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Jansen JM, Franse ME. Executive functioning in antisocial behavior: A multi-level systematic meta-analysis. Clin Psychol Rev 2024; 109:102408. [PMID: 38430781 DOI: 10.1016/j.cpr.2024.102408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 01/30/2024] [Accepted: 02/19/2024] [Indexed: 03/05/2024]
Abstract
Neurobiological information - including executive functioning - is increasingly relevant for forensic clinical practice, as well as for the criminal justice system. Previous meta-analyses report that antisocial populations show impaired performance on executive functioning tasks, but these meta-analyses are outdated, have limitations in their methodological approach, and are therefore in need of an update. The current multi-level meta-analysis including 133 studies (2008-2023) confirms impaired performance in executive functioning (d=.42), but studies are heterogeneous. Several moderator analyses showed that neuropsychological test used, type of executive function component, and control group characteristics moderated the overall effect. Specifically, matching psychiatric problems in the non-antisocial control group eliminated any differences in executive functioning between groups. No moderation effects were found for assessment quality, hot or cold executive functions, and various population characteristics. These results could indicate that the assessment of executive functioning in antisocial populations may be less relevant for recidivism risk assessment than thought, although this should first be assessed in prospective longitudinal studies. Executive functioning could potentially be used to identify or screen for individuals with certain treatment needs or be used as a responsivity factor, especially in disorders which are often underdiagnosed in criminal justice settings.
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Affiliation(s)
- Jochem Milan Jansen
- Institute for Criminal Law & Criminology, Faculty of Law, Leiden University, Leiden, Netherlands; Inforsa, Arkin, Amsterdam, The Netherlands.
| | - Melanie Elisabeth Franse
- Netherlands Institute of Forensic Psychiatry and Psychology, Department of Science and Education, Herman Gorterstraat 5, 3511EW Utrecht, Netherlands; Institute of Education and Child Studies, Faculty of Social Sciences, Leiden University, Wassenaarseweg 52, 2333AK Leiden, Netherlands
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2
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Abstract
Functional magnetic resonance imaging (fMRI) studies consistently indicate differences in emotion processing in youth with conduct problems. However, no prior meta-analysis has investigated emotion-specific responses associated with conduct problems. This meta-analysis aimed to generate an up-to-date assessment of socio-affective neural responding among youths with conduct problems. A systematic literature search was conducted in youths (ages 10-21) with conduct problems. Task-specific seed-based d mapping analyses examined responses to threatening images, fearful and angry facial expressions, and empathic pain stimuli from 23 fMRI studies, which included 606 youths with conduct problems and 459 comparison youths. Whole-brain analyses revealed youths with conduct problems relative to typically developing youths, when viewing angry facial expressions, had reduced activity in left supplementary motor area and superior frontal gyrus. Additional region of interest analyses of responses to negative images and fearful facial expressions showed reduced activation in right amygdala across youths with conduct problems. Youths with callous-unemotional traits also exhibited reduced activation in left fusiform gyrus, superior parietal gyrus, and middle temporal gyrus when viewing fearful facial expressions. Consistent with the behavioral profile of conduct problems, these findings suggest the most consistent dysfunction is found in regions associated with empathic responding and social learning, including the amygdala and temporal cortex. Youth with callous-unemotional traits also show reduced activation in the fusiform gyrus, consistent with reduced attention or facial processing. These findings highlight the potential role of empathic responding, social learning, and facial processing along with the associated brain regions as potential targets for interventions.
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Affiliation(s)
- Kathryn Berluti
- Department of Psychology, Georgetown University, Washington, DC, USA.
