High Callous-unemotional Traits Research Articles

Callous-Unemotional Traits Trajectories Interact with Earlier Conduct Problems and Executive Control to Predict Violence and Substance Use Among High Risk Male Adolescents.

Callous-unemotional (CU) traits, conduct problems (CP), and deficits in executive control are all linked to the development of more severe antisocial behavior, including violence and substance use. Though previous research has examined the impact of these factors on antisocial outcomes, little work has examined trajectories of CU traits across adolescence and how these trajectories predict greater antisocial behavior in adulthood. Moreover, no study has assessed how severity of early CP and executive control may exacerbate these pathways and increase risk for later violence and substance use. The current study (a) identified trajectories of CU traits among a large, high-risk sample of adolescent males, (b) examined the relationship between CU traits trajectories and future violence and substance use, and (c) examined whether early CP and executive control moderated the effects of a high CU traits trajectory membership and high CP on violence and substance use. Results indicated that: (a) CU traits could be grouped into three stable trajectories across adolescence, (b) the 'high' CU traits trajectory, particularly in the presence of 'elevated' CP, was related to higher violence and substance use, over and above a variety of environmental risk factors, and (c) the effects the 'high' CU traits trajectory on both violence and substance and in the presence of 'elevated' CP was stronger among youth with high executive control. These findings highlight the utility of identifying subgroups of youth who differ on trajectories of CU traits for understanding the development and maintenance of severe antisocial behavior.

Unemotional on all counts: Evidence of reduced affective responses in individuals with high callous-unemotional traits across emotion systems and valences

The current study aimed to identify atypical neurophysiological activity associated with deficient affective processing in individuals with high callous-unemotional traits (CU). Fifty-six participants (M age = 20.52; 46% male) divided in two groups, differentiated on levels of CU traits, were invited to participate in the experimental phase of the study. Medial prefrontal cortex activity, measured with functional Near-Infrared Spectroscopy, and facial electro-myography activity were recorded during videos depicting violent, comedy and neutral scenes. Individuals high on CU traits showed similar medial prefrontal cortex oxygenated hemoglobin (HbO2) activity to positive and negative films, while the pre-frontal cortical responses of low CU individuals were more pronounced to positive than negative materials. High CU participants also showed reduced facial electromyography at the corrugator muscle in response to violent films, which was not differentiated from their responses to comedy films. These findings suggest that individuals high on CU traits show reduced but not absent (i.e., flat) affect to emotional material. Deficits in processing positive and negative valent material, measured with different neuro-physiological modalities, might be essential to understand CU traits.

Impact of Maternal Prenatal Risk Factors On Oxytocin Methylation, and On Occurrence of Conduct Disorders During Adolescence

Youth with high callous-unemotional traits (CU) are at risk for early-onset and persistent conduct problems. Research suggests that there may be different developmental pathways to CU (genetic/constitutional vs environmental), and that the absence or presence of co-occurring internalizing problems is a key marker. However, it is unclear whether such a distinction is valid. Intermediate phenotypes such as DNA methylation, an epigenetic modification regulating gene expression, may help to clarify etiological pathways. This is the first study to examine prospective inter-relationships between environmental risk (prenatal/postnatal) and DNA methylation (birth, age 7 and 9) in the prediction of CU (age 13), for youth low vs high in internalizing problems. We focused on DNA methylation in the vicinity of the oxytocin receptor (OXTR) gene as it has been previously implicated in CU. Participants were 84 youth with early-onset and persistent conduct problems drawn from the Avon Longitudinal Study of Parents and Children. For youth with low internalizing problems (46%), we found that (i) OXTR methylation at birth associated with higher CU (age 13) as well as decreased experience of victimization during childhood (birth–age 9), (ii) higher prenatal parental risks (maternal psychopathology, criminal behaviors, substance use) associated with higher OXTR methylation at birth and (iii) OXTR methylation levels were more stable across time (birth–age 9). In contrast, for youth with high internalizing problems, CU were associated with prenatal risks of an interpersonal nature (that is, intimate partner violence, family conflict) but not OXTR methylation. Findings support the existence of distinct developmental pathways to CU.

