Child Psychopathy: Symptoms, Causes and Treatments

The child psychopathy shown in children with lack of empathy and guilt, are egocentric, have limited affect, are insincere and have a surface charm.

Psychopathy is one of the mental disorders that has more devastating consequences in the person who suffers it and especially in their environment. In addition, as we will see later, it is one of the most difficult disorders to treat.

Although there are not many studies of childhood and adolescent psychopathy, it has been shown that the disorder begins in childhood. Even some studies indicate that the presence of psychopathy in childhood and adolescence is a variable that can predict criminal behavior in adulthood.

Child Psychopathy

Already in the year 1976 Cleckley defined the psychopathic personality with a series of key characteristics:

  • These people show a superficial charm and high intelligence.
  • They do not have delusions or other symptoms of irrational thinking.
  • Absence of nervousness and other neurotic symptoms.
  • Lack of sincerity
  • Lack of remorse and shame.
  • Antisocial behavior without an adequate reason for it.
  • Inability to learn from experiences.
  • Pathological egocentricity and inability to love.
  • Affectivity limited.
  • Lack of intuition
  • Indifference towards personal relationships.
  • Amazing and undesirable behavior.
  • Suicide is something infrequent.
  • Sexual triviality
  • Inability to follow a coherent life plan.

On the other hand, researchers agree that when referring to children and adolescents talk about psychopathic traits and not psychopathy itself, because some of these children do not develop the disorder when they become adults.

Robert Hale, one of the greatest experts in this field, describes psychopaths as predators of their own species. In addition, these individuals are distinguished by characteristic symptoms in the affective, interpersonal and behavioral fields:

  • Affective plane : they are characterized by having superficial emotions that change quickly. They lack empathy and show an inability to maintain lasting links with other people.
  • Interpersonal plane : they are arrogant, self-centered, manipulative, dominant and energetic.
  • Behavioral plane : they are irresponsible and impulsive. They look for new and strong sensations and transgress social norms in a habitual way. They also tend to have a socially unstable lifestyle.

Other features that appear in children and adolescents with psychopathy are:

  • Absence of remorse and guilt towards behaviors that can harm other people.
  • Emotional insensitivity
  • Children tend to be more difficult and mischievous, they constantly try to challenge the rules and the people of authority.
  • They use the lie in a pathological way.
  • Aggressive behavior, which causes physical harm or threat to people or animals and also shows cruelty in these behaviors. Destructive behaviors appear and / or ignite objects.
  • They are often socially isolated, not involved in activities or interpersonal relationships.

Other studies on this topic have shown that the adolescent with psychopathic features has developed in childhood other pathologies such as attention deficit hyperactivity disorder, conduct disorder in childhood or the disorder of disociality.

Diagnosis of child psychopathy

It is important to make an adequate diagnosis and distinguish between a normal adolescent or child and one with the disorder.

Children and adolescents can have a series of characteristics typical of this period, such as lack of empathy, transgression of norms or risk behaviors such as substance use.

Some authors such as Seagrave and Grisso indicate that many of the psychotic characteristics that appear in adolescence are the normal aspects of this stage of development.

However, there are other authors who, while agreeing with the previous statement, consider that many of the symptoms of psychopathy in children and adolescents are more than normal manifestations at this stage of development.

According to some authors, an especially distinctive feature in these children is that they are considered to be not very fearful and the effects of socialization are practically nil by not experiencing guilt or learning from punishment.

Parents teach the child when and how to experience emotions such as pride, shame, respect or guilt using punishment when they act badly. In these children it is not easy to instill the feeling of guilt because they have not developed it.

They do not feel anxiety or fear when they are going to transgress a norm, nor the fear of reprisals from parents or other authority figures. This greatly hinders a standardized socialization.

Within this group of children and adolescents with such varied traits it is necessary to pay special attention to those who, in addition to having antisocial behavior and constant challenge to the norm and authority, are cold, manipulative individuals with difficulty in experiencing emotions. These personality traits together with the lack of internalization of the norm make these children and adolescents especially difficult to deal with.


There are numerous studies on the causes that lead to the development of this psychiatric disorder. Research in this field continues because a clear determinant for its development has not been found. Rather it seems the result of the influence of several factors.

Genetic factors

There have been numerous investigations with families, with twins, or adopted children. The results show that genes may be responsible for some individuals being vulnerable to developing this type of disorder.

But no single gene is responsible for the disorder. It is about multiple genes that combine to generate that vulnerability. And on the other hand, the risk of suffering from the disorder could vary depending on the number of genes shared by an individual with someone who suffers from the disease.

Biological factors

Some studies indicate that brain damage or dysfunction may be influential in developing the disorder. On the other hand, there seems to be a lack of connection between the amygdala (responsible for regulating emotions) and the prefrontal cortex in these subjects.

