Callous-unemotional traits and developmental pathways to severe conduct problems

Identification of treatment elements for adolescents with callous unemotional traits: a systematic narrative review

Adolescents with callous unemotional (CU) traits are at risk for poor quality-of-life outcomes such as incarceration, suicide, and psychopathy. It is currently unknown which treatments are implemented with CU adolescents specifically and which elements make up these interventions. A narrative systematic review was used to identify the treatments and common elements used with CU adolescents (12-18 years). Eligible studies were randomized controlled trials and quasi-experimental studies evaluating psychosocial interventions, delivered within a clinical context, and directed towards the adolescent or their family. Eight studies with 1291 participants were included. Significant decreases in CU traits were demonstrated only in a minority of studies. The most utilized practice elements were set goals for treatment, practice interpersonal/communication skills, prepare for termination, and teach parents skills and strategies; the most utilized process elements were formal therapy, practice exercises, important others, and flexible/adaptive. A majority of the studies did not report an implementation element. While theoretical frameworks for CU children are employed with CU adolescents, there is still uncertainty regarding their suitability for this age group. Given the limited empirical evidence, there is a critical need for further exploration.

Within-Person Bidirectional Associations Over Time Between Parenting and Youths' Callousness

OBJECTIVE

Callousness has been identified as a key driver of aggressive and violent behavior from childhood into early adulthood. Although previous research has underscored the importance of the parenting environment in contributing to the development of youth callousness, findings have generally been confined to the between-individual level and have not examined bidirectionality. In the current study, we test whether aspects of parenting are associated with callousness from childhood to adolescence both between and within individuals, examine the temporal ordering of associations, and test whether these relations are moderated by gender or developmental stage.

METHOD

Data came from a longitudinal study in which parents of 1,421 youth (52% girls; 62% White and 22% Black) from the second, fourth, and ninth grades were interviewed three times, with one year between consecutive interviews.

RESULTS

A random-intercept cross-lagged panel model indicated that elevated youth callousness predicts subsequent increases in parental rejection and decreases in consistency of discipline. Findings were largely similar for boys and girls, but within-individual associations were generally stronger for 4th graders compared to the 2nd and 9th graders.

CONCLUSIONS

Callousness and parenting practices and attitudes were related both at the between-individual and within-individual level. These results have implications for the etiology and treatment of children and adolescents who exhibit callousness.

The Moderating Role of Maternal CU Traits in the Stability of Justice-Involved Adolescents' CU Traits

OBJECTIVE

Callous-unemotional (CU) traits are associated with chronic and severe antisocial behavior. Although previous research has found that parents play an important role in the etiology and maintenance of youth CU traits, little research has examined the extent that parents' own CU traits impact the stability of their children's CU traits. The present study investigated the moderating role of maternal CU traits on developmental changes in youth CU traits.

METHOD

A sample of 346 mother-son dyads, in which all youth were justice-involved males (Mage = 15.81; 57.80% Latino, 20.52% White, 18.21% Black, 3.47% other race/ethnicity), across three states (California, Louisiana, and Pennsylvania) completed a semi-structured interview.

RESULTS

Youth exhibited a decrease in CU traits over 30 months. Mothers' CU traits moderated this relation, such that high maternal CU traits were associated with a smaller decrease in CU traits than low or average maternal CU traits, both when considering youth CU traits continuously and using a clinically significant cut score. The findings remained for continuous CU traits even after accounting for environmental factors (i.e., maternal warmth, maternal hostility, victimization, and witnessing violence), and these environmental factors did not vary over time.

CONCLUSION

The results highlight the importance of maternal influence in understanding how youth CU traits change over time, and have important implications for the use of parenting and family-level interventions among justice-involved youth.

Restorative Justice and Trauma: Responding to the Needs and Misdeeds of Young People with Trauma Histories

Young people that offend evidence higher rates of trauma and post-traumatic distress than non-offending peers. Effects of post-traumatic distress also parallel research on some young people that participate in restorative justice (RJ) meetings who struggle with communication, emotionally withdraw, become agitated or defiant, evidence poor understanding of harms they have caused, or fail to demonstrate empathy or remorse. In this paper I suggest post-traumatic distress may explain some variation in RJ process and outcomes hitherto ignored in existing research. I also suggest research on trauma in young people raises four areas of concern for thinking about RJ as a "trauma-informed" practice, including impacts of trauma and post-traumatic distress on (1) oral language proficiency and non-verbal communication; (2) the experience and expression of emotions; (3) offender perceptions of fairness and respect; and (4) difficulties in behavioural changes following participation in RJ meetings. I conclude with discussion of challenges to and suggestions for using RJ as a trauma-informed practice in youth justice settings.

Callous-unemotional behaviors and conduct problems in Chinese preschoolers: the moderating roles of surgency and gender

Introduction

Conduct problems in children are related to callous-unemotional (CU) behaviors. However, results of the relationships between CU behaviors and conduct problems among preschoolers mainly focused on Western countries, no studies have examined whether CU behaviors predict conduct problem in Chinese preschoolers. The primary objective of the current study therefore was to examine the associations between CU behaviors and conduct problems as well as the moderating effects of surgency and child gender in Chinese preschool children.

Methods

The present study randomly selected 2,154 children (1,043 boys, Mage = 56 months, SD = 10.47) from six kindergartens in Shanghai, People's Republic of China. Mothers rated children's surgency and teachers reported children's CU behaviors and conduct problems.

Results

Results demonstrated that CU behaviors were positively associated with conduct problems. Surgency and child gender significantly moderated these associations. Specifically, CU behaviors were positively associated with conduct problems, with a stronger effect found for high levels of surgency. CU behaviors had a positive association with conduct problems, with a stronger effect found for boys.

Discussion

This study indicate that temperament and gender characteristics influence conduct problems in preschoolers who exhibit high levels of CU behaviors. As well, the findings emphasize the significance of considering the meaning and implication of CU behaviors in Chinese culture.

