Are Callous Unemotional
Traits a Relevant Construct in
Early Childhood?
Michael Willoughby
FPG Child Development Institute
February 3, 2010
Outline
•
•
•
•
Heterogeneity of conduct problems
Downward extensions of psychopathy
Extension to early childhood
3 questions
– Measurement
– Distinct pathways
– Early parenting effects
Heterogeneity of Conduct Problems
• Approaches
– Age of onset
– Type aggression (proactive, reactive, relational)
– Comorbidity (ADHD)
• Limitations
–
–
–
–
Heterogeneity remains in early onset
Lack of distinct etiological pathways
No clear treatment implications
Doesn’t link to adult psychopathy
Adult Psychopathy
• Reduces heterogeneity among incarcerated
• Dimensions
– Affective (low guilt, empathy)
– Interpersonal (grandiosity, manipulative)
– Behavioral (impulsive, antisocial)
• Advantages
– Differential treatment response
– Differential risk for recidivism
– Neurological profile (Amygdala, “Para-limbic”)
Downward Extension of Psychopathy
• Focus
– Adolesence & Middle childhood
– Affective (Callousness)
• Utility
– Measurement & stability
– Predicts severity and stability of CP
– Differential emotional processing (fear)
– Different risk factors (parenting, genetics)
– Treatment implications
Extending CU to Early Childhood
• Developmental relevance
– Temperament (fear, effortful control)
– Emergence of empathy
– Parental use of punishment
• Three Qs
– Measurement & stability
– Differential pathways (temperament)
– Parenting effects
• Secondary data analysis
Secondary Data Analysis
• Economical (time & money)
• Address limitations of extant CU work
– Prospective longitudinal designs from infancy
– Early measurement
• Temperament
• Physiology
• Parenting
• Opportunities for cross validation if identify
commonly used instrument (CBCL)
Durham Child Health & Development
Study
• Design
– Recruited in infancy
– Convenience sample (N = 206)
– 4 cells (poverty x race)
– Visits @ 3, 6, 12, 18, 24, 30, 36, 60m+
• Data
– Observed & rated temperament, parenting
– Genes
– CBCL (1.5 – 5 year old)
Items from CBCL (1.5-5 years)
CU
• Doesn’t feel guilty
after misbehavior
• Punishment
doesn’t change
behavior
• Shows too little fear
of getting hurt
• Shows little
affection to people
• Unresponsive to
affection
ODD
•
•
•
•
•
Defiant
Disobedient
Angry moods
Stubborn/irritable
Uncooperative
ADHD
•
•
•
•
Can’t concentrate
Can’t sit still
Can’t stand waiting
Demands must be
met immediately
• Gets into
everything
• Quickly shifts
between activities
Question 1 – Measurement
CFA model fit (3 factors)
N
36m
178
60m
137
χ2 (df)
Latent correlations
CFI RMSEA
80 (36) .95
39 (24) .97
1.
2.
3.
4.
5.
.08
1. ADHD 36
--
.07
2. ODD 36
.78
--
3. CU 36
.88
.90
--
4. ADHD 60
.79
.49
.75
--
5. ODD 60
.52
.69
.72
.81
--
6. CU 60
.54
.55
.84
.82
.79
3 factor models fits, but highly correlated factors. CU stability similar ADHD, ODD
Question 1 – Measurement
Item characteristics (36m)
Item-Total Correlation Alpha
M (Range)
Item R2
ADHD
.60 (.51 - .68)
.83
.61
ODD
.60 (.56 - .69)
.83
.61
CU
.41 (.23 - .60)
.65
.49 (.57)
With exception of “shows little affection”, CU items behave similar to ADHD, ODD
Question 1 – Measurement
CU factor score - total
- ODD group (T score > 63)
Question 1 – Measurement
Summary
• Parents can distinguish CU from ADHD, ODD
• CU items behave in similar manner to ADHD,
ODD
• 2-year stability of CU is comparable to that of
ADHD, ODD
• Variation in CU among those with elevated ODD
Question 2 – Distinct Pathways
• Frick & Morris 2004
– Emotional dysregulated
•
•
•
•
High negative reactivity
Poor regulation (effortful control)
Coercive PC interactions
Overt & reactive aggression
– Low fear
•
•
•
•
Low resting autonomic arousal
Reduced reactivity?
