Research into the nature of callousness is both helped and hindered by its recognition within the construct of psychopathology. However, not only do competing models of the condition exist which can differ in their exact terminology (Skeem et al, 2003, p. 41), but callousness may find its expression in all human lives. Contrast that to any other disease process where a blood test or observation of an unusual growth can be positively diagnostic. To return to the question of terminology, questions arise as to whether what are called callous-unemotional traits (CU) are truly synonymous or even asymptotic to concepts such as meanness, boldness and such like. However, this is the current parlance of such traits in academia and forensic settings.
Psychopathy itself, even in its full expression as a disorder, may not be entirely maladaptive (Benning et al, 2018, p. 585). Some professions can be specifically attractive to the psychopath, such as policing, although when certain traits are heightened it can lead to poor outcomes for the public in that field (McKinley & Verona, 2023, p. 591). High levels of perceived charisma and leadership abilities correlate with measures of psychopathy (Welsh & Lenzweger, 2021, p. 9). We can even admire to some degree the person in policing, the military or even business who acts with little regard to emotionality and is able to shake off or completely ignore what can be interpreted as negative sentimentality.
Callous and unemotional traits can be specifically imaged within the amygdala (Dotterer et al, 2020, p. 918), further indicating that this is possibly an evolutionary artifact rather than a disease process, perhaps maladaptive in the context of civilizational prosociality but not within the much broader scope of our existence as a species. The problem it poses to civilization has been recognized from its earliest days, and even the ancients sought to cure it or weed it out (Abdul-Hamid & Stein, 2023, p. 671). Still, when callousness is given free reign, particularly collectively, the consequences can be as dire as the Holocaust itself, or even merely the tendency to ignore it (Weisel, 2006). Several people in Canada have been voluntarily euthanized due to no other factor than chronic homelessness, begging the question of societal indifference to the inadequacy of social safety systems and an apparent preference to simply kill people whose live are incongruent with the demands of free market capitalism (Reed, 2024). History may eventually look as unkindly on the latter as it does on the former.
Callousness may be defined as an insensitive and cruel disregard for the feelings and even the rights of others. It is a trait not uncommon in forensic populations where it can rise to a clinical degree and become diagnostic in multiple personality disorders (Latzman et al, 2020). However, every individual may have callous moments either in interpersonal interactions or as a response to environmental factors.
Compassion could be interpreted as the opposite of callousness. A state where both cognitive and affective empathy drive a person to act in an assistive manner. Derived from etymological roots meaning “to suffer with”, phenomenon such as compassion fatigue are elucidated to the extent that excessive compassion can be seen as maladaptive as clinical callousness (Gustafsson & Hemberg, 2022, p. 157). Certainly in some high stake professions where assisting in issues that involve suffering, not least of all the medical profession or practicing law, an emphasis is placed on maintaining an objectivity considered imperative to being able to work effectively. As such, and as is often the case, the callousness observed at extreme ends of the spectrum are expressions of an extreme change in degree rather than a wholly different kind of psychological experience. Studying callousness in isolation, particularly if there is any extent to which it may be correlated with biological factors like neurology and endocrinology, could serve numerous purposes within the field of behavioral management not strictly limited to issues of criminality.
Although the study by Rodgers et al (2024, p. 203) is drawn from a pool of 1200 youths, as will happen in any longitudinal study, the ending sample size of only 9 participants hopefully fairly reflects the natural drop out rate and the extreme granularity of the question, it nonetheless challenges credulity. The finding is that a supportive relationship from the birth mother seems to have no effect on the expression of CU traits in those subject to rearrest, Despite its limitation, the result seems to resonate with commonly lived experience that some people have these callous-unemotional traits regardless of their upbringings or support networks. This alone indicates that this is an evolutionary response, organically borne on genetic pathways that have been refining themselves for incomprehensible lengths of time. The study, as well as an understanding of evolution itself, highlights how intractable such a problem may prove to be. One could hardly conceive of a greater source of support and validation than a loving mother. Certainly no state-run system can adequately replace it, and should not endeavor to try.
