Differential correlates to self-report and parent-report of callous-unemotional traits in a sample of juvenile sexual offenders

Vocally-Encoded Emotional Arousal as a Marker of Callous-Unemotional Traits in a Sample of Justice-Involved Adolescents

Callous-unemotional (CU) traits are associated with severe and persistent juvenile offending. CU traits are also associated with dampened emotional arousal, which suggests that fundamental frequency (f0), a measure of vocally-encoded emotional arousal, may serve as an accessible psychophysiological marker of CU traits in youth. This study investigated the associations between f0 range measured during an emotionally evocative task, CU traits, and emotion dysregulation in a mixed-gender sample of 168 justice-involved youth. For boys, after controlling for covariates, wider f0 range-indicating greater emotional arousal-was negatively associated with CU traits and positively associated with emotion dysregulation. For girls, no significant associations with f0 range emerged; however, CU traits were positively associated with emotion dysregulation. Findings suggest that f0 range may serve as a valid indicator of CU traits in JJ-involved boys, and that detained boys and girls with high CU traits are characterized by different profiles of emotion dysregulation.

Do Juveniles Who Have Committed Sexual Offenses Have Higher Callous-Unemotional Traits Compared to Juveniles Who Have Committed General Offenses? A Systematic Review

The importance of assessing psychopathic traits in juveniles who have committed sexual offenses has been established in individuals who demonstrate a particularly severe and violent pattern of behavior. Additionally, the assessment of these traits in other juveniles might be relevant considering that higher levels of these traits represent an increased probability of the juvenile committing offenses. This study is a systematic review of the literature about the presence of callous-unemotional (CU) traits in juveniles who have committed sexual and non-sexual offenses, in order to ascertain eventual differences between these groups regarding the presence of CU traits. Studies were obtained from multiple databases, with predefined exclusion and inclusion criteria, according to PRISMA-P guidelines. A total of 18 studies were reviewed and included in the final analysis. The 18 studies used measures of CU traits and reported descriptive categories of CU traits in juveniles who have committed general offenses or juveniles who have committed sexual offenses. Meta-analytic procedures such as pooled means, pooled variances, and pooled standard deviations are presented in this study. The main conclusion obtained is that juveniles who have committed general offenses present higher levels of CU traits compared to juveniles who have committed sexual offenses. Although the review highlights limitations in the literature, the identification of these characteristics in different types of juveniles who have committed offenses is important to shed light on the phenomenon and develop interventions better suited to their characteristics. Recommendations for future research are also presented.

Measurement invariance of the inventory of Callous‑Unemotional traits in different age groups from preschool age to late adolescence in Germany

BACKGROUND

Callous-unemotional traits are associated with the development of severe behavior problems, delinquency, and psychopathy. Previous studies have repeatedly shown that CU traits may be present as early as preschool age, and they have consistently used the Inventory of Callous-Unemotional Traits (ICU) to assess CU traits in children and adolescents. A three-factor structure for the ICU has been widely endorsed.

METHOD

The aim of our study is to compare the three-factor structure of the ICU in different age groups (preschool, middle childhood, early, and late adolescence) and to test for measurement invariance in a German sample of N = 2368 children and adolescents (M = 11.76 years; SD = 3.72).

RESULTS

The results of our study indicate configural measurement invariance, suggesting that the ICU has the same structure in all age groups but with different meanings, parameters, and mean values in the groups.

CONCLUSION

Accordingly, the ICU cannot be applied in the same way to children and adolescents of different age groups, which emphasizes the need for a more differentiated assessment.

Meta-analysis of the implied distribution of callous-unemotional traits across sampling methods and informant

Callous-unemotional (CU) traits have been measured in a variety of sample-types (e.g., community or forensic) and from the perspective of different informants (e.g., self-report or parent-report) using the inventory of callous-unemotional traits total score (ICU-T). Although the positive association between CU traits and antisocial behavior is uncontroversial, the degree to which sample-types are different from each other has received little attention despite such knowledge being important for generalization and interpretation of research findings. To address this gap in the literature, we estimated the implied distribution of the ICU-T across sample-types, informants, and their interaction using meta-analytic models of sample means and variances. In unconditional models, we found that sample-type significantly moderated mean ICU-T scores but not variance, while informant significantly moderated the variance of ICU-T scores but not means. There was also a significant interaction between sample-type and informant. Mean parent-reported ICU-T scores were significantly lower than self-reported scores in community samples, but not significantly different in samples with elevated levels of antisocial behavior. Implications of our findings include improved research efficiency, the need for different ICU-T norms across informants, and greater understanding of informant biases.

Prefrontal cortex structural and developmental associations with callous-unemotional traits and aggression

Youths with high levels of callous-unemotional (CU) traits and aggression are at an increased risk for developing antisocial behaviours into adulthood. In this population, neurostructural grey matter abnormalities have been observed in the prefrontal cortex. However, the directionality of these associations is inconsistent, prompting some to suggest they may vary across development. Although similar neurodevelopmental patterns have been observed for other disorders featuring emotional and behavioural dysregulation, few studies have tested this hypothesis for CU traits, and particularly not for aggression subtypes. The current study sought to examine grey matter correlates of CU traits and aggression (including its subtypes), and then determine whether these associations varied by age. Fifty-four youths (10-19 years old) who were characterized for CU traits and aggression underwent MRI. Grey matter volume and surface area within the anterior cingulate cortex was positively associated with CU traits. The correlation between CU traits and medial orbitofrontal cortex (mOFC) volume varied significantly as a function of age, as did the correlation between reactive aggression and mOFC surface area. These associations became more positive with age. There were no significant findings for proactive/total aggression. Results are interpreted considering the potential for delayed cortical maturation in youths with high CU traits/aggression.

