The Role of Positive Child-Parent Relationships in Children with Callous-Unemotional Traits

What might be an effective intervention approach with children who exhibit psychopathic-like features? Kochanska and colleagues (2013) have been focusing on callous-unemotional (CU) features, which include low levels of guilt and empathy, disregard for rules, shallow emotions, and fearlessness. CU features in children are predictive of several negative outcomes such as delinquency and externalizing behavior problems (e.g., running away, school problems, aggression, substance use). One potential approach might be to encourage the development of Mutually Responsive Orientation (MRO) or positive affect (e.g., joy and affection) between child and parent. MRO measures the amount of mutually cooperative behaviors that are characterized by warmth, acceptance, and support (Kochanska, 1997). The purpose of the current study was to examine if having a positive child-parent relationship (MRO or positive affect) could reduce the number of future externalizing behavior problems in children with elevated CU features.


A sample of 100 two-parent families in the community with a biological child aged 38 months participated. The design used was longitudinal with assessments collected over 5.5 years. To assess positive qualities of the child-parent relationship both mothers and fathers were observed interacting with their child during several naturalistic contexts (e.g., preparing a snack, play, craft project) when their child was aged 38 and 52 months. Coders viewed the videotapes and gave an overall MRO score (ranging from a low score of 1 to a high score of 5) that reflected the degree of communication, cooperation, and emotion between child and parent. Measures of positive affect (i.e., shared enjoyment) between the child and each parent were also coded from the videotaped interactions. Children were assessed for CU features by having both parents complete the Inventory of Callous-Unemotional traits when the child was 67 months. Over three time periods (67, 80, and 100 months) parents also completed the Child Symptom Inventory-4 to measure symptoms of Oppositional Defiant Disorder (e.g., easily annoyed, often angry, refuses to comply to rules, argues with authority figures) and Conduct Disorder (e.g., often lies, steals, destroys property, bullies others, drug or alcohol use, skipping school). For each parent, scores were averaged across 80 and 100 months to create the outcome measure of externalizing behavior problems.


Overall the children scored low on CU features. Boys scored slightly higher on CU features and engaged in more externalizing behaviors as compared to girls. Children were divided into two groups, a high group in which they had elevated CU features and a low group in which they had few CU features. There were different findings based on data from mothers and fathers with regard to the prediction of mothers’ ratings of externalizing behavior at 80 to 100 months. The low CU group displayed relatively few externalizing problems regardless of child-parent MRO or positive affect scores. However, for children with high CU traits, higher levels of mother-child MRO scores were related to a decrease in externalizing behavior problems. For fathers with high CU children, higher father-child positive shared affect predicted fewer externalizing behavior problems.


Prior studies have found that it is the interplay between a child’s characteristics and the quality of their relationship with their parents that predicts negative and positive outcomes. This study suggests that for children with elevated CU features a highly positive parent-child relationship decreases future problematic behaviors. Children with CU features do pose many challenges to their parents but positive forms of parenting appear to be more successful as compared to a punitive approach. This study examined a low-risk sample of high functioning families in the community. The levels of CU features and externalizing behaviors were much lower than would be found in a clinical sample. However, research by Pasalich, Dadds, Hawes, and Brennan (2011) using an older sample of clinic referred conduct-disordered boys also found that parents’ warmth towards their sons was related to fewer conduct disorder problems. Future research should examine whether parenting interventions that focus on warmth, positive interactions, and rewards are effective methods to treat children with CU features.


Kochanska, G., Kim, S., Boldt, L. J., & Yoon, J. E. (2013). Children’s callous‐unemotional traits moderate links between their positive relationships with parents at preschool age and externalizing behavior problems at early school age. Journal of Child Psychology and Psychiatry, 54, 1251-1260.


Also referenced:

Kochanska, G. (1997b). Mutually responsive orientation between mothers and their young children: Implications for early socialization. Child Development, 68, 94–112.

Pasalich, D.S., Dadds, M.R., Hawes, D.J., & Brennan, J. (2011). Do callous-unemotional traits moderate the relative importance of parental coercion versus warmth in child conduct problems? An observational study. Journal of Child Psychology and Psychiatry, 52, 1308–1315.

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