Thesis
Girls Only: Psychopathy, Emotion Regulation and Aggression.
Words: 4474
Name: Nina Surya Eken
studentnumber: 10359664 Supervisor: Lieke Nentjes
Abstract
Psychopathy is characterized by a pattern of aggressive behavior. Even though there is a rise in girls exhibiting serious aggressive behavior, the majority of studies on psychopathy are focused on male subjects in particular. Therefore this study focuses on girls to provide a better understanding of psychopathic traits in girls. Aggressive behavior can be divided into proactive aggression and reactive aggression. The goal of the current research was to identify the role of psychopathic traits in the kind of aggression expressed by girls. In addition, it was examined whether and to what extent emotion regulation mediates the relationship between psychopathic traits and aggression. It was expected that callous-unemotional traits were associated with overcontrolling emotion regulation, which in turn leads to proactive aggression. Behavioral psychopathic traits were expected to relate to undercontrolled emotion regulation, which in turn was hypothesized to be associated with reactive aggression. Callous-unemotional traits, overcontrolled emotion regulation and proactive aggression were unrelated to each other. However, a link has been found between behavioral psychopathic traits and both types of aggression. Undercontrolled emotion regulation was not related to both behavioral psychopathic traits and reactive aggression .
1. Girls Only: Psychopathy, Emotion Regulation and Aggression. According to Hare (1980) psychopaths can be described as individuals that use violence, manipulation and intimidation to fulfill their own needs. Psychopaths are noted for their failure to regulate inappropriate behaviors, to experience a normal range and depth of emotion and to form meaningful attachments (Cleckley, 1941). The most widely used tool to assess psychopathy is the Psychopathy Checklist—revised (Hare, 1991). According to Hare, the construct has a two-factor structure. The first factor represents the interpersonal and affective components of the disorder. This factor includes: selfishness, empathy, a lack of remorse and coldness. The second factor is the
behavioral aspect of the disorder. This includes impulsivity, thrill seeking, antisocial behavior and an unstable lifestyle. Researchers have not agreed upon the defining features of the construct (Rogers, Duncan, Lynett, & Sewell, 1994). Though theoretical and empirical research has focused on
understanding psychopathy, a debate continues on whether the construct is primarily behavioral-based or personality-behavioral-based (Lilienfeld, 1994).
Even though a lot of studies investigating psychopathy among males, little is known about the applicability of this construct to female populations. Working groups who were engaged in the development of the DSM-5 have emphasized that more research is required into the construct of psychopathy in females (Pardini , Frick , Moffitt, & Building, 2010). Research has shown that
prevalence rate, symptom presentation, and diagnostic comorbidity differ for females as compared to males (Salekin, Rogers, Ustad, & Sewell, 1998). Mulder (1994) found that these females have high rates of comorbid psychiatric disorders, such as depression, anxiety, and suicidal behavior. This author also found that females with psychopathic traits have high rates of marital separation, chronic unemployment and are more dependent upon government agencies for social services in
comparison to females without psychopathic traits. Despite the fact that psychopathy differs in males and females and females with psychopathic traits have many associated problems, there is no special treatment for women.
Before any treatment can be designed, it is necessary to investigate the precursors of psychopathy in females. Not surprisingly, the interest in studying potential precursors of
psychopathy has increased in recent years in an effort to understand the developmental processes (Kruh, Frick, & Clements, 2005). There seems to be a growth in evidence that supports the
presumption that psychopathy can be regarded as a developmental disorder (Nentjes, 2015). Research suggests that interpersonal and affective psychopathy traits, as seen in adults, are very similar to certain characteristics of children with conduct disorder (Frick, O'Brien, Wootton, & McBurnett,1994). These characteristics are called callous-unemotional traits, and include traits such as lack of guilt, lack of empathy and lack of affective expressions. (Frick & White, 2008). The presence of callous–unemotional traits seem to constitute an important subgroup of juveniles with antisocial problems. This subgroup also exhibits a more severe and stable pattern of antisocial
behavior(Viding, Frick, & Plomin, 2007). Not surprisingly, research shows that children with callous-unemotional traits are at risk to develop psychopathy in adulthood (Nentjes, 2015).However, the research on potential precursors of psychopathy is done in male adolescents and not in female, therefore it is unclear whether psychopathy can also be regarded as a developmental disorder in females.
Further research could provide important information for developing effective treatments for both girls and women with elevated levels of psychopathic traits.