The Proposed Specifiers for Conduct Disorder (PSCD) in Iranian School-Attending Adolescents: A Multi-Informant Validation Study of the PSCD Parent- and Youth Self-Report Versions

The Proposed Specifier for Conduct Disorder (PSCD) was developed to measure the broad psychopathy construct with grandiose-manipulative, callous-unemotional, daring-impulsive, and conduct disorder subscales. This study tested the psychometric properties of Persian parent-and-child self-report PSCD versions with 974 parents (86% mothers) and children/adolescents (46.5% boys) dyads. Results showed that with some modifications the proposed hierarchical four-factor structure for both PSCDs was confirmed and was found to be invariant across gender. Across versions, all PSCD scores were internally consistent and demonstrated expected correlations with parent-reported externalizing problems, anxiety/depression, and poor school performance, supporting the PSCDs scores' validity. This study also is the first to examine and establish acceptable to excellent parent-child agreement of PSCD scores. Finally, all PSCD child-report scores offered small though significant incremental validity over their corresponding PSCD parent-version scores in predicting parent-reported conduct problems and proactive aggression. Findings indicated that both Persian PSCDs may hold promise for assessing psychopathy components in Iranian school-attending adolescents and generating additional research on this topic.

The association between callous-unemotional traits and substance use in childhood and adolescence: A systematic review and meta-analysis

Callous-unemotional (CU) traits are characterized by a lack of guilt and empathy, restricted affect, and low concern about performance, and are increasingly recognized as co-occurring with substance use in youth. However, there is mixed evidence concerning whether they make a unique contribution to substance use. This systematic review and meta-analysis sought to quantify the association between CU traits and substance use in childhood, accounting for potential moderators including sample characteristics (age, gender, community versus clinical/forensic samples), CU traits measure and informant, and study design (cross-sectional or longitudinal). Separate meta-analyses were conducted for alcohol, cannabis, and a substance use composite. Small, significant associations were found between CU traits and alcohol (θ = 0.17), cannabis (θ = 0.17) and the substance use composite (θ = 0.15), which were present in both community and clinical/forensic samples. Findings suggest that CU traits co-occur with a range of substance use problems, and that CU traits should be considered in assessments of youth presenting with substance use problems regardless of the nature of the setting.

Examining the Roles of Prior Victimization, Perpetrator Identity and the Correlates of Female Rape Myth Acceptance Among Indian Females

This research attempts to address a widely under-explained phenomenon of female rape myth acceptance (RMA) among the female population. A total number of 500 literate women from India with a mean age of 28.89 years were selected to examine the different determinants of their RMA. The research explored the important correlates of RMA among women, where the stepwise regression model revealed the significant impact of sexual desires, rejection sensitivity, loneliness, and neuroticism/emotional stability on their RMA. This further implied that women high on these four constructs run a 17.7% chance of endorsing female rape myths. The model eliminated the construct of online pornography usage, owing to its non-significant impact on RMA. Further, it was revealed that the history of prior victimization had a significant effect on the rape myths endorsed by the women. The study also reflected on the identity of the perpetrators of the women with a prior victimization history, where 55.43% reported it was perpetrated by a "known" person in their last experienced assault (and 44.57% "stranger" perpetrator). Whereas most women were victimized by "known" perpetrators, there was no significant difference in the sample's RMA, between the perpetrator identity groups (known and stranger perpetrators). The research concretely adds novel knowledge on identifying and predicting the female rape supportive attitudes among females.

Validation of the Proposed Specifiers for Conduct Disorder (PSCD) Self-Report Version in Iranian School-Attending Adolescents

The Proposed Specifiers for Conduct Disorder (PSCD) scale was developed to advance the study of child and adolescent psychopathy, especially as it relates to conduct disorder. This study is the first to test the factor structure, measurement invariance, internal consistency, and validity of the Persian PSCD self-report version in a gender-mixed sample of 1,506 school-attending 11 to 18 years old youth (M age = 15.23; SD = 1.83; 49.60% boys). Confirmatory factor analysis supported the proposed four-factor hierarchical structure of the PSCD, though with 19 items loaded on grandiose-manipulative, callous-unemotional, daring-impulsive, and conduct disorder components. This factor structure was also invariant across gender. The PSCD total and four components scores were internally consistent and exhibited the expected relations with proactive aggression, externalizing problems, anxiety and depression, and poor school performance, supporting the PSCD scores' convergent, discriminant, and criteria validity. The findings indicated that with some modifications, the Persian PSCD might hold promise for assessing psychopathy components in Iranian school-attending adolescents and may spark additional research in a variety of settings.

Validation of the Proposed Specifiers for Conduct Disorder (PSCD) Scale in a Sample of Italian Students

This study aimed to further validate the self-reported version of the Proposed Specifiers Conduct Disorder (PSCD) scale, testing the associations between the PSCD with a scale that measures emotional/behavioral difficulties and prosocial behaviors (Strength and Difficulties Questionnaire, SDQ). A total of 536 Italian students (47.76% male; 11-14 years) completed the PSCD, while their caregivers and teachers completed the SDQ. A series of confirmatory factor analyses to test the best fitting model were run. The internal consistency of the PSCD was evaluated, and the correlations between the PSCD self-reported scores and SDQ Parent and Teacher report scores were examined. A bi-factor model was fitted with a refined 19-item version of the scale, which showed adequate fit indices. The PSCD total score was strongly associated with higher parent- and teacher-rated conduct problems, hyperactivity, and lower prosocial behavioral symptoms. In conclusion, this study indicated that the self-report PSCD shows preliminary promise as a reliable, easy-to-use tool, for measuring psychopathic traits in Italian children and young adolescents.

