Callous-Unemotional Traits and Subtypes of Conduct Disorder

There has been growing consensus that children with conduct disorder (CD) constitute a very heterogeneous group containing children who vary substantially on the development, course, and causes of the disorder. While many have recognized the importance of this heterogeneity for developing better causal theories and for developing more effective treatments, there has been little consensus as to the best way to subtype children with CD. In this paper, we review a number of approaches to subtyping, each with some evidence for its validity for certain purposes. We focus on two recent approaches that have great potential for integrating past subtyping approaches and for advancing causal theory. The first approach is the division of children with CD into those with a childhood onset to their severe antisocial behavior and those with an adolescent onset to their behavior. The second approach is to designate children within the childhood-onset group who show callous and unemotional traits, which is analogous to adult conceptualizations of psychopathy. Both approaches help designate children who many show different causal processes underlying their severe aggressive and antisocial behavior, and who may warrant different approaches to treatment.     

Intelligence, Callous-Unemotional Traits, and Antisocial Behavior

Research has consistently shown that children with severe conduct problems often exhibit intellectual deficits, especially in their verbal abilities. We investigated whether or not this finding only applies to certain subgroups of children with severe conduct problems. In a sample of 117 clinic-referred children between the ages of 6 and 13, we assessed for Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) symptoms using a structured diagnostic interview with each child's parent and teacher, callous and unemotional traits using parent and teacher ratings, and intellectual functioning using a standard individually administered intelligence test. Children with an ODD or CD diagnosis who did not show callous and unemotional traits showed a deficit on subtests measuring verbal reasoning ability relative to a clinic control group. Children with an ODD or CD diagnosis who also showed callous and unemotional traits did not show a verbal deficit and, in fact, showed a trend toward having weaker nonverbal abilities. These results highlight the importance of recognizing distinct subgroups of children with severe conduct problems when studying potential intellectual deficits in these children.     

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 in Individuals Receiving Accommodations in University

Research with antisocial individuals suggests that callous-unemotional (CU) traits, a dimension of psychopathy, consistently predict severe antisocial behaviours and correlate with deficits in recognizing negative emotions, especially fearful facial expressions. However, the generalizability of these findings to non-antisocial populations remains uncertain and largely unexplored. This small, exploratory study aimed to extend this research by measuring CU traits and facial emotion recognition in university students with Attention-Deficit Hyperactivity Disorder (ADHD), learning disabilities, other psychiatric disorders, and comparison participants with physical/sensory disabilities. As the clinical groups can exhibit deficits in emotion recognition, this study sought to shed light on the candidacy of CU traits as a factor in emotion recognition. Results suggested that individuals in the diagnostic groups possess similar levels of CU traits to the comparison group and that the relationship between CU traits and emotion recognition deficits previously seen in antisocial populations is not present in this sample. Contrary to the hypothesis, those in the diagnostic groups displayed similar levels of accuracy on an emotion recognition task as the comparison group. Recommendations are made for future research to use more specific and representative diagnostic populations to further assess the relationships between CU traits and emotion recognition in non-antisocial populations.     

Associations Between Parental Psychopathic Traits,Parenting, and Adolescent Callous-Unemotional Traits

Research on Child and Adolescent Psychopathology - Callous-unemotional (CU) traits (i.e., callousness, low empathy, shallow affect) have been conceptualized as a downward extension of the...     

Linking Callous-Unemotional Traits to Instrumental and Non-Instrumental Forms of Aggression

The current study investigated the relation of callous-unemotional (CU) traits to bullying, victimization, and proactive and reactive aggression. We also examined whether CU traits will be more strongly related to groups of children exhibiting combined or pure forms of proactive and reactive aggression and combined or pure forms of bullying and victimization. The findings suggested that the presence of CU traits, which consists of three dimensions of behavior, uncaring, callousness, and unemotional, may designate important subgroups of aggressive children. Evidence suggested that the adolescents characterized by higher levels of CU traits were more likely to exhibit combined proactive and reactive aggression in comparison to pure forms of proactive or reactive aggression. Additionally, bullies scored higher on the uncaring dimension, and bully-victims (adolescents exhibiting both bullying and victimization) scored higher on the callous dimension. In contrast, victims of bullying scored lower on the uncaring dimension of behavior.     

Callous-Unemotional Traits Modulate Brain Drug Craving Response in High-Risk Young Offenders

Adults with psychopathy have a high propensity for substance abuse, generally starting from a young age. This investigation tested hypotheses about differences in the neural responses associated with drug craving among high-risk young offenders with histories of abuse of stimulants and other drugs as a function of psychopathic traits. Fifty-four male adolescents (44 with a history of stimulant abuse and 10 controls) incarcerated at a maximum-security facility (M age = 17.08 years) completed a drug-cue exposure task while brain hemodynamic activity was monitored using functional magnetic resonance imaging (fMRI) with a mobile MRI scanner stationed at the facility. Psychopathic traits were assessed using the Hare Psychopathy Checklist: Youth Version (PCL:YV). In the stimulant abuser group, drug cues elicited activity in classic reward circuitry. Consistent with studies of adult psychopathic traits and substance abuse, there was a negative association between PCL-YV scores and hemodynamic response related to drug craving in the amygdala and ACC in youth with a history of stimulant abuse. However, there were considerably more negative associations between the PCL:YV and hemodynamic response among youth than adults and this was primarily due to callous-unemotional traits rather than interpersonal or behavioral traits. The implications for how personality traits modulate motivations for drug-seeking behavior among adolescent offenders are discussed.     

