The Moderating Role of Anxiety in the Associations of Callous-Unemotional Traits with Self-Report and Laboratory Measures of Affective and Cognitive Empathy

Callous-Unemotional Traits and Co-occurring Anxiety in Preschool and School-age Children: Investigation of Associations with Family's Socioeconomic Status and Home Chaos

While contemporary literature has traditionally viewed youth with Callous-Unemotional (CU) traits as a homogeneous group, there is a growing interest in delineating two variants of CU traits based on high or low levels of anxiety. Extensive attention has been brought in the CU traits literature to the study of relational factors such as maltreatment and parenting practices. However, very few studies have looked at other environmental contexts in which the children within these two variants evolve, such as home chaos or socioeconomic status (SES). In a community sample of children aged 4 to 9, divided into a preschool sample (N = 107; Mage = 4.95, SD = 0.62) and a school-age sample (N = 153; Mage = 7.49, SD = 1.11), the current study investigated whether anxiety moderates the associations of CU traits with SES and home chaos. Hierarchical regression analyses revealed that CU traits were positively associated with home chaos, regardless of anxiety levels. CU traits were negatively associated with SES, but this effect emerged only at high levels of anxiety. Notably, these findings were observed solely in the school-age subsample. Implications for understanding the two variants of CU traits (i.e., primary and secondary) and hypotheses regarding their developmental trajectories are discussed.

Emotion Recognition Deficits in Children and Adolescents with Psychopathic Traits: A Systematic Review

Children and adolescents with psychopathic traits show deficits in emotion recognition, but there is no consensus as to the extent of their generalizability or about the variables that may be moderating the process. The present Systematic Review brings together the existing scientific corpus on the subject and attempts to answer these questions through an exhaustive review of the existing literature according to PRISMA 2020 statement. Results confirmed the existence of pervasive deficits in emotion recognition and, more specifically, on distress emotions (e.g., fear), a deficit that transcends all modalities of emotion presentation and all emotional stimuli used. Moreover, they supported the key role of attention to relevant areas that provide emotional cues (e.g., eye-region) and point out differences according to the presence of disruptive behavior and based on the psychopathy dimension examined. This evidence could advance the current knowledge on developmental models of psychopathic traits. Yet, homogenization of the conditions of research in this area should be prioritized to be able to draw more robust and generalizable conclusions.

An 'embedded brain' approach to understanding antisocial behaviour

Antisocial behaviour (ASB) incurs substantial costs to the individual and society. Cognitive neuroscience has the potential to shed light on developmental risk for ASB, but it cannot achieve this potential in an 'essentialist' framework that focuses on the brain and cognition isolated from the environment. Here, we present the case for studying the social transactional and iterative unfolding of brain and cognitive development in a relational context. This approach, which we call the study of the 'embedded brain', is needed to fully understand how risk for ASB arises during development. Concentrated efforts are required to develop and unify methods to achieve this approach and reap the benefits for improved prevention and intervention of ASB.

Cognitive and affective perspective taking amongst adolescent offenders with variants of callous-unemotional traits

Evidence suggests that associations between antisocial behaviour, callous-unemotional (CU) traits and cognitive empathy (e.g. perspective taking) vary depending on more fine-grained dimensions of these constructs. This study examined associations between adolescent antisocial behaviour and individual differences in cognitive and affective perspective taking ability. Based on current theory regarding distinct variants of CU traits, we further tested whether the correlates of CU traits differed amongst youth with high versus low levels of anxiety. Participants were 130 male adolescents (81 youth offenders; 49 non-offenders) aged 13-20 years, of predominantly Caucasian and Aboriginal Australian ethnicity. Perspective taking skills were indexed using performance-based testing, and self-report data was collected on CU traits and anxiety in a cross-sectional design. Offender status was associated with poorer cognitive and affective perspective taking. In addition, associations between CU traits and perspective taking skills were moderated by anxiety. Specifically, CU traits were associated with poorer skills for second-order cognitive perspective taking amongst high-anxiety youth, whereas CU traits were associated with better cognitive and affective perspective taking skills amongst low-anxiety youth. More fine-grained assessment of such factors stands to enhance understanding of, and effective intervention for, antisocial youth.

