To be cautious and in order to be sure that the relationship between serotonin and
CU traits was not being driven by medication effects, the regression analysis was repeated with boys using SSRIs / MAOIs (or a combination including SSRIs / MAOIs)(N = 5) excluded.
Recent reviews have highlighted the need to clarify the relevance of
CU traits over and above DBD [14].
Analyses with
CU traits indicate that adolescents with high levels of
CU traits show a pattern of «inverted» social reward, in a similar manner to adults with high levels of psychopathic traits [13].
In a recent publication exploring developmental trajectories of
CU traits, youth with persisting high
CU traits had experienced more maternal harshness, low parental knowledge, and monitoring compared to the moderate or low CU youth groups [64].
The Differential Amygdala Activation Model (DAAM)[12] is a recently developed model of amygdala function that has proposed a mechanism by which the subtle cognitive and emotional deficits characteristic of people with high
CU traits, may develop.
Stability for
CU traits and number of ODD - symptoms between ages 3 and 5 was statistically significant but moderate - low (intra-class correlation under.40).
The goal of this study is to ascertain cross-sectionally and longitudinally: a) the specific contribution of the CU level and the presence of ODD diagnosis on psychological and functional measures as early as preschool age in the general population; b) the existence of a potential interaction CU × ODD, to determine if the contribution of CU levels on the children's clinical state varied for children with ODD and those without the diagnosis; and c) the stability of
CU traits from ages 3 to 5.
Many factors may be implicated in the development and maintenance of
the CU traits, although it is hard to separately test the specific contribution of each element, i.e., genetic vs. environmental, to the onset and progression of these traits.
More specifically, harshness increased significantly across groups from low to high
CU traits, and youth with low
CU traits reported higher parental warmth, but there were no differences between the warmth reported by high compared to moderated groups.
Other longitudinal studies have suggested that
CU traits are relatively stable across childhood, and from childhood to adolescence.
There is very limited research regarding the aetiology of
CU traits in girls and this study requires replication in a female sample.
Assessment and identification of
CU traits from preschool might help to identify a subset of children who could have socialization problems, not only among those with ODD but also among those without a diagnosis of conduct problems.
There thus appears to be a deleterious effect of the heterozygous genotype on
CU traits: however, as true heterozygous effects are rare and the numbers of minor homozygotes in the high CU group are small, replication is required in larger cohorts to determine whether this is a true effect.
At step 2, serum serotonin level (β = − 0.004, Wald criteria = 7.44, p = 0.006, Exp (B) = 0.996) was the only significant predictor of
CU traits group.
We here provide a narrative review of the available evidences on
CU traits in three main domains: aetiology (encompassing genetic liability and environmental risk factors), presentation (early signs and longitudinal trajectories) and treatments.
Importantly, parental depression moderated the link between corporal punishment and
CU traits.
This study also demonstrated that within a sample of children with antisocial behaviour problems there is a relationship between
CU traits and peripheral serotonin levels that is independent from antisocial behaviour severity.
Although these new interventions specifically developed for children with CD and elevated
CU traits are promising, other more traditional treatments addressed for behavioural problems are available [25].
Moreover, their scores have shown higher internal consistency than those of parents, and have proved useful for discriminating
CU traits in children [46].
We also compared adolescents with CD and higher levels of
CU traits (CD / CU +) with those with CD and lower levels of
CU traits (CD / CU --RRB- in terms of task performance.
Results revealed that
CU traits were negatively correlated with pro-social but positively correlated with aggression.
Currently available psychotherapeutic treatments for children with conduct disorder and high
CU traits
However, clinical assessment of
CU traits may present specific caveats.
To our knowledge, there is no evidence to suggest that self - report measures of
CU traits are less valid than parent - report or teacher - report measures, although we acknowledge that collecting data from multiple informants would have strengthened the study.
001) and poor supervision / monitoring predicted increases in
CU traits (p = 0.03) however, the inverse relations were not found.