Incarcerated youths with high or low callous–unemotional traits: a comparison controlling for age of crime onset

The aim of this study was to analyze the relevance of callous–unemotional (CU) traits in incarcerated juvenile delinquents. A sample of 160 incarcerated male youths was used. Results showed that youths with high CU traits had an earlier age of crime onset and of trouble with the law, and also had higher levels of conduct disorder. When controlling for age of crime onset, youths with high CU traits showed higher levels of general psychopathic traits and of psychopathy taxon membership as well as lower levels of prosocial behavior, but no differences were found for self-reported delinquency, crime seriousness, impulsivity-conduct problems, and general conduct problems. Also, no significant associations of CU traits with self-reported delinquency and crime seriousness were found when controlling for age of crime onset. Future studies of CU traits should take into account the specific importance of age of onset.

Reduced Face Preference in Infancy: A Developmental Precursor to Callous-Unemotional Traits?

BackgroundChildren with callous-unemotional (CU) traits, a proposed precursor to adult psychopathy, are characterized by impaired emotion recognition, reduced responsiveness to others’ distress, and a lack of guilt or empathy. Reduced attention to faces, and more specifically to the eye region, has been proposed to underlie these difficulties, although this has never been tested longitudinally from infancy. Attention to faces occurs within the context of dyadic caregiver interactions, and early environment including parenting characteristics has been associated with CU traits. The present study tested whether infants’ preferential tracking of a face with direct gaze and levels of maternal sensitivity predict later CU traits. MethodsData were analyzed from a stratified random sample of 213 participants drawn from a population-based sample of 1233 first-time mothers. Infants’ preferential face tracking at 5 weeks and maternal sensitivity at 29 weeks were entered into a weighted linear regression as predictors of CU traits at 2.5 years. ResultsControlling for a range of confounders (e.g., deprivation), lower preferential face tracking predicted higher CU traits (p = .001). Higher maternal sensitivity predicted lower CU traits in girls (p = .009), but not boys. No significant interaction between face tracking and maternal sensitivity was found. ConclusionsThis is the first study to show that attention to social features during infancy as well as early sensitive parenting predict the subsequent development of CU traits. Identifying such early atypicalities offers the potential for developing parent-mediated interventions in children at risk for developing CU traits.

Environmental risk, Oxytocin Receptor Gene (OXTR) methylation and youth callous-unemotional traits: a 13-year longitudinal study.

Youth with high callous-unemotional traits (CU) are at risk for early-onset and persistent conduct problems. Research suggests that there may be different developmental pathways to CU (genetic/constitutional vs environmental), and that the absence or presence of co-occurring internalizing problems is a key marker. However, it is unclear whether such a distinction is valid. Intermediate phenotypes such as DNA methylation, an epigenetic modification regulating gene expression, may help to clarify aetiological pathways. This is the first study to examine prospective inter-relationships between environmental risk (prenatal/postnatal) and DNA methylation (birth, age 7, age 9) in the prediction of CU (age 13), for youth low vs. high in internalizing problems. We focused on DNA methylation in the vicinity of the oxytocin receptor (OXTR) gene as it has been previously implicated in CU. Participants were 84 youth with early-onset and persistent conduct problems drawn from the Avon Longitudinal Study of Parents and Children. For youth with low internalizing problems (46%), we found that: (i) OXTR methylation at birth associated with higher CU (age 13) as well as decreased experience of victimization during childhood (birth – age 9), (ii) higher prenatal parental risks (maternal psychopathology, criminal behaviors, substance use) associated with higher OXTR methylation at birth, and (iii) OXTR methylation levels were more stable across time (birth – age 9). In contrast, for youth with high internalizing problems, CU was associated with prenatal risks of an interpersonal nature (i.e., intimate partner violence, family conflict) but not OXTR methylation. Findings support the existence of distinct developmental pathways to CU.

Commentary: Integrating callous and unemotional traits into the definition of antisocial behaviour--a commentary on Frick et al. (2014).

