Trajectories of callous–unemotional traits from childhood to adolescence in referred youth with a disruptive behavior disorder who received intensive multimodal therapy in childhood

Abstract

PurposeOur aims were to explore the developmental trajectories of callous–unemotional (CU) traits using a growth curve analysis in Italian children with disruptive behavior disorders treated with a multimodal intervention, and to test both predictors and distal outcomes of CU traits trajectories.Patients and methodOne hundred and sixty-eight children were enrolled, of whom 24 were lost in the follow-up and 144 were followed up from ages 8–9 to 14–15 years with four assessment points. Patients included 128 males (88.9%) with a mean age of 8.7 years, 96 with oppositional defiant disorder (66.7%) and 48 with conduct disorder (CD) (33.3%). The developmental trajectories of CU traits were assessed with the Inventory of Callous–Unemotional Traits (ICU).ResultsOur findings revealed that CU features were likely to fit a quadratic model from childhood to adolescence. The CU traits tended to decrease during childhood, with stabilization in adolescence and a significant variability in the growth curves. Pretreatment CD and higher levels of externalizing behavioral problems were associated with higher level of CU traits at baseline, whereas positive parenting was associated with lower levels. No significant effects were found for all the other predictors (socioeconomic status, negative parenting, combined pharmacotherapy). Regarding outcomes into adolescence, both higher levels of CU traits at the baseline and a lower decrease of CU traits across time points predicted a higher risk of CD diagnosis, and higher rate of referrals to mental health services and of substance use. Furthermore, pretreatment CD and negative parenting predicted a higher risk of substance use into adolescence.ConclusionOur findings suggest that a close monitoring of CU traits in referred children with disruptive behavior disorders may help to detect the patients at higher risk of poor outcome.

Role of Callous and Unemotional (CU) Traits on the Development of Youth with Behavioral Disorders: A Systematic Review

“…Among many different tools (see note to Table S2 ), measures of behavioral and emotional symptomatology in children and adolescents (e.g., CD, ODD, ADHD, anxiety, depression) have been mainly assessed using the SDQ (e.g., [ 4 , 79 ]), the CBCL (e.g., [ 72 , 94 ]) the Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS-PL; [ 95 ]), e.g., [ 96 , 97 ] and the Reactive-Proactive Aggression Questionnaire (RPQ; [ 98 ]), e.g., [ 69 , 99 ]. To measure the presence of autistic traits in children and adolescents, different scales have been used, as the Social Responsiveness Scale (SRS; [ 100 ]), e.g., [ 101 ] and the Social Communication Questionnaire (SCQ; [ 102 ]), e.g., [ 75 ].…”

“…Summary of results—cognitive dimension. References [ 7 , 21 , 36 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 94 , 96 , 99 , 101 , 104 , 105 , 106 , 107 , 108 , 109 , 110 , 111 , 112 , 113 , 114 , 115 , 116 , 117 , 118 , 119 , 120 , 121 , 122 , 123 , 124 , 125 , 126 , 127 , 128 ] are cited in the Supplementary Materials.…”

Intervenciones psicológicas en niños y adolescentes con trastorno de conducta y rasgos insensibles y carentes de emociones: una revisión narrativa

“…De los trece artículos revisados, que se encuentran en su mayoría en la tabla 1, fueron realizados entre los años de 2005 y de 2013 ocho estudios, luego en la tabla 2, entre los años 2014 y 2019 aparecen cinco estudios. Un número significativo de estudios (Salekin, et al 2012;White, et al 2013;Simpson, et al 2013;Miller, et al 2014;Masi, et al 2018;Lui, et al 2019) utilizó entre sus instrumentos de diagnóstico de los CUT el inventario de rasgos insensibles y carentes de emociones (ICU por sus siglas en inglés), utilizando diferentes métodos de evaluación (Kimonis, Frick, Skeem, Marsee, Cruise, Muñoz & Morris 2008).…”

“…Se pudo evidenciar que la mayoría de los estudios (Hawes et al 2005;Enebrink et al 2012;Kimonis et al 2013;White et al 2013;Hyde et al 2013) trabajaron con un modelo de intervención familiar, seguido por investigaciones como las de Simpson et al 2013, Masi et al 2018, Lui et al 2019, Gallego et al 2019, que contaron con un modelo de intervención individual y finalmente, Salekin et al 2012, Miller et al 2014 con un modelo de intervención grupal.…”

Fearlessness as an Underlying Mechanism Leading to Conduct Problems: Testing the INTERFEAR Model in a Community Sample in Spain

“…Empathy deficits stand out as a clear indication of CU traits (e.g., lack of guilt, remorse) [42][43][44][45], which are intricately connected to violence, psychopathy, and arrest even after controlling for disruptive behaviors [46]. In addition, prospective studies indicate that children characterized by CU traits tend to have more severe and stable forms of CP [47,48].…”