Effects of multidomain environmental and mental health factors on the development of empathetic behaviors and emotions in adolescence

Empathy is at the core of our social world, yet multidomain factors that affect its development in socially sensitive periods, such as adolescence, are incompletely understood. To address this gap, this study investigated associations between social, environmental and mental health factors, and their temporal changes, on adolescent empathetic behaviors/emotions and, for comparison, callous unemotional (CU) traits and behaviors, in the early longitudinal Adolescent Brain Cognitive Development sample (baseline: n = 11062; 2-year follow-up: n = 9832, median age = 119 and 144 months, respectively). Caregiver affection towards the youth, liking school, having a close friend, and importance of religious beliefs/spirituality in the youth's life were consistently positively correlated with empathetic behaviors/emotions across assessments (p<0.001, Cohen's f = ~0.10). Positive family dynamics and cohesion, living in a neighborhood that shared the family's values, but also parent history of substance use and (aggregated) internalizing problems were additionally positively associated with one or more empathetic behaviors at follow-up (p<0.001, f = ~0.10). In contrast, externalizing problems, anxiety, depression, fear of social situations, and being withdrawn were negatively associated with empathetic behaviors and positively associated with CU traits and behaviors (p<0.001, f = ~0.1-0.44). The latter were also correlated with being cyberbullied and/or discriminated against, anhedonia, and impulsivity, and their interactions with externalizing and internalizing issues. Significant positive temporal correlations of behaviors at the two assessments indicated positive (early) developmental empathetic behavior trajectories, and negative CU traits' trajectories. Negative changes in mental health adversely moderated positive trajectories and facilitated negative ones. These findings highlight that adolescent empathetic behaviors/emotions are positively related to multidomain protective social environmental factors, but simultaneously adversely associated with risk factors in the same domains, as well as bully victimization, discrimination, and mental health problems. Risk factors instead facilitate the development of CU traits and behaviors.

Oral language skills, callous and unemotional traits and high-risk patterns of youth offending

Extensive research has associated adolescent delinquent behavior with verbal deficits, yet for some subgroups of youth offenders better verbal ability has been associated with increased risk. This study examined associations between specific oral language skills and established markers of high-risk youth offending comprising callous and unemotional (CU) traits, early age of the first offence, and violent offending. Measures of language, CU traits, anxiety, as well as official youth justice data, were collected for adolescent male offenders and non-offenders (n = 130; aged 13-19 years; 62% youth offenders). Pragmatic language was found to be differentially associated with distinct variants of CU traits based on high/low levels of anxiety. Furthermore, among youth offenders with primary variant (low anxiety) CU traits, more violent offending was associated with better structural language skills, while earlier age of first offence was associated with better pragmatic language skills.

Primary and Secondary Variants of Callous-Unemotional Traits in Early and Middle Childhood: Distinction, Evaluation and Empathic Differences

Current literature demonstrates the relevance of considering two variants of CU traits based on high or low levels of anxiety. However, there is limited information about these variants in young community samples. The current study used cluster analyses to investigate the primary and the secondary variants of CU traits in two samples of children: preschool (N = 107; Mage = 4.95, SD = 0.62) and school-age (N = 153; Mage = 7.49, SD = 1.11). The identified clusters were compared on empathic dimensions, aggressive behavior and criteria from the "with limited prosocial emotions" specifier from the DSM-V. The primary variant was identified as early as preschool age while the secondary variant was only identified in the school-age sample. In this latter sample, the two variants did not differ on assessed variables, except for aggressive behavior. Despite the similarities between the two variants, these results suggest distinct developmental trajectories.

Psychopathic Traits and Theory of Mind Task Performance: A Systematic Review and Meta-analysis

This meta-analysis aims to examine the relationship between psychopathic traits and theory of mind (ToM), which is classically and broadly defined as competency in representing and attributing mental states such as emotions, intentions, and beliefs to others. Our search strategy gathered 142 effect sizes, from 42 studies, with a total sample size of 7463 participants. Random effects models were used to analyze the data. Our findings suggested that psychopathic traits are associated with impaired ToM task performance. This relationship was not moderated by age, population, psychopathy measurement (self-report versus clinical checklist) or conceptualization, or ToM task type (cognitive versus affective). The effect also remained significant after excluding tasks that did not require the participant to 1) mentalize or 2) differentiate self and other perspectives. However, interpersonal/affective traits were associated with a more pronounced impairment in ToM task performance compared to lifestyle/antisocial traits. Future research should investigate the effects of distinct psychopathy facets that will allow for a more precise understanding of the social-cognitive bases of relevant clinical presentations in psychopathy.

The association between callous-unemotional traits and suicide ideation among youth: A conditional process analysis

BACKGROUND

The relationship between callous-unemotional (CU) traits (the affective facet of psychopathy and the psychopathy that occurs during childhood and adolescence) and suicide ideation (SI) remains unclear. The mechanisms underlying this association still have a gap in the literature. The aims of this study were to determine whether and how callous-unemotional traits were associated with suicide ideation, and to evaluate the mediating effect of negative affect (includes irritability, depression, and anxiety) and the moderating effect of future orientation on the association.

