Contextual risk factors as predictors of disruptive behavior disorder trajectories in girls: the moderating effect of callous-unemotional features

Background: The presence of callous-unemotional (CU) features may delineate a severe and persistent form of conduct problems in children with unique developmental origins. Contextual risk factors such as poor parenting, delinquent peers, or neighborhood risk are believed to influence the development of conduct problems primarily in children with low levels of CU features. However, longitudinal studies examining the moderating effect of CU features on the relation between contextual risk factors and conduct problems trajectories in girls are rare. Methods: Growth curve analysis was conducted using five annual measurements of oppositional defiant disorder/conduct disorder (ODD/CD) behaviors in a community sample of 1,233 girls aged 7-8 at study onset. The relation between contextual risk factors in multiple domains (i.e., family, peer, community) and trajectories of ODD/CD behaviors across time were examined for girls with differing levels of CU features. Results: Growth curve analysis indicated that CU features were associated with chronically high levels of ODD/CD symptoms over time. Low levels of parental warmth were also associated with chronically high levels of ODD/CD, and this effect was particularly pronounced for girls with high CU features. Exposure to harsh parenting was associated with higher ODD/CD behaviors for girls in childhood regardless of their level of CU features, but this effect dissipated over time. Conclusions: Girls with elevated CU features who are exposed to low levels of parental warmth seem to exhibit particularly severe ODD/CD symptoms and should be targeted for intensive intervention in childhood.