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.     

Roles of Callous-Unemotional Traits,Narcissism, and Machiavellianism in Childhood Aggression

This study obtained teacher ratings of impulsivity, callous-unemotional traits, narcissism, and Machiavellianism for a sample of 252 middle school children, and investigated the extent to which these variables were related to reactive versus proactive aggression and physical versus relational aggression. Results showed a main effect for gender, with boys rated highest on all measures of psychopathy and aggression, with the exception of relational aggression. Results of hierarchical multiple regressions showed that whereas impulsivity was associated with all types of aggression, CU traits, narcissism, and Machiavellianism were differentially related to specific forms of childhood aggression. In addition, Machiavellianism mediated the relationship between narcissism and relational aggression. Implications for fine-tuning interventions in ways that account for the motivators underlying subtypes of childhood aggression are discussed.     

Callous-Unemotional Traits are Uniquely Associated with Poorer Peer Functioning in School-Aged Children

This study examines externalizing symptoms (attention-deficit/hyperactivity disorder [ADHD], conduct problems, and callous-unemotional [CU] traits) in relation to domains of peer functioning (social competence, loneliness, and close friendship quality), with a specific focus on the role of CU traits. One hundred twenty-four elementary students (grades 3–6; 45% boys) completed multiple measures of peer functioning, and teachers completed measures of externalizing symptoms and social competence. After controlling for demographic variables and other externalizing symptoms, CU traits were significantly associated with poorer peer functioning across all variables except for demands of exclusivity in close friendships. ADHD symptoms were also uniquely associated with poorer social functioning across a number of variables. In contrast, conduct problems were at times associated with better social functioning after controlling for the effects of other externalizing problems. These findings bolster the importance of developing and evaluating social skills interventions for children displaying elevated CU traits.     

Relating Callous-Unemotional Traits to Physically Restrictive Treatment Measures Among Child Psychiatric Inpatients

We examined the association of callous-unemotional (C/U) traits with the rates of seclusion and restraint among a sample of child psychiatric inpatients (N = 101). Analyses focused on the incremental value of C/U traits as a predictor over and above the influence of other risk factors for physically restrictive treatment measures found in previous research, including gender, age, verbal intelligence, ethnicity, the diagnosis of a conduct disorder or an oppositional defiant disorder, maltreatment history, and the other dimensions of psychopathy (i.e., narcissism and impulsivity). Results of hierarchical multiple regressions indicated that younger age and C/U traits predicted seclusion rates, whereas only C/U traits predicted restraint rates. The discussion of these findings focuses on the necessity of developing effective intervention programs for inpatient children with prominent C/U traits, to help forestall the physically dangerous behavior that necessitates a seclusion or restraint.     

Callous-Unemotional Traits and Antisocial Behavior among Adolescents: the Role of Self-Serving Cognitions

Self-serving cognitions and callous-unemotional traits play important roles in adolescent antisocial behavior. The objective of this study was to cross-sectionally explore the mediating role of self-serving cognitions in the relationship between callous-unemotional traits and antisocial behavior. A sample of 972 high-school students completed self-report questionnaires assessing callous-unemotional traits, self-serving cognitive distortions and antisocial behavior. Two competing models exploring indirect effects accounting for the relationships between self-serving cognitive distortions, callous-unemotional traits and antisocial behaviors were tested. Both models revealed significant indirect effects, suggesting both pathways are possible. Gender was found to moderate these models. These findings suggest the importance of targeting self-serving cognitions in therapeutic interventions and increase our understanding of the role of self-serving cognitions in antisocial behavior.     

Predicting the Stability of Conduct Problems in Children with and Without Callous-Unemotional Traits

We tested predictors of persistence in conduct problems for children with and without callous-unemotional (CU) traits. Participants were 79 children of an original 98 children recruited from a community-wide screening to oversample children with conduct problems and to ensure equal numbers of children high and low on CU traits. The sample was reassessed at four yearly intervals and the 79 children (81%) were those with data at all four assessments. Children within each conduct problem group were divided into those with more and less stable patterns of conduct problems based on structured interviews with parent and child. Stability in conduct problems for children without CU traits was more strongly related to level of impulsivity and socioeconomic status, whereas children high on CU traits showed more stable conduct problems if they experienced higher rates of life stressors.     

