Callous–Unemotional Traits and Their Association with Neurodevelopmental Disorders: Insights from Gaze Behaviour During Emotion Recognition

TL;DR

People with callous–unemotional traits and neurodevelopmental disorders like ASD, ADHD, or CD avoid looking at eyes, especially when seeing fearful faces, suggesting shared socioemotional challenges.

Contribution

The paper proposes that CU traits are a transdiagnostic developmental construct shaped by early attentional-emotional mechanisms, not a disorder-specific identity.

Findings

Elevated CU traits are linked to reduced eye fixations, especially when viewing fearful faces.

Co-occurrence of CU traits with ASD, ADHD, or CD amplifies gaze avoidance during emotional processing.

Current theories fail to fully explain the complexity of gaze behavior in CU traits.

Abstract

What are the main findings?
Individuals with CU traits (and those with ASD, ADHD, or CD) show atypical eye-gaze behaviour, especially reduced attention to the eye region, most notably when viewing fearful faces.Co-occurrence of CU traits with ASD, ADHD, or CD amplifies avoidance of the eyes during emotional processing, suggesting compounded socioemotional difficulties.

Individuals with CU traits (and those with ASD, ADHD, or CD) show atypical eye-gaze behaviour, especially reduced attention to the eye region, most notably when viewing fearful faces.

Co-occurrence of CU traits with ASD, ADHD, or CD amplifies avoidance of the eyes during emotional processing, suggesting compounded socioemotional difficulties.

What are the implications of the main findings?
While theories such as amygdala dysfunction, oculomotor disinhibition, and hostile attribution bias explain aspects of gaze behaviour, none fully capture the complexity, highlighting the need to view CU traits as a developmental, cross-disorder construct shaped by environmental factors.

While theories such as amygdala dysfunction, oculomotor disinhibition, and hostile attribution bias explain aspects of gaze behaviour, none fully capture the complexity, highlighting the need to view CU traits as a developmental, cross-disorder construct shaped by environmental factors.

Callous–unemotional (CU) traits are characterised by reduced empathy, guilt, and emotional responsiveness, and are strongly linked to atypical socioemotional processing. Eye-tracking research provides a valuable window into these processes by capturing early developing patterns of attention to emotionally salient social cues, particularly facial expressions. This narrative review examines how alterations in gaze behaviour contribute to the emergence of CU traits across neurodevelopmental disorders (NDs), with a focus on autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and conduct disorder (CD). Across studies, elevated CU traits are associated with reduced fixations on the eye region, most consistently in response to fearful faces. ASD is associated with robust eye avoidance, ADHD with inhibitory and attentional control difficulties during face processing, and CD with atypical gaze allocation to negative emotional expressions such as fear and anger. These patterns appear amplified when CU traits co-occur with NDs. Competing explanatory accounts, including aberrant amygdala functioning, oculomotor disinhibition, and hostile attribution biases, each capture aspects of these patterns but fail to provide a unified explanation. Integrating developmental, neurobiological, and environmental perspectives, we propose that CU traits reflect a transdiagnostic developmental construct shaped by early attentional–emotional mechanisms, rather than a disorder-specific identity.