dimensions, social support, and presence of meaning. However, since the interaction between health problems and gender approached statistical significance, this association was further explored indicating a more detrimental role of health problems in relation to the presence of meaning in life among older men than among older women. Overall, the study highlights the importance of physical and psychosocial health and social support for the presence of meaning in life among older adults and warrants further research on possible gender differences in the relation between health problems and meaning in late life.

Studying Configurations of Psychopathic Traits: Exploring the Viability of Psychopathic Personality in Early Childhood.

The idea that very young children can manifest a constellation of personality traits that looks like psychopathy has rarely been explored. To fill this void, data from 2,247 children, aged 3-6 years (M = 4.25; SD = 0.91), from the Estudio Longitudinal para una Infancia Saludable (ELISA) were utilized. Parents and teachers completed questionnaires at baseline and at 1-year follow-up. Using three parent-rated psychopathy dimensions as indicators, the authors conducted latent profile analysis and arrived at five latent classes: Control (39.2%), Impulsive-Need for Stimulation (34.8%), Grandiose-Deceitful (16.5%), Callous-Unemotional (6.2%), and Putative Psychopathic Personality (PP, 3.3%). Children in the PP class, overall, engaged in higher levels of concurrent, future, and stable conduct problems and reactive and proactive aggression, and lower levels of prosocial behavior, as rated by parents or teachers. Findings also revealed meaningful differences between the remaining four classes. Person-oriented analyses seem to offer a fruitful avenue to identify 3-to 6-year-olds who exhibit a putative psychopathic personality and are at risk for future maladjustment.

Affective Fear of Crime and Its Association with Depressive Feelings and Life Satisfaction in Advanced Age: Cognitive Emotion Regulation as a Moderator?

Fear of crime is a substantial problem for older adults and is associated with reduced subjective well-being. However, less is known about factors that could moderate the associations between fear of crime and mental health problems and well-being in advanced age. Cognitive emotion regulation could serve as a potentially buffering factor for adverse health outcomes related to fear of crime due to its potential importance in managing feelings when facing threatening situations. The current study investigated the associations between affective fear of crime with depressive feelings and life satisfaction and examined whether adaptive and maladaptive cognitive emotion regulation strategies moderated these associations in a sample of older adults (age 64-106) in Sweden (N = 622). The results showed that affective fear of crime was associated with more depressive feelings, less life satisfaction, and more frequent use of such maladaptive cognitive emotion regulation strategies as rumination, catastrophizing, and blaming others. Moreover, rumination and self-blame moderated the associations between affective fear of crime and life satisfaction. Adaptive emotion regulation strategies were not associated with affective fear of crime and did not decrease the strength of its association with depressive feelings and with life satisfaction. These findings allow us to conclude that maladaptive emotion regulation could be considered a vulnerability factor in the association of fear of crime with life satisfaction.

The DSM-5 Limited Prosocial Emotions Specifier for Conduct Disorder: Comorbid Problems, Prognosis, and Antecedents.

OBJECTIVE: A limited prosocial emotions (LPE) subtype of conduct disorder (CD) has been added to the DSM-5. Empirical studies on this categorically defined subtype are scarce, and existing work is predominantly cross-sectional. Hypotheses surrounding the LPE subtype that relate to comorbidity, prognosis, and developmental antecedents, and overlap with psychopathic personality, have received no or little scrutiny. METHOD: These knowledge gaps were addressed in a community sample of 1,839 children 8 to 10 years of age who were enrolled in the study in early childhood (age 3-5 years) and were followed up in early adolescence (age 11-13 years). Parents and teachers completed questionnaires that tap theoretically and clinically relevant features. RESULTS: Children with the LPE subtype exhibited more CD symptoms and comorbid problems, including fearlessness, and symptoms of oppositional defiant disorder and attention-deficit/hyperactivity disorder. These children were also at higher risk for future CD symptoms at the 3-year follow-up. Additionally, fearlessness, callous-unemotional traits, interpersonal traits, and harsh parenting assessed in early childhood were identified as developmental antecedents of the LPE subtype. Findings tentatively suggest that the LPE subtype is a heterogeneous group differentiated on other psychopathic personality traits. CONCLUSION: The LPE subtype appears to identify a troubled, etiologically distinct group of children with conduct problems who are at heightened risk for future maladjustment. Findings can inform the underlying mechanisms related to the LPE subtype, and can lead to the development and improvement of prevention and intervention programs for children with conduct problems.

