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Simmons C, Mitchell-Adams H, Baskin-Sommers A. Environmental Predictors of Within-Person Changes in Callous-Unemotional Traits among Justice-Involved Male Adolescents. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024; 53:577-594. [PMID: 35900060 DOI: 10.1080/15374416.2022.2093207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Youth who display elevated callous-unemotional (CU) traits are at risk for negative developmental outcomes. Previous studies demonstrate that environmental conditions contribute to elevated levels of CU traits, but the majority of this work focuses on a single source of environmental influence. To better understand how environmental conditions contribute to changes in CU traits during adolescence, the current study examined the time-varying relation between CU traits, parent, peer, and community conditions. METHOD Using data from the longitudinal Pathways to Desistance study (N = 1,026 males, Mage = 15.98, SD = 1.16; 40.94% Black, 34.11% Latino, 20.66% White, 4.29% Other), full-factorial fixed effect regression models were implemented to examine how parental hostility, antisocial peers, community violence, and neighborhood disorder are individually and interactively associated with within-person changes in CU traits during adolescence (15-21 years). RESULTS Results indicated that proximal conditions (i.e., negative parenting, antisocial peers) had more consistent associations with CU traits than distal conditions (i.e., neighborhood disorder, community violence). Affiliation with antisocial peers was not significantly related to CU traits when youth were simultaneously exposed to high community violence and low neighborhood disorder. Further, the association between CU traits and impact of living in high disordered, high violence neighborhoods was stronger for younger youth. CONCLUSION Results indicate that the association among parents, peers, and CU trait development is more nuanced than previously suggested, such that the risk that each environmental condition poses is moderated by a youth's age and their exposure to distal conditions.
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Bellato A, Sesso G, Milone A, Masi G, Cortese S. Systematic Review and Meta-Analysis: Altered Autonomic Functioning in Youths With Emotional Dysregulation. J Am Acad Child Adolesc Psychiatry 2024; 63:216-230. [PMID: 36841327 DOI: 10.1016/j.jaac.2023.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/20/2023] [Accepted: 02/16/2023] [Indexed: 02/27/2023]
Abstract
OBJECTIVE To systematically investigate if there is a significant association between markers of autonomic functioning and emotional dysregulation (ED) in children and adolescents. METHOD Based on a preregistered protocol (PROSPERO: CRD42021239635), PubMed, Web of Knowledge/Science, Ovid MEDLINE, Embase, and APA PsycInfo databases were searched until April 21, 2021, to identify empirical studies reporting indices of autonomic nervous system (ANS) functioning in youths meeting DSM (version III, IV, IV-TR, 5 or 5-TR) or International Classification of Diseases (ICD) (version 9 or 10) criteria for any psychopathological/neurodevelopmental condition and assessed for ED with a validated scale. Eligible outcomes included correlation coefficients between ED and ANS measures or differences in ANS measures between youths with and without ED. Study quality was assessed with the Appraisal tool for Cross-Sectional Studies (AXIS) and the Newcastle-Ottawa Scale (NOS) for cohort studies. Random-effects meta-analyses were used for data synthesis. RESULTS There were 12 studies (1,016 participants) included in the descriptive review and 9 studies (567 participants) included in the meta-analyses. No evidence of a significant association between ED and altered cardiac or electrodermal functioning was found. However, exploratory meta-regressions suggested a possible association between reduced resting-state cardiac vagal control and increased ED. CONCLUSION This study did not find evidence of an association between ED and autonomic dysfunction. However, preliminary evidence that reduced vagal control at rest might be a transdiagnostic marker of ED in young people was found. Additional studies comparing autonomic measures in youths with and without ED are needed and should also assess the effects of interventions for ED on ANS functioning. STUDY PREREGISTRATION INFORMATION Systematic Review and Meta-Analysis: Is Autonomic Nervous System Functioning Atypical in Children and Adolescents With Emotional Dysregulation? https://www.crd.york.ac.uk/prospero/; CRD42021239635.
