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Practitioner Review: Involving young people with callous unemotional traits in treatment - does it work? A systematic review

Wilkinson, S; Waller, R; Viding, E; (2016) Practitioner Review: Involving young people with callous unemotional traits in treatment - does it work? A systematic review. Jornal of Child Psychology and Psychiatry , 57 (5) pp. 552-565. 10.1111/jcpp.12494. Green open access

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Abstract

BACKGROUND: Children and adolescents with callous unemotional (CU) traits are at risk of severe and persistent antisocial behavior. It is commonly assumed that these children are difficult to treat but it has been proposed that they may benefit from being involved in interventions that go beyond typical parent training programs. This systematic review sought to answer two previously unanswered questions: do interventions involving young people reduce levels of CU traits? Do CU traits predict the effectiveness of interventions for antisocial behavior involving young people? METHOD: Studies were included that adopted an randomized controlled trial, controlled or open trial design and that had examined whether treatment was related to reductions in CU traits or whether CU traits predicted or moderated treatment effectiveness. RESULTS: Treatments used a range of approaches, including behavioral therapy, emotion recognition training, and multimodal interventions. 4/7 studies reported reductions in CU traits following treatment. There was a mixed pattern of findings in 15 studies that examined whether CU traits predicted treatment outcomes following interventions for antisocial behavior. In 7/15 studies, CU traits were associated with worse outcomes, although three of these studies did not provide data on baseline antisocial behavior, making it difficult to evaluate whether children with high CU traits had shown improvements relative to their own behavioral baseline, despite having the worst behavioral outcomes overall. CU traits did not predict outcomes in 7/15 studies. Finally, a single study reported that CU traits predicted an overall increased response to treatment. CONCLUSIONS: Overall, the evidence supports the idea that children with CU traits do show reductions in both their CU traits and their antisocial behavior, but typically begin treatment with poorer premorbid functioning and can still end with higher levels of antisocial behavior. However, there is considerable scope to build on the current evidence base.

Type: Article
Title: Practitioner Review: Involving young people with callous unemotional traits in treatment - does it work? A systematic review
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/jcpp.12494
Publisher version: http://dx.doi.org/10.1111/jcpp.12494
Language: English
Additional information: Copyright © 2016 Association for Child and Adolescent Mental Health. All rights reserved. This is the peer reviewed version of the following Wilkinson, S; Waller, R; Viding, E; (2016) Practitioner Review: Involving young people with callous unemotional traits in treatment - does it work? A systematic review. Jornal of Child Psychology and Psychiatry , 57 (5) pp. 552-565 which has been published in final form at 10.1111/jcpp.12494. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving, http://olabout.wiley.com/WileyCDA/Section/id-820227.html#terms
Keywords: Callous unemotional traits, antisocial behavior, intervention, treatment
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
URI: https://discovery.ucl.ac.uk/id/eprint/1483787
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