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

Abstract

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.

Can reciprocated parent–child eye gaze and emotional engagement enhance treatment for children with conduct problems and callous‐unemotional traits: a proof‐of‐concept trial

“…These large effect sizes achieved for drops in CU traits are consistent with those reported for similar interventions (e.g. Elizur et al., ; Hawes & Dadds, ; McDonald, Dodson, Rosenfield, & Jouriles, ); however, this study is the first to assess change in a sample selected to be high at pretreatment, and for these children, the final mean levels are still in the borderline high range, despite the large reductions. In this regard it should be noted that the current sample were screened to ensure that levels of CU traits were both high and stable prior to the commencement of treatment.…”

“…We thus tested whether parents could implement novel emotional engagement strategies (EE) in the context of a parent training programme, and whether they produced changes in the child's emotional engagement. Furthermore, although high levels of CU traits have been associated with compromised treatment outcomes, these traits themselves may also reduce in response to treatment (Elizur, Somech, & Vinokur, ; Hawes et al., ; Kjøbli, Zachrisson, & Bjørnebekk, ). Evidence regarding these reductions has been difficult to interpret, however, as reductions have been reported for children showing the full range (including low levels) of CU traits.…”

Parenting Is an Environmental Predictor of Callous-Unemotional Traits and Aggression: A Monozygotic Twin Differences Study

“…4,61 This evidence is critical for informing intervention efforts that are directed at parents to ameliorate CU traits or to reduce aggression and CU traits in children with CD. The limited evidence from randomized controlled trials in this area suggests that parenting interventions can be effective in reducing aggression even among children with high CU traits, 62 and that intervention-related increases in parental warmth specifically reduce children’s CU traits. 44 The findings from the current study highlight that adapted treatments for children with CD and/or CU traits could incorporate treatment modules targeting the emotional aspects of the parent-child relationships linked to low warmth, including increasing parent-child affiliation 30 or training children to better recognize emotions to promote empathic concern.…”

Ultraorthodox Jewish Fathers in Israel: Predictors of Involvement and Acceptance

“…This finding may be explained by the penetration of psychological and democratic discourses into Haredi communities and education systems, changing the perceptions that fathers may not show love and affection toward their children (Hakak, 2011). This process led to increased demand for therapists and counsellors in the ultraorthodox community, especially for children and youth (Hakak, 2011), and parents participated in parent training programs (Elizur, Somech, & Vinokur, 2017; Schnitzer, Loots, Escudero, & Schechter, 2009). In this vein, parents’ religiousness was associated with parental warmth and self-efficacy (Bornstein et al, 2017).…”