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  1. Mohamad Khalil AE, Kuay HS, Husain M, Kueh YC
    PLoS One, 2023;18(2):e0276724.
    PMID: 36795657 DOI: 10.1371/journal.pone.0276724
    A key component in the study of antisocial behaviour among adolescents is the presence of callous-unemotional (CU) traits. Among the established tools available to measure CU traits is the Inventory of Callous-Unemotional traits (ICU). To date, there is no validated questionnaire to assess CU traits for the local population. Therefore, there is a need to validate the Malay version of the ICU (M-ICU) so that research can be conducted to explore CU traits among adolescents in Malaysia. The aim of the study is to validate the M-ICU. Two phases of cross-sectional study involving 409 (phase 1 -exploratory factor analysis (EFA), n = 180; phase 2-confirmatory factor analysis (CFA), n = 229) adolescents aged between 13 to 18 years old were conducted from July until October 2020 at six secondary schools in Kuantan district. Participants were selected via multistage random sampling. The ICU was initially translated into Malay language using forward-backward translation procedure by a group of bilingual researchers. Study participants completed the final version of the M-ICU questionnaire and socio-demographic questionnaire. Data was analysed using SPSS version 26 and MPlus software for factor structure validity by performing EFA and CFA. Initial EFA revealed three factors with two items deleted. A further EFA with two factors resulted in the deletion of unemotional factor items. Cronbach's alpha for overall scale improved from 0.70 to 0.74. CFA supported a two-factor solution with 17 items compared to the original English version that has three factors with 24 items. The findings revealed acceptable fit indices (RMSEA = 0.057, CFI = 0.941, TLI = 0.932, WRMR = 0.968). The study revealed that a two-factor model with 17 items of the M-ICU has good psychometric properties. The scale is valid and reliable to measure CU traits among adolescents in Malaysia.
  2. Kuay HS, Lee S, Centifanti LC, Parnis AC, Mrozik JH, Tiffin PA
    Int J Law Psychiatry, 2016 Jul-Aug;47:60-7.
    PMID: 27016774 DOI: 10.1016/j.ijlp.2016.02.035
    Although family violence perpetrated by juveniles has been acknowledged as a potentially serious form of violence for over 30years, scientific studies have been limited to examining the incidence and form of home violence. The present study examined the prevalence of family aggression as perpetrated by youths; we examined groups drawn from clinic-referred and forensic samples. Two audits of case files were conducted to systematically document aggression perpetrated by referred youths toward their family members. The purpose of the first audit was fourfold: i) to identify the incidence of the perpetration of family aggression among clinical and forensic samples; ii) to identify whether there were any reports of weapon use during aggressive episodes; iii) to identify the target of family aggression (parents or siblings); and iv) to identify the form of aggression perpetrated (verbal or physical). The second audit aimed to replicate the findings and to show that the results were not due to differences in multiple deprivation indices, clinical diagnosis of disruptive behavior disorders, and placement into alternative care. A sampling strategy was designed to audit the case notes of 25 recent forensic Child and Adolescent Mental Health Service (CAMHS) cases and 25 demographically similar clinic-referred CAMHS cases in the first audit; and 35 forensic cases and 35 demographically similar clinic-referred CAMHS cases in the second audit. Using ordinal chi-square, the forensic sample (audit 1=64%; audit 2=82.9%) had greater instances of family violence than the clinical sample (audit 1=32%; audit 2=28.6%). They were more likely to use a weapon (audit 1=69%; audit 2=65.5%) compared to the clinical sample (audit 1 and 2=0%). Examining only the aggressive groups, there was more perpetration of aggression toward parents (audit 1, forensic=92%, clinical=75%; audit 2, forensic=55.17%, clinical=40%) than toward siblings (audit 1, forensic=43%, clinical=50%; audit 2, forensic=27.58%, clinical=30%). Based on these findings, we would urge professionals who work within the child mental health, particularly the forensic area, to systematically collect reports of aggression perpetrated toward family members.

    Study conducted in England
  3. Kuay HS, Boothroyd LG, Towl GJ, Tiffin PA, Muñoz LC
    PMID: 34605308 DOI: 10.1177/0306624X211049190
    This study examined the relations between callous-unemotional traits and perpetration of aggression toward parents in two separate studies, while also considering motivation for aggression and parenting styles experienced among young people. Study 1 involved 60 parents of children aged between 11 and 17 years old. The online study found high callous-unemotional traits, as reported by parents, to be associated with aggression toward both parents. Both types of motivation (proactive and reactive, as reported by parents) were associated with aggression toward parents. Study 2 involved 42 youths from an alternative education sample (between 11 and 16 years old). Youths with higher self-reported callous-unemotional traits reported more aggression toward both parents. Both studies, which had different reporters and different samples, showed youths with higher callous-unemotional traits were more aggressive toward their parents. In discussing the results, we note the importance of including callous-unemotional traits in future research on parent-directed aggression and in studies on domestic violence more broadly.
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