Examining the Association between Psychopathic Traits and Fearlessness among Maximum-Security Incarcerated Male Adolescents

Studies have reported positive associations between youth psychopathy scores and measures of 'fearlessness'. However, prior studies modified fearlessness items to be age appropriate, shifting from assessing hypothetical, extreme forms of physical risk-taking (e.g., flying an airplane) to normative risk-taking (e.g., riding bicycles downhill). We hypothesize that associations between youth psychopathy scores and alternative forms of sensation seeking (i.e., Disinhibition) have been conflated under a false fearlessness label. We tested this hypothesis among incarcerated male adolescents, investigating whether youth psychopathy scores were significantly associated with two different forms of sensation seeking: Disinhibition and Thrill and Adventure Seeking (TAS). Youth psychopathic traits were assessed using the Psychopathy Checklist: Youth Version (PCL:YV), Antisocial Process Screening Device (APSD), Child Psychopathy Scale (CPS), Inventory of Callous and Unemotional Traits (ICU), and Youth Psychopathic Traits Inventory (YPI). Disinhibition and fearlessness (i.e., TAS) were assessed using an unmodified version of the Zuckerman Sensation Seeking Scales (SSS). Consistent with hypotheses, youth psychopathy scores were associated with higher Disinhibition and lower TAS scores. Our results contribute to a growing body of literature suggesting that psychopathic traits, including among adolescents, are not concomitant with physical risk-taking and descriptions of psychopathy including fearlessness distort a precise understanding of psychopathy's core features.

Physiological Dysregulation in Children With and Without Externalizing Difficulties: Novel Insights From Intensive Longitudinal Data

Extant research on physiological dysregulation in children has focused on point-in-time measures and absolute mean levels of physiology. However, these methods do not capture dynamic fluctuations in physiology that characterize dysregulation. In the present work, we aimed to assess whether physiological dysregulation as captured by fluctuations rather than mean levels would differentiate between children with and without clinically elevated levels of externalizing behavior. As an exploratory approach, we examined fluctuations in children's physiological responses (i.e., root mean square of successive differences [RMSSD] in beat-to-beat heart rate intervals) to social transgression scenarios across 15 short-term measurement occasions (5-second bins). Controlling for mean RMSSD, as well as emotional and cognitive correlates of externalizing behavior (i.e., sympathy and inhibitory control), children with externalizing difficulties exhibited greater within-person fluctuations in RMSSD (i.e., physiological dysregulation) compared to children without externalizing difficulties. The present findings provide preliminary support for using intensive longitudinal data comprised of short-term physiological measurements and point to the centrality of within-child physiological variability as a marker of dysregulation, particularly amongst children with externalizing disorders for whom self-regulation is a core challenge.

The Impact of Callous-Unemotional Traits on Achievement, Behaviors, and Relationships in School: A Systematic Review

Disruptive behavior disorders (DBDs) are associated with significant academic, behavioral, and relationship challenges in the school setting. Children with co-occurring DBDs and callous-unemotional (CU) traits show a distinct pattern of early starting, chronic, and aggressive disruptive behavior and are resistant to traditional DBD interventions. There is growing evidence that CU traits have important consequences for children's school functioning. The purpose of this systematic review is to synthesize research on CU traits in school with a focus on academics, relationships, and behavior. We searched PsycINFO, PubMed, and Education Full-Text to identify 37 empirical studies that met inclusionary criteria. Findings suggest that CU traits are associated with poor academic performance, high levels of aggression and conduct problems, and difficulty forming relationships at school, often above and beyond the impact of DBDs alone. Findings and future directions are discussed including how the current study can support key stakeholders in promoting the success of students with elevated CU traits.

Effects of multidomain environmental and mental health factors on the development of empathetic behaviors and emotions in adolescence

Empathy is at the core of our social world, yet multidomain factors that affect its development in socially sensitive periods, such as adolescence, are incompletely understood. To address this gap, this study investigated associations between social, environmental and mental health factors, and their temporal changes, on adolescent empathetic behaviors/emotions and, for comparison, callous unemotional (CU) traits and behaviors, in the early longitudinal Adolescent Brain Cognitive Development sample (baseline: n = 11062; 2-year follow-up: n = 9832, median age = 119 and 144 months, respectively). Caregiver affection towards the youth, liking school, having a close friend, and importance of religious beliefs/spirituality in the youth's life were consistently positively correlated with empathetic behaviors/emotions across assessments (p<0.001, Cohen's f = ~0.10). Positive family dynamics and cohesion, living in a neighborhood that shared the family's values, but also parent history of substance use and (aggregated) internalizing problems were additionally positively associated with one or more empathetic behaviors at follow-up (p<0.001, f = ~0.10). In contrast, externalizing problems, anxiety, depression, fear of social situations, and being withdrawn were negatively associated with empathetic behaviors and positively associated with CU traits and behaviors (p<0.001, f = ~0.1-0.44). The latter were also correlated with being cyberbullied and/or discriminated against, anhedonia, and impulsivity, and their interactions with externalizing and internalizing issues. Significant positive temporal correlations of behaviors at the two assessments indicated positive (early) developmental empathetic behavior trajectories, and negative CU traits' trajectories. Negative changes in mental health adversely moderated positive trajectories and facilitated negative ones. These findings highlight that adolescent empathetic behaviors/emotions are positively related to multidomain protective social environmental factors, but simultaneously adversely associated with risk factors in the same domains, as well as bully victimization, discrimination, and mental health problems. Risk factors instead facilitate the development of CU traits and behaviors.

Predictive Validity of Adolescent Callous-Unemotional Traits and Conduct Problems with Respect to Adult Outcomes: High- and Low-Risk Samples

Current understanding of the predictive validity of callous-unemotional (CU) traits is limited by (a) the focus on externalizing psychopathology and antisocial behaviors, (b) a lack of long-term prospective longitudinal data, (c) samples comprised of high-risk or low-risk individuals. We tested whether adolescent CU traits and conduct problems were associated with theoretically relevant adult outcomes 12-18 years later. Participants were drawn from two studies: higher-risk Fast Track (FT; n = 754) and lower-risk Child Development Project (CDP; n = 585). FT: conduct problems positively predicted externalizing and internalizing psychopathology and partner violence, and negatively predicted health, wellbeing, and education. Three conduct problems × CU traits interaction effects were also found. CDP: CU traits positively predicted depression and negatively predicted health and education; conduct problems positively predicted externalizing and internalizing psychopathology and substance use, and negatively predicted wellbeing. CU traits did not provide incremental predictive validity for multiple adult outcomes relative to conduct problems.

