Callous-unemotional traits in a community sample of adolescents

This study examined the structure, distribution, and correlates of a new measure of self-reported callous-unemotional (CU) traits in 1,443 adolescents (774 boys, 669 girls) between the ages of 13 to 18 years. The Inventory of Callous-Unemotional Traits was subjected to exploratory factor analysis and confirmatory factor analysis. Exploratory factor analysis produced three factors: callousness, uncaring, and unemotional. Fit indexes suggested that the three-factor model, with a single higher-order factor, represented a satisfactory solution for the data. This factor structure fits well for both boys and girls. CU traits correlated significantly with measures of conduct problems and psychosocial impairment. Furthermore, the traits showed predicted associations with sensation seeking and the Big Five personality dimensions, supporting the construct validity of the measure of CU traits.     

The Association between Callous-Unemotional Traits and Behavioral and Academic Adjustment in Children: Further Validation of the Inventory of Callous-Unemotional Traits

Callous-unemotional (CU) traits have been associated with problems in behavioral adjustment in past research which has led to proposals to include them in diagnostic classification systems for child behavior problems. In the current study, the factor structure of a comprehensive measure of CU traits was tested in a sample of 540 Italian children in grades 6 and 8. Consistent with past factor analyses in other countries, CU traits could be described as having three subfactors (i.e., callousness, uncaring, unemotional) which load on an overarching general factor. Importantly, this factor structure was invariant across gender and grade. Consistent with past studies, CU traits were positively associated with school behavior problems, bullying, and reactive aggression and this was largely accounted for by the callousness and uncaring subscales. The current results advance past work in showing that these associations extend to cyberbullying and to bullying reported by both self-report and by peer nominations. Further, CU traits were also associated with lower levels of academic achievement, and this was also largely accounted for by the callousness and uncaring dimensions. Finally, although the unemotional subscale did not show consistent associations with problems in behavioral or academic adjustment, it did contribute independently to the prediction (negatively) of peer-reported prosocial behaviors.     

Callous-Unemotional Traits and Effortful Control Mediate the Effect of Parenting Intervention on Preschool Conduct Problems

Parenting intervention (PI) is an effective treatment for children’s conduct problems (CP) that has been shown to be mediated by improved parenting practices and parenting self-efficacy. Recently, Hitkashrut’s randomized controlled trial demonstrated that ineffective parenting (IP) mediated effects on callous-unemotional (CU) traits and effortful control (EC), while controlling for more general treatment effects on CP. These temperament and personality-based features predict the formation of early-onset antisocial trajectories with poor long-term prognosis. The objective of this study was to use Hitkashrut’s 3-wave dataset to test posttreatment EC and CU mediation of treatment effect on 1-year follow-up CP, and to determine whether mediation by each child-level potential mediator remains significant when tested concurrently with the parenting mediator. Parents of 209 3–5 year-old preschoolers (163 boys; 46 girls), with subclinical-clinical range CP were assigned to 14-session co-parent training groups (n?=?140 couples), or to minimal intervention control groups (n?=?69 couples). Assessments were based on both parents’ questionnaires. An intent-to-treat analysis showed that EC and CU traits simultaneously mediated treatment effects on CP in one EC/CU mediational model. The concurrent testing of child- and parent-level mediators showed mediation by IP and CU traits in the CU/IP model, and IP mediation in the EC/IP model. Similar results were obtained in mediational analyses that controlled for the shared variance between the mediators and CP at T2. Overall, the findings support an intervention model of coaching parents of high-CP children to promote moral self-regulatory competencies while concurrently applying behavioral methods that directly target CP.     

Heritability of antisocial behaviour at 9: do callous‐unemotional traits matter?

A previous finding from our group indicated that teacher-rated antisocial behaviour (AB) among 7-year-olds is particularly heritable in the presence of callous-unemotional (CU) traits. Using a sample of 1865 same-sex twin pairs, we employed DeFries-Fulker extremes analysis to investigate whether teacher-rated AB with/without CU traits also shows aetiological differences among 9-year-olds. Furthermore, we assessed whether the differences in the magnitude of heritability would be evident even when hyperactive symptoms were controlled for in the statistical analysis. AB among 9-year-olds was more heritable with than without concomitant CU. The heritability difference was even more pronounced in magnitude when hyperactive symptoms were controlled. CU traits thus appear to index one valid way of sub-typing children with early-onset AB.     

