Skip to main content
SpringerLink
Log in

Variants of Girls and Boys with Conduct Disorder: Anxiety Symptoms and Callous-Unemotional Traits

  • Published:
Journal of Abnormal Child Psychology Aims and scope Submit manuscript

Abstract

Recent research suggests that among the group of aggressive and antisocial adolescents, there are distinct variants who exhibit different levels of anxiety symptoms and callous-unemotional traits (CU traits). The purpose of the present study was to examine whether such variants are also present in male and female adolescents diagnosed with conduct disorder (CD). We used model-based cluster analysis to disaggregate data of 158 adolescents with CD (109 boys, 49 girls; mean age =15.61 years) living in child welfare and juvenile justice institutions. Three variants were identified: (1) CD only, (2) CD with moderate CU traits and anxiety symptoms, and (3) CD with severe CU traits. Variants differed in external validation measures assessing anger and irritability, externalizing behavior, traumatic experiences, and substance use. The CD variant with moderate CU traits and anxiety symptoms had the most severe pattern of psychopathology. Our results also indicated distinct profiles of personality development for all three variants. Gender-specific comparisons revealed differences between girls and boys with CD on clustering and external validation measures and a gender-specific cluster affiliation. The present results extend previously published findings on variants among aggressive and antisocial adolescents to male and female adolescents diagnosed with CD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Notes

  1. In line with Kimonis et al. (2011, 2012a) and Kahn et al. (2013), we use the term ‘variants’ instead of ‘subtypes’ since our aim was to identify prototypes instead of discrete categories of youths.

References

  • Achenbach, T. M. (1991). Manual of the child behaviour checklist 4/18 and 1991 profile. Burlington: University of Vermont Department of Psychiatry.

    Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders: DSM-IV-TR. New Dehli: Jaypee Brothers Medical Publishers.

    Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington: American Psychiatric Publishing.

    Book  Google Scholar 

  • Andershed, H., Kerr, M., Stattin, H., & Levander, S. (2002). Psychopathic Traits in Non Referred Youth: Initial Test of a new assessment tool. In E. Blaauw, & L. Sheridaan (Eds.), Psychophaths Current International Perspectives (pp. 131–158). The Hague: Elsevier. Deutsche Version: Schmeck, Hinrichs & Fegert (2005).

  • Angold, A., Costello, E. J., & Erkanli, A. (1999). Comorbidity. Journal of Child Psychology and Psychiatry, 40(1), 57–87.

    Article  PubMed  Google Scholar 

  • Buitelaar, J. K., Smeets, K. C., Herpers, P., Scheepers, F., Glennon, J., & Rommelse, N. N. (2013). Conduct disorders. European Child and Adolescent Psychiatry, 22(Suppl 1), S49–S54. doi:10.1007/s00787-012-0361-y.

    Article  PubMed  Google Scholar 

  • Cauffman, E. (2004). A statewide screening of mental health symptoms among juvenile offenders in detention. Journal of the American Academy of Child and Adolescent Psychiatry, 43(4), 430–439. doi:10.1097/00004583-200404000-00009.

    Article  PubMed  Google Scholar 

  • Cauffman, E., Kimonis, E. R., Dmitrieva, J., & Monahan, K. C. (2009). A multimethod assessment of juvenile psychopathy: Comparing the predictive utility of the PCL:YV, YPI, and NEO PRI. Psychological Assessment, 21(4), 528–542. doi:10.1037/A0017367.

    Article  PubMed Central  PubMed  Google Scholar 

  • Cloninger, C. R., Przybeck, T. R., & Svrakic, D. M. (1991). The tridimensional personality questionnaire: U.S. normative data. Psychological Reports, 69(3 Pt 1), 1047–1057.

    Article  PubMed  Google Scholar 

  • Cloninger, C. R., Svrakic, D. M., & Przybeck, T. R. (1993). A psychobiological model of temperament and character. Archives of General Psychiatry, 50(12), 975–990.