Empathy deficits, callous-unemotional traits and structural underpinnings in autism spectrum disorder and conduct disorder youth

Distinct empathy deficits are often described in patients with conduct disorder (CD) and autism spectrum disorder (ASD) yet their neural underpinnings and the influence of comorbid Callous-Unemotional (CU) traits are unclear. This study compares the cognitive (CE) and affective empathy (AE) abilities of youth with CD and ASD, their potential neuroanatomical correlates, and the influence of CU traits on empathy. Adolescents and parents/caregivers completed empathy questionnaires (N = 148 adolescents, mean age = 15.16 years) and T1 weighted images were obtained from a subsample (N = 130). Group differences in empathy and the influence of CU traits were investigated using Bayesian analyses and Voxel-Based Morphometry with Threshold-Free Cluster Enhancement focusing on regions involved in AE (insula, amygdala, inferior frontal gyrus and cingulate cortex) and CE processes (ventromedial prefrontal cortex, temporoparietal junction, superior temporal gyrus, and precuneus). The ASD group showed lower parent-reported AE and CE scores and lower self-reported CE scores while the CD group showed lower parent-reported CE scores than controls. When accounting for the influence of CU traits no AE deficits in ASD and CE deficits in CD were found, but CE deficits in ASD remained. Across all participants, CU traits were negatively associated with gray matter volumes in anterior cingulate which extends into the mid cingulate, ventromedial prefrontal cortex, and precuneus. Thus, although co-occurring CU traits have been linked to global empathy deficits in reports and underlying brain structures, its influence on empathy aspects might be disorder-specific. Investigating the subdimensions of empathy may therefore help to identify disorder-specific empathy deficits.

Variants of Callous-unemotional traits in childhood: investigation of attachment profile and hostile attribution bias

There is increasing evidence of interest in describing two variants of CallousUnemotional (CU) traits based on high (secondary variant) or low (primary variant) levels of anxiety. However, studies are limited in childhood. The present study aimed to further the understanding of the variants, specifically in association with hostile attribution bias (HAB) and attachment. In a community sample of children aged 4 to 9 (N = 70), the study examined whether anxiety moderated the association of CU traits with HAB, secure and disorganized attachment representations. Hierarchical regression analyses revealed that CU traits were positively associated with disorganized attachment, regardless of the anxiety level. In contrast, CU traits were not associated with secure attachment. A significant interaction revealed that CU traits were positively associated with HAB only at high levels of anxiety. Implications for understanding the variants of CU traits and hypotheses regarding their developmental trajectories are discussed.

Morality in middle childhood: the role of callous-unemotional traits and emotion regulation skills

BACKGROUND

The development of morality is vital for fostering prosocial behavior and enhancing both individual and societal well-being. Clarifying what contextual and individual factors play a role in moral processes during childhood can contribute to our understanding of the development of morality. Given the previous acknowledgment of importance, yet lack of existing empirical findings, the study focused on the significance of callous-unemotional traits (i.e., an affective-interpersonal personality trait, related to psychopathy in adulthood) and emotion regulation (i.e., an essential part of socio-emotional competence, and a transdiagnostic factor in the development of psychopathology) for moral emotions and cognitions during middle childhood. The concrete aim was to examine direct and indirect effects of callous-unemotional trait dimensions (callousness, uncaring, unemotionality) onto immoral emotional attribution (i.e., feeling good after immoral decisions) and admissibility of immoral actions (i.e., evaluating immoral actions as being okay) via emotion regulation skills.

METHODS

A cross-sectional study was conducted with 194 children attending Grades 1 to 4, and their primary caregivers. The children completed the Inventory of Callous-Unemotional Traits and caregivers completed the Emotion Regulation Checklist. The children were also presented with a set of moral dilemma vignettes, and asked about the emotions of protagonists who acted immoral, and the admissibility of their actions.

RESULTS

Path-model analysis revealed (1) negative direct effects of emotion regulation skills onto immoral emotional attribution and admissibility of immoral actions, (2) positive direct effects of the dimensions callousness and uncaring onto immoral emotional attribution and admissibility of immoral actions, and (3) negative direct effects of dimensions callousness and uncaring onto emotion regulation skills. Indirect effects, indicating that emotion regulation skills mediate the association between the callous-unemotional trait dimensions and morality, were also found.

CONCLUSION

The findings address a knowledge gap and indicate that emotion regulation skills, callousness, and uncaring play an important role in morality in middle childhood and should be included in frameworks of moral decision-making and development.

Differential processing of risk and reward in delinquent and non-delinquent youth

The present study examined the behavioral and neural differences in risky decision-making between delinquent (n = 23) and non-delinquent (n = 27) youth ages 13-17 years (M = 16, SD = 0.97) in relation to reward processing. While undergoing functional neuroimaging, participants completed an experimental risk task wherein they received feedback about the riskiness of their behavior in the form of facial expressions that morphed from happy to angry. Behavioral results indicated that delinquent youth took fewer risks and earned fewer rewards on the task than non-delinquent youth. Results from whole-brain analyses indicated no group differences in sensitivity to punishments (i.e. angry faces), but instead showed that delinquent youth evinced greater neural tracking of reward outcomes (i.e. cash-ins) in regions including the ventral striatum and inferior frontal gyrus. While behavioral results show that delinquent youth were more risk-averse, the neural results indicated that delinquent youth were also more reward-driven, potentially suggesting a preference for immediate rewards. Results offer important insights into differential decision-making processes between delinquent and non-delinquent youth.

Specific interpretation biases as a function of social anxiety and callous-unemotional traits in a community and a clinical adolescent sample

BACKGROUND

Threatening and hostile interpretation biases are seen as causal and maintaining mechanisms of childhood anxiety and aggression, respectively. However, it is unclear whether these interpretation biases are specific to distinct problems or whether they are general psychopathological phenomena. The specificity versus pervasiveness of interpretation biases could also differ depending on mental health status. Therefore, in the current study, we investigated whether social anxiety and callous-unemotional (CU) traits were uniquely related to threatening and hostile interpretation biases, respectively, in both a community and a clinical sample of adolescents.

METHODS

A total of 161 adolescents between 10 to 15 years of age participated. The community sample consisted of 88 participants and the clinical sample consisted of 73 inpatients with a variety of psychological disorders. Social anxiety and CU-traits were assessed with self-report questionnaires. The Ambiguous Social Scenario Task was used to measure both threatening and hostile interpretations in response to written vignettes.

