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welcome to my scientifically informed
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insider look at mental health topics if
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you find this video to be interesting or
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helpful please like it and subscribe to
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my channel oh this is dr. grande today's
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question is what are the signs that a
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child could become a psychopath I've
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actually been asked this question a
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number of times a number of ways another
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version here is one of the signs that a
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child has already become a psychopath
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and I said the word psychopath I've also
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received this question with the term
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antisocial personality disorder
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now I receive this question almost a
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year ago now so it's it's been a while
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and I had to do a bit of research on
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this and also I want to talk to a number
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of clinicians before I attempted to
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answer this question there's really a
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lot to this because you're dealing with
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a construct like psychopathy which has a
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lot of serious consequences attached to
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it and then of course referring this or
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relating this to children and a lot of
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times in mental health we don't like to
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label children as psychopathic and I'll
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talk more about that in a moment so
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first let me explore the difference
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between psychopathy and antisocial
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person I've sorta SAN area of confusion
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and that really does lend an important
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component here to this discussion like
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understand that difference is important
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here so psychopathy is a construct it's
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not a mental disorder and it has two
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factors to it so really there's two
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types of psychopathy primary and
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secondary sometimes they're also called
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factor 1 and factor 2 and sometimes to
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make it even more confusing psychopathy
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factor 1 psychopathy is referred to as
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just the word psychopathy and factor 2
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psychopathy is referred to as sociopathy
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so we have a lot of terms to really talk
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about the same two types of psychopathy
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factor 1 psychopathy has traits like
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being callous unemotional manipulative
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deceitful and factor 2 has
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characteristics that we more typically
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associate with antisocial behavior like
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impulsivity irresponsibility and
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committing crimes
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so factor to psychopathy secondary
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psychopathy has a stronger association
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with the mental disorder antisocial
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personality so that is an actual mental
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disorder in the DSM and the Diagnostic
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and Statistical Manual so somebody can
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be diagnosed with antisocial personality
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sorter and again it aligns with factor
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to psychopathy and has some overlap with
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factor one psychopathy so when you look
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at the research and you look at how
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children could have psychopathic
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tendencies a lot of times they're
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talking about antisocial personality and
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not psychopathy so to make things even a
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bit more confusing antisocial
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personality or can't be diagnosed until
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age 18
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so before 18 another disorder named
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conduct disorder is oftentimes used so
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again we have when working with children
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and the construct of psychopathy we have
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a lot of confusing elements here and
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when you look at the research it's not
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always clear to what they are referring
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psychopathy factor 1 or factor 2
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antisocial personality disorder or
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conduct disorder so to answer this
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question about the signs that a child
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will become a psychopath I titled this
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video 11 signs that a child is at risk
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for psychopathy because that's what I'm
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really talking about here since we're
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not going to label children as
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Psychopaths we really talking about the
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risk for future psychopathy and
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psychopathy is an important topic this
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is a topic that really deserves more
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attention
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there aren't many psychopaths in the
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general population depending on the
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research you look at maybe 1% but we
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know that psychopaths are responsible
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for a large percentage of violent crimes
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and the exact percent really isn't known
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because again psychopathy is confused
