Exploring the Prevalence of Callous-Unemotional Traits in Young People with Autism and Their Association with Conduct Problems

Poster Presentation
Saturday, May 12, 2018: 11:30 AM-1:30 PM
Hall Grote Zaal (de Doelen ICC Rotterdam)
Y. Mahadevan1, W. Mandy2, A. McKenna3, K. Stevenson3, M. Bindman3, M. Murin4 and D. H. Skuse5, (1)UCL, London, United Kingdom, (2)University College London, London, United Kingdom of Great Britain and Northern Ireland, (3)Great Ormond Street Hospital, London, United Kingdom, (4)Great Ormond Street Hospital for Children, London, United Kingdom of Great Britain and Northern Ireland, (5)Behavioural and Brain Sciences Unit, Population Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom

Most autistic children and adolescents experience additional neurodevelopmental, behavioural and mental health difficulties, and these have a significant impact on their wellbeing and functioning. Identifying and understanding such co-occuring difficulties is therefore of the upmost importance. Conduct problems are common amongst autistic youths, but the mechanisms underlying these are not currently well understood, which limits efficacy of treatment. One possibility is that in some instances, conduct problems may reflect the presence of callous-unemotional (CU) traits, conceptualised as atypical emotional processing leading to indifference to the suffering of others. To date, only one study has explored the link between CU-traits and ASD, finding a positive correlation in an adolescent-only sample. However, the potential role played by CU traits in the development of conduct problems of autistic young people has not been investigated.


To use gold-standard measures to investigate: (1) the prevalence of CU traits amongst a clinical population of autistic children and adolescents; and (2) the association between CU traits and conduct problems in autistic young people.


Participants were 80 children and adolescents meeting diagnostic criteria for autism spectrum disorder who had IQs in the normal range. Autistic symptoms were measured using the Developmental, Dimensional and Diagnostic Interview (3Di) and the Autism Diagnostic Observation Schedule, Second Edition (ADOS-II). IQ was measured using Wechsler Scales. CU-traits were quantified with parent and teacher versions of the Inventory of Callous-Unemotional Traits. Conduct problems were assessed using DSM checklists, and the Strengths and Difficulties Questionnaire.


In this sample of autistic children and adolescents, CU-traits scores were common, normally distributed and unrelated to autism symptom severity and IQ. They were strongly and significantly predictive of oppositional behaviours and emotional dysregulation. In addition they were significantly associated with more severe conduct problems indicative of a conduct disorder, including bullying, stealing and lying. These associations between CU-traits and conduct problems persisted when we controlled for autism symptom severity, IQ and symptoms of attention deficit/hyperactivity disorder.


CU-traits appear to represent a key dimension of variability amongst autistic children and adolescents, and are highly predictive of conduct problems. Autistic young people, and especially those with co-occurring conduct problems, should be assessed for CU-traits in order to enhance clinical formulation.