Validation of the Proposed Specifiers for Conduct Disorder (PSCD) Scale in a Sample of Italian Students

This study aimed to further validate the self-reported version of the Proposed Specifiers Conduct Disorder (PSCD) scale, testing the associations between the PSCD with a scale that measures emotional/behavioral difficulties and prosocial behaviors (Strength and Difficulties Questionnaire, SDQ). A total of 536 Italian students (47.76% male; 11-14 years) completed the PSCD, while their caregivers and teachers completed the SDQ. A series of confirmatory factor analyses to test the best fitting model were run. The internal consistency of the PSCD was evaluated, and the correlations between the PSCD self-reported scores and SDQ Parent and Teacher report scores were examined. A bi-factor model was fitted with a refined 19-item version of the scale, which showed adequate fit indices. The PSCD total score was strongly associated with higher parent- and teacher-rated conduct problems, hyperactivity, and lower prosocial behavioral symptoms. In conclusion, this study indicated that the self-report PSCD shows preliminary promise as a reliable, easy-to-use tool, for measuring psychopathic traits in Italian children and young adolescents.

Associations Between Parental Psychopathic Traits, Parenting, and Adolescent Callous-Unemotional Traits

Callous-unemotional (CU) traits (i.e., callousness, low empathy, shallow affect) have been conceptualized as a downward extension of the interpersonal and affective components of adult psychopathy and are associated with stable and severe antisocial behavior. Research suggests that CU traits are moderately heritable, but also influenced by environmental factors, particularly parenting. We examined associations among mother and father psychopathic traits, parenting practices, and offspring CU traits in a community sample of 550 adolescent twins (Mean age = 13.99 years; SD 2.37; 56.4% male), incorporating multiple informants (mothers, fathers, child). Parental interpersonal-affective psychopathic traits were associated with adolescent CU traits and negative parenting (increased harshness, reduced warmth). Moreover, increased parental harshness and reduced warmth partially explained associations between parental interpersonal-affective traits and adolescent CU traits. There was also a significant direct effect specifically between mother interpersonal-affective traits and adolescent CU traits. Finally, using a twin difference design, we confirmed that adolescent CU traits were significantly impacted by non-shared environmental parenting influences (increased harshness, reduced warmth). These results suggest that mother and father interpersonal-affective traits appear to impact parenting practices and serve as risk factors for adolescent CU traits. However, many of the findings did not replicate when using cross-informant reports and were only present within single informant models, highlighting a role for shared informant variance as well. The results suggest the importance of accounting for parent personality in the development of effective parenting interventions for CU traits.

Reflexive Gaze Shifts and Fear Recognition Deficits in Children with Callous-Unemotional Traits and Impulsivity/Conduct Problems

The ability to efficiently recognize the emotions on others' faces is something that most of us take for granted. Children with callous-unemotional (CU) traits and impulsivity/conduct problems (ICP), such as attention-deficit hyperactivity disorder, have been previously described as being "fear blind". This is also associated with looking less at the eye regions of fearful faces, which are highly diagnostic. Previous attempts to intervene into emotion recognition strategies have not had lasting effects on participants' fear recognition abilities. Here we present both (a) additional evidence that there is a two-part causal chain, from personality traits to face recognition strategies using the eyes, then from strategies to rates of recognizing fear in others; and (b) a pilot intervention that had persistent effects for weeks after the end of instruction. Further, the intervention led to more change in those with the highest CU traits. This both clarifies the specific mechanisms linking personality to emotion recognition and shows that the process is fundamentally malleable. It is possible that such training could promote empathy and reduce the rates of antisocial behavior in specific populations in the future.

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

Numerous studies have shown that youth with behavioral disorders (BD) present an increased risk for developing severe and persistent antisocial behaviors in adulthood. Retrospective research notes that not all children and adolescents follow a negative trajectory and explains this heterogeneity in particular by the severity of CU traits. Our study examines how these traits affect the functioning of children and adolescents with BD. Method: A systematic literature review conducted through various databases and using different keywords made it possible to analyze 52 studies published from 2015 to 2020 that measured the bidirectional effects of CU traits on the functioning of young. Results: Out of the 52 studies, 47 analyzed links between CU traits and neurobiological or mental health, 20 examined family and school contexts, eight focused on social adjustment, 10 on social interactions and 19 measured links with cognitive functioning, especially executive functions. Conclusion: Consistent with previous recommendations in the field, our findings emphasize the importance of assessing the presence of UC traits in early childhood to prevent the emergence of comorbid disorders and to target multimodal (early) interventions to influence the life trajectories of youth with high CU traits.

A Multi-Informant Study of the Validity of the Inventory of Callous-Unemotional Traits in a Sample of Norwegian Adolescents with Behavior Problems

The Inventory of Callous-Unemotional traits (ICU) is a widely used measure of the affective aspects of psychopathy in children and adolescents. Although a 3-bifactor model of the ICU has often been supported, method-variance effects and mixed results for the Unemotional subscale raise concerns. This study applied a multi-informant design to investigate the structural and concurrent validity of the self-, parent- and teacher-versions of the ICU in a Norwegian at-risk adolescent sample (N = 160, female = 46.3%, mean age = 14.73 years, SD = 1.47). Confirmatory Factor Analysis demonstrated method-variance effects of the standard- and reverse-scored items. The best fitting model was the 12-item 2-factor ICU, comprising a Callousness and an Uncaring factor. The scale reliabilities were acceptable with Cronbach alphas ranging from .810 to .906 across respondent groups. Cross-rater reliability was poor, with Intra Class Correlations ranging from .170 to .226. The concurrent validity of the ICU12 was supported by within-rater associations to externalizing problems, aggression, and problematic alcohol use. Cross-rater associations of ICU12-scores to self-reported delinquency and lower levels of anxiety, provided additional support for the concurrent validity. The unidimensional ICU12 total score was associated both to delinquency and rule-breaking behavior as observed for the Callousness factor and to lack of anxiety and reduced fear sensitivity as observed for the Uncaring factor. The ICU items aimed at capturing lack of prosocial emotions, seem to need revision. Future research should assess the predictive validity and clinical relevance of unidimensional versus factor models of the ICU.

