David J. Hawes

Australian Data and Psychometric Properties of the Strengths and Difficulties Questionnaire

Objective: We examine the Australian psychometric properties of the Strengths and Difficulties Questionnaire (SQD), a brief screening measure of behavioural and emotional problems in children and adolescents. Method: Using a large community sample (n = 1359) of young Australian children (4–9 years), we assessed the internal consistency, stability, and external validity of the parent-report SDQ. Normative data and cut-offs were also produced. Results: Moderate to strong internal reliability was exhibited across all SDQ subscales, and support was found for the original five-factor structure of the measure. Adequate validity was evidenced in the relationship of these scales to one another, while correlations between the SDQ subscales, teacher ratings, and diagnostic interviews demonstrated sound external validity. SDQ total difficulties scores were associated with concurrent treatment status and scores over a 12-month period were stable. Conclusions: The current study of the SDQ with Australian children presents evidence of sound psychometric properties. Being the first study to empirically support the use of the SDQ in Australia, it is recommended that the youth and teacher-report forms of the measure receive similar attention in the future.

Disentangling the underlying dimensions of psychopathy and conduct problems in childhood: a community study.

The psychometric and predictive validity of callous-unemotional (CU) traits as an early precursor of conduct disorder and antisocial behavior were assessed. A community sample of children (4-9 years of age) were tested 12 months apart with the Antisocial Process Screening Device (APSD; P. J. Frick & R. D. Hare, 2002), a measure of early signs of psychopathy in children. Factor analysis supported the structure of the APSD. Given controversy surrounding construct overlap between psychopathy and conduct problems, a factor analysis was conducted on pooled items from the Strengths and Difficulties Questionnaire and APSD. A 5-factor solution resulted: antisocial, hyperactivity, CU traits, anxiety, and peer problems. CU traits added small but significant improvements in the 12-month prediction of antisocial behavior for boys and older girls, after controlling for Time 1 measures. These results indicate that although the dimensions of the APSD overlap with dimensions of the disruptive behavior disorders, CU traits have unique predictive validity in childhood.

Stability and Malleability of Callous-Unemotional Traits During Treatment for Childhood Conduct Problems

This study examined stability and malleability in the callous-unemotional (CU) traits of young boys (M age = 6.29 years, SD = 1.55) referred to clinics with conduct problems who underwent a parent-training intervention. In contrast to the high stability predicted, CU scores dropped posttreatment for a subset of the sample. However, as hypothesized, posttreatment and 6-month follow-up measures of CU traits and general conduct problems were predicted by different variables. Post hoc analyses of cases grouped according to pattern of CU stability indicated that boys with the most stable high CU traits showed the poorest outcomes at follow-up.

Do callous-unemotional traits moderate the relative importance of parental coercion versus warmth in child conduct problems? An observational study.

BACKGROUND Research suggests that parenting has little influence on the development of antisocial behavior in children with callous-unemotional (CU) traits. We aimed to extend and improve on prior studies examining the moderating role of CU traits on associations between parenting and conduct problems, by using independent observations of two key dimensions of parenting: coercion and warmth. METHODS The participants included clinic-referred conduct-disordered boys (4-12 years; N = 95) and their families. Coercive parenting was coded from observations of family interaction and parental warmth was coded from Five-Minute Speech Samples. CU traits and conduct problems were rated by multiple informants. RESULTS In both mothers and fathers, CU traits moderated links between observed parenting and conduct problems. Specifically, coercive parenting was more strongly positively associated with conduct problems in boys with lower levels of CU traits, whereas parental warmth was more strongly negatively associated with conduct problems in boys with higher levels of CU traits. CONCLUSIONS These findings suggest that different dimensions of parenting may need to be targeted in the treatment of early onset conduct problems in children high and low on CU traits.

Do Childhood Callous-Unemotional Traits Drive Change in Parenting Practices?

This study examined the relationship between callous-unemotional (CU) traits and parenting practices over time in a mixed-sex community cohort (N = 1,008; 52.6% boys), aged 3 to 10 years (M = 6.5, SD = 1.3). Measures of CU traits, externalizing psychopathology, parenting practices, and socioeconomic risk factors were collected at baseline, and parenting practices and CU traits were reassessed at 12-month follow-up. CU traits uniquely accounted for change in three domains of parenting (inconsistent discipline, punishment, and parental involvement). Likewise, multiple domains of parenting (positive parenting, parental involvement, and poor monitoring/supervision) uniquely predicted change in CU traits. These seemingly bidirectional dynamics between CU traits and parenting were found to be largely moderated by child age and sex. Results partially replicate previous findings regarding the association between quality of parenting and prospective change in CU traits, and provide initial evidence that CU traits disrupt parenting practices over time.