METHODS

Data were extracted from a longitudinal study involving middle and high school students, with 1,913 students (55.3% girls) aged 11 to 19 years (14.9 ± 1.6 years) completing a self-reported online survey. The conditional process analysis was examined using Mplus 8.3.

RESULTS

We found that callous-unemotional traits positively predicted youths' current suicide ideation, with the observed positive relationship partly mediated by negative affect. However, callous-unemotional traits did not predict the worst-point suicide ideation, which indicated the connection fully mediated by negative affect. Furthermore, future orientation moderated these indirect effects.

LIMITATIONS

Use of self-report measures and cross-sectional design.

CONCLUSIONS

These findings provided evidence for current debates and conflicting conclusions, and set the foundation for future research, as well as implied the important intervention goals for reducing suicide ideation in youth.

Anxiety as a differentiating variable in emotional recognition in juvenile offenders with high callous-unemotional traits

BACKGROUND

The presence of so-called callous-unemotional (CU) traits-lack of remorse/empathy, callous use of others and shallow/deficient affect-defines an important subgroup of children and adolescents with more severe and stable antisocial behaviours over time and may be a precursor to so-called psychopathy in adults. There are two main hypotheses to account for such traits, one emphasising deficits in recognition of specific emotions-the distress specific-and the other in aspects of facial recognition-the attention to the eyes hypothesis, but it may be that the manifestation of deficits is affected by the person's own emotional state.

AIMS

To test the effect of anxiety scores on emotion recognition among young people high scoring for CU traits.

METHODS

14- to 21-year-olds serving sentences in youth justice institutions across Spain were invited to participate. Only those scoring above the cut-off on the Kimonis Inventory of Callous and Unemotional Traits were included. Anxiety was measured using the State-Trait Anxiety Inventory. Emotion recognition was assessed using the Emotional Face and Emotional Gaze Tasks.

RESULTS

Of 91 (90% male) eligible participants, 53 had above threshold anxiety scores. The latter group recognised the emotional expressions of sadness, anger and fear earlier than their non-anxious peers, both when only the eye region was presented and when full faces were presented. There was less difference between groups in the case of the emotions of disgust and happiness, with both groups recognising these emotions earlier and more accurately when a full face was presented.

CONCLUSIONS

Our findings suggest that 14- to 21-year old who struggle with callous emotional traits should not be treated as a homogenous group but that testing for other relevant problems, including anxiety, may inform optimal routes to the emotion recognition training that is likely to help them relate to others more prosocially.

Callous-Unemotional Traits and Face-Emotion Recognition as Mediators in Conduct Problems of Children With ADHD

BACKGROUND

Attention-deficit/hyperactivity disorder (ADHD) is associated with increased risk for conduct problems (CP), as well as with callous-unemotional traits (CUt) and lower accuracy in face emotional recognition (FER). It is unclear, however, whether CUt and low accuracy in FER contribute to the risk for CP in ADHD. The present study investigated the possibility of such contribution.

METHODS

This pilot study's participants included 31 children aged 7-17 years, diagnosed with ADHD, and treated in a psychiatric outpatient clinic. The parents rated their children on the ADHD Rating Scale, Inventory of Callous-Unemotional Traits, and the Child Behavior Checklist-Conduct Problems scale. Participants completed the Hebrew version of the children's Reading the Mind in the Eyes Test (cRMET)-a Theory of Mind measure. A bootstrapped multiple mediator model was used, adjusting for age and gender.

RESULTS

ADHD symptoms were associated with CP. This association was not mediated by CUt or cRMET. CUt was associated with CP independent of ADHD symptom severity.

CONCLUSIONS

ADHD symptoms and CUt both should be considered when assessing risk for CP and devising a treatment plan, in children with ADHD. Current results did not confirm the hypothesis that cRMET and CUt mediate between ADHD symptoms and CP. More studies employing larger samples, longitudinal design, and other emotion recognition measures are needed.

Callous-unemotional traits and anxiety in adolescents: a latent profile analysis to identify different types of antisocial behavior in a high-risk community sample

OBJECTIVE

Callous-unemotional (CU) traits are associated with a more severe and chronic trajectory of antisocial behavior. The present study aimed to identify different classes of CU and anxiety and to compare these classes on overt and covert antisocial behavior and several clinical correlates.

METHOD

In a prospective high-risk cohort of adolescents (N = 679; mean age = 14.77, SD = 0.81), latent profile analysis was conducted using CU traits and anxiety symptoms as indicators, and multi-informant aggressive and rule breaking behavior as distal outcomes. Post-hoc analyses with binary logistic regression and a series of ANCOVA were performed on identified classes assessing violent aggression, property offending, and clinical correlates.