A Comparison of the Youth Psychopathic Traits Inventory (YPI)-Triarchic Scales and the YPI in a Sample of Justice-Involved Youth

The Triarchic model (Patrick, Fowles, & Krueger, 2009) posits that psychopathy consists of three elements: Boldness, Meanness, and Disinhibition. Drislane et al. (2015) recently derived scales from the Youth Psychopathic Traits Inventory (YPI; Andershed, Kerr, Stattin, & Levander, 2002) to assess these traits. The initial validation efforts appeared promising, but researchers have yet to evaluate these scales among justice-involved youth. The current study examines the validity of the YPI-Triarchic scales in an archival sample of 928 male adolescent offenders and tests whether the new scales provide information incremental to the original YPI. The YPI-Triarchic scales were strongly correlated with original YPI scales (rs = .56-.96), and some associations were contrary to predictions and previous findings about the Triarchic model (e.g., YPI-Boldness was not inversely related to symptomatology). Thus, caution is warranted when attempting to study the Triarchic model with the YPI-Triarchic scales.

Relationships between Early Life Victimization, Antisocial Traits, and Sexual Violence: Executive Functioning as a Mediator

Few research studies examine how the relationship between trauma and executive functioning can influence sexual violence among youth. Knight and Sims-Knight (2004) proposed a Developmental Etiological Theory (DET) connecting early life physical and sexual victimization to sexual violence via antisocial traits. Drawing from research that identifies a link between early life victimization and executive functioning, this study tests an adaptation to the DET by including executive functioning as an intervening factor. Using data on adolescents adjudicated of sexual and non-sexual crimes in a western state (N = 200), multiple structural equation models tested direct and indirect relationships between early life sexual, physical victimization, and other adversity, four differential forms of executive functioning, callousness, and sexual violence. Results revealed statistically significant direct pathways between variables of interest and a multi-meditational effect of certain forms of executive functioning and callousness in the relationship between victimization and sexual violence. Treatment and research implications are discussed.

Callous and uncaring traits are associated with reductions in amygdala volume among youths with varying levels of conduct problems

BACKGROUND

The emergence of callous unemotional (CU) traits, and associated externalizing behaviors, is believed to reflect underlying dysfunction in the amygdala. Studies of adults with CU traits or psychopathy have linked characteristic patterns of amygdala dysfunction to reduced amygdala volume, but studies in youths have not thus far found evidence of similar amygdala volume reductions. The current study examined the association between CU traits and amygdala volume by modeling CU traits and externalizing behavior as independent continuous variables, and explored the relative contributions of callous, uncaring, and unemotional traits.

METHODS

CU traits and externalizing behavior problems were assessed in 148 youths using the Inventory of Callous Unemotional Traits (ICU) and the Child Behavior Checklist (CBCL). For a subset of participants (n = 93), high-resolution T1-weighted images were collected and volume estimates for the amygdala were extracted.

RESULTS

Analyses revealed that CU traits were associated with increased externalizing behaviors and decreased bilateral amygdala volume. These results were driven by the callous and uncaring sub-factors of CU traits, with unemotional traits unrelated to either externalizing behaviors or amygdala volume. Results persisted after accounting for covariation between CU traits and externalizing behaviors. Bootstrap mediation analyses indicated that CU traits mediated the relationship between reduced amygdala volume and externalizing severity.

CONCLUSIONS

These findings provide evidence that callous-uncaring traits account for reduced amygdala volume among youths with conduct problems. These findings provide a framework for further investigation of abnormal amygdala development as a key causal pathway for the development of callous-uncaring traits and conduct problems.

The INventory of Callous-Unemotional Traits and Antisocial Behavior (INCA) for Young People: Development and Validation in a Community Sample

Callous-unemotional traits are defined as potential markers of psychopathy in children and adolescents. Previous studies with the most widely used instrument designed specifically to assess these traits, the Inventory of Callous-Unemotional Traits (ICU), have shown major methodological problems. For this reason, the purpose of the present study was to develop a valid and reliable test to assess callous-unemotional traits for the adolescent population free of the response biases social desirability (SD) and acquiescence (AC). In order to obtain responses free of these biases, we used SD item markers as well as content balanced items to identify a factor related to SD and AC, so that SD and AC effects can be removed from the individual scores on content factors. As well as the CU traits (unemotional, callousness, and uncaring scales), this new questionnaire also contains an additional scale for assessing antisocial behaviors. The test was administered to 719 adolescents between 13 and 19 years old. Exploratory and confirmatory factor analysis yielded the following expected four dimensions with a good fit: Unemotional, Callousness, Uncaring, and Antisocial Behavior. These scales also showed good psychometric properties with good reliability, and convergent, discriminant and criterion validity.

A Prospective, Longitudinal Examination of the Influence of Childhood Home and School Contexts on Psychopathic Characteristics in Adolescence

Much of the existing research examining etiological contributors to psychopathic characteristics considers only biological and physiological deficits, with little consideration given to contextual factors that may play a role in their development. This prospective, longitudinal study examined the influence of childhood home and school environments on adolescent psychopathic characteristics among 390 youth (50.5% female; 46.2% Black/African American, 44.9% Hispanic/Latino, 6.9% Asian or Native American/Alaska Native, and 2.1% Non-Hispanic White). Specifically, this study examined (1) the effect of home chaos and poor parental monitoring on adolescent primary and secondary psychopathy and callous-unemotional traits through the lens of multiple reporters, and (2) whether classroom climate quality across three years of childhood moderated these relationships. The results indicated that delinquency and home chaos in childhood were related to primary psychopathy in adolescence and that exposure to higher quality classroom climates across childhood acted as a buffer by mitigating the negative relationship between parental monitoring in childhood and secondary psychopathy in adolescence. These findings have implications for designing interventions to mitigate the manifestation of youth psychopathy.