    Article  PubMed  Google Scholar 

  • Connor, D. F., Ford, J. D., Albert, D. B., & Doerfler, L. A. (2007). Conduct disorder subtype and comorbidity. Annals of Clinical Psychiatry, 19(3), 161–168. doi:10.1080/10401230701465269.

    Article  PubMed  Google Scholar 

  • Copeland, W., Landry, K., Stanger, C., & Hudziak, J. J. (2004). Multi-informant assessment of temperament in children with externalizing behavior problems. Journal of Clinical Child and Adolescent Psychology, 33(3), 547–556. doi:10.1207/s15374424jccp3303_12.

    Article  PubMed  Google Scholar 

  • Dadds, M. R., Perry, Y., Hawes, D. J., Merz, S., Riddell, A. C., Haines, D. J., et al. (2006). Attention to the eyes and fear-recognition deficits in child psychopathy. British Journal of Psychiatry, 189, 280–281. doi:10.1192/bjp.bp.105.018150.

    Article  PubMed  Google Scholar 

  • Delmo, C., Weiffenbach, O., Gabriel, M., Stadler, C., & Poustka, F. (2005). Kiddie-Sads-Present and Lifetime Version (K-SADS-PL). 5. Auflage der deutschen Forschungsversion, erweitert um ICD-10-Diagnostik, Juli 2000/Juli 2001 Frankfurt am Main: Klinik für Psychiatrie und Psychothe-rapie des Kindes- und Jugendalters.

  • Disney, E. R., Elkins, I. J., McGue, M., & Iacono, W. J. (1999). Effects of ADHD, conduct disorder, and gender on substance use and abuse in adolescence. American Journal of Psychiatry, 156(10), 1515–1521.

    Article  PubMed  Google Scholar 

  • Dolan, M. C., & Rennie, C. E. (2007). The relationship between psychopathic traits measured by the youth psychopathic trait inventory and psychopathology in a UK sample of conduct disordered boys. Journal of Adolescence, 30(4), 601–611. doi:10.1016/j.adolescence.2006.07.002.

    Article  PubMed  Google Scholar 

  • Essau, C. A., Sasagawa, S., & Frick, P. J. (2006). Callous-unemotional traits in a community sample of adolescents. Assessment, 13(4), 454–469. doi:10.1177/1073191106287354.

    Article  PubMed  Google Scholar 

  • Euler, F., Sterzer, P., & Stadler, C. (2014). Cognitive control under distressing emotional stimulation in adolescents with conduct disorder. Aggressive Behavior, 40(2), 109–119. doi:10.1002/ab.21508.

    Article  PubMed  Google Scholar 

  • Fanti, K. A., Demetriou, C. A., & Kimonis, E. R. (2013). Variants of callous-unemotional conduct problems in a community sample of adolescents. Journal of Youth and Adolescence, 42(7), 964–979. doi:10.1007/s10964-013-9958-9.

    Article  PubMed  Google Scholar 

  • Fazel, S., Doll, H., & Langstrom, N. (2008). Mental disorders among adolescents in juvenile detention and correctional facilities: a systematic review and metaregression analysis of 25 surveys. Journal of the American Academy of Child and Adolescent Psychiatry, 47(9), 1010–1019. doi:10.1097/CHI.ObO13e31817eecf3.

    PubMed  Google Scholar 

  • Fink, B. C., Tant, A. S., Tremba, K., & Kiehl, K. A. (2012). Assessment of psychopathic traits in an incarcerated adolescent sample: a methodological comparison. Journal of Abnormal Child Psychology, 40(6), 971–986. doi:10.1007/s10802-012-9614-y.

    Article  PubMed Central  PubMed  Google Scholar 

  • Frick, P. J., & Ellis, M. (1999). Callous-unemotional traits and subtypes of conduct disorder. Clinical Child and Family Psychology Review, 2(3), 149–168.