| | - Montana L Ploe
- Department of Psychology, Washington State University, Pullman, DC, USA
| | - Abigail A Marsh
- Department of Psychology, Georgetown University, Washington, DC, USA
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3
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Zhu Y, Liu L, Yang D, Ji H, Huang T, Xue L, Jiang X, Li K, Tao L, Cai Q, Fang Y. Cognitive control and emotional response in attention-deficit/ hyperactivity disorder comorbidity with disruptive, impulse-control, and conduct disorders. BMC Psychiatry 2021; 21:232. [PMID: 33947370 PMCID: PMC8094501 DOI: 10.1186/s12888-021-03221-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 04/19/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND This study investigated cognitive and emotional functioning in children and adolescents with attention-deficit/hyperactivity disorder (ADHD) and disruptive, impulse-control, and conduct disorders (DICCD). METHODS Thirty patients with ADHD, 26 with DICCD, 22 with ADHD+DICCD were recruited from the outpatient department of Shanghai Changning Mental Health Center, plus 20 healthy controls (HC). Differences between the groups in cognitive and emotional functioning were examined using Golden's Stroop and Emotional Stroop tests. For Emotional Stroop Mean reaction time (RT) of positive word (POS) and negative word (NEG) with color congruence (C) or incongruence (I) were recorded as POS-C, POS-I, NEG-C and NEG-I, respectively. RESULTS For Golden's interference scores (IGs), both errors and RTs in the ADHD group were higher than in the other groups. Longer mean RTs of POS-C, POS-I, NEG-C and neural word (NEU) of the ADHD group, and NEG-I of ADHD+DICCD and DICCD groups were observed compared to HC. After 12 weeks of methylphenidate treatment, differences between ADHD subgroups and HC on Golden's Stroop RT disappeared, but differences in Golden's Stroop errors and Emotional Stroop mean RTs remained. The ADHD+DICCD group showed longer mean RTs in NEG-C, NEG-I and NEU of the Emotional Stroop test than the ADHD group. CONCLUSIONS Our study shows that regardless of emotional responding, deficit in cognitive control is the core symptom of ADHD. However, emotionally biased stimuli may cause response inhibitory dysfunction among DICCD with callous-unemotional traits, and the comorbidity of ADHD and DICCD tends to account for the negative emotional response characteristic of DICCD. These deficits may be eliminated by medication treatment in ADHD, but not the ADHD with comorbid DICCD. Our results support the notion that ADHD with comorbid DICCD is more closely related to DICCD than to ADHD.
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Affiliation(s)
- Yuncheng Zhu
- grid.415630.50000 0004 1782 6212Shanghai Hongkou Mental Health Center, Shanghai, 200083 China ,grid.16821.3c0000 0004 0368 8293Clinical Research Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China ,grid.410642.5Shanghai Changning Mental Health Center, Shanghai, 200335 China
| | - Li Liu
- grid.410642.5Shanghai Changning Mental Health Center, Shanghai, 200335 China
| | - Daoliang Yang
- grid.410642.5Shanghai Changning Mental Health Center, Shanghai, 200335 China
| | - Haifeng Ji
- grid.410642.5Shanghai Changning Mental Health Center, Shanghai, 200335 China
| | - Tianming Huang
- grid.410642.5Shanghai Changning Mental Health Center, Shanghai, 200335 China
| | - Lianxue Xue
- grid.410642.5Shanghai Changning Mental Health Center, Shanghai, 200335 China
| | - Xixi Jiang
- Shanghai Changning Mental Health Center, Shanghai, 200335, China.
| | - Kaiyun Li
- grid.454761.5University of Jinan, Shandong Province, Jinan, 250022 China
| | - Lily Tao
- grid.22069.3f0000 0004 0369 6365Key Laboratory of Brain Functional Genomics (MOE & STCSM), Shanghai Changning-ECNU Mental Health Center, Institute of Cognitive Neuroscience, School of Psychology and Cognitive Science, East China Normal University, Shanghai, 200062 China
| | - Qing Cai
- grid.22069.3f0000 0004 0369 6365Key Laboratory of Brain Functional Genomics (MOE & STCSM), Shanghai Changning-ECNU Mental Health Center, Institute of Cognitive Neuroscience, School of Psychology and Cognitive Science, East China Normal University, Shanghai, 200062 China
| | - Yiru Fang
- Clinical Research Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China. .,CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai, 200031, China. .,Shanghai Key Laboratory of Psychotic disorders, Shanghai, 201108, China.
