Wednesday, May 24, 2017

When your child is a psychopath

Samantha’s parents, Jen and Danny, adopted Samantha when she was 2. They already had three biological children, but they felt called to add Samantha (not her real name) and her half sister, who is two years older, to their family. They later had two more kids.

From the start, Samantha seemed a willful child, in tyrannical need of attention. But what toddler isn’t? Her biological mother had been forced to give her up because she’d lost her job and home and couldn’t provide for her four children, but there was no evidence of abuse. According to documentation from the state of Texas, Samantha met all her cognitive, emotional, and physical milestones. She had no learning disabilities, no emotional scars, no signs of ADHD or autism. 

But even at a very young age, Samantha had a mean streak. When she was about 20 months old, living with foster parents in Texas, she clashed with a boy in day care. The caretaker soothed them both; problem solved. Later that day Samantha, who was already potty trained, walked over to where the boy was playing, pulled down her pants, and peed on him. “She knew exactly what she was doing,” Jen says. “There was an ability to wait until an opportune moment to exact her revenge on someone.”

When Samantha got a little older, she would pinch, trip, or push her siblings and smile if they cried. She would break into her sister’s piggy bank and rip up all the bills. Once, when Samantha was 5, Jen scolded her for being mean to one of her siblings. Samantha walked upstairs to her parents’ bathroom and washed her mother’s contact lenses down the drain. “Her behavior wasn’t impulsive,” Jen says. “It was very thoughtful, premeditated.”

Jen, a former elementary-school teacher, and Danny, a physician, realized they were out of their depth. They consulted doctors, psychiatrists, and therapists. But Samantha only grew more dangerous. They had her admitted to a psychiatric hospital three times before sending her to a residential treatment program in Montana at age 6. Samantha would grow out of it, one psychologist assured her parents; the problem was merely delayed empathy. Samantha was impulsive, another said, something that medication would fix. Yet another suggested that she had reactive attachment disorder, which could be ameliorated with intensive therapy. More darkly—and typically, in these sorts of cases—another psychologist blamed Jen and Danny, implying that Samantha was reacting to harsh and unloving parenting.

One bitter December day in 2011, Jen was driving the children along a winding road near their home. Samantha had just turned 6. Suddenly Jen heard screaming from the back seat, and when she looked in the mirror, she saw Samantha with her hands around the throat of her 2-year-old sister, who was trapped in her car seat. Jen separated them, and once they were home, she pulled Samantha aside.

“What were you doing?,” Jen asked.

“I was trying to choke her,” Samantha said.

“You realize that would have killed her? She would not have been able to breathe. She would have died.”

“I know.”

“What about the rest of us?”

“I want to kill all of you.”

Samantha later showed Jen her sketches, and Jen watched in horror as her daughter demonstrated how to strangle or suffocate her stuffed animals. “I was so terrified,” Jen says. “I felt like I had lost control.”

Four months later, Samantha tried to strangle her baby brother, who was just two months old.

Jen and Danny had to admit that nothing seemed to make a difference—not affection, not discipline, not therapy. “I was reading and reading and reading, trying to figure out what diagnosis made sense,” Jen tells me. “What fits with the behaviors I’m seeing?” Eventually she found one condition that did seem to fit—but it was a diagnosis that all the mental-health professionals had dismissed, because it’s considered both rare and untreatable. In July 2013, Jen took Samantha to see a psychiatrist in New York City, who confirmed her suspicion.

“In the children’s mental-health world, it’s pretty much a terminal diagnosis, except your child’s not going to die,” Jen says. “It’s just that there’s no help.” She recalls walking out of the psychiatrist’s office on that warm afternoon and standing on a street corner in Manhattan as pedestrians pushed past her in a blur. A feeling flooded over her, singular, unexpected. Hope. Someone had finally acknowledged her family’s plight. Perhaps she and Danny could, against the odds, find a way to help their daughter. 

Samantha was diagnosed with conduct disorder with callous and unemotional traits. She had all the characteristics of a budding psychopath.

Pssychopaths have always been with us. Indeed, certain psychopathic traits have survived because they’re useful in small doses: the cool dispassion of a surgeon, the tunnel vision of an Olympic athlete, the ambitious narcissism of many a politician. But when these attributes exist in the wrong combination or in extreme forms, they can produce a dangerously antisocial individual, or even a cold-blooded killer. Only in the past quarter century have researchers zeroed in on the early signs that indicate a child could be the next Ted Bundy.

Researchers shy away from calling children psychopaths; the term carries too much stigma, and too much determinism. They prefer to describe children like Samantha as having “callous and unemotional traits,” shorthand for a cluster of characteristics and behaviors, including a lack of empathy, remorse, or guilt; shallow emotions; aggression and even cruelty; and a seeming indifference to punishment. Callous and unemotional children have no trouble hurting others to get what they want. If they do seem caring or empathetic, they’re probably trying to manipulate you.