Predicting Risky Sexual Behavior: the Unique and Interactive Roles of Childhood Conduct Disorder Symptoms and Callous-Unemotional Traits

Conduct disorder (CD) symptoms and callous-unemotional (CU) traits have been shown to be uniquely associated with risky sexual behavior (RSB) in adolescence and early adulthood, yet their interactive role in predicting RSB remains largely unknown. This study aimed to investigate the predictive value of CD symptoms and CU traits, as well as their interaction, on several RSB outcomes in adolescence and early adulthood. A total of 683 participants (41.7 % female, 47.4 % African American) were followed annually and self-reported age of first sexual intercourse, frequency of condom use, pregnancy, contraction of sexually transmitted infections, and engagement in sexual solicitation from grade 7 to 2-years post-high school. CD symptoms predicted age of first sexual intercourse, condom use, and sexual solicitation. CU traits predicted age of first sexual intercourse and pregnancy. Their interaction predicted a composite score of these RSBs such that CD symptoms positively predicted the composite score among those with high levels of CU traits but not among those with low levels of CU traits. The current findings provide information regarding the importance of both CD symptoms and CU traits in understanding adolescent and early adulthood RSB, as well as the benefits of examining multiple RSB outcomes during this developmental period. These findings have implications for the development and implementation of preventive efforts to target these risky behaviors among adolescents and young adults.

The reliability, concurrent validity and association with salivary oxytocin of the self-report version of the Inventory of Callous-Unemotional Traits in adolescents with conduct disorder

The present study evaluated the self-report version of the Inventory of Callous-Unemotional Traits (ICU-SR) in terms of reliability, concurrent validity, and correlation with salivary oxytocin levels, a potential biomarker of CU traits. 67 socially at-risk male adolescents (mean 16.2 years) completed the ICU-SR, ICU teacher-version (ICU-TR), Strengths and Difficulties Questionnaire, and their medical files were coded for previous antisocial acts using Brown-Goodwin Lifetime Aggression Scale. Salivary samples were assayed for oxytocin. The reliability of ICU-SR was lower (α = 0.71) than ICU-TR (α = 0.86). ICU-SR mean score was significantly lower than ICU-TR (M = 25.29, SD = 8.02; M = 33.14, SD = 9.47). ICU-TR but not ICU-SR, significantly correlated with history of antisocial acts (r = 0.40). Two-way analysis of variance showed a significant effect of conduct disorder and oxytocin on ICU-TR but not ICU-SR [F(1,59) = 6.53; F(1,59) = 6.08], and a significant interaction only for ICU-TR [F(1,59) = 2.89]. Subjective self-reports of CU traits may be less reliable and valid than teachers' reports.

Callous-Unemotional Traits Among Adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD): Associations with Parenting

This study examined the extent to which positive and negative parenting relates to conduct problems (CP) and callous-unemotional (CU) traits among 172 adolescents (72 % males; Mage = 16.91 years, SD = .67) with attention-deficit/hyperactivity disorder and whether CU traits moderate the link between parenting and CP. Mothers reported on their adolescents' CP, CU traits, and their own parenting practices. Maternal behaviors were observed during a problem-solving communication task. Parents who engaged in more positive parenting (self-reported and observed) reported their adolescents as having lower levels of CU traits. No effect was found for negative parenting. Moderation analyses indicated that lower levels of positive maternal behavior was only associated with higher CP in the presence of higher levels of CU traits. Negative parenting was positively related to CP regardless of CU traits. Positive parenting, irrespective of measurement approach, uniquely relates to adolescents' CU traits while both positive and negative parenting relate to CP.

Therapeutic alliance and treatment outcome in the outpatient treatment of urban adolescents: The role of callous-unemotional traits

Callous-unemotional (CU) traits designate a unique subset of youth with externalizing psychopathology who have a severe pattern of aggressive behavior and tend to have worse outcomes in treatment. However, little research has addressed how CU traits relate to different components of psychotherapy, such as the therapeutic alliance. The current study examined the role of CU traits in predicting therapeutic alliance in 59 adolescents (M age = 15.3, 51% female, 64% Hispanic American, 15% African American) who were part of a larger randomized naturalistic trial of outpatient behavioral psychotherapy. Multilevel regression analysis further investigated the role of therapeutic alliance in predicting treatment outcome (as measured by self-reported delinquency) and the moderating role of CU traits. Results suggested that regardless of the severity of their externalizing problems, youth with higher levels of CU traits reported more positive ratings of therapeutic alliance. In addition, a positive therapeutic alliance predicted reductions in delinquent behavior, and this association was even stronger for youth higher in CU traits. Our results suggest that CU traits are related to improvement in the formation of the therapeutic alliance among youth with externalizing psychopathology, perhaps because these youth lack many of the social and emotional deficits that other youth with conduct problems possess. Adolescents high in CU traits should not be viewed as untreatable. Indeed, the therapeutic alliance may be an important mechanism for affecting meaningful change in these adolescents' lives. (PsycINFO Database Record

Psychiatric evaluation of youths with Disruptive Behavior Disorders and psychopathic traits: A critical review of assessment measures

Disruptive Behavior Disorders (DBDs) are stable and impairing disorders, heterogeneous in presentation, developmental pathways, and treatment needs. Disentangling subtypes according to psychopathological dimensions is helpful for timely diagnoses, precise prognoses and tailored interventions. Psychopathic traits are relevant in subtyping DBDs with severe antisocial and aggressive behaviors. Three psychopathy dimensions have been found: 1) an affective dimension, the callous-unemotional (CU) trait, with lack of empathy and remorse, and with short-lived emotions; 2) an interpersonal dimension, the narcissistic domain, with manipulative abilities, superficial charm, egocentricity and grandiosity; 3) a behavioral dimension, the impulsivity or impulsive-irresponsibility, with irresponsibility, proneness to boredom, and novelty seeking. Recently, research suggests that youth with CU traits, similarly to adults with psychopathy, can present a low-anxious "primary" and high-anxious "secondary" variants. Our aim is to critically review the main measures of psychopathic traits, including the three main dimensions (with specific emphasis on CU traits), and the "primary/secondary" distinction, focusing on the assessment in clinical settings. An assessment procedure is proposed, based on previous literature and personal clinical experience.

