How callous and nonemotional traits affect youth functioning?

Abstract

Background Numerous studies have shown that children and adolescents with conduct disorder (CD) have an increased risk of developing severe and persistent antisocial behaviours in adulthood. These patterns place a significant burden on the individual as well as on society in general. If not all young people follow a negative trajectory, this heterogeneity can be explained by the severity of callous and unemotional traits (hereafter CU), a specificity of conduct disorder integrated in the 5th version of the DSM in 2013. CU traits are described by a constellation of emotional and personality traits in children considered as a precursor to adult psychopathy. Our research aims to examine the influence of CU traits on the five developmental dimensions of children and adolescents with behavioral disorders (BD). The responses are articulated around the five dimensions of the AAIDD model on the functioning of young people with BD.

Methods A systematic literature review conducted through different databases (PubMed, Scopus and Web of Science) and using different keywords (callous, unemotional, conduct disorders, etc.) analyzed 52 studies published between 2015 and 2020 that measured the bidirectional effects of CU traits on the functioning of young people with behavioral disorders.

Results/Aims Out of the 52 studies, 47 analyzed links between CU traits and neurobiological or mental health, 20 examined family and school contexts, 8 focused on social adjustment, 10 on social interactions and 19 measured links with the cognitive functioning, especially executive functions. Related to the mental health dimension, outcomes show that that CU traits are not specific to children with conduct disorder but may also be observed in children with other disorders as autism or ADHD. This supports other authors’ conclusion that early disruptive behaviors could have a neurodevelopmental basis. As concern with the cognition dimension, outcomes point out various deficits in executive functions, emotional regulation and inhibition which impact several core functioning dimensions of cognitive abilities in youths. Combined with findings on other dimensions of human functioning, those results argue for preventive interventions to identify CU traits at a very early stage.

Conclusions Results indicate a need to investigate CU traits also with IDD children and adolescents. They also argue for early interventions in both physical health (e.g. nutrient supplementation, environmental enrichment) and family and school care (e.g. positive reinforcement of prosocial behaviors, emotion recognition, parental interventions).

From Science to Practise In view of the effects on all dimensions of young people's functioning, early identification of CU traits coupled with early multimodal interventions could positively influence the developmental trajectory of these children and adolescents and limit serious and severe consequences in adulthood.