Child Psychopath: Helpful or Harmful Diagnosis?

In her article "Can You Call a 9-Year-Old a Psychopath?" for The New York Times, Jennifer Kahn explores what are known as Callous-unemotional traits in children. She focuses on Michael, a 9-year-old boy who was for many years a behavioral mystery. His "periodic rages alternate with moments of chilly detachment" since early childhood have created a less than perfect environment at home. What is interesting about Callous-unemotional (or C.U.) children like Michael is that their traits are very similar to those of psychopathic adults. C.U. children often seem unable to understand how their actions influence others’; they are often extremely manipulative and unrepentant. They will do practically anything within their means to get what they want, even at the expense of someone else's happiness. However, psychologists across the board are hesitant to diagnose or label children as psychopathic due to the extensive changes occurring in the brain during development.  

I find Michael's case to be particularly interesting when compared alongside Dr. Neuman's Perspectives on Psychopathy. In his lecture, Neuman offered many widely accepted hypothesis of psychopathy including Dr. Lykken's "Low Fear" Hypothesis that suggests low fear in psychopathic individuals leads to poor fear conditioning and eventually poor passive avoidance. Neuman's own research however has led him to observe a common thread among psychopathic individuals. He asserts that once focused on a goal orienting behavior, psychopaths have a hard time taking into consideration outside information. His Instructed Fear Conditioning task that reveals that when focused, a psychopath's fear response is normal. However, when a psychopath's attention is diverted slightly, there is a significant fear deficit. 

When dealing with development, Neuman recognizes that self-regulation of aggression requires inhibiting a violent response to an aggressor, which requires executive functioning. For 9-year-old Michael, that aggressor could be something as simple as his younger brother Allan sitting near him while watching his Pokémon shows. Simple triggers can send Michael into a violent rage. Exhausting many other treatments, his parents decide to send him to a "summer camp" run by Dan Waschbusch, a researcher who has been studying Callous-unemotional children for 10 years. The camp focuses on the idea that C.U. children, like psychopaths, respond better comparatively to reward than punishment. As it turns out, "Waschbusch’s analysis of the reward-versus-punishment strategies showed little consistency" in his first summer camp. Given Neuman’s ideas that psychopaths do not learn from experience because they do not pause to think about their mistakes, this is not wholly surprising. Also, it is important to note that since violence inhibition requires higher executive functioning, perhaps frontal lobe development in children is a contributing factor. I would be interested to know if Neuman's treatment plans for psychopaths including emphasis on plasticity and attention learning would be as effective when applied to Callous-unemotional children. 

Kahn, J. (2012,  May 11). Can You Call a 9-Year-Old a Psychopath? The New York Times. http://www.nytimes.com/2012/05/13/magazine/can-you-call-a-9-year-old-a-psychopath.html?smid=pl-share