Validating Proposed Conduct Disorder Specifiers in U.S. Youth

Featured Article | Psychological Assessment | 2024, Vol. 36, No. 3, p. 175-191

Proposed Specifiers for Conduct Disorder (PSCD): Further Validation of the Parent-Report Version in a Nationally Representative U.S. Sample of 10- to 17-Year-Olds

Nicholas A. Bellamy - Department of Psychology, The University of Alabama

Craig S. Neumann - Department of Psychology, University of North Texas

Beatriz Mendez - Department of Psychology, The University of Alabama

Blair D. Batky - Department of Psychology, The University of Alabama

Harriet R. DeGroot - Department of Psychology, Stony Brook University

Robert D. Hare - Department of Psychology, University of British Columbia

Randall T. Salekin - Department of Psychology, The University of Alabama

The Proposed Specifiers for Conduct Disorder (PSCD; Salekin & Hare, 2016) is a new self-report and informant measure designed to assess psychopathic characteristic domains along with symptoms of conduct disorder in youth. Previous factor analytic studies on the PSCD have found that the items are accounted for by a four-factor model reflecting grandiose–manipulative, callous–unemotional, daring–impulsive, and conduct disorder (CD) symptoms. The present study examined the factor structure, psychometric properties, and criterion-related validity of the parent-report version of the PSCD (PSCD-P) in a nationally representative U.S. sample of children and adolescents (N=1,091, Mage=13.39, SD=2.20, range age=10–17; 50.0%boys, 76%White). Confirmatory factor analyses for the full (24-item) and a shortened (13-item) PSCD-P revealed good internal reliability estimates and support for the four-factor model (grandiose–manipulative, callous-unemotional, daring–impulsive, CD). Results also provided evidence for (a) measurement invariance of the PSCD-Pitemsacross sex, race/ethnicity, and age of the child; (b) convergent validity with CD/oppositional defiant disorder symptoms and discriminant validity with a measure of neuroticism; and (c) criterion-related validity with respect to prosociality, peer and family functioning, reactive and proactive aggression, delinquency, academic performance, and substance use. The prevalence for psychopathic personality propensity was found to be 2%. We discuss clinical and research implications regarding the use of the parent-report version of the PSCD for school-aged children.

conduct disorder, grandiose–manipulative, callous-unemotional, daring–impulsive, psychopathy

Youth involved in the justice system face an increased risk of recidivism when they experience co-occurring psychiatric and substance-related problems, yet the reasons behind this phenomenon remain poorly understood. This issue is critically important as it underscores the complexity of addressing the needs of youth with conduct disorder (CD) and related psychiatric issues within the justice system. To address this gap in knowledge, the present study aims to evaluate the factor structure, psychometric properties, and criterion-related validity of the parent-rated Proposed Specifiers for Conduct Disorder (PSCD-P).

Efforts to assess psychopathic traits in youth have led to the development of measures like the Proposed Specifiers for Conduct Disorder (PSCD), aiming to provide a comprehensive understanding of psychopathy in young individuals. Despite limited studies on the PSCD, existing research demonstrates promising psychometric properties and criterion-related validity across diverse samples, indicating its potential utility in clinical and research settings. 

The study recruited a diverse sample of 1,091 children and adolescents aged 10 to 17 years, with 50.0% male and 24% minority status, from across the United States. Parents between the ages of 25 and 65 years old rated the youth. The study employed a cross-sectional design and utilized online surveys administered through an internet survey company. Measures completed by the participants were the Proposed Specifiers for Conduct Disorder (PSCD), the Child Behavior Checklist (CBCL), the Big Five Personality-10 (BFI-10), the Strengths and Difficulties Questionnaire (SDQ), the Issues Checklist (ICT), the Reactive and Proactive Aggression Questionnaire (RPQ), the Multiple Problem Behavior Index (MPBI), and items assessing academic performance and substance use. 

The study examined the psychometric properties and criterion-related validity of the parent-report version of the PSCD. The findings supported a four-factor model of psychopathic propensity domains, including Grandiose-Manipulative (GM), Callous-Unemotional (CU), Daring-Impulsive (DI), and CD characteristics. These factors demonstrated measurement invariance across sex, race/ethnicity, and two child age bands. Reliability analyses showed good internal consistency of the PSCD scores.

Furthermore, the study investigated the convergent and discriminant validity of the PSCD, finding strong correlations with CD and ODD symptoms but negligible correlations with neuroticism. The PSCD scores were also linked to lower levels of prosociality, peer functioning, and family functioning, indicating that youth with elevated psychopathic traits may struggle in interpersonal relationships and exhibit more parent-child conflict. Additionally, elevated PSCD scores were associated with higher levels of reactive and proactive aggression, delinquent behavior, and academic difficulties, as well as increased alcohol and substance use.

Structural equation modeling (SEM) results showed that the broad hierarchical psychopathy factor predicted negative outcomes, including aggression and family conflict, across demographic groups. Finally, the study estimated the prevalence of elevated psychopathic characteristics in youth to be around 4.6%, suggesting that these traits are present in a significant portion of the population. 

Impact on Treatment Approaches: The findings suggest that clinicians may need to broaden their focus beyond individual elements and consider a broader set of psychopathic traits when assessing and treating youth with CD. This broader perspective can provide more comprehensive profiles and aid in tailoring treatment strategies.

Clinical Utility of PSCD: While additional research is needed, the PSCD has the potential to become a valuable tool for clinicians in assessing and providing care to youth with CD and associated personality traits. It may aid in case conceptualization and treatment planning by providing a more nuanced understanding of the underlying dimensions of psychopathy and their relation to conduct problems.

Importance of a Broader Conceptualization: In understanding CD and its relationship with psychopathic traits, clinicians should adopt a broader perspective that encompasses various personality dimensions. By considering a wider range of traits, such as Grandiosity Manipulative (GM) and Deceitful Interpersonal (DI) traits, clinicians better understand the disorder's etiology and its external correlates. This approach enables clinicians to create detailed profiles of youth, which is crucial for effective case conceptualization and treatment strategies. Moreover, it allows for better adaptation of clinical approaches to accommodate differences across dimensions, ultimately improving care for youth with CD.

Need for Further Research: While considering a broader set of traits is important, more research is needed to effectively determine how to use the information gathered from PSCD in clinical settings. This includes questions about the number of personality items to consider, how long symptoms should persist, and how to integrate information from both parents and youth.

“ The present study has limitations through which the present research findings must be viewed. First, the study was a concurrent validity study and as such warrants consideration in relation to inferences regarding directionality. Other studies are needed to prospectively examine the longitudinal outcomes of youth with CD and elevated PSCD scores. Second,the study relied on parent ratings of all survey measures and thus future studies could build upon this work by incorporating multiple informants (e.g., self, teachers, clinicians) as well as diverse methods such as observational and performance-based tasks, semi structured clinical interviews, and psychophysiological and neuroscience measurement. Third, the present study did not examine the stability of psychopathic characteristics and additional research is needed on the stability (and instability) of these characteristics. However, it is known from casework that most adults with psychopathic traits exhibit these traits in childhood making the study of the condition in childhood and adolescence critically important. We know that psychopathy appears to be moderately stable through adolescents and into young adulthood (Lynametal., 2007) but much more research is needed on the risk and protective factors as well as on the processes that may contribute to the stability of the disorder” (p. 187).