1
|
Castagna PJ, Babinski DE, Waschbusch DA. Callous-unemotional traits moderate the association between inhibitory control and disruptive behavior problems. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02582-9. [PMID: 39276248 DOI: 10.1007/s00787-024-02582-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 09/10/2024] [Indexed: 09/16/2024]
Abstract
The presence of callous-unemotional (CU) traits may not be unique to conduct disorder (CD) but also extend to oppositional defiant disorder (ODD). While a distinct neurocognitive profile characterizes CU traits, it remains unclear whether this CU-related neurocognitive profile differs between youth with CD and ODD. This study investigated whether CU traits moderate the relationship between inhibitory control and CD or ODD symptoms. We leveraged computational modeling to decompose task-based inhibitory control in a sample of 200 children (59.5% boys, 86.5% Caucasian), aged 8 to 15 years (M = 10.10, SD = 1.88), referred to an outpatient child diagnostic clinic focused on externalizing problems. Analyses examined whether CU traits moderated the relationship between inhibitory control and CD or ODD symptoms while controlling for ADHD symptoms and child demographics. The results indicated that the strength of the relationship between inhibitory control and CD and ODD symptoms varies as a function of CU traits. Specifically, CD was linked to a more cautious decision-making style when elevated CU traits were present, whereas ODD was associated with more efficient decision making. These findings suggest distinct neurocognitive profiles based on CU traits, which vary between CD and ODD. Clinically, this underscores the importance of tailoring interventions for CD-CU and ODD-CU, focusing on decision making processes rather than merely addressing impulsivity. This research contributes to a more nuanced understanding of the interaction between neurocognitive processes and disruptive behavior, with significant implications for both theoretical models and treatment approaches.
Collapse
Affiliation(s)
- Peter J Castagna
- Department of Psychology, The University of Alabama, 368C Gordon Palmer Hall, Tuscaloosa, AL, 35487, USA.
| | - Dara E Babinski
- Department of Psychiatry and Behavioral Health, Penn State Hershey Medical Center and College of Medicine, Hershey, PA, USA
| | - Daniel A Waschbusch
- Department of Psychiatry and Behavioral Health, Penn State Hershey Medical Center and College of Medicine, Hershey, PA, USA
| |
Collapse
|
2
|
Fanti KA, Mavrommatis I, Díaz-Vázquez B, López-Romero L, Romero E, Álvarez-Voces M, Colins OF, Andershed H, Thomson N. Fearlessness as an Underlying Mechanism Leading to Conduct Problems: Testing the INTERFEAR Model in a Community Sample in Spain. CHILDREN (BASEL, SWITZERLAND) 2024; 11:546. [PMID: 38790541 PMCID: PMC11119632 DOI: 10.3390/children11050546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 04/26/2024] [Accepted: 04/30/2024] [Indexed: 05/26/2024]
Abstract
Conduct problems (CP) in childhood and adolescence have a significant impact on the individual, family, and community. To improve treatment for CP, there is a need to improve the understanding of the developmental pathways leading to CP in boys and girls. Prior research has linked the child's fearlessness and callous-unemotional (CU) traits, as well as experiences of parental warmth and punitive parenting, to CP. However, few studies have tested the interplay of these factors in contributing to future CP development. The present study aimed to test the InterFear model, which suggests that fearlessness in early childhood leads to CP through an indirect pathway involving low positive parenting, high negative/punitive parenting, and callous-unemotional (CU) traits. The sample included 2467 Spanish children (48.1% girls; Mage = 4.25; SD = 0.91), followed up across a five-year period. Besides a direct association between fearlessness in early childhood and future CP, the results found an indirect pathway whereby fearlessness reduces positive parenting and increases punitive parenting, which contributes to the development of CU traits and sets the stage for CP in later childhood. The specific indirect effect from fearlessness to CP via CU traits accounted for most of the variance, suggesting the existence of a temperamental pathway independent of parental variables. Further, two additional indirect pathways, exclusive of fearlessness, were identified, which started with low parental warmth and positive parenting, leading to CP via CU traits. These findings support the InterFear model, demonstrating multiple pathways to CP with the involvement of fearlessness, parenting practices, and CU traits. This model might play a pivotal role in the development of targeted prevention and intervention strategies for CP.
