Download Unique Associations of Callous-Unemotional Versus Oppositional

 Uniqque asso
ociations of callous‐uneemotionnal versuus oppossitional a
and atteention‐deficit/hyyperactiive behaaviors am
mong prreschool childreen: are therre multipple dom
mains witthin earlly‐startiing childd behaviior problems? Key Terrms Defin
ned Callous‐une
emotional beh
havior – Callouus unemotionaal (CU) behavio
ors refer to beh
haviors such as a lack of e
empathy, low g
guilt, and shal low affect. Oppositiona
al behavior – O
Oppositional b
behaviors incluude behaviors s
such as irritablle mood, defiance, vin
ndictiveness, n
negative affectt, and emotion
nal dysregulation. Authors & Affiliations R
Rebecca Wa
aller1 Lu
uke W. Hyd
de1,2,3 Ad
dam S. Grab
bell1,4 M
Martha L. Allves1 Sheryl L. Olson1,2 1
Departmen
nt of Psycchology, University of Michigan, USA 2
C
Center for Hu
uman Growth an
nd Developme
ent, Univversity of Michigan, USA 3
In
nstitute for S
Social Reseearch, Unive
ersity of Michigan, U
USA 4
Departmen
nt of Psyychiatry, University of P
Pittsburgh M
Medical Center, US
SA Attention d
deficit/hyperacctive behaviorr ‐ Attention deficit/hyperacttive (ADH) beh
haviors refer to behaviorss, such as atten
ntional problem
ms, impulsivityy, lack of focuss, and an inability to concentrate
e. Nomologica
al network ‐ re
efers to the chaaracteristics and observable behaviors thaat define the variables of interest in a sttudy, includingg their associattions with otheer variables and the outcomes th
hey predict. Proactive ag
ggression ‐ plaanned and goaal‐oriented agg
gressive behavvior for individual gain, including maaterial possesssions or social dominance. Reactive ag
ggression ‐ frusstrated and hoostile aggressivve behavior in response to peerceived provocation
n or stimulation
n. Backgro
ound Child behavior problems (e
e.g., aggressioon, rule‐breaking), beginning
g as early as the toddler n important pu
ublic health co ncern becausee of the harm t
they cause to t
he well‐
years, are an
being of chilldren, families, communitiess, and schools. In particular, e
early child beh
havior problems pu
ut children at r
isk of develop ing aggression
n and violence as they grow u
up, which is harmful to t
hemselves, other people, annd very costly t
to society as a whole. Thus th
here is a evention and trreatment proggrams that worrk with families and children to reduce need for pre
the risk for f
future aggression and violencce. However, a
an issue that complicates our ability to design effecctive treatments is that child behavior prob
blems are heteerogeneous in n
nature, differing in t
the age that th
hey start (e.g., early childhoo
od versus earlyy adolescence),, the outcomes th
hat they are asssociated with,, and the facto
ors that cause t
them. Research is needed to identify d
different types of behavior prroblems so we can better maatch different t
treatments according to
o children’s ind
dividual needs.. In relation to
o this question
n, researchers h
have proposed
d three differen
nt domains witthin child behavior pro
oblems. The firrst domain is d
defined by high
h levels of oppositional behaavior and includes deffiance, anger, a
and emotionall dysregulation
n. A second do
omain comprisees attention‐
deficit/hyperactive (ADH) behavior, com
mprising poor in
nhibitory control, high impulsivity, and onal control. Finally, a third d
domain focusess on callous‐un
nemotional (CU) behavior low attentio
and includess reduced emo
otional responssiveness, deficcits in empathyy, and a lack off guilt. Several rece
ent studies havve investigatedd these three d
domains among older childreen and adolescents (see a review by Frick et al., 2014), but litttle research has been conduccted among i.e., under 5 yeears old), which
preschool‐aged samples (i
h is a critical peeriod for severral reasons. e or violent havve often shown
n behavior pro
oblems as youn
ng children. Adults who are aggressive
Thus, a focu
us on understan
nding the emeergence and deevelopment off behavior prob
blems before they become severe is imp
portant for infoorming interveentions that co
ould help preveent children uent violence o
or crime. In ad
ddition, evidence suggests th
hat behavior from perpettrating subsequ
National Cente
er for Injury Prevvention and Coontrol Unique associations of callous‐unemotional versus oppositional and attention‐deficit/hyperactive behaviors among preschool children: are there multiple domains within early‐starting child behavior problems? problems are more malleable at younger ages (e.g., Dishion et al., 2008; Reid et al., 2004), allowing for greater possibility of improving children’s current and future outcomes through early‐starting treatment and interventions strategies. Finally, the preschool years represent an important time of change when children undergo rapid physical, neurological, and psychological development. This period of transition is often very hard for parents to manage and a time when break‐downs in the parent‐child relationship can commonly occur. The current study investigated three research questions. First, can these three domains of child behavior problems (ADH, oppositional, and CU behaviors) be measured as separate constructs at age 3? To test this question we collected parent