Callous-Unemotional Traits

Question 1

What are Callous-Unemotional (CU) traits?

Answer 1

CU traits are a set of personality characteristics in children, similar to adult psychopathy, marked by low empathy, guilt, and shallow emotions.

Question 2

What are the four core features of CU traits?

Answer 2

Lack of remorse or guilt, callousness/lack of empathy, shallow or blunted affect, and unconcerned about performance (e.g., in school).

Question 3

How early can CU traits be reliably measured in children?

Answer 3

As young as age 2.

Question 4

Why are CU traits clinically significant?

Answer 4

They indicate a particularly severe and impaired subgroup of antisocial children with higher risks for future issues like psychopathy, antisocial personality disorder, substance abuse, and criminal justice involvement.

Question 5

What disorders are commonly comorbid with CU traits?

Answer 5

Conduct disorder (with Limited Prosocial Emotions), Oppositional Defiant Disorder (ODD), and Attention-Deficit Hyperactivity Disorder (ADHD).

Question 6

How are CU traits associated with conduct disorder in the DSM-5?

Answer 6

CU traits are included as a specifier for conduct disorder called “Limited Prosocial Emotions.”

Question 7

What are the main emotional processing deficits in children with CU traits?

Answer 7

Reduced emotional reactivity, difficulties in recognizing fear, and hypoactivity in the amygdala.

Question 8

What physiological responses are commonly muted in children with CU traits?

Answer 8

Reduced heart rate, lower skin conductance levels, and decreased startle reflex.

Question 9

What is reinforcement learning, and how does it relate to CU traits?

Answer 9

Reinforcement learning is the modification of behavior through rewards and punishments. Children with CU traits often exhibit punishment insensitivity, showing a preference for reward-focused learning.

Question 10

What is “response preservation,” and how is it seen in CU traits?

Answer 10

Response preservation is the tendency to continue a previously rewarded behavior, even if it is no longer beneficial. Children with CU traits often persist in such behaviours despite punishment.

Question 11

Name three theories related to reinforcement learning in CU traits.

Answer 11

Reinforcement Sensitivity Theory (Gray, 1987), Integrated Emotion Systems Model (Blair, 2004), and Response Modulation Hypothesis (Newman et al., 1997).

Question 12

How does punishment insensitivity impact the behavior of children with CU traits?

Answer 12

They are less responsive to punishments and more likely to respond positively to rewards, meaning punishment-based discipline is often ineffective.

Question 13

How does harsh parenting affect CU traits over time?

Answer 13

Harsh parenting is associated with an increase in CU traits, as children with CU traits are more resistant to punishment and may evoke harsher disciplinary responses.

Question 14

How does warm parenting impact CU traits?

Answer 14

Warm parenting is associated with decreases in CU traits over time, as it may encourage empathy and emotional connection.

Question 15

What are gene-environment correlations, and how do they relate to CU traits?

Answer 15

Gene-environment correlations suggest that genetic traits (like CU traits) can evoke specific environmental responses, such as harsher parenting.

Question 16

Describe the findings of twin studies in relation to CU traits and parenting.

Answer 16

Twin studies have shown that differences in parenting can influence CU traits, even in identical twins, suggesting an interplay between genes and environmental factors.

Question 17

Why do children with CU traits show poorer outcomes with traditional parenting programs?

Answer 17

Traditional programs often emphasize punishment, which is less effective due to the punishment insensitivity seen in children with CU traits.

Question 18

What modifications to treatment approaches are more effective for children with CU traits?

Answer 18

Emphasizing rewards over punishments and using structured reward-based interventions show better outcomes for children with CU traits.

Question 19

What is emotion training, and how is it used to treat CU traits?

Answer 19

Emotion training involves exercises to improve emotional recognition, empathy, and responsiveness, such as eye gaze training and parental modelling of prosocial behaviours.

Question 20

What were the three groups in Dadds et al.’s (2019) emotion training study?

Answer 20

Parent Management Training (PMT) + emotional engagement (EE), PMT + child-centred play (CCP), and PMT only.

Question 21

What were the results of Dadds et al.’s (2019) study on emotion training?

Answer 21

All three treatment types improved parental warmth, but emotional engagement and shared eye gaze improved only briefly.

Question 22

What is the PCIT-CU adjunctive module, and what does it target?

Answer 22

It is an addition to Parent-Child Interaction Therapy designed to enhance emotional responsivity, improve emotion recognition, and teach prosocial behaviours through role-play and parent modelling.

Question 23

Why are rewards emphasized over punishments in CU trait treatment?

Answer 23

Due to punishment insensitivity, children with CU traits respond better to positive reinforcement like praise and tangible rewards, which have been linked to decreased CU traits.

Question 24

Describe Waschbusch et al.’s (2019) summer treatment program for CU traits.

Answer 24

It was an 8-week program using modified behavior therapy focused on rewards. Children gained points for positive behaviours, and serious misbehaviour could result in time-out, which could be reduced with improved behavior.

Question 25

What specific reward strategies were used in Waschbusch et al.’s program?

Answer 25

The program included a token system, “Caught You Being Good” tickets exchangeable for toys, and emphasized gaining rewards rather than losing points for negative behaviours.

Question 26

How do age differences affect reward preferences in children with CU traits?

Answer 26

Younger children may respond better to tangible rewards, while older children may benefit more from social rewards like praise, indicating the need for age-appropriate reward strategies.

Question 27

What role does the parent-child relationship play in treatment outcomes for CU traits?

Answer 27

A strong, warm relationship can enhance the effectiveness of interventions, as children with CU traits are more likely to respond positively to reinforcement in a supportive environment.

Question 28

What are the main goals of CU trait treatment according to current research?

Answer 28

To reduce CU traits, improve emotional engagement, increase responsiveness to social cues, and encourage prosocial behavior.