Collapse
Affiliation(s)
- Kostas A. Fanti
- Department of Psychology, Faculty od Social Sciences and Education, University of Cyprus, P.O. Box 20537, Nicosia 1678, Cyprus;
| | - Ioannis Mavrommatis
- Department of Psychology, Faculty od Social Sciences and Education, University of Cyprus, P.O. Box 20537, Nicosia 1678, Cyprus;
| | - Beatriz Díaz-Vázquez
- Instituto de Psicoloxía (IPsiUS), Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain; (B.D.-V.); (L.L.-R.); (E.R.); (M.Á.-V.)
| | - Laura López-Romero
- Instituto de Psicoloxía (IPsiUS), Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain; (B.D.-V.); (L.L.-R.); (E.R.); (M.Á.-V.)
| | - Estrella Romero
- Instituto de Psicoloxía (IPsiUS), Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain; (B.D.-V.); (L.L.-R.); (E.R.); (M.Á.-V.)
| | - María Álvarez-Voces
- Instituto de Psicoloxía (IPsiUS), Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain; (B.D.-V.); (L.L.-R.); (E.R.); (M.Á.-V.)
| | - Olivier F. Colins
- Department of Special Needs Education, Faculty of Psychology and Educational Siences, Ghent University, Dunantlaan 1, 9000 Gent, Belgium;
| | - Henrik Andershed
- School of Behavioural, Social and Legal Sciences, Örebro University, 701 82 Örebro, Sweden;
| | - Nicholas Thomson
- Department of Surgery and Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA;
| |
Collapse
|
3
|
Bellato A, Sesso G, Milone A, Masi G, Cortese S. Systematic Review and Meta-Analysis: Altered Autonomic Functioning in Youths With Emotional Dysregulation. J Am Acad Child Adolesc Psychiatry 2024; 63:216-230. [PMID: 36841327 DOI: 10.1016/j.jaac.2023.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/20/2023] [Accepted: 02/16/2023] [Indexed: 02/27/2023]
Abstract
OBJECTIVE To systematically investigate if there is a significant association between markers of autonomic functioning and emotional dysregulation (ED) in children and adolescents. METHOD Based on a preregistered protocol (PROSPERO: CRD42021239635), PubMed, Web of Knowledge/Science, Ovid MEDLINE, Embase, and APA PsycInfo databases were searched until April 21, 2021, to identify empirical studies reporting indices of autonomic nervous system (ANS) functioning in youths meeting DSM (version III, IV, IV-TR, 5 or 5-TR) or International Classification of Diseases (ICD) (version 9 or 10) criteria for any psychopathological/neurodevelopmental condition and assessed for ED with a validated scale. Eligible outcomes included correlation coefficients between ED and ANS measures or differences in ANS measures between youths with and without ED. Study quality was assessed with the Appraisal tool for Cross-Sectional Studies (AXIS) and the Newcastle-Ottawa Scale (NOS) for cohort studies. Random-effects meta-analyses were used for data synthesis. RESULTS There were 12 studies (1,016 participants) included in the descriptive review and 9 studies (567 participants) included in the meta-analyses. No evidence of a significant association between ED and altered cardiac or electrodermal functioning was found. However, exploratory meta-regressions suggested a possible association between reduced resting-state cardiac vagal control and increased ED. CONCLUSION This study did not find evidence of an association between ED and autonomic dysfunction. However, preliminary evidence that reduced vagal control at rest might be a transdiagnostic marker of ED in young people was found. Additional studies comparing autonomic measures in youths with and without ED are needed and should also assess the effects of interventions for ED on ANS functioning. STUDY PREREGISTRATION INFORMATION Systematic Review and Meta-Analysis: Is Autonomic Nervous System Functioning Atypical in Children and Adolescents With Emotional Dysregulation? https://www.crd.york.ac.uk/prospero/; CRD42021239635.
Collapse
Affiliation(s)
- Alessio Bellato
- University of Nottingham Malaysia, Malaysia; King's College London, United Kingdom.
