Callous-unemotional Traits Research Articles

Punishment and Reward Sensitivity in Risk-Taking as Potential Mechanisms Explaining the Relationships Between Childhood Callous-Unemotional Traits and Adolescent Substance Use in a Longitudinal Cohort Study Sample.

Childhood callous-unemotional (CU) traits are associated with a neurocognitive response style of high reward and low punishment sensitivity, which may make these children particularly vulnerable to substance misuse. However, the mechanisms explaining the link between CU traits and substance use are poorly understood. This study investigated the mediating influences of reward and punishment sensitivity on the association between childhood CU traits and adolescent substance use. Using data from the UK Millennium Cohort Study, mediation analyses were conducted to investigate the potential indirect effects of age 14 reward and punishment sensitivity in risk-taking on the relationships between age 11 CU traits and alcohol, cannabis, and other illicit drug use at age 17. No direct effects of CU traits on substance use were found when accounting for gender, baseline alcohol use, poverty, emotional symptoms, conduct problems, hyperactivity, and verbal ability at age 11. Indirect effects of increased reward sensitivity on the relationship between CU traits and increased use were seen for alcohol, cannabis, and other drugs. There was a significant indirect effect of reduced punishment sensitivity on the relationship between CU traits and increased alcohol use, but not cannabis or other substance use. Findings suggest that reward and punishment sensitivity may have independent effects on decision-making processes contributing to adolescent substance use. Prevention and early intervention for substance use should consider modifying intervention strategies to fit the needs of adolescents with a callous interpersonal style and a neurocognitive profile characterized by a high drive for rewards and low risk aversion.

Gender Differences in Co-developmental Trajectories of Internalizing and Externalizing Problems: A 7-Year Longitudinal Study from Ages 3 to 12.

The co-occurrence of externalizing and internalizing problems is acknowledged, but gender differences remain unclear. The present study examines gender differences in the longitudinal relationships between conduct and emotional problems throughout childhood. The sample, drawn from the ELISA project, included 2368 children (48.1% girls; ages 3-12). Latent growth curve models were employed to analyze the trajectories of parent-reported conduct problems and emotional symptoms separately, while parallel process latent growth curve models were utilized to compare joint trajectories. The decrease in conduct problems was consistent for girls, but not for boys. High initial emotional symptoms predicted a slower increase in emotional symptoms over time for girls. Parental positivity was a protective factor for conduct problems in girls. Grandiose-deceitful traits were more related to conduct problems in girls, while callous-unemotional traits were related to emotional symptoms in boys. This study highlights the importance of considering gender in childhood conduct and emotional problems.

Child Maltreatment Increases the Risk for Callous-Unemotional Traits: A Three-Level Meta-Analytic Review.

Callous-unemotional (CU) traits are characterized by lack of remorse and guilt, lack of empathy, and shallow and deficient emotions. A growing body of research has examined the association between child maltreatment and CU traits. However, empirical findings on this association are inconclusive. Therefore, this meta-analytic review aimed to examine the overall association between child maltreatment and CU traits and potentially moderating variables. After searching five databases (Web of Science, ScienceDirect, PubMed, MEDLINE, and CNKI), a total of 37 studies (N = 26,010 participants) yielding 165 effect sizes were synthesized in three-level meta-analytic models. Results showed that child maltreatment is significantly and positively related to CU traits (mean r = .183; p < .001). Moderator analyses showed that this association is larger in females than in males, larger in community samples (r = .243) than in clinical samples (r = .073), and in terms of CU trait dimensions stronger for callousness (r = .251) than for uncaring (r = .134) and unemotional dimensions (r = .050). It is concluded that child maltreatment is a risk factor for the development of CU traits and discussed that interventions for CU traits in antisocial groups should be aware of the environmental influence of interpersonal trauma resulting from childhood maltreatment experiences.

Investigating cross-sectional and longitudinal relationships between brain structure and distinct dimensions of externalizing psychopathology in the ABCD sample.

