A Short-Term Intervention for Adolescents with Callous-Unemotional Traits and Emotion-Processing Deficits

Abstract

Introduction: Research documents a robust relation between callous-unemotional (CU) traits and impairments in emotion-processing in youth, yet few evidence-based treatments targeting these deficits exist for youth with CU traits. This study examined a novel Emotion-Processing Skills Training (EPST) to target emotion recognition and perspective-taking deficits in adolescents with CU traits through an additive design. Methods: Fifty-six adolescents (Mage = 16.54, SD = .57, 83.9% male, 67.9% White/Caucasian) attending a voluntary residential program received treatment as usual (TAU) or the EPST intervention plus TAU (EPST + TAU) in a partially randomized trial. Assessments were conducted at four time-points, and they involved adolescent-, parent-, peer-, and staff-report. Outcomes of interest included emotion recognition, perspective-taking, CU traits, empathy, prosocial behaviors, social problems, and externalizing problems. Results: Participants who received EPST significantly improved more on perspective-taking at post-treatment than those who only received TAU. Those who only received TAU significantly declined on self-reported empathy and prosocial behaviors from baseline to 12-week follow-up, but those who received EPST declined less or had minimal change. Participants across conditions improved on self-reported CU traits, social problems, and externalizing problems and parent-reported CU traits, social problems, and externalizing problems across time. Discussion: The EPST intervention yielded largely comparable changes to TAU, but in some cases, EPST may have buffered participants from decline in their affective, social, and behavioral functioning. Implications for treatment of adolescents with CU traits are discussed.