Variants of Callous-Unemotional Conduct Problems in a Community Sample of Adolescents

Abstract

Callous-unemotional traits are believed to be a childhood precursor to psychopathy, and among youth with conduct problems they designate those showing a particularly severe, stable, and aggressive pattern of antisocial behavior. Youth with callous-unemotional traits are a heterogeneous population and, analogous to adults with psychopathy, research suggests that lower anxious primary and high-anxious secondary variants exist. Using a community sample of 2,306 Greek-Cypriot adolescents (M age = 16 years; 49.7 % female), the first aim of the study was to examine whether variants of callous-unemotional traits could be identified using latent profile analysis of scores on measures of callous-unemotional traits, conduct problems, and anxiety. Additional aims of the study were to compare the identified clusters on external measures theorized to distinguish them (i.e., self-esteem, narcissism, impulsivity, sensation seeking and proactive/reactive aggression) and social factors relevant to adolescent development. Results indicated that, in addition to low risk (i.e., low scores on callous-unemotional traits, conduct problems, and anxiety) and anxious (i.e., high scores on anxiety, low scores on callous-unemotional traits and conduct problems) subgroups, two groups of youth scoring high on callous-unemotional traits and conduct problems were identified. High-anxious secondary callous-unemotional variants were distinguished by lower self-esteem in combination with greater narcissism, aggression, and markedly higher conduct problems, whereas lower anxious primary variants showed higher self-esteem. Secondary callous-unemotional variants also reported greater susceptibility to peer pressure and popularity striving than primary variants. Both variants exhibited poorer outcomes relative to low risk and anxious youth, although anxious youth reported lower self-esteem and higher impulsivity and reactive aggression scores in comparison with low risk youth. Findings integrate two lines of inquiry focused on subtyping children and adults with psychopathic traits and antisocial behaviors. They also support the utility of subtyping callous-unemotional traits based on conduct problems and anxiety levels and provide information on common and distinct risk factors associated with primary and secondary callous-unemotional variants in a community sample of adolescent boys and girls.

Anxiety and Callous-Unemotional Traits: Physiological and Behavioral Responses to Others' Distress

“…Overall, these results derived from observational child aggression data are consistent with previous research that has only utilized questionnaire-based data on child aggression (e.g., Fanti et al, 2013;Humayun et al, 2013;Rosan et al, 2015) in suggesting that CU traits are associated with greater aggression in the presence of higher levels of anxiety, and further clarify specific conditions under which this relationship applies. Specifically, the present findings obtained with an experimental paradigm indicate that anxiety moderates the effect of CU on child aggression, but only in the absence of salient distress cues from a potential victim.…”

“…Importantly, analogous to primary and secondary variants of psychopathy in adults (Karpman, 1948;Skeem, Poythress, Edens, Lilienfeld, & Cale, 2003), whereas the majority of youth showing CU traits do not show elevated levels of anxiety, a subset of CU youth do, and elevated anxiety appears to alter the presentation of CU traits in several key ways. Among children with CU, anxiety has been associated with greater questionnaire-based reports of impulsivity and externalizing behavior problems, as well as higher reports of aggression and delinquency Rosan et al, 2015;Vaughn et al, 2009), especially reactive aggression (Fanti et al, 2013), a more extensive criminal offense record (Kimonis et al, 2011), and increased reports of depressive and psychotic symptoms (Docherty et al, 2015;Vaughn et al, 2009) relative to CU youth without anxiety. These anxiety-related differences hold true despite comparable levels of CU traits, although some studies have noted increased (Kimonis et al, 2011;Lee et al, 2010) or decreased (Euler et al, 2015) CU trait severity among youth who show anxiety symptoms relative to CU youth without anxiety.…”

“…Anxiety may interact with CU in important ways, but the nature of such interactions and their impact on youth aggressive behavior remain unclear, impeding the identification of tailored treatment targets, and hindering efforts to address the unique needs of children at various points on these continua. Moreover, and importantly, research examining interactions between CU and anxiety and their effects on AB has relied almost exclusively on questionnaire reports of child aggressive behavior (e.g., Fanti et al, 2013;Kahn et al, 2013, Rosan et al, 2015, and the studies that used criminal records did not assess aggression in an experimental context (e.g., Kimonis et al, 2011;Lee et al, 2010), which limits interpretations and cannot rule out issues related to reporter biases, shared method variance, and external circumstances.…”

“…It is worthwhile to assess the degree to which the aggressive reactivity and internalizing symptoms (e.g., Docherty et al, 2015;Fanti et al, 2013) reported by CU youth experiencing anxiety symptoms may actually represent traumatic stress symptoms. Thus far, trauma exposure and traumatic stress symptoms have been examined as clinical correlates differentiating variants of CU youth with respect to anxiety (e.g., Humayun et al, 2013;Kimonis et al, 2012); the potential for traumatic stress to moderate the link between CU and observed aggression in the context of experimentally manipulated distress cues has not been explored.…”

“…Further, neural abnormalities in the form of limited amygdala function (e.g., Blair et al, 2006;Jones, Laurens, Herba, Barker, & Viding, 2009;Lozier et al, 2014) are associated with the "fearlessness" commonly ascribed to youth with high levels of CU (e.g., Pardini, 2006). Fearlessness is contradictory, however, to the worry and fears associated with chronic, trait-like anxiety in youth with CU (e.g., Fanti et al, 2013). It may be that anxiety lessens these CU-related abnormalities, reducing the blunted parasympathetic and sympathetic activity observed in non-anxious children with CU traits.…”