Emotion Processing in Children with Conduct Problems and Callous-Unemotional Traits: An Investigation of Speed, Accuracy, and Attention

Callous-unemotional Traits and Emotion Recognition Difficulties: Do Stimulus Characteristics Play a role?

Emotion recognition difficulties are linked to callous-unemotional (CU) traits, which predict risk for severe antisocial behavior. However, few studies have investigated how stimulus characteristics influence emotion recognition performance, which could give insight into the mechanisms underpinning CU traits. To address this knowledge gap, children aged 7-10 years old (N = 45; 53% female, 47% male; 46.3% Black/African-American, 25.9% White, 16.7% Mixed race or Other, 9.3% Asian) completed an emotion recognition task featuring static facial stimuli from child and adult models and facial and full-body dynamic stimuli from adult models. Parents reported on CU traits of children in the sample. Children showed better emotion recognition for dynamic than static faces. Higher CU traits were associated with worse emotion recognition, particularly for sad and neutral expressions. Stimulus characteristics did not impact associations between CU traits and emotion recognition.

Objective Linguistic Markers Associated with Callous-Unemotional Traits in Early Childhood

BACKGROUND

Callous-unemotional (CU) traits are associated with interpersonal difficulties and risk for severe conduct problems (CP). The ability to communicate thoughts and feelings is critical to social success, with language a promising treatment target. However, no prior studies have examined objective linguistic correlates of childhood CU traits in early childhood, which could give insight into underlying risk mechanisms and novel target treatments.

METHODS

We computed lexical (positive emotion, sad, and anger words) and conversational (interruptions and speech rate) markers produced by 131 children aged 5-6 years (M = 5.98; SD = 0.54, 58.8% female) and their parents while narrating wordless storybooks during two online visits separated by 6-8 weeks (M = 6.56, SD = 1.11; two books, order counterbalanced). Audio recordings were diarized, time-aligned, and orthographically transcribed using WebTrans. Conversational markers were calculated using R and word frequencies were calculated using Linguistic Inquiry and Word Count (LIWC) software. We examined links between child CU traits and linguistic markers, and explored whether relationships were moderated by child sex.

RESULTS

Higher CU traits were associated with fewer positive emotion words produced by parents and children. Higher CU traits were also associated with greater concordance in the degree of interruptions and expression of anger emotion words by parents and children.

CONCLUSIONS

Results suggest that objective linguistic correlates of CU traits are detectable during early childhood, which could inform adjunctive treatment modules that improve outcomes by precisely tracking and targeting subtle communication patterns.

Do Children with High Callous-Unemotional Traits Have Attentional Deficits to Emotional Stimuli? Evidence from a Multi-Method and Multi-Informant Study

Callous-unemotional (CU) traits in children and adolescents are linked to severe and persistent antisocial behavior. Based on past empirical research, several theoretical models have suggested that CU traits may be partly explained by difficulties in correctly identifying others' emotional states as well as their reduced attention to others' eyes, which could be important for both causal theory and treatment. This study tested the relationships among CU traits, emotion recognition of facial expressions and visual behavior in a sample of 52 boys referred to a clinic for conduct problems (Mage = 10.29 years; SD = 2.06). We conducted a multi-method and multi-informant assessment of CU traits through the Child Problematic Traits Inventory (CPTI), the Inventory of Callous-Unemotional (ICU), and the Clinical Assessment of Prosocial Emotions-Version 1.1 (CAPE). The primary goal of the study was to compare the utility of these methods for forming subgroups of youth that differ in their emotional processing abilities. An emotion recognition task assessed recognition accuracy (percentage of mistakes) and absolute dwell time on the eyes or mouth region for each emotion. Results from repeated measures ANOVAs revealed that low and high CU groups did not differ in emotion recognition accuracy, irrespective of the method of assessing CU traits. However, the high CU group showed reduced attention to the eyes of fearful and sad facial expressions (using the CPTI) or to all emotions (using the CAPE). The high CU group also showed a general increase in attention to the mouth area, but only when assessed by the CAPE. These findings provide evidence to support abnormalities in how those elevated on CU traits process emotional stimuli, especially when assessed by a clinical interview, which could guide appropriate assessment and more successful interventions for this group of youth.

