The Bidirectional Effects of Serious Conduct Problems, Anxiety, and Trauma Exposure: Implications for our Understanding of the Development of Callous-Unemotional Traits

The association of anxiety and trauma with childhood conduct problems has long been the focus of research, and more recently this area of research has become critical to understanding the development of callous-unemotional (CU) traits. Research in samples of children and adolescents has indicated that those elevated on both CU traits and anxiety seem to show more severe externalizing behaviors and are more likely to show histories of trauma. These findings have typically been interpreted as being indicative of a unique casual pathway to CU traits in those high on anxiety. However, an alternative explanation is that the higher rates of anxiety and trauma exposure in some youth with elevated CU traits is largely due to their higher levels of conduct problems. The current study recruited a sample of 1,216 justice-involved adolescents (M age = 15.28, SD = 1.28) from three distinct regions of the United States and were assessed at 6 months, 12 months, 18 months, 24 months, 30 months, 36 months, 48 months, and 60 months. Using multi-panel cross-lagged and longitudinal mediation analyses, we find evidence that anxiety and victimization are largely the consequence of an adolescent’s antisocial and aggressive behavior and that these externalizing problems explain the link between CU traits and increases in future anxiety and victimization. These results are consistent with a model suggesting that higher levels of externalizing behaviors result in higher levels of anxiety and victimization. Rather than being an indicator of etiological differences between primary and secondary CU variants, the presence of anxiety appears to be a marker of the severity of conduct problems in youth with CU traits. The outcomes of this study inform both theoretical work regarding the development of CU traits and applied work, such as interventions for children with serious conduct problems and CU traits