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R Sanchez C, L Cooley J. Peer Victimization and Callous-Unemotional Traits: The Impact of Parents and Teachers. Res Child Adolesc Psychopathol 2024:10.1007/s10802-024-01213-w. [PMID: 38819578 DOI: 10.1007/s10802-024-01213-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2024] [Indexed: 06/01/2024]
Abstract
Research on the link between peer victimization and callous-unemotional (CU) traits has primarily relied on cross-sectional designs and yielded equivocal findings. In light of the poor outcomes related to peer victimization and CU traits, it is important to determine whether this link is reciprocal in nature and to identify factors that may influence its strength. Accordingly, the current study investigated the bidirectional association between peer victimization and CU traits over a 6-month period, accounting for the moderating effects of parents (i.e., support and hostility) and teachers (i.e., support and conflict). Participants included 284 third- through fifth-grade students (ages 7-12; 51.8% boys; 51.1% Hispanic) and their homeroom teachers. Children provided ratings of peer victimization, parental hostility, and parent and teacher support. Teachers provided ratings of CU traits and student-teacher conflict. A series of cross-lagged panel models were estimated. Results revealed that, at higher levels of parental hostility, peer victimization predicted increases in CU traits over time; in contrast, peer victimization predicted decreases in CU traits at lower levels of parental hostility. Surprisingly, at higher levels of teacher conflict, peer victimization predicted decreases in CU traits over time. CU traits did not interact with parent or teacher variables to predict subsequent peer victimization. Moreover, parental hostility was positively associated with subsequent peer victimization, whereas teacher support predicted decreases in victimization over time. These findings build on previous research examining environmental influences on the expression of CU traits by highlighting peer victimization and parental hostility as potential risk factors.
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Affiliation(s)
- Carlos R Sanchez
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA.
| | - John L Cooley
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA
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2
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Craig SG, Dawson A, Chen S, Moretti MM, Pepler DJ. A systematic review of callous-unemotional traits and attachment in children and adolescents. Attach Hum Dev 2024; 26:133-158. [PMID: 38704613 DOI: 10.1080/14616734.2024.2349569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 04/26/2024] [Indexed: 05/06/2024]
Abstract
METHODS The systematic review and meta-analysis included 17 research articles from 1994 to 2022. Results were summarized by developmental periods. RESULTS Attachment insecurity was associated with CU traits across development (r = .17). This association was marginally stronger for high-risk samples (e.g., clinical, justice) and for continuous attachment measures versus coding schemes. From early to middle childhood, attachment disorganization was associated with CU traits (r = .17). IMPLICATIONS Research on attachment and CU traits in childhood is still in its infancy. Changes in attachment measures from childhood to adolescence make developmental comparisons difficult. Results suggest attachment as a potential developmental mechanism for youth with CU traits, however, the area requires more research.
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Affiliation(s)
| | - Alexis Dawson
- Department of Psychology, Simon Fraser University, Burnaby, Canada
| | - Susan Chen
- Department of Psychology, University of Utah, Salt Lake City, USA
| | | | - Debra J Pepler
- Department of Psychology, York University, Toronto, Canada
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3
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Paz Y, Perkins ER, Colins O, Perlstein S, Wagner NJ, Hawes SW, Byrd A, Viding E, Waller R. Evaluating the sensitivity to threat and affiliative reward (STAR) model in relation to the development of conduct problems and callous-unemotional traits across early adolescence. J Child Psychol Psychiatry 2024. [PMID: 38480986 DOI: 10.1111/jcpp.13976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/24/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND The Sensitivity to Threat and Affiliative Reward (STAR) model proposes low threat sensitivity and low affiliation as risk factors for callous-unemotional (CU) traits. Preliminary evidence for the STAR model comes from work in early childhood. However, studies are needed that explore the STAR dimensions in late childhood and adolescence when severe conduct problems (CP) emerge. Moreover, it is unclear how variability across the full spectrum of threat sensitivity and affiliation gives rise to different forms of psychopathology beyond CU traits. METHODS The current study addressed these gaps using parent- and child-reported data from three waves and a sub-study of the Adolescent Brain Cognitive Development Study® of 11,878 youth (48% female; ages 9-12). RESULTS Consistent with the STAR model, low threat sensitivity and low affiliation were independently related to CU traits across informants and time. Moreover, there was significant interaction between the STAR dimensions, such that children with lower sensitivity to threat and lower affiliation had higher parent-reported CU traits. Unlike CU traits, children with higher threat sensitivity had higher parent-reported CP and anxiety. Finally, children with lower affiliation had higher parent-reported CP, anxiety, and depression. Results largely replicated across informants and time, and sensitivity analysis revealed similar findings in children with and without DSM-5 defined CP. CONCLUSIONS Results support the STAR model hypotheses as they pertain to CU traits and delineate threat sensitivity and affiliation as independent transdiagnostic risk factors for different types of psychopathology. Future research is needed to develop fuller and more reliable and valid measures of affiliation and threat sensitivity across multiple assessment modalities.