Clinical Expression
It is important to reiterate that this paper attempts to understand what forensicists refer to callous-unemotional (CU) traits in an isolation moderately divorced from the medical psychology model, and even that will be parsed even further. The hope is that in doing so we may more adequately respond to it through therapies and social policy. In the same way that an aspirin can treat a fever but not the infection causing it, some demonstrable public good may yet be achievable by focusing on this symptom. Although its dominance of the personality, and its association with life-course persistent criminality, is found in the most extreme cases of truly deviant behavior (Cardinale et al, 2021, p. 39), being callous and unemotional commonly exists beneath the clinical level. To a degree, it may even be a human universal and prophylactic against severe existential psychological disturbance. Otherwise, every far away war might disable us. Being unemotional, famously, is considered imperative in a clinical setting. A surgeon who fell into a deep depression every time he lost a patient may not be a surgeon for long, and indeed declines in empathy and increases in cynicism have been broadly observed in medical students over the course of their education particularly during the clinical phase (Howick et al, 2023, p. 1) .
In pursuing an understanding of causality on the issue of callousness, although we must examine its clinical expression and origin we can be misled by studying it in isolation. The medical model of psychology by its nature seeks disorder and then diagnosis it with interventionist intent. There is both a strength and a weakness to this palliative approach. The impetus to improve the quality of life for people who are suffering is inherently humanitarian, and therefore laudable. However, this individualistic emphasis can be criticized as verging on the ideological. Comprehending callousness from an ecological model of psychology, particularly as it is a social phenomenon, highlights blind spots in the dominant paradigm. Utilizing such a perspective in no way obviates the potential need for a medical response, but occasionally the reverse of that statement can seem implied by all the talk of idiosyncratic neural anatomy, hormonal dysregulation and disease processes. It is important to remember that forensic psychology is not clinical psychology, nor is it experimental psychology. Though it is right and proper that forensics be informed by these adjacent disciplines, it is no way limited by them. Indeed, it is the entire purpose of forensic psychology to be adjudicated, not peer reviewed nor dependent upon therapeutic outcomes, but tested within a court of law. Almost paradoxically, freeing the subspecialty in this way could result in a superior relief of human misery by informing social policy towards higher productivity governance.
As callousness has a greater effect size on conduct disorders, and unemotional traits negatively correlated with both externalizing behaviors and sensation seeking (Essau et al, 2006, p. 454), we must ask the question as to whether these are not separate traits and their amalgamation into a single variable may be improper. Callousness may not merely be a more extroverted version of being unemotional. As with many things in the medical model of psychology it is possible to conflate conditions that are similar in presentation or outcomes. A man who falls from a great height may expire from injuries indistinguishable from another who has been bludgeoned to death, but the actual etiology is profoundly divergent.
Neural Correlates
Callous and unemotional traits can be specifically imaged within the amygdala (Dotterer et al, 2020, p. 918), further indicating that this is possibly an evolutionary artifact rather than a disease process, perhaps maladaptive in the context of civilizational prosociality but not within the much broader scope of our existence as a species.
While frontal lobe deficits seem to be of account in people who may show callous affect (Reber & Tranel, 2019, p. 147), the frontal lobe is also associated with our capacity to reason and IQ. People exist who are perfectly capable of reason, and even have high IQ’s, and yet can be callous. This is the lived experience, and yet high IQ is associated with maladaptive traits such as anxiety disorder and depression (Ravgani et al, 2024, p. 7). Intelligence is not automatically indicative of prosocial sentimentality, but it is interesting to note those who naturally engage in thorough cognitive processing seem prone to ruminations which negatively impact their functionality. Being an effective person in whatever endeavors one chooses to pursue can be aided by high intelligence, but that benefit is easily adulterated by emotional lability, and often is.
