Predicting Antisocial Behavior: How Callous- Unemotional Traits

165 Pages·2013·0.54 MB·English

Predicting Antisocial Behavior: How Callous-
Unemotional Traits Moderate Common Risk Factors
by
Stephanie Lynne Sebele Bass Daoud
A thesis submitted in conformity with the requirements
for the degree of Doctor of Philosophy
Graduate Department of Psychology
University of Toronto
© Copyright by Stephanie Lynne Sebele Bass Daoud 2013
Predicting Antisocial Behavior: How Callous-Unemotional Traits
Moderate Common Risk Factors
Stephanie Lynne Sebele Bass Daoud
Doctor of Philosophy
Department of Psychology
University of Toronto
2013
Abstract
Callous-unemotional (CU) traits are associated with severe and aggressive youth
antisocial behavior (ASB) and are under consideration as a potential specifier for the
diagnosis of Conduct Disorder in DSM-5 (Frick & Moffitt, 2010). This proposal demands
more inquiry into the impact that CU traits have on behavioral subtypes of youth ASB.
Normal-range personality traits, trait levels of anxiety, and hormonal stress reactivity (i.e.,
changes in the stress hormone, cortisol) are all factors that have been studied extensively in
relation to ASB, but these relationships have not yet been considered in combination with
CU traits. The purpose of the current set of studies was to examine the extent to which CU
traits moderated links between these three factors and both overall and behavioral subtypes
of ASB. In the first study, data were collected on children’s personality, CU traits, and three
behavioral categories of ASB (physical aggression, relational aggression and non-violent
rule-breaking behavior) for community (N = 742) and clinical (N = 183) samples of children.
In the community sample, CU traits moderated links between Neuroticism, Extraversion,
Agreeableness, Openness to Experience and ASB overall and externalizing behaviors,
between Neuroticism, Extraversion and physical aggression and between Agreeableness,
Extraversion and rule-breaking behaviors. In the clinical sample, CU traits moderated the
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link between Agreeableness and externalizing behaviors. In the second study, data were
collected on children’s trait anxiety, CU traits, and the same three behavioral categories of
ASB in a follow-up adolescent community sample (N = 145). Reactivity of cortisol in
response to an unanticipated social stress test was also measured. Results revealed that CU
traits moderated links between trait anxiety and ASB overall, externalizing behaviors and
physical aggression. In females only, CU traits also moderated links between cortisol
reactivity and ASB overall and externalizing behaviors. Combined, the results of these
studies support the proposal that CU traits are a clinically useful diagnostic specifier with
different implications for behavioral subtypes of ASB. Further, the present findings allow
recommendations to be made for future research to further our understanding of the role CU
traits play in CD, and to develop targeted interventions.

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Acknowledgments
I would like to acknowledge the extensive contributions of my supervisor, Dr.
Jennifer Tackett, and to thank her for her guidance and assistance. Further I would like to
thank Dr. Elizabeth Page-Gould and Dr. Anthony Ruocco for their roles as committee
members and for their valuable feedback and support. I would also like to thank the
members of the Tackett Lab for their exceptional work. I would also like to thank Dr.
Susanne Ferber, Dr. Jonathan Freedman, and Dr. Marc Fournier for their contributions. I
would like to thank my family, friends, and colleagues for their invaluable support. Finally, I
would like to acknowledge the funding assistance of the Ontario Mental Health Foundation
and the Government of Ontario.

