“Double, Double, Toil and Trouble?” The Psychopathy-Substance Abuse Nexus in Justice-Involved Youth and Its Implications for Risk, Need, and Responsivity

The present study examined the psychopathy-substance abuse nexus in a diverse Canadian sample of 420 justice-involved youth. The Psychopathy Checklist Youth: Version (PCL: YV) and a series of clinical and criminogenic substance abuse variables—assembled into a composite score that was corrected for missing indicators—were rated from court and treatment files and community recidivism was captured from criminal records. PCL: YV total, lifestyle, and antisocial facet scores showed strong convergence with clinical and criminogenic substance abuse indicators. Cox regression survival analyses demonstrated that certain indicators and the corrected composite incrementally predicted violent and general recidivism, controlling for PCL: YV total score across gender and ethnoracial groups. Kaplan–Meier survival analyses demonstrated that high psychopathy youth with medium or high substance-related concerns had steeper recidivism trajectories than low psychopathy youth with similar substance concerns. Results underscore the clinical and risk relevance of substance abuse and its intersection with juvenile psychopathy.