1.2 The Effect of Psychopathic Traits on Aggression.
Psychopathy is characterized by a pattern of aggressive behavior (Lahey & Waldman, 2012). Therefore, psychopaths are at a particularly high risk to re-offend. Since a reduced likelihood of recidivism is the main purpose of forensic psychological treatments, aggression is an important treatment target. Aggressive behavior includes proactive aggression and reactive aggression. Proactive aggression represents planned and goal-oriented aggression motivated by expected
gratification. Reactive aggression represents aggressive responses to external behavior that is perceived as threatening (Fite, Stoppelbein, & Greening, 2009).
Research suggests that individuals that are prone to use reactive aggression as a response to unpleasant external stimuli tend to be more antisocial and show more dysfunctional behavior, in comparison to individuals that are less amendable to show reactive aggression (Valiente et al., 2003). This could be due to the presence of an increased level of impulsivity which is related to reactive aggression (Brent, Oquendo, Birmaher, Greenhill, Kolko, & Stanley, 2003). Furthermore, research shows that callous-unemotional traits in juveniles are associated with proactive aggression, yet not with reactive aggression (Frick, Cornell, Barry, Bodin, & Dane, 2003; Marsee & Frick, 2007).
Hitherto, research suggests that callous-unemotional traits are associated with proactive aggression, whereas the behavioral aspect of psychopathy is related to reactive aggression.
1.3 Emotion Regulation as Mediator Between Psychopathic Traits and Aggression. a. The Effect of Psychopathic Traits on Emotion Regulation.
A fairly robust body of literature supports the relationship between psychopathic traits in juveniles and aggression. Very little is known, however, about the mechanisms underlying this association. Potentially, psychopathy in youth is associated with aggression due to aberrances in emotion regulation. Emotion regulation can be described as the attempts people make to maintain, inhibit and enhance emotional experience and expression (Bridges, Denham, & Ganiban, 2004). In general, it is found that problems in emotion regulation predict aggressive behavior (Eisenberg et al, 1996; Eisenberg, 2000; Sullivan, Helms, Kliewer, & Goodman, 2010).
Robin, John, Caspi, Moffitt and Stouthamer-Loeber (1996) identified three emotion regulation strategies. The adaptive strategy, the maladaptive undercontrolled strategy and the maladaptive overcontrolled strategy. The adaptive strategy is characterized by the regulation of emotions in a constructive way. The use of this strategy does not put someone at risk for self-harming or socially self-harming behavior and the person is generally free of psychopathology.
Individuals that use an maladaptive strategy of emotion regulation are not able to apply problem-focused coping strategies. The undercontrolled strategy is characterized by immediate and disinhibited expression of emotions and affects. Individuals that use the undercontrolled strategy seem to be highly impulsive, have short attention spans, externalize and behave quite antisocial. The overcontrolled strategy is characterized by excessive impulse control and inhibition of emotion. Individuals that use the overcontrolled strategy tend to be rigid and have a lack of empathy (Robin , John, Caspi, Moffitt and Stouthamer-Loeber, 1996).
To our knowledge, no research has investigated how these strategies relate to psychopathic traits in juveniles. It might be expected that behavioral and callous-unemotional traits can be
differentially linked to a poor emotion regulation (Eisenberg, 2000). Juveniles that show psychopathic behavioral traits could be expected to use the undercontrolled strategy, as this psychopathy
component involves impulsivity and low behavioral control (Clark & Watson 1999). In contrast, callous-unemotional traits might be associated with the overcontrolled strategy of emotion regulation. Inasmuch, individuals that practice the overcontrolled strategy show characteristics of callous-unemotional traits, such as little empathy and comprehension of others emotions as adults(Kagan, 1998).
b. The Effect of Emotion Regulation on Aggressive Behavior.
