Journal of Abnormal Child Psychology

, Volume 41, Issue 6, pp 929–938 | Cite as

Attachment-Related Mentalization Moderates the Relationship Between Psychopathic Traits and Proactive Aggression in Adolescence

  • Svenja TaubnerEmail author
  • Lars O. White
  • Johannes Zimmermann
  • Peter Fonagy
  • Tobias Nolte


The lack of affective responsiveness to others’ mental states – one of the hallmarks of psychopathy – is thought to give rise to increased interpersonal aggression. Recent models of psychopathy highlight deficits in attachment security that may, in turn, impede the development of relating to others in terms of mental states (mentalization). Here, we aimed to assess whether mentalization linked to attachment relationships may serve as a moderator for the relationship between interpersonal aggression and psychopathic traits in an adolescent community sample. Data from 104 males and females with a mean age of 16.4 years were collected on mentalization capacities using the Reflective Functioning Scale on the Adult Attachment Interview (AAI). Psychopathic traits and aggressive behavior were measured via self-report. Deficits in mentalization were significantly associated with both psychopathic traits and proactive aggression. As predicted, mentalization played a moderating role, such that individuals with increased psychopathic tendencies did not display increased proactive aggression when they had higher mentalizing capacities. Effects of mentalization on reactive aggression were fully accounted for by its shared variance with proactive aggression. Psychopathic traits alone only partially explain aggression in adolescence. Mentalization may serve as a protective factor to prevent the emergence of proactive aggression in spite of psychopathic traits and may provide a crucial target for intervention.


Mentalization Aggression Adolescence Psychopathy Reflective functioning 



This research was conducted with the help of funds from the German Federal Ministry of the Interior, University of Kassel, International Psychoanalytic Association and German Psychoanalytic Society. We would like to thank Fritz Hasper, Ramon Rodriguez-Sanchez. Marie Lübs and Christian Curth for their efforts during data-collection. In addition, we would like to express our gratitude to cooperating institutions, namely the Victim-Offender-Mediation Bremen (TOA Bremen e.V.), the Association for the Promotion of Accepting Youth-Work, (VaJa e.V.) and the comprehensive schools in Kassel, who granted us access to research participants.


  1. Alpers, G. W., & Eisenbarth, H. (2008). Psychopathic personality inventory-revised (PPI-R). Göttingen: Hogrefe.Google Scholar
  2. Bateman, A., & Fonagy, P. (2008). Comorbid antisocial and borderline personality disorders: mentalization-based treatment. Journal of Clinical Psychology, 64, 181–194.PubMedCrossRefGoogle Scholar
  3. Bateman, A., & Fonagy, P. (2011). Handbook of mentalizing in mental health practice. Washington, DC: American Psychiatric Association.Google Scholar
  4. Blair, R. J. (1995). A cognitive developmental approach to morality: investigating the psychopath. Cognition, 57, 1–29.PubMedCrossRefGoogle Scholar
  5. Blair, R. J. (1999). Responsiveness to distress cues in the child with psychopathic tendencies. Personality and Individual Differences, 27, 135–145.CrossRefGoogle Scholar
  6. Blair, J. (2008). Empathic dysfunction in psychopathy. In C. Sharp, P. Fonagy, & I. Goodyer (Eds.), Social cognition and developmental psychopathology (pp. 175–197). Oxford: Oxford University Press.CrossRefGoogle Scholar
  7. Blair, R. J., Sellars, C., Strickland, I., Clark, F., Williams, A., & Smith, M. (1996). Theory of mind in the psychopath. Journal of Forensic Psychiatry, 7, 15–25.CrossRefGoogle Scholar
  8. Blair, R. J., Mitchell, D. G., & Blair, K. (2005). The psychopath: Emotion and the brain. Oxford: Blackwell.Google Scholar