Neural processing of socioemotional content in conduct-disordered juvenile offenders with limited prosocial emotions.

BACKGROUND: Reflecting evidence on Callous-Unemotional (CU) traits (e.g., lack of empathy and guilt, shallow affect), the DSM-5 added a categorical CU-based specifier for Conduct Disorder (CD), labeled 'with Limited Prosocial Emotions' (LPE). Theory and prior work suggest that CD youths with and without LPE will likely differ in neural processing of negative socioemotional content. This proposition, however, is mainly derived from studies employing related, yet distinct, operationalizations of CU traits (e.g., dimensional measure/median split/top quartile), thus precluding direct examination of LPE-specific neurocognitive deficits. METHODS: Employing a DSM-5 informed LPE proxy, neural processing of recognizing and resonating negative socioemotional content (angry and fearful faces) was therefore examined here among CD offenders with LPE (CD/LPE+; N = 19), relative to CD offenders without LPE (CD/LPE-; N = 31) and healthy controls (HC; N = 31). RESULTS: Relative to HC and CD/LPE- youths and according to a linearly increasing trend (CD/LPE- < HC < CD/LPE+), CD/LPE+ youths exhibited hyperactivity within dorsolateral, dorsomedial, and ventromedial prefrontal regions during both emotion recognition and resonance. During emotion resonance, CD/LPE+ youths additionally showed increased activity within the posterior cingulate and precuneal cortices in comparison to HC and CD/LPE- youths, which again followed a linearly increasing trend (CD/LPE- < HC < CD/LPE+). These effects moreover seemed specific to the LPE specifier, when compared to a commonly employed method for CU-based grouping in CD (i.e., median split on CU scores). CONCLUSIONS: These data cautiously suggest that CD/LPE+ youths may exhibit an over-reliance on cortical neurocognitive systems when explicitly processing negative socioemotional information, which could have adverse downstream effects on relevant socioemotional functions. The findings thus seem to provide novel, yet preliminary, clues on the neurocognitive profile of CD/LPE+, and additionally highlight the potential scientific utility of the LPE specifier.

Prevalence of attention-deficit/hyperactivity disorder in older adults: A systematic review and meta-analysis.

There is a significant knowledge gap in research on Attention-Deficit/Hyperactivity Disorder (ADHD) in older adults. Via a systematic review and meta-analysis, we aimed to investigate the prevalence of ADHD in older adults, considering different assessment methods. We searched five electronic databases up to June 26, 2020. We identified 20 relevant studies with 32 datasets providing a total sample size of 20,999,871 individuals (41,420 individuals with ADHD). The pooled prevalence estimates differed significantly across assessment methods: 2.18 % (95 % CI = 1.51, 3.16) based on research diagnosis via validated scales, 0.23 % (0.12, 0.43) relying on clinical ADHD diagnosis, and 0.09 % (0.06, 0.15) based on ADHD treatment rates. Heterogeneity was significant across studies for all assessment methods. There is a considerable number of older adults with elevated levels of ADHD symptoms as determined via validated scales, and the prevalence of treated ADHD is less than half of the prevalence of clinically diagnosed ADHD. This highlights the need for increased awareness of ADHD clinical diagnosis and treatment in older adults.

The mental and physical health of older offenders: A systematic review and meta-analysis.

