The criminal justice system has been under critique in recent years for prioritizing punishment over treatment, but how can we be confident in who is open to benefiting from treatment? A study published in Research on Child and Adolescent Psychopathology explores how psychopathy traits may be related to treatment engagement for adolescents.
Adolescents who are involved in the criminal justice system due to antisocial behavior are often encouraged or mandated to have mental health treatment. This could potentially be very beneficial and could even prevent future antisocial behavior in adulthood. A key component of treatment planning is knowing who is open to engaging in treatment in order for it to have the desired effects.
Being engaged in treatment is more than just attending sessions and can be characterized by having a commitment to change and taking an active role in healing. Psychopathy is a trait that has a complicated relationship with treatment engagement, with the body of literature not drawing a firm conclusion as of now. This new study seeks to understand the specific aspects of psychopathy associated with treatment engagement for adolescents.
Study authors Athina Bisback, Cedric Recule, and Olivier F. Collins utilized 261 justice-involved male adolescents who were either 16 or 17 years old to serve as their sample. Participants were residing in two Dutch youth detention centers. Participants completed a measure on psychopathic traits that consists of ten subscales and three dimensions, as well as a measure on treatment engagement and sociodemographic information.
Results showed that remorselessness is the aspect of psychopathy that could most closely bridge the gap between psychopathy and treatment engagement, despite it being a difficult trait to target for intervention.
The researchers noted that “directly targeting lack of remorse is rather complicated because these individuals may feel that they have legitimate reasons to take harmful actions.”
“A more suitable target could be the enhancement of moral emotions that encourage prosocial behaviors. Targets that foster conscience development should be incorporated in therapy. More specifically, a potential target could be the focus on empathy as empathy can ultimately evoke moral emotions such as remorse. Recent research suggested that individuals with psychopathic traits fail to automatically take the perspective of others, but have the ability to do so.”
Empathy training programs have shown promising results in enhancing empathy levels in non-clinical populations, which in turn resulted in better treatment outcomes. The therapist can foster a transition from pure self-interest to qualified self-interest, which can help individuals with psychopathy consider the consequences of their actions.
“By using this approach, psychopathic individuals learn to get something out of it for themselves without inflicting harm to others,” the researchers wrote.
All three dimensions of psychopathy (grandiose-manipulative, callous-unemotional, and impulsive-irresponsible) had relationships with aspects of treatment engagement, showing the interrelatedness of the dimensions and the importance of considering all of them. The grandiose-manipulative dimension was negatively related to willingness to change, as well as the subscale of manipulation being negatively associated with forming a bond with staff.
Interestingly, the subscale of lying was positively associated with bonding with staff, emphasizing the need for mental health professionals to be vigilant about which people are engaging and which people are deceiving. The callous-unemotional dimension, which much previous research has focused on, was negatively associated with engaging in treatment. This supports past literature.
This study took important steps into better understanding factors related to treatment engagement for justice-involved teenagers. Despite this, there are limitations to note. One such limitation is that psychopathy and treatment engagement was assessed using self-report measures, which could be inaccurate, especially in a group with a heightened level of lying. Additionally, racial and ethnic variables were not considered in analysis, and only male participants were utilized; future research could use a more diverse sample and take group differences into account.
The study, “Psychopathic Traits, Treatment Engagement, and Their Interrelation in Criminal Justice-Involved Boys: A Cross-Sectional Network Analysis“, was authored by Athina Bisback, Cedric Reculé, and Olivier F. Colins.