Maltreatment and parenting in youth with primary and secondary callous‐unemotional traits: Anxiety matters

Background Youth with conduct disorder (CD) and high callous‐unemotional (CU) traits are not a homogenous group and can be disaggregated into primary and secondary subgroups. However, there are inconsistencies in defining primary and secondary subgroups, with some studies using anxiety, others using...

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Published inJCPP advances Vol. 5; no. 2; pp. e12266 - n/a
Main Authors Todorov, Jessica J., Kohls, Gregor, Pauli, Ruth, Rogers, Jack, Bernhard, Anka, Ackermann, Katharina, Raschle, Nora M., Dugre, Jules R., Fernandez‐Rivas, Aranzazu, Gonzalez‐Torres, Miguel Angel, Hervas, Amaia, Smaragdi, Areti, Gonzalez, Karen, Vetró, Ágnes, Dikeos, Dimitris, Popma, Arne, Stadler, Christina, Konrad, Kerstin, Freitag, Christine M., Fairchild, Graeme, Devine, Rory T., De Brito, Stephane A.
Format Journal Article
LanguageEnglish
Published United States John Wiley and Sons Inc 01.06.2025
Wiley
Subjects
anxiety
callous‐unemotional traits
conduct disorder
FemNAT‐CD
maltreatment
Original
parenting
primary and secondary CU traits
maltreatment
anxiety
primary and secondary CU traits
callous‐unemotional traits
conduct disorder
FemNAT‐CD
parenting
Online AccessGet full text
ISSN2692-9384
2692-9384
DOI10.1002/jcv2.12266

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Abstract Background Youth with conduct disorder (CD) and high callous‐unemotional (CU) traits are not a homogenous group and can be disaggregated into primary and secondary subgroups. However, there are inconsistencies in defining primary and secondary subgroups, with some studies using anxiety, others using maltreatment and still others using both features to identify subgroups. There is a paucity of work comparing primary and secondary subgroups with typically developing (TD) youth on experiences of maltreatment and parenting as well as a lack of studies investigating sex differences. Methods In a large sample of TD youth (n = 946, 66% female) and youth with CD (n = 885, 60% female), we used latent profile analysis in youth with CD aged between 9 and 18 years to address four aims: (i) to demonstrate how primary and secondary subgroup membership differs when anxiety, maltreatment, or both are used as continuous indicators, (ii) to compare primary and secondary subgroups with TD youth on abuse and neglect measures, and (iii) to compare primary and secondary subgroups with TD youth on parenting experiences, and (iv) to examine whether the results were consistent across sexes. Results Anxiety without maltreatment yielded the best fitting and most theoretically interpretable classification of primary and secondary subgroups across both sexes (Bayesian information criterion = 17832.33, Entropy = 0.75, Lo‐Mendell‐Rubin: p < 0.01). Compared with TD youth, youth with primary and secondary CU traits experienced greater levels of abuse and neglect (p < 0.001, η2p = 0.04−0.16) and maladaptive parenting practices (p < 0.001, η2p = 0.04−0.13). Youth with primary and secondary CU traits were equally high on levels of abuse, neglect, and maladaptive parenting (all p values >0.05). Conclusions We provide evidence that anxiety and maltreatment cannot be used interchangeably to identify youth with primary versus secondary CU traits. Anxiey yielded the best fitting and most theoretically interpretable classifications across both sexes. Our results signify the need for researchers and clinicians to adopt a unified approach to defining primary and secondary subgroups of CU traits using anxiety in both sexes. We investigated latent classes of typically developing youth with subgroups of primary and secondary callous‐unemotional youth. Sex differences were also explored. The groups were then compared on maltreatment histories (abuse and neglect) and experiences of parenting.
AbstractList We investigated latent classes of typically developing youth with subgroups of primary and secondary callous‐unemotional youth. Sex differences were also explored. The groups were then compared on maltreatment histories (abuse and neglect) and experiences of parenting.
