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

The relationship between psychopathy and autism: a systematic review and narrative synthesis

Background and methods

The aim of this systematic review was to synthesise research examining the relationship between autism and psychopathy to: (a) better understand the relationship between these two constructs, and (b) describe the clinical manifestation of the two when they co-occur. A systematic search of the literature returned 36 studies.

Results

Across all ages, autistic individuals and those with elevated autistic traits but no autistic diagnoses appeared to have increased callous and unemotional traits or psychopathy relative to the general population. Several studies evidenced that although both constructs are associated with empathetic dysfunction, the underlying mechanisms differ. In adults, psychopathy/psychopathic traits were associated with diminished affective empathy and intact cognitive empathy, whilst the opposite was seen autistic adults and those with elevated autistic traits. In children, those with autistic traits or a diagnosis of autism had diminished cognitive empathy, but not affective empathy, while the relationship between callous and unemotional traits/psychopathy and empathy amongst children was less clear. The co-occurrence of autism and psychopathy was seen to lead to additional empathic and cognitive impairment, but findings were mixed making it challenging to clearly describe the clinical manifestation.

Conclusion

There remains a paucity of research investigating the interaction between autism and psychopathy and included studies were characterised by multiple measurement difficulties. Attention should be directed toward developing better methods for identifying psychopathic traits in autistic individuals to advance our understanding of the relationship between autism and psychopathy to allow for the development of appropriate care pathways for this population.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=413672, identifier CRD42023413672.

The "Measure of Empathy in Early Childhood": Psychometric Properties and Associations with Externalizing Problems and Callous Unemotional Traits

Empathy is crucial to the development of socio-emotional skills in youth and empathy development is central to understanding and subtyping youth with externalizing problems. This study explored for the first time the psychometric properties of the Measure of Empathy in Early Childhood (MEEC) in a sample of 652 Italian children aged 6 to 8 years. The gender invariance of MEEC scores and their associations with other measures of empathy and prosocial behavior, and children's externalizing problems and callous-unemotional (CU) traits were also evaluated. Results indicated that with some modifications, a 5-factor structure of the Italian version of MEEC scores fitted the data and was invariant across gender. Results further supported the reliability and validity of MEEC total and subscale scores. Practical implications of these results are discussed.

Effect of Different Types of Empathy on Prosocial Behavior: Gratitude as Mediator

With the development of positive psychology, prosocial behavior has received widespread attention from researchers. Some studies have shown that emotion has a significant influence on individual prosocial behavior, but little research has studied the effect of different types of empathy on college students’ prosocial behaviors. The current study examined the mediating effects of gratitude among the associations between different types of empathy (perspective-taking, fantasy, empathic concern, and personal distress) and prosocial behavior among Chinese college students. For the study, we used the Prosocial Tendency Measurement questionnaire, the Hebrew version of Interpersonal Reactivity Index-C, and The Gratitude Questionnaire that investigated 1,037 participants. The results indicated that gratitude played a mediating role between perspective-taking and prosocial behavior, fantasy and prosocial behavior, empathic concern and prosocial behavior, and personal distress and prosocial behavior, respectively. The current study contributes to a better understanding of the relationship between empathy and prosocial behavior.

Physiological reactivity in children with high callous-unemotional and autistic traits: investigating unique and interactive effects

Empathy deficits are a hallmark sign of both callous-unemotional (CU) and autistic traits. Despite these similarities, prior work did not investigate how these traits relate to physiological reactivity (heart rate and skin conductance) in response to emotional or empathy-eliciting stimuli. Understanding the physiological mechanisms associated with emotional processing deficits among individuals with autistic or CU traits is a critical step for improving both assessment and interventions. The current study was designed to investigate the unique and interactive contributions of CU and autistic traits in predicting physiological reactivity. Heart rate (HR) and skin conductance (SC) activity in response to sad, fearful and happy emotional videos were collected form young children. Participants for the current study (n = 163; M_age = 7.30, SD= 1.42; 44.2% girls) were recruited from a larger community sample of 1652 children and were selected based on their levels of empathy. Regression analysis revealed that boys, but not girls, with high levels of CU traits exhibited low SC reactivity during sad and fearful stimuli. No significant associations were revealed for autistic traits. Finally, an interesting interaction effect suggested that CU traits were associated with stronger HR reactivity to fear stimuli only when autistic traits were low. The identified differences in physiological reactivity can inform etiological hypothesis by providing evidence for the underlying physiological mechanisms related to emotional processing among children high in CU traits but not in autistic traits.

