Dimensions of Callous-Unemotional Traits in Autism Spectrum Disorder

Background: Recent attempts to understand the multifinality of Conduct Disorder (CD) in the general population of children with severe conduct problems has proven useful for developing effective treatments for CD and for developing clinically meaningful ways to subtype children with CD. Evidence suggests that children with severe behavioural problems can be subtyped according to; type of conduct problem (aggressive versus rule-breaking, and instrumental versus reactive aggression) and age of onset of CD (i.e. childhood versus adolescent onset CD). Recently however, a body of research has unearthed the prospect of subtyping CD by the presence of Callous-unemotional (CU) traits. Sub divisions of these traits have been divided into three domains, Callousness, Unemotional and Uncaring. Young people who have CD and CU traits tend to have earlier onset of conduct problems, more severe difficulties and worse prognosis. Little is understood about CU traits in children with autism spectrum disorder; however conduct problems are common in this population. 

Objectives: To investigate how Callous-unemotional (CU) traits and Conduct Disorder (CD) present in a population of children with Autism Spectrum Disorder (ASD) and to examine whether the level of CU traits can put children with ASD at risk of more severe conduct problems, including conduct disorder.

Methods: Crossectional data were examined for 56 young people (84% male) with a clinical diagnosis of ASD. Parents completed a well-standardised parent-report interview (the 3Di) during the assessment to measure ASD, Oppositional Defiant Disorder (ODD) and CD symptoms. CU traits were measured using the Inventory of Callous-Unemotional Traits. Strengths and Difficulties Questionnaire by parent and teacher report measured conduct and other behavioural problems.

Results: In children with ASD, Callous-unemotional traits were correlated with CD symptoms as reported by teachers (r= .38, df= 50, p< .01) and parents (r= .42, df= 48, p< .01). In a regression model with the total CU traits score as a predictor of CD symptoms; total CU traits were a significant predictor of CD symptoms by both parent (β=.42) and teacher (β=.38) report. Additionally, in a regression model with Callousness, Uncaring and Unemotional symptoms as predictors, only callous behaviour significantly predicted conduct problems by both parent (β=.62) and teacher (β=.54) report.

Conclusions: Callous-unemotional traits are important predictors in understanding conduct problems in an ASD sample. Of the three domains of CU traits, callous behaviour, appears to be an important construct in this population, and is associated with a specific risk factor for more serious conduct problems in ASD. By contrast, unemotional and uncaring behaviours do not seem to be significantly related to severity in conduct problems in children with ASD. Effective clinical assessment of CU traits in ASD populations may help identify children most at risk of developing more severe conduct problems and inform the development of appropriate intervention programmes for children with ASD.

See more of: Medical and Emotional-Behavioral Comorbidity
See more of: Medical Co-Morbid Conditions
See more of: Symptoms, Diagnosis & Phenotype

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