The association between callous-unemotional traits and substance use in childhood and adolescence: A systematic review and meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of observational studies (graded Level 1 by design analogy).
PubMed 37390924 · doi:10.1016/j.jad.2023.06.051
What was done
The authors conducted a systematic review and meta-analysis quantifying the association between callous-unemotional (CU) traits and substance use in childhood and adolescence. Separate meta-analyses were performed for alcohol, cannabis, and a substance use composite. The review examined potential moderators including age, gender, community versus clinical/forensic settings, CU traits measure, informant, and study design (cross-sectional versus longitudinal).
What was found
Small, statistically significant associations were identified between CU traits and: - Alcohol use: θ = 0.17 - Cannabis use: θ = 0.17 - Substance use composite: θ = 0.15 These associations were present in both community and clinical/forensic samples. Confidence intervals, exact study counts, and participant numbers were not reported in the abstract.
Why it matters
This meta-analysis demonstrates that callous-unemotional traits consistently co-occur with adolescent substance use across diverse settings. The findings support evaluating CU traits during clinical assessments of youth presenting with substance use problems.
Limits
The abstract omits the number of included studies, total participant sample size, and confidence intervals. Because the underlying primary studies are observational, these associations cannot establish causality, and the abstract does not report whether associations remain independent after adjusting for co-occurring conduct problems.
Cited by
- context Between 50% and 75% of children with conduct disorder onset before age 10 and callous-unemotional traits develop an adult substance use disorder.