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.

Community Violence Exposure and Generalized Anxiety Symptoms: Do Callous-Unemotional Behaviors Moderate this Relation Among Urban Youth?

Community violence exposure (CVE; i.e., direct victimization and witnessed violence) is a major public health concern among youth who reside in low income, urban neighborhoods, who tend to experience CVE chronically and disproportionately. Frequent CVE is associated with generalized anxiety disorder (GAD) symptoms, such as persistent or excessive worry and difficulty concentrating. However, not all youth experiencing CVE exhibit such symptoms. One understudied factor that may moderate this relation is callous-unemotional (CU) behaviors (e.g., behaviors consistent with lack of guilt, low levels of empathy). CU behaviors are associated with lower levels of responsiveness to contextual processes; as such, CU behaviors may be associated with lower levels of GAD symptoms in the context of CVE. However, little research considers CU behaviors and GAD symptoms concurrently. To address this gap, the present study examined associations among witnessed and direct CVE, CU behaviors, and GAD symptoms among low-income, urban youth (N = 104, 50% male, Mage = 9.93 ± 1.22 years old, 95% African-American/Black). Multiple regression analyses indicated teacher-reported CU behaviors moderated the relations between CVE and caregiver-reported GAD symptoms. Post-hoc probing revealed that among youth with higher levels of CVE, higher levels of CU behaviors were associated with elevated GAD symptoms compared to their peers with lower levels of CU behaviors. Youth with lower levels of CU behaviors evidenced moderate levels of GAD symptoms regardless of their levels of CVE. Thus, low-income, urban youth who experience elevated levels of CVE may be at increased risk for co-occurring GAD and CU symptoms.

Individual differences in white matter of the uncinate fasciculus and inferior fronto-occipital fasciculus: possible early biomarkers for callous-unemotional behaviors in young children with disruptive behavior problems

BACKGROUND

Callous-unemotional (CU) behaviors are important for identifying severe patterns of conduct problems (CP). One major fiber tract implicated in the development of CP is the uncinate fasciculus (UF), which connects amygdala and orbitofrontal cortex (OFC). The goals of the current study were to (a) explore differences in the white matter microstructure in the UF and other major fiber tracks between young typically developing (TD) children and those with a disruptive behavior disorder (DBD) and (b) explore, within the DBD group, whether individual differences in these white matter tracts relate to co-occurring CP and CU behaviors.

METHODS

Participants included 198 young children (69% boys, M_age  = 5.66 years; 80% Latinx; 48.5% TD). CU behaviors and CP were measured via a combination of teacher/parent ratings. Non-invasive diffusion-weighted imaging (DWI) was used to measure fractional anisotropy (FA), an indirect indicator of white matter properties.

RESULTS

Relative to TD children, children in the DBD group had reduced FA on four out of the five fiber tracks we examined (except for cingulum and right ILF), even after accounting for whole brain FA, sex, movement, parental income, and IQ. Within the DBD group, no associations were found between CP and reduced white matter integrity across any of the fiber tracks examined. However, we found that even after accounting for CP, ADHD symptomology, and a host of covariates (whole brain FA, sex, movement, parental income, and IQ), CU behaviors were independently related to reduced FA in bilateral UF and left inferior fronto-occipital fasciculus (IFOF) in the DBD group, but this was not the case for TD children.

CONCLUSIONS

Alterations in the white matter microstructure within bilateral UF and left IFOF may be biomarkers of CU behaviors, even in very young children.

Callous-Unemotional Behaviors and Harsh Parenting: Reciprocal Associations across Early Childhood and Moderation by Inherited Risk

Callous-unemotional (CU) behaviors increase children's risk for subsequent antisocial behavior. This risk process may begin in early childhood with reciprocal pathways between CU behaviors and harsh parenting. In a sample of 561 linked triads of biological mothers, adoptive parents, and adopted children, the present study examined bidirectional links between CU behaviors and harsh parenting across three time points from 18 to 54 months and investigated moderation by inherited risk for psychopathic traits. Child CU behaviors and harsh parenting were measured using adoptive mother and adoptive father reports, and biological mothers provided reports of their personality characteristics. Findings supported reciprocal associations between harsh parenting and CU behaviors during early childhood, especially during the transition from toddlerhood (27 months) to the preschool period (54 months). Moreover, multiple-group analyses showed that level of inherited risk moderated associations between CU behaviors and harsh parenting. Specifically, there were statistically reliable associations between CU behaviors at 27 months and adoptive mothers' harsh parenting at 54 months, and between adoptive fathers' harsh parenting at 27 months and CU behaviors at 54 months among children at higher inherited risk, but not among those at lower inherited risk. The findings illustrate the dynamic interplay between parenting, CU behaviors, and heritable risk.

Emotion Recognition Deficits among Children with Conduct Problems and Callous-Unemotional Behaviors

Deficits in emotion recognition have been associated with psychopathic and callous-unemotional (CU) behaviors among adults, adolescents, and children. However, few previous studies have examined such associations exclusively during early and middle childhood, or demographic differences in emotion recognition that may result from early emotion socialization experiences. The current study used a large, population-stratified, randomly-selected sample of 2^nd grade children living in areas of high rural poverty to examine group differences in emotion recognition among children showing no conduct problems or CU behaviors (typical), conduct problems without CU behaviors (CP-only), and both CP and CU behaviors (CP+CU). Primary caregivers reported on children's conduct problems and callous-unemotional behaviors at 1^st grade and children completed a computerized facial emotion recognition task at 2^nd grade. Results indicated that CP/CU group differences in emotion recognition accuracy were moderated by child race, with children in the typical group showing better overall accuracy and better recognition of fearful and happy faces among European American children, whereas no group differences were found among African American children. Implications for emotion socialization, etiology of CP and CU behaviors, and future directions for research and treatment are discussed.

Respiratory sinus arrhythmia and heart period in infancy as correlates of later oppositional defiant and callous-unemotional behaviors

Extant literature suggests that oppositional defiant (ODD) and callous-unemotional (CU) behaviors in childhood and adolescence are associated with distinct patterns of psychophysiological functioning and that individual differences in these patterns have implications for developmental pathways to disorder. Very little is known about the associations between psychophysiological functioning in infancy and later ODD and CU behaviors. This study examined associations between basal autonomic nervous system (ANS) functioning in infancy and ODD and CU behaviors in later childhood. Using longitudinal heart period (HP) and respiratory sinus arrhythmia (RSA) data from the Durham Child Health and Development Study (N = 206), the current study tested associations, within a structural equation modeling framework, between continuous measures of HP and RSA across the first two years of life and later ODD and CU behaviors at first grade. Results indicate that ODD and CU behaviors in childhood are associated with lower baseline RSA, but not HP, across infancy. The implications of these findings for developmental models of ODD and CU behaviors are discussed.