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4
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Kohls G, Baumann S, Gundlach M, Scharke W, Bernhard A, Martinelli A, Ackermann K, Kersten L, Prätzlich M, Oldenhof H, Jansen L, van den Boogaard L, Smaragdi A, Gonzalez-Madruga K, Cornwell H, Rogers JC, Pauli R, Clanton R, Baker R, Bigorra A, Kerexeta-Lizeaga I, Sesma-Pardo E, Aguirregomoscorta-Menéndez F, Siklósi R, Dochnal R, Kalogerakis Z, Pirlympou M, Papadakos L, Dikeos D, Hervas A, Herpertz-Dahlmann B, Fernández-Rivas A, Popma A, Stadler C, De Brito SA, Blair JR, Freitag CM, Fairchild G, Konrad K. Investigating Sex Differences in Emotion Recognition, Learning, and Regulation Among Youths With Conduct Disorder. J Am Acad Child Adolesc Psychiatry 2020; 59:263-273. [PMID: 31026574 DOI: 10.1016/j.jaac.2019.04.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 03/27/2019] [Accepted: 04/17/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Conduct disorder (CD) is a serious neurodevelopmental disorder marked by notably higher prevalence rates for boys than girls. Converging evidence suggests that CD is associated with impairments in emotion recognition, learning, and regulation. However, it is not known whether there are sex differences in the relationship between CD and emotion dysfunction. Prior studies on emotion functioning in CD have so far been underpowered for investigating sex differences. Therefore, our primary aim was to characterize emotion processing skills in a large sample of girls and boys with CD compared to typically developing controls (TDCs) using a comprehensive neuropsychological test battery. METHOD We included 542 youths with CD (317 girls) and 710 TDCs (479 girls), 9 to 18 years of age, from a European multisite study (FemNAT-CD). Participants completed three experimental tasks assessing emotion recognition, learning, and regulation, respectively. Data were analyzed to test for effects of group and sex, and group-by-sex interactions, while controlling for potentially confounding factors. RESULTS Relative to TDCs, youths with CD showed impaired emotion recognition (that was related to more physical and proactive aggression, and higher CU traits), emotional learning (specifically from punishment), and emotion regulation. Boys and girls with CD, however, displayed similar impairments in emotion processing. CONCLUSION This study provides compelling evidence for a relationship between CD and deficient neurocognitive functioning across three emotional domains that have previously been linked to CD etiology. However, there was no support for sex-specific profiles of emotion dysfunction, suggesting that current neurocognitive models of CD apply equally to both sexes.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Martin Prätzlich
- Psychiatric University Clinics and University of Basel, Switzerland
| | | | - Lucres Jansen
- VU University Medical Center, Amsterdam, The Netherlands
| | | | | | | | | | | | - Ruth Pauli
- Centre for Human Brain Health, School of Psychology, University of Birmingham, UK
| | - Roberta Clanton
- Centre for Human Brain Health, School of Psychology, University of Birmingham, UK
| | - Rosalind Baker
- Centre for Human Brain Health, School of Psychology, University of Birmingham, UK
| | - Aitana Bigorra
- Child and Adolescent Mental Health Unit, University Hospital Mutua Terrassa, Barcelona, Spain
| | | | - Eva Sesma-Pardo
- Psychiatric Service, Basurto University Hospital, Bilbao, Spain
| | | | - Réka Siklósi
- Pediatrics and Child Health Center, University of Szeged, Szeged, Hungary
| | - Roberta Dochnal
- Pediatrics and Child Health Center, University of Szeged, Szeged, Hungary
| | | | | | | | | | - Amaia Hervas
- Child and Adolescent Mental Health Unit, University Hospital Mutua Terrassa, Barcelona, Spain
| | | | | | - Arne Popma
- VU University Medical Center, Amsterdam, The Netherlands
| | | | - Stephane A De Brito
- Centre for Human Brain Health, School of Psychology, University of Birmingham, UK
| | - James R Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Omaha, NE
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Fong VC, Hawes D, Allen JL. A Systematic Review of Risk and Protective Factors for Externalizing Problems in Children Exposed to Intimate Partner Violence. TRAUMA, VIOLENCE & ABUSE 2019; 20:149-167. [PMID: 29333951 DOI: 10.1177/1524838017692383] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Intimate partner violence (IPV) is a serious public health issue with innumerable costs to the victims, children, and families affected as well as society at large. The evidence is conclusive regarding a strong association between exposure to IPV and children's externalizing problems. Moving forward, the next step is to enhance our understanding of risk and protective factors associated with these outcomes in order to tailor treatments to meet the needs of both parents and children. The databases Medline, PubMed, and PsyINFO were searched combining variations of the key words such as parent*, child*, mother, partner abuse, domestic abuse, spousal abuse, interpersonal violence, domestic violence, or intimate partner violence. This search were combined with child externalizing behaviors specifically conduct*, oppositional defiant disorder, externaliz*, aggress*, hyperactivity, and ADHD. A total of 31 studies from all three databases were reviewed following application of inclusion and exclusion criteria. The main findings were that child age and gender, callous-unemotional traits, cognitive appraisals, maternal mental health, and quality of parenting emerged as key mediating and moderating factors of the relationship between IPV exposure and child externalizing problems. These findings suggest that interventions provided to families exposed to IPV need to target both maternal and child risk factors in order to successfully reduce child externalizing problems.