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with antisocial personality disorder so
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we just know it's a fairly large percent
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some estimates say as many as half of
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violent crimes can be connected to
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psychopathic traits so I mentioned
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before that we don't label children as
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psychopaths and kind of talked about
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conduct disorder a little bit it's
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important to understand here that in
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mental health again psychopathy has a
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stigma attached to it so a lot of times
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you'll see this term cows on emotional
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traits so you see a child has low level
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of guilt
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reduced empathy callousness and uncaring
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behavior sometimes this is referred to
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as pre psychopathic but I don't really
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like that term because again it kind of
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suggests that somebody is definitely
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going to be psychopathic or is likely
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going to be psychopathic so instead of
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psychopathy we use the disorder conduct
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disorder and specifically with the
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callous unemotional trait component
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there's what's called a specifier
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attached to that disorder so it's an
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element that explains more about the
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presentation of the disorder and the
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specifier for callous unemotional traits
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this called limited pro-social emotions
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so really when you see limited
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pro-social emotions that's the same
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thing as callous unemotional traits and
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we know that if somebody has limited
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pro-social emotions they're at a greater
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risk to develop psychopathy
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we also know that eighty percent of
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children that have this diagnosis will
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not develop into Psychopaths
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of course that means about 20 percent
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will so that's why again we have to take
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this kind of seriously when we see
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conduct disorder with limited pro-social
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emotions so with all this in mind my
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talk about a sign that somebody could
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develop psychopathy that a child could
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help psychopathy it's important remember
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that the sign is really in essence a
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risk factor so we see multiple risk
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factors and one child and we get worried
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that they may develop psychopathy
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someday but somebody can have a lot of
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risk factors and never develop
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psychopathy so the signs don't
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necessarily mean somebody definitely
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will develop psychopathy they're just
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things that we see in the literature and
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different elements I've seen in clinical
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experience in talking to other
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clinicians that are poor prognostic
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indicators but they don't
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deston somebody to having psychopathy or
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they don't mean certainly they will
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develop it now again I've used many
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references here for this video and I'll
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put the articles that I've used I'll put
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the references for those articles in the
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description for this video so let's get
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started with the eleven signs the child
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is at risk for psychopathy now if you
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want to stop here in terms of this video
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if you want to say well I don't want to
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into the different science that's
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certainly okay I'm going to avoid being
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graphic of course want to try to avoid
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being graphic as I do in all my videos
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but some of these signs are a little
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disturbing so if you stop now you still
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learned a lot about antisocial
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personality and psychopathy and conduct
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disorder so it's a win you can stop now
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and you've learned something and that's
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good the details aren't for everybody
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certainly so now moving into the signs
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so the first three are referred to as
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the Macdonald triad and I've seen all
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three of these and they do seem to have
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a connection to psychopathy but again
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they're don't guarantee the first one is
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bedwetting and I'm going to group a few
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different elements together here so
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bedwetting I also have seen children who
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urinate on furniture and urinate on
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other children and I think these are
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really kind of two separate issues
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bedwetting I think is usually a sign of
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trauma or at least it's often a sign of
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trauma and that may be how it connects
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to psychopathy in the future but
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urinating on furniture or in places they
