Original definitions of psychopathy suggest the existence of two variants that present with distinct clinical features among antisocial adults, but whether these clinical differences originate early in life or emerge at some point during childhood remains uncertain. We examined if primary and secondary variants follow distinct developmental trajectories of theoretically relevant clinical features among children with conduct problems (CP). Participants were 370 children (40.3% girls) with CP initially aged 8.49 years old in average (s.d. = 0.93). Variants indicators (callous-unemotional [CU] traits and anxiety [ANX]) and clinical features were measured at six yearly assessments. A dual trajectory modelling approach was used to identify groups and group memberships were entered in conditional growth models predicting trajectories of clinical features. Four groups were identified: CP-only, anxious (CP + ANX), primary (CP + CU), and secondary (CP + CU + ANX). Both variants showed higher initial levels of impairment than the CP-only group on most features. Compared to the primary variant, membership to the secondary variant was associated with more stable patterns of CP, oppositional problems, narcissism-grandiosity and impulsivity-irresponsibility traits. Moreover, children from the secondary variant showed higher initial levels of impairment in terms of cognitive abilities, depression, victimization, and dependency to teachers, with non-significant effects on the slope parameters suggesting that these early differences persist across development. In addition to showing distinct clinical features relatively early in childhood, children from the secondary variant of psychopathic traits are at high risk of experiencing an increasing psychopathological burden across childhood. The early identification and treatment of these children therefore appears particularly important.

精神病的原始定义表明存在两种在反社会成人中表现出不同临床特征的变异，但这些临床差异是起源于生命早期还是在儿童时期的某个时候出现仍不确定。我们检查了主要和次要变异是否遵循具有行为问题 (CP) 的儿童的理论相关临床特征的不同发展轨迹。参与者是 370 名患有 CP 的儿童（40.3% 为女孩），最初平均年龄为 8.49 岁（sd = 0.93）。变量指标（冷酷无情 [CU] 特征和焦虑 [ANX]）和临床特征在六次年度评估中进行测量。使用双轨迹建模方法来识别组，并在预测临床特征轨迹的条件生长模型中输入组成员。确定了四组：仅 CP、焦虑 (CP + ANX)、初级 (CP + CU) 和次级 (CP + CU + ANX)。在大多数功能上，这两种变体都显示出比仅 CP 组更高的初始损伤水平。与主要变体相比，次要变体的成员资格与更稳定的 CP 模式、对立问题、自恋-浮夸和冲动-不负责任的特征相关。此外，来自第二变体的儿童在认知能力、抑郁、受害和对教师的依赖方面表现出较高的初始损伤水平，对坡度参数的影响不显着，表明这些早期差异在整个开发过程中持续存在。除了在童年时期相对较早地表现出明显的临床特征外，来自精神病特征的次要变异的儿童在整个童年时期都面临着日益增加的心理病理负担的高风险。因此，对这些儿童的早期识别和治疗显得尤为重要。