Adolescents, on the other hand, are another story. When a teenager displays sociopathic behaviors, there is a major cause for concern – and parents of such children are right to worry. Though Antisocial Personality Disorder can only be diagnosed for individuals ages 18 years or older, many teens who engage in sociopathic behavior will ultimately be diagnosed with the full-blown disorder later. Black (2006) estimates that 25 to 40 percent of children with Conduct Disorder go on to develop Antisocial Personality Disorder as adults.
Children May Have Conduct Disorder, Not Antisocial Personality Disorder
While they’re still teenagers, kids who engage in sociopathic behavior get diagnosed with Conduct Disorder. To be diagnosed, according to the DSM-V, the child must meet three or more criteria in the past 3 months, and one of the criterion must be present for 6 months. The criteria span four different areas of functioning, with each area having specific behaviors associated with it. The four areas of behavior include aggression to people and animals (e.g., often bullies, threatens, or intimidates others; has been physically cruel to people; has been physically cruel to animals); destruction of property (e.g., fire-setting or destroying property); deceitfulness or theft (e.g., has broken into someone else’s house, building, or car; has stolen items of nontrivial value); and serious violations of rules (e.g., often stays out at night despite parental prohibitions, beginning before age 13 years; has run away from home overnight at least twice; is often truant at school, beginning before age 13 years).
Reading the list above, it is clear to see why parents of Conduct Disordered teens should worry about how their child is going to fare in the world once he’s on his own, away from the moral confines and behavioral restrictions imposed by parents.
Research on Adolescents with Sociopathic Traits
Recent research suggests that sociopathic traits – for those who display them – are fairly constant over the course of the critical adolescent years. Salihovic and colleagues (2013), for example, followed 1,068 youths in the seventh to ninth grades over a period of four years. Psychopathic traits were measured with the Youth Psychopathic Traits Inventory, a self-report measure created to capture psychopathic traits in youths 12 years and older. As predicted, most of the adolescents in the study had low to moderate levels of psychopathic traits that continued to diminish with age. For a small group of youths, however, these characteristics remained high and stable over the course of the study period.
When should parents worry the most about the potentially sociopathic trajectory in their child’s future? According to new research, the first arrest is critical. DeLisi and colleagues found that a juvenile's first arrest or contact with the police is the strongest indicator of future problems. The study included 252 children living in juvenile detention centers, and the results serve as an important reminder about just how severe some of these adolescents (ages 14-18 years) are by such a young age: The offenders on average had committed 15 delinquent acts in the prior year. Oh, how the families of such teens suffer when the adolescents’ behavior gets so severe.
As stressful as having a sociopathic child, student, or even neighbor can be, parents with such kids need to make more effort with them than ever – and time spent with them may be the best remedy. On the other hand, research suggests that watching television is not the answer. Specifically, Robertson and colleagues (2013) found that children and adolescents who watch a lot of television are more likely to manifest antisocial and criminal behavior when they become adults. Specifically, the study followed a group of approximately 1,000 children. Every two years between the ages of 5 and 15, they were asked how much television they watched. The results are troubling: The risk of receiving a criminal conviction by early adulthood increased by about 30% with each hour that children spent watching TV on an average weeknight. Perhaps most importantly, the study also found that watching more television in childhood was associated in adulthood with aggressive personality traits, an increased tendency to experience negative emotions, and an increased risk of antisocial personality disorder. What I find most compelling about the study is the fact that the researchers found that the relationship between TV viewing and antisocial behavior was not explained by socio-economic status, aggressive or antisocial behavior in early childhood, or parenting factors. In other words, it was TV viewing which accounted for the difference.
The study which associates excessive television viewing with antisocial behavior is upsetting, to be sure, but it also makes a lot of sense: One hallmark of sociopathy is the inability to maintain close and consistently harmonious relationships and to feel accountable and remorseful when you do something that hurts another’s feelings. By extension, if a child with a sociopathic predisposition is left to his own devices for hours to watch TV or play video games, the primary relationships he has are with characters on a screen. If parents can spend as much time as possible with these adolescents, it can help the child learn to invest more and rely on others, rather than to see others as objects who either slow them down or block them from reaching their goals.
Other research suggests that the goal for adolescents who display sociopathic behavior shouldn’t simply be to keep them busy – especially if they only work at a job and don’t attend school. Monahan and colleagues (2012) studied about 1,350 serious juvenile offenders who were 14 to 17 years old at the beginning of the study. Some of the results aren’t surprising: Going to school regularly without working was associated with the least antisocial behavior, and high-intensity employment (20-plus hours per week) was associated with reduced antisocial behavior only among youths who also attended school regularly. Here’s the critical group: Youths who worked long hours and didn't attend school regularly were at the greatest risk for antisocial behavior, followed by youths who worked long hours and didn't go to school at all.
The link between working and not going to school reminds us how important school is in the life of a child with sociopathic tendencies. In fact, it may not be the actual academic degree (e.g., the high school diploma) that matters as much as the psychological value of hope – the feeling that something bigger and better lies ahead for the child’s future. In school, for example, teachers and other authority figures are always preaching about what’s next for kids (e.g., get good grades so you get into college, play sports well because you might get a scholarship). If you’re simply working for money already at such a young age, on the other hand, who’s there to tell this child that positive things lie ahead? If he or she is working for money, odds are that the job is low-paying and intellectually unstimulating. The study is important because it reminds parents that kids with sociopathic tendencies shouldn’t simply work; they must be integrated into the school environment so they, too, can benefit from a communal sense of hope and momentum – and don’t see themselves as sectioned off from their ‘normal’ peers.