RESULTS

Three classes were found, a reference group (low CU, low anxiety; N = 500), a high CU-low anxiety group (N = 98), and an intermediate CU-high anxious group (N = 81). The high CU-low anxiety group scored highest on property offenses, while the intermediate CU-high anxious group scored highest on aggressive behavior. The intermediate CU-high anxious group scored highest on psychotic experiences, while the high CU group scored highest on internet gaming addiction problems and bullying victimization.

CONCLUSION

These findings provide further evidence for diverse variants of CU traits in a high-risk community sample. Future prospective studies should point out whether and to what extent adolescents with CU traits with and without anxiety develop criminal careers and psychiatric disorders in adulthood.

Factors impacting the experience of empathic distress in social anxiety: a path analysis approach

Personal distress is a manifestation of empathy characterized by a tendency to respond to others' difficulties by increasing one's distress. Previous work on socially anxious individuals has shown mixed results, consistent with a model of social anxiety symptomatology characterized by increased personal distress in empathy eliciting situations, which is driven by emotional dysregulation. The current study aimed to test a serial mediation model to uncover the role of emotional dysregulation in the relationship between social anxiety and empathic distress. 330 young adults were included in the sample. Social anxiety symptomatology, difficulty identifying one's feelings, expressive suppression, and empathic distress were analyzed through Structural Equation Modeling. Measurement and structural models were supported by data, with social anxiety exhibiting direct and indirect effects on empathic distress. Results also suggest that expressive suppression exhibits a negative effect on the distress exhibited in empathy eliciting situations, which brings forth relevant theoretical and clinical implications.

Primary and Secondary Variants of Psychopathic Traits in at-Risk Youth: Links with Maltreatment, Aggression, and Empathy

The current study examined whether two variants of psychopathic traits (PT) were identifiable in high-risk youth who had not yet been identified as antisocial, some of whom had documented histories of maltreatment (N = 167, M_age = 14.84), and then whether the variants differed in levels of aggression and empathy. High-PT youth with low anxiety and trauma (i.e., primary variant PT) and high anxiety and trauma (i.e., secondary variant PT) were differentiated. The secondary variant group was comprised largely of youth with documented histories of maltreatment. This group of youth also reported higher levels of proactive and reactive aggression than did the primary variant youth and low-PT youth. All youth reported similar levels of affective empathy and only small differences in cognitive empathy emerged: Primary variant youth reported lower cognitive empathy than low-PT youth. Findings support generalization of two variant groups of youth with psychopathic traits to diverse, high-risk samples not already identified as antisocial and have important implications for policy and practice.

Callous-Unemotional Features are Associated with Emotion Recognition Impairments in Young ODD Children with Low but not High Affective Arousal

Despite increasing support for the distinction between primary and secondary variants of callous-unemotional features in children with disruptive behavioural disorders, evidence about whether emotion recognition deficits are only characteristic of primary CU is inconclusive. We tested whether, in young children with Oppositional Defiant Disorder (ODD; N = 74), level of affective arousal moderated the association between CU and performance on behavioural measures of emotional abilities. The association between CU and emotion recognition abilities was dependent on the child's level of affective arousal with higher CU associated with poorer emotion recognition abilities for ODD children with lower affective arousal (r = - 0.49; p = .007) but not for those with higher levels (r = 0.03; p = .838). Our results replicate recent findings and give support to the notion that the primary CU variant is characterised emotionally by under arousal of affect, low affect dysregulation and impaired emotion recognition abilities.

Family Cohesion and Stress Consequences Among Chinese College Students During COVID-19 Pandemic: A Moderated Mediation Model

Family plays a pivotal role in individuals' mental health. During the COVID-19 epidemic, people were being quarantined at home to prevent the further spread of the virus. Therefore, the influence of family on individuals is more significant than usual. It is reasonable to assume that family cohesion can effectively alleviate the stress consequences during the COVID-19 epidemic. In the present study, a moderated mediation model was constructed to examine the mechanisms underlying the association between family cohesion and stress consequences among Chinese college students. A large sample of Chinese college students (N = 1,254, Mage = 19.85, SDage = 1.29) participated in the study. Results indicated that family cohesion was negatively related to stress consequences. Fear of COVID-19 partially mediated the link between family cohesion and stress consequences. Excessive affective empathy reported by participants served to aggravate the relation between fear of COVID-19 and stress consequences. The study helps us understand how internal and external factors affect individual mental health that provides meaningful implications for promoting mental health.

