Category: Child / Adolescent - Externalizing

PS11- #C67 - Callous-Unemotional Traits in Girls Referred for Treatment of Aggressive Behavior

Saturday, Nov 18
12:15 PM – 1:15 PM
Location: Indigo Ballroom CDGH, Level 2, Indigo Level

Keywords: Aggression / Disruptive Behaviors / Conduct Problems | Gender | Comorbidity

Background: Childhood disruptive behaviors such as aggression and irritability are among the most frequent reasons for mental health treatment. Aggression is a core symptom of disruptive behavior disorders and it can also be present in other childhood disorders, such as ADHD and anxiety. In addition, severity of aggression in childhood might be exacerbated by the presence of callous-unemotional (CU) traits. Despite the known differences in the prevalence rates and developmental trajectories of aggressive behavior in boys relative to girls, little is known about the gender differences in the types and correlates of aggression. Thus, we examined gender differences in the profiles of associations of aggression with hyperactivity, anxiety and CU traits, in a sample of children seeking treatment for aggressive behavior.



Methods:  Sample included 169 children, 51 girls and 118 boys, in the age range from 8 to 16 years (mean =11.5, SD =2.4) who were seeking treatment for disruptive behavior as part of a research study in a university setting. Parents completed the CBCL aggressive behavior scale (Achenbach, 2001), Affective Reactivity Index (ARI; Stringaris et al., 2012), Inventory of Callous-Unemotional Traits (ICU; Frick, 2003), The SNAP-IV ADHD scale (MTA cooperative group 1999), and the Multidimensional Anxiety Scale for Children (MASC-2; March, 2013).



Results: Boys and girls showed similar levels of severity on the parent ratings of aggression, irritability, ADHD symptoms and CU traits.  However, there were different patterns of correlations of aggression with these characteristics. Thus, in boys, aggression was positively and significantly correlated with hyperactivity (r=0.46, p < 0.001), inattention (r=0.29, p < 0.01), irritability (r=0.40, p < 0.001), and CU traits (r=0.46, p < 0.01). In girls, aggression was correlated only with CU traits (r=0.43, p < 0.01).  Fisher r-to-z transformation showed that the magnitude of correlation coefficients between aggression and hyperactivity was significantly different in boys and girls (z=2.43, p < 0.01). CU traits were also inversely correlated with anxiety in girls (r=-0.34, p < 0.05), but not in boys with aggressive behavior (r=-.012, p=0.26).  



Conclusions: In a sample of children seeking treatment for aggressive behavior, there were no gender differences in severity of aggression. However, there were important gender differences in the correlates of aggression. Thus, in boys, aggression was positively associated with symptoms of ADHD, irritability and CU traits. In girls aggression was associated only with CU traits.  Given that callous-unemotional traits can be associated with poorer response to behavioral interventions for aggression, our finding of the unique association of aggression with CU traits but not with the other dimensions of psychopathology highlights the importance of addressing CU traits during the assessment and treatment of aggression in girls.

Theresa R. Gladstone

Postgraduate Fellow
Yale Child Study Center, Yale School of Medicine

Emilie Bertschinger

Postgraduate Fellow
Yale Child Study Center, Yale School of Medicine
New Haven, Connecticut

Shivani A. Kaushal

Postgraduate Fellow
Yale Child Study Center, Yale School of Medicine

Megan E. Tudor

Assistant Clinical Professor
MIND Institute, University of California, Davis
New Haven, Connecticut

Justyna Piasecka

Clinical Fellow
Yale Child Study Center, Yale School of Medicine

Denis G. Sukhodolsky

Associate Professor
Yale Child Study Center, Yale School of Medicine
New Haven, Connecticut