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Affiliation(s)
- Vanessa C Fong
- 1 Department of Psychology and Human Development, UCL Institute of Education, London, United Kingdom
| | - David Hawes
- 2 School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Jennifer L Allen
- 1 Department of Psychology and Human Development, UCL Institute of Education, London, United Kingdom
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Jiang X, Liu L, Ji H, Gao J, Zhang M, Zhu Y, Li K, Ji W, Li G. [Response inhibition and emotional responding in attention-deficit/hyperactivity disorder with comorbid disruptive, impulse-control, and conduct disorders]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2019; 39:30-34. [PMID: 30692063 DOI: 10.12122/j.issn.1673-4254.2019.01.05] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To characterize the traits of neuropsychological functioning deficits in patients with attention-deficit/ hyperactivity disorder (ADHD) with comorbid disruptive, impulse-control, and conduct disorders (DICCD). METHODS Twenty out-patients with ADHD, 20 with ADHD with comorbid DICCD, and 20 with DICCD, all aged 6-16 years, were enrolled in this study, with 20 healthy subjects matched for age, gender and IQ serving as the healthy controls. The patients were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Revision (DSM-5). All the subjects were assessed with Golden Stroop test and emotional Stroop test to evaluate their response inhibition and emotional responding. RESULTS In Golden Stroop test, the interference scores (IGs) of errors and reaction time both differed significantly among the groups (P < 0.05), and were the highest in patients with ADHD only. In emotional Stroop test, the mean reaction time (MRT) showed significant differences among the groups (P < 0.05); the MRT of positive- congruent trials in ADHD with comorbid DICCD group was shorter than that in ADHD group but longer than that in group DICCD; the MRT in the 3 case groups were all longer than that in the control group. The MRT of both positive-incongruent trials and negative-congruent trials in ADHD with comorbid DICCD group and DICCD group was shorter than that in ADHD group but longer than that in the control group. The MRT of negative- incongruent trials in DICCD group was shorter than that in ADHD group and ADHD with comorbid DICCD group but longer than that in the control group. CONCLUSIONS The response inhibition deficit and abnormal emotional responding are the core symptoms of ADHD. Bias emotional stimuli may render response inhibitory dysfunction in patients with DICCD with callous-unemotional traits of emotional responding disorder, especially in dealing with negative emotional trials, while the comorbidity of ADHD and DICCD tends to have the emotional response trait of DICCD.
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Affiliation(s)
- Xixi Jiang
- Shanghai Changning Mental Health Center, Shanghai 200335, China
| | - Li Liu
- Shanghai Changning Mental Health Center, Shanghai 200335, China
| | - Haifeng Ji
- Shanghai Changning Mental Health Center, Shanghai 200335, China
| | - Ju Gao
- Shanghai Changning Mental Health Center, Shanghai 200335, China
| | - Minmin Zhang
- Shanghai Changning Mental Health Center, Shanghai 200335, China
| | - Yuncheng Zhu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Kaiyun Li
- University of Jinan, Jinan 250022, China
| | - Weidong Ji
- Shanghai Changning Mental Health Center, Shanghai 200335, China
| | - Guohai Li
- Zhenjiang Mental Health Center, Zhenjiang 212000, China
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7
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Fehlbaum LV, Raschle NM, Menks WM, Prätzlich M, Flemming E, Wyss L, Euler F, Sheridan M, Sterzer P, Stadler C. Altered Neuronal Responses During an Affective Stroop Task in Adolescents With Conduct Disorder. Front Psychol 2018; 9:1961. [PMID: 30405475 PMCID: PMC6200838 DOI: 10.3389/fpsyg.2018.01961] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 09/24/2018] [Indexed: 01/08/2023] Open
Abstract
Conduct disorder (CD) is a psychiatric disorder of childhood and adolescence which has been linked to deficient emotion processing and regulation. The behavioral and neuronal correlates targeting the interaction of emotion processing and response inhibition are still under investigation. Whole-brain event-related fMRI was applied during an affective Stroop task in 39 adolescents with CD and 39 typically developing adolescents (TD). Participants were presented with an emotional stimulus (negative/neutral) followed by a Stroop task with varying cognitive load (congruent/incongruent/blank trials). fMRI analysis included standard preprocessing, region of interest analyses (amygdala, insula, ventromedial prefrontal cortex) and whole-brain analyses based on a 2(group) × 2(emotion) × 3(task) full-factorial ANOVA. Adolescents with CD made significantly more errors, while reaction times did not significantly differ compared to TD. Additionally, we observed a lack of downregulation of left amygdala activity in response to incongruent trials and increased anterior insula activity for CD relative to TD during affective Stroop task processing [cluster-level family-wise error-corrected (p < 0.05)]. Even though no three-way interaction (group × emotion × task) interaction was detected, the findings presented still provide evidence for altered neuronal underpinnings of the interaction of emotion processing and response inhibition in CD. Moreover, our results may corroborate previous evidence of emotion dysregulation as a core dysfunction in CD. Future studies shall focus on investigating the interaction of emotion processing and response inhibition in CD subgroups (e.g., variations in callous-unemotional traits, impulsivity, or anxiety).
