{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T05:00:59Z","timestamp":1791867659391,"version":"4.3.4"},"reference-count":81,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T00:00:00Z","timestamp":1677628800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["1R01MH125904\u201001A1"],"award-info":[{"award-number":["1R01MH125904\u201001A1"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acamh.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Child Psychology Psychiatry"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Children with callous\u2010unemotional (CU) traits are at high lifetime risk of antisocial behavior. It is unknown if treatments for disruptive behavior disorders are as effective for children with CU traits (DBD+CU) as those without (DBD\u2010only), nor if treatments directly reduce CU traits. Separate multilevel meta\u2010analyses were conducted to compare treatment effects on DBD symptoms for DBD+CU versus DBD\u2010only children and evaluate direct treatment\u2010related reductions in CU traits, as well as to examine moderating factors for both questions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We systematically searched PsycINFO, PubMed, Cochran Library (Trials), EMBASE, MEDLINE, APA PsycNet, Scopus, and Web of Science. Eligible studies were randomized controlled trials, controlled trials, and uncontrolled studies evaluating child\u2010focused, parenting\u2010focused, pharmacological, family\u2010focused, or multimodal treatments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sixty studies with 9,405 participants were included (\n                      <jats:italic>M<\/jats:italic>\n                      <jats:sub>age<\/jats:sub>\n                      \u00a0\n                      <jats:italic>=<\/jats:italic>\n                      \u00a010.04,\n                      <jats:italic>SD<\/jats:italic>\n                      <jats:sub>age<\/jats:sub>\n                      \u00a0=\u00a03.89\u2009years, 25.09% female, 44.10% racial\/ethnic minority). First, treatment was associated with similar reductions in DBD symptoms for DBD+CU (\n                      <jats:italic>SMD<\/jats:italic>\n                      \u00a0=\u00a01.08, 95% CI\u00a0=\u00a00.45, 1.72) and DBD\u2010only (\n                      <jats:italic>SMD<\/jats:italic>\n                      \u00a0=\u00a01.01, 95% CI\u00a0=\u00a00.38, 1.64). However, DBD+CU started (\n                      <jats:italic>SMD<\/jats:italic>\n                      \u00a0=\u00a01.18, 95% CI\u00a0=\u00a00.57, 1.80) and ended (\n                      <jats:italic>SMD<\/jats:italic>\n                      \u00a0=\u00a00.73,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001; 95% CI\u00a0=\u00a00.43, 1.04) treatment with more DBD symptoms. Second, although there was no overall direct effect of treatment on CU traits (\n                      <jats:italic>SMD<\/jats:italic>\n                      \u00a0=\u00a0.09, 95% CI\u00a0=\u00a0\u22120.02, 0.20), there were moderating factors. Significant treatment\u2010related reductions in CU traits were found for studies testing parenting\u2010focused components (\n                      <jats:italic>SMD<\/jats:italic>\n                      \u00a0=\u00a00.21, 95% CI\u00a0=\u00a00.06, 0.35), using parent\u2010reported measures (\n                      <jats:italic>SMD<\/jats:italic>\n                      \u00a0=\u00a00.16, 95% CI\u00a0=\u00a00.04, 0.28), rated as higher quality (\n                      <jats:italic>SMD<\/jats:italic>\n                      \u00a0=\u00a00.26, 95% CI\u00a0=\u00a00.13, 0.39), conducted outside the United States (\n                      <jats:italic>SMD<\/jats:italic>\n                      \u00a0=\u00a00.19, 95% CI\u00a0=\u00a00.05, 0.32), and with less than half the sample from a racial\/ethnic minority group (\n                      <jats:italic>SMD<\/jats:italic>\n                      \u00a0=\u00a00.15, 95% CI\u00a0=\u00a00.002, 0.30).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>DBD+CU children improve with treatment, but their greater DBD symptom severity requires specialized treatment modules that could be implemented alongside\u00a0parenting programs. Conclusions are tempered by heterogeneity across studies and scant evidence from randomized controlled trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jcpp.13774","type":"journal-article","created":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T21:35:37Z","timestamp":1677706537000},"page":"1372-1387","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":86,"title":["Treatment of childhood disruptive behavior disorders and\n                    <scp>callous\u2010unemotional<\/scp>\n                    traits: a systematic review and two multilevel\n                    <scp>meta\u2010analyses<\/scp>"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6584-0786","authenticated-orcid":false,"given":"Samantha","family":"Perlstein","sequence":"first","affiliation":[{"name":"Department of Psychology University of Pennsylvania  Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maddy","family":"Fair","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Pennsylvania  Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Pennsylvania  Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5069-1183","authenticated-orcid":false,"given":"Rebecca","family":"Waller","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Pennsylvania  Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3]]},"reference":[{"key":"e_1_2_6_2_1","volume-title":"Manual for the ASEBA preschool forms and profiles","author":"Achenbach T.M.","year":"2000"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2011.11.003"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/per.455"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.20f13681"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpp.13461"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2017.01.024"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.07.015"},{"key":"e_1_2_6_9_1","unstructured":"Byrd A.L.(2016).Reward and punishment processing in subgroups of youth with conduct problems: Characterization of the neural response and implications for intervention. 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