Hawes David J, Price Matthew J, Dadds Mark R
School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia,
Clin Child Fam Psychol Rev. 2014 Sep;17(3):248-67. doi: 10.1007/s10567-014-0167-1.
The treatment of conduct problems among children and adolescents with callous-unemotional (CU) traits has been subject to much speculation; however, treatment outcome research has been surprisingly limited and findings have been mixed. This review examines the research to date in this field as it pertains to two key questions. First, are CU traits associated with clinical outcomes and processes in the family based treatment of child and adolescent conduct problems? Second, can family based intervention produce change in CU traits? Using a systematic search strategy, we identified 16 treatment outcomes studies that can be brought to bear on these questions. These studies provide strong evidence of unique associations between CU traits and risk for poor treatment outcomes, while at the same time indicating that social-learning-based parent training is capable of producing lasting improvement in CU traits, particularly when delivered early in childhood. We discuss the potential for this emerging evidence base to inform the planning and delivery of treatments for clinic-referred children with CU traits, and detail an ongoing program of translational research into the development of novel interventions for this high-risk subgroup.
对具有冷酷无情（CU）特质的儿童和青少年品行问题的治疗一直备受猜测；然而，治疗结果研究却出人意料地有限，且研究结果参差不齐。本综述考察了该领域迄今为止与两个关键问题相关的研究。第一，在基于家庭的儿童和青少年品行问题治疗中，CU特质是否与临床结果及过程相关？第二，基于家庭的干预能否改变CU特质？通过系统检索策略，我们确定了16项可用于解答这些问题的治疗结果研究。这些研究有力地证明了CU特质与治疗效果不佳风险之间存在独特关联，同时表明基于社会学习的家长培训能够使CU特质产生持久改善，尤其是在儿童早期进行培训时。我们讨论了这一新兴证据基础为有CU特质的临床转诊儿童的治疗规划和实施提供信息的潜力，并详细介绍了一项正在进行的转化研究项目，该项目旨在为这一高风险亚组开发新的干预措施。