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Affiliation(s)
- Alessio Bellato
- University of Nottingham Malaysia, Malaysia; King's College London, United Kingdom.
| | - Gianluca Sesso
- IRCCS Stella Maris Foundation, Pisa, Italy; University of Pisa, Italy
| | | | | | - Samuele Cortese
- University of Southampton, United Kingdom; New York University Langone Health, New York
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Tkalcec A, Bierlein M, Seeger-Schneider G, Walitza S, Jenny B, Menks WM, Felhbaum LV, Borbas R, Cole DM, Raschle N, Herbrecht E, Stadler C, Cubillo A. Empathy deficits, callous-unemotional traits and structural underpinnings in autism spectrum disorder and conduct disorder youth. Autism Res 2023; 16:1946-1962. [PMID: 37548142 DOI: 10.1002/aur.2993] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 07/06/2023] [Indexed: 08/08/2023]
Abstract
Distinct empathy deficits are often described in patients with conduct disorder (CD) and autism spectrum disorder (ASD) yet their neural underpinnings and the influence of comorbid Callous-Unemotional (CU) traits are unclear. This study compares the cognitive (CE) and affective empathy (AE) abilities of youth with CD and ASD, their potential neuroanatomical correlates, and the influence of CU traits on empathy. Adolescents and parents/caregivers completed empathy questionnaires (N = 148 adolescents, mean age = 15.16 years) and T1 weighted images were obtained from a subsample (N = 130). Group differences in empathy and the influence of CU traits were investigated using Bayesian analyses and Voxel-Based Morphometry with Threshold-Free Cluster Enhancement focusing on regions involved in AE (insula, amygdala, inferior frontal gyrus and cingulate cortex) and CE processes (ventromedial prefrontal cortex, temporoparietal junction, superior temporal gyrus, and precuneus). The ASD group showed lower parent-reported AE and CE scores and lower self-reported CE scores while the CD group showed lower parent-reported CE scores than controls. When accounting for the influence of CU traits no AE deficits in ASD and CE deficits in CD were found, but CE deficits in ASD remained. Across all participants, CU traits were negatively associated with gray matter volumes in anterior cingulate which extends into the mid cingulate, ventromedial prefrontal cortex, and precuneus. Thus, although co-occurring CU traits have been linked to global empathy deficits in reports and underlying brain structures, its influence on empathy aspects might be disorder-specific. Investigating the subdimensions of empathy may therefore help to identify disorder-specific empathy deficits.
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Affiliation(s)
- Antonia Tkalcec
- Child and Youth Psychiatry, University Psychiatric Clinic, Basel, Switzerland
| | - Maria Bierlein
- Child and Youth Psychiatry, University Psychiatric Clinic, Basel, Switzerland
| | - Gudrun Seeger-Schneider
- Child and Youth Psychiatry, Psychiatric University Clinic, University of Zurich, Zurich, Switzerland
| | - Susanne Walitza
- Child and Youth Psychiatry, Psychiatric University Clinic, University of Zurich, Zurich, Switzerland
| | - Bettina Jenny
- Child and Youth Psychiatry, Psychiatric University Clinic, University of Zurich, Zurich, Switzerland
| | - Willeke M Menks
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, and Radboud University Medical Centre, Nijmegen, the Netherlands
- Psychology of Language Department, Max Planck Institute for Psycholinguistics, Nijmegen, the Netherlands
| | - Lynn V Felhbaum
- Jacobs Center for Productive Youth, University of Zurich, Zurich, Switzerland
| | - Reka Borbas
- Jacobs Center for Productive Youth, University of Zurich, Zurich, Switzerland
| | - David M Cole
- Translational Psychiatry, University Psychiatric Clinic, Basel, Switzerland
| | - Nora Raschle
- Jacobs Center for Productive Youth, University of Zurich, Zurich, Switzerland
| | - Evelyn Herbrecht
- Child and Youth Psychiatry, University Psychiatric Clinic, Basel, Switzerland
| | - Christina Stadler
- Child and Youth Psychiatry, University Psychiatric Clinic, Basel, Switzerland
| | - Ana Cubillo
- Child and Youth Psychiatry, University Psychiatric Clinic, Basel, Switzerland
