Psychopathy traits and their link to emotion recognition impairments in conduct disorder

Neurocognitive models suggest that callous-unemotional (CU) traits in youths with conduct disorder (CD) are linked to emotion recognition impairments, particularly in identifying distress emotions like fear and sadness. However, CD may be accompanied by grandiose-manipulative (GM) and/or impulsive-irresponsible (II) traits in addition to CU traits, consistent with the notion that psychopathy is a multifaceted construct. It remains unclear whether subgroups of CD youths with GM or II traits, as well as a combination of multiple psychopathic traits, show distinct patterns of emotion recognition impairment.

We therefore assessed emotion recognition accuracy, focusing on the six basic emotions, in 538 youths with CD (315 girls, 9-18 years) who were assigned to one of eight mutually exclusive subgroups based on high or low scores (above/below the 75th percentile cut-offs) on CU, GM, and II traits as assessed by the Youth Psychopathy Inventory (YPI) self-report.

Support vector machine analyses supported the validity of the subgroup assignment based on YPI cut-off scores (sensitivities/specificities ≥75%-100%). Multinomial logistic regression models revealed that the CD subgroup with high levels across all three psychopathy traits had the most pervasive impairment in terms of higher error rates for recognizing sadness, disgust, and surprise. Notably, high CU traits were not consistently associated with impairments in fear and sadness recognition. Instead, CD youths with both high GM and II traits, but normal CU traits, showed impaired fear recognition.

These findings challenge existing models that prioritize CU traits as the main driver of emotion recognition impairments in CD. Instead, different psychopathy traits appear to contribute distinctively to such impairments, including the recognition of distress emotions. This suggests that CU traits alone may not sufficiently explain the neurocognitive heterogeneity in emotion recognition seen in youths with CD.