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The current study examines the role of callous/unemotional (CU) traits in response to treatment among children with conduct problems (CP) and attention-deficit/hyperactivity disorder (ADHD). Fifty-four children with CP/ADHD and 16 controls (age = 9.48, SD = 1.58) took part in a summer treatment and research program. Simple correlations showed that CU and CP were associated with a number of treatment outcome measures. When examined together in regression analyses, CU and CP were uniquely associated with three treatment outcomes each (CU-improvement in social skills and problem solving, negative behaviors in time-out; CP-time-outs per day, peer ratings, peer dislike). The implications for these findings with regard to treatment response in children with CP/ADHD with and without CU traits are explored.

This study examined whether response to behavior modification with and without methylphenidate differed for children with attention-deficit/hyperactivity disorder (ADHD) and conduct problems (CP) depending on the presence of callous/unemotional (CU) traits. Participants were 37 children ages 7 to 12, including 19 with ADHD/CP-only and 18 with ADHD/CP-CU, referred to a university-based summer treatment program. Results showed that ADHD/CP-CU children had worse behavior in the behavior-therapy-only (BT-only) condition, especially on measures of CP, noncompliance, and rule violations, but these differences largely disappeared when medication was added to BT. Children with ADHD/CP-CU were also less likely to be normalized by treatment than were children with ADHD/CP-only. These findings, though tentative, suggest that children with ADHD/CP-CU may not show a sufficient positive response to BT alone and that the combination of medication and BT may be especially important for them.

This study examined the association between social problem solving, conduct problems (CP), and callous-unemotional (CU) traits in elementary age children. Participants were 53 children (40 boys and 13 girls) aged 7-12 years. Social problem solving was evaluated using the Social Problem Solving Test-Revised, which requires children to produce solutions to eight hypothetical social problems, including five problems involving acquiring a desired object and three problems gaining access to a peer. Regression analyses showed that greater frequency of CP symptoms was associated with producing less flexible, relevant, and prosocial solutions and more overtly aggressive solutions. However, this pattern was present only when CU traits were low. Results add to a growing body of literature demonstrating that CU traits are an important moderator of CP in children.