Role of Callous and Unemotional (CU) Traits on the Development of Youth with Behavioral Disorders: A Systematic Review

Numerous studies have shown that youth with behavioral disorders (BD) present an increased risk for developing severe and persistent antisocial behaviors in adulthood. Retrospective research notes that not all children and adolescents follow a negative trajectory and explains this heterogeneity in particular by the severity of CU traits. Our study examines how these traits affect the functioning of children and adolescents with BD. Method: A systematic literature review conducted through various databases and using different keywords made it possible to analyze 52 studies published from 2015 to 2020 that measured the bidirectional effects of CU traits on the functioning of young. Results: Out of the 52 studies, 47 analyzed links between CU traits and neurobiological or mental health, 20 examined family and school contexts, eight focused on social adjustment, 10 on social interactions and 19 measured links with cognitive functioning, especially executive functions. Conclusion: Consistent with previous recommendations in the field, our findings emphasize the importance of assessing the presence of UC traits in early childhood to prevent the emergence of comorbid disorders and to target multimodal (early) interventions to influence the life trajectories of youth with high CU traits.

The personality dispositions and resting-state neural correlates associated with aggressive children

Despite aggression being detrimental to children's physical health, mental health and social development, the dispositional and neurological antecedents of aggression in the child are poorly understood. Here we examined the relationship between trait aggression as measured by Buss and Warren's Aggression Questionnaire and personality traits measured with Big Five Questionnaire for Children in 77 primary-school children and recorded resting-state brain activity (fractional amplitude of low-frequency fluctuations [fALFF]) and resting-state functional connectivity (rsFC) using functional magnetic resonance imaging. The present results showed that trait aggression was negatively correlated with agreeableness and positively correlated with neuroticism. The brain analyses showed that children with a higher propensity for aggression had a lower fALFF mainly in the left superior temporal gyrus, right parahippocampal gyrus and left supramarginal gyrus. Physical and total aggressions were negatively associated with rsFC between the right parahippocampal gyrus and the right putamen. Further analysis revealed that this rsFC could moderate the influence of neuroticism on total aggression. Moreover, the results suggest the presence of a sex difference in the neurodevelopmental mechanisms underlying aggression in middle childhood. Overall, our findings indicate that aggressive children have lower agreeableness and higher neuroticism, and the underlying neural systems are mainly implicated in social judgment and empathy.

Child maltreatment risk mediates the association between maternal and child empathy

BACKGROUND

Empathy deficits are related to parental maltreatment, and early exposure to maltreatment is associated with later impairments in social and interpersonal skills, possibly as the result of specific deficits in cognitive and emotional empathy.

OBJECTIVE

To examine the association between maternal and child's emotional and cognitive empathy, and how this relationship is mediated by maltreatment risk.

PARTICIPANTS AND SETTING

462 mothers of 4-10 years olds (48 % girls; M = 6.51 ± 1.57) were recruited through an online platform (Prolific Inc.) during 2018.

METHODS

Mothers were asked to report on their own cognitive and emotional empathy, views related to abuse risk, and their child's cognitive and emotional empathy.

RESULTS

Findings show that maternal perspective taking (a measure of cognitive empathy), and maternal personal distress predict child's cognitive empathy through abuse risk (beta = -0.29, p value = 0.0002 and beta = 0.22, p value = 0.0001, respectively). Conversely, for child's emotional empathy there was no mediation through abuse risk, rather direct associations were observed for empathic concern (a measure of emotional empathy; beta = 0.36, p value = 0.0197), personal distress (beta = 0.23, p value = 0.0332), and the fantasy scale (another measure of cognitive empathy; beta = 0.36, p value = 0.0019).

CONCLUSIONS

These findings help clarify the complex links between maternal empathy, abuse risk, and child's empathy, showing that maternal views related to abuse are specifically predictive of child's cognitive but not emotional empathy. As such, these findings raise further questions regarding the mechanism by which maternal characteristics and behavior are associated with child's empathy.