Aggressive Male Juvenile Offenders with Callous-Unemotional Traits Show Aberrant Attentional Orienting to Distress Cues

Antisocial youth with callous-unemotional (CU) traits exhibit a pattern of severe and persistent conduct problems and deficits in emotional processing that parallels adults with psychopathy. Aberrant emotional attention, particularly among individuals high on aggression, constitutes one such deficit; however, its robustness across race/ethnicity requires further investigation given findings that the psychopathy construct manifests differently across race (Sullivan and Kosson 2006), and emotional attention is susceptible to the influence of adverse environmental factors such as violence exposure that is more common among ethnic minority youth (Kimonis et al. in Development and Psychopathology, 20, 569–589, 2008b). Also, the development of a comprehensive measure of CU traits, the Inventory of Callous-Unemotional Traits (ICU), has identified specific CU dimensions (Uncaring, Callous, Unemotional) that are yet to be investigated in relation to emotional attention deficits. Thus, the purpose of the present study was to examine whether aggressive boys high on total CU traits and specific ICU dimensions show deficits in attentional orienting to negative stimuli on a dot-probe task that are consistent across race/ethnicity. Results from a predominately Latino sample of incarcerated male adolescents (N = 156) showed that aggression moderated the association between CU traits and facilitation to distress stimuli. That is, aggressive boys high on CU traits or the Uncaring dimension showed deficient attentional orienting; a finding that was consistent across racial/ethnic minority groups. Results are consistent with prior research suggesting that the combination of high CU traits and aggression defines a unique subgroup of antisocial individuals that more closely fits with the construct of psychopathy than the presence of CU traits alone.     

Confirmatory Factor Analyses of Self- and Parent- Report Inventory of Callous-Unemotional Traits in 8- to 10-Year-Olds

The factorial structure of the Inventory of Callous-Unemotional Traits (ICU; Frick 2004) has been inconsistent across various studies using different rater versions and samples. In this study the factorial structure of the self- and parent-report versions of the ICU was examined in a community sample of 340 boys and girls aged 8- to 10- years. A series of confirmatory factor analyses revealed that (1) for self-report ICU, a two-factor model comprising one Uncaring and one Callousness factor fit the data best; the factorial structure was invariant across sex, although boys showed higher scores than girls on the Uncaring factor; (2) for the parent-report ICU, a three-factor structure was supported, and boys and girls did not differ on factor structure or levels of the factors. For both versions, CU traits were positively associated with the count of Oppositional Defiant Disorder/Conduct Disorder and internalizing behavior symptoms, demonstrating ICU’s good convergent albeit unsatisfactory discriminant validity. Findings suggest further refinement of this instrument for the self-report and parent versions separately.     

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.     

Individual, Social, and Behavioral Factors Associated with Co-Occurring Conduct Problems and Callous-Unemotional Traits

Conduct problems (CP) and callous-unemotional (CU) traits can have a long-lasting negative impact into adulthood. Importantly, among youth with CP, those high on CU traits engage in a more severe, aggressive, and persistent pattern of antisocial behavior. The current study investigates the co-occurrence between CP and CU traits among a large sample of Greek-Cypriot adolescents (N?=?1,674; 50.1 % girls). Five distinct groups were identified with Latent Profile Analysis: low risk (48.7 %), average risk (33.8 %), co-occurring high CP-high CU (5.4 %), high CP-low CU (5.2 %), and low CP-high CU (6.9 %). Although more boys were identified in the higher risk groups, boys and girls within each group were not differentiated on levels of CP or CU traits during early adolescence. Youth in the identified groups were compared on early (Mean age?=?12.12) and middle (Mean age?=?14.02) adolescence individual and contextual factors. Youth with high CP-high CU were at higher risk for behavioral (bullying and substance use), individual (inattention, impulsivity, narcissism), and contextual (low family-support) problems compared to youth in the high CP-low CU and low CP-high CU groups, providing evidence that the combination of CP and CU traits might constitute a pathological group. These findings demonstrate the usefulness of sub-typing CP based on CU traits for the forthcoming fifth edition of the Diagnostic and Statistical Manual. Additional novel findings suggested that adolescents scoring high on CP, irrespective of CU, were not differentiated on hyperactivity, victimization, and anxiety/depression, and adolescents scoring high on CU traits, with or without CP, reported similar low levels of self-esteem and peer and family social-support.     

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.     

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.     

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.     

