A systematic review of callous-unemotional traits and attachment in children and adolescents

Abstract

ABSTRACT Youth with callous-unemotional (CU) traits are at risk for maladaptive outcomes across development. The caregiver-child attachment relationship may be a precursor to CU traits. This is the first systematic literature review of the association between attachment and CU traits. Methods The systematic review and meta-analysis included 17 research articles from 1994 to 2022. Results were summarized by developmental periods. Results Attachment insecurity was associated with CU traits across development (r = .17). This association was marginally stronger for high-risk samples (e.g., clinical, justice) and for continuous attachment measures versus coding schemes. From early to middle childhood, attachment disorganization was associated with CU traits (r = .17). Implications Research on attachment and CU traits in childhood is still in its infancy. Changes in attachment measures from childhood to adolescence make developmental comparisons difficult. Results suggest attachment as a potential developmental mechanism for youth with CU traits, however, the area requires more research.