Abstract
Research regarding callous–unemotional (CU) traits in non-conduct disorder (CD) diagnoses is sparse. We investigated the presence of high CU traits and their associations with quality of life (QoL) in a clinically referred sample of youths with non-CD diagnoses. Parents of 1018 children referred to a child and adolescent psychiatric clinic and rated their child’s CU traits and QoL. Experienced clinicians derived DSM-IV-TR diagnoses based on systematic clinical evaluations of these children. High CU traits compared to low CU traits were present in 38.5 % of the sample, and more often in boys than girls (69.4 vs. 30.6 %, p = .004), and were associated with more police contacts (12.2 vs. 3.5 %, p < .001). Logistic regression analyses revealed that those with diagnoses of autism spectrum disorder (odds ratio; OR = 1.61; 95 % CI 1.24–2.09; p < .001) and disruptive behavior disorder not otherwise specified/oppositional defiant disorder (OR = 4.98; 95 % CI 2.93–8.64; p < .001), but not attention-deficit/hyperactivity disorder (OR = 1.01; 95 % CI .79–1.31; p = .94), were more likely to have high than low CU traits. Those with anxiety/mood disorders were more likely to have low than high CU traits (OR = .59; 95 % CI .42–82; p = .002). In all diagnostic groups, high CU compared to low CU traits were associated with significantly lower QoL, while controlling for gender, age, and comorbidity. As such, high CU traits significantly modify QoL in non-CD disorders.Electronic supplementary materialThe online version of this article (doi:10.1007/s00787-015-0766-5) contains supplementary material, which is available to authorized users.
Highlights
Callous–unemotional (CU) traits are thought to represent the core component of psychopathy, and include symptoms such as lack of feeling guilty, lack of empathy, being very egocentric, showing callous use of others for one’s own gain, and lacking normal emotionality, especially in showing a lack of anxiety [13]
No widely accepted cut-off has been accepted yet, we used a cut-off score of 32 on the Inventory of Callous–Unemotional traits (ICU). This is in line with previous studies [21, 41], in which youths with similar age, with CP, and with autism spectrum disorder (ASD) was included
To examine whether high CU traits were linked to quality of life (QoL), t tests were performed to analyze the relationship between the dichotomous ICU scores and continuous Kidscreen data for the total sample and for each diagnostic group
Summary
Callous–unemotional (CU) traits are thought to represent the core component of psychopathy, and include symptoms such as lack of feeling guilty, lack of empathy, being very egocentric, showing callous use of others for one’s own gain, and lacking normal emotionality, especially in showing a lack of anxiety [13]. CU traits were incorporated in the DSM-5 [2] as a specifier for conduct disorder (CD). The specifier consists of four criteria of which at least two should be met to index a more severe form of CD. Research shows neurobiological underpinnings of psychopathy, in which reduced amygdala responsiveness to distress cues results in reduced empathic response to distress of other individuals (as captured by the callous–unemotional component of psychopathy). Dysfunction in the ventromedial prefrontal cortex and striatum results in deficient decision making and reinforcement learning
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