Parent Training Adapted to the Needs of Children With Callous–Unemotional Traits: A Randomized Controlled Trial

Callous–unemotional (CU) traits designate a distinct subgroup of children with early-starting, stable, and aggressive conduct problems. Critically, traditional parenting interventions often fail to normalize conduct problems among this subgroup. The aim of this study was to test whether parent–child interaction therapy (PCIT) adapted to target distinct deficits associated with CU traits (PCIT-CU) produced superior outcomes relative to standard PCIT. In this proof-of-concept trial, 43 families with a 3- to 7-year-old child (M age = 4.84 years, SD = 1.12, 84% male) with clinically significant conduct problems and elevated CU traits were randomized to receive standard PCIT (n = 21) or PCIT-CU (n = 22) at an urban university-based research clinic. Families completed five assessments measuring child conduct problems, CU traits, and empathy. Parents in both conditions reported good treatment acceptability and significantly improved conduct problems and CU traits during active treatment, with no between-group differences. However, linear mixed-effects models showed treatment gains in conduct problems deteriorated for children in standard PCIT relative to those in PCIT-CU during the 3-month follow-up period (ds = 0.4–0.7). PCIT-CU shows promise for sustaining improvements in conduct problems for young children with conduct problems and CU traits, but requires continued follow-up and refinement.     

Predicting Risky Sexual Behavior: the Unique and Interactive Roles of Childhood Conduct Disorder Symptoms and Callous-Unemotional Traits

Conduct disorder (CD) symptoms and callous-unemotional (CU) traits have been shown to be uniquely associated with risky sexual behavior (RSB) in adolescence and early adulthood, yet their interactive role in predicting RSB remains largely unknown. This study aimed to investigate the predictive value of CD symptoms and CU traits, as well as their interaction, on several RSB outcomes in adolescence and early adulthood. A total of 683 participants (41.7 % female, 47.4 % African American) were followed annually and self-reported age of first sexual intercourse, frequency of condom use, pregnancy, contraction of sexually transmitted infections, and engagement in sexual solicitation from grade 7 to 2-years post-high school. CD symptoms predicted age of first sexual intercourse, condom use, and sexual solicitation. CU traits predicted age of first sexual intercourse and pregnancy. Their interaction predicted a composite score of these RSBs such that CD symptoms positively predicted the composite score among those with high levels of CU traits but not among those with low levels of CU traits. The current findings provide information regarding the importance of both CD symptoms and CU traits in understanding adolescent and early adulthood RSB, as well as the benefits of examining multiple RSB outcomes during this developmental period. These findings have implications for the development and implementation of preventive efforts to target these risky behaviors among adolescents and young adults.     

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.     

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.     

Bidirectional Associations Between Parenting Behavior and Child Callous-Unemotional Traits: Does Parental Depression Moderate this Link?

The current study longitudinally examined bidirectional associations between callous-unemotional (CU) traits and parenting dimensions. This study extended the literature by examining whether parental depression moderated these relations in a pre-adolescent sample. Proposed relations were examined using a longitudinal sample of 120 aggressive children (59.6 % male) who were in the 4th grade (M?=?10.56 years, SD?=?0.56) at baseline and were followed annually over 4 years. A series of generalized estimating equation (GEE) models were used to examine proposed relations. At the first order level, corporal punishment (p?p?=?0.03) however, the inverse relations were not found. Importantly, parental depression moderated the link between corporal punishment and CU traits. Specifically, at high levels of depression, corporal punishment was predictive of increases in CU traits, but was unrelated to CU traits at low levels of depression. These findings aid in our understanding of the link between corporal punishment and CU traits by highlighting conditions under which certain parenting behaviors have an impact on CU traits, which in turn, may have important intervention implications. Further clinical implications, limitations and future directions are discussed.     

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.     

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.     

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.     

Callous-Unemotional Traits Only Versus the Multidimensional Psychopathy Construct as Predictors of Various Antisocial Outcomes During Early Adolescence

The aim of this study was to compare callous-unemotional (CU) traits versus the multidimensional psychopathy construct in their ability to predict future and stable antisocial behavior. At baseline, a community sample of 996 Cypriot 12-year old adolescents (52% girls) completed measures that tap conduct problems (CP) and psychopathic traits, including CU. CP, aggression, and substance use were self-reported at 1–3 year follow-ups. Youths were assigned to six mutually exclusive groups based on their baseline levels of CP and psychopathic traits. Youth with CP scoring high on all three psychopathic traits dimensions (Psychopathic Personality?+?CP) showed the most robust and highest risk for future and stable CP, aggression, and substance use, followed by youth who were high on all three psychopathic traits dimensions but displayed no concurrent CP (Psychopathic Personality Only) and CP youth with low levels of psychopathic traits (CP Only). Youth with CP who merely manifested callous-unemotional traits (Callous-Unemotional?+?CP) were only at risk for future CP. The findings suggest that the CU traits-based approach for subtyping children with CP is less informative compared to a subtyping approach using various psychopathic traits dimensions in predicting future and stable forms of various antisocial outcomes. These findings and their consistency with prior work indicate the need for additional research to examine the various psychopathic traits dimensions rather than focusing solely on CU traits, especially for CP subtyping purposes.     

