Anxiety and Callous-Unemotional Traits: Physiological and Behavioral Responses to Others\u27 Distress

Research documents considerable anxiety-related heterogeneity in youth with callous-unemotional traits (CU), a pattern of callousness and shallow emotionality (Frick & Ellis, 1999) associated with lasting impairment (Fontaine et al., 2011). This heterogeneity may relate to behavioral differences, with the presence of both CU and anxiety associated with increased questionnaire-based reports of aggression and/or historical documentations of past aggression (Kahn et al., 2013). Anxiety in CU youth is associated with greater attention to others\u27 distress cues (Kimonis et al., 2012) compared to CU-only counterparts, in contrast to the decreased distress-cue attentiveness thought to contribute to aggression in CU youth (Dadds et al., 2011). Through its association with improvements in CU youths\u27 ability to detect others\u27 distress, anxiety may heighten autonomic activity associated with emotional processing, in contrast to the dampened autonomic activity observed in CU youth (de Wied et al., 2012). It is possible that CU associations with distress-cue recognition and parasympathetic-based emotion-regulation vary as a function of anxiety, and in turn are associated with aggression. The present study, conducted with a sample of youth ages 7–13 (N=45), incorporated laboratory tasks and self- and caregiver-report questionnaires to assess the extent to which child anxiety, traumatic stress, CU, and their interactions, predict observed aggressive behavior toward other children and perceptions of others\u27 emotions while experimentally manipulating distress-cue salience. Exploratory analyses considered parasympathetic activity that may associate with observed relationships. Overall, results align with non-experimental research suggesting that CU is associated with greater aggression in the presence of anxiety (Fanti et al., 2013), and clarify that anxiety moderates the effect of CU on aggression, but only in the absence of distress cues from a potential victim. Results also hint that relationships between anxiety and parasympathetic responses to others\u27 distress may help explain anxiety-related heterogeneity in CU youths\u27 aggression. Findings suggest that children with CU and anxiety may benefit from emotional training to anticipate others\u27 distress and identify distress cues. In aggressive situations involving these youth, increasing others\u27 distress-cue salience may attenuate violence. Future research must further investigate emotional processing deficits, and their role in the development of aggression, among CU youth with anxiety