Association between callous unemotional traits cognitive control performance and reward sensitivity in youths with conduct problems – A systematic review and meta-analysis

Poor cognitive control (CC, i.e., low-level executive functions) capacity and increased reward sensitivity (RS) represent core traits and meaningful predictors in developing externalizing disorders. The inclusion of the limited-prosocial-emotions specifier (also termed callous-unemotional (CU) traits) into the DSM-5 diagnostic criteria for conduct disorders led to an increase in research on associations of CU traits with CC and RS. The review quantitatively summarizes this research and analyzes hypothesized moderator effects by target population (with conduct problems (CP); healthy community) and the socioeconomic status of the family. We focused on studies that assessed CC or RS using neuropsychological tasks. Literature search yielded 22 eligible studies (providing k = 27 observed effects). Regarding the link between CU traits and CC, the hypothesized moderator effect of population proved statistically significant. Using a random-effects model, the weighted mean effect size for the CU-CC association in youths with CP was r = .112 (CI₉₅: 0.00; 0.22, k = 10, p < .05). The result was robust against exclusion of an outlier (r = .138, CI₉₅: 0.04; 0.24, k = 9, p < .01). Among youths with CP, high CU traits related to less impaired CC performance, and vice versa. Regarding the CU-RS association, the moderator effect by population was not statistically significant. The weighted mean effect size for the CU-RS link in youths with CP reached significance after the exclusion of an outlier (r = .164, CI₉₅: 0.075; 0.252, k = 6, p < .001). The positive association between CU traits and CC among youths with CP aligns with models on antisocial behavior and findings from neurophysiological research. The moderator effect of population explains previously mixed findings.