Latent Profiles of Callous Unemotional Traits and Conduct Problems in Clinically Referred Youth

This study aimed to examined whether multidimensional callous-unemotional (CU) traits and conduct problems (CP) yield distinct latent profiles in a clinically referred sample of youth, and if these profiles differ on externalizing symptoms, aggression, irritability, and CU-related impairment. Participants were 290 clinically referred youth (57.9% male) aged 8–16 years (M = 10.40, SD = 2.33) and primarily identified as White (85.9%). Diagnoses included ADHD (90.7%), ODD (35.3%), and CD (3.5%). Mothers completed the Inventory of Callous-Unemotional Traits, Disruptive Behavior Disorders Rating Scale, Nova Scotia Modified IOWA Conners, Affective Reactivity Index, the Callous-Unemotional Problems and Impairment scale, Screen for Child Anxiety Related Disorders, and Short Mood and Feelings Questionnaire. Latent profile analysis was conducted using four ICU facets and a CP score to derive subtypes. A four-profile solution emerged: High CU/CP (16.2%), Emotionally Detached (32.8%), Low CU/CP (35.9%), and Remorseless–Callous (15.2%). Profiles differed significantly on CU and CP indicators (partial η² = 0.15). High CU/CP and Remorseless–Callous groups showed elevated ODD and CD diagnoses, proactive/reactive aggression, irritability, depression, and CU impairment compared to Emotionally Detached and Low CU/CP profiles. The High CU/CP class exhibited the highest slow dissipation of aggression, whereas the Remorseless–Callous class had greater relational aggression. The Emotionally Detached group had lower rates of anxiety. Multidimensional CU trait analysis revealed clinically distinct subtypes, including a novel Emotionally Detached profile. These findings underscore heterogeneity in CU presentations and highlight the need for tailored assessment and intervention. Future research should evaluate the stability and treatment responsiveness of these profiles.