Callous-Unemotional Traits and Risk of Gun Carrying and Use During Crime

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.

The relationship between nature exposure and depression among Chinese prisoners: a moderated mediation model

Aim

This study examined the association between self-reported nature exposure and depression among Chinese prisoners, as well as the mediating and moderating effects of meaning in life and callous-unemotional (CU) traits, respectively.

Background

Prisoners are more likely to experience depression than any other mental illness. Exposure to nature has been proposed as a highly cost-effective method of treating their depressive symptoms. However, the mechanism underlying the link between nature exposure and depression among prisoners needs further investigation, as the findings may provide new insights into how to address depression in incarcerated populations.

Method

Data were collected through a survey conducted in four prisons in southern China from April to May 2022. The participants were 574 prisoners who anonymously completed four questionnaires about nature exposure, meaning in life, depression, and CU traits.

Results

The results show that: (1) meaning in life significantly mediates the association between nature exposure and depression, and (2) CU traits moderate the connection between nature exposure and meaning in life.

Conclusion

The current study uncovered that prisoners who contact more with the natural environment have a higher meaning in life and lower depression, and individuals with higher CU traits can benefit more from nature exposure.

Exploring the Relationship between Callous-Unemotional Traits and Implicit Attitudes toward Violence

Past research has associated callous-unemotional traits (CU) in young people with serious conduct problems and antisocial behavior. However, whether CU traits influence implicit attitudes toward violence remains largely unexplored. We assess this hypothesis in two independent samples: a sample of youth with no criminal records (Study 1, N = 86), and in a sample of young offenders (Study 2, N = 61). Both groups were not compared due to theoretical (very different demographics) and statistical reasons (the total sample was insufficient to be able to reach the statistical power required in the comparison of both groups). Further, we use an implicit procedure to examine whether CU traits modulate wanting for violent stimuli. Across two samples of youth, we found little evidence of an association between CU traits and implicit violent cognition. In youth with no criminal records, implicit attitudes toward violence were related to the unemotional factor of CU traits, but unrelated to other factors and to a global CU traits score. CU traits were not associated with implicit attitudes toward violence in young offenders. The latter finding was mirrored in the implicit wanting task. Overall, our findings cast some doubts on the adequacy of implicit measures to assess implicit violent cognition in youth with CU traits. We discuss potential methodological limitations of this research (e.g., characteristics of the sample and performance in the implicit procedures) that may impact our results.

Testing Three New Scoring Methods to Identify Detained Adolescent Girls with Elevated Levels of Callous-Unemotional Traits

Different scoring methods have been proposed to identify adolescents with high levels of callous-unemotional (CU) traits as measured by the Inventory of Callous-Unemotional traits (ICU). This is the first study to scrutinize the usefulness of the normative, empirical, and DSM-5 with Limited Prosocial Emotions (LPE) scoring methods in criminal justice-involved girls (N = 192). Girls (Mage = 15.74) completed the ICU and other self-report questionnaires. A diagnostic interview was used to determine the presence of conduct disorder (CD) and other psychiatric disorders. Official arrest and rearrest data were also collected. The three scoring methods designated girls with (versus without) CU traits who scored higher on various indices of past and future antisocial behavior, exhibited higher rates of (childhood-onset) CD and higher levels of psychopathic traits, and displayed lower levels of agreeableness and conscientiousness. It was only when the normative and empirical scoring methods were applied that girls with CU traits had higher rates of substance use disorders and were less anxious, depressed, and/or neurotic. In a subsample of girls with CD (N = 119), the three scoring methods captured a more severely antisocial subgroup. Other expected group differences emerged, though mainly when the normative scoring method was used. Results provided support for the clinical utility of the three scoring methods but also showed that the normative scoring method most aligns with theoretical expectations. Research is warranted to explore if this normative scoring method serves as a better categorically-defined specifier for CD than the specifier that is incorporated in the DSM-5.

Emotion processing in youths with conduct problems: an fMRI meta-analysis

Functional magnetic resonance imaging (fMRI) studies consistently indicate differences in emotion processing in youth with conduct problems. However, no prior meta-analysis has investigated emotion-specific responses associated with conduct problems. This meta-analysis aimed to generate an up-to-date assessment of socio-affective neural responding among youths with conduct problems. A systematic literature search was conducted in youths (ages 10-21) with conduct problems. Task-specific seed-based d mapping analyses examined responses to threatening images, fearful and angry facial expressions, and empathic pain stimuli from 23 fMRI studies, which included 606 youths with conduct problems and 459 comparison youths. Whole-brain analyses revealed youths with conduct problems relative to typically developing youths, when viewing angry facial expressions, had reduced activity in left supplementary motor area and superior frontal gyrus. Additional region of interest analyses of responses to negative images and fearful facial expressions showed reduced activation in right amygdala across youths with conduct problems. Youths with callous-unemotional traits also exhibited reduced activation in left fusiform gyrus, superior parietal gyrus, and middle temporal gyrus when viewing fearful facial expressions. Consistent with the behavioral profile of conduct problems, these findings suggest the most consistent dysfunction is found in regions associated with empathic responding and social learning, including the amygdala and temporal cortex. Youth with callous-unemotional traits also show reduced activation in the fusiform gyrus, consistent with reduced attention or facial processing. These findings highlight the potential role of empathic responding, social learning, and facial processing along with the associated brain regions as potential targets for interventions.

