Maltreatment and parenting in youth with primary and secondary callous‐unemotional traits: Anxiety matters

Author:

Todorov Jessica J.1ORCID,Kohls Gregor2,Pauli Ruth1,Rogers Jack3,Bernhard Anka4,Ackermann Katharina4,Raschle Nora M.5,Dugre Jules R.1,Fernandez‐Rivas Aranzazu6,Gonzalez‐Torres Miguel Angel6,Hervas Amaia7,Smaragdi Areti8,Gonzalez Karen9,Vetró Ágnes10,Dikeos Dimitris11,Popma Arne12,Stadler Christina13,Konrad Kerstin1415,Freitag Christine M.4,Fairchild Graeme16,Devine Rory T.17ORCID,De Brito Stephane A.131718ORCID

Affiliation:

1. Centre for Human Brain Health School of Psychology University of Birmingham Birmingham UK

2. Department of Child and Adolescent Psychiatry and Psychotherapy Faculty of Medicine Technische Universität Dresden Dresden Germany

3. Institute for Mental Health School of Psychology University of Birmingham Birmingham UK

4. Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy University Hospital Frankfurt Goethe University Frankfurt am Main Germany

5. Jacobs Center for Productive Youth Development University of Zurich Zurich Switzerland

6. Psychiatric Service Basurto University Hospital Bilbao Spain

7. Child and Adolescent Mental Health Service University Hospital Mutua Terrassa Barcelona Spain

8. Child Development Institute Toronto Ontario Canada

9. Department of Psychology Middlesex University London England

10. Child and Adolescent Psychiatry Department Pediatrics and Child Health Center University of Szeged Szeged Hungary

11. Child and Adolescent Unit of the 1st Department of Psychiatry National and Kapodistrian University of Athens Athens Greece

12. Department of Child and Adolescent Psychiatry VU University Medical Center Amsterdam The Netherlands

13. Department of Child and Adolescent Psychiatry Psychiatric University Hospital University of Basel Basel Switzerland

14. Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy Child Neuropsychology Section RWTH Aachen University Aachen Germany

15. JARA‐Brain Institute II Molecular Neuroscience and Neuroimaging RWTH Aachen & Research Centre Juelich Juelich Germany

16. Department of Psychology University of Bath Bath UK

17. Centre for Developmental Science School of Psychology University of Birmingham Birmingham UK

18. Centre for Neurogenetics University of Birmingham Birmingham UK

Abstract

AbstractBackgroundYouth with conduct disorder (CD) and high callous‐unemotional (CU) traits are not a homogenous group and can be disaggregated into primary and secondary subgroups. However, there are inconsistencies in defining primary and secondary subgroups, with some studies using anxiety, others using maltreatment and still others using both features to identify subgroups. There is a paucity of work comparing primary and secondary subgroups with typically developing (TD) youth on experiences of maltreatment and parenting as well as a lack of studies investigating sex differences.MethodsIn a large sample of TD youth (n = 946, 66% female) and youth with CD (n = 885, 60% female), we used latent profile analysis in youth with CD aged between 9 and 18 years to address four aims: (i) to demonstrate how primary and secondary subgroup membership differs when anxiety, maltreatment, or both are used as continuous indicators, (ii) to compare primary and secondary subgroups with TD youth on abuse and neglect measures, and (iii) to compare primary and secondary subgroups with TD youth on parenting experiences, and (iv) to examine whether the results were consistent across sexes.ResultsAnxiety without maltreatment yielded the best fitting and most theoretically interpretable classification of primary and secondary subgroups across both sexes (Bayesian information criterion = 17832.33, Entropy = 0.75, Lo‐Mendell‐Rubin: p < 0.01). Compared with TD youth, youth with primary and secondary CU traits experienced greater levels of abuse and neglect (p < 0.001, η2p = 0.04−0.16) and maladaptive parenting practices (p < 0.001, η2p = 0.04−0.13). Youth with primary and secondary CU traits were equally high on levels of abuse, neglect, and maladaptive parenting (all p values >0.05).ConclusionsWe provide evidence that anxiety and maltreatment cannot be used interchangeably to identify youth with primary versus secondary CU traits. Anxiey yielded the best fitting and most theoretically interpretable classifications across both sexes. Our results signify the need for researchers and clinicians to adopt a unified approach to defining primary and secondary subgroups of CU traits using anxiety in both sexes.

Funder

Economic and Social Research Council

Publisher

Wiley

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