Treatment of youth and adults with psychopathic traits detained in forensic settings: A systematic review

Individuals with psychopathic traits detained in forensic settings are considered a difficult-to-treat population, but empirical support for this claim has not been systematically evaluated. This systematic review aimed to answer two research questions for both youth and adults detained in forensic settings: Are specialized (psycho)therapeutic interventions more effective than Treatment As Usual in (1) reducing psychopathic traits; and (2) reducing criminal recidivism in individuals with high psychopathic traits? Literature searches yielded five studies, involving 653 youth (four studies: two assessing the changeability of psychopathic traits; two assessing criminal recidivism) and 64 adults detained in forensic settings (one study assessing criminal recidivism). Regarding the changeability of psychopathic traits, one study showed a reduction of psychopathic traits for treatment participants in comparison with controls, while the other did not find differences between groups. Regarding criminal recidivism, studies with youth showed that criminal recidivism could be reduced after the delivery of psychotherapeutic interventions, while the study with adults found that treatment could reduce the severity of subsequent offenses, but not recidivism per se. Although scarce and limited, these findings presented promising treatment outcomes, especially in youth, stressing the need to develop evidence-based interventions to this high-risk population. (PROSPERO-CRD42021240218).