Youth with conduct disorder (CD) and high callous-unemotional (CU) traits are not a homogenous group and can be disaggregated into primary and secondary subgroups. However, there are inconsistencies in defining primary and secondary subgroups, with some studies using anxiety, others using maltreatment and still others using both features to identify subgroups. There is a paucity of work comparing primary and secondary subgroups with typically developing (TD) youth on experiences of maltreatment and parenting as well as a lack of studies investigating sex differences.BackgroundYouth with conduct disorder (CD) and high callous-unemotional (CU) traits are not a homogenous group and can be disaggregated into primary and secondary subgroups. However, there are inconsistencies in defining primary and secondary subgroups, with some studies using anxiety, others using maltreatment and still others using both features to identify subgroups. There is a paucity of work comparing primary and secondary subgroups with typically developing (TD) youth on experiences of maltreatment and parenting as well as a lack of studies investigating sex differences.In a large sample of TD youth (n = 946, 66% female) and youth with CD (n = 885, 60% female), we used latent profile analysis in youth with CD aged between 9 and 18 years to address four aims: (i) to demonstrate how primary and secondary subgroup membership differs when anxiety, maltreatment, or both are used as continuous indicators, (ii) to compare primary and secondary subgroups with TD youth on abuse and neglect measures, and (iii) to compare primary and secondary subgroups with TD youth on parenting experiences, and (iv) to examine whether the results were consistent across sexes.MethodsIn a large sample of TD youth (n = 946, 66% female) and youth with CD (n = 885, 60% female), we used latent profile analysis in youth with CD aged between 9 and 18 years to address four aims: (i) to demonstrate how primary and secondary subgroup membership differs when anxiety, maltreatment, or both are used as continuous indicators, (ii) to compare primary and secondary subgroups with TD youth on abuse and neglect measures, and (iii) to compare primary and secondary subgroups with TD youth on parenting experiences, and (iv) to examine whether the results were consistent across sexes.Anxiety without maltreatment yielded the best fitting and most theoretically interpretable classification of primary and secondary subgroups across both sexes (Bayesian information criterion = 17832.33, Entropy = 0.75, Lo-Mendell-Rubin: p < 0.01). Compared with TD youth, youth with primary and secondary CU traits experienced greater levels of abuse and neglect (p < 0.001, η 2 p = 0.04-0.16) and maladaptive parenting practices (p < 0.001, η 2 p = 0.04-0.13). Youth with primary and secondary CU traits were equally high on levels of abuse, neglect, and maladaptive parenting (all p values >0.05).ResultsAnxiety without maltreatment yielded the best fitting and most theoretically interpretable classification of primary and secondary subgroups across both sexes (Bayesian information criterion = 17832.33, Entropy = 0.75, Lo-Mendell-Rubin: p < 0.01). Compared with TD youth, youth with primary and secondary CU traits experienced greater levels of abuse and neglect (p < 0.001, η 2 p = 0.04-0.16) and maladaptive parenting practices (p < 0.001, η 2 p = 0.04-0.13). Youth with primary and secondary CU traits were equally high on levels of abuse, neglect, and maladaptive parenting (all p values >0.05).We provide evidence that anxiety and maltreatment cannot be used interchangeably to identify youth with primary versus secondary CU traits. Anxiey yielded the best fitting and most theoretically interpretable classifications across both sexes. Our results signify the need for researchers and clinicians to adopt a unified approach to defining primary and secondary subgroups of CU traits using anxiety in both sexes.ConclusionsWe provide evidence that anxiety and maltreatment cannot be used interchangeably to identify youth with primary versus secondary CU traits. Anxiey yielded the best fitting and most theoretically interpretable classifications across both sexes. Our results signify the need for researchers and clinicians to adopt a unified approach to defining primary and secondary subgroups of CU traits using anxiety in both sexes.
Background Youth with conduct disorder (CD) and high callous‐unemotional (CU) traits are not a homogenous group and can be disaggregated into primary and secondary subgroups. However, there are inconsistencies in defining primary and secondary subgroups, with some studies using anxiety, others using maltreatment and still others using both features to identify subgroups. There is a paucity of work comparing primary and secondary subgroups with typically developing (TD) youth on experiences of maltreatment and parenting as well as a lack of studies investigating sex differences. Methods In a large sample of TD youth (n = 946, 66% female) and youth with CD (n = 885, 60% female), we used latent profile analysis in youth with CD aged between 9 and 18 years to address four aims: (i) to demonstrate how primary and secondary subgroup membership differs when anxiety, maltreatment, or both are used as continuous indicators, (ii) to compare primary and secondary subgroups with TD youth on abuse and neglect measures, and (iii) to compare primary and secondary subgroups with TD youth on parenting experiences, and (iv) to examine whether the results were consistent across sexes. Results Anxiety without maltreatment yielded the best fitting and most theoretically interpretable classification of primary and secondary subgroups across both sexes (Bayesian information criterion = 17832.33, Entropy = 0.75, Lo‐Mendell‐Rubin: p < 0.01). Compared with TD youth, youth with primary and secondary CU traits experienced greater levels of abuse and neglect (p < 0.001, η2p = 0.04−0.16) and maladaptive parenting practices (p < 0.001, η2p = 0.04−0.13). Youth with primary and secondary CU traits were equally high on levels of abuse, neglect, and maladaptive parenting (all p values >0.05). Conclusions We provide evidence that anxiety and maltreatment cannot be used interchangeably to identify youth with primary versus secondary CU traits. Anxiey yielded the best fitting and most theoretically interpretable classifications across both sexes. Our results signify the need for researchers and clinicians to adopt a unified approach to defining primary and secondary subgroups of CU traits using anxiety in both sexes. We investigated latent classes of typically developing youth with subgroups of primary and secondary callous‐unemotional youth. Sex differences were also explored. The groups were then compared on maltreatment histories (abuse and neglect) and experiences of parenting.