Unique and Interactive Associations of Callous-Unemotional Traits,Impulsivity and Grandiosity with Child and Adolescent Conduct Disorder Symptoms

The construct of psychopathy remains underrepresented in the clinical diagnosis of Conduct Disorder (CD) as the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) only addresses one out of the three dimensions of child psychopathy, Callous Unemotional (CU) traits. This study tests if and to what extent there are unique and interactive associations of CU traits, impulsivity, and grandiosity with child and adolescent CD symptoms. Data were collected from two separate community samples of children (N?=?1599; Mage?=?9.46, SD?=?1.65; 52% female) and adolescents (N?=?2719; Mage?=?16.99, SD?=?0.99; 49% female), who were followed longitudinally after a year. Hierarchical linear regression analyses were conducted, testing cross-sectional and longitudinal associations with CD symptoms, taking into account all three psychopathy dimensions. The cross-sectional findings indicate that only youth presenting a combination of all three psychopathy dimensions scored above the clinical cut-off score for CD. On the other hand, longitudinal findings provided evidence that the combination of high initial levels of CD and CU traits as well as the combination between CD, grandiosity, and impulsivity can lead to clinical levels of future CD symptoms. Findings also indicated that CU traits and impulsivity more strongly predicted adolescent than child CD symptoms, and that CU traits were more strongly associated with boys’ than girls’ CD symptoms. Findings support the inclusion of CU traits as a specifier for the diagnosis of CD, and provide evidence that other psychopathy dimensions can also help clinicians to better understand and treat youth with CD, and should be considered for future revisions of the DSM.     

Effects of Parent Training on Callous-Unemotional Traits,Effortful Control,and Conduct Problems: Mediation by Parenting

Callous-unemotional (CU) traits and effortful control (EC) are personality and temperament traits implicated in early-onset antisocial trajectories. This secondary analysis of Hitkashrut’s randomized controlled trial first tested parent training’s effects on EC and CU traits while controlling for more general treatment effects on conduct problems (CP), and subsequently tested mediation by parenting. Prekindergarten teachers in three Israeli cities identified 209 3–5 year-old (163 boys; 46 girls) preschoolers with subclinical-clinical range conduct problems. All participants were Jewish ranging from ultra-orthodox to secular. They were assigned to 14-session co-parent training groups (n = 140 couples), or to minimal intervention control groups with referral to local services as necessary (n = 69 couples). We employed averaged indices of pre- and post-intervention questionnaires completed by both parents. The testing of all hypothesized models controlled for treatment effects on CP in order to strengthen the robustness of the analyses. We found significant concurrent treatment effects on CP and on either CU traits or EC. All effects were mediated by ineffective parenting (IP): a latent variable that was indicated by negative/inconsistent practices and perceived parenting inefficacy. This is the first demonstration of parenting mediated treatment effects on both EC and CU traits in a randomized controlled study conducted in everyday practice contexts. This finding supports a disruption model of change: the reduction of IP facilitates a caregiving environment that affects children’s behavior and developing personality. The changing of personality and temperament characteristics implicated in early-onset pathways suggests an innovative prevention strategy for disruptive behavior disorders.     

Community violence exposure and callous–unemotional traits in adolescents: Testing parental support as a promotive versus protective factor

Although callous–unemotional (CU) traits are associated with maladjustment in youth, literature predicting CU using prospective designs is rare. In the present study we examine associations between exposure to community violence, supportive relationships with caregivers, and CU in a sample of 236 low-income youth (M age = 13.00 years, SD = 1.56 years; 43% male; 92% African American) participating in a 3-wave longitudinal study of violence exposure and adjustment. Both promotive and protective models of linkages between exposure to community violence, support, and CU were investigated. Given known sex differences in CU, sex was explored as a moderator. Regression analysis revealed that witnessing and hearing about community violence, aggregated over 2 waves, were positively associated with CU at the final study wave. Supportive relationships with caregivers, aggregated over 2 waves, were negatively associated with CU but did not interact with violence exposure, suggesting that supportive relationships with caregivers has a promotive but not a protective association with CU in the context of exposure to violence. The pattern of associations did not vary by sex. This study informs our understanding of factors that contribute to the development of CU.     

Startle modulation during violent films: Association with callous–unemotional traits and aggressive behavior

The current study examined the unique and interactive associations of callous–unemotional (CU) traits, impulsive and premeditated aggression with startle modulation to violent films. Eighty-five participants (Mage = 20.52) at differential risk of CU traits, selected from a sample of 1105 young adults, participated in the physiological experiment. Startle eye-blink responses to acoustic probes were recorded during violent, comedy and neutral films. Self-report ratings of valence and arousal were also collected. Findings from regression analysis documented that CU traits were associated with diminished startle potentiation to violent films, whereas impulsive aggression was associated with increases in startle potentiation. Further, the negative association between CU traits with startle potentiation, valence, and arousal ratings to violent films was moderated by impulsive aggression. At the group level, individuals high on impulsive aggression without CU traits were the ones showing the highest levels of startle potentiation to violent films, and scored on the opposite extreme compared to individuals high on both CU traits and impulsive aggression.