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Affiliation(s)
- Yael Paz
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - Emily R Perkins
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - Olivier Colins
- Faculty of Psychology and Educational Sciences, Department of Special Needs Education, Ghent University, Gent, Belgium
| | - Samantha Perlstein
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - Nicholas J Wagner
- Department of Brain and Psychological Science, Boston University, Boston, MA, USA
| | - Samuel W Hawes
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Amy Byrd
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PN, USA
| | - Essi Viding
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Rebecca Waller
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
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4
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Brady RG, Donohue MR, Waller R, Tillman R, Gilbert KE, Whalen DJ, Rogers CE, Barch DM, Luby JL. Maternal emotional intelligence and negative parenting affect are independently associated with callous-unemotional traits in preschoolers. Eur Child Adolesc Psychiatry 2023; 32:2303-2311. [PMID: 36063216 PMCID: PMC10163950 DOI: 10.1007/s00787-022-02074-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 08/19/2022] [Indexed: 12/15/2022]
Abstract
Deficits in emotion intelligence (EI) are a key component of early-childhood callous-unemotional (CU) traits. Children's EI may be influenced by their mother's EI through both familial genetic and environmental mechanisms; however, no study has directly tested the role of maternal EI in the development of CU traits. This study investigated whether maternal EI had a direct relationship with children's CU traits when controlling for the potential influence of parenting affect and other psychiatric diagnoses. Mothers and their 3- to 5-year-old preschoolers (N = 200) were recruited as part of a parent-child interaction-emotion development therapy treatment trial for preschool clinical depression and comorbid psychopathology. Using data collected prior to treatment, regression models tested whether maternal EI was related to children's CU traits, which specific aspects of maternal EI were most strongly associated with CU traits, and whether associations held after accounting for observed parenting affect. Maternal EI (p < 0.005), specifically the ability to understand others' emotions (p < 0.01), was significantly associated with children's CU traits. This relationship was specific, as maternal EI did not predict depression or oppositional defiant disorder. Both maternal EI and observed negative parenting affect were independently and significantly related to CU traits (p < 0.05) in a combined model. Given that maternal EI and observed negative parenting affect were independent predictors of CU traits in preschoolers with comorbid depression, findings suggest that current treatments for CU traits that focus solely on improving parenting could be made more effective by targeting maternal EI and helping mothers better model emotional competence.
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Affiliation(s)
- Rebecca G Brady
- Division of Biology and Biomedical Sciences, Washington University School of Medicine, 660 South Euclid Ave, Box 8514, St. Louis, MO, 63110, USA.
