Childhood precursors
Psychopathy is not normally diagnosed in children or adolescents, and some jurisdictions explicitly forbid diagnosing psychopathy and similar personality disorders in minors. Psychopathic tendencies can sometimes be recognized in childhood or early adolescence and, if recognised, are diagnosed as
conduct disorder. It must be stressed that not all children diagnosed with conduct disorder grow up to be psychopaths, or even disordered at all, but these childhood signs are found in significantly higher proportions in psychopaths than in the general population. Conduct disorder, as well as a related disorder,
Oppositional Defiant Disorder, can sometimes develop into adult psychopathy. However, conduct disorder "fails to capture the emotional, cognitive and interpersonality traits - egocentricity, lack of remorse, empathy or guilt - that are so important in the diagnosis of psychopathy."
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Children showing strong psychopathic precursors often appear immune to punishment; nothing seems to modify their undesirable behavior. Consequently parents usually give up, and the behavior worsens.
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The following childhood indicators are to be seen not as to the type of behavior, but as to its relentless and unvarying occurrence. Not all must be present concurrently, but at least a number of them need to be present over a period of years[
citation needed]:
- An extended period of bedwetting past the preschool years that is not due to any medical problem.
- Cruelty to animals beyond an angry outburst.
- Firesetting and other vandalism. Not to be confused with playing with matches, which is not uncommon for preschoolers. This is the deliberate setting of destructive fires with utter disregard for the property and lives of others.
- Lying, often without discernible objectives, extending beyond a child's normal impulse not to be punished. Lies that are so extensive that it is often impossible to know lies from truth.
- Theft and truancy.
- Aggression to peers, not necessarily physical, which can include getting others into trouble or a campaign of psychological torment.
The three indicators—
bedwetting,
cruelty to animals and
firestarting, known as the
MacDonald triad—were first described by J.M. MacDonald as indicators of psychopathy.
[70] The relevance of these indicators to
serial murder etiology has since been called into question, and they are considered irrelevant to psychopathy.
The question of whether young children with early indicators of psychopathy respond poorly to intervention compared to conduct disordered children without these traits have only recently been examined in controlled clinical research. The empirical findings from this research have been consistent with broader anecdotal evidence, pointing to poor treatment outcomes.
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