Heterogeneity in the presentation, antecedents, prognosis and treatment response of antisocial behaviour has long provided a challenge to developmental psychopathology researchers. As illustrated in the incisive Frick and colleagues' Annual Research Review, there is growing evidence that the presence of high callous-unemotional (CU) traits identifies a subgroup of antisocial young people with a particularly aggressive and pervasive form of disorder. Frick and colleagues extend their developmental psychopathology approach to CU traits by linking in theories of conscience development and considering evidence on the stability of CU traits. This commentary addresses these themes and the area more generally, considering (1) comparison of a CU specifier to alternative approaches to antisocial heterogeneity (2) high CU traits in the absence of antisocial behaviour and (3) aspects of the measurement of CU traits.

Replication of a ROBO2 polymorphism associated with conduct problems but not psychopathic tendencies in children

The co-occurrence of conduct problems (CPs) and high callous-unemotional (CU) traits specifies risk for adult psychopathy and is under a high genetic influence. A previous genome-wide pooled DNA study of 7-year olds identified a set of candidate single-nucleotide polymorphisms (SNPs) that might differentiate high CP+CU children from healthy children. We attempted to replicate an identified subset of these SNP-psychopathy associations. In a case-control design, 210 clinically referred children were partitioned into Comparison, High CP+Low CU, and High CP+CU groups and genotyped. One SNP, rs13064369, differentiated the groups but was associated with high CP, regardless of the level of CU traits, that is, the rare and heterozygote variants CC and CT were significantly more frequent in both CP groups compared with Comparisons but did not differ from each other. We replicated the finding that a polymorphism associated with the ROBO2 gene, which is involved in neurodevelopment, confers risk for the common emotionally reactive, impulsive aspects of conduct disorder, independent of concurrent risk for psychopathy.

Recognition of Pain as Another Deficit in Young Males with High Callous-Unemotional Traits

Prior research on callous-unemotional (CU) traits supports a deficit in recognizing fear in faces and body postures. Difficulties recognising others' emotions may impair the typical behavioural inhibition for violent behaviour. However, recent research has begun to examine other distress cues such as pain. The present study examined emotion recognition skills, including pain, of school-excluded boys aged 11-16 years (N = 50). Using dynamic faces and body poses, we examined the relation between emotion recognition and CU traits using the youth psychopathic traits inventory (YPI) and the inventory of CU traits. Violent delinquency was covaried in regression analyses. Although fearful facial and fearful bodily expressions were unrelated to CU traits, recognition of dynamic pain facial expressions was negatively related to CU traits using the YPI. The failure to replicate a fear and sad deficit are discussed in relation to previous research. Also, findings are discussed in support of a general empathy deficit for distress cues which may underlie the problem behaviour of young males with CU traits.

Callous-Unemotional Traits, Proactive Aggression, and Treatment Outcomes of Aggressive Children With Attention-Deficit/Hyperactivity Disorder

Stimulant treatment improves impulse control among children with attention-deficit/hyperactivity disorder (ADHD). Decreased aggression often accompanies stimulant pharmacotherapy, suggesting that impulsiveness is integral to aggressive behavior in these children. However, children with high callous-unemotional (CU) traits and proactive aggression may benefit less from ADHD pharmacotherapy, because their aggressive behavior seems more purposeful and deliberate. This study's objective was to determine whether pretreatment CU traits and proactive aggression affect treatment outcomes among aggressive children with ADHD receiving stimulant monotherapy. We implemented a stimulant optimization protocol with 160 children 6 to 13 years of age (mean [SD] age of 9.31 [2.02] years; 78.75% male) with ADHD, oppositional defiant or conduct disorder, and significant aggressive behavior. Family-focused behavioral intervention was provided concurrently. The primary outcome was the Retrospective Modified Overt Aggression Scale. The Antisocial Process Screening Device and the Aggression Scale, also completed by parents, measured CU traits and proactive aggression, respectively. Analyses examined moderating effects of CU traits and proactive aggression on outcomes. In all, 82 children (51%) experienced remission of aggressive behavior. Neither CU traits nor proactive aggression predicted remission (CU traits: odds ratio [OR] = 0.94, 95% CI = 0.80-1.11; proactive aggression, OR = 1.05, 95% CI = 0.86-1.29). Children whose overall aggression remitted showed decreases in CU traits (effect size = -0.379, 95% CI = -0.60 to -0.16) and proactive aggression (effect size = -0.463, 95% CI = -0.69 to -0.23). Findings suggest that pretreatment CU traits and proactive aggression do not forecast worse outcomes for aggressive children with ADHD receiving optimized stimulant pharmacotherapy. With such treatment, CU traits and proactive aggression may decline alongside other behavioral improvements. Clinical trial registration information--Medication Strategies for Treating Aggressive Behavior in Youth With Attention Deficit Hyperactivity Disorder; http://clinicaltrials.gov/; NCT00228046; and Effectiveness of Combined Medication Treatment for Aggression in Children With Attention Deficit With Hyperactivity Disorder (The SPICY Study); http://clinicaltrials.gov/; NCT00794625.