- Department of Neurology, Washington University School of Medicine, St. Louis, USA.
| | - Meghan Rose Donohue
- Department of Psychiatry, Washington University School of Medicine, St. Louis, USA
| | - Rebecca Waller
- Department of Psychology, University of Pennsylvania, Philadelphia, USA
| | - Rebecca Tillman
- Department of Psychiatry, Washington University School of Medicine, St. Louis, USA
| | - Kirsten E Gilbert
- Department of Psychiatry, Washington University School of Medicine, St. Louis, USA
| | - Diana J Whalen
- Department of Psychiatry, Washington University School of Medicine, St. Louis, USA
| | - Cynthia E Rogers
- Department of Psychiatry, Washington University School of Medicine, St. Louis, USA
- Department of Pediatrics, Washington University School of Medicine, St. Louis, USA
| | - Deanna M Barch
- Department of Psychiatry, Washington University School of Medicine, St. Louis, USA
- Mallinckrot Institute of Radiology, Washington University School of Medicine, St. Louis, USA
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, USA
| | - Joan L Luby
- Department of Psychiatry, Washington University School of Medicine, St. Louis, USA
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5
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Campbell SM, Hawes T, Swan K, Thomas R, Zimmer-Gembeck MJ. Evidence-Based Treatment in Practice: PCIT Research on Addressing Individual Differences and Diversity Through the Lens of 20 Years of Service. Psychol Res Behav Manag 2023; 16:2599-2617. [PMID: 37465048 PMCID: PMC10350409 DOI: 10.2147/prbm.s360302] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 07/07/2023] [Indexed: 07/20/2023] Open
Abstract
Parent-Child Interaction Therapy (PCIT) is an intensive parent support program for caregivers and their children who exhibit difficult-to-manage disruptive behaviors. After more than four decades of research supporting its efficacy for reducing children's disruptive behaviors and improving parent-child relationships, PCIT has become one of the most popular and widely disseminated parenting support programs in the world. The evidence for the efficacy of PCIT can be found in many reviews of randomized clinical trials and other rigorous studies. To add to those reviews, our aim was to provide practical guidance on how PCIT can be part of an evidence-based program for families that depends on practitioner expertise, as well as attention to families' diverse needs. To do this, we describe the evolution of PCIT as practiced in a university-community partnership that has continued for over 20 years, alongside a narrative description of selected and recent findings on PCIT and its use in specific client presentations across four themes. These themes include studies of 1) whether the standard manualized form of PCIT is efficacious across a selection of diverse family situations and child diagnoses, 2) the mechanisms of change that explain why some parents and some children might benefit more or less from PCIT, 3) whether treatment content modifications make PCIT more feasible to implement or acceptable to some families, at the same time as achieving the same or better outcomes, and 4) whether PCIT with structural modifications to the delivery, such as online or intensive delivery, yields similar outcomes as standard PCIT. Finally, we discuss how these directions in research have influenced research and practice, and end with a summary of how the growing attention on parent and child emotion regulation and parents' responses to (and coaching of) their children's emotions has become important to PCIT theory and our practice.
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Affiliation(s)
- Shawna M Campbell
- School of Applied Psychology, Griffith University, Gold Coast, QLD, Australia
| | - Tanya Hawes
- School of Applied Psychology, Griffith University, Gold Coast, QLD, Australia
| | - Kellie Swan
- School of Applied Psychology, Griffith University, Gold Coast, QLD, Australia
| | - Rae Thomas
- Tropical Australian Academic Health Centre, Townsville, QLD, Australia
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia
| | - Melanie J Zimmer-Gembeck
- School of Applied Psychology, Griffith University, Gold Coast, QLD, Australia
- Griffith Centre for Mental Health, Griffith University, Gold Coast, QLD, Australia
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6
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Ulaş S, Seçer İ, Victory EJ, McNeil CB. Scientific collaborations and research trends in Parent-Child Interaction Therapy: a bibliometric analysis. Front Psychol 2023; 14:1167937. [PMID: 37251036 PMCID: PMC10213549 DOI: 10.3389/fpsyg.2023.1167937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 04/21/2023] [Indexed: 05/31/2023] Open
Abstract
Parent-child interaction therapy (PCIT) is considered to be an effective intervention for children aged 2-7 years with conduct problems. PCIT research has been conducted for approximately 50 years; however, an analysis of general research patterns has not been published. In this context, the present study outlines a bibliometric analysis of scientific collaborations, prevalence across locations on the basis of countries and organizations, leading researchers, and trends within PCIT research. Findings demonstrate that PCIT is an area in which international scientific collaborations are intense and current, and collaborations continue to be formed around the world. Additionally, results indicate that dissemination of intercultural PCIT adaptations are continuous.
