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Main Authors: Rachel C. Tomlinson, Patrizia Pezzoli, Essi Viding, Stephane A. De Brito, Kelly L. Klump, S. Alexandra Burt, Luke W. Hyde
Format: Artículo Open Access
Published: Wiley 2026
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Online Access:https://acamh.onlinelibrary.wiley.com/doi/10.1111/jcpp.70107
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author Rachel C. Tomlinson
Patrizia Pezzoli
Essi Viding
Stephane A. De Brito
Kelly L. Klump
S. Alexandra Burt
Luke W. Hyde
author_facet Rachel C. Tomlinson
Patrizia Pezzoli
Essi Viding
Stephane A. De Brito
Kelly L. Klump
S. Alexandra Burt
Luke W. Hyde
Rachel C. Tomlinson
Patrizia Pezzoli
Essi Viding
Stephane A. De Brito
Kelly L. Klump
S. Alexandra Burt
Luke W. Hyde
collection Wiley Open Access
contents The nature and nurture of primary and secondary callous–unemotional traits: evidence from two independent twin samples Rachel C. Tomlinson Patrizia Pezzoli Essi Viding Stephane A. De Brito Kelly L. Klump S. Alexandra Burt Luke W. Hyde Journal of Child Psychology and Psychiatry Background Callous–unemotional (CU) traits identify youth with more severe and chronic trajectories of conduct problems. However, the etiology of CU traits may be heterogeneous, undermining the search for effective treatments. The level of co‐occurring anxiety has been used to identify “primary” (lower anxiety) versus “secondary” (higher anxiety) variants of CU traits. The primary variant has been hypothesized to emerge from strong genetic influence and secondary variants as an adaptation to adversity, such as exposure to childhood maltreatment. However, little research has tested this hypothesis directly. Methods We examined whether anxiety moderates the etiology of CU traits to determine whether this phenotypic feature can help distinguish CU traits with stronger genetic or environmental risk. In two population‐based twin cohorts (initial sample: N  = 1,196, aged 6–11, oversampled for exposure to neighborhood disadvantage; follow‐up sample: N  = 13,486, age 7), we used genotype‐by‐environment interaction twin modeling to examine if parent‐reported child anxiety moderated the etiology of concurrent parent‐reported child CU traits. Results Anxiety moderated the etiology of CU traits across both samples, such that nonshared environmental influences increased as anxiety increased. Additionally, in the larger sample, genetic influences decreased with increasing anxiety. Conclusions These findings support theories suggesting that co‐occurring anxiety may distinguish CU traits with different origins: CU traits with higher anxiety appear more influenced by nonshared environmental factors—potentially including adversity—and may show weaker genetic influence. Assessing for co‐occurring child anxiety is likely important for diagnosing and personalizing treatments among children with CU traits. 10.1111/jcpp.70107 http://creativecommons.org/licenses/by/4.0/
doi_str_mv 10.1111/jcpp.70107
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institution Wiley Open Access
license_str_mv http://creativecommons.org/licenses/by/4.0/
publishDate 2026
publisher Wiley
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spellingShingle The nature and nurture of primary and secondary callous–unemotional traits: evidence from two independent twin samples
Rachel C. Tomlinson
Patrizia Pezzoli
Essi Viding
Stephane A. De Brito
Kelly L. Klump
S. Alexandra Burt
Luke W. Hyde
Journal of Child Psychology and Psychiatry
The nature and nurture of primary and secondary callous–unemotional traits: evidence from two independent twin samples Rachel C. Tomlinson Patrizia Pezzoli Essi Viding Stephane A. De Brito Kelly L. Klump S. Alexandra Burt Luke W. Hyde Journal of Child Psychology and Psychiatry Background Callous–unemotional (CU) traits identify youth with more severe and chronic trajectories of conduct problems. However, the etiology of CU traits may be heterogeneous, undermining the search for effective treatments. The level of co‐occurring anxiety has been used to identify “primary” (lower anxiety) versus “secondary” (higher anxiety) variants of CU traits. The primary variant has been hypothesized to emerge from strong genetic influence and secondary variants as an adaptation to adversity, such as exposure to childhood maltreatment. However, little research has tested this hypothesis directly. Methods We examined whether anxiety moderates the etiology of CU traits to determine whether this phenotypic feature can help distinguish CU traits with stronger genetic or environmental risk. In two population‐based twin cohorts (initial sample: N  = 1,196, aged 6–11, oversampled for exposure to neighborhood disadvantage; follow‐up sample: N  = 13,486, age 7), we used genotype‐by‐environment interaction twin modeling to examine if parent‐reported child anxiety moderated the etiology of concurrent parent‐reported child CU traits. Results Anxiety moderated the etiology of CU traits across both samples, such that nonshared environmental influences increased as anxiety increased. Additionally, in the larger sample, genetic influences decreased with increasing anxiety. Conclusions These findings support theories suggesting that co‐occurring anxiety may distinguish CU traits with different origins: CU traits with higher anxiety appear more influenced by nonshared environmental factors—potentially including adversity—and may show weaker genetic influence. Assessing for co‐occurring child anxiety is likely important for diagnosing and personalizing treatments among children with CU traits. 10.1111/jcpp.70107 http://creativecommons.org/licenses/by/4.0/
title The nature and nurture of primary and secondary callous–unemotional traits: evidence from two independent twin samples
topic Journal of Child Psychology and Psychiatry
url https://acamh.onlinelibrary.wiley.com/doi/10.1111/jcpp.70107