Polymorphisms in the oxytocin receptor gene are associated with the development of psychopathy

The co-occurrence of child conduct problems (CPs) and callous-unemotional (CU) traits confers risk for psychopathy. The oxytocin (OXT) system is a likely candidate for involvement in the development of psychopathy. We tested variations in the OXT receptor gene (OXTR) in CP children and adolescents with varying levels of CU traits. Two samples of Caucasian children, aged 4-16 years, who met DSM criteria for disruptive behavior problems and had no features of autism spectrum disorder, were stratified into low versus high CU traits. Measures were the frequencies of nine candidate OXTR polymorphisms (single nucleotide polymorphisms). In Sample 1, high CU traits were associated with single nucleotide polymorphism rs1042778 in the 3' untranslated region of OXTR and the CGCT haplotype of rs2268490, rs2254298, rs237889, and rs13316193. The association of rs1042778 was replicated in the second rural sample and held across gender and child versus adolescent age groups. We conclude that polymorphic variation of the OXTR characterizes children with high levels of CU traits and CPs. The results are consistent with a hypothesized role of OXT in the developmental antecedents of psychopathy, particularly the differential amygdala activation model of psychopathic traits, and add genetic evidence that high CU traits specify a distinct subgroup within CP children.

Methylation of the oxytocin receptor gene and oxytocin blood levels in the development of psychopathy

Child conduct problems (CPs) are a robust predictor of adult mental health; the concurrence of callous-unemotional (CU) traits confers specific risk for psychopathy. Psychopathy may be related to disturbances in the oxytocin (OXT) system. Evidence suggests that epigenetic changes in the OXT receptor gene (OXTR) are associated with lower circulating OXT and social-cognitive difficulties. We tested methylation levels of OXTR in 4- to 16-year-old males who met DSM criteria for a diagnosis of oppositional-defiant or conduct disorder and were stratified by CU traits and age. Measures were DNA methylation levels of six CpG sites in the promoter region of the OXTR gene (where a CpG site is a cytosine nucleotide occurs next to a guanine nucleotide in the linear sequence of bases along its lenth, linked together by phosphate binding), and OXT blood levels. High CU traits were associated with greater methylation of the OXTR gene for two cytosine nucleotide and guanine nucleotide phosphate linked sites and lower circulating OXT in older males. Higher methylation correlated with lower OXT levels. We conclude that greater methylation of OXTR characterizes adolescent males with high levels of CU and CPs, and this methylation is associated with lower circulating OXT and functional impairment in interpersonal empathy. The results add genetic evidence that high CU traits specify a distinct subgroup within CP children, and they suggest models of psychopathy may be informed by further identification of these epigenetic processes and their functional significance.

Childhood callous-unemotional traits moderate the relation between parenting distress and conduct problems over time.

The present short-term longitudinal study examines the bidirectional effects among paternal-reported and maternal-reported involvement, distress and conduct-problems (CP) in children ages 7–12 years with callous-unemotional (CU) traits as a potential moderator. Latent profile analysis revealed four groups: high, moderate, decreasing, and low on CU traits. Findings suggested that children high on CU traits were at higher risk to exhibit CP and were more likely to experience low parental-involvement and high parental-distress compared to children with low, decreasing, and moderate CU traits. Findings from the cross-lagged structural equation model suggested that high levels of CP predicted increases in parenting distress, and this was shown for youth with high levels of CU traits. In turn, parental-reported distress predicted increases in CP for children in the low and decreasing CU groups. A negative bidirectional association between maternal-involvement and CP was also identified. Findings extend cross-sectional research showing parents become distressed by CP behaviors, particularly when accompanied by high CU traits.

