Adolescents with Elevated Psychopathic Traits are Associated with an Increased Risk for Premature Mortality

The mortality rate among adolescents has been steadily increasing in recent years. Researchers have previously identified forms of externalizing psychopathology measured during adolescence associated with an increased risk for premature mortality, including attention-deficit/hyperactivity disorder (ADHD), substance use disorders (SUDs), oppositional defiant disorder (ODD), and conduct disorder (CD). The current study investigated whether additional personality traits (i.e., adolescent psychopathic traits, assessed via the Hare Psychopathy Checklist: Youth Version [PCL:YV]) were also associated with premature mortality risk among maximum-security incarcerated adolescents (N = 332). During a follow-up period ranging from 10 to 14 years, premature mortality was observed in n = 33 participants (9.94%), a mortality rate nearly ten times higher than population norms. We observed that adolescents scoring the highest on PCL:YV total scores exhibited significantly higher rates of premature mortality compared to adolescents scoring lower on PCL:YV total scores via Fisher's exact tests. Additionally, through univariate Cox proportional hazard regression analyses, PCL:YV total, Factor 2 (measuring lifestyle/behavioral and antisocial/developmental psychopathic traits), Facet 1 (measuring interpersonal psychopathic traits), and Facet 3 (measuring lifestyle/behavioral psychopathic traits) scores were associated with faster time to premature mortality. In supplemental analyses performed, we observed that adolescents meeting criteria for externalizing psychopathology (i.e., ADHD, SUDs, ODD, and CD) did not exhibit higher rates of premature mortality compared to control participants. The current study therefore identifies additional maladaptive personality traits to consider in relation to premature mortality risk (i.e., psychopathic traits) among a high-risk sample of incarcerated adolescents.