The Journal of Psychopathology and Behavioral Assessment published several articles for the month of June related to psychopathy and current efforts to weed out what is useful from what is not. Without holding our breaths on that one, thought I would share some excerpts of this article:
Assessing Callous Unemotional Traits in Children Aged 7- to 12-Years: A Confirmatory Factor Analysis of the Inventory of Callous Unemotional Traits
Stephen Houghton & Simon C. Hunter & Jedda Crow
J Psychopathol Behav Assess (2013) 35:215–222
DOI 10.1007/s10862-012-9324-3
Abstract
This study examined the factor structure of the Inventory of Callous and Unemotional Traits (ICU) with
268 Australian children aged 7.6 to 12.8 years of age. The ICU was initially subjected to item analysis, which resulted in the removal of 4 of its 24 items. Model fit indices from a confirmatory factor analysis showed mixed support for a three-factor model. To improve fit the item descriptors were reviewed and nine pairs of errors subsequently correlated. A two-factor model comprising one Uncaring and one Callous Unemotional factor represented a satisfactory solution for the data. This model was invariant across gender and age with respect to both factor loadings and factor variances. There was a small significant effect, with older children evidencing higher scores on Uncaring than younger children.
Callous unemotional traits (C/U) refer to specific deficiencies
in affective experience (absence of guilt, constrictive
display of emotion) and interpersonal (failure to show empathy,
callous use of others for one’s own gain) style (Cooke
et al. 2006; Fanti et al. 2009; Frick and White 2008; Kimonis
et al. 2008; Munoz et al. 2011). C/U traits are one of at least
three dimensions which consistently emerge in the construct
of adult (Cleckley 1976; Hare 1993) and adolescent psychopathy
(Andershed et al. 2002; Forth et al. 2003; Lynam
1997) whether using teacher, parent, self-report, or clinical
ratings (Frick and White 2008). Furthermore, there is evidence
from a number of studies, including longitudinal
studies, that C/U traits are relatively stable from late
childhood to early adolescence when measured using self- or
parent report (e.g., Munoz and Frick 2007; Obradović et
al. 2007).
C/U traits are important for designating a distinct subgroup
of antisocial and delinquent adolescents and preadolescents
(Essau, Sasagawa, & Frick 2006; see Frick 2006;
Frick and Marsee 2006; White and Frick 2010 as cited in in
Salekin and Lynam 2010, for reviews), whose causal processes
leading to their antisocial behavior operate differently
to those characteristic of other antisocial youth (Kimonis et
al. 2008). These individuals show a more severe, stable, and
aggressive pattern of behavior (Kahn et al. 2012) which is
more premeditated and instrumental in nature (Pardini et al.
2003). They are also at increased risk for early onset
delinquency, and later antisocial behavior (Frick and
White 2008). Furthermore, these young people are at
increased risk for poorer response to treatment (Frick
and Dickens 2006).
Given that C/U traits are one component of the features
indicative of adult psychopathy (Cooke and Michie 2001;
White and Frick 2010 as cited in in Salekin and Lynam
2010), and are more associated with the childhood onset
trajectory of severe conduct problems, the potential
importance of identifying those with C/U before the conduct
problems and aggression become too severe is critical. This
assumes greater importance given there is evidence of malleability
of levels of C/U traits during adolescence (Fontaine
et al. 2010). Distinguishing between those characterised by
childhood onset severe conduct problems and those by
adolescent onset could help understand the developmental
processes involved (Roose et al. 2011) and allow for preventive
intervention (Frick and White 2008).
Given the importance of C/U traits for understanding
antisocial children and adolescents, and differentiating within
these groups, there is a need for an efficient, reliable and
valid measure of these traits (see Essau et al. 2006; Kimonis
et al. 2008; Roose et al. 2011). The two most widely used
measures for most of the past research, the Antisocial
Process Screening Device (APSD: Frick and Hare 2001)
and the PCL-YV (Forth et al. 2003), have a number of
limitations in their assessment of C/U traits. First, both
assess a number of dimensions of psychopathy and the C/
U dimension is therefore only one of a number of subscales.
