When we think of “psychopathy” and “narcissism,” the last image that comes to mind is the innocence of youth. Yet one cannot deny that there are children who break the law, harm and bully others, exhibit shocking sadism and display cruelty to animals. Although neither Antisocial Personality Disorder or Narcissistic Personality Disorder can be diagnosed until an individual reaches adulthood, there are other terms, measures, and diagnoses that can signify behaviors that could potentially turn into more ingrained personality traits in adulthood. Signs of both psychopathy and narcissism often appear far earlier than when someone turns eighteen and there are measures to capture that. Antisocial Personality Disorder actually specifies that an individual has usually exhibited signs of a Conduct Disorder before the age of fifteen. Antisocial Personality Disorder is an umbrella term that can also refer to “psychopathy” or “sociopathy” as these terms don’t have their own separate diagnoses in the DSM. However, psychopathy is measured by Robert Hare’s Psychopathy Checklist Revised (PCL-R), a 20-item checklist that includes the more callous-unemotional traits associated with psychopathy.

Childhood Measures of Narcissism and Psychopathy

Researchers have created a version of the Psychopathy Checklist for younger populations (PCL-Youth Version) and studies on children with callous-unemotional traits indicate these traits are the predecessors of psychopathy in adulthood. Children with callous-unemotional traits show a lack of remorse, empathy, guilt and concern after violating others. They show little concern for the emotions and rights of others. This corresponds to some of the traits of antisocial personality disorder in adults. Callous-unemotional traits are heritable and have a strong genetic influence. For example, Viding and colleagues (2005) conducted a large-scale study 3,687 twin pairs who were tested for callous-unemotional traits. This study found that higher levels of callous-unemotional traits were influenced by genetics, not shared environment. This reveals that these traits may be more “hardwired,” more resistant to change, present at a very young age and must be taken seriously.

Potential psychopathy is not the only emerging trait that can be assessed in children. Similarly, there is also The Childhood Narcissism Scale which measures narcissistic traits in children that corresponds with the traits in adulthood, including traits such as a sense of superiority, a lack of empathic concern for others, and aggression following ego threat. According to the creators of the scale, narcissistic children tend to dominate social interactions and do not create genuine friendships. They lack the ability or willingness to empathize with their peers and may engage in bullying behaviors. They prioritize themselves above others and tend to be entitled, lashing out in aggression in retaliation to perceived slights or criticism. Sample items from this measure include: “I am a very special person,” “Kids like me deserve something extra,” and “I love showing off all the things I can do.” Researchers estimate that narcissistic traits and behaviors can begin around the age of 7, with children bragging about themselves, feeling superior to others, and attempting to monopolize attention. Children with emerging narcissistic traits also show higher levels of physiological reactivity in response to anticipated social evaluation during performance.

Conduct disorder is said to precede psychopathy and can be diagnosed after the age of ten (known as adolescence-onset) or before (known as childhood-onset). According to Dr. Martha Stout, longitudinal research studies reveal that about 60% of children diagnosed with Conduct Disorder will eventually go on to exhibit Antisocial Personality Disorder as adults. Remember, these traits don’t just affect you and your child: they affect the well-being of other children too. Studies reveal that the ringleaders of bullying groups tend to have psychopathic and narcissistic traits. When understanding these traits and behaviors, it’s important to assess not only the impact on your own child but also that of other children.

What is Conduct Disorder and the Limited Prosocial Emotions Specifier?

If you suspect your child has either narcissistic or psychopathic traits, it is important to see a mental health professional for treatment and management. According to the DSM-5, conduct disorder consists of a repetitive and persistent pattern of behavior where an individual regularly violates the basic rights of others. Conduct disorder must now be specified with certain additional indicators which can be key to understanding whether a child might have psychopathic traits. To qualify for a “with limited prosocial emotions” specifier, an individual must have displayed at least two of the following consistently for at least a year and in multiple relationships and contexts, reflecting their typical interpersonal and emotional patterns:

• Lack of remorse or guilt. They do not feel guilty when they do something wrong, with the exception of expressing remorse only when caught or punished. They exhibit a general lack of concern about the negative consequences of their actions and are not remorseful after harming someone or breaking the rules.
• Callous and lacking in empathy. They disregard and are unconcerned about the emotions of others. They are cold and uncaring. They are only concerned with the effects of their actions on themselves even when they’ve committed substantial harm to others.
• Unconcerned about performance. They don’t care about performing badly in school, work or other important activities. They don’t put in effort into doing well even when the expectations are made clear and blame others for their performance.
• Shallow or deficient affect. They don’t express or display emotions except for shallow, insincere and superficial emotions. These emotions may be contradicted by their actions and they may seem to turn their emotions on or off quickly or use their emotions for personal gain, displaying them to manipulate or intimidate others.

To be diagnosed with Conduct Disorder, you must have at least three or more of the following 15 criteria in the past year and at least one of these symptoms in the past six months.

Aggression to people and animals:

• Bullying, threatening or intimidating others
• Instigating physical fights
• Using weapons that can cause serious physical harm to others (e.g. knife, gun, brick, bat)
• Physical cruelty to people
• Physical cruelty to animals
• Has committed theft while confronting a victim in situations like armed robbery, mugging or extortion
• Forcing someone into sexual activities

Destruction of property:

• Has deliberately set fires with the intention of causing serious damage
• Has deliberately destroyed the property of others without the use of fire

Deceitfulness or theft

• Has broken into someone’s house, building or car
• Lies and cons to obtain resources, goods, or favors
• Has stolen items but without facing the victim (e.g. shoplifting, forgery).

Serious violations of rules

• Stays out late at night without parents prohibiting them before age 13
• Running away from home at least twice while living at home or running away once for a lengthy period
• Truancy and absence from school beginning before the age of 13

The severity of these behaviors can be specified as mild, moderate or severe. Mild severity means that the child has very few of these conduct problems and cause only minor harm to others (for example, lying, truancy or staying out late at night). Moderate severity indicates that the number of conduct problems may cause some harm such as stealing without confronting a victim or vandalism. A severe level means that there are too many conduct problems that can cause immense harm to others such as rape, physical cruelty, use of a weapon, stealing while harming a victim as well as breaking and entering.

If you suspect your child may have antisocial or psychopathic traits, it is important to see a mental health professional who specializes in child psychopathology. While there aren’t many effective interventions to “change” the underlying traits of psychopathy, studies do show that parent training in contingency-management, where the parent rewards their child for displaying prosocial behaviors or for the absence of aggressive behaviors, may help reduce harm to others. Click here for tips for preventing narcissistic tendencies in children. Early intervention with additional academic and social skills training may also improve behavior and reduce harm to other children.