reports on a child behavior questionnaire and used quantitative factor analytic techniques. Second, do ADH, oppositional, and CU behaviors have different nomological networks of associated behaviors? To test this question, we examined their unique associations with measures of various socio‐emotional and cognitive processes. Third, do oppositional, ADH, or CU behaviors predict higher teacher‐reported behavior problems from ages 3‐6 years old? Overall, the aims of the study were to provide a thorough examination of the potentially distinct nomological networks of ADH, oppositional, and CU behaviors; and to evaluate which of these behaviors predicted the worst outcomes at school age. Study Methods: Data are from 240 children (118 girls) and their parents, who were part of a study of young children at risk for behavior problems in Michigan. Data were collected when children were 3 years old and again when they were 6 years old. Most children were of European American background (86%), with others self‐identifying as African‐American (5%) or biracial (8%). We collected data from mothers and fathers in family homes. Parents answered questions about their children’s ADH behavior (e.g., ‘he/she can’t stand to wait’), oppositional behavior (e.g., ‘he/she is defiant’), and CU behavior (e.g., ‘he/she shows a lack of guilt after misbehavior’). Parents also completed questionnaires assessing children’s anger/frustration, fear, ability to control their attention, guilt, moral understanding, and empathy towards others. We also collected questionnaire data from teachers who reported on children’s general behavior problems, as well as their proactive aggression (e.g., ‘he/she bullies others’) and reactive aggression (e.g., ‘when teased, he/she strikes back’). Finally, children participated in a 4‐hour laboratory session at a local preschool, during which they completed six tasks to assess their effortful control (e.g., ability to delay responses, ability to regulate their emotions) which was videotaped and then coded by researchers. To examine a measurement model for ADH, ODD, and CU behavior, we used confirmatory factor analysis. To test nomological networks and which dimension predicted future behavior problems, we used linear regression. Results: The best‐fitting measurement model using items from a commonly used parent‐reported behavior checklist was one where ADH, oppositional, and CU behavior were assessed as three separate factors 1 (see Figure 1). We found that each domain was linked to a specific and distinct nomological network: oppositional behavior was strongly related to parent reports of anger and frustration; ADH behavior was related to lower observed ability to delay responses and regulate emotions as well as lower parent‐reported attentional focus; and CU behavior was related to lower parent‐
reported moral regulation, guilt, and empathic concern (see Figure 2). We found that age 3 CU behavior predicted externalizing behavior problems and proactive aggression at age 6, as judged by teachers. This prediction was over and above earlier teacher‐reports of externalizing behavior and ADH and oppositional behaviors. Overall, results showed that consistent with theory, ADH behaviors were specifically associated with difficulty regulating attention and behavior control, oppositional behavior was associated with difficulty controlling anger and frustration, and CU behavior was related to difficulties with empathy, guilt, and moral development (data not shown). Importantly, CU behaviors were the best predictor of identifying which children had most behavior problems in schools 3 years later, even after taking into account their initial levels of behavior problems. 1 Statistically, this model fit significantly better than a model where ADH, oppositional, or CU behavior all loaded onto one ‘problem behavior’ factor sdfsfdsfdadsf Uniique associa
ations of calllous‐unemo
otional versuus oppositioonal and atteention‐deficcit/hyperactive behaviors amoong prescho
ool children:: are there m
multiple dom
mains withinn early‐startting child beehavior probblems? Figure
e 1. Measurementt of oppositional, attentio
on‐deficitt/hyperacctive, and ca
allous une
emotional behaviors at ag
ge 3 baseed on con
nfirmatory factor analysis [Items aree based onn mother a
and fatherr reports on a child b
behavior questio
onnaire; Co
olored arro
ows (—,—
—,and —) i indicate th
he questionnaire item
ms that are inclluded in ea
ach of the three sepa
arate beha
avior dimeensions. Bllack doublle‐
headed
d arrows (↔
↔) indicatte overlap between d
dimensionss]. Figure
e 2. Differrential asssociations of opp
positionaal, attenttion‐
deficitt/hyperacctive, and
d callouss unemottional beh
haviors w
with relevvant socioe
emotiona
al and cog
gnitive co
orrelatess suggestting distiinct nomollogical ne
etworks of these behaviorral dimen
nsions sdfsfdsfdadsf s
Uniique associa
ations of callous‐unemo
otional versuus oppositioonal and atteention‐deficcit/hyperacttive behavio
ors among prescho
ool children: are there m
multiple dom
mains withinn early‐startting child beehavior probblems? Figure 3. Predicction of te
eacher re
eports off behavio
or problems at age 6 by teacher reportss of behavvior prob
