The association between callous-unemotional traits and substance use in childhood and adolescence: A systematic review and meta-analysis.

Callous-unemotional (CU) traits are characterized by a lack of guilt and empathy, restricted affect, and low concern about performance, and are increasingly recognized as co-occurring with substance use in youth. However, there is mixed evidence concerning whether they make a unique contribution to substance use. This systematic review and meta-analysis sought to quantify the association between CU traits and substance use in childhood, accounting for potential moderators including sample characteristics (age, gender, community versus clinical/forensic samples), CU traits measure and informant, and study design (cross-sectional or longitudinal). Separate meta-analyses were conducted for alcohol, cannabis, and a substance use composite. Small, significant associations were found between CU traits and alcohol (θ = 0.17), cannabis (θ = 0.17) and the substance use composite (θ = 0.15), which were present in both community and clinical/forensic samples. Findings suggest that CU traits co-occur with a range of substance use problems, and that CU traits should be considered in assessments of youth presenting with substance use problems regardless of the nature of the setting.

Longitudinal Associations between Callous-unemotional (CU) Traits and School-based Affiliative Relationships among South Korean Children.

OBJECTIVE: Callous-unemotional traits (CU) traits are characterized by low empathy, guilt, and reduced sensitivity to others' feelings, along with a reduced drive for social affiliation. However, little is known about the relationships between CU traits and social affiliation in the school context, or the influence of gender on these associations. This study tested reciprocal associations between CU traits and school-based affiliative relationships and explored gender as a potential moderator. METHOD: The sample included South Korean children aged 10 to 12 years (N = 218, M = 11.03, SD = .65, 52% boys). Children reported on CU traits, antisocial behavior, teacher-student relationship quality, and peer affiliation. Three-wave longitudinal cross-lagged models tested reciprocal associations between CU traits and affiliation with both teachers and peers, with multi-group modeling employed to test the moderating effect of gender. RESULTS: Higher CU traits at time 1 predicted decreases in teacher affiliation at time 2 controlling for CU traits, teacher-child affiliation, and antisocial behavior at time 1, while lower teacher-child affiliation at time 2 predicted increases in CU traits at time 3 accounting for CU traits, teacher-child affiliation, and antisocial behavior at time 2. However, there were no reciprocal associations between CU traits and teacher affiliation nor significant associations between CU traits and peer affiliation. Gender did not moderate any pathways between CU traits and teacher or peer affiliation. CONCLUSIONS: Findings indicate CU traits may reduce teacher-child affiliation, potentially escalating risk for further increases in CU traits. Thus, teacher-child affiliation may represent an important target for school-based intervention for children with elevated CU traits regardless of gender.

The Influence of Antisocial Behavior and Callous-Unemotional Traits on Trajectories of School Engagement and Achievement in South-Korean Children.

Poor educational outcomes are common among children with antisocial behavior problems, including among a subgroup of antisocial children with callous-unemotional traits, who show deficits in empathy, guilt, and prosociality. However, few studies have explored the unique contributions of antisocial behavior and callous-unemotional traits to school outcomes and most prior studies have been conducted in Western countries. The current study thus tested associations between callous-unemotional traits, antisocial behavior, and trajectories of school outcomes among South Korean children. Participants aged 10-12 years (N = 218; 52% boys) completed questionnaires assessing antisocial behavior, callous-unemotional traits, verbal ability, and school engagement, and teachers provided children's Math and Korean grades at three time points during a single academic year. Prospective associations were explored in conditional latent growth curve models. Both antisocial behavior and callous-unemotional traits were related to lower school engagement at the start of the academic year, but the magnitude of the associations was greater for callous-unemotional traits, suggesting a greater adverse effect of callous-unemotional traits on engagement than antisocial behavior. Moreover, children with high levels of callous-unemotional traits showed stable and low levels of school engagement. There were no significant predictive associations between antisocial behavior or callous-unemotional traits and trajectories of academic grades. The findings suggest that interventions aimed at improving educational outcomes among antisocial children should be tailored according to the presence of callous-unemotional traits to target the specific needs of individual students, particularly at the start of the school year.

To what extent does punishment insensitivity explain the relationship between callous-unemotional traits and academic performance in secondary school students?

BACKGROUND: Callous-unemotional (CU) traits are related to low achievement but not to deficits in verbal ability, commonly regarded as a major risk factor for poor academic outcomes in antisocial youth. This suggests that CU traits may have utility in explaining heterogeneous risk pathways for poor school performance in antisocial children. Reduced sensitivity to teacher discipline has been suggested as a potential explanation for the association between CU traits and low achievement, given its importance in facilitating engagement in learning. This study is the first to examine punishment insensitivity as a potential mechanism explaining the relationship between CU traits and poor achievement. AIM: The current study investigated the indirect pathway from CU traits via the predictor of punishment insensitivity to English, Maths, and Science grades. SAMPLE: A total of 437 English secondary school students aged 11 to 14 years (49% girls). METHODS: We conducted a mediation analysis within a structural equation modelling framework. CU traits and punishment insensitivity were assessed using child report questionnaires and academic grades were obtained from school records. RESULTS: CU traits were indirectly associated with low academic grades in Maths and Science, but not English, via punishment insensitivity, controlling for child age, gender, single parent household status, free school meals eligibility, externalizing problems, and classroom effects. CONCLUSIONS: Findings indicated that reduced sensitivity to discipline forms a pathway linking CU traits to poor performance in Maths and Science. Teachers may therefore need additional support to implement discipline effectively with children high in CU traits in order to prevent poor academic outcomes.

Callous-Unemotional Traits and Antisocial Behavior in South Korean Children: Links with Academic Motivation, School Engagement, and Teachers' Use of Reward and Discipline.

Callous-unemotional (CU) traits have been associated with atypical responses to reward and punishment cues, with evidence suggesting that such traits may shape caregiver use of reward and punishment practices over time. To date, research has predominantly focused on parental rewards and discipline, with far less attention paid to teacher behavior management strategies. The first aim of the current study was to investigate the potential moderating effect of CU traits on the relationship between teacher classroom management strategies (rewards and discipline) and two important school-related outcomes: student engagement and academic motivation. The second aim was to examine whether CU traits were related to teachers' use of discipline and reward strategies over time. Children attending South Korean primary schools (N = 218; aged 10-12 years; 52% boys) reported on CU traits, antisocial behavior, teacher classroom management strategies, school engagement and academic motivation at two time points (the beginning and end of a single academic year). First, harsh teacher discipline predicted lower school engagement, but only for children low in CU traits. Second, cross-lagged longitudinal models showed that CU traits predicted decreased use of teacher rewards, over and above associations with antisocial behavior. CU traits were not related to harsh discipline cross-sectionally or longitudinally in models that accounted for antisocial behavior. Findings show that CU traits are related to reduced sensitivity to teacher discipline, suggesting that teachers may need additional support to implement both discipline and reward-based strategies with children high in these traits.