Affective and Cognitive Empathy Deficits Distinguish Primary and Secondary Variants of Callous-Unemotional Youth

The current study examined whether a sample of detained male adolescents (n = 107; Mean age = 15.50; SD = 1.30) could be disaggregated into two distinct groups, consistent with past research on primary and secondary variants of callous-unemotional (CU) traits in adolescents. This study also sought to determine a possible explanation for the CU traits among youth in the secondary variant by examining whether they differ from primary variants on measures of cognitive and affective empathy. Using Latent Profile Analyses, two groups of adolescents high on CU traits were identified, a large group (n = 30) high on CU traits but low on anxiety (primary) and a smaller group high on both CU traits and anxiety (n = 10; secondary). Using self-report and computerized measures of affective (e.g., emotional reactivity) and cognitive empathy (e.g., affective facial recognition and theory of mind (ToM)), results revealed that the secondary variant demonstrated the lowest levels of cognitive empathy. In contrast, the primary variant demonstrated the lowest levels of self-report affective empathy, but these levels were not significantly different from the secondary variant. Multiple regression analyses testing the association among measures of empathy, CU traits, and anxiety produced a mostly consistent pattern of results. One exception was the finding of an interaction between CU traits and anxiety in the prediction of fear recognition accuracy that indicated that CU traits were positively associated with accuracy in recognizing fearful facial expressions when anxiety was low. The current study builds upon previous work examining primary and secondary variants of CU traits by suggesting that both primary and secondary variants may exhibit similar deficits in affective empathy, but that secondary variants may also exhibit deficits in cognitive empathy and perspective-taking that are not present in primary variants