Empirical evidence seems to affirm that maladaptive emotion regulation is associated with aggressive behavior (Eckhardt, Jamison,& Watts, 2002; Norstrom & Pape, 2010). Recent studies of reactive aggression among juveniles seem to indicate that aggression is used in an attempt to cease the sense of emotional vulnerability which the perpetrator is unable to regulate (Camodeca,
Goossens, Terwogt, & Schuengel, 2002; Barry, Thompson, Lochman, Adler,& Hill, 2007). In situations where individuals use reactive aggression, it permits the individual to externalize their frustration and regulate others’ behavior (Tager, Good, & Brammer, 2010). Several studies in patients with close head injuries, brain tumors, stroke lesions that caused specific brain damage which resulted in
emotional disinhibition show more inappropriate social behavior. Starkstein & Robinsons (1997) investigated the mechanism of disinhibition syndrome after brain lesions. Disinhibition syndromes result in inappropriate social or even full-blown antisocial behavior. This might be the result from lesions to specific brain areas which are normally used to regulate emotions . Patients with closed head injuries, brain tumors, stroke lesions, and focal epilepsy have demonstrated a significant association between emotional disinhibition and reactive aggression (Starkstein & Robinson,1997). Given the findings mentioned above, there appear to be indications that individuals that use the undercontrolled type of emotion regulation also utilize reactive aggression, since they are highly impulsive and tend to externalize their emotions.
There has been little research on the relation between the overcontrolled strategy of emotion regulation and aggressive behavior. Moreover, results are solely based on boys. There is evidence to suggest that inflexible use of emotion suppression strategies can lead to aggressive behavior. Furthermore Norstrom and Pape (2010) found that participants' level of suppressed anger was also directly related to their involvement in violent behavior. As previous research seems to point out, individuals that use the undercontrolled strategy show more reactive aggression and the individuals that use the overcontrolled strategy express more proactive aggression. To our
knowledge these constructs have never been studied in relation to psychopathy.
c. Scientific Relevance and Research Question
Research so far associates callous-unemotional traits with proactive aggression and
psychopathic behavior traits with reactive aggression. Further research is needed as we know little about the mechanisms that underlie this relationship. Moreover, what is known about the
mechanisms is based on male subjects.
There seems to be evidence for the notion that psychopathy might be linked to the manner of regulating emotion. Callous-unemotional traits could be linked to an overcontrolled way of regulating emotions. Individuals that use the overcontrolled strategy might express more proactive aggression.
The behavioral psychopathic traits could be related to under-regulating emotions. Individuals that use the undercontrolled strategy seem to show more reactive aggression. To our knowledge these associations have never been investigated in previous research.
Taking into account the above mentioned, we hypothesize that callous-unemotional psychopathic traits are associated with proactive aggression. Furthermore, we expect that this relationship is mediated by an increased tendency to overcontrol emotions. In addition, we hypothesize that behavioral psychopathic traits are associated with reactive aggression.
Furthermore, we expect that this relationship is mediated by a tendency to undercontrol emotions. The expectations are visualized in Figure 1.
2. Method. 2.1 Sample Characteristics.
The current research is part of the Female National Conduct Study (Fem-NAT) research, an ongoing research project on conduct disorder in girls during childhood and adolescence. It aims at studying the phenotypic subgroups, underlying biological and cognitive mechanisms leading to
Figure 1: Emotion regulation Model for Aggressive Behavior in Psychopathy
Overcontrolled Strategy of Emotion Regulation
Callous-unemotional Traits
Proactive Aggression
Undercontrolled Strategy of Emotion Regulation
pathological aggression in females .The research was approved by the Medical Ethical committee of the Vrije Universiteit medical center in Amsterdam.
We recruited 91 females from three clinical settings and one school. The clinical settings are closed or partially closed. These girls have problems at home, at school and in their free time often due to their behavior. Compared to their peers, they need special attention, treatment and support which their parents / guardians cannot provide. The girls that are recruited in the school are girls without any psychological and behavioral problems. Participants are approached after the Fem-NAT team received an informed consent signed by their parents. A second informed consent was
obtained from each participant prior to the start of the study. Participants received a few gifts or a €
10,- VVV voucher and a small gift as compensation.
The inclusion criteria were; an age between nine and 18 and a sufficient understanding of the Dutch language. Exclusion criteria were; the presence of schizophrenia, psychotic symptoms, autistic spectrum disorder, neurological impairment and an IQ beneath 70. We tried to ensure that the spread in scores were as widely ranged as possible by the way of recruiting the girls, the inclusion criteria and the exclusion criteria. Twenty-seven of the participants were excluded from participation due to the exclusion criteria. Fifteen girls refused to take part or left the institution. The final sample consisted out of 49 females.
A post hoc power analysis was conducted using G*Power software to calculate the research's power to detect differences in test scores, based on the parameters of the present sample (N = 49; two levels in the within subject factors, [alpha] = 0.05, and 1-ß = 0.75). This analysis demonstrated the current research to have the power to detect a small to medium effect size (f = 0.15).
