Developmental trajectories of callous-unemotional traits, anxiety and oppositionality in 3-7Â year-old children in the general population

•Different developmental trajectories emerged considering anxiety, ODD, and CU.•Pure and well recognized specifiers (CD with limited prosocial emotions) emerged.•Two trajectories reflected the primary and secondary psychopathy variants.•The secondary variant presented a more severe clinical picture and worse outcomes.•The recognition of these classes has implications for early detection and treatments.

There is increasing interest in describing different variants and subtypes that characterize the heterogeneity of behavior problems with the aim of supporting early detection and prevention, as well as facilitating research into etiological differences. This work examines the course of co-occurrence of callous-unemotional traits (CU), anxiety (ANX) and oppositionality (ODD-s) levels in a longitudinal community sample. A sample of 622 3-year-old preschoolers, followed up until age 7, was assessed annually with dimensional measures of callous-unemotional traits, oppositional defiant disorder and anxiety and related psychological constructs answered by parents, teachers and performed by children. Growth-Mixture-Modeling yielded six trajectories (null 58.9%, ANX-increasing 4.9%, CU + ANX + ODD 2.4%, CU + ODD-decreasing 8.1%, ODD-increasing 16.4%, and ANX-decreasing 9.2%) that represent the variants previously described with older subjects. The specifier ODD “with limited prosocial emotion” (CU + ODD decreasing and increasing) showed deficits in executive functioning, attention, aggressive behavior and social cognition in comparison with null trajectory. The secondary variant showed a more severe clinical picture and presented more difficulties in executive functioning, worse environmental characteristics, and worse outcomes at age 7. It is possible to identify the heterogeneity of disruptive behavior problems from preschool age. The identification of homogeneous groups in this category of disorders may help to design more suitable treatments with specific components for specific difficulties, and to progress in the etiological research of each class.