Practitioner Review: Involving young people with callous unemotional traits in treatment – does it work? A systematic review

Wilkinson, Simon; Waller, Rebecca; Viding, Essi

doi:10.1111/jcpp.12494

Cited by 107 publications

(96 citation statements)

References 47 publications

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“…Evidence to date suggests that parent-focused interventions implemented via regular contact with families in their communities, and that improve social support and increase motivation for change, can be effective at engaging families and reducing behavior problems even among children with high CU behaviors (Dishion et al, 2008; Hyde et al, 2013; Waller, Gardner, & Hyde, 2013). Emerging evidence also suggests that therapeutic efforts working directly with children can reduce CU behaviors by improving empathy, social skills, and emotion recognition, although more research is needed to examine the effectiveness of such interventions beginning in early childhood (see Wilkinson, Waller, & Viding, 2015 for a review).…”

Section: Discussionmentioning

confidence: 99%

Interactions between Callous Unemotional Behaviors and Executive Function in Early Childhood Predict later Aggression and Lower Peer-liking in Late-childhood

Waller

Hyde

Baskin‐Sommers

et al. 2016

J Abnorm Child Psychol

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112

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Callous unemotional (CU) behaviors are linked to aggression, behavior problems, and difficulties in peer relationships in children and adolescents. However, few studies have examined whether early childhood CU behaviors predict aggression or peer-rejection during late-childhood or potential moderation of this relationship by executive function. The current study examined whether the interaction of CU behaviors and executive function in early childhood predicted different forms of aggression in late-childhood, including proactive, reactive, and relational aggression, as well as how much children were liked by their peers. Data from cross-informant reports and multiple observational tasks were collected from a high-risk sample (N=240; female=118) at ages 3 and 10 years old. Parent reports of CU behaviors at age 3 predicted teacher reports of reactive, proactive, and relational aggression, as well as lower peer-liking at age 10. Moderation analysis showed that specifically at high levels of CU behaviors and low levels of observed executive function, children were reported by teachers as showing greater reactive and proactive aggression, and were less-liked by peers. Findings demonstrate that early childhood CU behaviors and executive function have unique main and interactive effects on both later aggression and lower peer-liking even when taking into account stability in behavior problems over time. By elucidating how CU behaviors and deficits in executive function potentiate each other during early childhood, we can better characterize the emergence of severe and persistent behavior and interpersonal difficulties across development.

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Section: Discussionmentioning

confidence: 99%

Interactions between Callous Unemotional Behaviors and Executive Function in Early Childhood Predict later Aggression and Lower Peer-liking in Late-childhood

Waller

Hyde

Baskin‐Sommers

et al. 2016

J Abnorm Child Psychol

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112

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“…Our findings highlight that boys who exhibit high levels of both IC and CP, even as early as 10 years of age, are at heightened risk for exhibiting later psychopathic features. Intervention research suggests that targeting multiple domains of risk, particularly in younger youth, may lead to improvements in IC over time, with treatments facilitating improvements in parenting practices, child social skills, and child problem solving leading to reductions in IC (for a review see Wilkinson, Waller, & Viding, ). In addition to early prevention and intervention efforts that have shown promising effects for youth with high IC (Hawes, Price, & Dadds, ; Waller et al., ), clinical pessimism about the absolute stability of these characteristics should be tempered in light of documented variability in these features over time.…”

Section: Discussionmentioning

confidence: 99%

“…Second, assessments of IC and CP were conducted during late childhood and early adolescence. A number developmental processes relevant to IC and CP are thought to take place during earlier childhood periods (Hawes, Price, et al., ; Wilkinson et al., ). Indeed, 10‐years‐old is the recommended cut‐off for designating childhood‐onset CD.…”

Section: Discussionmentioning

confidence: 99%

Late childhood interpersonal callousness and conduct problem trajectories interact to predict adult psychopathy