What Parents Can Do
Besides the obvious – giving lots of time and attention to the adolescent – what can parents do when they see traits that are sociopathic or which have a sociopathic flavor?
Treatment for a Conduct Disordered, potentially sociopathic adolescent should include a few different components. Individual therapy that focuses on developing impulse control, emotional regulation skills and empathy is crucial, though not enough to solidify real positive change. In addition, group therapy with other adolescents can help to improve social skills. Finally, many of these adolescents may benefit from medication therapy. There are a wide range of possible medications that can help to calm and slow down the individual whose impulses take them from 0 to 60 in a matter of seconds. Schedule a visit with a psychiatrist or even a general practitioner to begin a psychiatric evaluation and discuss possible medication options.
Ultimately, it’s going to be a mix of structure, love and time that help to keep the sociopathic adolescent from becoming a full-blown sociopath. Though helping the adolescent improve his relationships is important, I believe it is just as important to help the adolescent learn to love and value himself. One of the best ways to do this is to help boost his self-esteem, and this can be achieved when parents focus their efforts on helping the adolescent develop skills for which others will praise him. For example, you think Jason, a truant 16-year-old is headed for trouble? If, say, he plays basketball well, do everything you can to try to get him on a team – and don’t give up until he’s engaged in a positive activity. The more he feels that others notice his skills, the less he will need to rely on illegal or manipulative means to get what he wants and make himself look and feel good.
Getting your average teenager to do anything is tricky, so how do you motivate a potentially sociopathic adolescent? Parents must figure out what positive things or activities the adolescent cares about most and use positive reinforcement to encourage him. When reinforcements don’t work, use simple attention and convey interest in the adolescent and his life. Parents should work to give the adolescent the sense that they are on the same side, and avoid getting angry or devising harsher punishments as a means of controlling him – that just brews more anger. Positive emotion and reinforcement typically work better with this group of adolescents than yelling, boundary drawing, or severe punishments.
Part of the time you spend with the adolescent can include working toward a common goal which can help to improve the relationship. Though there may be resistance from the adolescent, this is where parents can use positive reinforcement to get the adolescent to join. For example, "I need your help for a half hour so we can paint the chipped wall in the hallway. If you agree to help, I'll show my appreciation by offering to…"
I believe that even the most resistant, sociopathic adolescent is capable of being reached emotionally, though it may require that the parent engage with the child from a sort of detached, auto-pilot positive parenting paradigm. You may wonder why I use the term “auto-pilot,” and here’s why: Dealing with this type of adolescent can be extremely frustrating – and even scary – for parents, so if they were to be at all authentic in their own emotional reactions to the adolescent, they’d often say or do something that could sever any tie that still exists between parent and child. Those parents who face this situation on a daily basis can only imagine themselves unleashing the raw, unadulterated truth on the difficult child: “You are so ungrateful and have made my life such a living nightmare!” Accordingly, parents of sociopathic adolescents must try to steel themselves against the constant transgressions and find a way toward auto-pilot positive parenting, sending the message that the child is loved and valued despite the problematic behaviors.
During episodes of conflict (e.g., the adolescent has a meltdown and hurls swear words at you, the parent), try – when possible – to end the interaction in a state of connection. For example, before he storms out of the house in a rage, meet him at the door with warm eye contact and say "See you later, honey." The key is to maintain the best connection possible and to remind the adolescent that he is still loved despite the problem behaviors. This adolescent needs the consistent message of “I love you” in order to anchor him and remind him that he is noticed, appreciated, and valued – even when he is the last person in the world the parent may feel good about at the time.
In addition, parents of sociopathic teens should consider volunteering at their child’s school. This intervention has multiple purposes, including showing the child that the parent is truly invested, as well as allowing the parents access to cultivate relationships with school personnel.
Finally, the parents of this subset of adolescents are going to need near-infinite social support. Parents should consider getting involved with the National Alliance for the Mentally Ill (NAMI), an organization for parents of children with mental illness. NAMI has support groups and meetings all over the country, and no one understands the plight of these parents than other parents who have mentally ill children.
For information about what adult sociopaths are like – especially when it comes to their relationships – you can read my article on adult sociopathy, "Understanding the Sociopath: Cause, Motivation, Relationships," on this same site.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Black, D. (2006). What Is Antisocial Personality Disorder?. Psych Central. Retrieved on January 29, 2014, from http://psychcentral.com/lib/what-is-antisocial-personality-disord...
Matt DeLisi, Tricia K. Neppl, Brenda J. Lohman, Michael G. Vaughn, Jeffrey J. Shook. Early starters: Which type of criminal onset matters most for delinquent careers? Journal of Criminal Justice, 2013; 41 (1): 12 DOI: 10.1016/j.jcrimjus.2012.10.002
Kathryn C. Monahan, Laurence Steinberg and Elizabeth Cauffman. Age Differences in the Impact of Employment on Antisocial Behavior. Child Development, 2012; DOI: 10.1111/cdev.12031
Lindsay A. Robertson, Helena M. McAnally, and Robert J. Hancox. Childhood and Adolescent Television Viewing and Antisocial Behavior in Early Adulthood. Pediatrics, February 18, 2013 DOI: 10.1542/peds.2012-1582
Selma Salihovic, Metin Özdemir, Margaret Kerr. Trajectories of Adolescent Psychopathic Traits. Journal of Psychopathology and Behavioral Assessment, 2013; DOI: 10.1007/s10862-013-9375-0