Abstract
Two variants of callous-unemotional (CU) traits and psychopathy have been proposed, referred to as primary and secondary. Whereas primary variants are thought to be underpinned by insufficient arousal to emotional cues, secondary variants are thought to develop as a coping mechanism in response to trauma exposure. Compared with adult samples, research on primary and secondary variants in children and adolescents under the age of 18 has only emerged in the past decade, and there is ongoing debate with regards to the identification, defining characteristics, and distinct correlates of these variants. The present systematic review synthesizes the current literature on primary and secondary variants in relation to: (1) constructs used to distinguish and define primary and secondary variants; (2) study population characteristics; (3) data analytic techniques to differentiate variants; and (4) differential associations with theoretically relevant indices related to emotional processing, maltreatment, biomarkers, and behavioral outcomes (e.g., substance use, aggression). This is the first systematic review to examine the growing literature on primary and secondary CU and psychopathy variants among youth. Findings support the distinction between youth with primary versus secondary variants and demonstrate that this distinction is related to unique clinical correlates. Recommendations are made for future research in the field.
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Notes
Our introduction relies on theoretical papers of CU and psychopathy variants; however, we avoid presenting references that would be included in our results.
Emotional processing has been used in this literature to describe numerous constructs, including, but not limited to, facial recognition, emotional reactivity, and eye gaze. Thus, we use this term to broadly describe multiple constructs.
As Flexon, 2016 used the same sample as Flexon, 2015 it was removed from this summary to avoid bias.
Two studies used exposure to trauma/abuse as both a clustering variable and outcome variable.
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All authors contributed to the study conception and design. Review preparation and literature search was performed by SC. Article review and data analysis was performed by SC and NG. The first draft of the manuscript was written by SC with contributions by NG, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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Craig, S.G., Goulter, N. & Moretti, M.M. A Systematic Review of Primary and Secondary Callous-Unemotional Traits and Psychopathy Variants in Youth. Clin Child Fam Psychol Rev 24, 65–91 (2021). https://doi.org/10.1007/s10567-020-00329-x
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DOI: https://doi.org/10.1007/s10567-020-00329-x