Conduct disorder and callous-unemotional traits in youth
Open accessAbstract
Children with repetitive rule-breaking, aggression, and disregard for others are at increased risk for substance abuse, educational disruption, and criminal behavior. Progress is being made toward understanding the clinical and neurocognitive features of callous youth.
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Emotional instability disorders are characterized by emotional hyper-responsiveness in amygdala and insula, regions involved in shaping emotional responses and experience.
“These “emotional instability disorders” are characterized by emotional hyper-responsiveness in amygdala and insula, regions involved in shaping emotional responses and experience (Blair, 2010; Rubia, 2011; Blair et al., 2014; Glenn and Raine, 2014; Krause-Utz et al., 2014).”
From Top-Down Dysregulation—From ADHD to Emotional Instability (2016) · cites this paper as Blair et al., 2014
The “Heightened Threat Sensitivity” section (page not supplied) reports elevated amygdala responses to threat in youth with conduct problems without callous–unemotional traits. It does not establish hyper-responsiveness in the insula or characterize emotional instability disorders generally this way; it also describes reduced amygdala responses in youth with callous–unemotional traits. (LLM, conf=0.87)
Experimental — accuracy not yet measuredStructurally, the gray matter volumes of amygdala and insula are often reduced in emotional instability disorders.
“Structurally, the gray matter volumes of amygdala and insula are often reduced in such disorders (Blair, 2010; Rubia, 2011; Blair et al., 2014; Glenn and Raine, 2014; Krause-Utz et al., 2014).”
From Top-Down Dysregulation—From ADHD to Emotional Instability (2016) · cites this paper as Blair et al., 2014
The References section (page unavailable) cites a study associating lower amygdala volume in men with childhood aggression, psychopathic traits, and future violence. That lends limited support to the amygdala-volume portion, but the paper does not report reduced insula volume or establish that both volumes are often reduced across emotional-instability disorders. Its Neurocognitive Dysfunctions sections discuss amygdala responses and function rather than structural volume. (LLM, conf=0.70)
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“…these disorders also include sub-populations with callousunemotional traits that are associated with decreased behavioral and neural responding to emotional stimuli, potentially confounding the contribution from emotional instability traits (Blair, 2010, 2013; Rubia, 2011; Blair et al., 2014).”
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“5,6 7-9 The challenges that CU traits and psychopathy pose for intervention 3 and the enormous societal costs associated with antisocial behavior make it imperative to develop strategies for preventing the onset of CU traits in those at increased risk.”
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- Authors
- Blair, R. J. R., Leibenluft, E., & Pine, D. S.
- Affiliations
- National Institutes of Health (US)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2014-12-04
- Volume
- 371
- Issue
- 23
- Pages
- 2207-2216
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- PMC
- PMC6312699
- OpenAlex
- W2041104702
- Cited by
- 371
- References
- 75
- Citations by year
- 2026: 11 · 2025: 27 · 2024: 27 · 2023: 30 · 2022: 43 · 2021: 34 · 2020: 50 · 2019: 33 · 2018: 28 · 2017: 35 · 2016: 35 · 2015: 17
- FWCI
- 4.38
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (Z99 MH999999)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- conduct disorder, callous-unemotional traits, youth, aggression, rule violations, substance abuse risk, criminal behavior, educational disruption, clinical features
- MeSH terms
- Adolescent, Amygdala, Antisocial Personality Disorder, Child, Child Behavior Disorders, Cognition Disorders, Decision Making, Empathy, Humans, Magnetic Resonance Imaging, Psychotherapy, Social Environment, Conduct Disorder
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