The amygdala is thought to be major center in the brain for processing emotions, and an important hormone to its function is oxytocin. Interestingly, some recent studies with oxytocin show some promise in diagnosing conditions related to emotional functions. Low plasma oxytocin level are found in US Veterans diagnosed with PTSD and may be an effective biomarker for the prediction of severity as well as an effective therapeutic avenue (Horn et al, 2024, p.1). In China the application of exogamous oxytocin has shown some promise in encouraging prosocial behavior in incarcerated youth (Yang et al, 2021, p. 430). Western medicine tends to lean toward the use of novel drugs to treat psychiatric and behavioral disorders. The Chinese application of exogamous oxytocin merely artificially but directly elevates the level of a naturally occurring hormone in the bloodstream, rather than a novel molecule never before encountered by the human body. In that regard alone, it may have promise, and represent something overlooked by our own cultural bias. However, such an approach is not without its complications. Other possible pharmacological avenues may be available, as we shall see, but those are also deeply fraught with controversy and possible unintended consequences.
The Legacy Effect
The tendency of abuse and trauma to cascade through generations is both extremely well documented and not terribly well understood (Greene et al, 2020). An intriguing avenue of exploration in recent years has been looking at endogenous oxytocin production and even the use of exogenous oxytocin as a therapeutic response. Oxytocin is usually produced during all manner of prosocial behaviors and seems mostly to work as a feedback loop to encourage more prosocial behavior and resilience in the face of psychological adversity (Sharma et al, 2020, p. 214). Lower levels of maternal oxytocin have been measured in new mothers who struggle during the post-partum period and are predictive of behavioral problems in their children by pre-school age (Kohlhoff et al, 2023, p. 1). Early studies on treating and providing support to the parents indicate may be a superior strategy (Lebowitz et al, 2020, p. 362), but the system as it currently composed has significant momentum in alternate responses.
Oxytocin may exist in a negative feedback mode as well, where the less of it is that is produced in the social ecosystem into which one is born will have enduring effects that are life course persistent and a negative legacy across families (England-Masson et al, 2022, p. 1). When mothers who were abused as children themselves produced oxytocin, rather than having its usual prosocial effect, it actually correlated with increases in emotional dysregulation and negative parenting (Julian et al, 2018, p. 375). Such outcomes may contraindicate use of exogamous oxytocin when there is prominent childhood abuse (Londono Tobon et al, 2018, p. 401). Our social regulation system is working contrary to expectations in such cases, and becomes a significant stimuli for perpetuating trauma and dysfunction often at great public expense not to mention human suffering.
Fierce debate rages over recent studies that seem to show that medical students lose empathy and gain cynicism over the course of medical school (Howick et al, 2023, p. 270). While different actuarial instruments were used to survey the medical students involved than are used on forensic populations to test for Callous-Unemotional (CU) traits, it is not a giant intellectual leap to see potential parallels between CU traits and the more eloquently worded description given to aspiring doctors. Possibly, research is poorly served by this dichotomy. It is an undeniable fact that there is significant mortality within the medical field, much of it the result of careless errors (Kohn et al, 2020, p. 1). The degree to which callousness plays a part in any of these negative outcomes warrants the most serious attention by all stakeholders. It would be a very interesting study to measure blood plasma levels and do imaging studies on medical students while they go through this educational process. However, no standard of what is a healthy level of plasma oxytocin or what the ideal structure of an amygdala has been set, or even particularly imagined. We merely see the differences between participants in a study in contrast to healthy controls. It may well be that treatment with exogamous oxytocin of medical students and doctors could increase their empathy and perhaps reduce medical errors. However, it is also unknown and entirely impossible to predict whether or not such treatment could result in burnout because the doctors become emotionally overwhelmed by the suffering they regularly encounter as part of their professional duties.