RESULTS

Results showed that social anxiety was uniquely related to more threatening interpretations, while CU-traits were uniquely related to more hostile interpretations. These relationships were replicated for the community sample. For the clinical sample, only the link between social anxiety and threatening interpretations was significant. Explorative analyses showed that adolescents with externalizing disorders scored higher on hostile interpretations than adolescents with internalizing disorders.

CONCLUSIONS

Overall, these results support the content-specificity of threatening interpretation biases in social anxiety and of hostile interpretation biases in CU-traits. Better understanding the roles of interpretation biases in different psychopathologies might open avenues for tailored prevention and intervention paradigms.

Facial reactions to emotional films in young children with conduct problems and varying levels of callous-unemotional traits

BACKGROUND

Elevated levels of callous-unemotional (CU) traits have proven useful for identifying a distinct subgroup of children whose conduct problems (CP) are early emerging, severe, persistent, and underpinned by aberrant emotional processing. The early childhood emotional experiences and expressions of CP subtypes are poorly understood, despite their importance to understanding the problematic attachments and atypical social affiliation experienced by children with elevated CU traits. The current study aimed to test for differences in facial emotional reactions to mood-inducing film clips in children with CP and varying levels of CU traits.

METHOD

We compared facial emotional reactions during a developmentally appropriate mood induction task in a mixed-sex sample of clinic-referred preschool children (Mage  = 3.64 years, SD = 0.63, 66.9% male) classified as CP with elevated levels of CU traits (CP + CU; n = 25) versus low CU traits (CP-only; n = 47), and typically developing children (TD; n = 28).

RESULTS

Relative to TD children, children with clinical CP showed less congruent and more incongruent facial emotional expressions to sad and happy film clips, controlling for child sex, age, and ethnicity.

CONCLUSIONS

Consistent with older samples, young children with CP show atypical facial emotional expressions in response to positive and negative emotional stimuli. Findings have implications for developmental models of childhood antisocial behavior and can inform the development of targeted interventions.

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.

The Effects of Young Children's Callous-Unemotional Traits on Behaviorally Observed Outcomes in Standard and Technology-Enhanced Behavioral Parent Training

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.

Callous-Unemotional Traits are Associated With Child-to-Parent Aggression

This study examined the relations between callous-unemotional traits and perpetration of aggression toward parents in two separate studies, while also considering motivation for aggression and parenting styles experienced among young people. Study 1 involved 60 parents of children aged between 11 and 17 years old. The online study found high callous-unemotional traits, as reported by parents, to be associated with aggression toward both parents. Both types of motivation (proactive and reactive, as reported by parents) were associated with aggression toward parents. Study 2 involved 42 youths from an alternative education sample (between 11 and 16 years old). Youths with higher self-reported callous-unemotional traits reported more aggression toward both parents. Both studies, which had different reporters and different samples, showed youths with higher callous-unemotional traits were more aggressive toward their parents. In discussing the results, we note the importance of including callous-unemotional traits in future research on parent-directed aggression and in studies on domestic violence more broadly.

Some critical considerations in applying the construct of psychopathy to research and classification of childhood disruptive behavior disorders

The recent inclusion of callous-unemotional traits in the diagnostic criteria for serious conduct problems has led to renewed interest in more comprehensive integrations of the construct of psychopathy into research and clinical classification of childhood disruptive behavior disorders. There have been a number of recent reviews of research focusing the many potential benefits for this integration. However, there are also a number of issues that could reduce these benefits and even potentially lead to harmful effects. The current paper focuses on several of these issues, some of which are common when attempting to integrate research findings across areas that have been conducted independently of each other. Other issues are more specific to the construct of psychopathy. Specifically, the current paper focuses on the lack of agreement on the necessary and sufficient dimensions needed to define psychopathy, the need to consider developmental relationships among these dimensions, the implications of the different associations among the dimensions of psychopathy with conduct problems in children and adolescents, the need to consider how these dimensions relate to existing constructs used in the classification of disruptive behavior disorders, and the potential harmful effects of labeling something "a dimension of psychopathy". These issues have several clear implications for using the construct of psychopathy to guide research on and diagnostic classification of childhood disruptive behavior disorders.

Larger striatal volume is associated with increased adult psychopathy

Prior studies have inconsistently reported increased volumes of the striatum in adults with psychopathy. A meta-analysis presented here indicates an overall effect size of d = 0.44. Nevertheless, variability in findings exist, and questions remain on confounding clinical conditions and generalizability to females. This study tests the hypothesis that striatal volumes are increased in adults with psychopathic traits, and that this relationship is mediated by stimulation-seeking and impulsivity. Striatal volume was assessed using magnetic resonance imaging in 108 adult community-dwelling males alongside psychopathy using the Psychopathy Checklist - Revised. Subsidiary, exploratory analyses were conducted on a small sample of females. Correlational analyses showed that increased striatal volumes were associated with more psychopathic traits (p = .001). Effects were observed for all striatal regions, controlling for age, substance dependence and abuse, antisocial personality disorder, attention deficit hyperactivity disorder, social adversity, and total brain volume. An analysis of 18 psychopathic individuals showed that striatal volumes were increased 9.4% compared with 18 matched controls (p = .01). Psychopathy in females was also significantly associated with increased striatal volume (p = .02). Stimulation-seeking and impulsivity partly mediated the striatal-psychopathy relationship, accounting for 49.4% of this association. Findings from these two samples replicate and build on initial studies indicating striatal enlargement in adults with psychopathy, yielding an updated effect size of d = 0.48. Results are consistent with the notion that striatal abnormalities in individuals with psychopathy partly reflect increased sensation-seeking and impulsivity, and support the hypothesis of abnormal reward processing in psychopathy.