Cognitive Empathy in Subtypes of Antisocial Individuals

Cognitive empathy allows individuals to recognize and infer how others think and feel in social situations and provides a foundation for the formation and maintenance of mutually constructive relationships. It may seem intuitive to assume that individuals who engage in antisocial behavior, who disregard the rights of others, might have problems with cognitive empathy. However, careful examination of the literature suggests that any dysfunction in cognitive empathy associated with antisociality varies by subtype of antisocial individual and is specific to subcomponents of cognitive empathy. In this review, we (1) briefly define subtypes of antisocial individuals ("psychopathic" vs. "antisocial-only"), (2) summarize specific components of cognitive empathy; (3) review existing literature examining cognitive empathy through questionnaires, behavioral tasks, and neuroimaging within different antisocial subtypes; and (4) discuss the limitations of the current research and potential future directions. Individuals in the psychopathic subtype fail to implicitly engage in cognitive empathy, and potentially lack insight into this issue reflected in no self-reported problems with cognitive empathy, but show an ability to engage in cognitive empathy when explicitly required. Individuals in the antisocial-only subtype appear able to engage in cognitive empathy, showing no differences on questionnaire or behavioral tasks that tap explicit cognitive empathy, but may display subtle difficulties accurately inferring (affective theory of mind) the emotions of others. We end the review by noting areas for future research, including the need to: (1) document the patterns of equifinality that exist across levels of analysis for these antisocial subtypes; (2) examine the temporality of empathy and antisociality development; (3) carefully consider and label subcomponents of cognitive empathy in research on antisocial behavior; and (4) investigate the intersection among environmental experiences, cognitive empathy, and antisocial behavior.

Conduct Disorders and Empathy Development

Childhood conduct disorders, a serious mental health concern, put children at risk for significant mental health problems throughout development. Elevations on callous-unemotional (CU) traits designate a subgroup of youth with conduct disorders who have unique causal processes underlying their problem behavior and are at a particularly high risk for serious impairment relative to others with these disorders. As a result, these traits have recently been integrated into major diagnostic classification systems for conduct disorders. Given that CU traits are partly defined by deficits in empathy, we review research on empathy development in typically developing children and use this research to (a) advance theories on the specific emotional deficits that may be associated with CU traits, (b) explain the severe pattern of aggressive behavior displayed by children with elevated CU traits, and (c) suggest possible ways to enhance prevention and treatment for children with conduct disorders and elevated CU traits.

A Systematic Review of Primary and Secondary Callous-Unemotional Traits and Psychopathy Variants in Youth

Two variants of callous-unemotional (CU) traits and psychopathy have been proposed, referred to as primary and secondary. Whereas primary variants are thought to be underpinned by insufficient arousal to emotional cues, secondary variants are thought to develop as a coping mechanism in response to trauma exposure. Compared with adult samples, research on primary and secondary variants in children and adolescents under the age of 18 has only emerged in the past decade, and there is ongoing debate with regards to the identification, defining characteristics, and distinct correlates of these variants. The present systematic review synthesizes the current literature on primary and secondary variants in relation to: (1) constructs used to distinguish and define primary and secondary variants; (2) study population characteristics; (3) data analytic techniques to differentiate variants; and (4) differential associations with theoretically relevant indices related to emotional processing, maltreatment, biomarkers, and behavioral outcomes (e.g., substance use, aggression). This is the first systematic review to examine the growing literature on primary and secondary CU and psychopathy variants among youth. Findings support the distinction between youth with primary versus secondary variants and demonstrate that this distinction is related to unique clinical correlates. Recommendations are made for future research in the field.

Distinct Empathy Profiles in Callous Unemotional and Autistic Traits: Investigating Unique and Interactive Associations with Affective and Cognitive Empathy

Empathy deficits are a hallmark of both callous-unemotional (CU) and autistic traits. However, it is unclear whether each trait is associated with deficits in distinct empathy subcomponents. The aim of the current study was to investigate the main and interactive effects of CU and autistic traits in predicting affective and cognitive empathy. We used data of 163 children (Mage = 7.30, SD = 1.42, 44.2% girls), selected from a large community sample (N = 1652). To ensure variability in empathy, we recruited participants with either low (1 standard-deviation below the mean; n = 78) or average to high (n = 85) levels of empathy. Partial correlation and regression analysis revealed that autistic traits were negatively associated with cognitive empathy, whereas CU traits were negatively related with both cognitive and affective empathy. Importantly, this is the first study testing the moderating effects of gender, revealing that CU traits negatively predicted affective empathy only among girls high on autistic traits. Findings can be used to understand the different empathy profiles of children with CU or autistic traits, and inform the development of effective interventions.