The Disruptive Adolescent as a Grown-Up: Predicting Adult Startle Responses to Violent and Erotic Films from Adolescent Conduct Problems and Callous-Unemotional Traits

The current study aimed to identify heterogeneous groups of adolescents differing on their levels of conduct problems (CP) and callous-unemotional (CU) traits, and compare them on startle reactivity to emotional videos (violent/erotic) during young adulthood. A Latent Profile Analysis, conducted among a longitudinal sample of 2306 adolescents, provided evidence for the existence of heterogeneous CP and CU subgroups (i.e., CP-only, CU-only, and CP+CU groups). Three years later, 82 young adults (Mage?=?19.95), randomly selected from the identified groups, participated in an experiment assessing their startle eye-blink responses during violent, erotic and neutral video scenes. Self-report ratings of fear, valence and arousal to affective scenes were also collected. Findings suggested that adolescents high on CP and low on CU traits showed high startle potentiation when viewing violent scenes during young adulthood, while those high on both CP and CU traits showed diminished startle reactivity to violent stimuli. Individuals high on CU traits without CP showed similar startle reactivity to controls. Further, the findings indicate that startle potentiation to violent stimuli can be a reliable physiological marker to distinguish antisocial individuals with and without CU traits. The finding that the CU only group was not differentiated from the control group on startle reactivity when viewing violent stimuli might explain their lower likelihood of engaging in antisocial behavior.     

Measuring Callous Unemotional Behaviors in Early Childhood: Factor Structure and the Prediction of Stable Aggression in Middle Childhood

This study sought to replicate the results of our earlier study, which were published in this Journal (Willoughby et. al 2011), that used mother-reported items from the Achenbach System of Empirically Based Assessment to develop a screening measure of callous unemotional (CU) behaviors for use with preschool-aged children. We further sought to extend those results by exploring the predictive validity of the CU measure with aggression trajectories in early-/mid- childhood. The current study involved secondary data analysis of the NICHD Study of Early Childhood and Youth Development (NICHD-SECCYD) dataset. Factor analyses included N?=?1,176 children who participated in the age 3 year assessment of the NICHD-SECCYD. Predictive models included N?=?1,081 children for whom four of the six possible teacher ratings of aggressive behavior were available from annual assessments spanning 1st–6th grades. Consistent with prior work, a three-factor confirmatory factor model, which differentiated CU from oppositional defiant (ODD) and attention deficit/hyperactive-impulsive (ADHD) behaviors, provided the best fit to the data. Among children with disorganized attachment status, the combination of high levels of mother-rated ODD behaviors and CU behaviors, was predictive of stable elevated levels of teacher-rated aggression from 1st–6th grade (predicted probability?=?0.38, compared with a base rate of 0.07). These results demonstrate that CU behaviors can be reliably measured by parent report in young children and are dissociable from more commonly assessed dimensions of disruptive behavior. Three-year-old children who exhibit elevated levels of ODD and CU behaviors, and who have disorganized attachments, are at increased risk for exhibiting elevated levels of aggression across middle childhood. Results are discussed from the perspective of early assessment and intervention.     

Do Genetic Factors Explain the Links Between Callous-Unemotional,Attention Hyperactivity and Oppositional Defiant Problems in Toddlers?

Research demonstrates that callous-unemotional (CU) behaviors, Attention Deficit Hyperactivity Disorder (ADHD) and Oppositional Defiant Problems (ODD) are related, but little is known about the sources of covariation among the three externalizing behaviors. The present study looked at genetic and environmental links between all three behavioral domains in twins at ages 2 and 3 years (MZ = 145, DZ = 169), a time when CU behaviors are beginning to emerge. CU, ADHD, and ODD behaviors as assessed using the Child Behavior Checklist 1.5–5 (Achenbach and Rescorla 2000) were strongly interrelated at both ages. Genetic factors primarily explained the covariation among the three behavioral domains via a common externalizing factor; however, there were also genetic factors unique to each behavior. Furthermore, the majority of nonshared environmental influences on each externalizing behavior were behavior-specific. The heritable externalizing factor was highly stable across age, largely due to genetic factors shared across ages 2 and 3 years. Despite their extensive phenotypic and genetic overlap, CU, ADHD, and ODD behaviors have unique genetic and nonshared environmental influences as early as toddlerhood. This supports phenotypic research showing that the three are related but distinct constructs in very young children.     