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Bachmann CJ, Humayun S, Stevens M, O'Connor TG, Scott S. Secure attachment predicts lower societal cost amongst severely antisocial adolescents. Child Adolesc Psychiatry Ment Health 2023; 17:56. [PMID: 37161491 PMCID: PMC10170786 DOI: 10.1186/s13034-023-00598-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 03/27/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Social and economic costs associated with antisocial behaviour are well-established, but little is known about the potential costs savings/benefits of secure attachment in this high-risk group. We aimed to provide the first test of attachment quality as a distinct predictor of economic costs. METHODS 111 adolescents (10-17 years of age, M = 15.0, SD = 1.6; 71% male) referred to young offender services due to high levels of antisocial behaviour were included. Costs were measured by detailed service-use interview, and attachment security to mother and father elicited through the Child Attachment Interview. The level of antisocial behaviour and callous-unemotional traits were assessed. Cost predictors were calculated using generalised linear models. RESULTS Mean 12-months service costs were £5,368 (sd 5,769) per adolescent, with justice system and educational service costs being the main components. After adjusting for covariates, economic costs were predicted by attachment quality to fathers, with a difference of £2,655 per year between those with secure (£3,338) versus insecure attachment (£5,993); significant cost effects were not found for attachment quality to mothers. Higher levels of callous-unemotional traits, lower verbal IQ, higher levels of antisocial behaviour, and older age were also significant cost predictors. CONCLUSIONS Secure attachment to fathers is a predictor of reduced public cost in adolescents with severe antisocial behaviour. This novel finding for severely antisocial youth extends previous findings in less antisocial children and underscores the public health and policy benefits of good caregiving quality and the value of population-level dissemination of evidence-based interventions that improve caregiving quality.
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Affiliation(s)
- Christian J Bachmann
- Department of Child and Adolescent Psychiatry, University of Ulm, Steinhövelstr. 5, 89075, Ulm, Germany.
| | - Sajid Humayun
- School of Human Sciences, Faculty of Education, Health and Human Sciences, University of Greenwich, Avery Hill, London, SE9 92UG, UK
| | - Madeleine Stevens
- London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK
| | - Thomas G O'Connor
- Department of Psychiatry, School of Medicine and Dentistry, University of Rochester Medical Center, 601 Elmwood Ave, Box PSYCH, Rochester, NY, 14642, USA
| | - Stephen Scott
- National Academy for Parenting Research, King's College London, 16 De Crespigny Park, Box 86, London, SE5 8AF, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, Box 86, London, SE5 8AF, UK
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Polaschek DLL, Bell RK, Casey AR, Dickson SR, Yesberg JA. Do Triarchic Psychopathy Components of New Zealand High-Risk Parolees Predict Probation Officer Relationship Quality, Quality of Life on Parole, and Recidivism? INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2022; 66:1682-1702. [PMID: 34657494 DOI: 10.1177/0306624x211049179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The Triarchic Psychopathy Measure (TriPM) is a self-report scale based on the Triarchic Model that has been little used in research in the criminal justice system. We sought to examine associations between pre-release TriPM components, probation officer relationships, and parolee quality of life, both measured after 2 months in the community, and reconviction 12 months after release. Using data from 234 New Zealand male high-risk prisoners, we tested four multivariate models each across three timepoints. Pre-release, we found Boldness was not predictive, but Meanness predicted poorer relationship quality after 2 months, both from probation officer and parolee perspectives, with the former in turn predicting reconviction within 12 months. Disinhibition predicted 12-month recidivism regardless of relationship quality or external life circumstances. This relationship to recidivism was partially explained in the final model which linked Disinhibition and poorer subjective wellbeing, with the latter in turn predicting recidivism.
