Psychopathy encompasses a constellation of personality traits—including callousness, boldness, and disinhibition—associated with lifetime outcomes such as criminal activity, substance use, aggression, and other antisocial behaviors. However, psychopathy's relationship with these outcomes can vary depending on the sample tested, and no prior study has assessed outcomes related to psychopathy in a representative U.S. population sample. We thus assessed the relationship between psychopathy and relevant outcomes using the Triarchic Psychopathy Measure (TriPM) administered to a sample recruited to be demographically representative of American adults (N = 289). Results showed that TriPM psychopathy was normally distributed and associated with antisociality and criminal behavior. Unlike some prior results, we found that neither gender nor income moderated the relationship between psychopathy and criminal behavior. Disinhibition and boldness subscales, but not meanness, were associated with criminal behavior. These results underscore the importance of understanding psychopathy in the general population to improve public safety and health.

Genetic algorithms (GAs) are quantitative optimization techniques that have exclusively been utilized for scale abbreviation despite their potential application to new scale development. Here, we modeled the trait constructs of the triarchic psychopathy framework (boldness, meanness, disinhibition) as latent factors, and then applied a modified GA to select items for assessing each using model-estimated factor scores as targets. Items for the new scales were selected from a separate construct-relevant inventory, the Elemental Psychopathy Assessment, based on their ability to efficiently index each triarchic factor, with consideration given to scale intercorrelations and item polarity. Structural and item response modeling methods were then used to refine the GA-selected item sets. The resultant EPA-Triarchic scales correlated highly with their target factor scores and exhibited stronger loadings than the pre-existing scale indicators when added into the model. This work, illustrating a GA approach to devising new scales for indexing latent factors, has broad potential applications in clinical assessment.

Threat sensitivity, an individual difference construct reflecting variation in responsiveness to threats of various types, predicts physiological reactivity to aversive stimuli and shares heritable variance with anxiety disorders in adults. However, no research has been conducted yet with youth to examine the heritability of threat sensitivity or evaluate the role of genetic versus environmental influences in its relations with mental health problems. The current study addressed this gap by evaluating the psychometric properties of a measure of this construct, the 20-item Trait Fear scale (TF-20), and examining its phenotypic and genotypic correlations with different forms of psychopathology in a sample of 346 twin pairs (121 monozygotic), aged 9-14 years. Analyses revealed high internal consistency and test-retest reliability for the TF-20. Evidence was also found for its convergent and discriminant validity in terms of phenotypic and genotypic correlations with measures of fear-related psychopathology. By contrast, the TF-20's associations with depressive conditions were largely attributable to environmental influences. Extending prior work with adults, current study findings provide support for threat sensitivity as a genetically-influenced liability for phobic fear disorders in youth.

Given the substantial symptom overlap between anxiety and depressive disorders, researchers have sought to develop approaches for better differentiating these subdimensions of internalizing psychopathology. Neurophysiological indices of biobehavioral processes specific to either subdimension may provide a means for doing so. Here, we report evidence for opposing associations of a well-established neural indicator of reward responsiveness—the reward positivity (RewP)—with trait indices of depressive and phobic-fear pathology. Furthermore, these relationships were strengthened when controlling for their shared variance via regression modeling. In addition, structural equation modeling revealed that broad negative affectivity reflected the shared variance between the two trait indices. Our findings point to the potential use of reduced RewP to improve differential diagnosis of depressive versus phobic-fear conditions. They also indicate that variance shared between conditions of these types may operate to obscure their observed associations with neural indicators of core processes unique to each.

The conventional clinical approach to characterizing traumatic brain injuries (TBIs) as mild, moderate, or severe using the Glasgow Coma Scale (GCS) total score has well-known limitations, prompting calls for more sophisticated strategies to characterize TBI. Here, we use item response theory (IRT) to develop a novel method for quantifying TBI severity that incorporates neuroimaging and blood-based biomarkers along with clinical measures. Within the multicenter Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) study sample (N = 2545), we show that a set of 23 clinical, head computed tomography (CT), and blood-based biomarker variables familiar to clinicians and researchers index a common latent continuum of TBI severity. We illustrate how IRT can be used to identify the relative value of these features to estimate an individual’s position along the TBI severity continuum. Finally, we show that TBI severity scores generated using this novel IRT-based method incrementally predict functional outcome over classic clinical (mild, moderate, severe) or International Mission for Prognosis and Analysis of Clinical Trials in TBI (IMPACT) classification methods. Our findings directly inform ongoing international efforts to refine and deploy new pragmatic, empirically-supported strategies for characterizing TBI, while illustrating a strategy that may be useful to evolve staging systems for other diseases.

