Understanding and treatment of antisocial behavior have improved through efforts to subtype individuals based on similar risk factors and outcomes. In particular, the presence of psychopathic traits is associated with distinct etiological factors and antisocial behavior that begins early in life, is aggressive, persistent, and less likely to normalize with traditional treatments, relative to individuals low on psychopathy or its childhood precursor, callous-unemotional (CU) traits. However, important distinctions can be made within individuals with CU/psychopathic traits according to the presence of elevated anxiety symptoms and/or adverse childhood experiences, known as secondary psychopathy/CU traits. This paper provides a broad and brief overview of theory and empirical literature supporting the existence of secondary psychopathy/CU variants as a distinct subtype of childhood antisocial behavior. It outlines the Emotionally Sensitive Child-Adverse Parenting Experiences-Allostatic (Over)Load (ESCAPE-AL) model for the developmental psychopathology of secondary psychopathic/CU traits and discusses research and theory supporting this perspective. Future research directions for testing this conceptual model and its implications for assessing and treating high-risk individuals with secondary CU/psychopathic traits are discussed.

通过根据相似的风险因素和结果对个人进行分类，对反社会行为的理解和治疗得到了改善。特别是，精神病特征的存在与独特的病因和反社会行为有关，这些行为在生命早期就开始了，具有攻击性、持续性，并且与精神病态程度低的个体或其童年前兆、冷酷无情的个体相比，用传统治疗不太可能正常化。不情绪化（CU）特征。然而，根据是否存在升高的焦虑症状和/或不良童年经历（称为继发性精神病/CU 特征），可以对具有 CU/精神病特征的个体进行重要区分。本文对支持继发性精神病/CU 变体作为儿童反社会行为的独特亚型存在的理论和实证文献进行了广泛而简短的概述。它概述了用于继发性精神病/CU 特征的发展精神病理学的情绪敏感儿童-不良父母体验-平衡（过度）负荷（ESCAPE-AL）模型，并讨论了支持这一观点的研究和理论。讨论了测试这一概念模型的未来研究方向及其对评估和治疗具有继发性 CU/精神病特征的高风险个体的影响。