Researchers believe that nearly 1 percent of children exhibit these traits, about as many as have autism or bipolar disorder. Until recently, the condition was seldom mentioned. Only in 2013 did the American Psychiatric Association include callous and unemotional traits in its diagnostic manual, DSM-5. The condition can go unnoticed because many children with these traits—who can be charming and smart enough to mimic social cues—are able to mask them.



  1. More than 50 studies have found that kids with callous and unemotional traits are more likely than other kids (three times more likely, in one study) to become criminals or display aggressive, psychopathic traits later in life. And while adult psychopaths constitute only a tiny fraction of the general population, studies suggest that they commit half of all violent crimes. Ignore the problem, says Adrian Raine, a psychologist at the University of Pennsylvania, “and it could be argued we have blood on our hands.”

    Researchers believe that two paths can lead to psychopathy: one dominated by nature, the other by nurture. For some children, their environment—growing up in poverty, living with abusive parents, fending for themselves in dangerous neighborhoods—can turn them violent and coldhearted. These kids aren’t born callous and unemotional; many experts suggest that if they’re given a reprieve from their environment, they can be pulled back from psychopathy’s edge.

    But other children display callous and unemotional traits even though they are raised by loving parents in safe neighborhoods. Large studies in the United Kingdom and elsewhere have found that this early-onset condition is highly hereditary, hardwired in the brain—and especially difficult to treat. “We’d like to think a mother and father’s love can turn everything around,” Raine says. “But there are times where parents are doing the very best they can, but the kid—even from the get-go—is just a bad kid.”

    Still, researchers stress that a callous child—even one who was born that way—is not automatically destined for psychopathy. By some estimates, four out of five children with these traits do not grow up to be psychopaths. The mystery—the one everyone is trying to solve—is why some of these children develop into normal adults while others end up on death row.

    A trained eye can spot a callous and unemotional child by age 3 or 4. Whereas normally developing children at that age grow agitated when they see other children cry—and either try to comfort them or bolt the scene—these kids show a chilly detachment. In fact, psychologists may even be able to trace these traits back to infancy. Researchers at King’s College London tested more than 200 five-week-old babies, tracking whether they preferred looking at a person’s face or at a red ball. Those who favored the ball displayed more callous traits two and a half years later.

    As a child gets older, more-obvious warning signs appear. Kent Kiehl, a psychologist at the University of New Mexico and the author of The Psychopath Whisperer, says that one scary harbinger occurs when a kid who is 8, 9, or 10 years old commits a transgression or a crime while alone, without the pressure of peers. This reflects an interior impulse toward harm. Criminal versatility—committing different types of crimes in different settings—can also hint at future psychopathy.(continued)

  2. (continued)But the biggest red flag is early violence. “Most of the psychopaths I meet in prison had been in fights with teachers in elementary school or junior high,” Kiehl says. “When I’d interview them, I’d say, ‘What’s the worst thing you did in school?’ And they’d say, ‘I beat the teacher unconscious.’ You’re like, That really happened? It turns out that’s very common.”

    For example, many psychopathic adults and callous children do not recognize fear or distress in other people’s faces. Essi Viding, a professor of developmental psychopathology at University College London recalls showing one psychopathic prisoner a series of faces with different expressions. When the prisoner came to a fearful face, he said, “I don’t know what you call this emotion, but it’s what people look like just before you stab them.”

    Why does this neural quirk matter? Abigail Marsh, a researcher at Georgetown University who has studied the brains of callous and unemotional children, says that distress cues, such as fearful or sad expressions, signal submission and conciliation. “They’re designed to prevent attacks by raising the white flag. And so if you’re not sensitive to these cues, you’re much more likely to attack somebody whom other people would refrain from attacking.”

    Psychopaths not only fail to recognize distress in others, they may not feel it themselves. The best physiological indicator of which young people will become violent criminals as adults is a low resting heart rate, says Adrian Raine of the University of Pennsylvania. Longitudinal studies that followed thousands of men in Sweden, the U.K., and Brazil all point to this biological anomaly. “We think that low heart rate reflects a lack of fear, and a lack of fear could predispose someone to committing fearless criminal-violence acts,” Raine says. Or perhaps there is an “optimal level of physiological arousal,” and psychopathic people seek out stimulation to increase their heart rate to normal. “For some kids, one way of getting this arousal jag in life is by shoplifting, or joining a gang, or robbing a store, or getting into a fight.” Indeed, when Daniel Waschbusch, a clinical psychologist at Penn State Hershey Medical Center, gave the most severely callous and unemotional children he worked with a stimulative medication, their behavior improved.

  3. While the idea of a psychopathic child may seem like it's out of a movie, a small number of psychopathic children do exist. In fact, psychopaths tend to develop their psychopathic traits before the age of 16. But what is a psychopathic tendency in a child and how can you spot psychopathic behavior in children?