Less sensitive to punishment (avoidance learning)
Covert & proactive aggression
Question 2 – Distinct Pathways
• DCHD sample
– N = 19 with T > 63 on ODD scale @ 36m
– Parse into 60/40 split typical of older samples
– Randomly select 15 comparisons (10 poor)
• CPCU (ODD+CU)
– N=7
– 86% poor, 70% male, 57% African American
• CP (ODD)
– N = 12
– 50% poor, 50% male, 67% African American
• Comparison
– N = 15 comparison
– 67% poor, 27% male, 40% African American
Question 2 – Distinct Pathways
• IBQ
–
–
–
–
–
(Garstein & Rothbart, 2003)
Combine 3 & 6m ratings (N = 34)
Distress Limitations (fuss or cry after sleep, wash face, confine place)
Fear (startle or distress to changes in stimulation, objects, persons)
Soothability (reduction in fussiness when soothed by caretaker)
Falling Reactivity/Rate of Recovery (rate recovery from peak distress)
• FFSFP
(Tronick et al, 1978)
– Episode: Normal play/talk, Still face, Reunion (2 mins/each)
– Affect coding (N = 31)
• 6m only
• % affect per episode (Moore et al, 2009)
– Physiology (N=31)
• Combine 3 & 6m
Question 2 – Distinct Pathways
CPCU v Compare
CP v Compare
CPCU vs CP
0.75
Effect size (Cohen d)
0.5
0.25
-1E-15
-0.25
-0.5
-0.75
Distress Limitations
Falling React
IBQ Scales
Fear
Soothability
Question 2 – Distinct Pathways
CP
CPCU
Compare
CP
CPCU
Compare
0.4
0.4
0.3
% Positive Affect
% Negative Affect
0.3
0.2
0.2
0.1
0.1
0
0
Talk
Talk
Still Face
Reunion
Affect during FFSFP (6m)
Still Face
Reunion
Question 2 – Distinct Pathways
CP
CPCU
Compare
CP
440
CPCU
Compare
4.5
430
4
420
3.5
RSA
Heart Period
410
400
3
390
380
2.5
370
360
2
Talk
Still Face
Reunion
Talk
Physiology during FFSFP (3 + 6m)
Still Face
Reunion
Question 2 – Distinct Pathways
CPCU / CT
Effect Size (Cohen d)
1
0.5
0
-0.5
-1
CP / CT
CPCU / CP
Question 2 – Distinct Pathways
•Wilks’ λ, F (12, 52) = 1.99, p = .04
•Canonical Correlations
•F1 = .64*
•F2 = .44
•Classification
•91% accurate
•CPCU (6/7)
•CP (11/12)
•Compare (14/15)
Variable
F1
F2
HP (Talk)
.58
-.21
HP (SF – Talk)
-.25
-.52
HP (ReU – SF)
.28
.29
IBR Fear
.24
.14
IBR Sooth
-.10
.50
Negative Affect
(ReU – SF)
.34
-.10
Question 2 – Distinct Pathways
Question 2 – Distinct Pathways
Summary
• CP ~ Emotional dysregulation pathway
– Parent ratings of high fear, low falling reactivity
– Increased negative affect across all phases of FFSFP
• CPCU ~ Low fear pathway
– Parent ratings of high falling reactivity, soothability
– Minimal changes in affect during FFSFP
– Minimal changes in HP during FFSFP
• Infancy (3 & 6m) measures correctly classified
behavior groups 2.5 years later
Question 3 – Parenting Effects
Mixed results re: role of parenting to CP, CU
•
•
•
•
Negative parenting x CU  CP (e.g., Wooten et al, 1997)
Heritability of CP: CPCU > CP (Viding et al, 2005, 2008)
Substantial heritability of CU (Viding et al, 2005, 2007; Larsson et al, 2008)
Socialization modifies, not causes CU (Blair et al, 2006)
• Early negative parenting precedes CP/CPCU (Larsson et al, 2008)
• Animal studies indicate that environment influences the
development of punishment insensitivity (Dadds & Salmon, 2003)
Question 3 – Parenting Effects
• Child contributions (bi-directionality)
– Child evocative effects (Larsson et al, 2008)
– Fear conditioning & aggression (Gao, Raine, et al, 2009)
• Brain Derived Neurotrophic Factor (Hajcak et al, 2009)
– SNP ~ val/val vs. val/met, met/met
– Fear conditioning
• Early maltreatment  BDNF methylation in
PFC; rat cross-fostering (Roth et al, 2009)
Question 3 –Parenting Effects
• Parenting X BDNF  CU
• Parenting
– Observed behavior
– Self-reported cognitions
– Markers of socialization milieu
• BDNF
– 81% val/val (N = 138)
– 19% val/met, met/met (N = 33)
Question 3 –Parenting Effects
Observed Parenting Behavior(Cox & Mills-Koonce)