Alexithymia in chronic urticaria patients

Alexithymia has been described as an important dimension in several medical and psychiatric diseases. Chronic urticaria (CU) is a chronic condition, in which treatment is difficult. Our aim is to determine the prevalence of alexithymia traits in patients with CU, and to identify the relationships between alexithymia and psychological variables and quality-of-life dimensions. Fifty-five sequential CU patients in a faculty ambulatory specialized consultation, with an average age of 44.92, were compared with 31 healthy volunteers. Both groups were studied by means of validated scales for alexithymia (Toronto Alexithymia Scale [TAS-20]), attachment (Adult Attachment Scale-R [AAS-R]), psychopathology (Brief Symptom Inventory [BSI]), personality dimensions (The NEO Five-Factor inventory [NEO-FFI]) and quality of life (Short Form-36 [SF-36]). The classification of CU reactions was obtained from the patient's history, physical examination, laboratory assessment and histopathologic findings. All the patients were under treatment with sedating H1-antihistamines, non-sedating H1-antihistamines combination of H1 and H2 blocker, 2 H1-antihistamines and 3 H1-antihistamines. High traits of alexithymia were found on CU patients (56.9%) as well as high symptom rates of anxiety. Alexithymia traits were significantly positively correlated with insecure attachment styles, with psychopathological symptoms, and with the defense mechanism turn against self. We also reported a significant negative correlation between alexithymia traits and the dimensions of quality of life. Insecure attachment styles were positively correlated with psychopathological symptoms and negatively correlated with quality of life. We did not find significant statistical correlations between alexithymia and clinical variables. CU patients present serious difficulty in dealing with emotion arousal. There is strong evidence of a psychosomatic specificity in CU, with marked alexithymic traits.     

Predictors and outcomes of joint trajectories of callous-unemotional traits and conduct problems in childhood

Callous-unemotional (CU) traits are associated with antisocial and delinquent behaviors in children and represent a potential risk factor for adult psychopathy. However, there is a paucity of longitudinal research that explores the development of these traits, their longitudinal association with conduct problems (CP), and their psychosocial predictors and outcomes. Using a large sample of children followed longitudinally from the Twins Early Development Study (N=9,578), we described the joint developmental trajectories of CU traits and CP during childhood (between ages 7 and 12) and examined the child- and family-level predictors (4 years old) and concomitant outcomes (12 years old) associated with the trajectories. The developmental trajectories were characterized with teachers' ratings of CU traits and CP from ages 7 to 12. Using general growth mixture modeling, we identified four trajectories of CU traits (stable high, increasing, decreasing, and stable low) and two trajectories of CP (high and low). Compared with the children who followed a low trajectory of CU traits and CP, those who followed a high trajectory of CU traits and CP had more negative child- and family-level predictors at 4 years (including CP, hyperactivity, negative parental discipline, and chaos in the home). Children with high or increasing levels of CU traits and concomitant high levels of CP presented the most negative outcomes at 12 years (including hyperactivity, peer problems, emotional problems, and negative parental feelings). Children with high CU traits and concomitant high levels of CP in childhood should be prioritized for targeted intervention.     

A Validation of the Inventory of Callous-Unemotional Traits in a Community Sample of Young Adult Males

Callous-unemotional (CU) traits have been shown to delineate a subgroup of individuals at high risk for exhibiting severe and persistent criminal behavior. The Inventory of Callous-Unemotional Traits (ICU; Frick 2004) was recently developed as a comprehensive rating scale designed to measure multiple facets of CU traits. However, validation of this measure has been limited to youth in adolescence and emerging adulthood (age range?=12–20), leaving questions about the utility of this measure in early adulthood unanswered. The current study evaluated the factor structure of the ICU within a racially diverse and well characterized community sample of adult males (n?=?425) using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). While results found the best fitting model to be the three-bifactor structure that has been previously reported in adolescent samples, the fit indices were only marginally acceptable and suggest the need for scale refinement. Total and subscales scores demonstrated significant and distinct associations with relevant external criteria (e.g., delinquency, psychopathy, psychopathology, psychosocial functioning). Implications and directions for future research are discussed.     

