Emotional dysregulation, executive functions and callous-unemotional traits in children and adolescents with Oppositional Defiant Disorder/Conduct Disorder and Autism Spectrum Disorder: a direct comparison.

Researchers compared children with autism to those with behavioral disorders (ODD/CD) on emotional regulation, thinking skills, and empathy. Both groups had more difficulties than typical children, but with some differences. Children with behavioral disorders had more trouble controlling impulses and planning, while both groups struggled similarly with memory and flexibility. Emotional difficulties were common in both conditions but more severe in behavioral disorders.

The study shows these conditions share many challenges but have unique features too.

This comparative study examined emotional dysregulation, executive functions, and callous-unemotional traits in 138 children and adolescents (ages 10-17) with Oppositional Defiant Disorder/Conduct Disorder (ODD/CD), Autism Spectrum Disorder (ASD), and typical development. Both clinical groups showed higher rates of internalizing/externalizing symptoms, emotional dysregulation, callous-unemotional traits, and executive dysfunction compared to controls. ODD/CD participants demonstrated greater impulse inhibition deficits and planning/organization problems than ASD participants, while working memory and cognitive flexibility were similarly impaired. Emotional dysregulation emerged as a transdiagnostic symptom, though more pronounced in ODD/CD.

Callous-unemotional traits differed between groups: ODD/CD showed greater callousness and uncaring behaviors, while unemotionality levels were comparable. The findings highlight overlapping but distinct neuropsychological profiles between these conditions.

Findings support transdiagnostic approaches for emotional dysregulation while highlighting need for condition-specific interventions targeting executive functions. Clinicians should assess both shared and distinct neuropsychological profiles when developing treatment plans. The overlapping yet distinct patterns suggest potential benefits from integrated assessment approaches that consider both autism and behavioral disorder presentations.

Study limitations are not explicitly detailed in the abstract. The cross-sectional design limits causal inferences. Sample size breakdown suggests relatively small group sizes, particularly for the ASD group (n=35), which may limit statistical power and generalizability of findings.

Autism Spectrum Disorder (ASD), Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) share many symptomatic dimensions. Emotional dysregulation (ED) and Callous-Unemotional (CU) traits have been described as transdiagnostic symptoms as well as executive dysfunctions. However, few previous studies compared these disorders directly at a clinical and a neuropsychological level. 138 children and adolescents aged 10-17 years (n = 63 ODD/CD; n = 35 ASD and n = 40 TDC), with an intelligence quotient ≥80 were included. The three groups were compared on the emotional and behavioural characteristics by the CBCL 6-18 questionnaire (with particular attention to the emotional dysregulation profile), on the CU traits assessed by the ICU questionnaire (parent version), and the executive functioning assessed by the BRIEF parent form.

Compared to controls, ODD/CDs and ASDs, showed a higher proportion of internalizing and externalizing symptoms, greater emotional dysregulation, higher presence of callous-unemotional traits and executive dysfunction. While participants with ODD/CD significantly differed from those with ASD with higher deficits in impulse inhibition as well as greater planning and organization problems, the two populations did not differ in working memory or the ability to initiate or shift as measured by the BRIEF. ED was confirmed as a transdiagnostic symptom, though more highly represented in ODD/CD compared to ASD. CU traits were also seen as cross-disorder problems, confirming deficits in empathy across both disorder groups, albeit with somewhat different profiles: ODD/CDs showed greater callousness and uncaring than ASDs, while they did not statistically differ from them in the unemotionality.

Our study provides a better understanding of the clinical and neuropsychological character of ODD/CD and ASD populations, showing that they present as overlapping entities but with some specific features.