Effects of behavioral treatment modified to fit children with conduct problems and callous-unemotional (CU) traits

Research suggests that children with conduct problems (CP) and callous-unemotional (CU) traits show a diminished response to behavior therapy, perhaps due to a reward-oriented, punishment insensitive learning style. Children with CP and CU may benefit from personalizing behavioral treatment for them by emphasizing rewards and de-emphasizing punishments. This hypothesis was tested in a sample of 46 children (78.3% boys), ages 7.0 to 12.6 years (M = 9.3, SD = 1.4). All participants met criteria for ODD and ADHD and 63% also met criteria for CD. Participants were oversampled for high CU, but CU scores ranged from average to high. Children received four weeks of modified behavior therapy that emphasized rewards and de-emphasized punishments and four weeks of treatment as usual, which was standard behavior therapy that balanced rewards and punishments. Treatments were implemented in a summer treatment program and compared using a within-subjects design, with order of treatment counterbalanced. Disruptive behavior was equal or slightly higher in modified behavior therapy than in standard behavior therapy on point system measures, but lower on parent weekly ratings. End of treatment ratings showed both treatments produced significant improvements compared to pre-treatment ratings but did not differ from each other. Personalizing behavior therapy for children with CP and CU produced inconsistent findings relative to standard behavior therapy. Behavior therapy is likely to be a necessary part of treatment for children with CP and CU, but treatment personalization efforts may provide some benefit by addressing other deficits shown by these children.

This is an Accepted Manuscript of an article published by Taylor & Francis in 'Journal of Clinical Child & Adolescent Psychology' on 2019-06-05, available online: https://www.tandfonline.com/10.1080/15374416.2019.1614000.



Work Title Effects of behavioral treatment modified to fit children with conduct problems and callous-unemotional (CU) traits
Open Access
  1. Daniel A. Waschbusch
  2. Michael T. Willoughby
  3. Sarah M. Haas
  4. Ty Ridenour
  5. Sarah Helseth
  6. Kathleen I. Crum
  7. Amy R. Altszuler
  8. J. Megan Ross
  9. Erika K. Coles
  10. William E. Pelham
License In Copyright (Rights Reserved)
Work Type Article
  1. Informa UK Limited
Publication Date June 5, 2019
Publisher Identifier (DOI)
  1. 10.1080/15374416.2019.1614000
  1. Journal of Clinical Child & Adolescent Psychology
Deposited September 09, 2021




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Work History

Version 1

  • Created
  • Added Waschbusch+et+al+(2020)+-+open+access+version+of+MRPS+study-1.pdf
  • Added Creator Daniel A. Waschbusch
  • Added Creator Michael T. Willoughby
  • Added Creator Sarah M. Haas
  • Added Creator Ty Ridenour
  • Added Creator Sarah Helseth
  • Added Creator Kathleen I. Crum
  • Added Creator Amy R. Altszuler
  • Added Creator J. Megan Ross
  • Added Creator Erika K. Coles
  • Added Creator William E. Pelham
  • Published
  • Updated
  • Updated
  • Updated