Cognitive and Emotional Profiles of CU Traits and Disruptive Behavior in Adolescence: a Prospective Study

In this study we followed 82-90 adolescents, 50% boys, from 15 to 16 years, investigating CU traits and disruptive behaviors as predictors of cognitive skills and arousal to emotional pictures. At age 15, CU traits were rated by adolescents and disruptive (aggregated ADHD-ODD-delinquent) behaviors were rated by parents and adolescents. At age 16, executive function, reaction time variability (RTV), IQ and arousal to negative pictures were assessed. The results showed that, with control for disruptive behaviors, CU traits predicted lower RTV, higher IQ and lower arousal to negative pictures. With control for CU traits, disruptive behaviors predicted lower spatial working memory, lower interference control and higher RTV. Our findings are of theoretical and clinical relevance as they point to highly diverging cognitive and emotional profiles of CU traits and disruptive behaviors.

Variants of Children with Psychopathic Tendencies in a Community Sample

To investigate the heterogeneity of children with psychopathic tendencies, this study identified heterogenous subgroups among a community sample of children based on their callous-unemotional (CU) traits, conduct problems (CP), and anxiety. A latent profile analysis classified 1861 primary school students (age 6-14) into four subgroups based on parent-report CU traits, CP and anxiety: low-risk children (i.e., low in CU traits, CP, and anxiety), anxious children (i.e., high in anxiety, low in CU traits and CP), primary variants of children with psychopathic tendencies (i.e., high in CU traits and CP, low in anxiety), and secondary variants of children with psychopathic tendencies (i.e., high in CU traits, CP, and anxiety). In particular, the secondary variants evidenced higher levels of CU traits, CP, and anxiety than the primary variants. Our findings extend the heterogeneity of psychopathy to childhood and encourage future research to examine the developmental trajectories of psychopathy.

Irritability and Limited Prosocial Emotions/Callous-Unemotional Traits in Elementary-School-Age Children

Affective traits, including irritability and limited prosocial emotions/callous-unemotional traits (LPE/CU), each explain significant variance in youth conduct problems but few studies have examined these constructs simultaneously. This study examined whether irritability, LPE/CU, or their combination explained significant variance in measures of internalizing or externalizing psychopathology, aggression, peer problems, impairment, or parenting. Participants were 219 elementary-school-age children, including 178 with attention-deficit/hyperactivity disorder, oppositional defiant disorder, and/or conduct disorder and 41 typically developing children. Results of analyses showed that irritability and LPE/CU had significant and sometimes unique associations with measures of child behavior, impairment, and parenting. There was also evidence that the interaction between irritability and LPE/CU was significantly associated with aggression and impairment. These findings suggest that irritability and LPE/CU should be examined together when assessing and treating conduct problems in youth.

The Validity of the Personality Assessment Inventory-Adolescent in Assessing Callous-Unemotional Traits in At-Risk Adolescents

This study examines the validity of the Personality Assessment Inventory-Adolescent (PAI-A; Morey) in assessing callous-unemotional (CU) traits within two independent samples of at-risk adolescents from a residential intervention program. The study tests the extent to which CU traits are represented within PAI-A scales with respect to empirically- or theoretically-related indicators, such as antisociality, aggression, low warmth, low social connectedness, and subdued internalizing psychopathology. The PAI-A substantive scales statistically accounted for an average of 55.0% of the variance in total scores on the Inventory of Callous-Unemotional Traits (ICU; Frick) across samples. Broadly, PAI-A substantive scales evinced theoretically-consistent relations with CU traits. Consistent with expectations, CU traits were broadly related to PAI-A-assessed constructs of antisocial features, aggression, low warmth and social disconnection, but not to subdued internalizing symptoms. Moreover, some of the PAI-A clinical, treatment consideration, and interpersonal scales or subscales demonstrated differential relations across the traits. Implications for assessment of CU traits using the PAI framework are discussed. Overall, this research adds to the literature on CU traits in broadband personality assessment and provides a foundation for future research on CU traits using the PAI-A.

Bullying Perpetration and Narcissistic Personality Traits across Adolescence: Joint Trajectories and Childhood Risk Factors

