Callous-unemotional (CU) traits have been linked to more severe and sustained behavior problems among adolescents. The aims of this study were to examine the treatment impact and malleability of CU traits among adolescents and explore potential moderation effects of treatment condition and CU sub-typology. A sample of 159 adolescents (45.9% girls; M age = 14.7 years, SD = 1.47) and their parents participated in a randomized controlled trial of Functional Family Therapy with three assessments (baseline, 6-months and 18-months) of behavior problems, CU traits, prosocial skills and the parent-youth relationship. Latent growth curve model (LGCM) analyses revealed that children with higher CU traits had greater reductions in aggressive and rule-breaking behavior and greater improvements in social skills (|standardized coefficients| = 0.27–0.32). Similarly, higher CU traits were linked to larger increases in parent-ratings of family cohesion and youth-ratings of maternal support (standardized coefficients = 0.26–0.27). Reliable Change Index summaries showed that CU traits remained unchanged for the majority of participants (73.6% and 72.6% had no reliable short- and long-term change, respectively). Baseline anxiety linked to CU sub-typology moderated some of the study results. Findings show that adolescents with co-occurring behavior problems and elevated CU traits can obtain improvement in behavioral and relational outcomes in out-patient treatment. Strikingly, such improvements can occur notwithstanding a limited reduction in CU traits. Future work should investigate whether the treatment gains would be more substantial and stable if treatment adjuncts modifying the CU traits themselves were concurrently deployed.

冷酷无情（CU）特征与青少年更严重和持续的行为问题有关。本研究的目的是检查青少年 CU 特征的治疗影响和延展性，并探索治疗条件和 CU 亚型的潜在调节作用。159 名青少年样本（45.9% 的女孩；M年龄 = 14.7 岁，SD = 1.47）和他们的父母参加了一项功能性家庭治疗的随机对照试验，对行为问题、CU 特征、亲社会技能和亲子关系进行了三项评估（基线、6 个月和 18 个月）。潜在生长曲线模型 (LGCM) 分析显示，具有较高 CU 特征的儿童攻击性和违反规则的行为减少得更多，社交技能提高得更多（|标准化系数| = 0.27-0.32）。同样，较高的 CU 特征与家庭凝聚力的父母评级和母亲支持的青年评级的较大增加有关（标准化系数 = 0.26-0.27）。可靠变化指数摘要显示，大多数参与者的 CU 特征保持不变（分别为 73.6% 和 72.6% 没有可靠的短期和长期变化）。与 CU 亚型相关的基线焦虑缓和了一些研究结果。研究结果表明，同时存在行为问题和 CU 特征升高的青少年可以在门诊治疗中获得行为和关系结果的改善。引人注目的是，尽管 CU 特征的减少有限，但仍可能发生这种改进。未来的工作应该调查如果同时部署修改 CU 特征本身的治疗辅助剂，治疗收益是否会更加显着和稳定。