Are Callous-Unemotional Traits Associated with Differential Response to Reward Versus Punishment Components of Parent-Training? A Randomized Trial

ABSTRACT

Relatively poor treatment outcomes have been reported for children with conduct problems (CPs) and high levels of callous-unemotional (CU) traits (e.g., a lack of guilt, a lack of empathy, shallow affect), yet the mechanisms underlying this effect are poorly understood. Recently, growing evidence of aberrant reward/punishment processing in children with CU traits has suggested that punishment-based parenting strategies may be less effective among children with high levels of CU traits. Using a randomized controlled trial design, we conducted an experimental test of whether CU traits are associated with differential response to reward versus punishment components of evidence-based parent-training interventions for CPs. Parents of children (n = 74) 3 to 8 years of age were randomized to either 5 weeks of reward-based or 5 weeks of punishment-based parenting strategies, after which time each received the alternative intervention. Contrary to predictions, neither type nor dosage of parent training strategies was found to moderate the relation between CU traits and treatment response. Implications for the treatment of CPs in children with high levels of CU traits, and research into mechanisms of behavior change, are discussed.

Acknowledgments

We thank Amanda Andreazza for her assistance in editing the manuscript for readability and clarity.

Additional information

Funding

During the preparation of this manuscript, Camilo Ortiz was supported by the National Institute of Mental Health Career Development Research Award (1 K01 MH067099).