***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Early-starting child conduct problems ( CP ) are linked to the development of persistent antisocial behavior . Research ers have theorized multiple pathways to CP and that CP comprise separable domains , marked by callous-unemotional ( CU ) behavior , oppositional behavior , or ADHD symptoms . However , a lack of empirical evidence exists from studies that have examined whether there are unique correlates of these domains . METHODS We examined differential correlates of CU , oppositional , and ADHD behaviors during the preschool years to test their potentially distinct nomological networks .  Multi  method  data  , including  parent and teacher reports and observations of child behavior  , were drawn from a prospect i ve , longitudinal study of children assessed at age 3 and age 6 ( N = 240 ; 48 % female ) . RESULTS Dimensions of CU , oppositional , and ADHD behaviors were separable within Confirmatory Factor Analyses across mother and father reports . There were differential associations between CU , oppositional , and ADHD behaviors and socioemotional , cognitive , and behavioral outcomes : CU behavior was uniquely related to lower moral regulation , guilt , and empathy . ADHD was uniquely related to lower attentional focusing and observed effortful control . Finally , CU behavior uniquely predicted increases in teacher-reported externalizing from ages 3 - 6 over and above covariates , and ADHD and oppositional behavior . CONCLUSIONS Consistent with theory , dimensions of CU , ADHD , and oppositional behavior demonstrated separable nomological networks representing separable facets within early-starting CP This study examined whether Project Support , a parenting intervention shown to reduce child conduct problems , also exerts positive effects on features of  psychopathy in children . Participants were 66 families ( mothers and children ) recruited from domestic violence shelters who participated in a r and omized controlled trial evaluating Project Support . Each family included at least one child between the ages of 4 and 9 who was exhibiting clinical levels of conduct problems . Families were r and omly assigned to the Project Support intervention condition or to an existing services comparison condition , and they were assessed on 6 occasions over 20 months , following their departure from the shelter . Children in families in the Project Support condition , compared with those in the comparison condition , exhibited greater reductions in features of psychopathy . Moreover , the changes in features of psychopathy remained after accounting for changes in conduct problems .  Project Support ’s effects on features of psychopathy were mediated by improvements in mothers ’ harsh and inconsistent parenting . These findings on the effects of an intervention on features of psychopathy are the first from a r and omized controlled trial . They inform the debate about whether features of psychopathy in children  are responsive to intervention , and hold important implication s for clinical practice The reliability and predictive validity of two experimental self-report versions of two measures of psychopathic features in youth , the Antisocial Process Screening Device ( APSD : Frick & Hare , 2001 ) and a modified version of the Child Psychopathy Scale ( CPS : Lynam , 1997 ) were examined in a sample of 69 arrested youth ( M age = 14.4 years ) referred to a juvenile diversion program . Parents or legal guardians completed parent-rating versions of the same measures . Reliability indicators for the APSD total measure were satisfactory although internal consistency indices ( coefficient alpha ) for the Callous/Unemotional and Impulsive/Conduct Problems scales were slightly lower than desirable . Reliability indicators for the CPS were excellent after deleting items that had poor corrected item-to-CPS total score correlations . Positive and statistically significant correlations for all measures were obtained with prospect i ve measures of program failure ( range 0.22 - 0.36 ) and rearrest at 1 year follow-up ( range 0.33 - 0.56 ) . Although further research is needed prior to the clinical use of these measures , these results signal the potential of such measures to inform clinical judgments regarding treatment compliance and risk with justice-involved youth OBJECTIVE To evaluate the effectiveness and mechanisms of Hitkashrut , a " common elements " co-parent training ( PT ) program for early intervention with preschoolers ( 3 - 5 years of age ) at risk for conduct problems ( CP ) . METHOD A r and omized controlled trial with 140 participants in PT and 69 in a minimal intervention control group . The primary outcome ( presence of CP ) was assessed at pre-intervention , post-intervention , and 1-year follow-up . Callous-unemotional traits , effortful control , parental distress , negative/inconsistent parenting , and couple relationship quality were assessed at pre- and post-intervention , whereas callous-unemotional traits and effortful control were also assessed in the PT group at follow-up . Retention was 87.1 % at post-intervention and 60 % at follow-up . Hitkashrut incorporated evidence -based components of established PT programs into a culturally adapted protocol . The facilitators were trained and supervised psychologists working in Israel 's Educational Psychology Services . RESULTS Intervention effect ( Cohen 's d ) was large at post-intervention ( ES = .76 , p < .001 ) , and an additional medium effect was found at follow-up ( ES = 0.63 , p < .001 ) . Parallel post-intervention and follow-up intervention effects were also found in the degree of clinical ly significant improvements . Effects of the intervention on callous-unemotional traits ( ES = 0.85 , p < .001 ) and effortful control ( ES = 0.47 , p < .001 ) were maintained at follow-up . Follow-up improvement in CP was mediated by improvements in parental practice s and distress . CONCLUSIONS Hitkashrut 's implementation and subsequent dissemination in real-world setting s demonstrates the potential effectiveness of common elements programs to promote innovations within service-delivery systems . Improvements in dispositional variables and the mediated follow-up effect support theoretical cascade models that emphasize early developmental malleability and the growing preventive effects of PT 's facilitated parental changes on disruptive developmental trajectories . Clinical trial registration information - The effect of a " common elements " co-parent training program ( called ' Hitkashrut ' ) on conduct in preschoolers at risk for conduct problems ; http://www.anzctr.org.au ; ACTRN12612000148875 This study examines the treatment outcomes of 139 , 6–11 year-old , clinical ly referred boys and girls diagnosed with Oppositional Defiant Disorder ( ODD ) or Conduct Disorder ( CD ) who were r and omly assigned to a modular-based treatment protocol  