| | - Gianluca Sesso
- IRCCS Stella Maris Foundation, Pisa, Italy; University of Pisa, Italy
| | | | | | - Samuele Cortese
- University of Southampton, United Kingdom; New York University Langone Health, New York
| |
Collapse
|
4
|
Sakki H, Clair MS, Hwang S, Allen JL. The association between callous-unemotional traits and substance use in childhood and adolescence: A systematic review and meta-analysis. J Affect Disord 2023; 338:502-517. [PMID: 37390924 DOI: 10.1016/j.jad.2023.06.051] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 06/06/2023] [Accepted: 06/26/2023] [Indexed: 07/02/2023]
Abstract
Callous-unemotional (CU) traits are characterized by a lack of guilt and empathy, restricted affect, and low concern about performance, and are increasingly recognized as co-occurring with substance use in youth. However, there is mixed evidence concerning whether they make a unique contribution to substance use. This systematic review and meta-analysis sought to quantify the association between CU traits and substance use in childhood, accounting for potential moderators including sample characteristics (age, gender, community versus clinical/forensic samples), CU traits measure and informant, and study design (cross-sectional or longitudinal). Separate meta-analyses were conducted for alcohol, cannabis, and a substance use composite. Small, significant associations were found between CU traits and alcohol (θ = 0.17), cannabis (θ = 0.17) and the substance use composite (θ = 0.15), which were present in both community and clinical/forensic samples. Findings suggest that CU traits co-occur with a range of substance use problems, and that CU traits should be considered in assessments of youth presenting with substance use problems regardless of the nature of the setting.
Collapse
Affiliation(s)
- Hanna Sakki
- Department of Psychology, University of Bath, 10 West, Claverton Down, Bath BA2 7AY, UK
| | - Michelle St Clair
- Department of Psychology, University of Bath, 10 West, Claverton Down, Bath BA2 7AY, UK
| | - Suhlim Hwang
- Department of Psychology and Human Development, University College London, Institute of Education, 25 Woburn Square, London WC1H 0AA, UK
| | - Jennifer L Allen
- Department of Psychology, University of Bath, 10 West, Claverton Down, Bath BA2 7AY, UK.
| |
Collapse
|
5
|
Sesso G, Masi G. Pharmacological strategies for the management of the antisocial personality disorder. Expert Rev Clin Pharmacol 2023; 16:181-194. [PMID: 36787887 DOI: 10.1080/17512433.2023.2181159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 02/09/2023] [Indexed: 02/16/2023]
Abstract
INTRODUCTION Antisocial personality disorder (AsPD) is a pervasive pattern of violation of others' rights, related to the concept of psychopathy. AsPD is stable over time from adolescence, with evidence of conduct disorder (CD) before 15 years. DSM-5 included a specifier 'with limited prosocial emotions' (LPE), which characterizes adolescents with higher developmental vulnerability to develop AsPD. Despite being relatively frequent with considerable societal impact, AsPD is a difficult-to-treat condition with high comorbidity rates and poor evidence for effective pharmacological interventions. AREAS COVERED We conducted a narrative review and searched PubMed up to September 2022. We included RCTs and naturalistic studies evaluating pharmacological interventions on AsPD in adults, including those with comorbid substance use disorder or psychopathic traits. Evidence in youths with CD, callous-unemotional (CU) traits and aggression were also reviewed, exploring the role of CU traits as moderators of response. EXPERT OPINION Psychosocial interventions are the first option, with possible improvement of CU traits, beyond behavioral and affective symptoms, particularly if implemented early during development. Limited information, based on low-quality studies, supports the pharmacological options. Second-generation antipsychotics, lithium, anti-epileptic drugs, and stimulants are first-line medications, according to different target symptoms. Developmental pathways including ADHD suggest a specific role of psychostimulants.
Collapse
Affiliation(s)
- Gianluca Sesso
- Social and Affective Neuroscience Group, Molecular Mind Lab, IMT School for Advanced Studies Lucca, Lucca, Italy
- Department of Child and Adolescent Psychiatry and Psychopharmacology, IRCCS Stella Maris Foundation, Pisa, Italy
| | - Gabriele Masi
- Department of Child and Adolescent Psychiatry and Psychopharmacology, IRCCS Stella Maris Foundation, Pisa, Italy
| |
Collapse
|
6
|
The significance of limited prosocial emotions among externalizing disorders in children. Eur Child Adolesc Psychiatry 2022; 31:589-600. [PMID: 33389151 DOI: 10.1007/s00787-020-01696-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 11/22/2020] [Indexed: 02/08/2023]
Abstract
Limited Prosocial Emotion (LPE) specifier of conduct disorder (CD) includes lack of remorse or guilt, callousness/lack of empathy, unconcern about performance, and shallow/deficient affect. Given the relatively recent inclusion of the LPE specifier in the Diagnostic and Statistical Manual, fundamental information is still unknown about LPE, such as how common the different domains are, how much they overlap with one another, whether they predict unique variance from each other, and the potential for the LPE specifier as a transdiagnostic facet of externalizing problems. Caregivers (n = 1,50) of children (Mage = 8.42, SD = 2.31) completed a questionnaire assessing individual LPE domains and measures of externalizing symptoms. Results showed that LPE specifier domains were highly related but separable. All LPEs were uniquely associated with oppositional defiant disorder (ODD), CD, and overall impairment after controlling for other LPE items, child sex, and ADHD symptoms. Being unconcerned about performance, emotionally manipulative, and having shallow/deficient affect were uniquely associated with ADHD while controlling for ODD and CD symptomatology. Our findings fit with the historical conceptualization of LPE as a unidimensional construct and contributes to the growing evidence of the potential utility of assessing LPE across externalizing disorders in children. Future research should look to replicate and extend our findings in clinical samples of youth.