冷酷无情特质：一种易于暴力犯罪的人格倾向

冷酷无情特质(callous unemotional trait, CU)是指对他人冷漠、缺乏罪责感、低共情的一种人格倾向, 伴随有高频率和高破坏性的反社会行为甚至暴力犯罪。CU特质者在情感上表现为对负性情绪加工不敏感, 缺乏共情; 在认知上表现出追求奖赏、忽视惩罚; 在生物学方面, CU特质者生理唤醒水平低、皮质醇水平低、杏仁核和腹内侧前额叶活动异常。未来研究的方向是修订发展本土化CU特质量表、探析CU特质者的性别差异、梳理CU与品行障碍等其他精神障碍的关系、为暴力犯循证矫正的方案设计提供科学依据。     

The insidious effects of failing to include design-driven correlated residuals in latent-variable covariance structure analysis

In practice, the inclusion of correlated residuals in latent-variable models is often regarded as a statistical sleight of hand, if not an outright form of cheating. Consequently, researchers have tended to allow only as many correlated residuals in their models as are needed to obtain a good fit to the data. The current article demonstrates that this strategy leads to the underinclusion of residual correlations that are completely justified on the basis of measurement theory and research design. In many designs, the absence of such correlations will not substantially harm the fit of the model; however, failure to include them can change the meaning of the extracted latent variables and generate potentially misleading results. Recommendations include (a) returning to the full multitrait-multimethod design when measurement theory implies the existence of shared method variance and (b) abandoning the evil-but-necessary attitude toward correlated residuals when they reflect intended features of the research design.     

Callous-Unemotional Traits and the Treatment of Conduct Problems in Childhood and Adolescence: A Comprehensive Review

The treatment of conduct problems among children and adolescents with callous-unemotional (CU) traits has been subject to much speculation; however, treatment outcome research has been surprisingly limited and findings have been mixed. This review examines the research to date in this field as it pertains to two key questions. First, are CU traits associated with clinical outcomes and processes in the family based treatment of child and adolescent conduct problems? Second, can family based intervention produce change in CU traits? Using a systematic search strategy, we identified 16 treatment outcomes studies that can be brought to bear on these questions. These studies provide strong evidence of unique associations between CU traits and risk for poor treatment outcomes, while at the same time indicating that social-learning-based parent training is capable of producing lasting improvement in CU traits, particularly when delivered early in childhood. We discuss the potential for this emerging evidence base to inform the planning and delivery of treatments for clinic-referred children with CU traits, and detail an ongoing program of translational research into the development of novel interventions for this high-risk subgroup.     

Callous-unemotional traits and empathy deficits: Mediating effects of affective perspective-taking and facial emotion recognition

Although empathy deficits are thought to be associated with callous-unemotional (CU) traits, findings remain equivocal and little is known about what specific abilities may underlie these purported deficits. Affective perspective-taking (APT) and facial emotion recognition may be implicated, given their independent associations with both empathy and CU traits. The current study examined how CU traits relate to cognitive and affective empathy and whether APT and facial emotion recognition mediate these relations. Participants were 103 adolescents (70 males) aged 16–18 attending a residential programme. CU traits were negatively associated with cognitive and affective empathy to a similar degree. The association between CU traits and affective empathy was partially mediated by APT. Results suggest that assessing mechanisms that may underlie empathic deficits, such as perspective-taking, may be important for youth with CU traits and may inform targets of intervention.     

Callous-Unemotional Traits and Autonomic Functioning in Toddlerhood Interact to Predict Externalizing Behaviors in Preschool

Callous-unemotional (CU) traits are one meaningful risk factor which helps to explain heterogeneity in the emergence of externalizing behavior problems. While the extant literature demonstrates links between early CU traits and later externalizing problems, there is a dearth of research examining for whom early CU traits confer risk. Data from a longitudinal study (n?= 108) were used to examine the extent to which parasympathetic functioning moderated links between CU traits in toddlerhood (m _age ?=?24.99 months) and externalizing behavior problems at preschool-age (m _age ?=?51 months). Neither CU traits nor parasympathetic functioning at age 2 directly predicted later externalizing behaviors. However, results show that high levels of CU traits predict elevated externalizing behavior problems, but only for toddlers exhibiting either high baseline respiratory sinus arrhythmia (RSA) or little to no RSA suppression in response to a fear stimulus.     

