Association between childhood maltreatment and callous-unemotional traits in youth: A meta-analysis

• Published in: Neuroscience and biobehavioral reviews 2023-03, Vol.146, p.105049-105049, Article 105049
• Main Authors: Todorov, Jessica J., Devine, Rory T., De Brito, Stephane A.
• Format: Article
• Language: English
• Subjects: Adolescent; Aggression - psychology; Antisocial Personality Disorder - psychology; Callous-unemotional traits; Child; Child Abuse - psychology; Child, Preschool; Childhood maltreatment; Conduct Disorder - psychology; Conduct problems; Copper; Emotions; Empathy; Female; Humans; Interpersonal trauma; Male; Prospective Studies; Psychopathy
• ISSN: 0149-7634; 1873-7528
• DOI: 10.1016/j.neubiorev.2023.105049

Callous-unemotional (CU) traits (i.e., lack of remorse or guilt, callous lack of empathy, deficient concern for the feelings of others) in youth with conduct problems confer risk for a particularly severe and persistent form of antisocial behaviour. Previous research has linked childhood maltreatment as a potential risk factor for CU traits, both primary (i.e., genetically underpinned) and secondary (i.e., environmentally influenced) variants, but findings have been inconsistent, and the association has not yet been tested in a meta-analysis. To address this gap, we conducted a meta-analysis to assess the nature and strength of the associations between childhood maltreatment and its subtypes with CU traits and potential variants (i.e., primary and secondary CU traits). A systematic search identified 29 eligible studies including 9,894 participants (42% female) between the ages of 3 and 18 years (Mage=14.22 years, SD = 1.07). Results revealed a significant moderate positive association between childhood maltreatment and CU traits. All subtypes of maltreatment bar sexual abuse were significantly associated with CU traits. However, it was not possible to compare primary and secondary CU traits directly due to inconsistencies in how they are defined. The limitations posed by current research signal the need for clinical and operational guidelines on how to define primary and secondary CU traits. Additionally, prospective longitudinal, genetically informed research is needed to clarify if maltreatment is a causal risk factor for CU traits. •Across 29 included studies (N = 9,894), we found a moderate, r = .23, significant association between overall childhood maltreatment and CU traits. Except for sexual abuse, all associations for the maltreatment subtypes were moderate and significant: physical abuse, r = .17, emotional abuse, r = .22, physical neglect, r = .23, and emotional neglect, r = .21.•Importantly, our third and fourth preregistered aims could not be explored due to inconsistencies in identifying and measuring variants of CU subgroups. Specifically, by defining variants of CU traits using putative causal or risk factors (e.g., maltreatment) rather than a phenotypical feature (e.g., anxiety) it was not possible to systematically assess the nature and the strength of the association between childhood maltreatment and CU trait variants. This is an important limitation of the current evidence base, which our meta-analysis is the first to highlight and disc