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Where Should Psychopathic Traits Be Placed in a Diagnostic Framework? Evidence for a Grandiose-Manipulative Specifier for ODD

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Abstract

Youth exhibiting psychopathic traits are at increased risk for a more severe, persisting, and treatment-resistant course of antisocial behavior. To reflect this diagnostically, the specifier with limited prosocial emotions (LPE) was added to the criteria for conduct disorder (CD). Yet, psychopathic traits often show an earlier onset than CD symptoms and LPE may exclude important dimensions of psychopathy. This study examines grandiose-manipulative (GM) traits both dimensionally and as a diagnostic specifier for behavioral disorders.Data come from a clinic sample of 177 boys aged 7–12 followed up annually through age 17. Annual parent reports of children’s GM, and symptoms of CD, oppositional defiant disorder (ODD), and attention-deficit/hyperactivity disorder (ADHD) were tested, controlling for other psychopathology and demographics. A categorical GM specifier for ODD or ADHD was also tested as a predictor of CD or ODD diagnosis.GM and ODD were significantly predictive of increases in CD. Reciprocal associations were observed between GM and ODD symptoms. The GM specifier was most commonly associated with ODD (91.9%), compared to CD (44.1%) or ADHD (67.1%), and was significantly predictive of future CD when applied to ODD. GM as a specifier for ADHD enhanced the prediction from ADHD to ODD, but not to CD. Including GM as a specifier for disorders beyond CD improves the prediction of future behavioral disorders, distinguishing youth with ODD at risk for CD, and youth with ADHD at risk for ODD. Failing to do so may miss a substantial portion of elevated GM.

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Data Availability

The data from the Developmental Trends Study is not publicly available.

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Not applicable.

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Funding

Data for this study were supported with a grant (MH42529) to Dr. Rolf Loeber and Dr. Benjamin B. Lahey from the National Institute of Mental Health. The authors have no conflicts of interest to report.

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Authors and Affiliations

  1. Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA

    Jeffrey D. Burke, Oliver G. Johnston & Asia G. Perkins

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  1. Jeffrey D. Burke
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  2. Oliver G. Johnston
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  3. Asia G. Perkins
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Correspondence to Jeffrey D. Burke.

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This project was approved by the Institutional Review Board of the University of Pittsburgh.

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Parents provided informed consent regarding their own and their children’s participation in the study; children provided assent.

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Burke, J.D., Johnston, O.G. & Perkins, A.G. Where Should Psychopathic Traits Be Placed in a Diagnostic Framework? Evidence for a Grandiose-Manipulative Specifier for ODD. Res Child Adolesc Psychopathol 50, 1289–1298 (2022). https://doi.org/10.1007/s10802-022-00924-2

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