  9. Card, N., & Little, T. (2006). Proactive and reactive aggression in childhood and adolescence: a meta-analysis of differential relations with social adjustment. International Journal of Behavioral Development, 30, 466–480.CrossRefGoogle Scholar
  10. Cattell, R. B., & Weiß, R. H. (1971). Grundintelligenztest Skala 3 (CFT 3). Göttingen: Hogrefe.Google Scholar
  11. Cleckly, H. (1941). The mask of sanity. St. Louis: Mosby.Google Scholar
  12. Cohen, J., Cohen, P., West, S. G., & Aiken, L. S. (2003). Applied multiple regression/correlation analysis for the behavioral sciences (3rd ed.). Mahwah: Lawrence Erlbaum.Google Scholar
  13. Dadds, M.R., Allen, J.L., Oliver, B.R., Faulkner, N., Legge, K., Moul, C., … Scott, S. (2012). Love, eye contact and the developmental origins of empathy v. psychopathy. British Journal of Psychiatry, 200, 191–196.Google Scholar
  14. Dozier, M., & Kobak, R. R. (1992). Psychophysiology in attachment interviews: converging evidence for deactivating strategies. Child Development, 63, 1473–1480.PubMedCrossRefGoogle Scholar
  15. Eisenbarth, H., & Alpers, G. (2007). Validierung der deutschen Übersetzung des psychopathic personality inventory (PPI). Zeitschrift für Klinische Psychologie und Psychotherapie, 36, 216–224.CrossRefGoogle Scholar
  16. Fearon, P. R. M., Van Ijzendoorn, M. H., Fonagy, P., Bakermans-Kranenburg, M. J., Schuengel, C., & Bokhorst, C. L. (2006). In search of shared and nonshared environmental factors in security of attachment: a behavior-genetic study of the association between sensitivity and attachment security. Developmental Psychology, 42, 1026–1040.PubMedCrossRefGoogle Scholar
  17. Feshbach, N. D. (1987). Parental empathy and child adjustment/maladjustment. In N. Eisenberg & J. Strayer (Eds.), Empathy and its development (pp. 271–291). New York: Cambridge University Press.Google Scholar
  18. Fidell, L. S., & Tabachnick, B. G. (2003). Preparatory data analysis. In I. B. Weiner, I. B. Weiner, J. A. Schinka, & W. F. Velicer (Eds.), Handbook of psychology: Vol. 2: Research methods in psychology (pp. 115–141). Hoboken: Wiley.Google Scholar
  19. Fonagy, P., & Moran, G. S. (1991). Understanding psychic change in child psychoanalysis. The International Journal of Psycho-Analysis, 72, 15–22.PubMedGoogle Scholar
  20. Fonagy, P., & Target, M. (2005). Bridging the transmission gap: an end to an important mystery of attachment research? Attachment & Human Development, 7, 333–343.CrossRefGoogle Scholar
  21. Fonagy, P., Steele, M., Steele, H., Moran, G., & Higgitt, A. (1991). The capacity for understanding mental states: the reflective self in parent and child and its significance for security of attachment. Infant Mental Health Journal, 12, 201–218.CrossRefGoogle Scholar
  22. Fonagy, P., Leigh, T., Steele, M., Steele, H., Kennedy, R., Mattoon, G., … Gerber, A. (1996). The relation of attachment status, psychiatric classification, and response to psychotherapy. Journal of Consulting and Clinical Psychology, 64, 22–31.Google Scholar
  23. Fonagy, P., Redfern, S., & Charman, T. (1997a). The relationship between belief-desire reasoning and a projective measure of attachment security. British Journal of Developmental Psychology, 15, 51–61.CrossRefGoogle Scholar
  24. Fonagy, P., Steele, H., Steele, M., & Holder, J. (1997b). Attachment and theory of mind: overlapping constructs? Association of Child Psychology and Psychiatry Occasional Papers, 14, 31–40.Google Scholar
  25. Fonagy, P., Target, M., Steele, M., & Steele, H. (1997c). The development of violence and crime as it relates to security of attachment. In J. D. Osofsky (Ed.), Children in a violent society (pp. 150–177). New York: Guilford.Google Scholar
  26. Fonagy, P., Target, M., Steele, H., & Steele, M. (1998). Reflective functioning scale manual. Unpublished manuscript, London.Google Scholar