Affective empathy deficits correlate with greater aggression in psychopathy than cognitive empathy deficits and with higher trait callousness (Camara et al, 2025, p.1). In other words, despite any capacity to intellectually understand how someone is feeling, the failure to share those feelings increases the likelihood to violate the rights of others or be indifferent to the pain one might cause. The only suffering or deprivation given any merit by the perpetrator is their own. This may be the cause of an increase in externalizing behaviors. On a more mundane level, this can be seen as the difference between someone simply stepping over a homeless person on their way to work and someone who harasses the homeless while they do so. Or the doctor perhaps quietly inured to the pain caused by the diseases they treat, and the surgeon who works while intoxicated indifferent to safety. It is the difference between the policemen who is perhaps jaded and excessively officious, and the one who commits an unlawful homicide in the course of duty. It is the difference between the bottom line oriented businessman and the corporate raider who dismantles a company to extract profit. Although we can view these things in their starkest terms in the behavior of psychopaths, and for the sake of empiricism and risk management measure them most closely in forensic populations, these principles could be included in a conception of a prosocial general intelligence often highly demanded by current affairs and circumstances.
If you are able to understand why someone is upset, but do not feel that distress yourself, you are more likely to engage an externalizing response. If you are able to feel what someone else is feeling, regardless of whether or not you understand it, you are less likely to deploy problematic reactions. The tendency you are most likely to display, may be strongly influenced by activity in the amygdala and the prevalence of oxytocin in blood plasma. The exact mechanism remains unclear. However, evidence is accumulating that the more anti-social behaviors correlating with these metrics are disproportionately found in forensic populations. Still, all of these behaviors exist as an expected spectrum of human experience. Few, if any, people can claim they have never had an antisocial moment in their lives, and the ones that do should raise the most suspicion for a plethora of personality disorders.
Unique Stressors of Modernity
Social instincts and prosocial behaviors may become attenuated in the absence of appropriate stimulus, leading to less empathy and greater callousness. Loneliness is currently broadly recognized as being epidemic in proportion and over 150,000 US deaths a year can be attributed to social isolation (Veazie et al, 2019). Even in the absence of anti-social behaviors, possession of trait callousness is associated with higher degrees of reported loneliness (Matlasz, 2021). Again we see a possible feedback loop where callousness results in loneliness and loneliness produces callousness in a cycle where it is difficult to discern an origin point or a point of inflection that could lead to superior outcomes.
Disappointingly, technologies which increase our social engagement, while they have improved the quality of life in many ways, seem to be inversely proportionate to the emergence of the loneliness epidemic making them a key suspect in its causation (Jeste et al, 2020, p. 553). For those youths coming of age after childhood abuse into the data smog of the modern world, they have the greatest tendency to perpetuate cyberbullying on their peers, thereby contributing to a higher likelihood of negative social media experiences (Fang et al, 2022). Having callous and unemotional traits not only increased the likelihood of perpetrating cyberbullying but also for being victims of it (Wagner et al, 2020, p. 757). As we see repeatedly, these phenomenon build on each other. Further, the more information we are exposed to, the likelihood becomes higher that we will use of less of it to make important decisions (Hong & Kim, 2020).
Causation with callousness, even were greater data available, has difficulty escaping an infinite regression. The effects are the causes. The means are the ends. Just as the modern world demands our highest prosociality, those very demands send us in the other direction.
Controversial Interventions
There are obvious difficulties when trying to “solve” what amounts to a normal human trait like callousness, albeit intervention is unlikely in what could be thought of as subclinical expressions of the tendency. Still, if we consider that depression and anxiety disorders are also extreme manifestations of a fundamental human tendencies, we can see both the problems and the promise of seeking to ameliorate the conditions that lead to truly problematic callousness. However, because of the wide acceptance of the medical model of psychology, which results in such questionable practices as using mouse models as a proxy for complex human behavior (Ford, 2024), even a cautious approach to the problem increases the already high inherent complexity of the issue.
