Many individuals with Autism Spectrum Disorders (ASD) have been described to display a lack of empathy for others and lack of remorse for their actions. These behaviours are similar to those seen in individuals with Callous Unemotional (CU) traits. CU traits are found in a subgroup of individuals displaying anti-social behavior and these traits are associated with a severe and persistent pattern of anti-social behaviors. There has been debate about the prevalence and origins of CU traits among people with ASD.
Objectives:
To determine the prevalence of CU traits in adolescents with ASD and whether they display similar psychiatric and neurocognitive correlates to those found in typically developing populations
Methods:
This study involved 89 16 year old adolescents from the Special Needs and Autism Project (SNAP), a longitudinal, population-based cohort. Parent-reported symptoms of CU traits were measured using the Anti Social Processes Screening Device (APSD) and Conduct Problems (CP) using the Strengths and Difficulties Questionnaire (SDQ), for both measures, thresholds indicative of a significant problem were employed. Three groups were identified: those with CU and CP (CU+CP;n=8), those with only CU (CU-CP;n=38) and those with neither (ASD only; n=41). Independent measures included other psychiatric subscales, the Social Responsiveness Scales (SRS), IQ and performance on the Ekman emotion recognition task for six emotions: happiness, sadness, anger, fear, disgust and surprise.
Results:
Prevalence. 53% of the sample were above threshold for CU traits (above a t-score of 65), however within the CU+ group only 17% also displayed CP.
Psychiatric (SDQ). A multiple regression using group as a predictor variable and controlling for IQ found lower prosocial behaviour scores in the CU-CP and CU+CP groups compared to ASD only (p<0.01) but there were no group differences on the emotional and hyperactivity subscales.
IQ. The CU+CP displayed significantly lower verbal IQ (p<0.05) but not performance IQ than both the CU-CP and ASD only groups.
Emotion Recognition. There were no significant differences between scores on the Ekman emotional recognition task except in the Happiness category where the CU+CP group performed more poorly than both groups (p<0.05).
Relationship with autism severity and SRS Subscales. Autism severity was rated as higher in both groups displaying CU traits (p<0.05) but the relationship was not significant for clinician ratings of autistic symptoms or diagnosis. Subscales on the SRS relating to communication, awareness, cognition and motivation were all higher in both CU groups compared to ASD only (all p<0.01). Multiple regression accounting for communication found no differences in the mannerisms subscale between groups.
Conclusions:
CU traits are common in adolescents with ASD, but only a minority have CP, in contrast to the correlates seen in non-ASD populations. Furthermore, the typical deficit in fear recognition associated with CU traits was not replicated in our ASD sample. Those with CU traits had lower verbal IQ, poorer parent-rated communication, awareness and motivation. The present findings support the idea that CU traits in people with ASD may have a different origin than those seen in typically developing people, although further research is required.
See more of: Psychiatric/Behavioral Comorbidities
See more of: Symptoms, Diagnosis & Phenotype