Objectives: Although there is some evidence on the longitudinal associations between bullying perpetration and narcissistic personality traits, their joint developmental trajectories across early to late adolescence are largely unknown. Accordingly, we examined the co-development of bullying perpetration and narcissistic personality traits across adolescence and examined the childhood predictors of these joint trajectories. Method: Self-reports of bullying and narcissistic personality traits were assessed across 6 years of adolescence from Grade 7 (i.e., age 13) to Grade 12 (i.e., age 18) in a sample of 616 Canadian adolescents and childhood predictors were assessed in Grades 5 and 6. Results: As predicted, latent class growth analyses demonstrated that most adolescents were reflected in a trajectory of low decreasing bullying (82.0%) and a smaller group followed a moderate stable trajectory of bullying (18.0%). The majority of adolescents followed a moderate stable trajectory of narcissistic traits (56.3%), followed by a high increasing trajectory of narcissistic traits (22.8%), and a low decreasing trajectory of narcissistic traits (20.9%). Six percent of adolescents followed a high-risk dual trajectory of moderate stable bullying and high increasing narcissistic traits (high-risk group). Also as predicted, higher hyperactivity, higher frustration, and lower anxiety in childhood differentiated the high-risk group from a low-risk group (low decreasing bullying and low decreasing narcissistic traits; 19.0%). Higher childhood hyperactivity also differentiated a group of adolescents who followed a trajectory of moderate stable bullying and moderate stable narcissistic traits (10.0%) from the low-risk group. Results showed that moderate stable bullying was a better indicator of high increasing and moderate stable trajectories of narcissistic personality traits than the reverse. Conclusions: Findings suggest adolescence is a time when personality and bullying reflect dynamic and heterogeneous development. Early intervention of childhood risk factors may help prevent a high-risk developmental course of bullying and narcissistic personality traits across adolescence.

A meta-analysis of the associations between callous-unemotional traits and empathy, prosociality, and guilt

Antisocial behavior is harmful, financially costly to society, and hard to treat. Callous-unemotional (CU) traits, which predict greater risk for antisocial behavior, are defined in theoretical and diagnostic models as representing low empathy, guilt, and prosociality. However, no meta-analytic reviews have systematically integrated the findings of studies that have reported associations between measures of CU traits and empathy, guilt, or prosociality, or potential moderators of these associations, including gender, age, severity of antisocial behavior, and informant (i.e., self or other reports of measures). To address this gap in the literature, we conducted three separate meta-analyses exploring the association between CU traits and empathy, guilt, and prosociality. In follow-up analyses, we explored associations between CU traits and affective versus cognitive empathy. The results revealed statistically significant and moderate-to-large negative associations between measures of CU traits and empathy (ρ = -.57), guilt (ρ = -.40), and prosociality (ρ = -.66). The negative association between CU traits and cognitive empathy was stronger when the informant was a parent or teacher rather than the child, and in younger children. CU traits were also more strongly related to cognitive empathy than affective empathy when the informant was a parent or teacher rather than the child, and in younger children. The findings establish that CU traits are moderately-to-strongly correlated with the presence of callous (low empathy), uncaring (low prosociality), and remorseless (low guilt) behaviors.

Explanatory model of violent behaviours, self-concept and empathy in schoolchildren. Structural equations analysis

The increased visibility of bullying cases has led the scientific community to be more interested in analysing the factors affecting these behaviours in order to reduce bullying cases and their negative consequences. The aim of this study was to define and contrast an explanatory model that makes it possible to analyse the relationships between self-concept, empathy and violent behaviours in schoolchildren through structural equation analysis. The sample of this study is made up of 734 schoolchildren from the province of Granada (Spain), both male and female, aged between 10 and 12, and it consists of analysing self-concept (AF-5), empathy levels (TECA) and violent behaviour at schools (ECV). A structural equation model was performed and successfully adjusted (χ² = 563.203; DF = 59; p < 0.001; CFI = 0.943; NFI = 0.937; IFI = 0.943; RMSEA = 0.076). A positive and direct relationship between self-concept and cognitive empathy has been found; manifest aggression is negatively related to self-concept. Similarly, affective empathy has a negative relationship with relational aggression. The main conclusions of this study are that the levels of self-concept and empathy represent protective factors against the development of violent and victimisation behaviours in schoolchildren.

The Chinese version of the cognitive, affective, and somatic empathy scale for children: Validation, gender invariance and associated factors

Objectives

Empathy is hypothesized to have several components, including affective, cognitive, and somatic contributors. The only validated, self-report measure to date that assesses all three forms of empathy is the Cognitive, Affective, and Somatic Empathy Scale (CASES), but no current study has reported the psychometric properties of this scale outside of the initial U.S. sample. This study reports the first psychometric analysis of a non-English translation of the CASES.

Methods

Confirmatory factor analysis was used to assess the factor structure of CASES as well as its associations with callous-unemotional traits in 860 male and female children (mean age 11.54± .64 years) from the China Jintan Child Cohort Study.

Results

Analyses supported a three-factor model of cognitive, affective, and somatic empathy, with satisfactory fit indices consistent with the psychometric properties of the English version of CASES. Construct validity was established by three findings. First, females scored significantly higher in empathy than males. Second, lower scores of empathy were associated with lower IQ. Third, children with lower empathy also showed more callous-unemotional attributes.