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Table of Contents
Title Page ......................................................................................................................................... i
Abstract ........................................................................................................................................... ii
Acknowledgments.......................................................................................................................... iv 
Table of Contents ..........................................................................................................................v 
List of Tables ................................................................................................................................. ix 
List of Figures ................................................................................................................................ xi 
Chapter 1 General Introduction .......................................................................................................1 
1.1  Present Goals .......................................................................................................................1 
1.2  CU Trait Characteristics ......................................................................................................3 
1.3  CU Traits as a Specifier for the Diagnosis of Conduct Disorder .........................................5 
1.4  Application of Psychopathy Construct to Youth .................................................................6 
1.5  Development of CU Traits ...................................................................................................7 
1.6  Stability of CU Traits Across Development ......................................................................11 
1.7  Subgroup Identification within Conduct Disorder in the DSM .........................................13 
1.8  CU Traits as an Important Specifier for Conduct Disorder ...............................................14 
1.9  CU Traits as an Important Factor in the Presentation of Antisocial Behavior ..................16 
1.10 CU Traits as an Important Factor for Subtypes of Antisocial Behavior ............................19 
1.11 Interaction of CU Traits with Other Factors Related to Antisocial Behavior ....................23 
1.12 CU Traits and Normal-Range Personality in Relation to Antisocial Behavior .................25 
1.13 CU Traits and Trait Anxiety in Relation to Antisocial Behavior ......................................26 
1.14 CU Traits and Cortisol Reactivity in Relation to Antisocial Behavior ..............................27 
1.15 Current Studies...................................................................................................................28 
Chapter 2 Callous-Unemotional Traits Moderate Links Between Personality and
Antisocial Behavioral Subtypes in Youth Community and Clinical Samples ..........................29 
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2.1.1  Normal-Range Personality and Antisocial Behavior .............................................30 
2.1.2  Normal-Range Personality and Subtypes of Antisocial Behavior .........................31 
2.1.3  Personality and CU Traits ......................................................................................33 
2.1.4  Current Study .........................................................................................................35 
2.2  Methods..............................................................................................................................36 
2.2.1  Participants .............................................................................................................36 
2.2.2  Measures ................................................................................................................37 
2.2.3  Procedure ...............................................................................................................38 
2.3  Results ................................................................................................................................40 
2.3.1  Regressions Predicting Antisocial Behavior in the Community Sample...............41 
2.3.2  Regressions Predicting Antisocial Behavior in the Clinical Sample .....................43 
2.4  Discussion ..........................................................................................................................44 
2.4.1  Neuroticism, CU Traits, and Antisocial Behavior .................................................45 
2.4.2  Extraversion, CU Traits, and Antisocial Behavior ................................................46 
2.4.3  Openness to Experience, CU Traits, and Antisocial Behavior ..............................47 
2.4.4  Agreeableness, CU Traits, and Antisocial Behavior .............................................48 
2.4.5  Conscientiousness, CU Traits, and Antisocial Behavior .......................................49 
2.4.6  Personality, CU Traits, and Relational Aggression ...............................................50 
2.4.7  Limitations .............................................................................................................50 
2.4.8  Implications............................................................................................................51 
2.4.9  Future Directions ...................................................................................................52 
Chapter 3 Callous-Unemotional Traits Moderate Links Between Trait Anxiety, Cortisol
Reactivity, and Antisocial Behavioral Subtypes in an Adolescent Community Sample ..........58 
3.1.1  Trait Anxiety and Antisocial Behavior ..................................................................60 
3.1.2  Trait Anxiety and Subtypes of Antisocial Behavior ..............................................62 
3.1.3  Trait Anxiety and CU Traits ..................................................................................65 
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3.1.4  Cortisol Reactivity and Antisocial Behavior .........................................................68 
3.1.5  Cortisol Reactivity and Subtypes of Antisocial Behavior .....................................71 
3.1.6  Cortisol Reactivity and CU Traits ..........................................................................72 
3.1.7  Current Study .........................................................................................................75 
3.2  Methods..............................................................................................................................77 
3.2.1  Participants .............................................................................................................77 
3.2.2  Measures ................................................................................................................78 
3.2.3  Procedure ...............................................................................................................80 
3.3  Results ................................................................................................................................83 
3.3.1  Regressions Predicting Antisocial Behavior from Trait Anxiety and CU
Traits ......................................................................................................................83 
3.3.2  Regressions Predicting Antisocial Behavior from Cortisol Reactivity
Levels and CU Traits .............................................................................................85 
3.4  Discussion ..........................................................................................................................86 
3.4.1  Trait Anxiety, CU Traits, and Antisocial Behavior ...............................................87 
3.4.2  Cortisol Reactivity, CU Traits, and Antisocial Behavior ......................................90 
3.4.3  Limitations .............................................................................................................93 
3.4.4  Implications............................................................................................................95 
3.4.5  Future Directions ...................................................................................................96 
Chapter 4 General Discussion ......................................................................................................100 
4.1  Present Findings ...............................................................................................................100 
4.1.1  Normal-Range Personality, CU Traits, and Antisocial Behavior ........................100 
4.1.2  Trait Anxiety, Cortisol Reactivity, CU Traits, and Antisocial Behavior .............101 
4.2  Implications for Proposal to use CU Traits as a Specifier in Conduct Disorder .............102 
4.3  Importance of Considering ASB Subtypes ......................................................................104 
4.4  Subtypes within High Levels of CU Traits ......................................................................105 
4.5  Implications for Intervention ...........................................................................................106 
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4.6  Future Directions .............................................................................................................108 
4.6.1  Gender Differences ..............................................................................................109 
4.6.2  Developmental Trends .........................................................................................111 
4.6.3  Additional CU Trait Moderation .........................................................................112 
4.6.4  Beneficial Potential of CU Traits .........................................................................113 
4.6.5  CU Trait Stability .................................................................................................115 
4.6.6  Multiple Informants, Samples and Study Designs ...............................................116 
4.7  Conclusion .......................................................................................................................118 
References ....................................................................................................................................120 