Purpose: Parental history of criminal offending is a major risk factor for later criminal behavior in children. Extensive research has also shown low resting heart rate (RHR), a moderately heritable biological variable, to be prospectively predictive of criminal behavior. Despite its status as a replicable risk factor, limited research exists on RHR's role in the intergenerational transmission of crime. Specifically, it remains unclear whether parent-child resemblance for biological characteristics such as RHR might play a role in intergenerational crime transmission. Method: The current study was undertaken to clarify the role of RHR in the intergenerational transmission of crime, and test for moderating effects of socioeconomic status (SES) on its role, in a large Swedish population-based sample of fathers and their sons combined (N similar to 266,000). Results: Beyond replicating prior work documenting paternal crime history and RHR as predictors of later offspring crime, we show tfhat father-son resemblance for RHR accounts in part for father-to-son crime transmission, and that familial SES does not moderate this transmission. Conclusions: Our findings have important implications for understanding the role of biological and environmental influences in the intergenerational transmission of crime.

In the DSM-5 Alternative Model of Personality Disorders (AMPD), psychopathy is marked by the presence of attention seeking, low anxiousness, and lack of social withdrawal, along with traits from the domains of Antagonism and Disinhibition. The triarchic model of psychopathy (TriPM) posits three biobehaviorally based traits underlying it: disinhibition, meanness, and boldness. The current study directly compared relations for measures of the two models with the broad dimensions of externalizing, internalizing, and positive adjustment. Participants (1,678 adults) were surveyed regarding maladaptive personality traits, clinical symptoms, and positive adjustment features. The TriPM model explained more variance than the AMPD in substance use, positive adjustment, and empathy, whereas the AMPD model explained more variance in internalizing symptoms. In addition, AMPD Antagonism and the Psychopathy Specifier diverged from TriPM Meanness and Boldness in their associations with some specific outcomes. Overall, our study provides evidence for complementarity of the two models in characterizing the multifaceted nature of psychopathy.

Attention-deficit/hyperactivity disorder (ADHD) symptoms are associated with myriad adverse outcomes, including interpersonal difficulties, but factors that moderate the developmental course and functional impact of ADHD over time are not well understood. The present study evaluated developmental contributions of the triarchic neurobehavioral traits (boldness, meanness, and disinhibition) to ADHD symptomatology and its subdimensions from adolescence to young adulthood. Participants were twins and triplets assessed at ages 14, 17, and 19 (initial N = 1,185, 51.2% female). Path analyses using negative binomial regression revealed that boldness at age 14 was associated with more ADHD symptoms cross-sectionally (especially hyperactivity/impulsivity), but fewer symptoms (especially inattention) at age 19 in the prospective analysis. Notably, inclusion of interpersonal problems at ages 14 and 17 as covariates reduced the latter effect to nonsignificant. Disinhibition concurrently and prospectively predicted higher levels of ADHD symptoms, including both subdimensions, and the prospective effects were partially mediated by greater social impairment at age 17. Meanness prospectively (but not concurrently) predicted higher levels of hyperactivity/impulsivity symptoms. Sex moderated certain associations of meanness and disinhibition with ADHD symptoms. These findings highlight how fundamental neurobehavioral traits shape both psychopathology and adaptive outcomes in the developmental course of ADHD.

