Two variants of callous-unemotional (CU) traits and psychopathy have been proposed, referred to as primary and secondary. Whereas primary variants are thought to be underpinned by insufficient arousal to emotional cues, secondary variants are thought to develop as a coping mechanism in response to trauma exposure. Compared with adult samples, research on primary and secondary variants in children and adolescents under the age of 18 has only emerged in the past decade, and there is ongoing debate with regards to the identification, defining characteristics, and distinct correlates of these variants. The present systematic review synthesizes the current literature on primary and secondary variants in relation to: (1) constructs used to distinguish and define primary and secondary variants; (2) study population characteristics; (3) data analytic techniques to differentiate variants; and (4) differential associations with theoretically relevant indices related to emotional processing, maltreatment, biomarkers, and behavioral outcomes (e.g., substance use, aggression). This is the first systematic review to examine the growing literature on primary and secondary CU and psychopathy variants among youth. Findings support the distinction between youth with primary versus secondary variants and demonstrate that this distinction is related to unique clinical correlates. Recommendations are made for future research in the field.

已经提出了两种冷酷无情（CU）特征和精神病的变体，称为主要和次要. 虽然主要变异被认为是由对情绪线索的唤醒不足支撑的，但次要变异被认为是作为应对创伤暴露的应对机制而发展起来的。与成人样本相比，对 18 岁以下儿童和青少年的主要和次要变异的研究仅在过去十年中才出现，关于这些变异的识别、定义特征和明显相关性的争论正在进行中。本系统综述综合了有关主要和次要变异的当前文献，涉及以下方面：(1) 用于区分和定义主要和次要变异的结构；(2)研究人群特征；(3) 区分变体的数据分析技术；(4) 与与情绪处理、虐待、生物标志物和行为结果（例如，物质使用、攻击性）相关的理论相关指数的差异关联。这是第一次系统评价，以检查越来越多的关于青年原发性和继发性 CU 和精神病变体的文献。研究结果支持具有初级变异与次级变异的青年之间的区别，并证明这种区别与独特的临床相关性有关。对该领域的未来研究提出了建议。研究结果支持具有初级变异与次级变异的青年之间的区别，并证明这种区别与独特的临床相关性有关。对该领域的未来研究提出了建议。研究结果支持具有初级变异与次级变异的青年之间的区别，并证明这种区别与独特的临床相关性有关。对该领域的未来研究提出了建议。