Assessing Callous-Unemotional Traits in Adolescents: Determining Cutoff Scores for the Inventory of Callous and Unemotional Traits

OBJECTIVE

This study aims to establish a cut score for the Inventory of Callous-Unemotional Traits, a well-validated measure of callous-unemotional (CU) traits in youth for which there is currently no cutoff score.

METHOD

We analyzed data on 634 adolescents from high schools (n = 343) and juvenile detention centers (n = 291). Participants, their parents and guardians, and their teachers and staff members reported on participants' CU traits and aggressive/violent behavior.

RESULTS

All three reports of CU traits as well as intersource composites were associated with aggression, violence, and detained status. Parent report was a better indicator compared to self-reports and teacher reports. Appropriate cut scores based on each report and composite were determined.

CONCLUSION

We recommend that information from all available informants should be used whenever possible, but when only one informant report is feasible, parent reports are preferable.

Dual neurocircuitry dysfunctions in disruptive behavior disorders: emotional responding and response inhibition

BACKGROUND

To determine the functional integrity of the neural systems involved in emotional responding/regulation and response control/inhibition in youth (age 10-18 years) with disruptive behavioral disorders (DBDs: conduct disorder and/or oppositional defiant disorder) as a function of callous-unemotional (CU) traits.

METHOD

Twenty-eight healthy youths and 35 youths with DBD [high CU (HCU), n = 18; low CU (LCU), n = 17] performed the fMRI Affective Stroop task. Participants viewed positive, neutral, and negative images under varying levels of cognitive load. A 3-way ANOVA (group×emotion by task) was conducted on the BOLD response data.

RESULTS

Youth with DBD-HCU showed significantly less activation of ventromedial prefrontal cortex (vmPFC) and amygdala in response to negative stimuli, compared to healthy youth and youth with DBD-LCU. vmPFC responsiveness was inversely related to CU symptoms in DBD. Youth with DBD-LCU showed decreased functional connectivity between amygdala and regions including inferior frontal gyrus in response to emotional stimuli. Youth with DBD (LCU and HCU) additionally showed decreased insula responsiveness to high load (incongruent trials) compared to healthy youth. Insula responsiveness was inversely related to ADHD symptoms in DBD.

CONCLUSIONS

These data reveal two forms of pathophysiology in DBD. One associated with reduced amygdala and vmPFC responses to negative stimuli and related to increased CU traits. Another associated with reduced insula responses during high load task trials and related to ADHD symptoms. Appropriate treatment will need to be individualized according to the patient's specific pathophysiology.

Genetic and environmental aetiology of the dimensions of Callous-Unemotional traits

BACKGROUND

A Callous-Unemotional trait specifier (termed 'Limited Prosocial Emotions') was added to the diagnosis of conduct disorder in DSM-5. The Inventory of Callous-Unemotional Traits (ICU) is a comprehensive measure of these traits assessing three distinct, yet correlated dimensions--Callousness, Uncaring, and Unemotional--all thought to reflect the general Callous-Unemotional construct. The present study was the first to examine the degree to which the aetiology of these dimensions is shared v. independent.

METHOD

Parent-reported ICU data from 5092 16-year-old twin pairs from the Twins Early Development Study were subjected to confirmatory factor analysis. Multivariate genetic modelling was applied to the best-fitting structure.

RESULTS

A general-specific structure, retaining a general factor and two uncorrelated specific factors (Callousness-Uncaring, Unemotional), provided the best fit to the data. The general factor was substantially heritable (h2 = 0.58, 95% CI 0.51-0.65). Unusually, shared environmental influences were also important in accounting for this general factor (c2 = 0.26, 95% CI 0.22-0.31), in addition to non-shared environmental influences. The Unemotional dimension appeared phenotypically and genetically distinct as shown by the substantial loadings of unemotional items on a separate dimension and a low genetic correlation between Unemotional and Callousness-Uncaring.

CONCLUSIONS

A general factor, indicative of a shared phenotypic structure across the dimensions of the ICU was under substantial common genetic and more modest shared environment influences. Our findings also suggest that the relevance of the Unemotional dimension as part of a comprehensive assessment of CU traits should be investigated further.

Adolescent Callous-Unemotional Traits and Parental Knowledge as Predictors of Unprotected Sex Among Youth

Risky sexual behavior among adolescents is common and results in many negative consequences. The present study investigated longitudinal predictors of adolescents' likelihood of engaging in unprotected sexual intercourse. Parental knowledge, or the extent to which parents know about their children's activities, whereabouts, and friendships, is a robust predictor of youth risk behavior, including risky sexual behavior. However, parenting practices are typically less potent as predictors of subsequent behavior among youth with high levels of callous-unemotional (CU) traits. We conducted three logistic regression models, each of which examined parental knowledge in a different way (through child report, parent report, and a discrepancy score), allowing us to examine parental knowledge, CU traits, and their interaction as predictors of adolescents' subsequent engagement in sex without a condom. Results indicated that adolescents who perceived their parents to possess greater knowledge were less likely to engage in unprotected sex. Higher parent report of parental knowledge was also related to decreased likelihood of engaging in unprotected sex, but only for adolescents with high levels of CU traits. In addition, greater discrepancy between parent and adolescent reports of parental knowledge was related to increased likelihood of engaging in unprotected sex, but only for adolescents with low levels of CU traits. Results highlight the importance of considering both parent and adolescent perceptions of parental knowledge and have important implications for prevention and intervention efforts.

[Cognitive and affective perspective-taking in girls with conduct problems as a function of the callous-unemotional personality feature]

OBJECTIVE

Do girls with conduct problems (CP) and callous-unemotional (CU) traits show specific deficits in perspective-taking (PT) compared to healthy girls?

