Reduced face preference in infancy: a developmental precursor to callous-unemotional traits?

Bedford, R., Pickles, A., Sharp, H., Wright, N., & Hill, J. (2015). Reduced Face Preference in Infancy: A Developmental Precursor to Callous-Unemotional Traits? Biological Psychiatry, 78(2), 144-150. https://doi.org/10.1016/j.biopsych.2014.09.022

Children with callous unemotional (CU) traits, a proposed precursor to adult psychopathy, are characterized by impaired emotion recognition, reduced responsiveness to others’ distress and a lack of guilt or empathy. Reduced attention to faces, and more specifically the eye region, has been proposed to underlie these difficulties, although this has never been tested longitudinally from infancy. Attention to faces occurs within the context of dyadic caregiver interactions, and early environment such as parenting characteristics have also been associated with CU traits. Methods: The present study tested whether infants’ preferential tracking of a face with direct gaze and levels of maternal sensitivity predict later CU traits. The Neonatal Behavioral Assessment Scale (NBAS) was administered to the intensive sample at 5 weeks after birth in the laboratory. Because the focus of this study was face preference, we used only two subscales: 1) orientation to the human face, assessed as the extent to which the infant moves eyes and head to track the administrator’s face over a 180-degree horizontal arc and 30 degrees vertically and 2) orientation to an inanimate visual stimulus, a red ball (while the administrator keeps his or her face out of the infant’s line of vision). Results: Controlling for a range of confounders (e.g. deprivation) lower preferential face tracking predicted higher CU traits (p = 0.001). Higher maternal sensitivity predicted lower CU traits in girls (p = 0.009) but not boys. No significant interaction between face tracking and maternal sensitivity was found. Conclusions: This is the first study to show that attention to social features during infancy, as well as early sensitive parenting, predict the subsequent development of CU traits. Identifying such early atypicalities offers the potential for developing parent-mediated interventions in children at-risk for developing CU traits.