• Timing
– Early: free play @ 6 & 12 months
– Late: puzzle task @ 24 & 36 months
• Positive codes
– Sensitivity, Animation, Positive Regard, Detachment®
• Negative codes
– Intrusive, Negative regard
Question 3 – Parenting Effects
0
1
4
•Early Positive PCX
2
•Intx not sigificant
•Total r = -.14
0
•BDNF (v/v) r = -.17
-2
•BDNF (m) r = -.24
1
2
3
4
5
1
Early Positive PCX
Graphs by bdnf_d
2
3
4
5
Question 3 – Parenting Effects
1
•Early Negative PCX
4
0
•Intx is sigificant
2
•Total r = .17*
•BDNF (v/v) r = .10
-2
0
•BDNF (m) r = .60***
1
2
3
4
5
1
Early Negative PCX
Graphs by bdnf_d
2
3
4
5
Question 3 – Parenting Effects
1
•Late Positive PCX
4
0
•Intx is sigificant
2
•Total r = -.08
0
•BDNF (v/v) r = .03
-2
•BDNF (m) r = -.52
0
2
4
6
0
Late Positive PCX
Graphs by bdnf_d
2
4
6
Question 3 – Parenting Effects
1
•Late Negative PCX
4
0
•Intx is sigificant
2
•Total r = .12
•BDNF (v/v) r = .03
-2
0
•BDNF (m) r = .62
0
2
4
6
8
0
Late Negative PCX
Graphs by bdnf_d
2
4
6
8
Question 3 –Parenting Effects
Cognition - Parenting Opinions Scale (Hogan & Tudge, 1994)
– Spoiling
• Responding to cries spoils a baby
• A lot of attention may spoil a child
• Holding/rocking spoils a child
– Discipline/Control
• Be strict with 1-year olds
• Discipline is most important parental task
• Obedience makes a good student
– Perceived Contingency
• Parents can’t influence IQ before age 2 years
• Successful rearing is matter of luck
• Personality characteristics can’t be changed
Question 3 – Parenting Effects
0
1
4
•Spoiling
2
•Intx is sigificant
•Total r = .19*
0
•BDNF (v/v) r = .17+
-2
•BDNF (m) r = .59***
-1
0
1
2
3
-1
POS : Spoiling Scale
Graphs by bdnf_d
0
1
2
3
Question 3 – Parenting Effects
0
1
4
•Discipline/Control
•Intx is sigificant
2
•Total r = .19*
•BDNF (v/v) r = .14
-2
0
•BDNF (m) r = .48***
-2
-1
0
1
2
-2
-1
POS : Discipline / Control Scale
Graphs by bdnf_d
0
1
2
Question 3 – Parenting Effects
1
•Perceived Contingency ®
4
0
•Intx not sigificant
2
•Total r = .17*
0
•BDNF (v/v) r = .13
-2
•BDNF (m) r = .29
2
3
4
5
6
2
3
POS : Perc ' d Contingency Scale
Graphs by bdnf_d
4
5
6
Question 3 –Parenting Effects
Cognition - Parenting Stress scale (Abidin, 1995)
• Difficult Child
– My child seems to cry more than others
– My child wake up in bed in bad mood
– My child does things that greatly bother me
• PC Dysfunctional Relationship
–
–
–
–
–
Child rarely makes me feel good
Does not like me
Doesn’t giggle or laugh
Smiles less than expected
Can’t do as much as expected
Question 3 – Parenting Effects
0
1
4
•Difficult Child
2
•Intx not sigificant
•Total r = .37*
0
•BDNF (v/v) r = .37
-2
•BDNF (m) r = .36
-2
0
2
4
6
-2
0
PSI : Difficult Child Scale
Graphs by bdnf_d
2
4
6
Question 3 – Parenting Effects
1
4
0
•Dysfunctional Relationship
2
•Intx is sigificant
•Total r = .28***
0
•BDNF (v/v) r = .23**
-2
•BDNF (m) r = .56***
0
2
4
6
0
PSI : Diff PC Relationship Scale
Graphs by bdnf_d
2
4
6
Question 3 – Parenting Effects
Summary
• Non-normative parenting behaviors X child
BDNF (ability to learn from fear)  CU
• Specificity
–
–
–
–
Early: negative but not positive
Late: negative and positive
Cognitions re: discipline not general (POS)
Cognition about difficultly of relationship (PSI)
Conclusions
• CU is viable construction in early childhood
• Can we measure it? Is it stable?
– Yes. CU similar to ADHD, ODD screening items
• Distinct pathways?
– Maybe, emotional dysregulation vs. low fear
• Early parenting contribution?
– Yes, early social milieu | BDNF
Future Directions
• Measurement
– Linking
– Lab tasks
• Replication
– Large, prospective designs of high risk samples
– Better measures of fear reactivity, anger regulation
• Integrating perspectives
– ADHD
– Learning & Attention (Newman)
Thank you!
willoughby@unc.edu