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Affiliation(s)
- Sümeyye Ulaş
- Laboratory Department of Psychological Counseling and Guidance, Atatürk University, Erzurum, Türkiye
| | - İsmail Seçer
- Laboratory Department of Psychological Counseling and Guidance, Atatürk University, Erzurum, Türkiye
| | - Erinn J. Victory
- Department of Psychology, West Virginia University, Morgantown, WV, United States
| | - Cheryl B. McNeil
- Department of Psychiatry, University of Florida, Gainesville, FL, United States
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7
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Bachmann CJ, Humayun S, Stevens M, O'Connor TG, Scott S. Secure attachment predicts lower societal cost amongst severely antisocial adolescents. Child Adolesc Psychiatry Ment Health 2023; 17:56. [PMID: 37161491 PMCID: PMC10170786 DOI: 10.1186/s13034-023-00598-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 03/27/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Social and economic costs associated with antisocial behaviour are well-established, but little is known about the potential costs savings/benefits of secure attachment in this high-risk group. We aimed to provide the first test of attachment quality as a distinct predictor of economic costs. METHODS 111 adolescents (10-17 years of age, M = 15.0, SD = 1.6; 71% male) referred to young offender services due to high levels of antisocial behaviour were included. Costs were measured by detailed service-use interview, and attachment security to mother and father elicited through the Child Attachment Interview. The level of antisocial behaviour and callous-unemotional traits were assessed. Cost predictors were calculated using generalised linear models. RESULTS Mean 12-months service costs were £5,368 (sd 5,769) per adolescent, with justice system and educational service costs being the main components. After adjusting for covariates, economic costs were predicted by attachment quality to fathers, with a difference of £2,655 per year between those with secure (£3,338) versus insecure attachment (£5,993); significant cost effects were not found for attachment quality to mothers. Higher levels of callous-unemotional traits, lower verbal IQ, higher levels of antisocial behaviour, and older age were also significant cost predictors. CONCLUSIONS Secure attachment to fathers is a predictor of reduced public cost in adolescents with severe antisocial behaviour. This novel finding for severely antisocial youth extends previous findings in less antisocial children and underscores the public health and policy benefits of good caregiving quality and the value of population-level dissemination of evidence-based interventions that improve caregiving quality.
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Affiliation(s)
- Christian J Bachmann
- Department of Child and Adolescent Psychiatry, University of Ulm, Steinhövelstr. 5, 89075, Ulm, Germany.
| | - Sajid Humayun
- School of Human Sciences, Faculty of Education, Health and Human Sciences, University of Greenwich, Avery Hill, London, SE9 92UG, UK
| | - Madeleine Stevens
- London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK
| | - Thomas G O'Connor
- Department of Psychiatry, School of Medicine and Dentistry, University of Rochester Medical Center, 601 Elmwood Ave, Box PSYCH, Rochester, NY, 14642, USA
| | - Stephen Scott
- National Academy for Parenting Research, King's College London, 16 De Crespigny Park, Box 86, London, SE5 8AF, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, Box 86, London, SE5 8AF, UK
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8
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Vize CE, Byrd AL, Stepp SD. The Relative Importance of Psychopathy Features as Predictors of Externalizing Behaviors in Youth: A Multimethod Examination. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2023; 45:1-17. [PMID: 37691858 PMCID: PMC10488909 DOI: 10.1007/s10862-022-10017-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2022] [Indexed: 02/02/2023]
Abstract
Research in youth psychopathy has focused heavily on the affective features (i.e., callous-unemotional [CU] traits) given robust links to severe and chronic forms of externalizing behaviors. Recently, there have been calls to expand the scope of work in this area to examine the importance of other interpersonal (i.e., antagonism) and behavioral (i.e., disinhibition) features of psychopathy. In the present study, we apply an under-utilized statistical approach (i.e., dominance analysis) to assess the relative importance of CU traits, antagonism, and disinhibition in the prediction of externalizing behaviors in youth, cross-sectionally and at 9-month follow-up. Using a multi-informant (youth- and parent-report), multi-method (questionnaire, ecological momentary assessment [EMA]) preregistered approach in a diverse sample of clinically referred youth (Mage = 12.60 years, SD = .95 years, 47% female; 61% racial/ethnic minority), we found youth- and parent-reported psychopathy features accounted for a significant proportion of variance in externalizing behavior cross-sectionally and longitudinally. However, results provided limited support for our preregistered hypotheses. While antagonism and disinhibition had larger general dominance weights relative to CU traits for both youth- and parent-report, most differences were non-significant. Thus, the interpersonal, affective, and behavioral psychopathy features could not be distinguished from one another in terms of their importance in the prediction of externalizing behavior, assessed cross-sectionally or longitudinally. Taken together, the results highlight promising avenues for future research on the relative importance of youth psychopathy features.