    Article  PubMed  Google Scholar 

  • Frick, P. J., & Nigg, J. T. (2012). Current issues in the diagnosis of attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder. Annual Review of Clinical Psychology, 8(8), 77–107. doi:10.1146/annurev-clinpsy-032511-143150.

    Article  PubMed Central  PubMed  Google Scholar 

  • Frick, P. J., & White, S. F. (2008). Research review: The importance of callous-unemotional traits for developmental models of aggressive and antisocial behavior. Journal of Child Psychology and Psychiatry, 49(4), 359–375. doi:10.1111/j.1469-7610.2007.01862.x.

    Article  PubMed  Google Scholar 

  • Frick, P. J., Lilienfeld, S. O., Ellis, M., Loney, B., & Silverthorn, P. (1999). The association between anxiety and psychopathy dimensions in children. Journal of Abnormal Child Psychology, 27(5), 383–392. doi:10.1023/A:1021928018403.

    Article  PubMed  Google Scholar 

  • Frick, P. J., Ray, J. V., Thornton, L. C., & Kahn, R. E. (2014). Annual research review: A developmental psychopathology approach to understanding callous-unemotional traits in children and adolescents with serious conduct problems. Journal of Child Psychology and Psychiatry, 55(6), 532–548. doi:10.1111/jcpp.12152.

    Article  PubMed  Google Scholar 

  • Goth, K., & Schmeck, K. (2009). Das junior temperament und charakter inventar. Göttingen: Hogrefe.

    Google Scholar 

  • Grasmann, D., & Stadler, C. (2011). VIA–an intensive therapeutic treatment program for conduct disorders. Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie, 39(1), 23–30. doi:10.1024/1422-4917/a000080. quiz 30–21.

    Article  PubMed  Google Scholar 

  • Grisso, T., & Barnum, R. (2006). Massachusetts youth screening instrument-version 2 (MAYSI-2): User’s manual and technical report. Sarasota: Professional Recource Press.

    Google Scholar 

  • Grisso, T., Fusco, S., Paiva-Salisbury, M., Perrauot, R., Williams, V., & Barnum, R. (2012). The Massachusetts youth screening instrument-version 2 (MAYSI-2): comprehensive research review. Worcester: University of MassachusettsMedical School. www.nysap.us.

    Google Scholar 

  • Hart, S. D., & Hare, R. D. (1996). Psychopathy and antisocial personality disorder. Current Opinion in Psychiatry, 9(2), 129–132. doi:10.1097/00001504-199603000-00007.

    Article  Google Scholar 

  • Hodgins, S., de Brito, S., Simonoff, E., Vloet, T., & Viding, E. (2009). Getting the phenotypes right: an essential ingredient for understanding aetiological mechanisms underlying persistent violence and developing effective treatments. Frontiers in Behavioral Neuroscience, 3, 44. doi:10.3389/neuro.08.044.2009.

    Article  PubMed Central  PubMed  Google Scholar 

  • Humayun, S., Kahn, R. E., Frick, P. J., & Viding, E. (2014). Callous-unemotional traits and anxiety in a community sample of 7-year-olds. Journal of Clinical Child and Adolescent Psychology, 43(1), 36–42. doi:10.1080/15374416.2013.814539.

    Article  PubMed Central  PubMed  Google Scholar 

  • Kahn, R. E., Frick, P. J., Youngstrom, E. A., Youngstrom, J. K., Feeny, N. C., & Findling, R. L. (2013). Distinguishing primary and secondary variants of callous-unemotional traits among adolescents in a clinic-referred sample. Psychological Assessment, 25(3), 966–978. doi:10.1037/A0032880.

    Article  PubMed Central  PubMed  Google Scholar 

  • Karpman, B. (1941). On the need of separating psychopathy into two distinct clinical types: The symptomatic and the idiopathic. Journal of Criminal Psychopathology, 3, 112–137.

    Google Scholar 

  • Karpman, B. (1948). The myth of the psychopathic personality. American Journal of Psychiatry, 104(9), 523–534.