Externalizing psychopathology in childhood is a predictor of poor outcomes across the lifespan. Children exhibiting elevated externalizing symptoms also commonly show emotion dysregulation and callous-unemotional (CU) traits. Examining cross-sectional and longitudinal neural correlates across dimensions linked to externalizing psychopathology during childhood may clarify shared or distinct neurobiological vulnerability for psychopathological impairment later in life. We used tabulated brain structure and behavioural data from baseline, year 1, and year 2 timepoints of the Adolescent Brain Cognitive Development Study (ABCD; baseline n = 10,534). We fit separate linear mixed effect models to examine whether baseline brain structures in frontolimbic and striatal regions (cortical thickness or subcortical volume) were associated with externalizing symptoms, emotion dysregulation, and/or CU traits at baseline and over a two-year period. The most robust relationships found at the cross-sectional level was between cortical thickness in the right rostral middle frontal gyrus and bilateral pars orbitalis was positively associated with CU traits (β = |0.027-0.033|, pcorrected = 0.009-0.03). Over the two-year follow-up period, higher baseline cortical thickness in the left pars triangularis and rostral middle frontal gyrus predicted greater decreases in externalizing symptoms ((F = 6.33-6.94, pcorrected = 0.014). The results of the current study suggest that unique regions within frontolimbic and striatal networks may be more strongly associated with different dimensions of externalizing psychopathology. The longitudinal findings indicate that brain structure in early childhood may provide insight into structural features that influence behaviour over time.

Daily Associations between Parental Warmth and Discipline and Adolescent Conduct Problems and Callous-Unemotional Traits.

Past longitudinal research has demonstrated links between parenting behaviors and adolescent conduct problems (CP) and callous-unemotional (CU) traits on macro timescales (e.g., years). Less is known about daily fluctuations in parenting behaviors and adolescent CP and CU traits, as well as their daily associations on a micro timescale. This study investigated thedaily reciprocal associations between three key dimensions of parenting behaviors-parental warmth, inconsistent discipline, and non-harsh discipline-and adolescent CP and CU traits, and explored potential moderating effects of person-mean levels of these parenting behaviors on within-person cross-day links. Participants included an ethnically-racially diverse low risk community sample of 86 adolescents (Mage = 14.5years, 55% female, 45% non-White) who completed daily reports over 1month regarding their perceived parenting behaviors and their own levels of CP and CU traits (2056 total observations). Results from dynamic structural equation modeling showed that at the within-person level, higher than average levels of inconsistent discipline were linked to higher than average levels of CU traits the next day. Among adolescents with higher person-mean levels of parental warmth and non-harsh discipline, daily parental warmth and non-harsh discipline were protective against CU traits. Moreover, among adolescents with higher person-mean levels of parental warmth, adolescent CU traits also evoked lower parental warmth the next day. These findings have significant implications for understanding daily fluctuations in parenting behaviors and adolescent CP and CU traits, and inform novel parenting-based interventions that capitalize on recent advances in mobile and other technology.

Development and validation of the Parental Affection/Warmth Scale (PAWS) in a sample of parents of 2- to 8-year-olds.

Parental warmth is a treatment target of emerging interventions for children with callous-unemotional traits. However, research to date has yet to examine the empirical structure of parental warmth toward young children due to the lack of clinically feasible, psychometrically sound, and comprehensive measures of warmth for this population. To address this knowledge gap, the present study developed and tested the psychometric properties of a self-report measure of parental warmth, the Parental Affection/Warmth Scale (PAWS). A sample of 899 parents of 2- to 8-year-old children (M = 4.77 years, SD = 1.95; 46.1% girls) was recruited online using Amazon's Mechanical Turk and CloudResearch. Exploratory factor analysis identified a novel three-factor structure: Warmth, Toddler-oriented Interaction, and Play-based Interaction, which was validated by a confirmatory factor analysis. However, only the PAWS Warmth subscale functioned consistently with theoretical expectations. PAWS Warmth scores were internally consistent; convergent with existing positive parenting scales; discriminant from negative parenting scales; and concurrent with child empathy, callous-unemotional traits, and conduct problems. Findings have implications for refining treatment targets for interventions focused on enhancing parental warmth. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Five Factor Model of Personality as predictor of Callous-Unemotional Traits among Students

Five Factor Model of Personality as predictor of Callous-Unemotional Traits among Students

Exploring Moderation Dynamics: Callous-Unemotional Traits, Parental Practices and Conduct Problems in JuvenileDelinquency.

