Callous-unemotional traits in youth with autism spectrum disorder (ASD): Replication of prevalence estimates and associations with gaze patterns when viewing fearful faces

Virginia Carter Leno, Rachael Bedford, Susie Chandler, Isabel Yorke, Pippa White, Tony Charman, Andrew Pickles, Emily Simonoff

Research output: Contribution to journalArticlepeer-review

7 Citations (SciVal)


Research suggests an increased prevalence of callous-unemotional (CU) traits in children with autism spectrum disorder (ASD), and a similar impairment in fear recognition to that reported in non-ASD populations. However, past work has used measures not specifically designed to measure CU traits and has not examined whether decreased attention to the eyes reported in non-ASD populations is also present in individuals with ASD. The current paper uses a measure specifically designed to measure CU traits to estimate prevalence in a large community-based ASD sample. Parents of 189 adolescents with ASD completed questionnaires assessing CU traits, and emotional and behavioral problems. A subset of participants completed a novel emotion recognition task (n = 46). Accuracy, reaction time, total looking time, and number of fixations to the eyes and mouth were measured. Twenty-two percent of youth with ASD scored above a cut-off expected to identify the top 6% of CU scores. CU traits were associated with longer reaction times to identify fear and fewer fixations to the eyes relative to the mouth during the viewing of fearful faces. No associations were found with accuracy or total looking time. Results suggest the mechanisms that underpin CU traits may be similar between ASD and non-ASD populations.

Original languageEnglish
Pages (from-to)1220 - 1228
Number of pages9
JournalDevelopment and Psychopathology
Issue number4
Early online date29 Jun 2020
Publication statusPublished - 5 Oct 2021

Bibliographical note

Funding Information:
We would like to thank all the participants and their caregivers for taking the time to contribute to this study. We also thank Drs Jacqueline Bold and Mark O'Leary for assistance with the QUEST follow-up study. The original QUEST sample was funded by Clothworkers' Foundation, brokered by Research Autism (R011217 Autism M10 2011/12). The IAMHealth research program was funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research program (RP-PG-1211-20016). ES and AP receive NIHR Senior Investigator Awards (NF-SI-0514-10073, NF-SI-0617-10120). VCL is supported by a Sir Henry Wellcome Postdoctoral Fellowship. RB is supported by a King's Prize Fellowship (204823/Z/16/Z). The study was partially supported through the NIHR Maudsley Biomedical Research Centre at the South London and Maudsley NHS Foundation Trust in partnership with King's College London. The views expressed are those of the authors and not necessarily those of the NHS, the MRC, the NIHR or the Department of Health.

Publisher Copyright:
Copyright © The Author(s), 2020. Published by Cambridge University Press.


  • autism
  • callous-unemotional traits
  • conduct problems
  • fear recognition

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health


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