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Affiliation(s)
- Colin E. Vize
- School of Medicine, Department of Psychiatry, University of Pittsburgh, 4307 Sennott Square, Pittsburgh, PA 15260, USA
| | - Amy L. Byrd
- School of Medicine, Department of Psychiatry, University of Pittsburgh, 4307 Sennott Square, Pittsburgh, PA 15260, USA
| | - Stephanie D. Stepp
- School of Medicine, Department of Psychiatry, University of Pittsburgh, 4307 Sennott Square, Pittsburgh, PA 15260, USA
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9
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McKee LG, Yang Y, Highlander A, McCall M, Jones DJ. Conceptualizing the Role of Parent and Child Emotion Regulation in the Treatment of Early-Onset Behavior Disorders: Theory, Research, and Future Directions. Clin Child Fam Psychol Rev 2023; 26:272-301. [PMID: 36385585 DOI: 10.1007/s10567-022-00419-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2022] [Indexed: 11/18/2022]
Abstract
Behavior disorders (BDs) are common and costly, making prevention and early-intervention a clinical and public health imperative. Behavioral Parent Training (BPT) is the standard of care for early-onset (3-8 years old) BDs, yet effect sizes vary and wane with time suggesting the role of underlying factors accounting for variability in outcomes. The literature on emotion regulation (ER), which has been proposed as one such underlying factor, is reviewed here, including a brief overview of ER, theory and research linking ER, externalizing symptoms, and/or BDs, and still largely preliminary work exploring the role of parent and child ER in BPT outcomes. Research to date provides clues regarding the interrelationship of ER, BDs, and BPT; yet, determining whether adaptations to BPT targeting ER are necessary or useful, for whom such adaptations would be most important, and how those adaptations would be implemented requires addressing mixed findings and methodological limitations. To guide such work, we propose a conceptual model elucidating how standard BPT may impact ER and processes linked to ER, which we believe will be useful in organizing and advancing both basic and applied research in future work.
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Affiliation(s)
- Laura G McKee
- Department of Psychology, Georgia State University, Atlanta, GA, USA
| | - Yexinyu Yang
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - April Highlander
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Madison McCall
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Deborah J Jones
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC, 27599, USA.
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10
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Parent J, Jones DJ, DiMarzio K, Yang Y, Wright KL, Sullivan ADW, Forehand R. The Effects of Young Children's Callous-Unemotional Traits on Behaviorally Observed Outcomes in Standard and Technology-Enhanced Behavioral Parent Training. Res Child Adolesc Psychopathol 2023; 51:165-175. [PMID: 36344876 DOI: 10.1007/s10802-022-00979-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2022] [Indexed: 11/09/2022]
Abstract
Behavioral Parent Training (BPT) remains the current standard of care for early onset behavior disorders (BD); however, problem behaviors characterized by relatively high callous unemotional (CU) traits are linked to poorer treatment outcomes, highlighting the need for novel interventions. This study examined the relation of baseline child CU traits to changes in observed parent and child (3 to 8 years old) behavior in 101 families with low-income randomized to either a standard (Helping the Noncompliant Child, HNC) or technology-enhanced BPT program (TE-HNC). Assessments occurred at baseline, post-intervention, and at a three-month follow-up. Treatment group moderated the relation between CU traits and observed parenting behaviors and child compliance. Specifically, higher levels of child CU traits at baseline predicted lower levels of positive parenting at post-intervention and follow-up, and lower levels of child compliance at follow-up but only in the standard program (HNC). This is the first intervention study to behaviorally assess the differential impact of CU traits in standard, relative to technology-enhanced, BPT and suggests the promise of a technology-enhanced treatment model.