Callous-unemotional (CU) traits, parental practices and conduct problems (CP) have been consistently identified across numerous studies as significant predictors of the severity and persistence of juvenile delinquency. This study seeks to investigate the moderation dynamics underlying the relationships between these variables among Arab incarcerated youth. Specifically, the study aims to (1) explore whether parental practices moderate the relationship between CU traits and CP among incarcerated youth in Jordan and (2) examine the bidirectional moderating influence of CU traits in shaping the dynamic relationship between parental practices and CP within the context of Arab juvenile delinquency. An observational survey design was employed, gathering data from 184 incarcerated youth across 11 rehabilitation centres in Jordan. Latent profile analysis identified three parental practice classes: more positive, balanced and more negative. Moderation analyses indicated significant associations between CU traits, parental practices and CP. Parental practices, especially positive ones, moderated the relationship between CU traits and CP, highlighting the protective influence of balanced parenting. Furthermore, bidirectional moderation effects were observed: CU traits moderated the link between parental practices and CP, while CP influenced parenting practices, particularly in the presence of elevated CU traits. The findings of this study underscore the vital role mental health nurses can play in addressing the behavioural and psychological challenges faced by youth involved in the justice system and their families. Specifically, mental health nurses can aid in ameliorating mental distress by supporting parents in understanding and managing CU traits and CP. Nurses can provide targeted educational programmes that empower parents with strategies to reinforce positive parenting practices and reduce negative interactions. Furthermore, nurses can facilitate access to community resources and therapy options, helping families build a supportive environment conducive to the mental well-being of the youth. These interventions are crucial not only for the direct treatment of juveniles but also in providing holistic support to their families, thereby enhancing the overall efficacy of mental health care in juvenile delinquency. This study highlights the essential role that mental health nurses play in managing behavioural issues among youth, emphasising the significance of implementing culturally sensitive interventions. Mental health nurses possess a pivotal position in early detection and intervention, which enables them to guide families in fostering positive parenting practices, essential for preventing delinquent behaviours. Their efforts to promote understanding and responsiveness within family dynamics make a significant contribution to the mental well-being of individuals, highlighting the necessity of their role in global mental health.

Modeling maladaptive personality traits with unipolar item response theory: The case of Callousness

Most IRT applications in personality assume that the measured trait is a bipolar dimension, normally distributed in the population. These assumptions, however, could be questionable for maladaptive, (quasi) pathological traits that still fall in the normal range. This study focuses on one such trait, Callousness, and uses two different instruments and samples to determine whether there is a basis for modeling it as a unipolar trait instead of a bipolar one. More specifically, the following community samples were used, recruited in several Spanish high schools: a) 719 adolescents (13-19 years old, 55.8% girls), b) 681 adolescents (13-19 years old, 44.9% girls). Callousness was assessed with the Inventory of Callous-unemotional traits and Antisocial behavior in the first sample and with the Inventory of Callous Unemotional traits in the second sample. We compared the outcomes of fitting the Graded-Response model (a bipolar-trait model) and the Log-Logistic model (a unipolar trait model) in these community samples and found that they differed considerably at the scoring level. In terms of accuracy, the conditional reliability functions had opposite patterns: it was maximum at high levels in the Graded-Response model and at low levels in the Log-Logistic model. In terms of validity, the models showed different results regarding the prediction of indirect aggressiveness and non-planning impulsiveness.

Callous-unemotional traits moderate the association between inhibitory control and disruptive behavior problems.

The presence of callous-unemotional (CU) traits may not be unique to conduct disorder (CD) but also extend to oppositional defiant disorder (ODD). While a distinct neurocognitive profile characterizes CU traits, it remains unclear whether this CU-related neurocognitive profile differs between youth with CD and ODD. This study investigated whether CU traits moderate the relationship between inhibitory control and CD or ODD symptoms. We leveraged computational modeling to decompose task-based inhibitory control in a sample of 200 children (59.5% boys, 86.5% Caucasian), aged 8 to 15 years (M = 10.10, SD = 1.88), referred to an outpatient child diagnostic clinic focused on externalizing problems. Analyses examined whether CU traits moderated the relationship between inhibitory control and CD or ODD symptoms while controlling for ADHD symptoms and child demographics. The results indicated that the strength of the relationship between inhibitory control and CD and ODD symptoms varies as a function of CU traits. Specifically, CD was linked to a more cautious decision-making style when elevated CU traits were present, whereas ODD was associated with more efficient decision making. These findings suggest distinct neurocognitive profiles based on CU traits, which vary between CD and ODD. Clinically, this underscores the importance of tailoring interventions for CD-CU and ODD-CU, focusing on decision making processes rather than merely addressing impulsivity. This research contributes to a more nuanced understanding of the interaction between neurocognitive processes and disruptive behavior, with significant implications for both theoretical models and treatment approaches.

