Emotion versus cognition: differential pathways to theory of mind for children with high versus low callous-unemotional traits

J Child Psychol Psychiatry. 2019 Dec;60(12):1300-1308. doi: 10.1111/jcpp.13078. Epub 2019 May 31.


Background: Theory of mind (ToM) serves as a foundation for developing social cognition. Developmental theory suggests that early emotion understanding supports the development of ToM, but few studies have tested this question within longitudinal designs. Additionally, children with callous-unemotional (CU) traits directly challenge this theory as they appear to develop intact ToM despite deficits in emotion understanding. Inhibitory control is proposed as one possible compensatory mechanism for ToM development in children with high CU traits.

Methods: We examined emotion understanding and inhibitory control at age 3 as predictors of ToM at age 6 and tested whether these pathways were different in children with high versus low levels of CU traits. Multimethod data included observations of child emotion understanding and inhibitory control and parent reports of CU traits drawn from a prospective, longitudinal study (N = 240, 48% female).

Results: Consistent with our hypothesis, emotion understanding at age 3 significantly predicted ToM at age 6 only for children with low CU traits. Although there was a significant interaction between inhibitory control and CU traits in relation to later ToM, the simple slopes were not significant.

Conclusions: We find prospective longitudinal evidence that emotion understanding is a developmental precursor of ToM. However, this pathway was not evident in children with high CU traits. Future research is needed to further explore potential mechanisms by which children with CU traits develop ToM with a potential focus on higher-order cognitive skills.

Keywords: Theory of mind; callous-unemotional traits; emotion understanding; executive function.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Affective Symptoms / physiopathology*
  • Child
  • Child Development / physiology*
  • Child, Preschool
  • Comprehension / physiology*
  • Executive Function / physiology*
  • Female
  • Humans
  • Inhibition, Psychological*
  • Longitudinal Studies
  • Male
  • Social Perception*
  • Theory of Mind / physiology*