Promoting Empathy and Affiliation in Relationships (PEAR) study: protocol for a longitudinal study investigating the development of early childhood callous-unemotional traits

• Published in: BMJ open 2023-10, Vol.13 (10), p.e072742-e072742
• Main Authors: Wagner, Nicholas, Perkins, Emily, Rodriguez, Yuheiry, Ordway, Cora, Flum, Michaela, Hernandez-Pena, Lucia, Perelstein, Polina, Sem, Kathy, Paz, Yael, Plate, Rista, Popoola, Ayomide, Lynch, Sarah, Astone, Kristina, Goldstein, Ethan, Njoroge, Wanjikũ F M, Raine, Adriane, Pincus, Donna, Pérez-Edgar, Koraly, Waller, Rebecca
• Format: Article
• Language: English
• Subjects: Antisocial personality disorder; Antisocial Personality Disorder - etiology; Antisocial Personality Disorder - psychology; Child, Preschool; Childhood; Children & youth; Conduct Disorder - complications; Conduct Disorder - psychology; Data collection; Emotions - physiology; Empathy; Female; Humans; Impulse control disorders; Longitudinal Studies; Male; Mental Health; Parenting - psychology; Parents & parenting; Personality disorders; Physiology; PSYCHIATRY; Psychopathology; Risk factors
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2023-072742

IntroductionChildren with callous-unemotional (CU) traits are at high lifetime risk of antisocial behaviour. Low affiliation (ie, social bonding difficulties) and fearlessness (ie, low threat sensitivity) are proposed risk factors for CU traits. Parenting practices (eg, harshness and low warmth) also predict risk for CU traits. However, few studies in early childhood have identified attentional or physiological markers of low affiliation and fearlessness. Moreover, no studies have tested whether parenting practices are underpinned by low affiliation or fearlessness shared by parents, which could further shape parent–child interactions and exacerbate risk for CU traits. Addressing these questions will inform knowledge of how CU traits develop and isolate novel parent and child targets for future specialised treatments for CU traits.Methods and analysisThe Promoting Empathy and Affiliation in Relationships (PEAR) study aims to establish risk factors for CU traits in children aged 3–6 years. The PEAR study will recruit 500 parent–child dyads from two metropolitan areas of the USA. Parents and children will complete questionnaires, computer tasks and observational assessments, alongside collection of eye-tracking and physiological data, when children are aged 3–4 (time 1) and 5–6 (time 2) years. The moderating roles of child sex, race and ethnicity, family and neighbourhood disadvantage, and parental psychopathology will also be assessed. Study aims will be addressed using structural equation modelling, which will allow for flexible characterisation of low affiliation, fearlessness and parenting practices as risk factors for CU traits across multiple domains.Ethics and disseminationEthical approval was granted by Boston University (#6158E) and the University of Pennsylvania (#850638). Results will be disseminated through conferences and open-access publications. All study and task materials will be made freely available on lab websites and through the Open Science Framework (OSF).