Conclusions

We established for the first time cross-cultural validity for Cognitive, Affective, and Somatic Empathy Scale (CASES). Our Chinese data supports the use of this new instrument in non-Western samples, and affirms the utility of this instrument for a comprehensive assessment of empathy in children.

Individual differences in emotion regulation moderate the associations between empathy and affective distress

Individual differences in empathy can have positive and negative psychological outcomes. Yet, individual differences in the processing and regulation of empathy-induced emotion have not been fully explored within this dynamic. This study was designed to explore whether individual differences in emotion regulation strategies moderated the effects of empathy on common forms of affective distress. Eight hundred and forty four participants completed survey measures of trait empathy, emotion regulation strategies, and symptoms of depression, anxiety, and stress. Affective empathy typically predicted greater affective distress, but the effects on depression and anxiety were offset when people were effective at reappraising their emotions. Cognitive empathy predicted lower distress on average, but this beneficial effect on anxiety and stress was absent in those who typically suppressed their emotions. Finally, suppression unexpectedly reduced the depression and stress reported for people high in affective empathy. Individual differences in emotion regulation are an important moderator between empathy and psychological health, and thus a useful target for intervention.

Executive Attention and Empathy-Related Responses in Boys with Oppositional Defiant Disorder or Conduct Disorder, With and Without Comorbid Anxiety Disorder

This is a first study that investigated the relationships between executive attention-as an important aspect of emotion regulation-and state empathy and sympathy in ODD/CD boys with (N = 31) and without (N = 18) comorbid anxiety disorder (7-12 years). Empathic reactions were evoked using three sadness-inducing film clips. One clip was highly evocative involving a bear cub losing his mother, whilst two other clips were mildly evocative involving children in common childhood situations. Self-reports of empathy and sympathy were collected and executive attention was assessed with a performance task. Poor executive attention skills were associated with less empathy and sympathy, particularly in ODD/CD boys with anxiety and under conditions of a highly evocative stimulus. Our findings support the view that different mechanisms may be involved in empathy problems of ODD/CD children.

Characterising youth with callous-unemotional traits and concurrent anxiety: evidence for a high-risk clinical group

Growing evidence supports the existence of two variants of youth with high callous-unemotional (CU) traits who present with markedly different risk profiles and outcomes, with potential implications for risk assessment and treatment formulation. So far, studies have identified variants of CU youth mainly using data-driven cluster approaches based on levels of CU traits and co-occurring anxiety. Yet, the extent to which this knowledge may be translated into clinical practice is unclear. To this end, the present study employed a severity-based, cut-off approach to systematically characterise CU groups across a range of clinically informative domains, including trauma history, psychiatric symptomatology, affective functioning, attachment style and behavioural risk. Analyses were based on multi-rated data from a community sample of high-risk youths (n = 155, M = 18 years). Consistent with previous studies, we found that, whereas variants show comparable levels of antisocial behaviour, those who present with both high CU and high anxiety report more severe childhood maltreatment, psychological distress, ADHD symptomatology and behavioural risk-including substance use, suicidal ideation and unsafe sex. In addition, these youth show greater attachment insecurity and affective dysregulation, as indexed by levels of irritability and alexithymia. Together, findings indicate that (1) trauma history is a key factor that differentiates variants of CU youth high vs. low on anxiety, and (2) differences in individual functioning across variants point to the need for tailored clinical assessment tools and intervention strategies. Importantly, the present findings indicate that variants of CU youth can be meaningfully differentiated using cut-off based approaches that parallel methods used in clinical assessments.

Evaluation of the Parent-Report Inventory of Callous-Unemotional Traits in a Sample of Children Recruited from Intimate Partner Violence Services: A Multidimensional Rasch Analysis

OBJECTIVE

Our study applied multidimensional item response theory (MIRT) to compare structural models of the parent-report version of the Inventory of Callous and Unemotional Traits (ICU; English and North American Spanish translations).

METHOD

A total of 291 maternal caregivers were recruited from community-based domestic violence services and reported on their children (77.9% ethnic minority; 47% female), who ranged in age from 7 to 12 years (mean = 9.07, standard deviation = 1.64). We compared 9 models that were based on prior psychometric evaluations of the ICU.

RESULTS

MIRT analyses indicated that a revised 18-item version comprising 2 factors (callous-unemotional and empathic-prosocial) was more suitable for our sample. Differential item functioning was found for several items across ethnic and language groups, but not for child gender or age. Evidence of construct validity was found.

CONCLUSION

We recommend continued research and revisions to the ICU to better assess the presence of callous-unemotional traits in community samples of school-age children.