Therapeutic Alliance in Justice-Involved Adolescents Undergoing Mental Health Treatment: The Role of Callous-Unemotional Traits

The current study tested factors that could influence both youth and therapist-reported therapeutic alliance in 58 male adolescents ranging in age from 15 to 18 years old (M = 16.81, SD = 1.02) who were adjudicated for a delinquent offense and identified as needing mental health treatment. Therapeutic alliance was assessed through self-report by both the adolescent and therapist. Callous-unemotional (CU) traits and antisocial history were assessed through self-report and official record review respectively. Results indicated that the number of previous offenses was negatively associated with adolescent-reported therapeutic alliance but this was qualified by an interaction between antisocial history and CU traits. In those low on CU traits, there was a negative but non-significant association between number of previous offenses and the quality of the therapeutic alliance, whereas the association was significant and positive for those high on CU traits. In addition, CU traits were associated with violent institutional infractions during treatment. Thus, the combination of high CU traits and a high number of previous offenses seemed to reflect a group of adolescents who reported more positive therapeutic alliances but still had violent institutional infractions. These results provide support for tailored interventions for youth high on CU traits which consider the quality of the therapeutic relationship.

An exploration of the serotonin system in antisocial boys with high levels of callous-unemotional traits.

BackgroundThe serotonin system is thought to play a role in the aetiology of antisocial and aggressive behaviour in both adults and children however previous findings have been inconsistent. Recently, research has suggested that the function of the serotonin system may be specifically altered in a sub-set of antisocial populations – those with psychopathic (callous-unemotional) personality traits. We explored the relationships between callous-unemotional traits and functional polymorphisms of selected serotonin-system genes, and tested the association between callous-unemotional traits and serum serotonin levels independently of antisocial and aggressive behaviour.MethodParticipants were boys with antisocial behaviour problems aged 3–16 years referred to University of New South Wales Child Behaviour Research Clinics. Participants volunteered either a blood or saliva sample from which levels of serum serotonin (N = 66) and/or serotonin-system single nucleotide polymorphisms (N = 157) were assayed.ResultsFunctional single nucleotide polymorphisms from the serotonin 1b receptor gene (HTR1B) and 2a receptor gene (HTR2A) were found to be associated with callous-unemotional traits. Serum serotonin level was a significant predictor of callous-unemotional traits; levels were significantly lower in boys with high callous-unemotional traits than in boys with low callous-unemotional traits.Conclusion Results provide support to the emerging literature that argues for a genetically-driven system-wide alteration in serotonin function in the aetiology of callous-unemotional traits. The findings should be interpreted as preliminary and future research that aims to replicate and further investigate these results is required.

Knowing Right from Wrong, but Just Not Always Feeling it: Relations Among Callous-Unemotional Traits, Psychopathological Symptoms, and Cognitive and Affective Morality Judgments in 8- to 12-Year-Old Boys

The present research expands our understanding of cognitive and affective morality by exploring associations with callous-unemotional (CU) traits and externalizing symptoms. Participants were 46 8- to 12-year-old boys from the community who completed the Affective Morality Index, the Youth Self-Report, and the Inventory of Callous-Unemotional Traits. A pattern of results was found indicating that in particular the combination of high CU traits and high externalizing symptoms was associated with lack of affective morality, and an increased perceived likelihood of recommitting antisocial acts (recidivism). The implications of these findings and suggestions for future research are discussed.

Reduced Cortisol in Boys with Early-Onset Conduct Disorder and Callous-Unemotional Traits

Background. A growing body of evidence suggests an association between altered hypothalamic-pituitary-adrenal axis reactivity and the development of persistent antisocial behavior in children. However the effects of altered cortisol levels remain poorly understood in the complex context of conduct disorder, callous-unemotional (CU) personality traits, and frequent comorbidities, such as attention deficit hyperactivity disorder (ADHD). The aim of the current study was to investigate associations among CU traits, antisocial behavior, and comorbid ADHD symptomatology with cortisol levels in male children and adolescents. Methods. The study included 37 boys with early-onset conduct disorder (EO-CD, mean age 11.9 years) and 38 healthy boys (mean age 12.5 years). Participants were subjected to multiple daytime salivary cortisol measurements and a psychometric characterization. Results. Subjects in the EO-CD group with elevated CU traits showed a diminished cortisol awakening response compared to healthy participants. In the EO-CD group, high CU traits and impulsivity were associated with decreased diurnal cortisol levels, while associations with antisocial behavior were not detected. The cortisol awakening response was significantly inversely associated with hyperactivity (P = 0.02) and marginally significant with CU traits (P = 0.07). Conclusions. These results indicate a specific association between CU traits and a diminished stress response, which is not explained by antisocial behavior in general.