Autonomic regulation and comorbid symptoms in children with attention deficit hyperactivity disorder.

Vagally-mediated heart rate variability (vmHRV) is regarded as transdiagnostic marker of emotion regulation and cognitive control capacity. We analysed vmHRV of children with attention deficit/hyperactivity disorder (ADHD). Based on previous research, we expected to find comorbid symptom dimensions (i.e. internalizing symptoms, conduct problems (CP), and callous unemotional (CU) traits) to relate to vmHRV measures. The sample comprised 100 (70 boys) medication naïve children with ADHD. Children were 6 to 11 years old. High frequency HRV (HF-HRV) was measured at rest and during a delay of gratification task. Additionally, sympathetic reactivity was assessed via skin conductance responses (SCR). Comorbid symptoms were assessed by parent-report questionnaires and clinical interviews. The multiple correlation between CU traits and the HF-HRV scores proved statistically significant. Higher CU traits were associated with higher HRV resting-state and response scores. CP were positively associated with the SCR score. In children with ADHD, increased CU traits might point to a comparatively less impaired self-regulation capacity in the reward-related context. The result corresponds to findings from previous studies. In the future, CU traits should be considered in analyses of autonomic regulation in ADHD.

Impact of an 8-Week, Intensive Summer Treatment Program on Improving Coercive Caregiver-Child Interactions Among Children With and Without Callous Unemotional Traits

The coercive process is the primary explanatory mechanism implicated in the maintenance of disruptive behavior disorders (DBDs), and understanding the coercive cycle may be especially important for caregivers with children with elevated callous-unemotional (CU) traits. The purpose of the current pilot study is twofold. First, we assessed whether the Summer Treatment Program (STP), an established intensive behavioral intervention for children with DBDs, reduced coercive caregiver-child interactions using a novel parent-report measure of coercive interactions. We then sought to assess whether the STP improved coercive caregiver-child interactions among children with elevated CU traits (i.e., moderated the effect). Thirty-three caregivers and their children who had been diagnosed with DBDs participated in the STP, which involved the children receiving behavior modification for 9 hours per day and caregivers attending a weekly behavioral parent training group session over the course of 8 weeks. Children (Mage = 8.51 years old, SD = 1.70, range 6–12) were primarily male (78.5%) and Hispanic/Latine (84.8%). A linear multilevel model revealed a statistically significant improvement in caregiver-child coercive interactions from pre- to posttreatment. However, child pretreatment CU traits moderated this effect such that families with children with elevated CU traits did not show improvement in caregiver-child coercive cycles following treatment. Results suggest the benefits of intensive behavioral treatment on the caregiver-child coercive cycle for many families, but the need to modify the intensity or dose of treatments for those with children with DBDs and elevated CU traits.

The Inventory of Callous-Unemotional Traits (ICU) self-report version: Factor structure, measurement invariance, and predictive validity in justice-involved male adolescents.

