title: Behavior therapy and callous-unemotional traits: effects of a pilot study examining modified behavioral contingencies on child behavior.
abstract: The conduct problems of children with callous-unemotional (CU) traits (i.e., lack of empathy, lack of guilt/lack of caring behaviors) are particularly resistant to current behavioral interventions, and it is possible that differential sensitivities to punishment and reward may underlie this resistance. Children with conduct problems and CU (CPCU) are less responsive to behavioral punishment techniques (e.g., time-out), whereas reward techniques (e.g., earning points for prizes or activities) are effective for reducing conduct problems. This study examined the efficacy of modified behavioral interventions, which de-emphasized punishment (Condition B) and emphasized reward techniques (Condition C), compared with a standard behavioral intervention (Condition A). Interventions were delivered through a summer treatment program over 7 weeks with an A-B-A-C-A-BC-A design to a group of 11 children (7-11 years; 91% male). All children were diagnosed with either oppositional defiant disorder or conduct disorder, in addition to attention-deficit hyperactivity disorder. Results revealed the best treatment response occurred during the low-punishment condition, with rates of negative behavior (e.g., aggression, teasing, stealing) increasing over the 7 weeks. However, there was substantial individual variability in treatment response, and several children demonstrated improvement during the modified intervention conditions. Future research is necessary to disentangle treatment effects from order effects, and implications of group treatment of CPCU children (i.e., deviancy training) are discussed.
authors.affiliation: University of British Columbia. Electronic address: nvmiller@psych.ubc.ca.
authors.forename: Natalie V
authors.initials: NV
authors.lastname: Miller
authors.affiliation: Center for Children and Families, University of Buffalo-SUNY.
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Haas
authors.affiliation: Center for Children and Families, Florida International University; Penn State Hershey Medical Center.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Waschbusch
authors.affiliation: Frank Porter Graham Child Development Institute; The University of North Carolina at Chapel Hill.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Willoughby
authors.affiliation: Center for Children and Families, Florida International University.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Helseth
authors.affiliation: Center for Children and Families, Florida International University.
authors.forename: Kathleen I
authors.initials: KI
authors.lastname: Crum
authors.affiliation: Center for Children and Families, Florida International University.
authors.forename: Erika K
authors.initials: EK
authors.lastname: Coles
authors.affiliation: Center for Children and Families, Florida International University.
authors.forename: William E
authors.initials: WE
authors.lastname: Pelham
mesh_terms: D000987:Antisocial Personality Disorder / Q000523:psychology / Q000628:therapy*; D001289:Attention Deficit Disorder with Hyperactivity / Q000523:psychology / Q000628:therapy*; D001521:Behavior Therapy / Q000379:methods*; D002648:Child; D002652:Child Behavior; D004644:Emotions / Q000502:physiology*; D004645:Empathy; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D012189:Retrospective Studies
keywords: attention-deficit/hyperactivity disorder; callous-unemotional traits; conduct problems; summer treatment program