Unique versus shared neural correlates of externalizing psychopathology in late childhood

Childhood externalizing psychopathology is heterogeneous. Symptom variability in conduct disorder (CD), oppositional defiant disorder (ODD), attention-deficit/hyperactivity disorder (ADHD), and callous-unemotional (CU) traits designate different subgroups of children with externalizing problems who have specific treatment needs. However, CD, ODD, ADHD, and CU traits are highly comorbid. Studies need to generate insights into shared versus unique risk mechanisms, including through the use of functional magnetic resonance imaging (fMRI). In this study, we tested whether symptoms of CD, ODD, ADHD, and CU traits were best represented within a bifactor framework, simultaneously modeling shared (i.e., general externalizing problems) and unique (i.e., symptom-specific) variance, or through a four-correlated factor or second-order factor model. Participants (N = 11,878, age, M = 9 years) were from the Adolescent Brain and Cognitive Development Study. We used questionnaire and functional magnetic resonance imaging data (emotional N-back task) from the baseline assessment. A bifactor model specifying a general externalizing and specific CD, ODD, ADHD, and CU traits factors demonstrated the best fit. The four-correlated and second-order factor models both fit the data well and were retained for analyses. Across models, reduced right amygdala activity to fearful faces was associated with more general externalizing problems and reduced dorsolateral prefrontal cortex activity to fearful faces was associated with higher CU traits. ADHD scores were related to greater right nucleus accumbens activation to fearful and happy faces. Results give insights into risk mechanisms underlying comorbidity and heterogeneity within externalizing psychopathology. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Callous-Unemotional Traits and Emotion Perception Accuracy and Bias in Youths

This study investigated the associations among conduct problems, callous-unemotional (CU) traits, and indices of emotion recognition accuracy and emotion recognition bias obtained from human faces. Impairments in emotion recognition were considered within broader, impaired emotional and social functioning. The sample consisted of 293 middle-school students (51.19% girls; M age = 12.97 years, SD = 0.88 years). In general, CU traits were associated with less accuracy in recognizing emotions, especially fearful and angry faces, and such deficits in emotional recognition were not associated with conduct problems independent of CU traits. These results support the importance of studying potential deficits in the recognition of emotions other than fear. Furthermore, our results support the importance of considering the role of CU traits when studying emotional correlates of conduct problems. For children scoring high on CU traits, the emotion recognition accuracy of anger was low irrespective of the level of conduct problems, whereas in children scoring low on CU traits, less accuracy in recognizing emotions was related to increases in conduct problems. Finally, our results support the need for research to not only focus on accuracy of emotional recognition but also test whether there are specific biases leading to these inaccuracies. Specifically, CU traits were associated not only with lower accuracy in recognizing fearful faces but also with a tendency to interpret fearful faces as angry. This suggests that the emotional deficit associated with CU traits is not just a deficit in empathic concern toward others distress but also includes a tendency to overinterpret emotions as potential threats to oneself.

Emotion Recognition Deficits in Children and Adolescents with Psychopathic Traits: A Systematic Review

Children and adolescents with psychopathic traits show deficits in emotion recognition, but there is no consensus as to the extent of their generalizability or about the variables that may be moderating the process. The present Systematic Review brings together the existing scientific corpus on the subject and attempts to answer these questions through an exhaustive review of the existing literature according to PRISMA 2020 statement. Results confirmed the existence of pervasive deficits in emotion recognition and, more specifically, on distress emotions (e.g., fear), a deficit that transcends all modalities of emotion presentation and all emotional stimuli used. Moreover, they supported the key role of attention to relevant areas that provide emotional cues (e.g., eye-region) and point out differences according to the presence of disruptive behavior and based on the psychopathy dimension examined. This evidence could advance the current knowledge on developmental models of psychopathic traits. Yet, homogenization of the conditions of research in this area should be prioritized to be able to draw more robust and generalizable conclusions.

Callous and Unemotional Traits as Precursors to the Development of Female Psychopathy

OBJECTIVE

Conduct a systematic review concerning the literature that reflects whether the callous and unemotional traits present in childhood and/or adolescence are precursors in the development of female psychopathy in adulthood.

MATERIALS AND METHODS

A systematic review involved consulting three databases-EBSCO, the Web of Science, and PubMed-for peer-reviewed and quantitative studies within the period 2000-2023. Nine articles with quality of three and above were included.