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shouldn't urinate or certainly urinating
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on other people and other children
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that's more of a sign of domination the
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literature isn't really clear on this
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some theorists think it's domination
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others just think it's aggression but
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either way it's a poor prognostic
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indicator so moving to number two this
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would be arson and this is really not
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only arson but a fascination with fire
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and destruction I've seen this take many
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forms but usually with children that are
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really young you'll see getting into
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matches or looking at flames or candles
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and being fascinated with that and then
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it'll develop into having desire to set
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small fires and then sometimes it leads
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to again arson
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so usually doesn't start with no
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interest and move right to arson that
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would be a fairly unusual presentation
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usually it's a fascination that develops
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over time and the flames the looking at
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flames looking at videos of flames or
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fires really captures the attention of
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the child that's one of the things I've
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noticed it's not something they can
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really be distracted from usually too
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easily there's a genuine
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interest in flames and destruction and
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the power of fire
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so the third sign is hurting small
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animals sometimes we see this referred
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to as torturing or killing small animals
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and this one's particularly disturbing
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of all these signs this one really
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stands out is a particularly poor
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prognostic indicator so again with this
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one just like we see with a lot of these
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signs
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it doesn't necessarily start out by
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hurting small animals so if somebody
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just doesn't go from nothing to getting
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a household pet and torturing them
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usually we see this starts with an
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interest in hurting animals and one way
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this is expressed is on stuffed animals
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so I've talked to a number of counselors
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in my career who treat children with
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conduct disorder and kind of specialize
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in the area of weil behavioral problems
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like the cow's unemotional traits and
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many of them keep stuffed animals in the
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office and they might have like a teddy
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bear or some other stuffed animal and
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they want to see what the children will
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do in therapy with the animal and
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sometimes it's really disturbing we know
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it's a stuffed animal not a real animal
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I've had clinicians tell me stories of
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how children ripped off all the limbs of
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a teddy bear or stuffed animal put the
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stuffed animal in the door and slam the
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door on the stuffed animals head flush
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the stuffed animal down the toilet or
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attempted to and even tried to set a
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stuffed animal on fire so fortunately
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I've never heard of an instance where
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they were successful at siting the fire
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but that's fairly disturbing if
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somebody's going to do that to a stuffed
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animal again that's a bad sign they may
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try to do it to an actual animal
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now this hurting small animal sign is
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one of those signs that a lot of times
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we see when a child comes in for
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counseling because this is an indication
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that pushes parents kind of over the
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edge so if the family cat or dog was
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hurt by a child in the household that is
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a moment when parents would oftentimes
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seek counseling for a child so
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unfortunately this becomes kind of the
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entry point right so the child hurts a
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small animal and then they come into
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therapy so we don't necessarily see the
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child before that in a lot of cases now
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this isn't something that all children
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with cow
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unemotional traits do again it's just a
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sign it's just an Associated feature
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that we see with callous unemotional
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traits now the fourth sign or risk
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factor here is cheating friends enemies
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and individuals who are neutral to the
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child so what do I mean by this now with
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children we usually don't see fraud or
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manipulation at the level we would see
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with an adult but sometimes we'll see
