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

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.

What is the Best Source of Information for Psychopathic Traits in Youth? A Review and Meta-analysis of Self- and Other-Reported Psychopathic Traits and Their Association with Negative Outcomes

Child psychopathic traits appear to be associated with negative outcomes. Despite the study of youth psychopathy often relying on multiple reporters (e.g., child, caregivers, teachers), there is limited insight into how much information these various sources contribute and moreover, how this information is integrated. The present study sought to address this gap in the literature by examining the magnitude of relationships between self- and other-reported youth psychopathy and negative outcomes (e.g., delinquency, aggression) using a meta-analytic approach. Results revealed a moderate association between psychopathic traits and negative outcomes. Moderator analyses showed a greater relationship for other- than self-reported psychopathy, although not to a substantive extent. Results further indicated the magnitude of the overall psychopathy-negative outcomes association was stronger for externalizing than internalizing outcomes. Study findings can inform improvements in the assessment of youth psychopathy across research and practice, in addition to advancing our understanding of the utility of psychopathic traits in the prediction of clinically relevant outcomes. This review also provides guidance for future multisource raters and source-specific information in the study of psychopathy in youth.

Validation of the inventory of Callous-Unemotional Traits among school-going adolescents in Malaysia

A key component in the study of antisocial behaviour among adolescents is the presence of callous-unemotional (CU) traits. Among the established tools available to measure CU traits is the Inventory of Callous-Unemotional traits (ICU). To date, there is no validated questionnaire to assess CU traits for the local population. Therefore, there is a need to validate the Malay version of the ICU (M-ICU) so that research can be conducted to explore CU traits among adolescents in Malaysia. The aim of the study is to validate the M-ICU. Two phases of cross-sectional study involving 409 (phase 1 -exploratory factor analysis (EFA), n = 180; phase 2-confirmatory factor analysis (CFA), n = 229) adolescents aged between 13 to 18 years old were conducted from July until October 2020 at six secondary schools in Kuantan district. Participants were selected via multistage random sampling. The ICU was initially translated into Malay language using forward-backward translation procedure by a group of bilingual researchers. Study participants completed the final version of the M-ICU questionnaire and socio-demographic questionnaire. Data was analysed using SPSS version 26 and MPlus software for factor structure validity by performing EFA and CFA. Initial EFA revealed three factors with two items deleted. A further EFA with two factors resulted in the deletion of unemotional factor items. Cronbach's alpha for overall scale improved from 0.70 to 0.74. CFA supported a two-factor solution with 17 items compared to the original English version that has three factors with 24 items. The findings revealed acceptable fit indices (RMSEA = 0.057, CFI = 0.941, TLI = 0.932, WRMR = 0.968). The study revealed that a two-factor model with 17 items of the M-ICU has good psychometric properties. The scale is valid and reliable to measure CU traits among adolescents in Malaysia.

Factorial Structure of the Parent-Reported Version of the Inventory of Callous-Unemotional Traits Among Belgian Children: A Theory-Based Model

The factorial structure of the Inventory of Callous-Unemotional traits (ICU) is still under debate in the current literature and the published models are predominantly based on the empirical results of the statistical analyses rather than on a strong theoretical background. Aimed at overcoming these limits, the current study examined a factorial structure initiated by a theoretical framework for the parent-version of the ICU, based on a community sample of Belgian children aged 3–9 (N = 437; M age = 5.59; 54.7% boys). Further, the current study investigated measurement invariance across age and gender, and the external validity of this structure. Confirmatory factor analysis (CFA) indicated that empirical factor models from the current literature demonstrated a relatively poor fit to the data. Alternative models were built based on theory, specifically criteria from the DSM-V specifier “with limited prosocial emotions.” CFA supported an 18-item second order model with three first order factors (Lack of conscience, Unconcern about performance, Lack of emotional expression), a second order latent factor (General dimension of CU traits) and a methodological factor encompassing negatively worded items. Results supported measurement invariance across child gender, and to a lesser extent across age. As expected, the general dimension correlated with measures of aggressive behavior, attention problems, internalizing behavior and empathy. The Lack of emotional expression subfactor showed a different pattern of associations in comparison to the two other subfactors. The implications of these findings are discussed, specifically in relation to the DSM-V LPE specifier.