Abstract Background Youth with conduct disorder (CD) and high callous‐unemotional (CU) traits are not a homogenous group and can be disaggregated into primary and secondary subgroups. However, there are inconsistencies in defining primary and secondary subgroups, with some studies using anxiety, others using maltreatment and still others using both features to identify subgroups. There is a paucity of work comparing primary and secondary subgroups with typically developing (TD) youth on experiences of maltreatment and parenting as well as a lack of studies investigating sex differences. Methods In a large sample of TD youth (n = 946, 66% female) and youth with CD (n = 885, 60% female), we used latent profile analysis in youth with CD aged between 9 and 18 years to address four aims: (i) to demonstrate how primary and secondary subgroup membership differs when anxiety, maltreatment, or both are used as continuous indicators, (ii) to compare primary and secondary subgroups with TD youth on abuse and neglect measures, and (iii) to compare primary and secondary subgroups with TD youth on parenting experiences, and (iv) to examine whether the results were consistent across sexes. Results Anxiety without maltreatment yielded the best fitting and most theoretically interpretable classification of primary and secondary subgroups across both sexes (Bayesian information criterion = 17832.33, Entropy = 0.75, Lo‐Mendell‐Rubin: p < 0.01). Compared with TD youth, youth with primary and secondary CU traits experienced greater levels of abuse and neglect (p < 0.001, η2p = 0.04−0.16) and maladaptive parenting practices (p < 0.001, η2p = 0.04−0.13). Youth with primary and secondary CU traits were equally high on levels of abuse, neglect, and maladaptive parenting (all p values >0.05). Conclusions We provide evidence that anxiety and maltreatment cannot be used interchangeably to identify youth with primary versus secondary CU traits. Anxiey yielded the best fitting and most theoretically interpretable classifications across both sexes. Our results signify the need for researchers and clinicians to adopt a unified approach to defining primary and secondary subgroups of CU traits using anxiety in both sexes.
Youth with conduct disorder (CD) and high callous-unemotional (CU) traits are not a homogenous group and can be disaggregated into primary and secondary subgroups. However, there are inconsistencies in defining primary and secondary subgroups, with some studies using anxiety, others using maltreatment and still others using both features to identify subgroups. There is a paucity of work comparing primary and secondary subgroups with typically developing (TD) youth on experiences of maltreatment and parenting as well as a lack of studies investigating sex differences. In a large sample of TD youth (  = 946, 66% female) and youth with CD (  = 885, 60% female), we used latent profile analysis in youth with CD aged between 9 and 18 years to address four aims: (i) to demonstrate how primary and secondary subgroup membership differs when anxiety, maltreatment, or both are used as continuous indicators, (ii) to compare primary and secondary subgroups with TD youth on abuse and neglect measures, and (iii) to compare primary and secondary subgroups with TD youth on parenting experiences, and (iv) to examine whether the results were consistent across sexes. Anxiety without maltreatment yielded the best fitting and most theoretically interpretable classification of primary and secondary subgroups across both sexes (Bayesian information criterion = 17832.33, Entropy = 0.75, Lo-Mendell-Rubin:  < 0.01). Compared with TD youth, youth with primary and secondary CU traits experienced greater levels of abuse and neglect (  < 0.001,  = 0.04-0.16) and maladaptive parenting practices (  < 0.001,  = 0.04-0.13). Youth with primary and secondary CU traits were equally high on levels of abuse, neglect, and maladaptive parenting (all values >0.05). We provide evidence that anxiety and maltreatment cannot be used interchangeably to identify youth with primary versus secondary CU traits. Anxiey yielded the best fitting and most theoretically interpretable classifications across both sexes. Our results signify the need for researchers and clinicians to adopt a unified approach to defining primary and secondary subgroups of CU traits using anxiety in both sexes.