blems at age 3 and parentt reports of opposittional, atttention‐‐deficit/h
hyperactiive, and callous u
unemotio
onal behaviors at ag
ge 3. Figure 3 Notte. All models a
also controlled
d for child gend
der, child age ( (in months), faamily income, a
and child verbal IQ. Teacher‐ reports of extern
nalizing behavvior problems a
at age 3 predictted teacher‐reeportes of exteernalizing behaavior problems, p
proactive aggre
ession, and reaactive aggression at age 6 (ppurple arrows →
→). Parent rep
ports of CU beh
havior at age 3 also predicted teacher re
eports of exterrnalizing behavior and proacctive aggressio
on at age 6 (blu
ue arrows →). Neither al nor ADH beh
haviors at age 3
3 predicted teaacher‐reportedd outcomes att age 6 (no arro
ows shown). oppositiona
Implica
ations forr Violencce Preven
ntion The findings of this study have importan
nt violence pre
evention impliccations that arre relevant to p
parents, teachers, and We showed tha
at oppositionall, ADH, and CU
U behaviors ca n be separately assessed am
mong young children and clinicians. W
that they ha
ave separate nomological ne
etworks: oppossitional (i.e., annger/frustratio
on), ADH (i.e., low attentionaal and effortful con
ntrol), and CU (i.e., deficits in
n conscience, i including low g
guilt and a lackk of empathic c
concern) behaviors. We also found t
that CU behavior (but not op
ppositional or A
ADH behavior)) uniquely pred
dicted increasees in child behaavior problems att school. These findin
ngs highlight t
he need for strategies to ide
entify the diffe rent types of e
early behavior problems amo
ong children in order to f
facilitate accesss to appropriaate treatment. More broadly,, although we know that inteerventions that target parenting p
practices and skkills are the mo
ost effective fo
or reducing chiildren’s behaviior problems, t
the findings fro
om this study suggest tha
at we might have an even gre
eater effect forr reducing childdren’s behavio
or by personaliizing treatmen
nts according to children’s preschool levvels of oppositional, ADH, an
nd CU behavio rs. For examplle, because children with CU
U behaviors athy for others, treatments could focus on increasing emotional saliencce of situationss to help seem to havve lower empa
children mo
odify their aggression. Treatm
ment strategie
es that have shhown promise in this area foccus on promotting warmth, affect and e
eye contact bettween parentss and children (
(see Dadds et al., 2014; Hydee, Waller, & Bu
urt, 2014). Other r
resourcess for info
ormation on this t
topic This brief is a summary off research that has been published in the Joournal of Child Psychology an
nd Psychiatry. T
The paper is om/doi/10.1111/jcpp.12326/ppdf available at: http://onlinellibrary.wiley.co
Unique associations of callous‐unemotional versus oppositional and attention‐deficit/hyperactive behaviors among preschool children: are there multiple domains within early‐starting child behavior problems? References Dadds, M.R., Allen, J.L., McGregor, K., Woolgar, M., Viding, E. & Scott, S. (2014). Callous‐unemotional traits in children and mechanisms of impaired eye contact during expressions of love: a treatment target? Journal of Child Psychology and Psychiatry, 55, 771–780. Dishion, T.J., Shaw, D., Connell, A., Gardner, F., Weaver, C., & Wilson, M. (2008). The Family Check‐Up with high‐risk indigent families: Preventing problem behavior by increasing parents' positive behavior support in early childhood. Child Development, 79, 1395‐1414. Frick, P.J., Ray, J.V., Thornton, L.C., & Kahn, R.E. (2014). Annual Research Review: A developmental psychopathology approach to understanding callous‐unemotional traits in children and adolescents with serious conduct problems. Journal of Child Psychology and Psychiatry, 55, 532‐548. Hyde, L.W., Waller, R. and Burt, S.A. (2014). Commentary: Improving treatment for youth with callous‐unemotional traits through the intersection of basic and applied science – reflections on Dadds et al. (2014). Journal of Child Psychology and Psychiatry, 55, 781–783. Reid, M. J., Webster‐Stratton, C., & Baydar, N. (2004). Halting the development of conduct problems in Head Start children: The effects of parent training. Journal of Clinical Child and Adolescent Psychology, 33, 279‐291. Waller, R., Hyde, L.W., Grabell, A., Alves, M.A., & Olson, S.L. (2014). Differential associations of early callous‐
unemotional, ODD, and ADH behaviors: multiple domains within early‐starting conduct problems? Journal of Child Psychology and Psychiatry, in press This brief is a summary of research presented at the 21st World Meeting of the International Society for Research on Aggression. Support for the development of this research brief was provided by the Centers for Disease Control and Prevention (CDC). The findings and conclusions in this brief are those of the authors and do not necessarily represent the official position of the CDC.
This project was supported by Grant #2012‐JF‐FX‐0062 awarded by the Office of Juvenile Justice and Delinquency Prevention, Office of Justice Programs, U.S. Department of Justice. The opinions, findings, and conclusions or recommendations expressed in this publication are those of the author and do not necessarily reflect those of the Department of Justice.asadfsdf