Do psychopathic traits assessed in mid-adolescence predict mental health, psychosocial, and antisocial, including criminal outcomes, over the subsequent 5 years?
OBJECTIVE
To determine whether psychopathic traits assessed in mid-adolescence predicted mental health, psychosocial, and antisocial (including criminal) outcomes 5 years later and would thereby provide advantages over diagnosing conduct disorder (CD).


METHODS
Eighty-six women and 61 men were assessed in mid-adolescence when they first contacted a clinic for substance misuse and were reassessed 5 years later. Assessments in adolescence include the Psychopathy Checklist-Youth Version (PCL-YV), and depending on their age, either the Kiddie-Schedule for Affective Disorders and Schizophrenia for School-Aged Children or the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID). Assessments in early adulthood included the SCID, self-reports of psychosocial functioning, aggressive behaviour, and criminality and official criminal records.


RESULTS
The antisocial facet score positively predicted the number of anxiety symptoms and likelihood of receiving treatment for substance use disorders (SUDs). Lifestyle and antisocial facet scores negatively predicted Global Assessment of Functioning scores. By contrast, the interpersonal score and male sex independently and positively predicted the number of months worked or studied, as did the interaction of Lifestyle × Sex indicating that among men, but not women, an increase in lifestyle facet score was associated with less time worked or studied. Interpersonal and antisocial scores positively predicted school drop-out. Antisocial facet scores predicted the number of symptoms of antisocial personality disorder, alcohol and SUDs, and violent and nonviolent criminality but much more strongly among males than females. Predictions from numbers of CD symptoms were similar.


CONCLUSIONS
Psychopathic traits among adolescents who misuse substances predict an array of outcomes over the subsequent 5 years. Information on the levels of these traits may be useful for planning treatment.
Clinical Psychologist, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
Malin
M
Hemphälä
Professor, Département de Psychiatrie, Université de Montréal, Montréal, Québec; Professor, Institute of Psychiatry, King's College London, London, England; Director of Research, Maria-Ungdom, Stockholm, Sweden.
Sheilagh
S
Hodgins
D000293:Adolescent; D000328:Adult; D000987:Antisocial Personality Disorder / Q000175:diagnosis* / Q000453:epidemiology; D001007:Anxiety / Q000175:diagnosis* / Q000453:epidemiology; D015897:Comorbidity; D019955:Conduct Disorder / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007398:Interpersonal Relations; D007604:Juvenile Delinquency / Q000706:statistics & numerical data*; D008297:Male; D008603:Mental Health; D011237:Predictive Value of Tests; D012737:Sex Factors; D013332:Student Dropouts / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult
adolescence; assessment; conduct disorder; psychopathy; substance misuse