Clinical Profiles of Children with Disruptive Behaviors Based on the Severity of Their Conduct Problems, Callous–Unemotional Traits and Emotional Difficulties

Abstract

This study identified clinical profiles of referred children based on the severity of callous-unemotional (CU) traits, emotional difficulties, and conduct problems. Parents of 166 children (132 males) aged 6-12 years referred to a hospital clinic because of disruptive behavior completed measures to assess these key indicators, and person-centered analysis was used to identify profiles. Four distinct profiles were identified that include: (1) Children low in severity on the three domains, (2) Children high in severity on the three domains, (3) Children high in severity in conduct problems and CU traits with minimal emotional difficulties, and (4) Children high in severity in conduct problems and emotional difficulties with minimal CU traits. Profiles differed in degree of aggression and behavioral impairment. Findings show that clinic-referred children with disruptive behaviors can be grouped based on these important indicators into profiles that have important implications for assessment and treatment selection.

Profiles of primary and secondary callous-unemotional features in youth: The role of emotion regulation

“…A higher proportion of youth were found to present with a primary profile of CU features compared to secondary profile in the current study. These proportions (19.4% and 6.5% for primary and secondary CU features, respectively) are in line with previous research with clinical or community populations, finding the fraction of youth presenting with a primary profile of CU features to range from 8% to 35%, and those presenting with a secondary profile of CU variants ranging from 3% to 31% (Andrade et al, 2015;Fanti et al, 2013;Kahn et al, 2013). The observed variability in rates seen in the current study compared with previous research could potentially be explained by the variability in the indicators used in identifying profiles; however, due to the smaller number of youth presenting with a secondary profile, interpretations must be made with caution.…”

“…This could lead to a self-selective sample in that parents are willing to engage in treatment and thus are less likely to have engaged in maltreatment. However, the sample is comparable to other clinical samples that are reliant on parent-referrals (e.g., Andrade et al, 2015). The population may have also impacted the rate of CU features, because CU features have traditionally been associated with highly aggressive youth in custody centers.…”

“…However, findings for the secondary profile have been inconsistent, with some studies finding a higher proportion of girls (e.g., Bennett & Kerig, 2014, Gill & Stickle, 2016), and others finding a higher proportion of boys (Fanti et al, 2013). Further, in clinical populations, studies have found either no gender difference in the variants, or a higher proportion of males overall in the secondary profile (Andrade et al, 2015; Kahn et al, 2013). Further research is needed to understand sample characteristics that may account for differing proportions of males and females in the secondary class.…”

Parenting Skills and Parent Readiness for Treatment Are Associated With Child Disruptive Behavior and Parent Participation in Treatment

“…The utility of person-centered approaches has been emphasized because the patterning of multiple constructs can be examined within individuals to determine overlap of characteristics, permitting the identification of client-centered profiles that may most closely represent the breadth of clinical risk and protective factors. This methodology has been successfully applied to domains of child psychopathology (Andrade, Sorge, Na, & Wharton-Shukster, 2014;Kuny et al, 2013;Ostrander, Herman, Sikorski, Mascendaro, & Lambert, 2008). Following this logic, the application of person-centered methodology to parents who present to children's mental health clinics may capture the range of characteristics on which parents are similar.…”