The Inventory of Callous-Unemotional Traits (ICU) is a widely used measure of callous-unemotional (CU) traits that may aid in the assessment of the diagnostic specifier "with limited prosocial emotions," which has been added to diagnostic criteria for conduct disorder. Though there is substantial support for use of the ICU total score, the scale's factor structure has been highly debated. Inconsistencies in past factor analyses may be largely attributed to failure to control for method variance due to item wording (i.e., half of the items being worded in the callous direction and half worded in the prosocial direction). Thus, the present study used a multitrait-multimethod confirmatory factor analytic approach that models both trait and method variance to test the factor structure of the ICU self-report in a clinically relevant, high-risk sample of justice-involved male adolescents (N = 1,216). When comparing the fit of empirical and theoretical models, goodness of fit indices (χ² = 1105.877, df = 190, root-mean-square error of approximation = .063, comparative fit index = .916, Tucker-Lewis index = .878, standardized root-mean-square residual = .051) provided support for a hierarchical four-factor model (i.e., one overarching callous-unemotional factor, four latent trait factors) when accounting for method variance (i.e., covarying positively worded items). This factor structure is consistent with the way the ICU was constructed and with criteria for the limited prosocial emotions specifier. In addition, measurement invariance of this factor structure across age, race, and ethnicity was supported, and the predictive validity of the ICU was supported across these demographic groups in predicting self-reported antisocial behavior and rearrests over a 5-year period following an adolescent's first arrest. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Parent-Child Interaction Therapy with Separated Parents of a 3-Year-Old Child with Conduct Problems and Callous-Unemotional Traits

Callous and unemotional (CU) traits are associated with an earlier onset of conduct problems in children. The presence of CU traits typically predicts a severe, stable, and aggressive pattern of behavior, especially when the onset of such behaviors begins in childhood. Children with conduct problems and CU continue to exhibit challenging behavior despite implementation of behavior management strategies compared to children with conduct problems alone. An emerging body of research suggests that Parent-Child Interaction Therapy (PCIT) specifically tailored to address the characteristics unique to CU traits (PCIT-CU) may be an effective intervention for children with conduct problems + CU. This case study presents the treatment of a 3-year-old boy using PCIT-CU who presents with oppositional defiant disorder (ODD), attention-deficit/hyperactivity disorder—combined presentation (ADHD-C), and CU traits. Both caregivers participated but were separated. Following the completion of treatment, conduct problems improved, parent ratings of CU traits decreased, and positive parenting practices increased. This case study adds to the growing literature in support of tailoring behavioral management training interventions for children with conduct problems + CU.

An Ecological Neurodevelopmental Model of the Development of Youth Antisocial Behavior and Callous-Unemotional Traits

Research has begun to identify genetic, environmental, and neurocognitive risk factors related to the development of youth antisocial behavior (aggression, rule-breaking). We review environmental and genetic risk factors for the development of antisocial behavior and related outcomes (e.g., callous-unemotional traits), as well as provide an overview of neural correlates of antisocial behavior. Next, we connect these findings to work in developmental neuroscience linking exposure to adversity to brain structure and function. Then we integrate across these literatures to provide a multilevel model of the development of antisocial behavior that includes transactions between genetic and environmental risk that shape brain development. Throughout, we focus on how pathways may differ for youth with different subtypes of antisocial behavior (e.g., early-onset) with a particular focus on callous-unemotional traits. We end by identifying challenges and future directions for the field.

Testosterone, cortisol, and psychopathy: Further evidence with the Levenson self-report psychopathy scale and the inventory of callous unemotional traits

ABSTRACT The current study explored associations between testosterone, cortisol, and both the Levenson Self-Report Psychopathy Scale (LSRPS) and the Inventory of Callous Unemotional (ICU) traits. Data were gathered from a relatively large sample of university students (n = 522) and analyses considered direct and interactive associations between hormones and psychopathic traits, as well as interactions between these associations and the time of day at which samples were gathered and the sex of participants. Baseline cortisol had a negative association with LSRPS primary psychopathy scores. In addition, baseline cortisol interacted with the time of day in association with LSRPS total scores. Simple slopes analyses indicated cortisol had a negative association with LSRPS total scores in the morning but not the afternoon. Interactions among hormone measures were not statistically significant. There was also no evidence for the moderation of associations between hormones and psychopathic traits by sex.

Early Childhood Temperament Factors and Callous-Unemotional Traits in Preschool and School Aged- Children: A Systematic Narrative Review

Early Childhood Temperament Factors and Callous-Unemotional Traits in Preschool and School Aged- Children: A Systematic Narrative Review

Do Children with High Callous-Unemotional Traits Have Attentional Deficits to Emotional Stimuli? Evidence from a Multi-Method and Multi-Informant Study.