Considerable research has linked relative reduction in the amplitude of the P3 event-related potential (ERP) during cognitive task performance (i.e., Target-P3) with increased risk of alcohol-related problems. A separate literature indicates that a relative increase in the amplitude of the P3 elicited by cues signaling alcohol availability (i.e., ACR-P3) also is associated with alcohol use and problems. To date, no research has integrated these seemingly discrepant findings. Here, we aimed to demonstrate that P3 amplitudes elicited in different task contexts reflect distinct domains of functioning relevant to problematic alcohol involvement (PAI), and therefore can inform heterogeneity in the etiology of PAI. 156 emerging adults (61% women; 88% White/Non-Hispanic) completed a mental rotation task and a picture-viewing task while ERPs were recorded. Participants also completed questionnaire measures of trait disinhibition, alcohol use, and alcohol-related problems. Findings from regression analyses indicated that (a) Target-P3 was negatively associated and ACR-P3 was positively associated with a PAI latent variable; (b) the two P3s accounted for unique variance in PAI, beyond that accounted for by recent drinking; and (c) the association between Target-P3 and PAI—but not ACR-P3 and PAI—was statistically mediated by trait disinhibition. The present findings highlight the unique contributions of distinct functional domains associated with disinhibition and incentive salience in the etiology of PAI. Moreover, findings are consistent with a nuanced understanding of the P3 ERP, whereby its specific meaning varies according to the task context in which it is elicited.

BACKGROUND:Neuropsychiatric symptoms are common after traumatic brain injury (TBI) and often resolve within 3 months post-injury. However, the degree to which individual patients follow this course is unknown. We characterized trajectories of neuropsychiatric symptoms over 12 months post-TBI. We hypothesized that a substantial proportion of individuals would display trajectories distinct from the group-average course, with some exhibiting less favorable courses. METHODS:Participants were level 1 trauma center patients with TBI (n = 1943), orthopedic trauma controls (n = 257), and non-injured friend controls (n = 300). Trajectories of six symptom dimensions (Depression, Anxiety, Fear, Sleep, Physical, and Pain) were identified using growth mixture modeling from 2 weeks to 12 months post-injury. RESULTS:Depression, Anxiety, Fear, and Physical symptoms displayed three trajectories: Stable-Low (86.2-88.6%), Worsening (5.6-10.9%), and Improving (2.6-6.4%). Among symptomatic trajectories (Worsening, Improving), lower-severity TBI was associated with higher prevalence of elevated symptoms at 2 weeks that steadily resolved over 12 months compared to all other groups, whereas higher-severity TBI was associated with higher prevalence of symptoms that gradually worsened from 3-12 months. Sleep and Pain displayed more variable recovery courses, and the most common trajectory entailed an average level of problems that remained stable over time (Stable-Average; 46.7-82.6%). Symptomatic Sleep and Pain trajectories (Stable-Average, Improving) were more common in traumatically injured groups. CONCLUSIONS:Findings illustrate the nature and rates of distinct neuropsychiatric symptom trajectories and their relationship to traumatic injuries. Providers may use these results as a referent for gauging typical v. atypical recovery in the first 12 months post-injury.

Background Lower autonomic arousal is a well-known correlate of criminal offending and other risk-taking behaviors in men, but few studies have investigated this association in women.Aim To test associations between autonomic arousal and criminal offending as well as unintentional injuries among female conscripts.Methods All women born 1958-1994 in Sweden who participated in voluntary military conscription (n = 12,499) were identified by linking Swedish population-based registers. Predictors were resting heart rate (RHR) and systolic blood pressure (SBP). Covariates were height, weight, and physical energy capacity. Main outcomes were criminal convictions (any, violent, and non-violent) from the National Crime Register. Secondary outcome was unintentional injuries requiring medical treatment or causing death. We used survival analyses to test for associations between predictors and outcomes.Results Low RHR, relative to high RHR, was associated with an increased risk of any criminal conviction, non-violent criminal convictions, and unintentional injuries. Low SBP, relative to high SBP, was associated with an increased risk of violent criminal convictions.Conclusions Results support lower autonomic arousal, particularly lower RHR, as a correlate of criminal offending among women that warrants further examination, as the reported findings have potential implications for the prediction of future female crime.

