Love, eye contact and the developmental origins of empathy v. psychopathy

Background A propensity to attend to other people's emotions is a necessary condition for human empathy. Aims To test our hypothesis that psychopathic disorder begins as a failure to attend to the eyes of attachment figures, using a `love' scenario in young children. Method Children with oppositional defiant disorder, assessed for callous–unemotional traits, and a control group were observed in a love interaction with mothers. Eye contact and affection were measured for each dyad. Results There was no group difference in affection and eye contact expressed by the mothers. Compared with controls, children with oppositional defiant disorder expressed lower levels of affection back towards their mothers; those with high levels of callous–unemotional traits showed significantly lower levels of affection than the children lacking these traits. As predicted, the former group showed low levels of eye contact toward their mothers. Low eye contact was not correlated with maternal coercive parenting or feelings toward the child, but was correlated with psychopathic fearlessness in their fathers. Conclusions Impairments in eye contact are characteristic of children with callous–unemotional traits, and these impairments are independent of maternal behaviour.