2.2 Questionnaires.
The constructs were measured by self-report questionnaires. The independent variables (callous-unemotional and behavioral psychopathic traits) will be measured with the Youth Psychopathic Traits Inventory (Baardewijk et al., 2010). The dependent variables (proactive
aggression and reactive aggression) will be measured with the score on the Reactive-Proactive Aggression Questionnaire (RPQ; Raine et al., 2006). The mediator (emotion regulation) will be measured with the score on the Emotion Regulation Questionnaire (ERQ; Gross & John, 2013).
2.2.1 Emotion Regulation Questionnaire (ERQ).
The ERQ will be used to assess girls’ differences in the use of two emotion regulation
strategies: undercontrolling and overcontrolling emotions (Gross & John, 2003). The ERQ is a 10-item questionnaire. Research showed that the ERQ has an adequate test–retest reliability (r = .69)
(Gullone & Taffe, 2012).The ERQ had acceptable internal consistency for both the expressive and suppression subscales (respectively; α = .69 and .71).
2.2.2 Reactive-Proactive Aggression Questionnaire (RPQ).
Aggression will be measured using the Dutch version of the RPQ. This is a 23-item self-report questionnaire that consists out of two subscales (reactive and proactive aggression; Raine, 2006). Research showed that the internal consistency, for the subscales and the total scale is high to excellent (α ≥. 83; (Cima, Raine,Meesters, &Popma, 2013; Raine, 2006). In this study the internal consistency was good (α ≥.81).
2.2.3 Youth Psychopathic Traits Inventory (YPI).
The Dutch version of the YPI is a 50-item self-report which measures psychopathic traits in adolescents. The YPI contains ten sub-dimensions which measure the core traits of psychopathy (Hillege, Das, &De Ruiter, 2010). We will use the 15- item callous-unemotional dimension which consists out of remorselessness, unemotionality and callousness, and we will use the 15-item Behavioral (Impulsive-irresponsible) dimension which consists out of Thrill-seeking, Impulsiveness and Irresponsibility. Hillege, Das and De Ruiter(2010) showed that the internal consistencies for the
dimensions are overall acceptable. The YPI sub-dimensions had an questionable internal consistency in this study (callous-unemotional dimension; α= 0.67, behavioral dimension; α= 0.62).
2.3 Procedure.
Testing occurred in a low-stimulus area. The participants were tested individually. Each participant was tested by two experimenters. It was asked if there were any questions regarding the participant information. Next, the informed consent was signed by the participant. After signing the informed consent, the questionnaires were administered. The questionnaires were read to children under twelve. Children above twelve were allowed to choose the if they would like to read it by themselves or if they prefer that the questionnaires were read to them.
2.4 Data Analysis
The method of Baron and Kelly (1986) will be used to examine the mediation. This mediation procedure will be performed twice, once for each model described in figure one.
The first step will be an analysis to investigate whether psychopathic traits (independent variable) are a significant predictor for the kind of aggression (dependent variable) that is expressed. The second step is an analysis to investigate if psychopathic traits (independent variable) are a significant predictor of the kind of emotion regulation (the mediator). If they are not associated, emotion regulation cannot be a mediator. In the last step the dependent variable (aggression) will be regressed on both the mediator (emotion regulation) and independent variable (aggression). This last step is used to investigate whether emotion regulation is a significant predictor of the kind of
aggression, while controlling for psychopathic traits. This step involves demonstrating that when emotion regulation and psychopathic traits are used at the same time to predict the kind of aggression, the previously significant association between psychopathic traits and the kind of aggression is decreased. Such findings would lead to the conclusion that emotion regulation mediates the relationship between psychopathic traits and the type of aggression.
Full mediation could occur if the inclusion of emotion regulation would decreased the relationship between psychopathic traits and the type of aggression to zero. Since this rarely happens, it is more likely that the relation between psychopathic traits and the type of aggression becomes a weaker, yet still significant relation with the inclusion of emotion regulation. This would mean that emotion regulation could be a partial mediator. Sobel’s test will be calculated to
determine if the relationship between psychopathic traits and the type of aggression has been significantly reduced after inclusion of emotion regulation. This test assesses whether emotion regulation is a significant mediator.
3. Results.
Table 1 shows an overview of participant characteristics and correlations of the constructs.
Table 1.