  27. Fonagy, P., Gergely, G., Jurist, E., & Target, M. (2002). Affect regulation, mentalization and the development of self. New York: Other Press.Google Scholar
  28. Fonagy, P., Gergely, G., & Target, M. (2007). The parent-infant dyad and the construction of the subjective self. Journal of Child Psychology and Psychiatry, 48, 288–328.PubMedCrossRefGoogle Scholar
  29. George, C., Kaplan, N., & Main, M. (1996). The Berkeley adult attachment interview. Unpublished manuscript, Berkeley.Google Scholar
  30. Gergely, G., & Unoka, Z. (2008). Attachment, affect-regulation, and mentalization: The developmental origins of the representational self. In C. Sharp, P. Fonagy, & I. M. Goodyer (Eds.), Social cognition and developmental psychopathology. New York: Oxford University Press.Google Scholar
  31. Gretton, H. M., Hare, R. D., & Catchpole, R. (2004). Psychopathy and offending from adolescence to adulthood: a 10-year follow-up. Journal of Consulting and Clinical Psychology, 72, 636–645.PubMedCrossRefGoogle Scholar
  32. Grienenberger, J., Kelly, K., & Slade, A. (2005). Maternal reflective functioning, mother infant affective communication, and infant attachment: exploring the link between mental states and observed caregiving behavior in the intergenerational transmission of attachment. Attachment & Human Development, 7, 299–311.CrossRefGoogle Scholar
  33. Griffin, R. S., & Gross, A. M. (2004). Childhood bullying: current empirical findings and future directions for research. Aggression and Violent Behavior, 9, 379–400.CrossRefGoogle Scholar
  34. Gullestad, F. S., Johansen, M. S., Høglend, P., Karterud, S., & Wilberg, T. (2012). Mentalization as a moderator of treatment effects: findings from a randomized clinical trial for personality disorders. Psychotherapy Research. doi: 10.1080/10503307.2012.684103.
  35. Hare, R. (1990/91). The psychopathy checklist – revised manual. Toronto Multi Health Systems.Google Scholar
  36. Harris, G. T., & Rice, M. E. (2006). Treatment of psychopathy: A review of the empirical findings. In C. J. Patrick (Ed.), Handbook of psychopathy (pp. 555–572). New York: Guildford Press.Google Scholar
  37. Hawes, D. J., & Dadds, M. R. (2005). The treatment of conduct problems in children with callous-unemotional traits. Journal of Consulting and Clinical Psychology, 73, 737–741.PubMedCrossRefGoogle Scholar
  38. Hayes, F., & Matthes, J. (2009). Computational procedures for probing interactions in OLS and logistic regression: SPSS and SAS implementations. Behavior Research Methods, 41, 924–936.PubMedCrossRefGoogle Scholar
  39. Hill, J., Fonagy, P., Lancaster, G., & Broyden, N. (2007). Aggression and intentionality in narrative responses to conflict and distress story stems: an investigation of boys with disruptive behaviour problems. Attachment & Human Development, 9, 223–237.CrossRefGoogle Scholar
  40. Hill, J., Murray, L., Leidecker, V., & Sharp, H. (2008). The dynamics of threat, fear and intentionality in the conduct disorders: longitudinal findings in the children of women with post-natal depression. Philosophical Transactions of the Royal Society B: Biological Sciences, 363, 2529–2541.CrossRefGoogle Scholar
  41. Jones, A., Laurens, K., Herba, C., Barker, G., & Viding, E. (2009). Amygdala hypoactivity to fearful faces in boys with conduct problems and callous-unemotional traits. The American Journal of Psychiatry, 166, 95–102.PubMedCrossRefGoogle Scholar
  42. Kosson, D., Suchy, Y., Mayer, A., & Libby, J. (2002). Facial affect recognition in criminal psychopaths. Emotion, 2, 398–411.PubMedCrossRefGoogle Scholar
  43. Larsson, H., Andershed, H., & Lichtenstein, P. (2006). A genetic factor explains most of the variation in the psychopathic personality. Journal of Abnormal Psychology, 115, 221–230.PubMedCrossRefGoogle Scholar
  44. Leistico, A. M., Salekin, R. T., DeCoster, J., & Rogers, R. (2008). A large-scale meta-analysis relating the hare measures of psychopathy to antisocial conduct. Law and Human Behavior, 32, 28–45.PubMedCrossRefGoogle Scholar