Differentiating Preschool Children with Conduct Problems and Callous-Unemotional Behaviors through Emotion Regulation and Executive Functioning

Callous-unemotional (CU) traits are important characteristics for identifying severe patterns of conduct problems (CP). The current study focused on (a) identifying subgroups of young children displaying a combination of CP and CU behaviors and (b) examining the extent to which executive functioning (EF) and emotion regulation (ER) are associated with CU behaviors. Participants included 249 preschoolers (N = 249, 78% boys, Mage = 4.95 years; 81% Latino/Hispanic) referred to treatment because of externalizing behavior problems. CU behaviors and CP were measured via a combination of teacher/parent rating scales. A multimethod approach was used to measure EF and ER including parent/teacher rating scales, neuropsychological, and observational tasks. Poorer ER as rated by parents/teachers and observed was associated with greater levels of CU behaviors. Latent profile analyses identified three subgroups of children displaying (a) low CU/low CP, (b) moderate CU/moderate CP, and (c) high CU/high CP. Children in the high CU/high-CP group were rated as having significantly poorer rated ER compared to all other groups and poorer observed ER compared to the low-CU/low-CP group. Exploratory analyses found that children in the high-CU/high-CP group displayed marginally lower levels of rated ER but significantly better EF performance on standardized neuropsychological tasks compared to children in a low-CU/high-CP group.Children with higher levels of reported CU behaviors and CP display poorer ER yet may display relatively better EF performance compared to children with lower levels of CU behaviors and CP.

Subgrouping children and adolescents with disruptive behaviors: symptom profiles and the role of callous-unemotional traits

Disruptive behavior during childhood and adolescence is heterogeneous and associated with several psychiatric disorders. The identification of more homogeneous subgroups might help identify different underlying pathways and tailor treatment strategies. Children and adolescents (aged 8-18) with disruptive behaviors (N = 121) and healthy controls (N = 100) were included in a European multi-center cognition and brain imaging study. They were assessed via a battery of standardized semi-structured interviews and questionnaires. K-means cluster-model analysis was carried out to identify subgroups within the group with disruptive behaviors, based on clinical symptom profiles, callous-unemotional (CU) traits, and proactive and reactive aggression. The resulting subgroups were then compared to healthy controls with regard to these clinical variables. Three distinct subgroups were found within the group with disruptive behaviors. The High CU Traits subgroup presented elevated scores for CU traits, proactive aggression and conduct disorder (CD) symptoms, as well as a higher proportion of comorbidities (CD + oppositional defiant disorder + attention deficit hyperactivity disorder (ADHD). The ADHD and Affective Dysregulation subgroup showed elevated scores for internalizing and ADHD symptoms, as well as a higher proportion of females. The Low Severity subgroup had relatively low levels of psychopathology and aggressive behavior compared to the other two subgroups. The High CU Traits subgroup displayed more antisocial behaviors than the Low Severity subgroup, but did not differ when compared to the ADHD and Affective Dysregulation subgroup. All three subgroups differed significantly from the healthy controls in all the variables analyzed. The present study extends previous findings on subgrouping children and adolescents with disruptive behaviors using a multidimensional approach and describes levels of anxiety, affective problems, ADHD, proactive aggression and CU traits as key factors that differentiate conclusively between subgroups.

Variants of psychopathic personality in Korean and UK incarcerated offenders: Using latent profile analysis and discriminant analysis

Since the popularization of the Psychopathy Checklist-Revised (PCL-R), research on the construct of psychopathy has drastically increased. However, there has been little research examining the extent to which psychopathy varies across different cultures. This study is the first to use latent profile analysis to examine cultural variations in psychopathic traits between large samples of male inmates in Korean (n = 1102) and UK (n = 1316) prisons. Supplementary discriminate analysis was also used to validate the classification profiles and determine which items of the PCL-R were most important in defining the differences or similarities between each of the classes in the two large samples. Based on the analysis, two variants of primary psychopathy could be distinguished in the Korean sample but not in the UK sample. Conversely, only secondary psychopathy was identified in the UK sample. This result was also confirmed by supplementary analysis, which verified classification accuracy and also provided structure matrixes listing the correlations between each PCL-R item and the two discriminant functions. Our results point to the possibility of cultural differences in the structure of psychopathy and provide practical implications for clinical assessment and diagnosis.

The Relation of Callous-Unemotional Traits and Bullying in Early Adolescence Is Independent from Sex and Age and Moderated by Conduct Problems

In youths, callous–unemotional (CU) traits and conduct problems (CP) are independently associated with bullying perpetration and these effects are also observed when controlling for sex. Moreover, research indicates that the co-existence of high levels of both CU and CP further increase the risk. Although several studies have examined the relationship between CU traits and traditional bullying, few have also included a measure of cyberbullying and very few of them have focused the early adolescence. The aim of this study was to replicate and extend these findings in a large sample of Italian early adolescents considering both traditional and cyberbullying behaviors. Data were extracted from the Bullying and Youth Mental Health Naples study (BYMHNS) which included 2959 students of 10–15 years of age. CP, CU traits, traditional bullying behaviors, and cyberbullying behaviors were assessed by multi-item self-report scales. As expected, we replicated the significant and specific association between CU traits and traditional bullying, extending the findings to cyberbullying. In addition, in the latter case the effect was moderated by CP. The theoretical and clinical implications of these results were discussed.

Modulation of Amygdala Response by Cognitive Conflict in Adolescents with Conduct Problems and Varying Levels of CU Traits

Adolescents with conduct problems and low callous-unemotional traits are characterised by high levels of reactive aggression. Prior studies suggest that they can have exaggerated neural and behavioural responses to negative emotional stimuli, accompanied by compromised affect regulation and atypical engagement of prefrontal areas during cognitive control. This pattern may in part explain their symptoms. Clarifying how neurocognitive responses to negative emotional stimuli can be modulated in this group has potential translational relevance. We present fMRI data from a cognitive conflict task in which the requirement to visually scan emotional (vs. calm) faces was held constant across low and high levels of cognitive conflict. Participants were 17 adolescent males with conduct problems and low levels of callous-unemotional traits (CP/LCU); 17 adolescents with conduct problems and high levels of callous-unemotional traits (CP/HCU, who typically show blunted reactivity to fear), and 18 typically developing controls (age range 10-16). Control participants showed typical attenuation of amygdala response to fear relative to calm faces under high (relative to low) conflict, replicating previous findings in a healthy adult sample. In contrast, children with CP/LCU showed a reduced (left amygdala) or reversed (right amygdala) attenuation effect under high cognitive conflict conditions. Children with CP/HCU did not differ from controls. Findings suggest atypical modulation of amygdala response as a function of task demands, and raise the possibility that those with CP/LCU are unable to implement typical regulation of amygdala response when cognitive task demands are high.