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List of Tables
Table 1. Means, Standard Deviations and Pearson r Correlations with Callous-Unemotional
Traits with the Five Factor Model of Personality and Antisocial Behavior Scores in the
Community and Clinical Samples
Table 2. Multiple Regression Analyses Predicting Externalizing Behaviors, Physical
Aggression, Relational Aggression, and Rule-Breaking Behavior From Personality Traits
Moderated by CU Traits in the Community Sample Using Standardized Scores
Table 3. Multiple Regression Analyses Predicting Externalizing Behaviors, Physical
Aggression, and Rule-Breaking Behavior From Personality Traits Moderated by CU Traits in
the Clinical Sample Using Standardized Scores
Table 4. Means, Standard Deviations and t-test Results Comparing Mail-Only versus Lab
Participants for Callous-Unemotional Traits, Trait Anxiety, Cortisol Reactivity Scores, and
Antisocial Behavior Scores using Parent and Youth Data
Table 5. Means, Standard Deviations and Pearson r Correlations with Callous-Unemotional
Traits with Trait Anxiety, Cortisol Reactivity Scores, and Antisocial Behavior Scores using
Parent and Youth Data.
Table 6. Multiple Regression Analyses Predicting Externalizing Behaviors, Physical
Aggression, Rule-Breaking Behavior, and Relational Aggression From Trait Anxiety
Moderated by CU Traits with Parent Data Using Standardized Scores
Table 7. Multiple Regression Analyses Predicting Externalizing Behaviors, Physical
Aggression, Rule-Breaking Behavior, and Relational Aggression From Trait Anxiety
Moderated by CU Traits with Youth Data Using Standardized Scores
Table 8. Multiple Regression Analyses Predicting Externalizing Behaviors, Physical
Aggression, Rule-Breaking Behavior, and Relational Aggression From Cortisol Reactivity
Scores Moderated by CU Traits for Males with Parent Data Using Standardized Scores
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Table 9. Multiple Regression Analyses Predicting Externalizing Behaviors, Physical
Aggression, Rule-Breaking Behavior, and Relational Aggression From Cortisol Reactivity
Scores Moderated by CU Traits for Females with Parent Data Using Standardized Scores
Table 10. Multiple Regression Analyses Predicting Externalizing Behaviors, Physical
Aggression, Rule-Breaking Behavior, and Relational Aggression From Cortisol Reactivity
Scores Moderated by CU Traits for Males with Youth Data Using Standardized Scores
Table 11. Multiple Regression Analyses Predicting Externalizing Behaviors, Physical
Aggression, Rule-Breaking Behavior, and Relational Aggression From Cortisol Reactivity
Scores Moderated by CU Traits for Females with Youth Data Using Standardized Scores

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