A Pilot Study of Emotional Response to Time-Out in Children With Conduct Problems and Callous-Unemotional Traits

Multimodal Assessment of Emotion Dysregulation in Children with and without ADHD and Disruptive Behavior Disorders

OBJECTIVE

We sought to explore if specific domains of emotion dysregulation (emotion regulation [EREG], emotional reactivity/lability [EREL], emotion recognition/understanding [ERU], and callous-unemotional [CU] behaviors) were uniquely associated with diagnostic classifications.

METHOD

This study utilized a multimodal (parent/teacher [P/T] reports and behavioral observations) approach to examine emotion dysregulation in a sample of young children (68.7% boys; mean age = 5.47, SD = 0.77, 81.4% Latinx) with attention-deficit/hyperactivity disorder (ADHD Only; n = 46), ADHD + disruptive behavior disorders (ADHD+DBD; n = 129), and typically developing (TD) children (n = 148).

RESULTS

All three diagnostic groups were significantly different from one another on P/T reports of EREG, EREL and CU. For the ADHD+DBD group, P/T reported worse EREG and EREL, and higher mean scores of CU, compared to both ADHD Only and TD groups. The ADHD+DBD group also performed significantly worse than the TD group (but not the ADHD Only group) on observed measures of EREG, EREL and ERU. P/T reported EREG, EREL and CU for the ADHD Only group were significantly worse than the TD group. Using multinomial logistic regression, P/T reported EREG, EREL, and CU were significantly associated with diagnostic status above and beyond observed measures of emotion dysregulation. The model successfully classified children with ADHD+DBD (91.3%) and TD (95.9%); however, children in the ADHD Only group were correctly identified only 45.7% of time.

CONCLUSION

Our findings suggest that measures of emotion dysregulation may be particularly helpful in correctly identifying children with ADHD+DBD, but not necessarily children with ADHD Only.

Identifying the Inter-Domain Relations Among ODD, CD, and CU Traits in Preschool Children Using Network Analysis

Oppositional defiant disorder (ODD) and conduct disorder (CD) are two of the most common forms of disruptive behavior disorders during childhood. Callous-unemotional (CU) traits are an important factor in understanding the presentation of these externalizing forms of psychopathology. ODD, CD, and CU traits are highly related constructs, yet little work has examined how these externalizing forms of psychopathology are related at the domain level. The current study utilized network analysis to identify the distinct domains that explain the associations among ODD, CD, and CU traits. In a sample of 104 preschoolers (M age = 4.76), results demonstrated that the symptom domains of (a) angry/irritable mood and argumentative/defiant behavior, (b) aggression to people and animals, and (c) callousness were the primary bridge domains for ODD, CD, and CU traits, respectively. Findings of the current study offer a more nuanced insight into the relations amongst ODD, CD, and CU traits. Identification of bridge symptom domains can inform intervention practices by targeting specific symptom domains that are contributing to the maintenance of such aggressive and disruptive behaviors.

To what extent does punishment insensitivity explain the relationship between callous-unemotional traits and academic performance in secondary school students?

BACKGROUND

Callous-unemotional (CU) traits are related to low achievement but not to deficits in verbal ability, commonly regarded as a major risk factor for poor academic outcomes in antisocial youth. This suggests that CU traits may have utility in explaining heterogeneous risk pathways for poor school performance in antisocial children. Reduced sensitivity to teacher discipline has been suggested as a potential explanation for the association between CU traits and low achievement, given its importance in facilitating engagement in learning. This study is the first to examine punishment insensitivity as a potential mechanism explaining the relationship between CU traits and poor achievement.

AIM

The current study investigated the indirect pathway from CU traits via the predictor of punishment insensitivity to English, Maths, and Science grades.

SAMPLE

A total of 437 English secondary school students aged 11 to 14 years (49% girls).

METHODS

We conducted a mediation analysis within a structural equation modelling framework. CU traits and punishment insensitivity were assessed using child report questionnaires and academic grades were obtained from school records.

RESULTS

CU traits were indirectly associated with low academic grades in Maths and Science, but not English, via punishment insensitivity, controlling for child age, gender, single parent household status, free school meals eligibility, externalizing problems, and classroom effects.

CONCLUSIONS

Findings indicated that reduced sensitivity to discipline forms a pathway linking CU traits to poor performance in Maths and Science. Teachers may therefore need additional support to implement discipline effectively with children high in CU traits in order to prevent poor academic outcomes.