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

Background: 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. Methods: 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. Results: 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. Conclusions: 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.