Author Fernandez‐Rivas, Aranzazu
Gonzalez‐Torres, Miguel Angel
Rogers, Jack
Smaragdi, Areti
Stadler, Christina
Kohls, Gregor
Hervas, Amaia
Raschle, Nora M.
Dikeos, Dimitris
Devine, Rory T.
De Brito, Stephane A.
Bernhard, Anka
Pauli, Ruth
Gonzalez, Karen
Dugre, Jules R.
Popma, Arne
Ackermann, Katharina
Konrad, Kerstin
Freitag, Christine M.
Todorov, Jessica J.
Vetró, Ágnes
Fairchild, Graeme
AuthorAffiliation 14 Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy Child Neuropsychology Section RWTH Aachen University Aachen Germany
13 Department of Child and Adolescent Psychiatry Psychiatric University Hospital University of Basel Basel Switzerland
3 Institute for Mental Health School of Psychology University of Birmingham Birmingham UK
6 Psychiatric Service Basurto University Hospital Bilbao Spain
10 Child and Adolescent Psychiatry Department Pediatrics and Child Health Center University of Szeged Szeged Hungary
5 Jacobs Center for Productive Youth Development University of Zurich Zurich Switzerland
8 Child Development Institute Toronto Ontario Canada
4 Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy University Hospital Frankfurt Goethe University Frankfurt am Main Germany
11 Child and Adolescent Unit of the 1st Department of Psychiatry National and Kapodistrian University of Athens Athens Greece
12 Department of Child and Adolescent Psychia
AuthorAffiliation_xml – name: 11 Child and Adolescent Unit of the 1st Department of Psychiatry National and Kapodistrian University of Athens Athens Greece
– name: 2 Department of Child and Adolescent Psychiatry and Psychotherapy Faculty of Medicine Technische Universität Dresden Dresden Germany
– name: 1 Centre for Human Brain Health School of Psychology University of Birmingham Birmingham UK
– name: 12 Department of Child and Adolescent Psychiatry VU University Medical Center Amsterdam The Netherlands
– name: 4 Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy University Hospital Frankfurt Goethe University Frankfurt am Main Germany
– name: 7 Child and Adolescent Mental Health Service University Hospital Mutua Terrassa Barcelona Spain
– name: 18 Centre for Neurogenetics University of Birmingham Birmingham UK
– name: 14 Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy Child Neuropsychology Section RWTH Aachen University Aachen Germany
– name: 17 Centre for Developmental Science School of Psychology University of Birmingham Birmingham UK
– name: 6 Psychiatric Service Basurto University Hospital Bilbao Spain
– name: 3 Institute for Mental Health School of Psychology University of Birmingham Birmingham UK
– name: 9 Department of Psychology Middlesex University London England
– name: 10 Child and Adolescent Psychiatry Department Pediatrics and Child Health Center University of Szeged Szeged Hungary
– name: 16 Department of Psychology University of Bath Bath UK
– name: 15 JARA‐Brain Institute II Molecular Neuroscience and Neuroimaging RWTH Aachen & Research Centre Juelich Juelich Germany
– name: 8 Child Development Institute Toronto Ontario Canada
– name: 13 Department of Child and Adolescent Psychiatry Psychiatric University Hospital University of Basel Basel Switzerland
– name: 5 Jacobs Center for Productive Youth Development University of Zurich Zurich Switzerland
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  email: s.a.debrito@bham.ac.uk
  organization: University of Birmingham
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Issue 2
Keywords maltreatment
anxiety
primary and secondary CU traits
callous‐unemotional traits
conduct disorder
FemNAT‐CD
parenting
Language English
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Snippet Background Youth with conduct disorder (CD) and high callous‐unemotional (CU) traits are not a homogenous group and can be disaggregated into primary and...
Youth with conduct disorder (CD) and high callous-unemotional (CU) traits are not a homogenous group and can be disaggregated into primary and secondary...
We investigated latent classes of typically developing youth with subgroups of primary and secondary callous‐unemotional youth. Sex differences were also...
Abstract Background Youth with conduct disorder (CD) and high callous‐unemotional (CU) traits are not a homogenous group and can be disaggregated into primary...
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SubjectTerms anxiety
callous‐unemotional traits
conduct disorder
FemNAT‐CD
maltreatment
Original
parenting
primary and secondary CU traits
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Title Maltreatment and parenting in youth with primary and secondary callous‐unemotional traits: Anxiety matters
URI https://onlinelibrary.wiley.com/doi/abs/10.1002%2Fjcv2.12266
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