In DSM 5, low prosocial emotions (i.e., callous-unemotional traits [CU] – lack of guilt, empathy), designate youth at risk for early-onset, persistent conduct problems (1, 2), and adult psychopathy (3). Yet, little is currently known about how CU traits develop. Research suggests that similar levels of CU may arise from distinct developmental circumstances (4, 5), and that the presence of co-occurring internalizing problems (anxiety/depression) is a key marker. More specifically, CU youth with low internalizing problems have been shown to experience less environmental risk (e.g. stressful life events) during childhood than those with high internalizing problems, despite showing similar levels of CU. This has led to speculations that CU may arise primarily from heritable/constitutional influences in the former group vs environmental influences in the latter group (6, 7). However, to date, few published biologically-informed longitudinal studies have tested whether such a distinction is valid.