  45. Levinson, A., & Fonagy, P. (2004). Offending and attachment. The relationship between interpersonal awareness and offending in a prison population with psychiatric order. Canadian Journal of Psychoanaysis, 12, 225–251.Google Scholar
  46. Levy, K.N., Meehan, K.B., Kelly, K.M., Reynoso, J.S., Weber, M., Clarkin, J.F., … Kernberg, O.F. (2006). Change in attachment patterns and reflective function in a randomized control trial of transference-focused psychotherapy for borderline personality disorder. Journal of Consulting and Clinical Psychology, 74, 1027–1040.Google Scholar
  47. Lilienfeld, S. O., & Widows, M. R. (2005). Psychopathic personality inventory revised (PPI-R). Professional manual. Lutz: Psychological Assessment Resources.Google Scholar
  48. Luyten, P., Mayes, L., Fonagy, P., & Van Houdenhove, B. (submitted 2012). The interpersonal regulation of stress.Google Scholar
  49. McDonald, R., Dodson, M., Rosenfield, D., & Jouriles, E. (2011). Effects of a parenting intervention on features of psychopathy in children. Journal of Abnormal Child Psychology, 39, 1013–1023.PubMedCrossRefGoogle Scholar
  50. Neitzke, C., & Röhr-Sendelmeier, U. (1996). Achievement motivation of intellectually gifted students when confronted with challenging and unchallenging tasks. In A. J. Cropley & D. Dehn (Eds.), Fostering the growth of high ability: European perspectives (pp. 193–202). Norwood: Ablex Publishing Corporation.Google Scholar
  51. Nolte, T., Guiney, J., Fonagy, P., Mayes, L., & Luyten, P. (2011). Interpersonal stress regulation and the development of anxiety disorders: an attachment-based developmental framework. Frontiers in Behavioral Neuroscience, 5, 55.PubMedCrossRefGoogle Scholar
  52. Nolte, T., Bolling, D.Z., Hudac, C., Fonagy, P., Mayes, L.C., & Pelphrey, K. (submitted 2013). Brain mechanisms underlying the impact of attachment-related stress on social cognition.Google Scholar
  53. Pasalich, D. S., Dadds, M. R., Hawes, D. J., & Brennan, J. (2012). Attachment and callous-unemotional traits in children with early-onset conduct problems. Journal of Child Psychology and Psychiatry, 41, 302–313.Google Scholar
  54. Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40, 879–891.PubMedCrossRefGoogle Scholar
  55. Raine, A., Dodge, K., Loeber, R., Lynam, D., Reynolds, C., Stouthamer-Loeber, M., et al. (2006). The reactive-proactive aggression questionnaire: differential correlates of reactive and proactive aggression in adolescent boys. Aggressive Behavior, 32, 159–171.PubMedCrossRefGoogle Scholar
  56. Richell, R., Mitchell, D., Newman, C., Leonard, A., Baron-Cohen, S., & Blair, J. (2003). Theory of mind and psychopathy: can psychopathic individuals read the ‘language of the eyes’? Neuropsychologia, 41, 523–526.PubMedCrossRefGoogle Scholar
  57. Roisman, G. I., & Fraley, R. C. (2008). A behavior-genetic study of parenting quality, infant attachment security, and their covariation in a nationally representative sample. Developmental Psychology, 44, 831–839.PubMedCrossRefGoogle Scholar
  58. Roisman, G. I., Tsai, J. L., & Chiang, K. S. (2004). The emotional integration of childhood experiences: physiological, facial expressive, and self-reported emotional response during the adult attachment interview. Developmental Psychology, 40, 776–789.PubMedCrossRefGoogle Scholar
  59. Rutherford, H. J. V., Wareham, J. D., Vrouva, I., Mayes, L. C., Fonagy, P., & Potenza, M. N. (2012). Sex differences moderate the relationship between adolescent language and mentalization. Personality Disorders: Theory, Research, and Treatment, 3, 393–405.CrossRefGoogle Scholar
  60. Sharp, C., & Venta, A. (2012). Mentalizing problems in children and adolescents. In N. Midgley & I. Vrouva (Eds.), Mind the child: Mentalization-based interventions with children, young people and their families (pp. 35–53). London: Routledge.Google Scholar