Without question, the best way to prevent the emergence of severe callous-unemotional traits as measured by actuarial instruments in forensic populations is to prevent the adverse childhood experiences that are thought to correlate with their emergence in the personality. To this end the United States does indeed have child-protective services and laws intended to protect children by punishing those who abuse them. However, the efficacy of the strategies employed by such services, such as family separation as opposed to family support, has been called into question (Austin et al, 2020). Additionally, such state administered agencies and facilities are chronically underfunded and understaffed (Matthews et al, 2020). When abuse occurs within an individual institution, which is hardly unknown, negative outcomes are no less profound than when they occur privately (Car et al, 2020, p. 660). Staff themselves are subject to vicarious trauma and the field has very high levels of burnout (Molnar et al, 2020). Many areas of concern are also understudied (Finkelhor, 2020). Broad article review is underway, but the aggregation of data is hampered by the natural lag of longitudinal studies. Specific responses and programs intended for children cannot be properly measured until many years later and then only with great effort.
Another potential response, the use of psychedelic assisted therapy, is not only extraordinarily controversial but employs methodology which regulatory bodies such as the Food and Drug Administration (FDA) are very suspicious of (Kupferschmidt, 2024). 3,4-Methyl enedioxy methamphetamine (MDMA), also known as the party drug ecstasy, has shown anecdotal evidence of treating callousness (Newer, 2023) and is currently undergoing testing as a possible therapeutic avenue for treating Post Traumatic Stress Disorder (PTSD) (Latimer et al, 2021). The FDA recently declined to approve MDMA as a treatment for PTSD (Kupferschmidt, 2024), but testing continues on this and other psychedelic compounds and early indications are that these could be potent palliatives (Blatchford et al, 2021, p. 163).
Psychedelic substances have a long, and occasionally sordid, history with the public at large and the psychological sciences in particular. Explication of that history is readily found in numerous other sources and beyond the scope of this paper. The exploration of psychedelics as a therapeutic modality has been hindered by its legal status, but that is hardly where such problems end. As a group of baroque molecules they defy the standard drug testing protocols. It is impossible to test them against a placebo as their effects are obvious. Therapeutic use involves a certain level of supervision dedicated to the pursuit of a safe experience and a positive outcome. Such guidance is anathema not only to every other drug study but to the scientific method itself. These are very large hurdles to overcome. Nonetheless, numerous efforts are underway for their efficacious use. Depending on individual social networking, their ease of their acquirement for recreational use also makes psychedelics an operative object within society.
Although the exact mechanics of psychedilic action is at best loosely understood, and such actions can vary considerably among molecules in this class, generally understood they seem to have profound effects on the brain. These effects alter mood, perception and the sense of self. An enduring neuroplasticity has been demonstrated (Siegel et al, 2024, p. 131). Single dose events have been known to make lasting changes with positive outcomes. Negative outcomes are not unknown, although the subject is prone to hyperbole and the vast majority of such events happen in unsupervised contexts (Schlag et al. 2022, p. 258). Regardless of their current status, or any future determination of their efficacy, interest in psychedelics show no sign of abatement
Discussion
Solving for callousness may be akin to solving for love. It is a human trait no one entirely escapes and yet it causes a large portion of human suffering and dysfunction. Callousness does. Love has its own problems, but that is beyond the scope of this paper save noting that the idea of solving for love is terrifyingly dystopian. Even if we did cast out callousness we would be wise to take care what we use to fill the void. It is natural for me to care to more about my sick dog than your sick mother. By focusing our cares and narrowing the scope of identification we are better able to function in a world that has never had any shortage of suffering. Still, when its expression is problematic a better understanding can only serve the prosocial demands of society, and reduce that suffering at least to a degree.
It is not an unreasonably utopian endeavor to seek the expansion of empathy in human affairs despite its absence, at least episodically or contextually, being a human universal. Many of the societal problems we face seem related to a callous disregard for the rights and dignity of those around us. That disregard can be lethal in its effects. Even the willingness to face these problems seems at its most fundamental level to be related to trait callousness. The civilization we inhabit exists at a level of complexity and interconnectivity we have never faced before. In many ways, it is not so unusual that we are not doing better in handling these problems, than it is that we are doing as well as we are. With a superior understanding of our own emotions, and perhaps therapeutic support in managing them, we can do better.
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