Callous-Unemotional Traits and the Treatment of Conduct Problems in Childhood and Adolescence: A Comprehensive Review

The treatment of conduct problems among children and adolescents with callous-unemotional (CU) traits has been subject to much speculation; however, treatment outcome research has been surprisingly limited and findings have been mixed. This review examines the research to date in this field as it pertains to two key questions. First, are CU traits associated with clinical outcomes and processes in the family based treatment of child and adolescent conduct problems? Second, can family based intervention produce change in CU traits? Using a systematic search strategy, we identified 16 treatment outcomes studies that can be brought to bear on these questions. These studies provide strong evidence of unique associations between CU traits and risk for poor treatment outcomes, while at the same time indicating that social-learning-based parent training is capable of producing lasting improvement in CU traits, particularly when delivered early in childhood. We discuss the potential for this emerging evidence base to inform the planning and delivery of treatments for clinic-referred children with CU traits, and detail an ongoing program of translational research into the development of novel interventions for this high-risk subgroup.

Cortisol, callous-unemotional traits, and pathways to antisocial behavior.

Purpose of review Two decades of research has implicated the hypothalamic–pituitary–adrenal (HPA) axis in the development of antisocial behavior in children. However, findings regarding the association between cortisol and antisocial behavior have been largely inconsistent, and the role of the HPA axis in relation to broader etiological processes remains unclear. We examine evidence that the role of the HPA axis in the development of antisocial behavior may differ across subgroups of children. Recent findings A meta-analysis has supported the prediction that low levels of cortisol are associated with risk for childhood antisocial behavior, but the relationship is weaker than previously assumed. Recent studies suggest the association between cortisol levels and antisocial behavior may vary depending on type of antisocial behavior, patterns of internalizing comorbidity, and early environmental adversity. The findings are consistent with evidence that two early-onset pathways to antisocial behavior can be distinguished based on the presence or absence of callous-unemotional traits. Summary We speculate that early adversity is important to the development of chronic antisocial behavior in children with low levels of callous-unemotional traits and HPA-axis hyperactivity, but that high levels of callous-unemotional traits and HPA-axis hypoactivity characterize a particularly severe subgroup, for whom antisocial behavior develops somewhat independently of adversity.

Associations Among Cruelty to Animals, Family Conflict, and Psychopathic Traits in Childhood

Previous research has produced mixed findings on the role of child and family factors in the genesis of childhood cruelty. The authors examined the relationships of cruelty to animals to a range of child and family factors. First, the authors test the idea that cruelty is a callous aggression that will be more strongly associated with psychopathic (callous or unemotional, CU) traits than general externalizing problems. Second, the authors operationalize family problems as open conflict rather than parenting problems as used earlier. Results indicated that for both genders, CU traits were associated strongly with cruelty. For boys, externalizing problems also added prediction in regression analyses. Family conflict was not associated with cruelty for either. These results suggest that cruelty to animals may be an early manifestation of the subgroup of children developing conduct problems associated with traits of low empathy and callous disregard rather than the more common pathway of externalizing problems and parenting problems.

Methylation of the oxytocin receptor gene and oxytocin blood levels in the development of psychopathy

Child conduct problems (CPs) are a robust predictor of adult mental health; the concurrence of callous-unemotional (CU) traits confers specific risk for psychopathy. Psychopathy may be related to disturbances in the oxytocin (OXT) system. Evidence suggests that epigenetic changes in the OXT receptor gene (OXTR) are associated with lower circulating OXT and social-cognitive difficulties. We tested methylation levels of OXTR in 4- to 16-year-old males who met DSM criteria for a diagnosis of oppositional-defiant or conduct disorder and were stratified by CU traits and age. Measures were DNA methylation levels of six CpG sites in the promoter region of the OXTR gene (where a CpG site is a cytosine nucleotide occurs next to a guanine nucleotide in the linear sequence of bases along its lenth, linked together by phosphate binding), and OXT blood levels. High CU traits were associated with greater methylation of the OXTR gene for two cytosine nucleotide and guanine nucleotide phosphate linked sites and lower circulating OXT in older males. Higher methylation correlated with lower OXT levels. We conclude that greater methylation of OXTR characterizes adolescent males with high levels of CU and CPs, and this methylation is associated with lower circulating OXT and functional impairment in interpersonal empathy. The results add genetic evidence that high CU traits specify a distinct subgroup within CP children, and they suggest models of psychopathy may be informed by further identification of these epigenetic processes and their functional significance.

Attachment and callous‐unemotional traits in children with early‐onset conduct problems

BACKGROUND Antisocial children with callous-unemotional (CU) traits appear to be disconnected from other peoples emotions; although little is known about their experience of the parent-child emotional bond. This study examined parent-child attachment relationships and levels of CU traits in conduct-problem children. METHOD Attachment classifications in boys (M = 6.31 years) with disruptive behaviour disorders were assessed using the Manchester Child Attachment Story Task. Multiple informants rated childrens CU traits. RESULTS Independent of severity of conduct problems, high levels of CU traits were associated with more insecure attachment; specifically, disorganised attachment representations; however, CU traits were not associated with avoidant representations. CONCLUSIONS Among conduct-problem children, those higher on CU traits appear to be at increased risk of experiencing disruptions in parent-child attachment relationships; attachment may be an important area for treatment and prevention efforts for CU traits in young children.