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stealing money or stealing toys so if
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you think about this you think of normal
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child behavior think well maybe some
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children would steal toys from other
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children this isn't particularly
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shocking or unusual but it strikes me
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with this particular sign is really the
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cheating or stealing from friends
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enemies and from people that would be
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neutral like that's the distinction
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usually children will at some point
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steal toys that's not again
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super unusual but not from friends not
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from people who already share their toys
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with them so that's the line that's
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being crossed here if a child views
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another child as an enemy and they take
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something from them that's one thing
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it's not pro-social but that's one thing
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but to take toys or other material goods
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from a friend that's what really seems
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unusual to me and that's really what has
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a stronger connection to psychopathy not
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recognizing when somebody's an ally an
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enemy or neutral having no recognition
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for that boundary and then just crossing
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that boundary now the fifth sign really
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usually applies to children they're a
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little younger maybe even as young as 3
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or 4 years old but it can of course
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apply to children a little older as well
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and this is ignoring another child who
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is crying this is a bad prognostic
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indicator one of the theories here is
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that children who have psychopathic
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tendencies or traits or callous
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unemotional traits can't recognize the
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stress in faces so if they see the
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another child is crying they're not
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going to react to that that's not
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something they recognize as being
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problematic and the reason that this
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sign tends to matter I think is because
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we believe that this inability to
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recognize distress and faces leads to
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aggression
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so one of the things about someone who
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has a fearful expression or who's crying
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in a sense it can be a sign of
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submission it can be a sign that
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somebody's not a threat to you but if
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somebody can't see that sign if a child
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can't recognize that another child is
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trying to move away from a fight or
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submit then the child with the cows and
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emotional traits is more likely to
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attack so this really results in a
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problem where they don't recognize who's
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trying to dominate them and who's trying
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to submit to them they look at everybody
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as potentially threatening so again I'm
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kind of starting here with ignoring a
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child who's crying and moving to
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potential attacks but that's really what
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we worry about what this particular sign
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has indicated the sixth sign is being
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dominant with an authority figure so let
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me give some examples of this one of the
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most distressing or alarming symptoms or
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signs connected with this risk factor is
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attacking a teacher if we look at the
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research literature we see that when a
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child commits crimes like an adolescent
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commits crimes and they look back at the
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history that child most of the time they
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see some sort of incident that involves
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somebody being dominant with an
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authority figure and a lot of times that
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comes in the form of attacking a school
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teacher so this really kind of breaks
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from the conventional thinking that a
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child would be kind of afraid to attack
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a teacher or would submit instead we see
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a child trying to dominate I've also
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seen this with children who attack
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police officers again that's a poor
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prognostic indicator I would say it's a
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bad sign if a child hacks anyone
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regardless of whether that individual is
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an authority figure or not but on top of
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this what really worries me is when
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there's a weapon used so it's one thing
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to impulsively attack or try to dominate
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somebody that's problematic but to use a
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weapon kind of shows planning and an
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intent to really do a lot of damage and
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potentially lethal damage so that's even
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more worrisome when you add the weapon
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on to the attack also if the attack is