    Article  PubMed  Google Scholar 

  • Keenan, K., Loeber, R., & Green, S. (1999). Conduct disorder in girls: A review of the literature. Clinical Child and Family Psychology Review, 2(1), 3–19.

    Article  PubMed  Google Scholar 

  • Keenan, K., Hipwell, A., Chung, T., Stepp, S., Stouthamer-Loeber, M., Loeber, R., et al. (2010). The Pittsburgh girls study: Overview and initial findings. Journal of Clinical Child and Adolescent Psychology, 39(4), 506–521. doi:10.1080/15374416.2010.486320.

    Article  PubMed Central  PubMed  Google Scholar 

  • Kimonis, E. R., Skeem, J. L., Cauffman, E., & Dmitrieva, J. (2011). Are secondary variants of juvenile psychopathy more reactively violent and less psychosocially mature than primary variants? Law and Human Behavior, 35(5), 381–391. doi:10.1007/s10979-010-9243-3.

    Article  PubMed  Google Scholar 

  • Kimonis, E. R., Frick, P. J., Cauffman, E., Goldweber, A., & Skeem, J. (2012a). Primary and secondary variants of juvenile psychopathy differ in emotional processing. Development and Psychopathology, 24(3), 1091–1103. doi:10.1017/S0954579412000557.

    Article  PubMed  Google Scholar 

  • Kimonis, E. R., Tatar, J. R., 2nd, & Cauffman, E. (2012b). Substance-related disorders among juvenile offenders: what role do psychopathic traits play? Psychology of Addictive Behaviors, 26(2), 212–225. doi:10.1037/a0028047.

    Article  PubMed Central  PubMed  Google Scholar 

  • Kimonis, E. R., Fanti, K. A., Isoma, Z., & Donoghue, K. (2013). Maltreatment profiles among incarcerated boys with callous-unemotional traits. Child Maltreatment, 18(2), 108–121. doi:10.1177/1077559513483002.

    Article  PubMed  Google Scholar 

  • Lee, Z., Salekin, R. T., & Iselin, A. M. R. (2010). Psychopathic traits in youth: Is there evidence for primary and secondary subtypes? Journal of Abnormal Child Psychology, 38(3), 381–393. doi:10.1007/s10802-009-9372-7.

    Article  PubMed  Google Scholar 

  • Lehto-Salo, P., Narhi, V., Ahonen, T., & Marttunen, M. (2009). Psychiatric comorbidity more common among adolescent females with CD/ODD than among males. Nordic Journal of Psychiatry, 63(4), 308–315. doi:10.1080/08039480902730615.

    Article  PubMed  Google Scholar 

  • Lynam, D. R., Caspi, A., Moffitt, T. E., Raine, A., Loeber, R., & Stouthamer-Loeber, M. (2005). Adolescent psychopathy and the big five: results from two samples. Journal of Abnormal Child Psychology, 33(4), 431–443.

    Article  PubMed  Google Scholar 

  • Moffitt, T. E., Arseneault, L., Jaffee, S. R., Kim-Cohen, J., Koenen, K. C., Odgers, C. L., et al. (2008). Research review: DSM-V conduct disorder: research needs for an evidence base. Journal of Child Psychology and Psychiatry, 49(1), 3–33. doi:10.1111/j.1469-7610.2007.01823.x.

    Article  PubMed Central  PubMed  Google Scholar 

  • Olsson, M. (2009). DSM diagnosis of conduct disorder (CD)–a review. Nordic Journal of Psychiatry, 63(2), 102–112. doi:10.1080/08039480802626939.

    Article  PubMed  Google Scholar 

  • Pajer, K., Stein, S., Tritt, K., Chang, C. N., Wang, W., & Gardner, W. (2008). Conduct disorder in girls: neighborhoods, family characteristics, and parenting behaviors. Child and Adolescent Psychiatry and Mental Health, 2(1), 28. doi:10.1186/1753-2000-2-28.

