Helsinki University and Helsinki University Hospital, Forensic Psychiatry, Helsinki, Finland
The psychopathy syndrome consists of spesific interpersonal, affective and behavioral character traits. In terms of interpersonal style a ptototypical psychopath is glib and superficially charming, prone to grandiose self presentation, deceit, and manipulation. His/her deficient affective experience relates to low remorse and quilt, callousness, low empathy and lack of concience. The lifestyle reflects need for stimulation, lack of long-term goals, irresponsibility, parasitic living, and impulsivity. Current conceptualizations see psychopathy as a developmental neuropsychological disorder, and psychopathic traits on a dimensional continuum, where psychopathy is a malicious version of the extremes of normal personality traits. Based on these findings, there has been a sharp increase in interest in applying the construct of psychopathy to children and adolescents. In 2013, a specifier called “with limited prosocial emotions” for conduct disorder was introduced in the fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM 5). The specifier is used when a conduct disordered child/adolescent exhibits two or more of the following characteristics: 1. lack of remorse or quilt, 2. callousness/ lack of empathy, 3. unconcern about his/her performance, and 4. shallow or deficient affect. According to DSM 5, children and adolescents with conduct disorder who meet criteria for the specifier have a relatively more severe form of the disorder and a show different treatment response. On the other hand, measuring psychopathic traits among adolescents is of contraversy. Personality undergoes substantial changes during adolescence, and thus it is problematic to label developing individuals with constructs referring to stable abnormality. Debate has also been centered on whether some of the features associated with adult psychopathy are, in fact, normative and temporary features of youth. The term psychopathy has also been seen as stigmatizing, and it carries a potential for harm when used improperly.