Epigenetic regulation of the oxytocin receptor gene: implications for behavioral neuroscience.

Genetic approaches have improved our understanding of the neurobiological basis of social behavior and cognition. For instance, common polymorphisms of genes involved in oxytocin signaling have been associated with sociobehavioral phenotypes in healthy samples as well as in subjects with mental disorders. More recently, attention has been drawn to epigenetic mechanisms, which regulate genetic function and expression without changes to the underlying DNA sequence. We provide an overview of the functional importance of oxytocin receptor gene (OXTR) promoter methylation and summarize studies that have investigated the role of OXTR methylation in behavioral phenotypes. There is first evidence that OXTR methylation is associated with autism, high callous-unemotional traits, and differential activation of brain regions involved in social perception. Furthermore, psychosocial stress exposure might dynamically regulate OXTR. Given evidence that epigenetic states of genes can be modified by experiences, especially those occurring in sensitive periods early in development, we conclude with a discussion on the effects of traumatic experience on the developing oxytocin system. Epigenetic modification of genes involved in oxytocin signaling might be involved in the mechanisms mediating the long-term influence of early adverse experiences on socio-behavioral outcomes.

Emotional true and false memories in children with callous-unemotional traits

Several studies have found that children with callous-unemotional (CU) traits have a deficit in processing emotionally negative material. The present study examined whether this deficit also affects emotional memory. Twenty-two children with low CU traits and 24 children with high CU traits between 8 and 12 years of age were selected from a community sample and presented with neutral and negative emotional words, using the Deese–Roediger–McDermott paradigm. On true recall, there was no difference between the groups. Both groups had higher true recall rates for the neutral word lists than for the negative lists. However, on false recall, although there were no group differences for neutral word lists, the high CU group recalled significantly fewer critical lures on the negative word lists than the low CU group. Furthermore, the high CU group had significantly less false recall on the negative word lists compared to the neutral word lists, while the low CU group showed no difference in false recall between the word lists. These results indicate that children with high CU traits have no deficiencies in true memory performance, yet are less susceptible to developing false memories concerning emotionally negative material.

Amygdala Response to Preattentive Masked Fear in Children With Conduct Problems: The Role of Callous-Unemotional Traits

In children with conduct problems, high levels of callous-unemotional traits are associated with amygdala hypoactivity to consciously perceived fear, while low levels of callous-unemotional traits may be associated with amygdala hyperactivity. Behavioral data suggest that fear processing deficits in children with high callous-unemotional traits may extend to stimuli presented below conscious awareness (preattentively). The authors investigated the neural basis of this effect. Amygdala involvement was predicted on the basis of its role in preattentive affective processing in healthy adults and its dysfunction in previous studies of conduct problems. Functional MRI was used to measure neural responses to fearful and calm faces presented preattentively (for 17 ms followed by backward masking) in boys with conduct problems and high callous-unemotional traits (N=15), conduct problems and low callous-unemotional traits (N=15), and typically developing comparison boys (N=16). Amygdala response to fearful and calm faces was predicted to differentiate groups, with the greatest response in boys with conduct problems and low callous-unemotional traits and the lowest in boys with conduct problems and high callous-unemotional traits. In the right amygdala, a greater amygdala response was seen in boys with conduct problems and low callous-unemotional traits than in those with high callous-unemotional traits. The findings were not explained by symptom levels of conduct disorder, attention-deficit hyperactivity disorder, anxiety, or depression. These data demonstrate differential amygdala activity to preattentively presented fear in children with conduct problems grouped by callous-unemotional traits, with high levels associated with lower amygdala reactivity. The study's findings complement increasing evidence suggesting that callous-unemotional traits are an important specifier in the classification of children with conduct problems.