    Psychopathic Children

    Children (those under the age of 18) are not, technically, psychopaths, even if they meet every criteria as psychopathy is only officially diagnosed in adults. However, when psychopathic adults are studied, it's clear that their psychopathic personality and tendencies developed as children and young adults. Some psychopaths even kill before their 18th birthday.

    Psychopathic Behavior in Children

    Several checklists have been developed to help identify children with psychopathic tendencies. These include Hare's Psychopathy Checklist – Revised; Youth version, the Youth Psychopathic Traits Inventory (YPI) and the Antisocial Process Screening Device – Self Report (APSD-SR). These three screening devices help to pinpoint the behaviors of psychopathic children.

    The following are examples of psychopathic behaviors in children as identified by the APSD-SR:

    Has shallow emotions
    Brags about accomplishments
    Uses or cons others
    Teases other people
    Is charming in insincere ways
    Becomes angry when corrected
    Thinks he or she is more important than others
    Blames others for mistakes
    Gets bored easily
    Acts without thinking
    Engages in risky and dangerous behavior
    Does not plan ahead
    Does not show emotions
    Breaks promises
    Doesn't feel bad or guilty
    Is not concerned about the feelings of others
    Doesn't keep the same friends
    Isn't concerned about schoolwork
    Lies easily and skillfully
    Engages in illegal activities
    It's important to remember that no, single psychopathic behavior indicates that a child is a psychopath but, rather, it's a constellation of traits that indicate psychopathy.

    Also keep in mind that some of psychopathy is genetic and if a child has psychopathic parents or parents with psychopathic tendencies, the child will have a greater chance of becoming a psychopath him or herself.

    If You Suspect Your Child Has Psychopathic Tendencies

    If you spot psychopathic tendencies in your child and are concerned, you should get help immediately from someone such as a psychologist or psychiatrist who specializes in psychopathy (treatment of psychopaths).

    While studies have shown that no treatment has helped change the behavior of adult psychopaths, the same has not been true of children with psychopathic tendencies. A therapy known as decompression treatment has shown positive results in helping children with psychopathic behavior. Some specialized institutions offer this treatment but the treatment tends to last a year or more and does not work for everyone.

  4. It’s always comforting to think that people can change if they’re given the right conditions. If, as the philosopher John Locke suggested, we are all born as “blank slates,” any writing on these slates that occurs early in life should be modifiable. Even renowned psychologist William James felt that personality wasn’t set in stone until we reach age 30. How, then, do we explain the results of new research by University of Michigan’s Rebecca Waller and colleagues (2016) suggesting that early signs of psychopathy can be seen in children as young as two years old?

    When looking back at the behavior of adults with known antisocial or psychopathic tendencies, people often say that they "saw it coming," citing examples such as bullying other children, abusing family pets, and engaging in petty thievery. However, such theorizing about people is generally done retrospectively. In other words, you know that a person has become antisocial or exhibited psychopathic tendencies as an adult, and that colors the way you remember the person as a child. It’s much more meaningful to predict psychopathy in adulthood moving forward, starting with observations of individuals in childhood and following up to see if those traits develop.
    To clarify the meaning of psychopathy, most definitions rely on Robert D. Hare’s two-factor model, which distinguishes between Factor 1—the shallow affect, superficial charm, manipulativeness, and lack of empathy—and Factor 2, or the inability to show remorse and the behaviors associated with the socially deviant lifestyle of impulsiveness and criminality. Both of these may become evident in childhood, but how early?...

    The Waller team's measure of psychopathy asked the primary parent, the other parent, and teachers to rate the child in question on Deceitful-Callous (DC) behavior to assess both the tendency to lack feelings for others and the tendency to lie. (The CU measures in other, similar studies didn't ask for ratings of deceitfulness.)

    These were the five items on the DC scale:

    Child doesn’t seem guilty after misbehaving.
    Punishment doesn’t change behavior.
    Child is selfish/won’t share.
    Child lies.
    Child is sneaky and tries to get around me.
    Children’s behavior problems were indicated by items such as getting into fights, destroying toys and other objects, and having temper tantrums....

    The findings revealed that by age three, toddlers who were rated high on the DC scale developed into children with significant behavior problems. This prediction was significant above and beyond the effect of earlier behavior predicting later behavior. The mothers' DC ratings of their two-year-olds were enough to predict later behavior problems, and by age three, the DC ratings provided by other caregivers and teachers became reliable predictors as well...

    The answer to the question of how early you can spot a psychopath appears to be almost as early as children’s personalities begin to emerge—the age of two when it comes to parents, and by the age of three when it comes to others in a child’s life. The good news is that, with this knowledge, interventions can be taken to help alter the course of the child’s development.

    Whether you believe it's nature or nurture that causes a person to become a psychopath, early recognition of these behavior problems is vital to altering that child’s ultimate path through life. In an earlier paper, a team led by the University of Michigan's Luke Hyde (2016) concluded that parenting style can help children with heritable risk for developing the CU form of early psychopathy.