Prior studies have found an association between reduced P3 brain responses-a neural marker of task engagement-and increased depressive symptoms during adolescence. However, it is unclear whether P3 correlates with depression globally, or with certain facets. Existing depression studies have also typically quantified P3 as a cross-trial average, neglecting possible trial-by-trial effects. Among 72 adolescents (44% female), the current study evaluated relations of distinct depression symptom facets-anhedonia and negative mood-with P3s from a three-stimulus go/no-go task, quantified both in average- and trial-level terms. Although no relationship was evident between overall depressive symptoms and average P3 amplitudes, opposing relations were found for each symptom facet with P3 to frequent and infrequent 'go' stimuli: higher anhedonia predicted smaller P3, whereas increased negative mood predicted larger P3. Single-trial, multilevel modeling analyses clarified these effects by showing reduced P3 across stimuli types at task outset, along with greater trial-to-trial attenuation of P3 to infrequent-go stimuli, for adolescents experiencing greater anhedonia. Conversely, increased negative mood was distinctly related to larger P3 at task onset but was unrelated to amplitude change across trials. Results demonstrate differential relations for anhedonic and negative mood symptoms with P3-indicative of task disengagement versus heightened vigilance, respectively-that may be obscured in analyses focusing on overall depressive symptoms. The divergent associations for anhedonia and negative mood with P3 underscore the need to consider these distinct symptom facets in research aimed at clarifying the nature of neural-circuitry dysfunction in depression.

The triarchic model posits that distinct trait constructs of boldness, meanness, and disinhibition underlie psychopathy. The triarchic model traits are conceptualized as biobehavioral dimensions that can be assessed using different sets of indicators from alternative measurement modalities; as such, the triarchic model would hypothesize that these traits are not confined to any one item set. The present study tested whether the triarchic model dimensions would emerge from a hierarchical-structural analysis of the facet scales of the Elemental Psychopathy Assessment (EPA), an inventory designed to comprehensively index psychopathy according to the five-factor personality model. Study participants (Ns = 811, 170) completed the EPA and three different scale sets assessing the triarchic traits along with criterion measures of antisocial/externalizing behaviors. Bass-ackwards modeling of the EPA facet scales revealed a four-level structure, with factors at the third level appearing similar to the triarchic trait dimensions. An analysis in which scores for the Level-3 EPA factors were regressed onto corresponding latent-trait dimensions defined using the different triarchic scale sets revealed extremely high convergence (beta s = .84-.91). The Level-3 EPA factors also evidenced validity in relation to relevant criteria, approximating and sometimes exceeding that evident for the Level-4 EPA factors. Together, these results indicate that the triarchic trait constructs are embedded in a psychopathy inventory designed to align with a general personality model and effectively predict pertinent external criteria.

The Hierarchical Taxonomy of Psychopathology (HiTOP) is a dimensional framework for psychopathology advanced by a consortium of nosologists. In the HiTOP system, psychopathology is grouped hierarchically from super-spectra, spectra, and subfactors at the upper levels to homogeneous symptom components and maladaptive traits and their constituent symptoms, and maladaptive behaviors at the lower levels. HiTOP has the potential to improve clinical outcomes by planning treatment based on symptom severity rather than heterogeneous diagnoses, targeting treatment across different levels of the hierarchy, and assessing distress and impairment separately from the observed symptom profile. Assessments can be performed according to this framework with the recently developed HiTOP-Self-Report (HiTOP-SR). Examples of how to use HiTOP in clinical practice are provided for the internalizing spectrum, including the use of the Unified Protocol and other modularized treatments, measurement-based care, psychopharmacology, and in traditionally underserved populations. Future directions are discussed in this State of the Science review including HiTOP's use in further developing transdiagnostic treatments, extending the model to include other information such as environmental factors, establishing the treatment utility of clinical assessment for the HiTOP-SR, developing new treatments, and disseminating the model.

Intimate partner violence (IPV) is a serious and recurrent phenomenon in many societies with severe physical and psychological consequences. In the present study, we aimed to explore the role of triarchic dimensions of psychopathy (disinhibition, boldness, and meanness) across gender in this occurrence. A questionnaire on inflicted (self) and experienced (partner) IPV and the Triarchic Psychopathy Measure were administered to a sample of 1,149 individuals from the Italian community. In general, self and partner IPV were moderately correlated. Bayesian regression analysis showed that disinhibition was positively correlated to both self and partner IPV (psychological and physical). In addition, boldness was negatively associated with perpetrated psychological IPV. Interactions by gender showed that meanness was positively related to perpetrated IPV in women (psychological and physical), whereas men with disinhibition features inflicted more physical violence than women. A high externalizing tendency (i.e., disinhibition) is therefore an important correlate of both perpetrated and reported IPV; moreover, boldness was associated with less psychological violence in general, whereas the effect of meanness depended on the gender of the individuals involved. Interestingly, the association between IPV and self-reported delinquent activities was low in magnitude (Spearman's Rho around .20) suggesting limited overlap between these two constructs.

