Callous–unemotional traits are associated with clinical severity in referred boys with conduct problems

Abstract

Clinical practice with the heterogeneous group of children that present with conduct problems may benefit from improved formats for diagnostic subtyping. We investigated whether high levels of callous-unemotional traits (i.e. lack of empathy, remorselessness and shallow affects) would differentiate clinic-referred conduct-problem boys from those low on such traits. A consecutive series of 41 boys with conduct problems (6-13 years, mean age=9.60 years) referred to public child psychiatric units in Sweden were studied with data elicited from caregivers. Conduct-problem boys with many callous-unemotional traits had significantly more pervasive, varied and aggressive disruptive behavioural problems than boys low on these traits had. Higher levels of conduct problems in subjects with callous-unemotional traits were not explained by confounding presence of DSM-IV attention-deficit hyperactivity disorder and oppositional defiant disorder/conduct disorder symptoms. Boys with callous-unemotional traits also experienced poorer household circumstances and lived in families under high stress. Interestingly, they less often received help in school from special teachers but were more often diagnosed with dysthymia than boys low on callous-unemotional traits. We conclude that callous-unemotional traits might designate a subgroup of boys with different aetiology to their conduct problems and possibly with specific treatment needs. However, the findings need to be replicated with larger samples.

Assessment of the Affective Dimensions of Psychopathy with the Danish version of the Inventory of Callous-Unemotional Traits among Incarcerated Boys: A study of Reliability, Criterion Validity, and Construct Validity

“…In this study, we found that CU traits were positively associated with psychosocial impairments. These findings are consistent with recent research that has suggested that CU traits are independently and longitudinally associated with psychiatric problems in the community (10) and clinical severity (9). Together, these results suggest that CU traits are associated with considerable psychiatric treatment needs.…”

“…Together, these results suggest that CU traits are associated with considerable psychiatric treatment needs. Moreover, CU traits were significantly associated with social problems, and this is consistent with previous research (9,60,61).…”

“…Available longitudinal follow-up studies indicate that CU traits are relatively stable during childhood (5,6) and from childhood into early adolescence (7,8) and that they are predictive of later antisocial behavior (2), clinical severity (9), and future psychiatric difficulties (10). Studies furthermore suggest that high levels of CU traits during adolescence are associated with psychopathy in adulthood (11)(12)(13).…”

Callous-Unemotional Traits and Their Implication for Understanding and Treating Aggressive and Violent Youths

“…However, much of this research has focused on CU traits and their association with antisocial behavior in general, for which aggression is just one component. That is, in terms of their association specifically with aggression, CU traits seem to designate a subgroup of antisocial youth who show more severe aggression and who are more likely to show both instrumental (e.g., for gain) and reactive (e.g., in response to perceived provocation) aggression (Enebrink et al, 2005;Fanti et al, 2009;Fite et al, 2009;Kruh, Frick, & Clements, 2005). For example, in a sample of incarcerated juvenile offenders (ages 16 to 21), Kruh et al (2005) identified two subtypes of violent offenders.…”

“…Although these studies were weighted toward adolescent samples and tended to have limited follow-up periods (e.g., 1 to 2 years), the review did include studies with samples as young as age 3 and with follow-up periods as long as 10 years (Gretton, Hare, & Catchpole, 2004). Not included in this review were 12 additional concurrent studies with clinical, forensic, and community samples showing the association between CU traits and severity of conduct problems (Dadds, Whiting, & Hawes, 2006), violence and aggression (Barry et al, 2007;Dolan & Rennie, 2006a;Enebrink, Anderson, & Langstrom, 2005;Fite, Stoppelbein, & Greening, 2009;Skeem & Cauffman, 2003;Vitacco, Neumann, Caldwell, Leistico, & Van Rybroek, 2006), bullying (Fanti, Frick, & Georgiou, 2009;Muñoz, Qualter, & Padgett, 2010;Viding, Simmonds, Petrides, & Frederickson, 2009), and delinquency (Dolan & Rennie, 2006b;Loeber et al, 2005;Poythress, Dembo, Wareham, & Greenbaum, 2006). Also, four longitudinal studies show the predictive relationships between CU traits and later antisocial personality (Loeber, Burke, & Lahey, 2002), violence and aggression (Ridenour, Marchant, & Dean, 2001), and delinquency (Lynam et al, 2009;Pardini, Obradovic, & Loeber, 2006).…”