METHOD

We examined cognitive and affective PT in girls with CP and high CU scores (SVP-CU+), girls with CP and low CU-scores (SVP-CU-), and a healthy control group (KG) using a video sequence task and the animated shapes task. The sample consisted of 59 girls aged 8;6 to 16; 11 years.

RESULTS

The groups did not differ in affective or in cognitive PT.

CONCLUSION

The results emphasize the necessity of studies of PT in girls with CP and CU traits that account for differences in age ,and gender.

Factor Structure and Construct Validity of the Parent-Reported Inventory of Callous-Unemotional Traits Among High-Risk 9-Year-Olds

The presence of callous-unemotional (CU) traits delineates a subgroup of youth with severe antisocial behavior. However, debate surrounds the best method to assess CU traits. This study examined the factor structure of the parent-reported Inventory of Callous-Unemotional Traits (ICU) among high-risk 9-year-olds (N = 540) and its predictive validity over 1 year. Confirmatory factor analysis showed support for a three-factor bifactor model and revised two-factor model using a shortened ICU. Within a three-factor bifactor framework the general CU traits factor and specific uncaring factor scores were related to higher externalizing and lower internalizing behavior problems at ages 9.5 and 10.5. Findings were replicated using teacher-reported outcomes. However, results also suggest the need for item refinement and highlight the utility of a two-factor solution using a shortened ICU. In particular, the meaning of the unemotional items is discussed in relation to the conceptualization of CU traits.

Callous-Unemotional traits in youth from a DSM-5 trait perspective

The current study investigated how the Callous-Unemotional (CU) trait specifier is empirically associated with the proposed trait system for personality pathology in DSM-5, and addressed the use of multiple raters in the assessment of CU traits and additional maladaptive traits in an adolescent community sample. Both mothers and adolescents (N = 197) participated in the present study. Results showed that CU traits are located in different parts of the personality space, and are significantly associated with four broad maladaptive trait dimensions, Negative Affect, Detachment, Antagonism, and Disinhibition. Despite moderate agreement between raters, self- and maternal-rated CU traits were related in a congruent manner with PID-5 traits, and adolescents provided incremental information in CU trait assessment above maternal ratings. The present results have clear implications for the conceptualization of CU traits within the overarching model of personality pathology, proposed in DSM-5, and partially supported the application of a multi-informant approach in CU trait assessment.

An exploration of psychopathy in self-report measures among juvenile sex offenders

Researchers have indicated that adult psychopathy often originates in childhood or adolescence. It has also been established that psychopathic traits are linked to disruptive behavior, criminality, and violence. As knowledge about psychopathy and its manifestations in juvenile sex offender populations remains limited, several instruments have been developed in an effort to measure the construct. In this study, we assessed how the relationship of diverse scales of psychopathy related to characteristics of sexual aggression, and determined which scales were most correlated to sexual and nonsexual delinquency. We utilized four measures of juvenile psychopathy: the Modified Childhood Psychopathy Scale (mCPS; Lynam, 1997), the Antisocial Process Screening Device (APSD; Frick & Hare, 2001; Frick, O'Brien, Wootton, & McBurnett, 1994), the Millon Adolescent Clinical Inventory (MACI; Millon & Davis, 1993; using two derived psychopathy scales), and the Inventory of Callous and Unemotional (ICU) Traits (Frick, 2003), in a sample of 191 incarcerated adolescent sex offenders located in juvenile detention facilities across a Midwestern state. We found that of the four instruments and seven subscales, only the APSD Narcissism and Impulsivity Scale was significantly correlated to a characteristic of sexual crime (i.e., number of victims, level of crime severity). No subscales were found to predict sexual crime at a significant level. However, several scales were correlated to the total delinquency score as measured by the Self-Reported Delinquency Measure. In a series of multiple regressions, the MACI Factor 2 and ICU total score were determined as the best fit to total nonsexual delinquency. Implications are offered.

Callous-unemotional traits and conduct disorder symptoms as prospective risk factors for adolescent sexual activity

Conduct disorder (CD) has been shown to increase risk for adolescent sexual activity and pregnancy. Despite increasing evidence underscoring callous-unemotional (CU) traits as a marker for youth with CD prone to especially poor outcomes, researchers have yet to explore whether CU traits confer additional risk of early sexual intercourse, unprotected sex, and pregnancy. The Developmental Pathways Project sample, including 471 ethnically diverse 6th-grade boys and girls followed into 12th grade, was used to examine whether CU traits and CD symptoms in 6th grade uniquely and/or synergistically predicted having sexual intercourse by age 13 as well as unprotected sex and pregnancy by 12th grade. Parent-rated CU traits and CD symptoms interacted to predict young adolescents having sexual intercourse, such that youth with elevated CU traits and CD symptoms in 6th grade were more likely to reporting having sex by age 13 than those with low CU traits and/or low CD symptoms. Elevated CD symptoms, but not CU traits, uniquely increased risk of pregnancy by 12th grade. Neither CU traits nor CD symptoms predicted engagement in unprotected sex in 12th grade. Our findings indicate that adolescents with conduct problems and CU traits are especially at risk for early sexual intercourse. Conversely, elevated CU traits do not appear to increase risk of unprotected sex or pregnancy among young adolescents with conduct problems. Research is needed to replicate these findings and to explore mechanisms underlying the association between CU traits, CD symptoms, and early adolescent sexual activity.

The relationship between large cavum septum pellucidum and antisocial behavior, callous-unemotional traits and psychopathy in adolescents

BACKGROUND

The presence of a large cavum septum pellucidum (CSP) has been previously associated with antisocial behavior/psychopathic traits in an adult community sample.

AIMS

The current study investigated the relationship between a large CSP and symptom severity in disruptive behavior disorders (DBD; conduct disorder and oppositional defiant disorder).

METHOD

Structural MRI scans of youth with DBDs (N = 32) and healthy comparison youth (N = 27) were examined for the presence of a large CSP and if this was related to symptom severity.