that was applied by research study clinicians either in the community ( COMM ) or a clinic office ( CLINIC ) . To examine normative comparisons , a matched sample of 69 healthy control children was included . Multiple informants completed diagnostic interviews and self-reports at six assessment timepoints ( pretreatment to 3-year follow-up ) to evaluate changes in the child ’s behavioral and emotional problems , psychopathic features , functional impairment , diagnostic status , and service involvement . Using HLM and logistic regression models , COMM and CLINIC showed significant and comparable improvements on all outcomes . By 3-year follow-up , 36 % of COMM and 47 % of CLINIC patients no longer met criteria for either ODD or CD , and 48 % and 57 % of the children in these two respective conditions had levels of parent-rated externalizing behavior problems in the normal range . We discuss the nature and implication s of these novel findings regarding the role of treatment context or setting for the treatment and long-term outcome of behavior disorders Booster interventions have been presumed to be important methods for maintaining the effects of evidence -based programs for children with behavioral problems , but there has been remarkably little empirical attention to this assumption . The present study examines the effect of a child-oriented booster preventive intervention with children who had previously received an abbreviated version ( 24 child sessions , 10 parent sessions ) of the Coping Power targeted prevention program . Two hundred and forty-one children ( 152 boys , 89 girls ) were screened as having moderate to high levels of aggressive behavior in 4th grade , then half were r and omly assigned to receive the abbreviated Coping Power program in 5th grade , and half of the preventive intervention children were then r and omly assigned to a Booster condition in 6th grade . The Booster sessions consisted of brief monthly individual contacts , and were primarily with the children . Five assessment s across 4 years were collected from teachers , providing a three-year follow-up for all children who participated in the project . Results indicated that the abbreviated Coping Power program ( one-third shorter than the full intervention ) had long-term effects in reducing children ’s externalizing problem behaviors , proactive and reactive aggression , impulsivity traits and callous-unemotional traits . The Booster intervention did not augment these prevention effects . These findings indicate that a briefer and more readily disseminated form of an evidence -based targeted preventive intervention was effective . The findings have potential implication s for policy and guidelines about possible intervention length and booster interventions This study examined dimensions of callous behaviors in early childhood and the role of these behaviors in the development of conduct problems , as well as responsiveness to a family-centered preventative intervention . Caregiver reports of callous behaviors were examined using exploratory and confirmatory factor analysis . Problem behavior was examined using within- and cross-informant reports of these behaviors . Parenting was measured using observational methods within the context of a r and omized control trial of the Family Check-Up with a sample of 731 ethnically diverse boys and girls ( followed from ages 2 to 4 ) at high risk for later conduct problems . Results demonstrated that a measure of deceitful-callous ( DC ) behaviors had acceptable factor loadings and internal consistency at ages 3 and 4 . DC behaviors at age 3 predicted problem behavior concurrently and longitudinally within and across informant . However , DC behaviors did not reduce the effectiveness of the family preventative intervention .  These findings have implication s for our underst and ing of behaviors that may precede later callous-unemotional traits and for our underst and ing of the development and prevention of early starting conduct problems Objective The aim of the present study was to determine whether psychopathic traits act as a predictor and /or moderator of the effectiveness of Multisystemic Therapy ( MST ) . Method The sample included N = 256 adolescents ( 188 boys and 68 girls ) referred for conduct problems , r and omized to MST or Treatment As Usual ( TAU ) . The mean age was 16 years ( SD = 1.31 ) . Assessment s were carried out before and immediately after treatment ( 6 months later ) . Three psychopathic traits ( callous/unemotional traits , narcissism , and impulsiveness ) were assessed with parent reports . Adolescents and parents were informants on externalizing problems . Results MST was more effective than TAU in decreasing externalizing problems for the “ lower callous/unemotional ” and “ lower narcissism ” group , but not for the “ high callous/unemotional ” and “ high narcissism ” group ( moderators ) . Impulsiveness was found to predict more post-treatment externalizing problems rated by adolescents ( predictor ) , but not more post-treatment externalizing problems rated by parents . Conclusions These findings point out the clinical relevance of adequately assessing psychopathic traits in adolescents referred for treatment of antisocial behaviour , and identifying those adolescents who show high levels of these traits . It is important to tailor MST specifically to meet the needs of juveniles with high levels of callous/unemotional traits and high levels of narcissism to obtain the same level of effectiveness as with juveniles scoring lower on these traits Impairments in emotion recognition skills are a trans-diagnostic indicator of early mental health problems and may be responsive to intervention . We report on a r and omized controlled trial of " Emotion-recognition-training " ( ERT ) versus treatment-as-usual ( TAU ) with N=195 mixed diagnostic children ( mean age 10.52 years ) referred for behavioral/emotional problems measured at pre- and 6 months post-treatment . We tested overall outcomes plus moderation and mediation models , whereby diagnostic profile was tested as a moderator of change . ERT had no impact on the group as a whole . Diagnostic status of the child did not moderate outcomes ; however , levels of callous-unemotional ( CU ) traits moderated outcomes such that children with high CU traits responded less well to TAU , while ERT produced significant improvements in affective empathy and conduct problems in these children . Emotion recognition training has potential as an adjunctive intervention specifically for clinical ly referred children with high CU traits , regardless of their diagnostic status 
    Output:
    
Overall , the evidence supports the idea that children with CU traits do show reductions in both their CU traits and their antisocial behavior , but typically begin treatment with poorer premorbid functioning and can still end with higher levels of antisocial behavior .