The Emotionally Sensitive Child-Adverse Parenting Experiences-Allostatic (Over)Load (ESCAPE-AL) Model for the Development of Secondary Psychopathic Traits

Independent Impacts of Maltreatment and Amygdala Volume on Worsening Callous-Unemotional Traits in High-Risk Youths

Callous-unemotional traits are a major risk factor for aggression and other externalizing behaviors. These traits frequently co-occur with maltreatment exposure, and both of these variables have been independently linked to changes in amygdala structure and function. However, relatively little research has explored how trauma exposure and amygdala structure and function combine to shape callous-unemotional traits. We assessed maltreatment exposure and callous-unemotional traits at two timepoints in children and adolescents who were aged 8-16 years at baseline (54.37% Male, 45.63% Female). We also used magnetic resonance imaging (MRI) to assess amygdala volume and activation in a subset of these youths at baseline (N = 161) and 18 months later (N = 117) using both linear and non-linear approaches. At baseline, maltreatment exposure and callous-unemotional traits were both independently associated with reduced right and left amygdala volume. Lower amygdala volume at baseline and maltreatment exposure independently predicted increases in callous-unemotional traits 18 months later. However, the effect of maltreatment on callous-unemotional traits was not mediated by amygdala volume. We find that accounting for maltreatment and amygdala volume, but not amygdala activation, improves the prediction of future callous-unemotional trait severity. These findings provide the first longitudinal evidence that maltreatment and lower amygdala volume independently predict worsening callous-unemotional traits in high-risk youths.

Affective and Behavioral Responses to Time-Out in Preschool Children With Conduct Problems and Varying Levels of Callous-Unemotional Traits

Punishment insensitivity characterizes individuals with callous-unemotional (CU) traits. This has been put forward as an explanation for their persistent conduct problems despite intervention. The purpose of the current study was to compare the emotional and behavioral responses to parent-implemented time-out within a behavioral parent training intervention between children with conduct problems who are high versus low on CU traits. Children (N = 87; M age = 4.88 years, SD = 1.32; 78% male) referred to a specialty clinic for the treatment of conduct problems were observed and coded during time-out, and their parents rated their conduct problem severity and CU traits using psychometrically robust measures. Children with conduct problems and high CU traits showed significantly more calm/neutral emotion and less negative emotion upon initial placement in time-out by parents, but did not engage in more negative behaviors or spend longer in time-out relative to children with conduct problems alone. After a minimum of 3 weeks of exposure to this form of parental discipline, most children complied with effective parental commands in that they did not require time-out for noncompliance during the fourth discipline-focused treatment session. Findings have implications for understanding why children with CU traits continue showing high levels of conduct problems post behavioral interventions, and they lend further support for the need to personalize treatment to their distinct needs.

Differential Mapping of Psychopathic Traits and General Psychopathology in a Large Young Adult Sample

Psychopathy is a personality disorder characterized by affective-interpersonal features and an impulsive-antisocial lifestyle. Psychopathy commonly co-occurs with other forms of psychopathology, but current understanding of how behavioral features of psychopathy co-occur with, or are distinct from, other mental health problems is limited. In this study, we analysed data from a large sample of young adults to study the relationship between different facets of psychopathic traits and general psychopathology ("p"). Data were collected between 2010 and 2016 and included 1,324 U.S. undergraduate students (Mage = 19.7 years; 57% female). Linear regression models revealed that the antisocial facet of psychopathy was distinct from p, while the lifestyle facet was correlated with p and externalizing behavior. Interpersonal and affective facets were correlated with internalizing behaviors. Collectively, these findings suggest that psychopathic traits of severe, premeditated antisocial behavior are distinct from general psychopathology, whereas impulsive and uninhibited lifestyle traits are a shared feature of psychopathology.

