15 Exploring the prevalence of callous-unemotional traits in children and adolescents with asd and their association and significance in relation to conduct problems

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Abstract

Background

Autism Spectrum Disorder (ASD) is a developmental disorder characterised by difficulties in social communication, interaction, restrictive/repetitive behaviours, and sensory processing. Co-morbid neurodevelopmental and psychiatric difficulties are common but can be difficult to identify in young people with ASD. Comorbidities have a significant impact on functioning; the importance of identification and treatment cannot be underestimated. One example is conduct problems (CP), which may be linked to underlying callous-unemotional (CU) traits, conceptualised as atypical emotional processing leading to indifference to the suffering of others. CP observed in children can include behaviour dysregulation and violation of the rights of others and social norms. Only one study has explored the link between CU-traits and ASD, finding a positive correlation in an adolescent-only sample. This study looks at children and adolescents with ASD and utilises specific measures of CP to explore the prevalence of CU-traits and their association with identified CP.

Methods

Questionnaire measures of CU-traits and CP were given to the parents and teachers of 73 children meeting diagnostic criteria for ASD on clinical assessments. These assessments include the Developmental, Dimensional and Diagnostic Interview (3Di) and the Autism Diagnostic Observation Schedule (ADOS). Intelligent Quotient (IQ) was also measured. Measures of CU-traits and CP were the Inventory of Callous-Unemotional Traits, Conduct Disorder Questionnaire, and Strengths and Difficulties Questionnaire.

Results

CU-traits scores were common, normally distributed and unrelated to autism symptom severity and IQ. They were strongly and significantly predictive of CP; a more severe CP indicative of a conduct disorder. These associations between CU-traits and CP persisted when we controlled for confounding variables.

Conclusions

CU-traits appear to represent a key dimension of variability amongst people with autism, and are highly predictive of CP. Young people with autism, and especially those with co-occurring CP should be assessed for CU-traits in order to enhance clinical formulation.

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