Psychophysiology can help elucidate the structure and developmental mechanisms of psychopathology, consistent with the Research Domain Criteria initiative. Cross-sectional research using categorical diagnoses indicates that P300 is an electrocortical endophenotype indexing genetic vulnerability to externalizing problems. However, current diagnostic systems' limitations impede a precise understanding of risk. The Hierarchical Taxonomy of Psychopathology (HiTOP) overcomes these limitations by delineating reliable dimensions ranging in specificity from broad spectra to narrow syndromes. The current study used a HiTOP-aligned approach to clarify P300's associations with a higher-order externalizing factor versus syndrome-specific manifestations within externalizing and internalizing spectra during middle and late adolescence. Participants from the Minnesota Twin Family Study's Enrichment Sample contributed psychophysiological and clinical data at age 14 (N = 930) and follow-up clinical data at age 17 (N = 913). Blunted target P300 at age 14 was selectively associated with externalizing as manifested at age 17 at the superspectrum level (rather than specific externalizing syndromes). Unlike in prior work, target P300 amplitude was positively associated with age 17 depressive symptoms (once controlling for standard stimuli). No association was observed with lifetime symptoms of childhood externalizing or depression evident by age 14. The results indicate that blunted target P300 elucidates specific risk for the development of late-adolescent/young-adult expressions of general externalizing, over and above symptoms evident by middle adolescence. Additionally, the findings speak to the synergistic utility of studying HiTOP-aligned dimensions using multiple measurement modalities to build a more comprehensive understanding of the development of psychopathology.

Understanding the neurobiological mechanisms involved in psychopathology has been hindered by the limitations of categorical nosologies. The Hierarchical Taxonomy of Psychopathology (HiTOP) is an alternative dimensional system for characterizing psychopathology, derived from quantitative studies of covariation among diagnoses and symptoms. HiTOP provides more promising targets for clinical neuroscience than traditional psychiatric diagnoses and can facilitate cumulative integration of existing research. We systematically reviewed 164 human neuroimaging studies with sample sizes of 194 or greater that have investigated dimensions of psychopathology classified within HiTOP. Replicated results were identified for constructs at five different levels of the hierarchy, including the overarching p-factor, the externalizing superspectrum, the thought disorder and internalizing spectra, the distress subfactor, and the depression symptom dimension. Our review highlights the potential of dimensional clinical neuroscience research and the usefulness of HiTOP, while also suggesting limitations of existing work in this relatively young field. We discuss how HiTOP can be integrated synergistically with neuroscience-oriented, transdiagnostic frameworks developed by the National Institutes of Health, including the Research Domain Criteria (RDoC), Addictions Neuroclinical Assessment (ANA), and NIDA Phenotyping Assessment Battery (NIDA PhAB), and how researchers can use HiTOP to accelerate clinical neuroscience research in humans and other species.

The triarchic model of psychopathy emphasizes the role of three phenotypic personality domains (boldness, meanness, and disinhibition) that have been operationalized using the well-established Multidimensional Personality Questionnaire. The present study sought to further validate the MPQ-Tri scales and examine their temporal stability and predictive validity across two time points (ages 18 and 26) from the Dunedin Multidisciplinary Health and Development Study, a population-representative and longitudinal sample (N = 1,037). This investigation necessitated modification of the MPQ-Tri scales to enable their use in a broader range of samples, including the Dunedin Study. The revised MPQ-Tri scales demonstrated good temporal stability, and correlation and multiple linear regression analyses predominantly revealed associations consistent with theoretical expectations. Overall, the findings provide support for the MPQ-Tri scales as reliable, stable, and valid measures of the triarchic constructs, which provide a unique opportunity to examine highly novel research questions concerning psychopathy in a wide variety of samples.