Irritability and Limited Prosocial Emotions/Callous-Unemotional Traits in Elementary-School-Age Children

Affective traits, including irritability and limited prosocial emotions/callous-unemotional traits (LPE/CU), each explain significant variance in youth conduct problems but few studies have examined these constructs simultaneously. This study examined whether irritability, LPE/CU, or their combination explained significant variance in measures of internalizing or externalizing psychopathology, aggression, peer problems, impairment, or parenting. Participants were 219 elementary-school-age children, including 178 with attention-deficit/hyperactivity disorder, oppositional defiant disorder, and/or conduct disorder and 41 typically developing children. Results of analyses showed that irritability and LPE/CU had significant and sometimes unique associations with measures of child behavior, impairment, and parenting. There was also evidence that the interaction between irritability and LPE/CU was significantly associated with aggression and impairment. These findings suggest that irritability and LPE/CU should be examined together when assessing and treating conduct problems in youth.     

What do others feel? Cognitive empathy deficits explain the association between callous-unemotional traits and conduct problems among preschool children

Abstract

Callous-unemotional traits (CU) are a risk factor for antisocial behavior, although it is unclear whether deficits in affective or cognitive empathy explain this association. Using a multi-informant approach involving data collection from parents and teachers (N = 167, M age = 4.7 years), the current study aimed to test whether cognitive or affective empathy deficits account for the association between CU traits and antisocial behavior among preschool children. Results revealed that cognitive, but not affective, empathy was associated with both CU and conduct problems, and also mediated the relationship between CU traits and conduct problems. These findings were not replicated for overt and relational aggressive behavior. Our findings suggest that cognitive empathy deficits may be more important than affective empathy in explaining antisocial behavior in preschool children. As a result, interventions aiming to reduce conduct problems early in development may need to target difficulties in understanding what others are thinking or feeling.     

Callous-Unemotional Traits as Unique Prospective Risk Factors for Substance Use in Early Adolescent Boys and Girls

Youth with elevated conduct disorder (CD) symptoms who also have callous-unemotional (CU) traits exhibit more antisocial behavior than youth without CU traits. However, evidence regarding whether CU traits increase risk of substance use over and above CD symptoms, and whether these associations differ for boys and girls, is scarce. Using the Developmental Pathways Project sample of 521 middle school students, we examined whether adolescent- and parent-reported CU traits measured in 6th grade prospectively predicted the onset and recurrence of substance use and use-related impairment by 9th grade. We also examined the degree to which CU traits uniquely predicted substance use and impairment over and above CD symptoms, as well as whether gender moderated these associations. Results indicated that adolescent-reported CU traits increased the likelihood of substance use and impairment onset and recurrence by 9th grade. Analyses revealed that CD symptoms accounted for prospective associations between adolescent-reported CU and substance use, but gender moderated these associations. Boys with elevated CU traits and CD symptoms were not more likely to report alcohol use onset or recurrence, but they were at highest risk of recurrent marijuana use, use of both alcohol and marijuana, and use-related impairment by 9th grade. Girls with low CU traits and high CD symptoms were most likely to report onset and recurrent use of alcohol, as well as recurrent marijuana use, use of both substances and impairment. Study findings highlight the importance of accounting for CD symptoms and gender when examining links between CU traits and substance use in early adolescence.     

Attentional Orienting to Emotional Faces Moderates the Association Between Callous-Unemotional Traits and Peer-Nominated Aggression in Young Adolescent School Children

Callous-unemotional (CU) traits are associated with aggressive behavior but preliminary research suggests this relationship is modified by patterns of emotional processing. This study examined whether attentional orienting to emotional faces moderated the association between CU traits and peer-nominated aggression in 251 middle school students (53% females, mean age = 13.24 years, SD = 0.73). Attentional orienting was assessed using an emotional faces (i.e., angry, fearful, happy, sad, and neutral) variant of the dot-probe task. Students also completed a self-report measure of CU traits and their classmates made peer nominations of aggression. Logistic regression analyses showed that peer-nominated aggression was positively related to CU traits at low levels of attentional orienting to angry faces, whereas aggression was unrelated to CU traits at high levels of attentional orienting to angry faces. That is, peer-nominated aggression was greatest for youth high on CU traits who were not engaged by angry faces. These findings support the importance of considering different patterns of emotional responding when studying the association between CU traits and aggressive behavior in youth.     

The role of correlated factors in factor analysis

The fundamental factor theorem is developed in matrix form for the case of correlated factors. The properties of the correlated factor system are discussed, and some effects of sampling error considered. The psychological meaning of correlated factors is discussed, and several mechanisms by which general factors may operate in the factorial system are indicated.