Are callous-unemotional children pre-psychopaths? Can intervention alter a path toward adult psychopathy or criminal behavior? Jennifer Kahn raises more questions than she answers in a fascinating article on the subject for the NY Times. It's consistent with my experience that the more I learn, the less I know about this phenomenon. We did some reading on psychopathy in graduate school, but relatively little time was spent on the subject, which was perhaps a reflection of the general lack of confidence on how to approach it.
Researchers have linked coldblooded behaviors to low levels of cortisol and below-normal function in the amygdala, the portion of the brain that processes fear and other aversive social emotions, like shame. The desire to avoid those unpleasant feelings, Waschbusch notes, is part of what motivates young children to behave. “Normally, when a 2-year-old pushes his baby sister, and his sister cries, and his parents scold him, those reactions make the kid feel uncomfortable,” Waschbusch continued. “And that discomfort keeps him from doing it again. The difference with the callous-unemotional kids is that they don’t feel uncomfortable. So they don’t develop the same aversion to punishment or to the experience of hurting someone.”
Waschbusch cited one study that compared the criminal records of 23-year-olds with their sensitivity to unpleasant stimuli at age 3. In that study, the 3-year-olds were played a simple tone, then exposed to a brief blast of unpleasant white noise. Though all the children developed the ability to anticipate the burst of noise, most of the toddlers who went on to become criminals as adults didn’t show the same signs of aversion — tensing or sweating — when the advance tone was played.
In the 1970s, the psychiatry researcher Lee Robins conducted a series of studies on children with behavioral problems, following them into adulthood. Those studies revealed two things. The first was that nearly every psychopathic adult was deeply antisocial as a child. The second was that almost 50 percent of children who scored high on measures of antisocial qualities did not go on to become psychopathic adults. Early test scores, in other words, were necessary but not sufficient in predicting who ultimately became a violent criminal.
That gap is what gives researchers hope. If a genetic predisposition to psychopathy is a risk factor, the logic goes, that risk might be mitigated by environmental influences — the same way that diet can be used to lower an inherited risk for heart disease. Like many psychologists, Frick and Lynam also suspect that the famously “intractable” nature of psychopathy may actually be overblown, a product of uninformed treatment strategies. Researchers are now careful to distinguish between callous-unemotional traits observed in children and full-blown adult psychopathy, which, like most psychological disorders, becomes harder to treat the longer it persists.