Altered White-Matter Microstructure in Conduct Disorder Is Specifically Associated with Elevated Callous-Unemotional Traits

Adolescents with conduct disorder (CD) and elevated callous-unemotional (CU) traits have been reported to present with a more severe and persistent pattern of antisocial behaviour than those with low levels of CU traits. However, relatively few studies have investigated whether there are differences in brain structure between these subgroups.We acquired diffusion tensor imaging data and used tract-based spatial statistics (TBSS) to compare adolescents with CD and high levels of CU traits (CD/CU+; n?=?18, CD and low levels of CU traits (CD/CU-; n?=?17) and healthy controls (HC; n?=?32) on measures of fractional anisotropy (FA), axial (AD), radial (RD) and mean (MD) diffusivity. Compared to CD/CU- adolescents, those with CD/CU+ presented increased FA and reduced RD and MD (lower diffusivity) in several tracts including: body and splenium of the corpus callosum, right inferior longitudinal fasciculus, ILF; right inferior fronto-occipital fasciculus, IFOF; left superior longitudinal fasciculus, SLF; left cerebral peduncle, bilateral internal capsule, left superior and posterior corona radiata, bilateral thalamic radiation and left external capsule. In addition, relative to CD/CU- individuals, adolescents with CD/CU+ showed lower diffusivity (indexed by reduced RD and MD) in left uncinate fasciculus and bilateral fornix. Finally, relative to healthy controls, CD/CU+ individuals showed lower diffusivity (reduced RD) in the genu and body of the corpus callosum and left anterior corona radiata. These results suggest that CD/CU+ individuals present with white-matter microstructural abnormalities compared to both CD/CU- individuals and age-matched healthy controls. This finding is consistent with emerging evidence suggesting that CD/CU+ represents a distinct subtype of CD, and illustrates the importance of accounting for heterogeneity within CD populations.     

Violence Exposure Mediates the Relation Between Callous-Unemotional Traits and Offending Patterns in Adolescents

The link between callous-unemotional (CU) traits in youth and delinquent, aggressive and violent behavior is well-replicated in the literature. However, the mediating effects of violence exposure on this relationship are unclear. The current study addresses this important gap in the literature with a sample of 88 detained, primarily ethnic minority adolescent boys (M age?=?15.57; SD?=?1.28). Results indicate that exposure to violence fully mediated the relationship between CU traits and violent delinquency, and this pattern of mediation was accounted for by exposure to witnessed violence, but not direct violent victimization. Secondly, exposure to violence, both direct and witnessed forms, also mediated the relationship between CU traits and drug delinquency. These findings suggest that (a) the well-established link between CU traits and violence may be attributed to high rates of witnessed violence among this subpopulation, and (b) specific types of violence exposure may be important for predicting the offending patterns of youth high on CU traits. Theoretical and practical implications are discussed.     

Negative Life Events and Posttraumatic Stress Disorder among Incarcerated Boys with Callous-Unemotional Traits

Historically, researchers have searched extensively for biological explanations regarding causes of psychopathy and its theorized developmental precursor, callous-unemotional (CU) traits (i.e., lack of empathy/guilt, shallow affect). In consequence, environmental factors such as exposure to negative life events and posttraumatic stress that often follows have been relatively overlooked. The present study tests whether exposure to negative life events and related symptoms of posttraumatic stress disorder (PTSD) are associated with CU traits among a sample of 238 incarcerated boys. Additionally, youth high on CU traits were disaggregated into primary and secondary variants based on the presence of anxiety to examine differences in their experiences of negative life events and PTSD symptoms. Results suggest that CU traits are significantly positively associated with both the experience of negative life events as well as PTSD symptomatology. Additionally, high-anxious youth scoring high on CU traits (secondary variant) were significantly more likely to report a history of negative life events and PTSD symptoms than were lower anxious boys scoring high on CU traits (primary type) and non-psychopathic youth. Thus, study findings warrant further exploration of how trauma might impact or maintain the development of CU traits over time and indicate that issues of differential diagnosis must be considered in order to more effectively tailor treatment for trauma-exposed CU youth.     

The Social Correlates to Callous-Unemotional Traits in a Sample of High School Students

Callous-Unemotional (CU) traits are strongly related to early-onset and severe levels of conduct problems. However, much less research has focused on their association with potential problems in adolescents’ social relationships. Further, it is important to determine if CU traits explain variance in important social variables, independent of conduct problems or general personality dimensions related to sociability, like agreeableness. In the current study, we examined the association of CU traits with a range of social variables in a community sample of Italian adolescents (N = 563; 460 girls; mean age = 15.80, SD = 1.50). Measures for the social variables included assessment of peer rejection, adolescents’ prosocial behaviors, satisfaction in peer relationships, and feelings of connection with school and classmates. We also obtained self-report ratings of CU traits, conduct problems (CP) and agreeableness. Analyses showed that CU traits were significantly associated with all the social variables. After controlling for CP and agreeableness, CU traits were still positively associated with ratings of peer rejection and negatively associated with prosocial behavior and satisfaction in relationships with peers. However, the negative associations with feelings of connection to school and peers were no longer significant. These findings provide further support for the clinical usefulness of CU traits and further evidence for potential targets of intervention, particularly focused on the adolescent’s relational skills.     

Dimensional Latent Structure of Callous-Unemotional Traits in German Adolescents: Results from Taxometric Analyses

Research on Child and Adolescent Psychopathology - A large amount of research has addressed the issue of the latent status of psychiatric disorders and related phenomena. We used a new taxometric...