RESULTS

The presence of callous and unemotional traits designates a group of youth that show characteristics associated with psychopathy, specifically when predicting a more severe and chronic pattern of antisocial behaviour. Children with high rates of callous and unemotional traits, who show symptoms of attention deficit hyperactivity disorder in combination with severe conduct problems, are most likely to show features associated with psychopathy. The multidimensional psychopathy construct is considered a better predictor of future and stable antisocial behaviour than the callous and unemotional traits alone model.

CONCLUSIONS

According to the studies selected, the callous and unemotional traits in childhood seem to be precursors of female psychopathy in adulthood, but only because of the way they seem to enhance conduct problems, disruptive behaviour disorders, and, as a possible outcome, delinquency and antisocial traits, which may be precursors of future psychopathy.

Machine learning classification of conduct disorder with high versus low levels of callous-unemotional traits based on facial emotion recognition abilities

Conduct disorder (CD) with high levels of callous-unemotional traits (CD/HCU) has been theoretically linked to specific difficulties with fear and sadness recognition, in contrast to CD with low levels of callous-unemotional traits (CD/LCU). However, experimental evidence for this distinction is mixed, and it is unclear whether these difficulties are a reliable marker of CD/HCU compared to CD/LCU. In a large sample (N = 1263, 9-18 years), we combined univariate analyses and machine learning classifiers to investigate whether CD/HCU is associated with disproportionate difficulties with fear and sadness recognition over other emotions, and whether such difficulties are a reliable individual-level marker of CD/HCU. We observed similar emotion recognition abilities in CD/HCU and CD/LCU. The CD/HCU group underperformed relative to typically developing (TD) youths, but difficulties were not specific to fear or sadness. Classifiers did not distinguish between youths with CD/HCU versus CD/LCU (52% accuracy), although youths with CD/HCU and CD/LCU were reliably distinguished from TD youths (64% and 60%, respectively). In the subset of classifiers that performed well for youths with CD/HCU, fear and sadness were the most relevant emotions for distinguishing them from youths with CD/LCU and TD youths, respectively. We conclude that non-specific emotion recognition difficulties are common in CD/HCU, but are not reliable individual-level markers of CD/HCU versus CD/LCU. These findings highlight that a reduced ability to recognise facial expressions of distress should not be assumed to be a core feature of CD/HCU.

Are Children High on Callous-Unemotional Traits Emotionally Blind? Testing Eye-Gaze Differences

Callous-unemotional traits have been associated with difficulties in identifying and responding to others' emotions. To inform this line of research, the current study investigated the eye gaze behavior of children (n = 59; mean-age = 6.35) with varying levels of callous-unemotional (CU) traits with the use of eye-tracker methodology, as well as their ability to accurately identify emotional expressions. Participating children were selected from a large screening sample (N = 1283). Main findings supported a reduced fixation rate to the eye-region and an increased fixation in the mouth area of emotional faces among children high on callous-unemotional traits (HCU), irrespective of emotion expressed (i.e., fear, sad, angry and happy) and age of individuals portrayed in images (adult versus child faces). Further, findings suggested that HCU children were less likely to accurately identify facial emotional expressions, which might be due to the identified attentional neglect to the eye region of emotional faces. Current findings support the importance of early prevention and intervention programs that can enhance the emotional development and social adjustment of HCU children.

Frozen with Fear? Attentional Mechanisms in Children with Selective Mutism

Background

Children with selective mutism (SM) are consistently unable to speak in certain social situations. Due to an overlap between SM and social anxiety disorder (SAD) in children, similar mechanisms could apply to both disorders. Especially biased attentional processing of threat and fear-induced reduced visual exploration (referred to as attentive freezing) appear promising in SM.

Methods

A total of N = 84 children (8–12 years, SM: n = 28, SAD: n = 28, typical development (TD): n = 28) participated in an eye-tracking paradigm with videos of a social counterpart expressing a question, a social evaluation or a neutral statement. We investigated gaze behavior towards the social counterpart’s eye-region and the extent of visual exploration (length of scanpath), across conditions.

Results

There were no group differences regarding gaze behavior on the eye region. Neither gaze behavior with respect to the eye region nor visual exploration were dependent on the video condition. Compared to children with TD, children with SM generally showed less visual exploration, however children with SAD did not.

Conclusion

Reduced visual exploration might be due to the mechanism of attentive freezing, which could be part of an extensive fear response in SM that might also affect speech-production. Interventions that counteract the state of freezing could be promising for the therapy of SM.