Since
CU traits have shown a certain stability from early childhood to adolescence [32, 34], and given the evidence of severe outcome associations, more research is needed in large community samples from different cultures to identify the clinical benefits of identifying the ODD plus
CU traits subgroup, especially early in life, given the preventive potential of early identification.
This study explored the relationships between the serotonin system and
CU traits in an antisocial sample with the general hypothesis that high levels of
CU traits would be associated with indicators of reduced serotonin - system function.
The current study evaluated the factor structure, psychometric properties, and validity of scores on a comprehensive measure of
CU traits, the Inventory of Callous - Unemotional Traits (ICU), in relation to measures of antisocial / prosocial behavior and emotional processing, administered to preschool children.
A recent study [98] found that the Coping Power program can lead to a significant decrease in
CU traits, and this reduction was maintained at the 1 - year follow - up evaluation.
In the study by Muratori et al. [24] involving children with disruptive behaviour disorder, a higher level of socio - economic status at baseline was related to lower level of
CU traits.
No drug treatments specifically work for
CU traits, and they may be predictors of poor response to pharmacological treatments in CD, although data are still inconclusive [100, 103].
In particular, we consider the importance of delineating what precisely works for children with
CU traits (and their parents) and the ways in which intervention and prevention programs may be optimized to improve engagement as well as clinical outcomes.
Well designed longitudinal studies, both naturalistic and intervention, mainly in clinical samples, are needed to further delineate developmental trajectories, their predictors, and how
CU traits alone or interacting with behavioural symptoms predict the outcomes.
In the research that has addressed this issue, in both clinical and community samples from middle childhood to adolescence,
CU traits have shown significant correlation with a number of ODD symptoms [30, 31].
The heritability of
CU traits is estimated at between 40 % and 78 % [9].
When treating
CU traits as a dimensional measure, which is arguably a more powerful approach than using a median split, we found an inverse relationship between
CU traits and EA for sadness, with higher levels of
CU traits being associated with a reduced ability to track changes in the intensity of sadness.
Regarding ODD and CU in preschoolers, Willoughby et al. [32] reported that
CU traits were stable from ages 3 to 5, and distinguished a group of children with ODD+CU that were less fearful, recovered more easily after an upset, and showed less negative reactivity, lower heart period reactivity and higher levels of general arousal than those with ODD only.
Two functional serotonin - system SNPs were significantly associated with
CU traits.
They found a mediating role of hostile parenting in the association between parent and adolescent
CU traits, especially in the context of high household chaos.
Participants homozygous for the major allele (CC) were more likely to have high
CU traits than heterozygotes (C / T) or minor homozygotes (TT).
Taken together, the results also suggest that the assessment and identification of
CU traits from preschool age onwards might help us to identify a subset of children who may have sustained and severe social and behavioral problems.
In all, there is some indication that the function of the serotonin system may be important in
CU traits.
Higher CU behaviours in children as early as 3 year - old are related to lower guilt and empathy, more proactive aggression [67], and, perspectively, to
CU traits in late childhood [67, 82, 83].
For instance, Kochanska et al. [29] showed that
CU traits moderate the effect between early parenting and externalizing behavior problems: in children high in
CU traits, parents» positive affect reduced the probability of future behavior problems.
This and other reviews [21, 26, 46, 72, 79] clearly demonstrate that
CU traits are highly heritable, that a timely identification is possible, since early years, and that they are associated with identifiable environmental risk factors.
Although few studies specifically explored these mutual influences, preliminary evidences suggest that
CU traits may be more predictive of changes in parenting over time than parenting on changes in
CU traits [47, 48].
Only among girls,
CU traits also positively predicted indirect bullying.
Although most of the studies about
CU traits associated to CD are focused on children and adolescents, more recently the interest has been expanded to early childhood and toddler age, in order to detect early sings of CU behaviours.
They concluded that there is a heightened vulnerability to intergenerational transmission of these traits in a contest of household chaos that may exacerbate the effects of hostile parenting on
CU traits during adolescence.
The DAAM posits that reduced serotonin neurotransmission may be integral to the pattern of amygdala activation it describes and hence to the development of the three deficits which, in turn, lead to high levels of
CU traits.