Evaluating the sensitivity to threat and affiliative reward (STAR) model in relation to the development of conduct problems and callous-unemotional traits across early adolescence

BACKGROUND

The Sensitivity to Threat and Affiliative Reward (STAR) model proposes low threat sensitivity and low affiliation as risk factors for callous-unemotional (CU) traits. Preliminary evidence for the STAR model comes from work in early childhood. However, studies are needed that explore the STAR dimensions in late childhood and adolescence when severe conduct problems (CP) emerge. Moreover, it is unclear how variability across the full spectrum of threat sensitivity and affiliation gives rise to different forms of psychopathology beyond CU traits.

METHODS

The current study addressed these gaps using parent- and child-reported data from three waves and a sub-study of the Adolescent Brain Cognitive Development Study® of 11,878 youth (48% female; ages 9-12).

RESULTS

Consistent with the STAR model, low threat sensitivity and low affiliation were independently related to CU traits across informants and time. Moreover, there was significant interaction between the STAR dimensions, such that children with lower sensitivity to threat and lower affiliation had higher parent-reported CU traits. Unlike CU traits, children with higher threat sensitivity had higher parent-reported CP and anxiety. Finally, children with lower affiliation had higher parent-reported CP, anxiety, and depression. Results largely replicated across informants and time, and sensitivity analysis revealed similar findings in children with and without DSM-5 defined CP.

CONCLUSIONS

Results support the STAR model hypotheses as they pertain to CU traits and delineate threat sensitivity and affiliation as independent transdiagnostic risk factors for different types of psychopathology. Future research is needed to develop fuller and more reliable and valid measures of affiliation and threat sensitivity across multiple assessment modalities.

Assessing Callous-Unemotional Traits Across Early Adolescence: Further Evaluation of Short Versions

Literature on the Inventory of Callous-Unemotional (ICU) traits has suggested different versions of the instrument for assessing these traits during development. However, consensus on the instrument version and the best factorial solution remains a matter of debate, with only a few studies having validated ICU versions from a longitudinal perspective. The current study aims to contribute to the literature by comparing ICU models in a longitudinal sample of early adolescents (N = 739; 70.6% of eligible subjects, 371 females and 368 males, in the 6th grade at baseline assessment and in the 8th grade at the second assessment). We tested the validity of various versions of the ICU scales and their respective dimensions by conducting a series of confirmatory factor analyses to verify the factor structure, alongside assessments of internal consistency. For the best-fitting structure, we then analyzed gender and longitudinal invariance in addition to construct and predictive validity, using internalizing and externalizing criteria as well as prosocial behavior. From the comparative analysis, it emerged that the abbreviated 11-item ICU scale version displayed overall better data fit than the full 24-item version. Moreover, its confirmed gender invariance underscores its applicability across genders within the studied age group. With regard to longitudinal invariance, our findings advise caution when comparing ICU scores across early adolescence. Practical implications are discussed.

Primary and Secondary Callous-Unemotional Childhood Variants in a Korean Community Sample

Despite the growing support for the multiple developmental pathways to phenotypic callous-unemotional (CU) traits (i.e., primary, and secondary CU variants), there remains limited research on childhood manifestations of CU variants in non-Western, community samples. Using a latent profile analysis with data sourced from the longitudinal, nationwide Korean sample (N = 1597, 48.7% girls), we discerned heterogeneous groups of children, based on externalizing problems, CU traits, and emotional reactivity level. The optimal five-profile solution identified distinct subgroups: low-risk, primary CU (characterized by low emotional reactivity and externalizing problem), reactive (low CU/moderate emotion reactivity and externalizing problem), and two secondary CU groups (i.e., secondary-high CU and secondary-moderate CU; both high in emotional reactivity and externalizing problems). The two secondary CU variants demonstrated differences from the primary CU variants, in that both are high in preschool externalizing problems (age 6) and school-age conduct problems (age 11). However, the secondary-moderate CU group displayed greater levels of anxiety at age 11 compared to secondary-high CU, indicating divergent developmental trajectories of secondary CU variants. These findings expand our understanding of CU variants among Korean preschoolers and highlight the role of emotional reactivity in distinguishing such subtypes and identifying their developmental outcomes across time.