Collapse
|
7
|
Squillaci M, Benoit V. Role of Callous and Unemotional (CU) Traits on the Development of Youth with Behavioral Disorders: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094712. [PMID: 33925165 PMCID: PMC8125599 DOI: 10.3390/ijerph18094712] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 12/11/2022]
Abstract
Numerous studies have shown that youth with behavioral disorders (BD) present an increased risk for developing severe and persistent antisocial behaviors in adulthood. Retrospective research notes that not all children and adolescents follow a negative trajectory and explains this heterogeneity in particular by the severity of CU traits. Our study examines how these traits affect the functioning of children and adolescents with BD. Method: A systematic literature review conducted through various databases and using different keywords made it possible to analyze 52 studies published from 2015 to 2020 that measured the bidirectional effects of CU traits on the functioning of young. Results: Out of the 52 studies, 47 analyzed links between CU traits and neurobiological or mental health, 20 examined family and school contexts, eight focused on social adjustment, 10 on social interactions and 19 measured links with cognitive functioning, especially executive functions. Conclusion: Consistent with previous recommendations in the field, our findings emphasize the importance of assessing the presence of UC traits in early childhood to prevent the emergence of comorbid disorders and to target multimodal (early) interventions to influence the life trajectories of youth with high CU traits.
Collapse
Affiliation(s)
- Myriam Squillaci
- Department of Special Education, University of Fribourg, 1700 Fribourg, Switzerland
- Correspondence:
| | - Valérie Benoit
- Department of Special Education, University of Teacher Education of State of Vaud, 1014 Lausanne, Switzerland;
| |
Collapse
|
8
|
Domínguez-Álvarez B, Romero E, López-Romero L, Isdahl-Troye A, Wagner NJ, Waller R. A Cross-Sectional and Longitudinal Test of the Low Sensitivity to Threat and Affiliative Reward (STAR) Model of Callous-Unemotional Traits Among Spanish Preschoolers. Res Child Adolesc Psychopathol 2021; 49:877-889. [PMID: 33624154 DOI: 10.1007/s10802-021-00785-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2021] [Indexed: 10/22/2022]
Abstract
Despite advances in the theoretical and empirical literature, a better understanding of the etiological determinants of callous-unemotional (CU) traits is needed. In this study, we tested the hypotheses advanced by the Sensitivity to Threat and Affiliative Reward (STAR) model, a theoretical framework, which proposes that individual differences in two temperament dimensions, fearlessness and low affiliation, jointly contribute to the development of CU traits. Specifically, we examined the unique and interactive effects of fearlessness and low affiliation on CU traits, both cross-sectionally and longitudinally and within and across informants (teachers and parents) in a large community sample of Spanish preschoolers (N = 2467, 48.1% girls, M = 4.25 years; SD = 0.91). Both fearlessness and low affiliation were independently related to higher CU traits across models. Consistent with the purported relationships outlined in the STAR model, we also found that a significant interaction between fearlessness and low affiliation explained unique variance in CU traits. The results suggested that main and interactive effects were specific to CU traits and not to other related dimensions of psychopathic traits that are measurable in early childhood (i.e. grandiose-deceitfulness and impulse need of stimulation). Thus, we provide new empirical support to the hypotheses generated by the STAR model in relation to the development of CU traits. Fearlessness and low affiliation are potential targets of future child-focused interventions to prevent or treat the development of CU traits and childhood conduct problems.