Research has also been conducted on the influence of neurotransmitters such as dopamine or serotonin.

Psychological factors

The predominant theory in this field is the so-called vulnerability-stress model. It has as basic assumption that in order for the disorder to develop, the existence of a vulnerability is necessary, which can be activated by various stressors that precipitate the appearance of the disorder.


Regarding the treatment of this disorder, it has not yet been proven that there is a type of intervention that is successful with these individuals. Studies in this context are also pessimistic and some authors such as Harris and Rice even conclude that in some cases the treatment is not only not effective but also can be counterproductive.

The main problems at the time of making an intervention are, on the one hand, the limitations of the studies that have been carried out in this regard, and on the other, the characteristics of these individuals that make the treatment ineffective.

These characteristics include the impossibility of creating a link between the therapist and the patient; they do not feel the need to change, there is no sincere communication and they make emotional work impossible.

In the year 2000 Lösel has summarized a series of principles that should guide the intervention with these subjects taking into account the study of the treatments applied up to that moment that prove to be the most effective. According to concludes, the treatment programs should have these foundations:

  1. They should be based on studies on the cause of psychopathy at a psychological and biological level.
  2. Carry out an in-depth evaluation of the individual so that it leads to an accurate diagnosis and not confuse the habitual behavior of a teenager with pathological features.
  3. Follow an intensive and prolonged treatment.
  4. Carry out the treatment in structures and specialized institutions in these cases to avoid the possible manipulation of the psychopath.
  5. Create a positive environment in the institution and keep it against the hostile behavior of the subjects treated.
  6. Direct part of the treatment in making them understand that their antisocial behaviors are harmful mainly to them, since in principle harm to others has no negative effect for them.
  7. Treatment programs with a multimodal and cognitive-behavioral orientation have proved to be the most successful in this field.
  8. Make sure that the treatment program is fully complied with.
  9. Select, train and supervise in detail the professionals who will intervene in the treatment.
  10. Reinforce natural protection factors, such as firm and consistent parents that encourage the development of prosocial skills.
  11. Perform a controlled follow-up once the subject completes the treatment and prevents relapse.

Although today there is no program that has proven effective in the treatment of children, adolescents and adults with this pathology, studies and research are still conducted to find it.

Kochanska in 1997 already stressed the importance of assessing the temperament of children because those with little fearful personality characteristics will have difficulty developing emotions such as guilt or empathy.

Likewise, there is evidence that interventions with children and adolescents have to go mainly to control antisocial impulses with a strict and orderly treatment for compliance with norms and habits.

But ultimately, to date it has not been concluded what kind of intervention is appropriate for a person with these characteristics. It is necessary to know more about the causes and the processes involved in its development in order to provide a joint treatment from pharmacology and psychology.

Advice for parents of children with psychopathy

1- Be aware of the problem

The first step that parents should take if they suspect that their child may have this disorder is to be aware of it. Many times out of fear or fear of what they will say is trying to hide the problem but that will not help to find a solution or the possible improvement of the symptoms.

2- Consulting with a professional

Given the complexity of the disorder it is essential to go to a professional expert in this field, who can guide and advise on the appropriate treatment. In addition, you can provide parents with behavioral and educational guidelines that are necessary to treat these children and adolescents.

3- Learn about the disease

Knowing the possible causes of the disorder or how it works can help parents better understand and accept the process their child is going through.

4- Do not respond with aggressiveness

Although in many cases this is a response that seems uncontrollable, in no case is it beneficial for the treatment of these children.

5- Promote adaptive social habits and behaviors

It is about fostering adaptive social habits and behaviors, getting it to respect certain norms and placing special emphasis on explaining and demonstrating that this adequate behavior has positive repercussions mainly on themselves.

6- Search for an external support system

It is very important that parents who have to deal with this disorder can have a support network with which to share their concerns or in which to seek support when necessary.

This network can be formed by relatives, friends and even mutual help groups formed by more parents in the same situation in which they can share their concerns.

7- Show tolerance and patience

It is important to keep in mind that the child or adolescent with this disorder will only look after their own interests and needs. It is more advisable in these cases to reach agreements with him than to face and discuss their beliefs and / or behaviors.

8- Firmness and security

It is advisable for parents to be firm and sure of themselves before the child or adolescent and show the least possible weakness points before him to avoid manipulation.

Also Read: Avoidant Attachment: Development, Symptoms and Treatment

9- Do not lose hope

In many cases this situation can overwhelm the parents and abandon all hope of improvement. It can even lead them to make decisions or perform behaviors that are harmful to themselves, such as substance abuse or medication to cope with the situation. This in no case helps the improvement of the child but significantly worsens the family situation.