Gun Violence and Psychopathy Among Female Offenders

Research exploring risk factors of gun violence is limited, especially research involving women as perpetrators of violence. Yet, women account for 18-21% of convicted violent crime. The present study aimed to test if psychopathy, a notable risk factor for violence, was related to past convictions of gun violence, general forms of violence, and non-violent crime. In a sample of 206 female offenders, multinomial logistic regressions assessed how interpersonal, affective, and behavioral psychopathic traits increased the likelihood of women belonging to the gun violence group, a violent crime group, and a non-violent crime group. Results showed the interpersonal and affective facets increased the likelihood of women belonging to the gun violence group compared to both the violent and non-violent crime groups. The behavioral facet increased the likelihood of women belonging to the violent crime group when compared to the gun violence and non-violent crime groups. These results suggest that gun violence has different risk factors than violent and non-violent crime. This line of inquiry indicates that existing violence prevention strategies may need to be modified to address gun violence.

Describing Callous Unemotional Traits and Stressful Life Event Trajectories: Differences on Risk Factors and Mental Health Outcomes from the Age of 3 to 10

Callous Unemotional (CU) traits are associated with different environmental risk factors, such as negative stressful life events (SLE). The most common studied SLE associated with CU trait has been childhood maltreatment, but less is known about how other SLE impact the development of CU traits. Therefore, this work examines risk factors, personal factors (executive functioning), and mental health outcomes associated with the trajectories of Callous Unemotional (CU) traits and Stressful Life Events (SLE) in a community sample of children. A cohort of 377 preschoolers were followed up between ages 3 and 10. Several risk factors and outcomes for three trajectory groups (high CU/SLE; high CU/low SLE; and the reference group with low CU/SLE) were analyzed by using multiple post-hoc comparisons. We hypothesized that children with high CU/SLE would face more contextual risk factors, more executive functioning difficulties and more mental health problems than children with high CU/low SLE or the reference group. At the age of 3, children who showed high CU/SLE faced more early contextual adversity, including socioeconomic difficulties and maternal antisocial behavior than the other groups of children. At the age of 10, children with high CU/SLE presented more peer problems and higher psychopathology symptoms than the reference group, but no differences on mental health outcomes in comparison to the high CU/low SLE group. These results have potential implications for clinical practice and studies attempting to identify different CU subtypes in children.

A Within-Individual Examination of the Predictors of Gun Carrying During Adolescence and Young Adulthood Among Young Men

Although prior studies have identified several risk factors for gun carrying, no prior longitudinal studies have examined a comprehensive set of explanatory factors together in within-individual change models or examined whether the predictors of gun carrying change across adolescence and early young adulthood. The present study fills these gaps by examining the predictive utility of several risk factors for gun carrying, and by examining whether any of the associations vary by age. The sample included 1216 young men who were arrested for the first time during adolescence (approximately 15 years old) and interviewed regularly for 5 years (until approximately 20 years old) after the first arrest. The outcome was youth-self-reported gun carrying and the risk factors included several variables consistent with various explanations for gun carrying (psychosocial maturity deficits; antisocial behavioral style; socialization; victimization). Research questions were addressed with fixed effects dynamic panel models (within-individual change models). Results showed that the most robust predictors of gun carrying were increased exposure to guns and gun-related violence and increased engagement in other antisocial and illegal behavior. The results emphasize the specific etiology of gun carrying and the potential social contagion effect of gun-related events. Overall, the study points to the need for prevention and intervention programs to specifically target the reduction of the real and perceived prevalence of gun-related events in young men's lives.

Reduced neural responsiveness to looming stimuli is associated with increased aggression

While neuro-cognitive work examining aggression has examined patients with conditions at increased risk for aggression or individuals self-reporting past aggression, little work has attempted to identify neuro-cognitive markers associated with observed/recorded aggression. The goal of the current study was to determine the extent to which aggression by youth in the first three months of residential care was associated with atypical responsiveness to threat stimuli. This functional MRI study involved 98 (68 male; mean age = 15.96 [sd = 1.52]) adolescents in residential care performing a looming threat task involving images of threatening and neutral human faces or animals that appeared to be either loom or recede. Level of aggression was negatively associated with responding to looming stimuli (irrespective of whether these were threatening or neutral) within regions including bilateral inferior frontal gyrus, right inferior parietal lobule, right superior/middle temporal gyrus and a region of right uncus proximal to the amygdala. These data indicate that aggression level is associated with a decrease in responsiveness to a basic threat cue-looming stimuli. Reduced threat responsiveness likely results in the individual being less able to represent the negative consequences that may result from engaging in aggression, thereby increasing the risk for aggressive episodes.