Hawes

Byrd

Waller

et al. 2016

Child Psychology Psychiatry

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Background Studies have demonstrated a robust association between interpersonal callousness (IC) and the development of severe and chronic conduct problems (CP) in youth. Although children exhibiting IC are also believed to be at particularly high risk for developing psychopathic personality features in adulthood, there is little longitudinal evidence supporting this assumption, particularly after controlling for co-occuring CP severity. Methods This study used data collected on a longitudinal cohort of boys (n = 508), with an oversampling of youth exhibiting elevated conduct problems. Analyses examined the unique and interactive association between latent growth curve trajectories of IC and CP assessed bi-annually from late childhood to early adolescence (~ages 10–13) and features of psychopathy in early adulthood (age ~ 24) assessed using the Psychopathy Checklist – Short Version (PCL:SV; Hart, Cox, & Hare, 1995). Results Growth curve analysis indicated that initial levels of IC and CP in childhood (~age 10 intercept) both uniquely predicted the development of the interpersonal/affective features of adult psychopathy, and boys with a combination of high initial levels of IC and CP were at particularly high risk for developing the impulsive/antisocial features of the disorder. Boys who exhibited systematic increases in CP from late childhood to early adolescence also demonstrated higher adult psychopathy scores, but changes in IC across this developmental period did not significantly add to the prediction of adult psychopathy. Conclusions Findings highlight the importance of developing targeted interventions for boys exhibiting severe IC and CP in childhood, as they appear to be at high risk for developing adult psychopathic features.

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“…Callous-unemotional (CU) traits are reported to be an important modifier of aggression. These behaviors characterized by limited prosocial emotions have been added to further specify CD in the DSM-5 (American Psychiatric Association, 2013) and were shown to reduce treatment response and worsen clinical outcome (Wilkinson, Waller and Viding, 2016; Bakker et al , 2017). Moreover, CU traits seem associated with impaired empathy (Blair, Leibenluft and Pine, 2014; Ciucci et al , 2015), neurocognitive dysfunctions in emotion and reward learning processes (Reidy et al , 2017), and adult psychopathy (Frick and White, 2008; Frick et al , 2013).…”

Section: Introductionmentioning

confidence: 99%

Different Whole-Brain Functional Connectivity Correlates of Reactive-Proactive Aggression and Callous-Unemotional Traits in Disruptive Children and Adolescents

Werhahn

Mohl

Willinger

et al. 2019

Preprint

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Background. Disruptive behavior in children and adolescents can manifest itself in reactive (RA) and proactive (PA) aggression and is modulated by callous-unemotional (CU) traits and comorbidity. Research on aggression subtype-specific neural correlates is limited and the role of comorbid symptoms largely neglected.Methods. The current multi-center study extended previous efforts by investigating unrestricted resting state functional connectivity (rsFC) alterations. The large sample (n = 207) of children and adolescents aged 8 -18 years (mean age = 13.30 ± 2.60 years) included 118 cases with disruptive behavior (80 diagnosed with Oppositional Defiant Disorder and/or Conduct Disorder) and 89 controls. Attention-deficit/hyperactivity disorder (ADHD) and anxiety symptoms were added as covariates. We measured changes in global and local voxelto-voxel rsFC using functional magnetic resonance imaging at 3T (mean acquisition time = 8 min 25 sec).Results. Compared to controls, cases demonstrated altered rsFC including frontal areas when anxiety but not ADHD symptoms were considered. Within cases, RA and PA scores related to changes in global and local rsFC in central gyrus and precuneus previously linked to aggression-related impairments. CU trait severity correlated with global rsFC alterations including inferior and middle temporal gyrus implicated in empathy, emotion, and rewardrelated activity. Importantly, most observed aggression subtype-specific patterns could only be identified when ADHD and anxiety problems were also accounted for.Conclusions. The current study clarifies that distinct though overlapping brain connectivity measures can disentangle differing manifestations of aggressive behavior. Moreover, our results highlight the importance of considering comorbid symptoms for detecting aggressionrelated rsFC alterations. Werhahn et al. 5

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Practitioner Review: Involving young people with callous unemotional traits in treatment – does it work? A systematic review

Abstract: Background: Children and adolescents with callous unemotional (CU) traits are at risk

Cited by 107 publications

References 47 publications

Interactions between Callous Unemotional Behaviors and Executive Function in Early Childhood Predict later Aggression and Lower Peer-liking in Late-childhood

Interactions between Callous Unemotional Behaviors and Executive Function in Early Childhood Predict later Aggression and Lower Peer-liking in Late-childhood

Late childhood interpersonal callousness and conduct problem trajectories interact to predict adult psychopathy

Different Whole-Brain Functional Connectivity Correlates of Reactive-Proactive Aggression and Callous-Unemotional Traits in Disruptive Children and Adolescents

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