Editorial: Treatment of Early Childhood Callous-Unemotional Traits: What Do We Know and Where Do We Go from Here?

Callous-unemotional (CU) traits, characterized by lack of remorse, guilt, or empathy, are represented in DSM-5 under the limited prosocial emotions specifier for conduct disorder. Research suggests that some interventions for conduct problems are less effective for children with higher levels of CU traits,1 and few interventions have been shown to reduce CU traits. Specifically, behavioral parenting interventions, evidence-based treatments for conduct problems, have been shown to be less effective for children with higher levels of CU traits.2 Although research suggests high comorbidity of internalizing and externalizing problems in early childhood,3 no prior studies examined the effect of CU traits on the treatment of childhood internalizing problems. Donohue et al.4 addressed this significant gap in the literature by evaluating the efficacy of Parent-Child Interaction Therapy-Emotion Development (PCIT-ED) in the treatment of preschoolers with major depressive disorder (MDD) and oppositional defiant disorder (ODD) and the moderating role of child CU traits on treatment outcomes. In this editorial, we discuss the contributions and limitations of the article by Donohue et al.4 and provide recommendations for future research to advance the field.