Revisiting the treatment of conduct problems in children with callous-unemotional traits

Abstract

Our findings replicate previous evidence that CU traits are uniquely associated with poor clinical outcomes among children treated for conduct problems, and show for the first time that this association is not accounted for by symptoms of ASD.

The Reciprocal Influence of Callous-Unemotional Traits, Oppositional Defiant Disorder and Parenting Practices in Preschoolers

“…Similar findings were observed in a high-risk sample of preschoolers age 2 to 3 [8]. At the same time, some evidence indicates that for children with high CU traits, exposure to negative parenting is less important than a lack of parental warmth or involvement [7]. Parental warmth seems to be related to decreases in both CU traits and ODD: In a longitudinal study of high-risk preschoolers [23], researchers found that CU traits did not moderate the effects of a positive parenting intervention on CD or ODD, suggesting that positive parenting is important to both CD and ODD in high-risk children ages 2 to 4 [9].…”

“…For instance, in a sample of boys age 4 to 8, those diagnosed with ODD who had high CU traits consistently retained diagnoses of ODD after a parenting intervention, whereas their low-CU counterparts benefitted from the treatment [6]. Relatedly, children age 3 to 9 with high levels of CU traits exhibited more severe ODD symptoms compared to their low-CU peers, indicating an elevated probability of negative clinical outcomes at an early age [7]. In light of evidence that the construct of CU traits does, in fact, seem to apply to younger children, researchers have begun to examine just how early in development CU traits PRESCHOOL CU TRAITS, ODD AND PARENTING STYLE 4 can be identified, with evidence that CU traits can be reliably identified in the preschool period [7,8,9].…”

“…Relatedly, children age 3 to 9 with high levels of CU traits exhibited more severe ODD symptoms compared to their low-CU peers, indicating an elevated probability of negative clinical outcomes at an early age [7]. In light of evidence that the construct of CU traits does, in fact, seem to apply to younger children, researchers have begun to examine just how early in development CU traits PRESCHOOL CU TRAITS, ODD AND PARENTING STYLE 4 can be identified, with evidence that CU traits can be reliably identified in the preschool period [7,8,9]. However, there is a need for research using representative samples of preschoolers, as previous studies largely examine a wider range of ages in high-risk or delinquent youth.…”

Exploring Links between Genotypes, Phenotypes, and Clinical Predictors of Response to Early Intensive Behavioral Intervention in Autism Spectrum Disorder

“…There is increasing support for the subtyping of childhood conduct problems based on whether children exhibit high versus low levels of callous-unemotional (CU) traits, such as a lack of guilt and empathy (Hawes et al, 2013). Research suggests that the conduct problems of children with high levels of CU traits are more severe and less responsive to established psychological interventions than those of children without CU traits (Hawes and Dadds, 2005; Waschbusch et al, 2007).…”

Functional Neurocircuitry in Conduct Disorder with and without Callous-Unemotional Traits

“…This is true of behavioral interventions; few studies examine the effect of CU traits on response to pharmacologic treatment. Young children with conduct problems and high levels of CU traits show lower rates of response and greater persistence of symptoms six months after parent management training; it has been suggested that this is due to their lower sensitivity to punishment in the form of timeout (Hawes & Dadds, 2005;Hawes, Dadds, Brennan, Rhodes, & Cauchi, 2013). On the other hand, the addition of emotion recognition training to parent management improved affective empathy and conduct symptoms in preadolescents with high levels of CU traits (Dadds, Cauchi, Wimalaweera, Hawes, & Brennan, 2012).…”