Participant Characteristics and Correlations of the Constructs
M (SD) 1 2 3 4 5 6 7
1 Age 14,0 (1,9)
2 Reactive Proactive
Questionnaire; reactive score 12,7 (4,8) -.12* 3 Reactive Poactive
Questionnaire; proactive score 5,1 (4,2) .05 .18* 4 Emotion Regulation Questionnaire; undercontrolled score 27,0 (7,7) .09 -.03 .14 5 Emotion Regulation Questionnaire; overcontrolled score 16,4 (6,0) .03 -.05 .08 -.10
6 Youth Psychopathic Traits Inventory; behavioral psychopathic traits score
36,1
(12,2) -.04 .13* .09 .08 -.04
7 Youth Psychopathic Traits Inventory: Callous-unemotional score
27,9
(8,93) .01 .06 .09 -.07 .04 .19*
3.1 The Influence of Callous-unemotional Traits and Behavioral Psychopathic Traits on Aggression. The regression model with callous-unemotional traits as independent variable and aggression as dependent variable was significant, F (1, 40) = 3,20, p = .05, b * = 0.23, t = 2,93. Therefore callous-unemotional traits (independent variable) is a significant predictor for the amount of aggression (dependent variable) that is expressed. Further investigation can be conducted into the relationship between callous-unemotional traits and proactive aggression.
The regression model behavioral psychopathic traits as independent variable and aggression as dependent variable was significant, F (1, 42) = 5,03, p < .05, b * = 0.41, t = 2,35. Therefore behavioral psychopathic traits (independent variable) is a significant predictor for the amount of aggression (dependent variable) that is expressed. Further investigation can be conducted into the relationship between behavioral psychopathic traits and reactive aggression.
3.2 Overcontrolled Emotion Regulation as a Mediator between Callous-unemotional Traits and Proactive Aggression.
The regression model with callous-unemotional traits as independent variable and proactive aggression as dependent variable was not significant, F (1, 40) = 1.86, p = .18, b * = 0.23, t = 4,85, 95% CI [0.08, 0.10].Therefore, the regression model cannot explain the degree of proactive aggression in girls.
The regression model with callous-unemotional traits as independent variable and
overcontrolled emotion regulation asdependent variable was not significant, F (1,42) = 2,08, p = .16, b * = 0.22, t = 2.22, 95% CI [-0.04, -0.05] and therefore cannot predict the use of overcontrolled emotion regulation.
3.3 Undercontrolled Emotion Regulation as a Mediator between Behavioral Psychopathic Traits and Reactive Aggression.
The regression model with reactive aggression as dependent variable and t behavioral psychopathic traits as independent variables was significant, F (1, 40) = 4.93, p = 0.03. Figure 2
visualizes the relationship between reactive aggression and behavioral psychopathic traits. The regression model can be used to predict the degree of reactive aggression in girls, but the prediction is low in terms of strength: 11 percent of the differences in score on reactive aggression can be predicted by the score on behavioral psychopathic traits (R² = 0.11 ). Behavioral psychopathic traits, b * = 0.33, t = 2.22, p = .03, 95% CI [0.12, 0.13] has a significant, moderately strong correlation with reactive aggression. Every point extra on behavioral psychopathic traits increases the score of reactive aggression by approximately 0.13. For this effect, it is assumed that all other variables were kept constant. The regression model with undercontrolled emotion regulation as dependent variable and behavioral psychopathic traits as independent variables was not significant, F (1,42) = .62, p = .44, b * = 0.13, t = 3.47, 95% CI [0.07, 0.08]. The regression model cannot be used to predict the use of undercontrolled emotion regulation.
The regression model with reactive aggression as independent variable and undercontrolled emotion regulation as dependent variables was not significant, F (1, 40) = 3.81, p = 0,08,b * = 0.22, t = 2.45, 95% CI [-0.02, -0.04]. The regression model is unusable to predict the extend of reactive
4.Discussion.
The present research investigated whether there was a link between the type of psychopathic traits and the type of aggression in girls. As expected, there appeared to be a
relationship between the two types of psychopathy traits and aggression. Results showed that the more psychopathic behavioral traits a girl had, the more likely she was to express reactive
aggression. This is consistent with previous studies (Lahey & Waldman, 2012; Valiente, Eisenberg, Smith, Reiser, Fabes, & Losoya, 2003; Frick, O'Brien, Wootton, & McBurnett,1994; Viding, Frick, & Plomin, 2007). Surprisingly though, callous-unemotional traits were not related to proactive aggression. This is striking because previous research has shown that callous-unemotional traits in juveniles are associated with proactive aggression (Frick, Cornell, Barry, Bodin, & Dane, 2003; Marsee & Frick, 2007). Moreover, Frick and White (2008) revealed that the presence of callous and
unemotional traits designates an subgroup of antisocial youth with a particularly severe and stable pattern of aggressive behavior.