RESULTS

Replicating previous results, a large CSP was associated with DBD diagnosis, proactive aggression, and level of psychopathic traits in youth. However, the presence of a large CSP was unrelated to aggression or psychopathic traits within the DBD sample.

CONCLUSIONS

Early brain mal-development may increase the risk of a DBD diagnosis, but does not mark a particularly severe form of DBD within patients receiving these diagnoses.

The Inventory of Callous and Unemotional Traits

The Inventory of Callous and Unemotional Traits (ICU), developed to assess callous/unemotional (CU) traits, has recently experienced increased attention in light of the proposal to add a CU specifier to the conduct disorder diagnosis in DSM-5. In a sample of 70 at-risk adolescents (ages 13-17 years) in the foster care system who received a contemplative intervention program, the present study placed the ICU within a nomological network of correlates, including anxiety, depression, hopefulness, loneliness, and physiological measures of stress (e.g., cortisol). The findings offered some support for the ICU’s construct validity, including significant negative associations with measures of compassion toward others. Nevertheless, unexpected substantial positive correlations emerged with multiple measures of psychological distress, raising questions concerning other aspects of the ICU’s construct validity. Taken together, results of the current study suggest that rather than assessing a dearth of all major emotions as implied by its name and some previous descriptions, the ICU may be heavily saturated with negative emotionality and global maladjustment.

A Validation of the Inventory of Callous-Unemotional Traits in a Community Sample of Young Adult Males

Callous-unemotional (CU) traits have been shown to delineate a subgroup of individuals at high risk for exhibiting severe and persistent criminal behavior. The Inventory of Callous-Unemotional Traits (ICU; Frick 2004) was recently developed as a comprehensive rating scale designed to measure multiple facets of CU traits. However, validation of this measure has been limited to youth in adolescence and emerging adulthood (age range=12-20), leaving questions about the utility of this measure in early adulthood unanswered. The current study evaluated the factor structure of the ICU within a racially diverse and well characterized community sample of adult males (n=425) using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). While results found the best fitting model to be the three-bifactor structure that has been previously reported in adolescent samples, the fit indices were only marginally acceptable and suggest the need for scale refinement. Total and subscales scores demonstrated significant and distinct associations with relevant external criteria (e.g., delinquency, psychopathy, psychopathology, psychosocial functioning). Implications and directions for future research are discussed.

Assessing Callous-Unemotional traits across different groups of youths: further cross-cultural validation of the Inventory of Callous-Unemotional traits

The Inventory of Callous-Unemotional (CU) Traits (ICU) is a self-report questionnaire which was developed to measure the affective features of psychopathy in children and adolescents. Previous studies reported both support and difficulties with this promising new measure. The present study investigated the psychometric and discriminating qualities of the Dutch questionnaire across different groups by examining its structure, distribution and correlates. The ICU was administered to young clinical offenders (detained, N=127), healthy controls (community, N=172), non-clinical offenders (not detained, N=42) and an externalizing non-offender group (under treatment for behavioral problems, N=42). The age range for all groups was 13-20years. Since confirmatory factor analysis of models from earlier research did not yield an acceptable fit, exploratory factor analysis was conducted. Five factors were extracted: Lack of Conscience, Uncaring, Unemotional, Callousness and Lack of Empathy. The results indicated moderate to good test-retest stability and adequate internal consistency. CU traits correlated well with measures of conduct problems and aggression, indicating a good criterion and convergent validity. Results indicate weak associations with expert (Psychopathy Checklist: Youth Version, PCL:YV) and informant (Antisocial Process Screening Device, APSD) measures of psychopathic traits. Although groups could be differentiated on a statistical basis, no meaningful distinction based on CU traits alone was possible. Results of this study cast doubt on the validity of the current ICU. Suggestions are made for improvement.

Callous-unemotional traits as a cross-disorders construct

PURPOSE

Callous-unemotional (CU) traits are currently viewed as the defining signs and symptoms of juvenile psychopathy. It is unclear, however, whether CU traits have validity only in the context of conduct disorder (CD) as proposed by Frick and Moffitt (A proposal to the DSM-V childhood disorders and the ADHD and disruptive behavior disorders work groups to include a specifier to the diagnosis of conduct disorder based on the presence of callous-unemotional traits, American Psychiatric Association, Washington, DC, 2010), or also outside CD, either in combination with other forms of psychopathology or as a stand-alone construct.

METHODS

The current review systematically studied the existent literature on CU traits in juveniles to examine their validity inside and outside CD according to the framework regarding the validity of a psychiatric diagnosis provided by Robins and Guze (Am J Psychiatry 126:983-987, 1970).

RESULTS

Inside youth with conduct problems, and CD specifically, it seems that CU traits meet the Robins and Guze criteria. As many of the reviewed studies included youth with ODD and ADHD as well, there are indications the same might be true for ODD and ADHD, although probably to a lesser extent. In other disorders, CU traits may be present as well, but their role is not firmly established. As stand-alone construct, data are lacking or are scarce on all of the above-mentioned criteria.

CONCLUSIONS

CU traits are a useful specifier in CD, and possibly also in disruptive behaviour disorders (DBDs) more generally. High CU traits outside DBDs exist but it is as yet unknown if there is a clinical need for defining CU traits as a stand-alone construct.

The relationship between juvenile psychopathic traits, delinquency and (violent) recidivism: a meta-analysis

A meta-analysis of k = 53 studies containing 60 non-overlapping samples and 10,073 participants was conducted to investigate whether psychopathy was associated with delinquency and (violent) recidivism in juveniles. The results showed that psychopathy was moderately associated with delinquency, general recidivism, and violent recidivism. Moderator effects revealed that various study and participant characteristics influenced the strength of the association between psychopathy, delinquency, and (violent) recidivism. It was concluded that screening for the (early) detection of psychopathy is important, as delinquent behavior and recidivism can be predicted from psychopathy as early as the transition from middle childhood to adolescence.