Relatively poor treatment outcomes have been reported for children with conduct problems and high levels of callous-unemotional (CU) traits (e.g., a lack of guilt, a lack of empathy, shallow affect), yet the mechanisms underlying this effect are poorly understood. Recently, growing evidence of aberrant reward/punishment processing in children with CU traits has suggested that punishment-based parenting strategies may be less effective among children with high levels of CU traits. Using a randomized controlled trial (RCT) design we conducted an experimental test of whether CU traits are associated with differential response to reward versus punishment components of evidence-based parent-training interventions for conduct problems. Parents of children (n = 74) aged 3 to 8 years were randomized to either five weeks of reward-based or five weeks of punishment-based parenting strategies, after which time each received the alternative intervention. Contrary to predictions, neither type nor dosage of parent training strategies was found to moderate the relation between CU traits and treatment response. Implications for the treatment of conduct problems in children with high levels of CU traits, and research into mechanisms of behavior change, are discussed.
Are Callous-Unemotional Traits Associated with Differential Response to Reward Versus Punishment Components of Parent-Training? A Randomized Trial