Developing Cutoff Scores for the Inventory of Callous-Unemotional Traits (ICU) in Justice-Involved and Community Samples

Objective: The recent addition of the callous-unemotional (CU) traits specifier, "with Limited Prosocial Emotions (LPE)," to major classification systems has prompted the need for assessment tools that aid in the identification of elevations on these traits for diagnostic purposes. The goal of the current study was to use and evaluate multiple methods for establishing cutoff scores for the multi-informant questionnaire, the Inventory of Callous-Unemotional Traits (ICU).Method: The present study compared the clinical utility of various proposed cutoff methods and scores (i.e., empirically derived cutoffs using receiver operating characteristic (ROC), normative cutoffs, and rational scoring approximations of LPE criteria) in both a longitudinal sample of justice-involved male adolescents (N = 1,216; M_age = 15.29, SD = 1.29) and a cross-sectional sample of school children (N = 289; M_age = 11.47 years; SD = 2.26).Results: Methods resulted in a range of cutoff scores with substantial diagnostic overlap and validity. Specifically, they designated justice-involved adolescents at risk for later delinquency, aggression, and rearrests, and they designated school children more likely to be rated by parents and teacher as having conduct problems and rated by peers as being rejected and mean.Conclusions: The results lead to ranges of ICU scores that have support for their validity and can help to guide clinical decisions about children and adolescents who may be elevated on CU traits.

Psychopathy

Psychopathy is a personality disorder characterized by a constellation of affective, interpersonal, lifestyle and antisocial features whose antecedents can be identified in a subgroup of young people showing severe antisocial behaviour. The prevalence of psychopathy in the general population is thought to be ~1%, but is up to 25% in prisoners. The aetiology of psychopathy is complex, with contributions of both genetic and environmental risk factors, and gene-environment interactions and correlations. Psychopathy is characterized by structural and functional brain abnormalities in cortical (such as the prefrontal and insular cortices) and subcortical (for example, the amygdala and striatum) regions leading to neurocognitive disruption in emotional responsiveness, reinforcement-based decision-making and attention. Although no effective treatment exists for adults with psychopathy, preliminary intervention studies targeting key neurocognitive disturbances have shown promising results. Given that psychopathy is often comorbid with other psychiatric disorders and increases the risk of physical health problems, educational and employment failure, accidents and criminality, the identification of children and young people at risk for this personality disorder and preventative work are important. Indeed, interventions that target the antecedents of psychopathic features in children and adolescents have been found to be effective.

Crossroads in juvenile justice: The impact of initial processing decision on youth 5 years after first arrest

The current study advances past research by studying the impact of juvenile justice decision making with a geographically and ethnically diverse sample (N = 1,216) of adolescent boys (ages 13-17 years) for the 5 years following their first arrest. Importantly, all youth in the study were arrested for an eligible offense of moderate severity (e.g., assault, theft) to evaluate whether the initial decision to formally (i.e., sentenced before a judge) or informally (i.e., diverted to community service) process the youth led to differences in outcomes. The current study also advanced past research by using a statistical approach that controlled for a host of potential preexisting vulnerabilities that could influence both the processing decision and the youth's outcomes. Our findings indicated that youth who were formally processed during adolescence were more likely to be re-arrested, more likely to be incarcerated, engaged in more violence, reported a greater affiliation with delinquent peers, reported lower school enrollment, were less likely to graduate high school within 5 years, reported less ability to suppress aggression, and had lower perceptions of opportunities than informally processed youth. Importantly, these findings were not moderated by the age of the youth at his first arrest or his race and ethnicity. These results have important implications for juvenile justice policy by indicating that formally processing youth not only is costly, but it can reduce public safety and reduce the adolescent's later potential contributions to society.

Special Section Introduction: Revitalizing Developmental Research on Adolescent Gun Involvement

Although firearm violence is universally recognized as a paramount public health problem in the United States, for nearly two decades a Congressional budget amendment prevented federal agencies from funding research aimed at understanding the antecedents and consequences of gun violence. These restrictions have been lifted in recent years; however, the field is struggling to overcome a considerable lapse in developmentally-informed longitudinal research on adolescent gun involvement. Some key areas in need of further investigation include: (a) examining developmental and gender differences in risk factors for adolescent gun carrying, (b) clarifying the mechanisms through which socio-economic disadvantage confers risk for engaging in adolescent gun violence, (c) identifying proximal risk and protective factors that are associated with engagement in adolescent gun violence among high risk youth, and (d) delineating the unique effect the exposure to gun violence has on adolescents' emotional and behavioral problems. This special section was organized in an attempt to revitalize research on these issues using a diverse array of longitudinal data sets consisting of both epidemiological and juvenile justice samples. Collectively, the findings from these studies are based upon repeated assessments conducted from childhood through early adulthood, making this set of papers uniquely positioned to advance our understanding of adolescent gun involvement from a developmental perspective.