Project Summary/Abstract Callous-unemotional (CU) traits, defined by low empathy, guilt, and prosociality, predict very high risk for childhood disruptive behavior disorders (DBD) and adverse adult outcomes, including violence, psychopathy, and crime. Standard treatments for DBD are not as effective for children with CU traits. To inform personalized treatments for DBD, a better understanding is needed of specific risk factors for CU traits beginning early in childhood. The overall objectives of this proposal are to identify specific child-level and parenting-level risk factors that predict CU traits across early childhood. The central hypothesis is that reduced sensitivity to cues of threat and affiliation will specifically predict CU traits. High parental harshness, low warmth, and low emotion scaffolding are also hypothesized to predict increases in CU traits, including via interactions with low threat sensitivity and affiliation among both parents and children. The rationale for the proposal is that by successfully isolating specific child- and parenting-level risk factors that predict CU traits, novel treatment strategies can be developed to reduce CU traits, and in turn, disrupt pathways to DBDs, including via multi-level treatment modules that target behavior, physiology, and attention. The hypotheses will be tested by pursuing the following specific aims: (1) Establish phenotypic markers of CU traits in early childhood; (2) Establish phenotypic markers of parenting practices; and (3) Illuminate shared temperament and parenting factors that predict CU traits. All three aims will be pursued within a prospective longitudinal study. Participants (N=500) will be recruited from community and clinical settings at the University of Pennsylvania (n=250) and Boston University (n=250) and assessed at time 1 (aged 3–4) and time 2 (aged 5-6). Under the first aim, low threat sensitivity and affiliation will be tested as child- level risk factors for CU traits across multiple levels of analysis, including parent-report and multiple new computer and observational tasks that allow simultaneous measurement of attentional (i.e., eye-tracking) and physiological (i.e., respiratory sinus arrythmia) processes. Under the second aim, low threat sensitivity and affiliation of parents, assessed again across multiple levels of analysis, will be tested as predictors of different parenting dimensions of harshness, low warmth, and low emotion scaffolding. Under the third aim, the interplay of parenting behaviors and shared temperament features of parents and children will be tested as dyadic risk factors for CU traits. The proposal is innovative because it will generate new measures of precision risk factors that predict CU traits, is guided by extensive preliminary data, hypotheses are tested during a critical developmental period for understanding CU traits, and the sophisticated quantitative analysis incorporates a rich multi-method measurement framework that will generate new knowledge about the biological, cognitive, social, and emotional processes underlying CU traits. The proposed research is significant because it will identify biomarkers and behavioral indicators of illness (NIMH Priority 2.2) and lead to improved capacity to operationalize specific risk factors to target in interventions to mitigate risky pathways to CU traits and DBD.

Project Narrative The proposed research is relevant to public health because it focuses on establishing child-level and parent- level risk factors in early childhood that specifically predict increases in callous-unemotional (CU) traits, which confer very high risk for disruptive behavior disorders (DBD) in childhood, including aggression, violence, and theft. Once these specific risk factors are identified, treatments and interventions for DBD can be personalized and made more effective to reduce CU traits and risk for DBD. Thus, the proposed research is relevant to the NIMH’s strategic plan to identify clinically useful biomarkers and behavioral indicators of risk for psychopathology and identify and validate new targets for treatment development.