    Article  PubMed Central  PubMed  Google Scholar 

  • Pardini, D. A., Lochman, J. E., & Powell, N. (2007). The development of callous-unemotional traits and antisocial behavior in children: are there shared and/or unique predictors? Journal of Clinical Child and Adolescent Psychology, 36(3), 319–333. doi:10.1080/15374410701444215.

    Article  PubMed  Google Scholar 

  • Pardini, D., Stepp, S., Hipwell, A., Stouthamer-Loeber, M., & Loeber, R. (2012). The clinical utility of the proposed DSM-5 callous-unemotional subtype of conduct disorder in young girls. Journal of the American Academy of Child and Adolescent Psychiatry, 51(1), 62–73. doi:10.1016/j.jaac.2011.10.005.

    Article  PubMed Central  PubMed  Google Scholar 

  • Polier, G. G., Vloet, T. D., Herpertz-Dahlmann, B., Laurens, K. R., & Hodgins, S. (2012). Comorbidity of conduct disorder symptoms and internalising problems in children: Investigating a community and a clinical sample. European Child and Adolescent Psychiatry, 21(1), 31–38. doi:10.1007/s00787-011-0229-6.

    Article  PubMed  Google Scholar 

  • Poythress, N. G., Edens, J. F., Skeem, J. L., Lilienfeld, S. O., Douglas, K. S., Frick, P. J., et al. (2010). Identifying subtypes among offenders with antisocial personality disorder: A cluster-analytic study. Journal of Abnormal Psychology, 119(2), 389–400. doi:10.1037/a0018611.

    Article  PubMed  Google Scholar 

  • Raven, J., Raven, J. C., & Court, J. H. (2003). Manual for Raven’s progressive matrices and vocabulary scales. San Antonio: Harcourt Assessment.

    Google Scholar 

  • Rettew, D. C., Copeland, W., Stanger, C., & Hudziak, J. J. (2004). Associations between temperament and DSM-IV externalizing disorders in children and adolescents. Journal of Developmental and Behavioral Pediatrics, 25(6), 383–391. doi:10.1097/00004703-200412000-00001.

    Article  PubMed Central  PubMed  Google Scholar 

  • Rowe, R., Maughan, B., Moran, P., Ford, T., Briskman, J., & Goodman, R. (2010). The role of callous and unemotional traits in the diagnosis of conduct disorder. Journal of Child Psychology and Psychiatry, 51(6), 688–695. doi:10.1111/j.1469-7610.2009.02199.x.

    Article  PubMed  Google Scholar 

  • Russo, M. F., & Beidel, D. C. (1994). Comorbidity of childhood anxiety and externalizing disorders - prevalence, associated characteristics, and validation issues. Clinical Psychology Review, 14(3), 199–221.

    Article  Google Scholar 

  • Schmeck, K., & Poustka, F. (2001). Temperament and disruptive behavior disorders. Psychopathology, 34(3), 159–163.

    Article  PubMed  Google Scholar 

  • Schmeck, K., Goth, K., Cloninger, C. R., & Poustka, F. (2001). Reliability and validity of the junior temperament and character inventory. International Journal of Methods in Psychiatric Research, 10, 172–182.

    Article  Google Scholar 

  • Schmid, M., Kölch, M., Fegert, J. M., Schmeck, K., & MAZ.-Team (2013). Abschlussbericht Modellversuch Abklärung und Zielerreichung in stationären Massnahmen. Zugriff unter http://www.ejpd.admin.ch/ejpd/de/home/themen/sicherheit/ref_straf_und_massnahmevollzug/ref_modellversuche/ref_evaluationsberichte.html.

  • Silverman, W. K., Pina, A. A., & Viswesvaran, C. (2008). Evidence-based psychosocial treatments for phobic and anxiety disorders in children and adolescents. Journal of Clinical Child and Adolescent Psychology, 37(1), 105–130. doi:10.1080/15374410701817907.