Callous-unemotional (CU) traits in children and adolescents are linked to severe and persistent antisocial behavior. Based on past empirical research, several theoretical models have suggested that CU traits may be partly explained by difficulties in correctly identifying others' emotional states as well as their reduced attention to others' eyes, which could be important for both causal theory and treatment. This study tested the relationships among CU traits, emotion recognition of facial expressions and visual behavior in a sample of 52 boys referred to a clinic for conduct problems (Mage = 10.29years; SD = 2.06). We conducted a multi-method and multi-informant assessment of CU traits through the Child Problematic Traits Inventory (CPTI), the Inventory of Callous-Unemotional (ICU), and the Clinical Assessment of Prosocial Emotions-Version 1.1 (CAPE). The primary goal of the study was to compare the utility of these methods for forming subgroups of youth that differ in their emotional processing abilities. An emotion recognition task assessed recognition accuracy (percentage of mistakes) and absolute dwell time on the eyes or mouth region for each emotion. Results from repeated measures ANOVAs revealed that low and high CU groups did not differ in emotion recognition accuracy, irrespective of the method of assessing CU traits. However, the high CU group showed reduced attention to the eyes of fearful and sad facial expressions (using the CPTI) or to all emotions (using the CAPE). The high CU group also showed a general increasein attention to the mouth area, but only when assessed by the CAPE. These findings provide evidence to support abnormalities in how those elevated on CU traits process emotional stimuli, especially when assessed by a clinical interview, which could guide appropriate assessment and more successful interventions for this group of youth.

Primary and Secondary Callous-Unemotional Childhood Variants in a Korean Community Sample.

Despite the growing support for the multiple developmental pathways to phenotypic callous-unemotional (CU) traits (i.e., primary, and secondary CU variants), there remains limited research on childhood manifestations of CU variants in non-Western, community samples. Using a latent profile analysis with data sourced from the longitudinal, nationwide Korean sample (N = 1597, 48.7% girls), we discerned heterogeneous groups of children, based on externalizing problems, CU traits, and emotional reactivity level. The optimal five-profile solution identified distinct subgroups: low-risk, primary CU (characterized by low emotional reactivity and externalizing problem), reactive (low CU/moderate emotion reactivity and externalizing problem), and two secondary CU groups (i.e., secondary-high CU and secondary-moderate CU; both high in emotional reactivity and externalizing problems). The two secondary CU variants demonstrated differences from the primary CU variants, in that both are high in preschool externalizing problems (age 6) and school-age conduct problems (age 11). However, the secondary-moderate CU group displayed greater levels of anxiety at age 11 compared to secondary-high CU, indicating divergent developmental trajectories of secondary CU variants. These findings expand our understanding of CU variants among Korean preschoolers and highlight the role of emotional reactivity in distinguishing such subtypes and identifying their developmental outcomes across time.

Unique versus shared neural correlates of externalizing psychopathology in late childhood.

Childhood externalizing psychopathology is heterogeneous. Symptom variability in conduct disorder (CD), oppositional defiant disorder (ODD), attention-deficit/hyperactivity disorder (ADHD), and callous-unemotional (CU) traits designate different subgroups of children with externalizing problems who have specific treatment needs. However, CD, ODD, ADHD, and CU traits are highly comorbid. Studies need to generate insights into shared versus unique risk mechanisms, including through the use of functional magnetic resonance imaging (fMRI). In this study, we tested whether symptoms of CD, ODD, ADHD, and CU traits were best represented within a bifactor framework, simultaneously modeling shared (i.e., general externalizing problems) and unique (i.e., symptom-specific) variance, or through a four-correlated factor or second-order factor model. Participants (N = 11,878, age, M = 9 years) were from the Adolescent Brain and Cognitive Development Study. We used questionnaire and functional magnetic resonance imaging data (emotional N-back task) from the baseline assessment. A bifactor model specifying a general externalizing and specific CD, ODD, ADHD, and CU traits factors demonstrated the best fit. The four-correlated and second-order factor models both fit the data well and were retained for analyses. Across models, reduced right amygdala activity to fearful faces was associated with more general externalizing problems and reduced dorsolateral prefrontal cortex activity to fearful faces was associated with higher CU traits. ADHD scores were related to greater right nucleus accumbens activation to fearful and happy faces. Results give insights into risk mechanisms underlying comorbidity and heterogeneity within externalizing psychopathology. (PsycInfo Database Record (c) 2024 APA, all rights reserved).