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.

Network Structure of Callous-Unemotional Traits and Conduct Disorder Symptoms Among At-Risk Youth: Multi-Informant Reports and Gender Differences

Network analytic techniques examine how items used to measure underlying constructs are related to one another and identify core characteristics. While many studies have examined the covariance of callous-unemotional (CU) traits or features and conduct disorder (CD) symptoms, the inter-item relations of these constructs and the core characteristics of the CU construct are unclear. The present study aimed to examine the network connectivity of, and between, CU features and CD symptoms. We also examined both parent-reports and youth self-reports and gender differences. CU features and CD symptoms were rated by parents (n = 814; 74% mothers; age 23-73, M age = 43.86, SD = 8.13) and their child (n = 608; 57% female; age 7-19, M age = 13.98, SD = 2.36). Network plots depicted greater connectivity (i.e., density and weights) for CU features relative to CD symptoms across both informants. However, youth-reported CU features and CD symptoms were less densely connected than parent-reports. Items commonly comprising the callousness subscale were more central and linked the two constructs together, relative to uncaring items, across informant and gender. Gender related effects indicated lower centrality for male versus female youth, and this finding was particularly evident in youth-reports. Our findings highlight relations between CU features and CD symptoms, and point to the importance of callousness items in conceptualizations of CU features among high-risk youth from both the perspective of the parent and child. We also inform understanding of gender differences in CU features for which the literature is currently limited.

Callous-Unemotional Traits Do Not Predict Functional Family Therapy Outcomes for Adolescents With Behavior Problems

Despite the availability of evidence-based treatment models for adolescent behavior problems, little is known about the effectiveness of these programs for adolescents with callous-unemotional (CU) traits. Defined by lack of empathy, lack of guilt, flattened affect and lack of caring, CU traits have been linked to long-term anti-social behavior and unfavorable treatment outcomes and might be negatively related to outcomes in evidence-based programs such as Functional Family Therapy (FFT). This study used a single-group pre-post evaluation design with a sample of 407 adolescents (49.1% female, mean age = 14.4 years, SD = 1.9) receiving FFT to investigate whether outcomes in FFT are predicted by CU traits and to what extent reliable changes in CU traits can be observed. The results showed that although CU traits are related to increased problem severity at baseline, they predicted neither treatment dropout nor post-treatment externalizing behavior and family functioning. CU traits were related to diminished improvement ratings, in particular with respect to parental supervision. Reductions in CU traits were observed across the time of treatment, and these were most profound among adolescents with elevated levels of CU traits at baseline. Further research should investigate whether certain evidence-based treatment components are more suited for adolescents with CU, and if the addition of specific intervention elements for reducing CU-traits could further improve outcomes for this high-risk population.

Factorial Structure and Nomological Network of the Inventory of Callous-Unemotional Traits Accounting for Item Keying Variance

The factorial structure of the Inventory of Callous Unemotional Traits (ICU) is currently under dispute. The present study aims to test the factorial structure of a Greek adaptation of the ICU by considering item keying variance and examining alternative theoretical and empirically derived models. Additionally, it aims to investigate the nomological network of the ICU subscales, after controlling for item keying variance. The sample consisted of 1536 Greek-Cypriot adolescents, who completed a battery of questionnaires, including the ICU. Results showed that the consideration of item keying variance improved the overall fit of all the examined models and led to significant changes in the predictive validity of the subscales, while method factors presented distinct patterns of associations with external variables. Overall, results suggest that ICU is contaminated by item keying variance, which can be filtered out to provide clinically useful insight into the factorial structure of the ICU.