High-quality foster care reduces chance of callous-emotional trait development for abandoned children early in life

A study to be published in the December 2015 issue of the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP) reports that high-quality foster care can mitigate the development of callous-unemotional traits for adolescents who experienced parent deprivation in early life.

Callous-unemotional traits are often considered a precursor to psychopathy associated with aggressive and destructive acts. Children expressing these traits can present significant clinical challenges and societal costs. The evidence base for treatment of children with high levels of callous-unemotional traits is limited.

Using data from a randomized controlled trial of high-quality foster care for children in institutional (orphanage) care, a group of researchers led by Drs. Kathryn Humphreys and Charles Zeanah of the Tulane University School of Medicine, examined the relationship between a high-quality foster care intervention when children were between 6-30 months in age and callous-unemotional traits at a follow-up when children were age 12 years. The authors hypothesized that those children who received the foster care intervention would have lower levels of callous-unemotional traits in early adolescence.

Overall, children who spent time in orphanage care had higher levels of callous-unemotional traits than children who were never institutionalized. In addition, those randomized to receive the foster care intervention had lower levels of callous-unemotional traits than those who did not receive the intervention. This finding was only found in boys, so that boys who received the intervention demonstrated the greatest benefit in reduction of callous-unemotional traits. The authors then examined aspects of the intervention that predicted the mitigation of callous-unemotional traits in boys. They found that caregiver sensitivity to the child's distress, as observed during a caregiver-child interaction, explained the association.

Given the public health concerns associated with psychopathy and its antecedents, effective preventive interventions early in life are essential. Based on their findings, the authors concluded that encouraging sensitive responding to children's distress may be an important target for at-risk children and families. Clinical interventions that enhance sensitive and responsive parenting, particularly for children who experienced deprivation in early life, may reduce callous-unemotional traits in early adolescence.