Callous-unemotional traits in Chinese preschool children with attention-deficit/hyperactivity disorder

BACKGROUND

Children with early onset of Callous-Unemotional (CU) traits are at a higher risk for long-term, persistent psychosocial problems. The current study aimed to explore the characteristics of CU in preschool children with Attention Deficit Hyperactivity Disorder (ADHD) and the diagnostic significance of CU traits in ADHD.

METHODS

A total of 176 preschool children (89 with ADHD and 87 Typically Developing Children [TDC]) aged 4-5 years old were recruited to the study. The participants were assessed for CU traits, emotional and behavioral problems, and how their executive functioning was associated with ADHD using multiple assessment scales. Multiple linear regression analysis was performed to assess the incremental validity of the Inventory of Callous-Unemotional Traits (ICU), adjusting for possible covariates by child's sex, conduct problems, and oppositional defiant symptoms.

RESULTS

The results showed that there was a significant difference of ICU scores between the ADHD and TDC groups (F = 30.12, P < 0.001). In terms of callousness, ADHD + Oppositional Defiant Disorder (ODD) group showed a significant high score, and the ADHD only group scored significantly higher than the TDC group (F = 20.42, P < 0.001). The ICU was negatively associated with the prosocial behaviour subscale (γ = - 0.57, P < 0.01) and showed low to moderate positive correlations with emotional and behavioural problems, as well as executive function (γ = 0.24-0.67, P < 0.05). The ICU scores explained 6% of the incremental validity in ADHD symptoms. The diagnostic value of the ICU for ADHD was medium and acceptable.

CONCLUSIONS

The current study indicated that early identification of CU traits may help clinicians better understand symptoms and behavioural problems in children with ADHD. CU traits therefore could be considered as a useful assessment tool for ADHD.

Prosocial and Aggressive Behavior: A Longitudinal Study

Developmental theorists have made strong claims about the fundamental prosocial or aggressive nature of the human infant. However, only rarely have prosocial behavior and aggression been studied together in the same sample. We charted the parallel development of both behaviors from infancy to childhood in a British community sample, using a two-construct, multimethod longitudinal design. Data were drawn from the Cardiff Child Development Study (CCDS), a prospective longitudinal study of a volunteer sample of parents and their firstborn children. A sample of 332 mothers was recruited from National Health Service (NHS) prenatal clinics and general practice clinics in Wales, UK, between Fall of 2005 and Summer of 2007. Potential participants represented the full range of sociodemographic classifications of neighborhoods. Participating families were divided about equally between middle- and working-class families, were somewhat more likely to have sons than daughters, and the majority (90%) were in a stable partnership. In response to standard categories recommended for use in Wales at the time, the majority (93%) of mothers reported themselves as Welsh, Scottish, English, or Irish; most others named a European or South Asian nationality. Of the 332 families agreeing to participate, 321 mothers (Mage  = 28 years) and 285 partners (Mage  = 31 years) were interviewed during the pregnancy and 321 of the families contributed data at least once after the child's birth. After an initial home visit at 6 months, data collection occurred in four additional waves of testing when children's mean ages were approximately 1, 1.5, 2.5, and 7 years. Data collection alternated between family homes and Cardiff University. Of those families seen after the child's birth, 89% were assessed at the final wave of testing. Data collection ended in 2015. Methods included direct observation, experimental tasks, and collection of reports from mothers, fathers, other relatives or family friends, and classroom teachers. Interactions with a familiar peer were observed at 1.5 years. Interactions with unfamiliar peers took place during experimental birthday parties at 1 and 2.5 years. At 7 years, parents were interviewed, parents and teachers completed questionnaires, and the children engaged in cognitive and social decision-making tasks. Based on reports from parents and other informants who knew the children well, individual differences in both prosocial behavior and aggression were evident in children. Both types of behavior showed stability across the second and third years. The association between prosocial behavior and aggression changed over time: at 1.5 years, they were not significantly related (the association approached zero), but they became negatively correlated by 3 years. Different patterns were seen when children played with familiar versus unfamiliar peers. At 1.5 years, when children were observed at home with a familiar peer, prosocial behavior and aggression were unrelated, thus showing a pattern of results like that seen in the analysis of informants' reports. However, a different pattern emerged during the experimental birthday parties with unfamiliar peers: prosocial behavior and aggression were positively correlated at both 1 and 2.5 years, contributing to a general sociability factor at both ages. Gender differences in prosocial behavior were evident in informants' reports and were also evident at the 1-year (though not the 2.5-year) birthday parties. In contrast, gender differences in both prosocial behavior and aggression were evident by 7 years, both in children's aggressive decision-making and in their parents' and teachers' reports of children's aggressive behavior at home and school. By age 7, children's aggressive decision-making and behavior were inversely associated with their verbal skills, working memory, and emotional understanding. Some children had developed aggressive behavioral problems and callous-unemotional traits. A few (12%) met diagnostic criteria for conduct disorder or oppositional-defiant disorders, which had been predicted by early angry aggressiveness and lack of empathy for other people. Taken together, the findings revealed a gradual disaggregation of two ways in which children interact with other people. Individual differences in both prosocial behavior and aggression revealed continuity over time, with gender differences emerging first in prosocial behavior, then in aggression. Restrictions in the participant sample and the catchment area (e.g., all were first-time parents; all were drawn from a single region in the United Kingdom) mean that it is not possible to generalize findings broadly. It will be important to expand the study of prosocial behavior and aggression in other family and environmental contexts in future work. Learning more about early appearing individual differences in children's approaches to the social world may be useful for both educational and clinical practice.

Conceptualizing callous-unemotional traits in preschoolers: Associations with social-emotional competencies and aggressive behavior

BACKGROUND

Extensive empirical evidence suggests that high Callous-Unemotional (CU) traits in childhood and adolescence can reliably identify individuals at risk for antisocial outcomes. The present study addresses research gaps by investigating the factor structure of CU traits in children at preschool age.

METHODS

The sample includes 371 children (49.6% female, M age = 4.7, SD = 0.69). Using the Inventory of Callous-Unemotional-Traits (ICU), six alternative confirmatory factor analyses were conducted to find the best fitting model for our preschool sample. Children's level of emotional competence and aggressive behavior was assed using a German questionnaire, the Behavior Rating Scales for Preschoolers (Verhaltensskalen für das Kindergartenalter, VSK) in a preschool teachers' rating. Post hoc cluster analytic strategies and ANOVA were applied to identify groups of children with regard to their combination of social-emotional competences and CU traits, and to examine associations with aggressive behavior.

