Journal of Applied Research on Children - Informing Policy for Children at Risk - Volume 14 - Issue 1 - Article 6

Oct 15, 2026

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Adolescent suicide is a major public health crisis, and suicidal thoughts and behaviors drive many psychiatric inpatient admissions. This study examines whether callous-unemotional (CU) traits relate to suicidal behavior in a high-risk inpatient sample of 396 adolescents. CU traits showed lower overall suicide behavior severity and fewer lifetime suicidal ideation endorsements, even controlling for established risk factors. However, CU traits weakened negative associations when family history risk was present and intensified effects on suicide attempt lethality via an aggregated risk latent variable, indicating context-dependent risk and clinical relevance.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages27

Reading Time1 h 8 min

AccessFree to download

Abstract

Introduction

Methods

Results

Conclusion

Journal of Applied Research on Children: Informing Policy for Children at Risk | Volume 14
Issue 1 Child and Adolescent Suicide
Prevention | Article 6 | | --- | --- | | 2023
The Association between Callous-Unemotional (CU) Traits and Suicidal Behavior in a Psychiatric Inpatient Adolescent Sample
Emily C. Kemp PhD
University of California San Diego, [emkemp@health.ucsd.edu](emkemp@health.ucsd.edu)
Paige Picou PhD
University of Rochester Medical Center, [paige_picou@urmc.rochester.edu](paige_picou@urmc.rochester.edu)
Erin P. Vaughan MA
Louisiana State University and Agricultural and Mechanical College, [evaugh7@lsu.edu](evaugh7@lsu.edu)
Emily L. Robertson PhD
Center for Child Behavior, [admin@centerforchildbehavior.com](admin@centerforchildbehavior.com)
Toni M. Walker PhD
The Harris Center for Mental Health and IDD, [twalker93414@gmail.com](twalker93414@gmail.com)
lelonweipsadfditdioitninl lohtr:s[https://digitalcommons.library.tmc.edu/childrenatrisk](https://digitalcommons.library.tmc.edu/childrenatrisk) | | Recommended Citation EC Kemp, P Picou, EP Vaughan, et al. (2023) "The Association between Callous-Unemotional (CU) Traits and Suicidal Behavior in a Psychiatric Inpatient Adolescent Sample," Journal of Applied Research on Children: Informing Policy for Children at Risk: Vol. 14: Iss. 1, Article 6. DOI: [https://doi.org/10.58464/2155-5834.1549](https://doi.org/10.58464/2155-5834.1549) Available at: [https://digitalcommons.library.tmc.edu/childrenatrisk/vol14/iss1/6](https://digitalcommons.library.tmc.edu/childrenatrisk/vol14/iss1/6) The Journal of Applied Research on Children is brought to you for free and open access by CHILDREN AT RISK at DigitalCommons@The Texas Medical Center. It has a "cc by-nc-nd" Creative Commons license" (Attribution NonCommercial No Derivatives) For more information, please [contact](contact digitalcommons@exch.library.tmc.edu)[ digitalcommons@exch.library.tmc.edu](contact digitalcommons@exch.library.tmc.edu) The Association between Callous-Unemotional (CU) Traits and Suicidal Behavior in a Psychiatric Inpatient Adolescent Sample Acknowledgements The authors have no disclosures or potential conflicts of interest to report. Authors Emily C. Kemp PhD, Paige Picou PhD, Erin P. Vaughan MA, Emily L. Robertson PhD, Toni M. Walker PhD, Paul J. Frick PhD, Ryan M. Hill PhD, and John de Back MD This article is available in Journal of Applied Research on Children: Informing Policy for Children at Risk: [https://digitalcommons.library.tmc.edu/childrenatrisk/vol14/iss1/6](https://digitalcommons.library.tmc.edu/childrenatrisk/vol14/iss1/6) ABSTRACT INTRODUCTION: Suicide in adolescents poses a major public health crisis as the second leading cause of death in youth. Suicidal thoughts and behaviors (STBs) are a principal reason for psychiatric hospitalization among adolescents. Numerous studies have identified risk factors (e.g. , depression, borderline personality (BPD) features, family history of suicide) associated with STBs, while research in adults largely reports that the affective component of psychopathy, captured by callous-unemotional (CU) traits, is negatively associated with STBs. However, the relationship between CU traits and STBrisk among adolescents remains unclear. METHODS: The present study tested associations between self-reported CU traits and STBs in a high-risk sample of adolescents ( N = 396, Mage = 14.5, SDage = 1.6) hospitalized for psychiatric inpatient acute care, 84% of whom were admitted for STBs. Hierarchical regressions were utilized to test the association between CU traits and STB outcomes, including clinician-rated STB severity, any endorsement of lifetime suicidal ideation (SI) or suicide attempt (SA) , total number of self-reported SAs, and any report of a past medically serious SA according to clinician judgement , and to test whether CU traits moderated the influence of STB risk factors on these outcom

FAQs

What is the main research question of the study?

The study tests whether self-reported callous-unemotional (CU) traits are associated with suicidal thoughts and behaviors in a high-risk psychiatric inpatient adolescent sample, and whether CU traits moderate the effects of suicide risk factors.

How were CU traits and suicidal outcomes measured?

CU traits were self-reported. Outcomes included clinician-rated suicidal behavior severity, lifetime suicidal ideation and suicide attempt endorsements, total number of self-reported suicide attempts, and medically serious suicide attempts based on clinician judgment.

What key findings were reported about CU traits and suicidal behavior?

CU traits were associated with lower suicidal behavior severity overall and with lower likelihood of any lifetime suicidal ideation. Significant interactions showed CU traits diminished negative associations in the presence of family history of suicide and increased suicide attempt lethality through an aggregated risk factor representing depression, BPD features, affective lability, impulsivity, and trauma.

What clinical implications does the study suggest?

Clinicians should consider CU traits during suicide risk assessments, especially for adolescents in acute care or high-risk settings. The findings also support tailored interventions and careful safety planning for adolescents with elevated CU traits.

Oct 15, 2026

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