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Affiliation(s)
- Lynn V. Fehlbaum
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics, University of Basel, Basel, Switzerland
| | - Nora M. Raschle
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics, University of Basel, Basel, Switzerland
| | - Willeke M. Menks
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics, University of Basel, Basel, Switzerland
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
| | - Martin Prätzlich
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics, University of Basel, Basel, Switzerland
| | - Eva Flemming
- Department of Psychiatry and Psychotherapy, Charité – University Medicine Berlin, Berlin, Germany
| | - Letizia Wyss
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics, University of Basel, Basel, Switzerland
| | - Felix Euler
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics, University of Basel, Basel, Switzerland
| | - Margaret Sheridan
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Philipp Sterzer
- Department of Psychiatry and Psychotherapy, Charité – University Medicine Berlin, Berlin, Germany
| | - Christina Stadler
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics, University of Basel, Basel, Switzerland
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Boys with Oppositional Defiant Disorder/Conduct Disorder Show Impaired Adaptation During Stress: An Executive Functioning Study. Child Psychiatry Hum Dev 2018; 49:298-307. [PMID: 28755013 PMCID: PMC5856866 DOI: 10.1007/s10578-017-0749-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Evidence for problems in executive functioning (EF) in children with oppositional defiant disorder/conduct disorder (ODD/CD) is mixed and the impact stress may have on EF is understudied. Working memory, sustained attention, inhibition and cognitive flexibility of boys with ODD/CD (n = 65) and non-clinical controls (n = 32) were examined under typical and stressful test conditions. Boys with ODD/CD showed impaired working memory under typical testing conditions, and impairments in working memory and sustained attention under stressful conditions. In contrast to controls, performance on sustained attention, cognitive flexibility and inhibition was less influenced by stress in boys with ODD/CD. These results suggest that boys with ODD/CD show impairments in adaptation to the environment whereas typically developing boys show adaptive changes in EF.
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Raschle NM, Fehlbaum LV, Menks WM, Euler F, Sterzer P, Stadler C. Investigating the Neural Correlates of Emotion-Cognition Interaction Using an Affective Stroop Task. Front Psychol 2017; 8:1489. [PMID: 28919871 PMCID: PMC5585191 DOI: 10.3389/fpsyg.2017.01489] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 08/17/2017] [Indexed: 01/30/2023] Open
Abstract
The human brain has the capacity to integrate various sources of information and continuously adapts our behavior according to situational needs in order to allow a healthy functioning. Emotion–cognition interactions are a key example for such integrative processing. However, the neuronal correlates investigating the effects of emotion on cognition remain to be explored and replication studies are needed. Previous neuroimaging studies have indicated an involvement of emotion and cognition related brain structures including parietal and prefrontal cortices and limbic brain regions. Here, we employed whole brain event-related functional magnetic resonance imaging (fMRI) during an affective number Stroop task and aimed at replicating previous findings using an adaptation of an existing task design in 30 healthy young adults. The Stroop task is an indicator of cognitive control and enables the quantification of interference in relation to variations in cognitive load. By the use of emotional primes (negative/neutral) prior to Stroop task performance, an emotional variation is added as well. Behavioral in-scanner data showed that negative primes delayed and disrupted cognitive processing. Trials with high cognitive demand furthermore negatively influenced cognitive control mechanisms. Neuronally, the emotional primes consistently activated emotion-related brain regions (e.g., amygdala, insula, and prefrontal brain regions) while Stroop task performance lead to activations in cognition networks of the brain (prefrontal cortices, superior temporal lobe, and insula). When assessing the effect of emotion on cognition, increased cognitive demand led to decreases in neural activation in response to emotional stimuli (negative > neutral) within prefrontal cortex, amygdala, and insular cortex. Overall, these results suggest that emotional primes significantly impact cognitive performance and increasing cognitive demand leads to reduced neuronal activation in emotion related brain regions, and therefore support previous findings investigating emotion–cognition interaction in healthy adults. Moreover, emotion and cognition seem to be tightly related to each other, as indicated by shared neural networks involved in both of these processes. Emotion processing, cognitive control, and their interaction are crucial for healthy functioning and a lack thereof is related to psychiatric disorders such as, disruptive behavior disorders. Future studies may investigate the neural characteristics of children and adolescents with disruptive behavior disorders.