RESULTS

Results indicate that a two-factor model revealed the best fit to our data, including a callous and an uncaring factor using 12 of the original 24 ICU items. Cluster analytic strategies reveal a risk group of children demonstrating high rates of callousness and uncaring combined with weak emotion knowledge/empathy and social competence. ANOVA shows that children in the risk group demonstrate the highest levels of aggressive behavior.

CONCLUSIONS

Group characteristics indicate that the construct of CU traits in early childhood may be nothing other than a social-emotional developmental deficit.

Parenting behavior and growth of child conduct problems: Moderation by callous-unemotional traits

Although positive parenting behavior is central to efficacious interventions for child conduct problems (CP), studies of youth CP have focused mostly on negative parenting behavior. That is, few studies have examined dimensions of positive parenting behavior (e.g., positive reinforcement, involvement) as independent predictors of CP and even fewer have investigated their potential moderation by callous-unemotional (CU) traits. A sample of 184 6-9 year-old children with and without attention-deficit/hyperactivity disorder (ADHD) was followed prospectively for two years. Controlling for baseline ADHD diagnostic status, initial CP, and negative parenting (i.e., corporal punishment), we examined CU traits, positive reinforcement and involvement, and their interactions as predictors of two-year change in CP. Positive reinforcement and CU traits independently predicted increased rule breaking behavior whereas parental involvement inversely predicted aggressive behavior. A significant positive reinforcement x CU traits interaction suggested that positive reinforcement predicted a decrease in aggressive behavior, but only in children with low CU traits; conversely, positively reinforcement marginally predicted increased aggressive behavior among children with high CU traits. No other significant parenting x CU traits interaction was observed. We consider these findings within a developmental psychopathology framework where interactive exchanges underlie the development of CP.

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.

Childhood Maltreatment and Risky Substance Use Behaviors: The Mediating Roles of Posttraumatic Stress Symptoms & Callous Unemotional Traits

Background: A robust relationship has been established between childhood maltreatment and risky substance use. Posttraumatic stress symptoms and callous-unemotional (CU) traits, both of which can be consequences of childhood maltreatment, have been implicated as potential mediators of this relationship, but despite phenotypic overlap have not been examined within the same model. Objective: The current cross-sectional study examined the indirect effect of childhood maltreatment severity on risky drug and alcohol use behaviors though PTSS and CU traits. Methods: Undergraduates (n = 355, 54.4% female) with childhood maltreatment histories completed questionnaires regarding childhood maltreatment, PTSS, substance use behaviors, and CU traits. Path modeling was utilized to examine indirect effects of childhood maltreatment on risky alcohol and drug use behaviors. Results: Overall the model demonstrated good fit. PTSS and CU traits were found to fully mediate the childhood maltreatment severity to risky alcohol use behaviors, with PTSS demonstrating a trending mediational effect to risky drug usage. Results support multiple pathways to risky alcohol use for individuals with childhood maltreatment histories through PTSS and CU traits, suggesting both PTSS as well as CU traits as potential targets of intervention for alcohol misuse among individuals with childhood maltreatment experiences.

Conduct Disorders and Empathy Development

Childhood conduct disorders, a serious mental health concern, put children at risk for significant mental health problems throughout development. Elevations on callous-unemotional (CU) traits designate a subgroup of youth with conduct disorders who have unique causal processes underlying their problem behavior and are at a particularly high risk for serious impairment relative to others with these disorders. As a result, these traits have recently been integrated into major diagnostic classification systems for conduct disorders. Given that CU traits are partly defined by deficits in empathy, we review research on empathy development in typically developing children and use this research to (a) advance theories on the specific emotional deficits that may be associated with CU traits, (b) explain the severe pattern of aggressive behavior displayed by children with elevated CU traits, and (c) suggest possible ways to enhance prevention and treatment for children with conduct disorders and elevated CU traits.

Core features of callous-unemotional traits: Network analysis of the inventory of callous-unemotional traits in offender and community samples

OBJECTIVE

Callous-unemotional (CU) traits have been added as a specifier labeled with "Limited Prosocial Emotion" used to diagnose conduct disorder in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. However, little is known about the core features of CU traits. Thus, this study aimed to identify the most central component of CU traits from a network perspective.

METHOD

Network analysis was applied to investigate the network structure of CU traits operationalized by the Inventory of Callous-Unemotional Traits in a sample of juvenile offenders (M_age  = 17.14, N = 609) and community youths (M_age  = 10.82, N = 487).

RESULTS

Our findings showed that items assessing callousness are the most central in the network across both samples. Also, the unemotional items were found to be located at a peripheral position, with fewer links apparent to callousness and uncaring items.

CONCLUSIONS

Callousness might be the key feature of CU traits in youths. Our findings further advance the general understanding about the core features of CU traits in clinical practice.

Mapping neural activity patterns to contextualized fearful facial expressions onto callous-unemotional (CU) traits: intersubject representational similarity analysis reveals less variation among high-CU adolescents

Callous-unemotional (CU) traits are early-emerging personality features characterized by deficits in empathy, concern for others, and remorse following social transgressions. One of the interpersonal deficits most consistently associated with CU traits is impaired behavioral and neurophysiological responsiveness to fearful facial expressions. However, the facial expression paradigms traditionally employed in neuroimaging are often ambiguous with respect to the nature of threat (i.e., is the perceiver the threat, or is something else in the environment?). In the present study, 30 adolescents with varying CU traits viewed fearful facial expressions cued to three different contexts ("afraid for you," "afraid of you," "afraid for self") while undergoing functional magnetic resonance imaging (fMRI). Univariate analyses found that mean right amygdala activity during the "afraid for self" context was negatively associated with CU traits. With the goal of disentangling idiosyncratic stimulus-driven neural responses, we employed intersubject representational similarity analysis to link intersubject similarities in multivoxel neural response patterns to contextualized fearful expressions with differential intersubject models of CU traits. Among low-CU adolescents, neural response patterns while viewing fearful faces were most consistently similar early in the visual processing stream and among regions implicated in affective responding, but were more idiosyncratic as emotional face information moved up the cortical processing hierarchy. By contrast, high-CU adolescents' neural response patterns consistently aligned along the entire cortical hierarchy (but diverged among low-CU youths). Observed patterns varied across contexts, suggesting that interpretations of fearful expressions depend to an extent on neural response patterns and are further shaped by levels of CU traits.