  61. Skeem, J. L., Miller, J. D., Mulvey, E., Tiemann, J., & Monahan, J. (2005). Using a five factor lens to explore the relation between personality traits and violence in psychiatric patients. Journal of Consulting and Clinical Psychology, 73, 454–465.PubMedCrossRefGoogle Scholar
  62. Sonuga-Barke, E. J., Schlotz, W., & Kreppner, J. (2010). Differentiating developmental trajectories for conduct, emotion, and peer problems following early deprivation. Monographs of the Society for Research in Child Development, 75, 102–124.PubMedCrossRefGoogle Scholar
  63. Steiger, J. H. (1980). Tests for comparing elements of a correlation matrix. Psychological Bulletin, 87, 245–251.CrossRefGoogle Scholar
  64. Sternberg, R. J. (2004). Culture and intelligence. American Psychologist, 59, 325–338.PubMedCrossRefGoogle Scholar
  65. Stevens, D., Charman, T., & Blair, R. (2001). Recognition of emotion in facial expressions and vocal tones in children with psychopathic tendencies. Journal of Genetic Psychology, 162, 201–211.PubMedCrossRefGoogle Scholar
  66. Sutton, J., Reeves, M., & Keogh, T. (2000). Disruptive behavior, avoidance of responsibility and theory of mind. British Journal of Developmental Psychology, 18, 1–11.CrossRefGoogle Scholar
  67. Taubner, S., Hörz, S., Fischer-Kern, M., Doering, S., Buchheim, A., & Zimmermann, J. (2012). Internal structure of the reflective functioning scale. Psychological Assessment. Advance online publication. doi: 10.1037/a0029138.
  68. Taylor, J., Loney, B., Bobadilla, L., Iacono, W., & McGue, M. (2003). Genetic and environmental influences on psychopathy trait dimensions in a community sample of male twins. Journal of Abnormal Child Psychology, 31, 633–645.PubMedCrossRefGoogle Scholar
  69. Uzieblo, K., Verschuere, B., Van den Bussche, E., & Crombez, G. (2010). The validity of the psychopathic personality inventory–revised in a community sample. Assessment, 17, 334–346.PubMedCrossRefGoogle Scholar
  70. Van Ecke, Y., Chope, R. C., & Emmelkamp, P. M. G. (2005). Immigrants and attachment status: research findings with Dutch and Belgian immigrants in California. Social Behavior and Personality, 33, 657–674.CrossRefGoogle Scholar
  71. Viding, E., Blair, R. J., Moffitt, T., & Plomin, R. (2005). Evidence for substancial genetic risk for psychopathy in 7-year-olds. Journal of Child Psychology and Psychiatry, 46, 592–597.PubMedCrossRefGoogle Scholar
  72. Viding, E., Frick, P. J., & Plomin, R. (2007). Aetiology of the relationship between callous-unemotional traits and conduct problems in childhood. The British Journal of Psychiatry, 190(Suppl. 49), s33–s38.CrossRefGoogle Scholar
  73. Viding, E., Jones, A. P., Frick, P. J., Moffitt, T. E., & Plomin, R. (2008). Heritability of antisocial behaviour at 9: do callous-unemotional traits matter? Developmental Science, 11, 17–22.PubMedCrossRefGoogle Scholar
  74. Wilson, L., Miller, J. D., Zeichner, A., Lynam, D., & Widiger, T. A. (2011). An examination of the validity of the elemental psychopathy assessment: relations with other psychopathy measures, aggression, and externalizing behaviors. Journal of Psychopathology and Behavioral Assessment, 33, 315–322.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Svenja Taubner
    • 1
    • 2
    • 5
    Email author
  • Lars O. White
    • 3
  • Johannes Zimmermann
    • 1
  • Peter Fonagy
    • 4
  • Tobias Nolte
    • 4
  1. 1.Department of PsychologyUniversity of KasselKasselGermany
  2. 2.International Psychoanalytic University BerlinBerlinGermany
  3. 3.Department of Child and Adolescent Psychiatry, Psychotherapy, and PsychosomaticsUniversity of LeipzigLeipzigGermany
  4. 4.Research Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK
  5. 5.Department of Psychology, Faculty of Human SciencesUniversity of KasselKasselGermany

Personalised recommendations