    Article  PubMed  Google Scholar 

  • Sourander, A., Jensen, P., Davies, M., Niemela, S., Elonheimo, H., Ristkari, T., et al. (2007). Who is at greatest risk of adverse long-term outcomes? the Finnish from a Boy to a Man study. Journal of the American Academy of Child & Adolescent Psychiatry, 46(9), 1148–1161. doi:10.1097/chi.0b013e31809861e9.

    Article  Google Scholar 

  • Stadler, C., Poustka, F., & Sterzer, P. (2010). The heterogeneity of disruptive behavior disorders - implications for neurobiological research and treatment. Frontiers in Psychiatry, 1(21), 1–14. doi:10.3389/fpsyt.2010.00021.

    Google Scholar 

  • Stadler, C., Euler, F., & Schwenck, C. (2013). Girls with conduct disorder: Are there gender-specific effects? Kindheit und Entwicklung, 22(3), 127–138. doi:10.1026/0942-5403/A000110.

    Article  Google Scholar 

  • Svrakic, D. M., Draganic, S., Hill, K., Bayon, C., Przybeck, T. R., & Cloninger, C. R. (2002). Temperament, character, and personality disorders: Etiologic, diagnostic, treatment issues. Acta Psychiatrica Scandinavica, 106(3), 189–195.

    Article  PubMed  Google Scholar 

  • Viding, E., Fontaine, N. M. G., & McCrory, E. J. (2012). Antisocial behaviour in children with and without callous-unemotional traits. Journal of the Royal Society of Medicine, 105(5), 195–200. doi:10.1258/jrsm.2011.110223.

    Article  PubMed  Google Scholar 

  • Vloet, T. D., & Herpertz-Dahlmann, B. (2011). The meaning of anxiety in the phenotyping of children and adolescents with conduct disorder - a path toward more consistent neurobiological findings? Zeitschrift für Kinder- und Jugenpsychiatrie und Psychotherapie, 39(1), 47–57. doi:10.1024/1422-4917/a000083.

    Article  Google Scholar 

  • Waschbusch, D. A. (2002). A meta-analytic examination of comorbid hyperactive-impulsive-attention problems and conduct problems. Psychological Bulletin, 128(1), 118–150. doi:10.1037/0033-2909.128.1.118.

    Article  PubMed  Google Scholar 

  • Wasserman, G. A., McReynolds, L. S., Ko, S. J., Katz, L. M., & Carpenter, J. R. (2005). Gender differences in psychiatric disorders at juvenile probation intake. American Journal of Public Health, 95(1), 131–137. doi:10.2105/Ajph.2003.024737.

    Article  PubMed Central  PubMed  Google Scholar 

  • Weiss, R. H. (2006). Grundintelligenztest Skala 2—Revision (CFT 20R). Göttingen: Hogrefe.

    Google Scholar 

Download references

Acknowledgments

The authors thank the MAZ research team and the MAZ evaluation team for the efforts made during data collection.

Conflict of Interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Child and Adolescent Psychiatry, Psychiatric University Clinics Basel, Wilhelm Klein-Strasse 27, 4012, Basel, Switzerland

    Felix Euler, Nils Jenkel, Christina Stadler, Klaus Schmeck & Marc Schmid

  2. Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Steinhoevelstrasse 5, 89075, Ulm, Germany

    Jörg M. Fegert & Michael Kölch

Authors
  1. Felix Euler
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nils Jenkel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Christina Stadler
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Klaus Schmeck
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jörg M. Fegert
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Michael Kölch
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Marc Schmid
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Felix Euler.

Electronic supplementary material

Below is the link to the electronic supplementary material.

ESM 1

(DOCX 15 kb)

ESM 2

(DOCX 15 kb)

ESM 3

(DOCX 16 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Euler, F., Jenkel, N., Stadler, C. et al. Variants of Girls and Boys with Conduct Disorder: Anxiety Symptoms and Callous-Unemotional Traits. J Abnorm Child Psychol 43, 773–785 (2015). https://doi.org/10.1007/s10802-014-9946-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10802-014-9946-x

Keywords

Search

Navigation