Frick and White (2008) have argued that the burgeoning
research on C/U traits clearly demonstrates the need to
develop assessments that separate these traits from other
antisocial dimensions. Second, each of the APSD and
PCL-YV also possess only a limited number of items
(APSD n06 and PCL-YV n04) that measure C/U, which
in the case of the APSD probably contributes to the moderate
internal consistency reported in many studies (Essau et
al. 2006). Third, all but one of the APSD items are positively
worded, therefore giving rise to the possibility that ratings
could be influenced by a specific response set. Finally, the
PCL-YV, which has primarily been used with incarcerated
adolescents, utilizes a 60–90 min interview format and
requires a review of the respondent’s offence records
(Kimonis et al. 2008).
In an attempt to overcome the limitations evident in
the APSD and PCL-YV, the Inventory of Callous and
Unemotional Traits (ICU: Frick 2004) was developed.
This 24-item self-report measure assesses three aspects
of C/U traits: Uncaring, Callousness, and Unemotional
using a four-point Likert scale (00Not at all true, 10
Somewhat true, 20Very true, 30Definitely true). Three
factors (i.e., Uncaring, Callousness, and Unemotional)
loading onto a higher order C/U dimension have consistently
emerged with a range of samples: 13 to 18 year
old German adolescents (Essau et al. 2006); 12 to
20 year old American adolescent offenders (with 22 of
the 24 ICU items) (Kimonis et al. 2008); 12 to 18 year
old Greek adolescents (Fanti et al. 2009); and 14 to
20 year old Belgian adolescents and young adults
(Roose et al. 2011).
The content of the ICU is based on the APSD (Frick and
Hare 2001) C/U scale, which consists of six items. The basis
of the ICU is the four items of the APSD that loaded
consistently on its C/U scale, in both clinical and community
samples (i.e., “Feels bad or guilty when he/she does
something wrong”, “Does not show feelings or emotions”,
“Is concerned about the feelings of others”, and “Is
concerned about how well he/she does at school or work”)
(see Frick et al. 2000). Three positively worded and three
negatively worded items were developed for each of these
original items, which resulted in the current 24 items. Of the
24 items, 12 are reverse scored. Currently, there are Youth
Self-Report, Parent Report, Teacher Report, Parent Report
(Preschool), and Teacher Report (Preschool) versions of the
ICU. Internal reliabilities have ranged between .77 and .81
suggesting satisfactory reliability. Thus, there is a growing
body of evidence supporting the ICU to be a promising
assessment instrument.
To date, however, there appears to have been comparatively
few applications of the ICU with younger children,
with most work instead being conducted using the APSD.
Thus, the validation of the ICU for use with younger children
is necessary if the development of preventive interventions
is to be forthcoming.
This current study tested the fit of the factor structure that
was established previously in samples of European and
American adolescents. We include assessment of the extent
to which different hypothesised measurement models account
for responses, and the extent to which the measure
is equivalent across males and females and across younger
and older children. Finally, we report on the effects of these
two variables (gender, school-stage) on the measure’s subscale
scores.
[...]
Discussion
The main aim of the present study was to examine the
structure and correlates of C/U traits in young mainstream
children using the ICU (Frick 2004). As the study involved
young mainstream children rather than children in clinical or
institutionalised settings we first tested the item functioning
of the ICU, using affectivity (i.e., items which participants
consistently find easy or difficult to endorse: see Osterlind
1989) and discrimination (i.e., the degree to which the
responses obtained for a particular item correlate with the
participants’ total scores on the instrument: Sax 1997;
Streiner and Norman 1995) indexes. Using Kline’s (2000)
dual criteria four items were found to be unsatisfactory for
this population and so they were deleted; the resulting
Cronbach’s alpha coefficient was satisfactory (.92).
Kimonis et al. (2008) and Essau et al. (2006) also raised
concerns about two of the four items deleted here, namely,
“What I think is right and wrong is different from what other
people think” and “I do not let my feelings control me” from
the Callousness dimension.