In addition, it was investigated whether emotion regulation was a mediator between the type of psychopathy and the type of aggression. No evidence was found for the presumption that emotion regulation serves as a mediator between these two. This is not entirely consistent with previous research. Empirical evidence seemed to affirm that maladaptive emotion regulation is associated with aggressive behavior (Eckhardt, Jamison,& Watts, 2002; Norstrom & Pape, 2010). In particular, research showed that behavioral psychopathic traits, undercontrolled emotion regulation and reactive aggression are related (Camodeca, Goossens, Terwogt, & Schuengel, 2002; Barry, Thompson, Lochman, Adler,& Hill, 2007). The relationship between callous-unemotional traits, overcontrolled emotion regulation and proactive aggression is still a neglected area of research. Previous research suggests that there might be a link between the overregulation of emotions and aggressive behavior (Roberton, Daffern, & Bucks, 2012). Though, there is still very little known about this relation. What needs to be kept in mind, however, is that what has been known about the
relationship between psychopathic traits, aggression and maladaptive emotion regulation is solely based on an adult population.
It is possible that the use of self-report questionnaires has influenced the results. The downside of self-report questionnaires is that children tend to give socially desirable answers. We have tried to minimize this by starting that everything they say is confidential. We wanted to make them feel comfortable by having a short conversation prior to the start of the study. In addition, it could be that children are not aware of their own undesirable behavior. In future research, this could be solved by including the parents/legal guardians.
Another alternative interpretation is that we measured what we were trying to measure, but the expected relationships did not exist in the sample. After all, it could be that the relationship between callous-unemotional traits and aggression actually differs between boys and girls. In that case, it would mean that the degree of proactive aggression which girls express is not influenced by callous-unemotional traits. In addition, it could be that emotion regulation does not play a role in aggression in girls. However, earlier research (Kimonis, Frick, Fazekas,& Loney, 2006; Marsee, Silverthorn, & Frick, 2005) found that associations amongst aggression, psychopathic traits and coping did not differ for boys and girls. Naturally, further research is necessary before any conclusion can be drawn.
Another possible explanation of the unexpected results may be that we used a convenience sample. We have contacted institutions, clubs and schools for permission to ask the girls at their location if they would like to participate. The research was eventually carried out at three institutions and one school. As a result, there is no guarantee that the results we obtained are representative for the population. After all, it may be that certain elements in the population have been less likely to participate than others since we did not use a probability sample. Moreover, it is not clear whether the people who did not participated would score differently on the variables in the questionnaire than those who have participated. The scores in this sample, however, were similar to previous studies (Frick, Kimonis, Dandreaux, Jamie, & Farell, 2003; Frick, Bodin, & Barry, 2000; Kimonis, Frick,
Fazekas ,& Loney, 2006) in which research was done in clinical samples and significant correlation were found between psychopathy and external correlates
.
The unexpected results could also be due to the power in this study. We have conducted an a priori power analyses with G*power and needed at least 56 girls to achieve an adequate power [alpha] = 0.05, and 1-ß = 0.80). In the current study, however, only 49 girls participated. This resulted in a lower power [alpha] = 0.05, and 1-ß = 0.74). Hence the lower power, we cannot rule out that we are dealing with a "false negative" result. This would mean that this should be re-examined with a larger sample size to investigate if there is a relationship between psychopathic traits, emotion regulation and aggression. However, since there was a limited timeframe we could not recruit more girls. Therefore this research could be a good starting point for further research into the relation psychopathic traits, emotion regulation and aggression in girls.
In addition, the reliability of the scales were on the low side. Yet, our methodology allowed us to be in a position to find effects on reactive aggression. A higher confidence level could also be achieved by means of a larger sample.
Despite the fact that psychopathy seems to be a heterogeneous disorder, there is no special treatment for women. Before any treatment can be designed, it is important to perform further research into the precursors of psychopathy in girls. As far as we know, this is the first research on the relation between psychopathy, emotion regulation and aggression in girls.
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