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unprovoked that just adds more alarm to
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that particular sign
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so number seven the seventh sign that a
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child could eventually be a psychopath
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would be committing a crime alone a lot
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of times we see the children to commit
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crimes it's relatively common but it's
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peer pressure that's involved so they
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get together with other children and the
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worry about consequences decreases they
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take more chances and then commit some
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sort of crime or there's an excitement
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element tied to it they want to do
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something together that's exciting but
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when we see children to commit crimes
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alone that's a particularly worrisome
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indicator now kind of tied to this
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around criminality I also see that when
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children get together sometimes they
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fantasize about crime like they'll see
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these different movies about a jewel
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heist for example or a bank robbery and
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they'll start to plan out the crime like
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can they break into the museum or the
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bank whatever at night and steal this
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high-value object but if an individual
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has the limited pro-social emotions the
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cows on emotional traits they're more
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likely to introduce the idea of harming
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somebody into those crime fantasies
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so if children are talking about a bank
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robbery kind of hypothetically again not
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seriously planning a bank robbery but
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just talking about how they would get
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away with it and a child introduces the
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idea of just knocking the guard out or
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something like that that's really
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jumping to another level of harm and
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it's a poor prognostic indicator so the
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eighth sign here is a desire to see
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disturbing images or scenes and this
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really connects to the lack of empathy
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so if there is an article about a car
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accident like in a newspaper or online
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and a child accesses that they may be
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disappointed because they couldn't see
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the bodies they couldn't see the dead
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bodies in the car accident or the
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injured bodies so again most people may
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look at the picture they may want to see
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how bad the Clarkson was but this is
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really a desire to see that people were
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hurt and you could look at this for
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another angle too sometimes with
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children have callous unemotional traits
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they really mentioned this idea that
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they want to see somebody die they want
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to actually see a human being
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pass away this is something I've heard
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dozens of times
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and it's no less distressing the 20th or
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30th time you hear it as it was the
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first time you hear it and what's
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interesting about this is the child
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doesn't always want to be the cause of
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the death but they just want to see the
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death now sometimes they do want to
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cause the death and this only magnifies
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to worry even more this is really
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probably one of the most disturbing
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elements that we see with the cows
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emotional traits when a child says to
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you as a counselor that they want to
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cause someone's death because they want
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to see it take place
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so it's disturbing no matter what the
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reason would be but for whatever reason
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for me anyway that just strikes me as
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particularly disturbing this one is
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frightening and a very poor prognostic
00:18:32
indicator so moving to number nine this
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one is about how sometimes children can
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be fearless with consequences so one
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thing we see with callous unemotional
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traits is that children aren't afraid of
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timeouts are not afraid of punishment
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they're not even afraid of physical pain
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so it's related to fearless dominance
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which is a characteristic of psychopathy
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we also see that after the punishment
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they resume the bad behavior almost
00:19:01
immediately so it's really like the
00:19:03
punishment that consequences just don't
00:19:05
matter at all now what's interesting
00:19:08
about this sign though is a lot of times
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when this is present a child will still
00:19:12
be motivated by reward so they're not
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afraid of punishment but they're still
00:19:16
motivated by reward so it's that's a
00:19:19
kind of interesting dynamic when trying
00:19:21
to lay out behavioral plans that will
00:19:24
help a child move away from cows on
00:19:26
emotional traits the tenth sign is when
00:19:29
a child bullies other children and
00:19:31
what's particularly notable here with
00:19:33