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Affiliation(s)
- Nora M Raschle
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics, University of BaselBasel, Switzerland
| | - Lynn V Fehlbaum
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics, University of BaselBasel, Switzerland
| | - Willeke M Menks
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics, University of BaselBasel, Switzerland
| | - Felix Euler
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics, University of BaselBasel, Switzerland
| | - Philipp Sterzer
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin BerlinBerlin, Germany
| | - Christina Stadler
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics, University of BaselBasel, Switzerland
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Villemonteix T, Marx I, Septier M, Berger C, Hacker T, Bahadori S, Acquaviva E, Massat I. Attentional control of emotional interference in children with ADHD and typically developing children: An emotional N-back study. Psychiatry Res 2017; 254:1-7. [PMID: 28437666 DOI: 10.1016/j.psychres.2017.04.027] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 02/28/2017] [Accepted: 04/15/2017] [Indexed: 10/19/2022]
Abstract
Emotional interference control refers to the ability to remain focused on goal-oriented processes when confronted with disrupting but irrelevant emotional stimuli, a process that may be impaired in children and adults with attention deficit/hyperactivity disorder (ADHD). However, emotional interference levels are known to be associated with trait anxiety, and patients with ADHD often display elevated levels of trait anxiety, such as these may have confounded previous findings of decreased emotional interference control in this population. In the present study, male and female 8-13 years old (mean =11.0 years) children with ADHD (n=33) and typically developing (TD) children (n=24) performed a visual emotional working memory (n-back) task with 2 memory loads and three different background pictures (neutral/positive/negative), and trait anxiety measures were obtained. Children with ADHD performed less well, and displayed increased emotional interference in the presence of aversive distractors when compared with TD children. Contrary to our expectations, trait anxiety did not mediate the association between diagnostic group membership and the degree of emotional interference control; however, co-morbid ODD was associated with decreased levels of emotional interference in ADHD. Future research should aim at characterizing the mechanisms subtending decreased emotional interference control in the ADHD population.
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Affiliation(s)
- Thomas Villemonteix
- EA 2007, Psychopathology and Neuropsychology Lab., Université Paris 8, Saint-Denis, France; UR2NF - Neuropsychology and Functional Neuroimaging Research Unit, Centre de Recherche Cognition et Neurosciences, Université Libre de Bruxelles (ULB), Bruxelles, Belgium.