Distinct Empathy Profiles in Callous Unemotional and Autistic Traits: Investigating Unique and Interactive Associations with Affective and Cognitive Empathy

Empathy deficits are a hallmark of both callous-unemotional (CU) and autistic traits. However, it is unclear whether each trait is associated with deficits in distinct empathy subcomponents. The aim of the current study was to investigate the main and interactive effects of CU and autistic traits in predicting affective and cognitive empathy. We used data of 163 children (Mage = 7.30, SD = 1.42, 44.2% girls), selected from a large community sample (N = 1652). To ensure variability in empathy, we recruited participants with either low (1 standard-deviation below the mean; n = 78) or average to high (n = 85) levels of empathy. Partial correlation and regression analysis revealed that autistic traits were negatively associated with cognitive empathy, whereas CU traits were negatively related with both cognitive and affective empathy. Importantly, this is the first study testing the moderating effects of gender, revealing that CU traits negatively predicted affective empathy only among girls high on autistic traits. Findings can be used to understand the different empathy profiles of children with CU or autistic traits, and inform the development of effective interventions.

Cognitive and Emotional Profiles of CU Traits and Disruptive Behavior in Adolescence: a Prospective Study

In this study we followed 82-90 adolescents, 50% boys, from 15 to 16 years, investigating CU traits and disruptive behaviors as predictors of cognitive skills and arousal to emotional pictures. At age 15, CU traits were rated by adolescents and disruptive (aggregated ADHD-ODD-delinquent) behaviors were rated by parents and adolescents. At age 16, executive function, reaction time variability (RTV), IQ and arousal to negative pictures were assessed. The results showed that, with control for disruptive behaviors, CU traits predicted lower RTV, higher IQ and lower arousal to negative pictures. With control for CU traits, disruptive behaviors predicted lower spatial working memory, lower interference control and higher RTV. Our findings are of theoretical and clinical relevance as they point to highly diverging cognitive and emotional profiles of CU traits and disruptive behaviors.

It's not just what you say, it's how you say it too. Adolescents' hostile attribution of intent and emotional responses to social comments

A highly prevalent and relevant situation in which adolescents have to interpret the intentions of others is when they interact with peers. We therefore successfully introduced a new paradigm to measure hostile attribution bias (HAB) and emotional responses to such social interactions and examined how it related to youth's aggressiveness. We presented 881 adolescents (M_age = 14.35 years; SD = 1.23; 48.1% male) with audio fragments of age‐mates expressing social comments that varied in content (e.g., what the person says) and tone of voice (e.g., how the person says it). Participants' peers also reported on their aggressiveness. In general, added negativity of content and tone was driving the youth's intent attribution and emotional responses to the comments. In line with the Social Information Processing model, we found more hostile attribution of intent and more negative emotional responses of aggressive youth to ambiguous stimuli. Aggression was also related to more hostile intent attributions when both content and tone were negative. Unlike most studies on HAB, the aggression effects in the current study emerged for girls, but not boys. Implications of these results and future use of the experimental paradigm are discussed.

Personality Heterogeneity in Adolescents With Disruptive Behavior Disorders1

We first confirmed adolescents diagnosed with disruptive behavior disorders (oppositional defiant, conduct disorder; n = 158) had lower constraint and higher negative emotionality, and greater psychiatric comorbidity and psychosocial dysfunction, relative to adolescents without (n = 755), in a population-based sample enriched for externalizing psychopathology (mean age = 17.90 years; 52% female). We then explored whether different personality types, defined by patterns of personality identified via latent profile analysis, were differently associated with clinical features in adolescents with a disruptive behavior disorder diagnosis. Four distinct personality types ("disinhibited," "high distress," "low distress," "positive") were meaningfully different from one another. Results highlight personality heterogeneity as a means of identifying individuals at greatest risk for the most deleterious forms of externalizing psychopathology.

Callous-Unemotional Traits Among Children and Adolescents in Asian Cultures: A Systematic Review

Considerable evidence now exists for callous and unemotional (CU) traits as markers for a high-risk pathway to child and adolescent conduct problems implicating unique risk processes and treatment needs, but research has been limited largely to Western countries. We review the evidence base related to CU traits in Asian countries that has emerged in recent years, with respect to four key questions. Specifically, are higher CU traits among Asian children and adolescents associated with (1) increased severity of conduct problems; (2) similar neurodevelopmental and neurocognitive correlates as reported in Western countries; (3) similar environmental risk factors as reported in Western countries; and (4) poorer treatment outcomes? A systematic search identified 28 studies that have reported on child and adolescent CU traits in Asian countries. Consistent with Western samples, CU traits were associated with individual risk factors including atypical neural activation during cognitive tasks and poor empathy, as well as parenting risk factors. CU traits were also positively associated with most measures of conduct problems. Differences from findings in Western samples, however, emerged for areas such as correlates of reactive aggression and delinquent peer influence. Treatment has been investigated in only one study to date and is therefore a high priority for future research. The limitations of existing evidence are addressed along with key directions for future cross-cultural research, including measurement research with children and adolescents.

Trait impulsivity and callous-unemotional traits as predictors of inhibitory control and risky choices among high-risk adolescents

Trait impulsivity and callous-unemotional traits are associated with behavioural problems among high-risk adolescents. While both are known to influence behaviour, the nature of their expression in high-risk behaviours, particularly those related to inhibitory control, is not well understood. In the current, preliminary study, we examined whether and how these traits predicted deficits in behaviour driven by bottom-up, automatic versus deliberate, top-down inhibitory processes among high-risk adolescents. Two go/no-go task variants, emotional and non-emotional, were used to assess reactive response inhibition, and the Balloon Analogue Risk Task was used to assess the ability to resist deliberate risky choices. The results showed that the two types of self-reported trait measures were differentially associated with performance on the two types of behavioural inhibition tasks. Trait impulsivity predicted non-emotional inhibitory control whereas callous-unemotional traits predicted risky choices. The results also showed that the emotions task elicited slower reaction times and higher false alarm rates than did the letters task, and that participants had greater difficulty inhibiting responses to negatively than to positively valenced no-go stimuli. While preliminary, the results suggest that the interplay between trait impulsivity and callous-unemotional traits is an important determinant of inhibitory behaviour in this high-risk adolescents.