A systematic review with meta-analysis was performed to: 1) estimate the prevalence of both mental and physical health problems in older offenders; 2) calculate relative risks for the health conditions in relation to non-offender older adults and; 3) explore the potential confounding role of several variables. We searched five databases up to August 2019. Studies involving offenders older than 50 years old were included. Fifty-five publications met criteria. The pooled prevalence for 18 mental and 28 physical health problems was calculated. In comparison with non-offender older adults, older offenders showed significantly higher risk for Hypertension (RR = 1.16, CI = 1.1, 1.2), Cardiovascular Diseases (RR = 1.24, CI = 1.09, 1.41), Respiratory diseases (RR = 1.75, CI = 1.29, 2.35), and Arthritis (RR = 1.19, CI = 1.12, 1.25). Heterogeneity was significant for all meta-analyses and partially explained by the confounding effect of country, the diagnosis assessment method, and the sample characteristics. Future research should include comparison groups of non-offender older adults and use longitudinal study designs to identify risk factors that can be targeted in preventive programmes.

Assessing Psychopathic Traits Among Children: The First Validation Study of the Child Problematic Traits Inventory in a Clinical Sample.

This is the first study that tested the psychometric properties of the Child Problematic Traits Inventory (CPTI) in clinic-referred children (ages 6-13 years). Teachers (N = 159) and parents (N = 173) completed the CPTI and various other measures. Confirmatory factor analyses supported the CPTI's three-factor structure when teachers and parents rated the 28 CPTI items. Teacher- and parent-reported CPTI scores showed the expected relations with external correlates (e.g., conduct problems and proactive aggression). Crucially, the validity of the CPTI scores was also supported across informants (i.e., when linking teacher-reported CPTI scores to parent-reported external correlates, and vice versa) and across methods (i.e., regardless if a questionnaire or a diagnostic interview was used to measure external correlates). We conclude that the CPTI holds promise as a research tool for assessing psychopathic traits in clinic-referred children. Until our findings have been replicated and extended, the CPTI should not be used for clinical decision making.

Cyberbullying and Psychological Well-being in Young Adolescence: The Potential Protective Mediation Effects of Social Support from Family, Friends, and Teachers.

In the current study, we tested the relations between cyberbullying roles and several psychological well-being outcomes, as well as the potential mediation effect of perceived social support from family, friends, and teachers in school. This was investigated in a cross-sectional sample of 1707 young adolescents (47.5% girls, aged 10-13 years, self-reporting via a web questionnaire) attending community and private schools in a mid-sized municipality in Sweden. We concluded from our results that the Cyberbully-victim group has the highest levels of depressive symptoms, and the lowest of subjective well-being and family support. We also observed higher levels of anxiety symptoms in both the Cyber-victims and the Cyberbully-victims. Moreover, we conclude that some types of social support seem protective in the way that it mediates the relationship between cyberbullying and psychological well-being. More specifically, perceived social support from family and from teachers reduce the probability of depressive and anxiety symptoms, and higher levels of social support from the family increase the probability of higher levels of subjective well-being among youths being a victim of cyberbullying (i.e., cyber-victim) and being both a perpetrator and a victim of cyber bullying (i.e., cyberbully-victim). Potential implications for prevention strategies are discussed.

Proposed Specifiers for Conduct Disorder (PSCD): Preliminary validation of the parent version in a Spanish sample of preschoolers.

The Proposed Specifiers for Conduct Disorder (PSCD) scale (Salekin & Hare, 2016) was developed as a measure of the broader construct of psychopathy in childhood and adolescence. In addition to conduct disorder (CD) symptoms, the PSCD addresses the interpersonal (grandiose-manipulative), affective (callous-unemotional), and lifestyle (daring-impulsive) traits of psychopathic personality. The PSCD can be scored by parents and teachers. The present study is a preliminary test of the psychometric properties of the PSCD-Parent Version in a sample of 2,229 children aged 3 to 6 years. Confirmatory factor analyses supported both a 3- and 4-factor structure being invariant across gender groups. The validity of the PSCD was also supported by convergent-divergent associations with an alternative measure of psychopathic traits as well as by the expected relations with fearlessness, conduct problems, reactive and proactive aggression, attention-deficit hyperactivity disorder and oppositional defiant disorder symptoms, and social competence skills. Overall, the PSCD is a promising alternative measure for assessing early manifestation of the broader construct of psychopathy in children. Its use should facilitate discussion of the conceptualization, assessment, predictive value, and clinical usefulness of the psychopathic construct as it relates to CD at early developmental stages. (PsycINFO Database Record (c) 2019 APA, all rights reserved).