| | - Ivo Marx
- Department of Child and Adolescent Psychiatry, Neurology, Psychosomatics and Psychotherapy, University Medicine Rostock, Rostock, Germany
| | - Mathilde Septier
- Assistance Publique-Hôpitaux de Paris, Department of Child and Adolescent Psychiatry, Robert-Debré Hospital, Paris, France; Inserm, U894, Psychiatry and NeurosciXence Center, Paris, France
| | - Christoph Berger
- Department of Child and Adolescent Psychiatry, Neurology, Psychosomatics and Psychotherapy, University Medicine Rostock, Rostock, Germany
| | - Thomas Hacker
- Department of Psychiatry and Psychotherapy, University Medicine Rostock, Rostock, Germany
| | - Sara Bahadori
- Assistance Publique-Hôpitaux de Paris, Department of Child and Adolescent Psychiatry, Robert-Debré Hospital, Paris, France; Inserm, U894, Psychiatry and NeurosciXence Center, Paris, France
| | - Eric Acquaviva
- Assistance Publique-Hôpitaux de Paris, Department of Child and Adolescent Psychiatry, Robert-Debré Hospital, Paris, France
| | - Isabelle Massat
- UR2NF - Neuropsychology and Functional Neuroimaging Research Unit, Centre de Recherche Cognition et Neurosciences, Université Libre de Bruxelles (ULB), Bruxelles, Belgium; Laboratory of Experimental Neurology, ULB, Bruxelles, Belgium; National Fund of Scientific Research (FNRS) Belgium
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11
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Balia C, Carucci S, Coghill D, Zuddas A. The pharmacological treatment of aggression in children and adolescents with conduct disorder. Do callous-unemotional traits modulate the efficacy of medication? Neurosci Biobehav Rev 2017; 91:218-238. [PMID: 28137460 DOI: 10.1016/j.neubiorev.2017.01.024] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 12/07/2016] [Accepted: 01/20/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Children and adolescents with conduct disorder (CD) show repetitive and persistent patterns of aggressive behaviour and the more severe forms are often associated with callous-unemotional (CU) traits. OBJECTIVES To systematically review and, where data are adequate, conduct meta-analyses on the efficacy of medication on aggression in children and adolescent with CD considering the impact of CU traits. RESULTS Few studies have investigated patients with CD as primary diagnosis, and few of these have discriminated between different types of aggression or reported measures of CU traits. Methylphenidate and risperidone showed the largest effects on aggression in randomized controlled trials; other antipsychotics showed clinical efficacy on CD but this evidence is mainly revealed by open label trials. There is some low quality evidence to support a small effect of mood stabilizers and other agents. There were only two papers describing the effects of CU traits thus providing inconclusive results. CONCLUSION Considering heterogeneity of the disorder, more proof-of-concept clinical studies are needed to define effects of medication and role of CU traits.
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Affiliation(s)
- Carla Balia
- Child & Adolescent Neuropsychiatric Unit, Department of Biomedical Science, University of Cagliari & "A. Cao" Microcitemico Paediatric Hospital, Cagliari, Italy
| | - Sara Carucci
- Child & Adolescent Neuropsychiatric Unit, Department of Biomedical Science, University of Cagliari & "A. Cao" Microcitemico Paediatric Hospital, Cagliari, Italy.
| | - David Coghill
- Division of Neuroscience, University of Dundee, Dundee, UK; Departments of Paediatrics and Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Australia
| | - Alessandro Zuddas
- Child & Adolescent Neuropsychiatric Unit, Department of Biomedical Science, University of Cagliari & "A. Cao" Microcitemico Paediatric Hospital, Cagliari, Italy
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Euler F, Steinlin C, Stadler C. Distinct profiles of reactive and proactive aggression in adolescents: associations with cognitive and affective empathy. Child Adolesc Psychiatry Ment Health 2017; 11:1. [PMID: 28077965 PMCID: PMC5217447 DOI: 10.1186/s13034-016-0141-4] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 12/21/2016] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Aggression comprises a heterogeneous set of behavioral patterns that aim to harm and hurt others. Empathy represents a potential mechanism that inhibits aggressive conduct and enhances prosocial behavior. Nevertheless, research results on the relationship between empathy and aggression are mixed. Subtypes of aggressive behavior, such as reactive and proactive aggression might be differently related to empathy. The aim of the present study was to investigate the interrelations of cognitive and affective empathy with reactive and proactive aggression. METHODS We recruited a sample of 177 (33% female, M age 15.6) adolescents from socio-educational and juvenile justice institutions and a community sample of 77 (36% female, M age 13.1) adolescents from secondary schools. Using bivariate correlation analysis and hierarchical multiple regression analysis, we firstly investigated associations between cognitive and affective empathy and reactive and proactive aggression. Subsequently, we performed cluster analysis to identify clusters of adolescents with meaningful profiles of aggressive behavior and compared derived clusters on measures of empathy. We applied the Basic Empathy Scale and the Reactive-Proactive Aggression Questionnaire. RESULTS Bivariate analysis and hierarchical regression analysis showed that cognitive and affective empathy were negatively associated with proactive aggression, but not with reactive aggression. Cluster-analysis revealed three clusters of adolescents with distinct aggression profiles: a cluster with elevated scores on reactive and proactive aggression, a clusters with high scores on reactive aggression only, and a low aggression cluster. Cluster comparisons revealed that the reactive-proactive aggression cluster showed significantly lower scores on cognitive and affective empathy than both other clusters. Results further indicated that within the reactive-proactive aggression cluster, girls did not differ significantly from boys in empathy. CONCLUSIONS The present study extends previously published findings, and possibly explains conflicting results in prior research. Our results indicated that cognitive and affective empathy are reduced in adolescents with high levels of reactive and proactive aggression. Our study may contribute to the development of tailored clinical interventions for different aggression clusters.