this one is when there's a desire for
00:19:36
the child to create fear in another
00:19:38
child so it's not about just taking
00:19:41
something from them but when a child
00:19:43
really wants another person to fear them
00:19:45
and when I find interesting here is
00:19:47
again we see a deficit and the ability
00:19:50
to recognize fear but that doesn't mean
00:19:52
that a child doesn't know that fear
00:19:54
exists is a construct so the last sign
00:19:57
the eleventh sign that a child could
00:19:59
potentially become a
00:20:00
psychopath is poor parenting and we see
00:20:04
this over and over in the research
00:20:06
literature cold parenting having
00:20:09
negative reactions to a child when they
00:20:11
disclose something failing to provide a
00:20:14
child positive feedback or being highly
00:20:16
critical and I think as well neglect any
00:20:20
type of neglect and abuse we know is
00:20:22
connected to psychopathy now it's
00:20:24
interesting here is if you look at some
00:20:28
of the horrible things that sometimes
00:20:30
parents do it becomes understandable
00:20:33
like psychopathy children developing
00:20:36
into Psychopaths eventually becomes
00:20:38
understandable now I'm going to go
00:20:40
through some of the things I've seen
00:20:41
here because they're just they're too
00:20:43
much but some of the traumatic events
00:20:46
you really just look at the horror
00:20:48
behind what children have to endure at
00:20:50
the hands of some bad parents criminally
00:20:52
bad parents you wonder how they could
00:20:54
become anything else but psychopathic it
00:20:57
makes sense the child would become cold
00:20:59
and distant and try to have feelings be
00:21:03
removed from them be detached from
00:21:05
feelings and not develop empathy now
00:21:08
another part of this of course we see in
00:21:10
the literature that psychopathic traits
00:21:12
in children do seem to worsen parenting
00:21:16
practices so it's not just a one-way
00:21:18
street here sometimes parenting can lead
00:21:21
to psychopathy and sometimes psychopathy
00:21:23
can lead to bad parenting so just as is
00:21:27
the case with all these different signs
00:21:28
the relationship between the sign and
00:21:32
psychopathy is complex so with all this
00:21:35
talk about how children can develop
00:21:36
psychopathic traits callous unemotional
00:21:38
traits and eventually develop
00:21:40
psychopathy is there any hope does
00:21:42
treatment tend to work well we know that
00:21:44
there is some success that has been
00:21:46
demonstrated with treatment so treatment
00:21:48
is always a good option and the earlier
00:21:51
the better we know the recovery may be
00:21:53
possible although many clinicians
00:21:55
believe that the type of recovery is
00:21:57
really simply an adjustment so a child
00:21:59
who develops into a psychopath may not
00:22:01
be an active psychopath in terms of
00:22:03
criminality they may learn to adjust to
00:22:06
society's norms they may still have a
00:22:09
lot of characteristics like low empathy
00:22:11
but they learn that they can get
00:22:14
more of what they want by following the
00:22:15
law as opposed to breaking the law so
00:22:18
this is kind of a grim view of recovery
00:22:22
from psychopathy and a groom few of how
00:22:24
a child could develop into a psychopath
00:22:26
but a lot of clinicians believe this a
00:22:28
lot of clinicians believe that the
00:22:29
psychopathy really can't be eradicated
00:22:33
somebody can just adjust to that type of
00:22:36
personality but either way we know that
00:22:39
the bottom line is success in terms of
00:22:41
society we may not be able to eliminate
00:22:43
psychopathy always but we can still help
00:22:46
children to develop into productive
00:22:48
citizens as they move into adulthood so
00:22:51
again it just kind of acknowledges the
00:22:54
concerns and the seriousness around
00:22:56
psychopathy it would be dismissive I
00:22:59
think to say well know if a child has
00:23:01
callous unemotional traits there's no
00:23:03
risk that they'll develop into
00:23:05
psychopathy and even if they do we can
00:23:08
work it out with treatment that's just
00:23:09
not the case there is a risk and the
00:23:12
treatment is not always successful and
00:23:15
sometimes when it is it's simply
00:23:17
functionally successful in terms of
00:23:19
society it doesn't really change the
00:23:21
underlying traits now on the topic of
00:23:23
treatment success one of the trends I've
00:23:24
seen over the last few years and again
00:23:27
this is understandable there's a lot of
00:23:29
agencies struggle to deal with children
00:23:31
who have callous unemotional traits
00:23:34
especially if there's any violence
00:23:36
involved so what happens is they get
00:23:38
kicked out of these agencies anger
00:23:41
referred to agencies that in theory can
00:23:42
handle these behaviors but we see very
00:23:45
few agencies that are willing to take
00:23:46
children especially again with the
00:23:49
violent aspect included so really the
00:23:51
children that would be at the most risk
00:23:53
to developing psychopathy I remember
00:23:56
visiting agency a few years ago when I
00:23:58
was walking through the hallway so I was
00:24:00
moving through these interior doors they
00:24:02
had so we had a hallway I was going
00:24:04
through these offices and one of the
00:24:06
offices didn't have a door and it seemed
00:24:09
unusual because it had a doorframe and
00:24:11
you could see at one time there were
00:24:13
places where the hinges went but they
00:24:14
appeared to be torn out so I asked one
00:24:17
of the counselors who worked there what
00:24:18
happened and they were telling me that
00:24:20
there was a child they were treating and
00:24:23
a child was around eight to ten years
00:24:25
old and
00:24:27
I broke the door off the hinges
00:24:30
so they Ram their whole body into the
00:24:32
door including their head so they just
00:24:35
stood up I got angry and they ran into
00:24:38
the door repeatedly so they're inside
00:24:40
the office here with the counselor where
00:24:41
this happened until the door broke and
00:24:44
just fell into the hallway and then just
00:24:47
walked away so you saw that all the
00:24:51
hinges again were ripped right out of
00:24:52
the doorframe and apparently the
00:24:54
doorknob was broken off the door as well
00:24:56
so they never bothered to replace it
00:24:58
they just used the office for something
00:24:59
else I don't know if there's storage or
00:25:02
where they did with it but they decided
00:25:03
not to replace that door and they
00:25:05
decided for similar sessions they were
00:25:08
just going to leave the door open and
00:25:09
they made some other changes to avoid
00:25:11
that becoming a problem with
00:25:13
confidentiality and on top of that they
00:25:16
changed their policy so that any
00:25:18
violence there's any violent act by any
00:25:21
child that was it they were going to be
00:25:23
discharged before they had tried to work
00:25:26
with a child but after that they weren't
00:25:29
going to do any more and I can
00:25:31
appreciate both sides of this right we
00:25:33
need to treat children who have these
00:25:35
traits to help prevent them from
00:25:36
becoming psychopathic because the damage
00:25:39
they can do as an adult in theory at
00:25:41
least would be much worse we also have
00:25:43
to protect counselors and staff and
00:25:45
nobody wants to work in a work
00:25:46
environment where they're threatened and
00:25:48
they have to fear for their safety so I
00:25:51
can appreciate again both sides of this
00:25:53
I'm not sure there's really any answer
00:25:55
except more funding for agencies that
00:25:58
are capable of handling children that
00:26:01
are at risk to become psychopathic but
00:26:04
of course it's always a simplistic
00:26:06
answer when you say well throw more
00:26:07
money at the problem but I'm just not
00:26:09
sure how else to address this issue
00:26:12
counselors aren't gonna work in fear but
00:26:14
we do have to address the psychopathy
00:26:16
issue because of all the violent crime
00:26:17
that's attached to it so it's an
00:26:20
interesting problem and I wish I had a
00:26:22
better answer in terms of a solution now
00:26:24
whenever I talk about topics like
00:26:26
psychopathy and antisocial personality
00:26:27
order especially one like this we're
00:26:29
talking about the signs that could lead
00:26:32
to it and children I know that they're
00:26:34
going to be a lot of strong opinions and
00:26:35
various directions and different
00:26:36
experiences so if you have opinions that
00:26:39
are the same
00:26:40
mine or different or other thoughts
00:26:42
please put those in the comments as
00:26:43
always I hope you found my description
00:26:45
about risk factors for psychopathy to be
00:26:47
interesting thanks for watching
