Trajectories of Alcohol and Marijuana Use Among Primary Versus Secondary Psychopathy Variants Within an Adjudicated Adolescent Male Sample

The study sample consisted of 1,170 male adolescents who had interacted with the justice system; data were collected as part of the Pathways to Desistance project. The study examined subgroup differences via self-reported measures of psychopathic traits and anxiety, aggression, depression, and posttraumatic stress disorder symptoms at baseline and at 6-month follow-up. Finally, the study tested whether groups had different trajectories of alcohol and marijuana use over 4 years, and whether poor impulse control or anxiety mediated these differences. Latent profile analysis identified four groups: low-anxious primary psychopathy, high-anxious secondary psychopathy, anxious only, and low risk. The secondary group had similar levels of aggression and psychopathy to the primary group, but more depression, anxiety, and posttraumatic stress symptoms. The primary and secondary psychopathy variants did not differ in rates of alcohol or marijuana use across adolescence, but alcohol use among secondary variants was specifically mediated via poor impulse control. The findings establish two psychopathy groups that differ meaningfully in their internalizing psychopathology and pathways to alcohol use. (publisher abstract modified)