With these items deleted we completed a confirmatory
factor analysis (CFA) with 268 children on the hypothesized
factor structure of the 20-item ICU (8 items measuring
Callousness, 4 for Emotionality and 8 for Uncaring). The
results of the CFA indicated that a two-factor structure for
the ICU fit adequately to the data and was superior to the
three-factor model tested. In other studies using the ICU the
three factor-structure (i.e., Callousness, Unemotional, and
Uncaring) has consistently emerged with samples ranging in
age from 13 to 20 years of age (see Essau et al. 2006;
Kimonis et al. 2008; Fanti et al. 2009; Roose et al. 2011).
In our study, however, the Unemotional factor had a poor
internal reliability and a problematic item, which when
removed reduced the reliability further. Clustering the
Unemotional items onto the Callousness factor did not improve
the fit and so the items were deleted.
Based on substantive a priori reasons we hypothesised
that the unique variances of the associated indicators overlapped
(i.e., measured something in common other than the
latent constructs represented in the model) and correlated
eight pairs of errors. Consequently, the CFA in our study
captured two dimensions of behavior that fit the data best.
One (Uncaring) was representative of a lack of caring about
one’s performance in tasks and for others’ feelings. The
second (Callous) captured behavior that included a lack of
empathy, guilt and remorse, and an absence of emotional
expression. None of the five items making up the ICU
unemotional factor (i.e., “I do not show my feelings to
others”, “I express my feelings openly”, “I hide my feelings
from others”, “It is easy for others to tell how I am feeling”,
and “I am very expressive and emotional”) loaded onto our
two-factor model. Furthermore, the ICU items “I care about
how well I do at school or work” (Uncaring factor), and “I
do not feel remorseful when I do something wrong”, “I do
not care who I hurt to get what I want”, and “I am concerned
about the feelings of others” (Callousness) did not load onto
our two-factor model. Given that our sample consisted of
mainstream children (7.6 to 12.8 years) who were younger
than those included in previous research using the ICU (i.e.,
predominantly 12 to 20 year olds), it is possible that many of
them were at an age whereby they could not “feel” the
(affective) emotions of others (see Dadds et al. 2009;
Munoz et al. 2011). Furthermore, they may not have had
the experience to be able to attribute these emotions to
themselves or others (see Widen and Russell 2010).
The two-factor model was invariant across gender, supporting
factor structure equivalence across the two groups.
Essau et al. (2006) reported gender differences in ICU
subscale scores consistent with past research indicating that
men tend to score higher than women on all dimensions of
psychopathy, including C/U. Our findings did show that
with regards to age, there was a small significant effect,
with older children have significantly higher scores on
Uncaring (i.e., a lack of caring about one’s performance in
tasks and for others’ feelings) than younger children. This is
consistent with developmental findings that during early
adolescence rebelliousness and antisocial attitudes become
more common (Moffitt 1993).
It must be acknowledged and taken into consideration
when interpreting the findings that our results are based
solely on self-report data and that corroborative information
such as file data and observations might enhance reliability.
Nevertheless, self-report is an effective means of obtaining
an accurate insight into the subjective dispositions that can
be difficult to obtain from third parties such as teachers and
parents (Andershed 2010 as cited in Salekin and Lynam
2010; Frick et al. 2009). Indeed, the validity of self-report
on psychopathology and personality tends to increase from
childhood to adolescence whereas parental and teacher report
decreases for this period (Essau et al. 2006). This
present study was purely school-based and therefore only
children attending school were assessed. Children presenting
with elevated C/U traits, such as those in clinical,
institutional or referral-based settings should therefore be
included in future studies so that distribution of C/U trait
scores using the ICU can be compared. Furthermore, to
obtain adequate fit to the data we had to correlate eight pairs
of errors, which although substantially less than the 25
correlated error terms in the initial test of the ICU (Essau
et al. 2006) suggests the factor structure needs to be replicated
in other samples.
In summary, the ICU was specifically designed to address
the limitations in previous measures of C/U and in
doing so to provide a comprehensive assessment of C/U
traits in young people. Although research has consistently
provided evidence of three factors for adolescents this was
not the case for younger children in this study. Thus, the
data presented here represent a strong case for the continued
use of the ICU with children aged 7–12 years in order to
build on its potential and to support its further development.