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Affiliation(s)
- Justin Parent
- Department of Psychiatry and Human Behavior, Brown University, Providence, USA.
- Warren Alpert Medical School, Brown University, 1 Hoppin St #204, Providence, RI, USA.
| | - Deborah J Jones
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Karissa DiMarzio
- Department of Psychology, Florida International University, Miami, USA
| | - Yexinyu Yang
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kat L Wright
- Department of Psychology, University of Kentucky, Lexington, USA
| | | | - Rex Forehand
- Department of Psychological Science, University of Vermont, Burlington, USA
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11
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Hyde LW, Dotterer HL. The Nature and Nurture of Callous-Unemotional Traits. CURRENT DIRECTIONS IN PSYCHOLOGICAL SCIENCE 2022. [DOI: 10.1177/09637214221121302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Callous-unemotional (CU) traits, a risk factor for psychopathy, delineate youths with relatively low empathy and guilt, and identify youths with high risk for chronic and severe antisocial behavior (e.g., rule breaking, aggression). We describe work identifying nature and nurture influences on the development of CU traits. Additionally, we clarify the relationship between CU traits and psychopathy, highlight potential misinterpretations of findings on influences of “nature” versus “nurture,” and discuss treatment implications.
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Affiliation(s)
- Luke W. Hyde
- Department of Psychology, University of Michigan
- Survey Research Center at the Institute for Social Research, University of Michigan
| | - Hailey L. Dotterer
- Department of Psychology, University of Michigan
- Department of Psychiatry, School of Medicine, Johns Hopkins University
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12
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Andrade BF, Aitken M, Brodkin S, Sawrikar V. Multiple needs and multiple treatments. What's a clinician to do? Update on the psychosocial treatment of disruptive behaviours in childhood. Curr Opin Psychiatry 2022; 35:409-416. [PMID: 36125210 PMCID: PMC9594137 DOI: 10.1097/yco.0000000000000823] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
PURPOSE OF REVIEW There are a wide range of psychosocial treatment options, delivered in different modalities, for children with disruptive behaviour. However, clinicians face many challenges in ensuring the empirically supported treatments (ESTs) they select will be effective for their patient. This has prompted studies to generate knowledge on how to improve treatment outcomes for children with disruptive behaviour. This review identifies the major challenges in treatment selection as well as emerging research seeking to improve outcomes. RECENT FINDINGS This review emphasizes the salience of the research-practice gap associated with establishing ESTs using narrow definitions of clinical problems. Recent research is reviewed considering the complex determinants of disruptive behaviours, including parent and family factors that influence outcomes. The review subsequently outlines recent advances in research and clinical practice guidelines aiming to surmount these challenges. Key advances discussed include examining the most impactful components of ESTs, personalizing interventions by targeting core dysfunction underlying behaviour, and addressing parent factors including mental health and cultural relevance to improve outcomes. SUMMARY Thorough assessment of patients' needs, combined with knowledge of treatment response predictors, are recommended to determine the most suitable treatment plan. Recent advances have focused on developing and designing interventions that meet needs in a way that is flexible and tailored.
