Callous-unemotional behaviors in early childhood: the development of empathy and prosociality gone awry

Proposed developmental model of CU behaviors. CU behaviors are conceptualized as emerging from a nexus of (at least) two inherited temperaments: fearlessness and low interpersonal emotional sensitivity. Low interpersonal emotional sensitivity represents the inherited phenotype of reduced attention to, orienting to, and recognition of emotion cues in others, explaining aspects of the CU construct related to low affective empathy and prosocial behavior. Fearlessness represents the inherited phenotype of low behavioral inhibition and explains aspects of the CU construct related to uncaring about punishment or behavioral consequences, high approach, and reward dominance. Early CU behaviors predict violence and rule-breaking later in childhood and adolescence, and represent a specific risk factor for psychopathy. Parenting practices, such as low warmth and harshness, interact with these temperament precursors to exacerbate risk for CU behaviors and harmful outcomes across development. Interventions that increase warmth and decrease harshness may be able to diminish this risk, even in those with temperament risk for CU behaviors.