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Affiliation(s)
- Felix Euler
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics Basel, Schanzenstrasse 13, 4056 Basel, Switzerland
| | - Célia Steinlin
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics Basel, Schanzenstrasse 13, 4056 Basel, Switzerland
| | - Christina Stadler
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics Basel, Schanzenstrasse 13, 4056 Basel, Switzerland
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Petrovic P, Castellanos FX. Top-Down Dysregulation-From ADHD to Emotional Instability. Front Behav Neurosci 2016; 10:70. [PMID: 27242456 PMCID: PMC4876334 DOI: 10.3389/fnbeh.2016.00070] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 03/29/2016] [Indexed: 12/31/2022] Open
Abstract
Deficient cognitive top-down executive control has long been hypothesized to underlie inattention and impulsivity in attention-deficit/hyperactivity disorder (ADHD). However, top-down cognitive dysfunction explains a modest proportion of the ADHD phenotype whereas the salience of emotional dysregulation is being noted increasingly. Together, these two types of dysfunction have the potential to account for more of the phenotypic variance in patients diagnosed with ADHD. We develop this idea and suggest that top-down dysregulation constitutes a gradient extending from mostly non-emotional top-down control processes (i.e., “cool” executive functions) to mainly emotional regulatory processes (including “hot” executive functions). While ADHD has been classically linked primarily to the former, conditions involving emotional instability such as borderline and antisocial personality disorder are closer to the other. In this model, emotional subtypes of ADHD are located at intermediate levels of this gradient. Neuroanatomically, gradations in “cool” processing appear to be related to prefrontal dysfunction involving dorsolateral prefrontal cortex (dlPFC) and caudal anterior cingulate cortex (cACC), while “hot” processing entails orbitofrontal cortex and rostral anterior cingulate cortex (rACC). A similar distinction between systems related to non-emotional and emotional processing appears to hold for the basal ganglia (BG) and the neuromodulatory effects of the dopamine system. Overall we suggest that these two systems could be divided according to whether they process non-emotional information related to the exteroceptive environment (associated with “cool” regulatory circuits) or emotional information related to the interoceptive environment (associated with “hot” regulatory circuits). We propose that this framework can integrate ADHD, emotional traits in ADHD, borderline and antisocial personality disorder into a related cluster of mental conditions.
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Affiliation(s)
- Predrag Petrovic
- Department of Clinical Neuroscience, Karolinska Institutet Stockholm, Sweden
| | - F Xavier Castellanos
- Department of Child and Adolescent Psychiatry, The Child Study Center at NYU Langone Medical CenterNew York, NY, USA; Nathan Kline Institute for Psychiatric ResearchOrangeburg, NY, USA
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Euler F, Jenkel N, Stadler C, Schmeck K, Fegert JM, Kölch M, Schmid M. Variants of girls and boys with conduct disorder: anxiety symptoms and callous-unemotional traits. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2016; 43:773-85. [PMID: 25349148 DOI: 10.1007/s10802-014-9946-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Recent research suggests that among the group of aggressive and antisocial adolescents, there are distinct variants who exhibit different levels of anxiety symptoms and callous-unemotional traits (CU traits). The purpose of the present study was to examine whether such variants are also present in male and female adolescents diagnosed with conduct disorder (CD). We used model-based cluster analysis to disaggregate data of 158 adolescents with CD (109 boys, 49 girls; mean age =15.61 years) living in child welfare and juvenile justice institutions. Three variants were identified: (1) CD only, (2) CD with moderate CU traits and anxiety symptoms, and (3) CD with severe CU traits. Variants differed in external validation measures assessing anger and irritability, externalizing behavior, traumatic experiences, and substance use. The CD variant with moderate CU traits and anxiety symptoms had the most severe pattern of psychopathology. Our results also indicated distinct profiles of personality development for all three variants. Gender-specific comparisons revealed differences between girls and boys with CD on clustering and external validation measures and a gender-specific cluster affiliation. The present results extend previously published findings on variants among aggressive and antisocial adolescents to male and female adolescents diagnosed with CD.
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Affiliation(s)
- Felix Euler
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics Basel, Wilhelm Klein-Strasse 27, 4012, Basel, Switzerland,
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