Collapse
Affiliation(s)
- Beatriz Domínguez-Álvarez
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Coruña, Spain.
| | - Estrella Romero
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Coruña, Spain
| | - Laura López-Romero
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Coruña, Spain
| | - Aimé Isdahl-Troye
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Coruña, Spain
| | - Nicholas J Wagner
- Department of Psychological and Brain Sciences, Boston University, Boston, USA
| | - Rebecca Waller
- Department of Psychology, University of Pennsylvania, Philadelphia, USA
| |
Collapse
|
9
|
Masi G, Fantozzi P, Muratori P, Bertolucci G, Tacchi A, Villafranca A, Pfanner C, Cortese S. Emotional dysregulation and callous unemotional traits as possible predictors of short-term response to methylphenidate monotherapy in drug-naïve youth with ADHD. Compr Psychiatry 2020; 100:152178. [PMID: 32386957 DOI: 10.1016/j.comppsych.2020.152178] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 04/20/2020] [Accepted: 04/25/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Emotional dysregulation (ED) and callous unemotional (CU) traits can be associated with ADHD in youth, influencing its natural history and outcome, but their effect on medication efficacy is unexplored. We examined whether two measures of baseline ED and CU traits, the Child Behavior Checklist-Dysregulation Profile (CBCL-DP) and the Antisocial Process Screening Device (APSD), respectively, were predictors of change of ADHD-Rating Scale (ADHD-RS) after a 4-week methylphenidate (MPH) monotherapy. METHODS 43 patients (37 males, 8-16 years, mean 9.9 ± 2.7 years) were included. Hierarchical linear regression models were used to explore whether CBCL-DP and APSD might predict ADHD-RS score, controlling for baseline severity. RESULTS Baseline CBCL-DP predicted higher post-treatment ADHD-RS scores in total and hyperactivity-impulsivity, but not in inattention subscale. Baseline APSD was not significantly related to ADHD-RS scores at the follow-up. LIMITATIONS Small sample size, lack of gender diversity, non-blind design and short period of observation. CONCLUSION ED, assessed with that CBCL-DP, might be a negative predictor of change of hyperactive-impulsive symptoms after MPH treatment and should be systematically assessed at baseline.
Collapse
Affiliation(s)
- Gabriele Masi
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy.
| | - Pamela Fantozzi
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy
| | - Pietro Muratori
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy
| | - Giulia Bertolucci
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy
| | - Annalisa Tacchi
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy
| | - Arianna Villafranca
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy
| | - Chiara Pfanner
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy
| | - Samuele Cortese
- Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Environmental and Life Sciences and Faculty of Medicine, University of Southampton, Southampton, UK
| |
Collapse
|
10
|
Kohlhoff J, Mahmood D, Kimonis E, Hawes DJ, Morgan S, Egan R, Niec LN, Eapen V. Callous-Unemotional Traits and Disorganized Attachment: Links with Disruptive Behaviors in Toddlers. Child Psychiatry Hum Dev 2020; 51:399-406. [PMID: 31894435 DOI: 10.1007/s10578-019-00951-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 12/13/2019] [Accepted: 12/16/2019] [Indexed: 10/25/2022]
Abstract
Children with callous-unemotional (CU) traits and children with disorganized attachment patterns are at heightened risk of poor psychological outcomes but little is known about the overlap between these constructs and their unique contributions to conduct problems in early childhood. This study examined associations between CU traits, disorganized attachment, and conduct problem (CP) severity in a sample of clinic-referred toddlers with behavioral problems. Mother-child dyads (n = 56; mean child age 19.50 months) completed parent-report questionnaires, a dyadic play session, and the Strange Situation Procedure to assess child attachment pattern. Significant positive associations were found between CU traits and disorganized attachment, independent of CP severity. CU traits but not disorganized attachment predicted CP severity. Results indicate that among toddlers with clinic-referred disruptive behavior problems, there are clear links between CU traits and attachment disorganization. Of the two constructs, however, CU traits appear to be most salient in the expression of CPs.
Collapse
Affiliation(s)
- Jane Kohlhoff
- School of Psychiatry, University of New South Wales, Sydney, Australia. .,Research Department, Karitane, Sydney, Australia.
| | - Dina Mahmood
- Department of Psychological Medicine, Children's Hospital at Westmead, Sydney Children's Hospital Network, Sydney, Australia
| | - Eva Kimonis
- School of Psychology, University of New South Wales, Sydney, Australia
| | - David J Hawes
- School of Psychology, University of Sydney, Sydney, Australia
| | - Sue Morgan
- Research Department, Karitane, Sydney, Australia
| | - Ryan Egan
- University of Oklahoma Health Sciences Center, Oklahoma, USA
| | - Larissa N Niec
- Center for Children, Families and Communities, Department of Psychology, Central Michigan University, Mt. Pleasant, MI, USA
| | - Valsamma Eapen
- School of Psychiatry, University of New South Wales, Sydney, Australia.,Academic Unit of Child Psychiatry, South Western Sydney Local Health District, Ingham Institute for Medical Research, Sydney, Australia
| |
Collapse
|