title: A Behavioral Measure of Costly Helping: Replicating and Extending the Association with Callous Unemotional Traits in Male Adolescents.
abstract: BACKGROUND
  Some conduct-disordered youths have high levels of callous unemotional traits and meet the DSM-5's "with limited prosocial emotions" (LPE) specifier. These youths often do aggressive, self-benefitting acts that cost others. We previously developed a task, the AlAn's game, which asks participants to repeatedly decide whether to accept or reject offers in which they will receive money but a planned charity donation will be reduced. In our prior work, more "costly helping" (i.e., rejecting the offered money and protecting the donation) was associated with lower callous unemotional traits. Here we extend that prior work in a larger sample of adolescent male patients with serious conduct problems and controls, and test whether this association is mediated specifically by a Moral Elevation response (i.e., a positive emotional response to another's act of virtue).
  
  
  METHODS
  The adolescent male participants were: 45 patients (23 with LPE) and 26 controls, who underwent an extensive phenotypic assessment including a measure of Moral Elevation. About 1 week later participants played the AlAn's game.
  
  
  RESULTS
  All AlAn's game outcomes demonstrated significant group effects: (1) money taken for self (p = 0.02); (2) money left in the charitable donation (p = 0.03); and, (3) costly helping (p = 0.047). Controls took the least money and did the most costly helping, while patients with LPE took the most money and did the least costly helping. Groups also significantly differed in post-stimulus Moral Elevation scores (p = 0.005). Exploratory analyses supported that the relationship between callous unemotional traits and costly helping on the AlAn's game may be mediated in part by differences in Moral Elevation.
  
  
  CONCLUSIONS
  The AlAn's game provides a standardized behavioral measure associated with callous unemotional traits. Adolescents with high levels of callous unemotional traits engage in fewer costly helping behaviors, and those differences may be related to blunting of positive emotional responses.
authors.affiliation: Division of Substance Dependence, Department of Psychiatry, University of Colorado School of Medicine, Denver, Colorado, United States of America.
authors.forename: Joseph T
authors.initials: JT
authors.lastname: Sakai
authors.affiliation: Division of Substance Dependence, Department of Psychiatry, University of Colorado School of Medicine, Denver, Colorado, United States of America.
authors.forename: Manish S
authors.initials: MS
authors.lastname: Dalwani
authors.affiliation: Division of Substance Dependence, Department of Psychiatry, University of Colorado School of Medicine, Denver, Colorado, United States of America.
authors.forename: Susan K
authors.initials: SK
authors.lastname: Mikulich-Gilbertson
authors.affiliation: Division of Substance Dependence, Department of Psychiatry, University of Colorado School of Medicine, Denver, Colorado, United States of America.
authors.forename: Shannon K
authors.initials: SK
authors.lastname: McWilliams
authors.affiliation: Division of Substance Dependence, Department of Psychiatry, University of Colorado School of Medicine, Denver, Colorado, United States of America.
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Raymond
authors.affiliation: Division of Substance Dependence, Department of Psychiatry, University of Colorado School of Medicine, Denver, Colorado, United States of America.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Crowley
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000342:Affective Symptoms / Q000523:psychology*; D000533:Altruism; D019955:Conduct Disorder / Q000523:psychology*; D005717:Games, Experimental; D037921:Gift Giving; D006379:Helping Behavior; D006801:Humans; D008297:Male; D028681:Moral Obligations; D000297:Psychology, Adolescent; D015203:Reproducibility of Results; D057566:Self Report; D019966:Substance-Related Disorders / Q000523:psychology; D011795:Surveys and Questionnaires