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Affiliation(s)
- Brendan F. Andrade
- Margaret and Wallace McCain Centre for Child Youth and Family Mental Health, Centre for Addiction and Mental Health
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health
- Ontario Institute for Studies in Education, University of Toronto, Toronto Canada
| | - Madison Aitken
- Margaret and Wallace McCain Centre for Child Youth and Family Mental Health, Centre for Addiction and Mental Health
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health
| | - Sabrina Brodkin
- Margaret and Wallace McCain Centre for Child Youth and Family Mental Health, Centre for Addiction and Mental Health
- Ontario Institute for Studies in Education, University of Toronto, Toronto Canada
| | - Vilas Sawrikar
- School of Health in Social Science, University of Edinburgh, UK
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13
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Levantini V, Muratori P, Calderoni S, Inguaggiato E, Masi G, Milone A, Tonacci A, Billeci L. Parenting practices moderate the link between attention to the eyes and callous unemotional traits in children with Disruptive Behavior Disorder: An eye-tracking study. J Psychiatr Res 2022; 146:272-278. [PMID: 34776250 DOI: 10.1016/j.jpsychires.2021.11.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 10/21/2021] [Accepted: 11/05/2021] [Indexed: 10/19/2022]
Abstract
Callous-unemotional (CU) traits are associated with gaze pattern deficits in youths, though it has not yet been explored if environmental factors could influence this relationship. Since parenting can influence both CU traits and children's emotion processing, the current study sought to test whether parenting moderated the relation between gaze pattern deficits and CU traits in a sample of children with Disruptive Behavior Disorder. The sample included 92 boys (aged 7-12 years) with Conduct Disorder (N = 12) and Oppositional Defiant Disorder (N = 80). All children completed a task, during which they were presented with 24 images depicting happy, sad, fearful, disgusted, angry, and neutral facial expressions. Gaze pattern has been recorded throughout the task with an eye-tracker. Positive parenting moderated the association between CU traits and first fixation duration to the eyes of facial expressions depicting negative emotions. Negative parenting moderated the association between CU traits and fixation count and fixation duration to the eyes of negative emotions. Negative parenting along with reduced attention to emotional cues (i.e., eyes) may identify a group of youths with Disruptive Behavior Disorder diagnosis at risk for severe outcomes.
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Affiliation(s)
- Valentina Levantini
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Pisa, Italy
| | - Pietro Muratori
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Pisa, Italy.
| | - Sara Calderoni
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Pisa, Italy; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Emanuela Inguaggiato
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Pisa, Italy
| | - Gabriele Masi
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Pisa, Italy
| | - Annarita Milone
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Pisa, Italy
| | - Alessandro Tonacci
- Institute of Clinical Physiology, National Research Council of Italy, CNR, Pisa, Italy
| | - Lucia Billeci
- Institute of Clinical Physiology, National Research Council of Italy, CNR, Pisa, Italy
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Editorial: Treatment of Early Childhood Callous-Unemotional Traits: What Do We Know and Where Do We Go from Here? J Am Acad Child Adolesc Psychiatry 2021; 60:1348-1350. [PMID: 34000332 DOI: 10.1016/j.jaac.2021.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 05/06/2021] [Indexed: 10/21/2022]
Abstract
Callous-unemotional (CU) traits, characterized by lack of remorse, guilt, or empathy, are represented in DSM-5 under the limited prosocial emotions specifier for conduct disorder. Research suggests that some interventions for conduct problems are less effective for children with higher levels of CU traits,1 and few interventions have been shown to reduce CU traits. Specifically, behavioral parenting interventions, evidence-based treatments for conduct problems, have been shown to be less effective for children with higher levels of CU traits.2 Although research suggests high comorbidity of internalizing and externalizing problems in early childhood,3 no prior studies examined the effect of CU traits on the treatment of childhood internalizing problems. Donohue et al.4 addressed this significant gap in the literature by evaluating the efficacy of Parent-Child Interaction Therapy-Emotion Development (PCIT-ED) in the treatment of preschoolers with major depressive disorder (MDD) and oppositional defiant disorder (ODD) and the moderating role of child CU traits on treatment outcomes. In this editorial, we discuss the contributions and limitations of the article by Donohue et al.4 and provide recommendations for future research to advance the field.
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