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de la Peña FR, Rosetti MF, Palacio JD, Palacios-Cruz L, Ulloa RE. Limited Prosocial Emotions in a Clinical Population of Children and Adolescents: Proposal for Core and Ancillary Characteristics. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2022; 67:289-294. [PMID: 33787362 PMCID: PMC9099082 DOI: 10.1177/07067437211004893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Limited prosocial emotions (LPE) has been recently incorporated into international classifications as a specifier for conduct disorder in the DSM-5 and for all disruptive behavioural disorders in the ICD-11. The aims of the current work were to determine (a) the accuracy of each of the characteristics used to assess the LPE specifier and (b) whether the manner in which symptoms group together supports the idea of LPE having core characteristics. METHOD Trained clinicians conducted interviews and determined LPE characteristics using responses from 74 parent/guardian and child/adolescent participants. RESULTS The distribution of LPE characteristics among those participants with LPE (n = 13) was compared to those with only one LPE characteristic (n = 11). The proposal of callous lack of empathy (CLE) and shallow deficient affect (SDA) as core characteristics was supported by strong associations with the presence of the LPE specifier, larger specificity, and sensitivity indices than those for unconcerned about performance and lack of remorse or guilt, as well as by a robust aggregation in a latent class analysis. CONCLUSIONS CLE and SDA could be considered as core characteristics of LPE in children and adolescents.
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Affiliation(s)
| | - Marcos F Rosetti
- 42584Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico.,61738Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Juan David Palacio
- 161932Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Lino Palacios-Cruz
- 42584Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Rosa Elena Ulloa
- 544147Hospital Psiquiátrico Infantil Dr. Juan N. Navarro, Mexico City, Mexico
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Neuropsychological Characterization of Aggressive Behavior in Children and Adolescents with CD/ODD and Effects of Single Doses of Medications: The Protocol of the Matrics_WP6-1 Study. Brain Sci 2021; 11:brainsci11121639. [PMID: 34942941 PMCID: PMC8699463 DOI: 10.3390/brainsci11121639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/25/2021] [Accepted: 12/07/2021] [Indexed: 12/12/2022] Open
Abstract
Aggressive behaviors and disruptive/conduct disorders are some of the commonest reasons for referral to youth mental health services; nevertheless, the efficacy of therapeutic interventions in real-world clinical practice remains unclear. In order to define more appropriate targets for innovative pharmacological therapies for disruptive/conduct disorders, the European Commission within the Seventh Framework Programme (FP7) funded the MATRICS project (Multidisciplinary Approaches to Translational Research in Conduct Syndromes) to identify neural, genetic, and molecular factors underpinning the pathogenesis of aggression/antisocial behavior in preclinical models and clinical samples. Within the program, a multicentre case-control study, followed by a single-blind, placebo-controlled, cross-over, randomized acute single-dose medication challenge, was conducted at two Italian sites. Aggressive children and adolescents with conduct disorder (CD) or oppositional defiant disorder (ODD) were compared to the same age (10–17 y) typically developing controls (TDC) on a neuropsychological tasks battery that included both “cold” (e.g., inhibitory control, decision making) and “hot” executive functions (e.g., moral judgment, emotion processing, risk assessment). Selected autonomic measures (heart rate variability, skin conductance, salivary cortisol) were recorded before/during/after neuropsychological testing sessions. The acute response to different drugs (methylphenidate/atomoxetine, risperidone/aripiprazole, or placebo) was also examined in the ODD/CD cohort in order to identify potential neuropsychological/physiological mechanisms underlying aggression. The paper describes the protocol of the clinical MATRICS WP6-1 study, its rationale, the specific outcome measures, and their implications for a precision medicine approach.
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Zhang J, Li W, Zhang H, Wilson A, Shuai L, Xia W, Wang Z, Qiu M, Wang Y. Callous-unemotional traits in Chinese preschool children with attention-deficit/hyperactivity disorder. Child Adolesc Psychiatry Ment Health 2021; 15:35. [PMID: 34246300 PMCID: PMC8272896 DOI: 10.1186/s13034-021-00388-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/01/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Children with early onset of Callous-Unemotional (CU) traits are at a higher risk for long-term, persistent psychosocial problems. The current study aimed to explore the characteristics of CU in preschool children with Attention Deficit Hyperactivity Disorder (ADHD) and the diagnostic significance of CU traits in ADHD. METHODS A total of 176 preschool children (89 with ADHD and 87 Typically Developing Children [TDC]) aged 4-5 years old were recruited to the study. The participants were assessed for CU traits, emotional and behavioral problems, and how their executive functioning was associated with ADHD using multiple assessment scales. Multiple linear regression analysis was performed to assess the incremental validity of the Inventory of Callous-Unemotional Traits (ICU), adjusting for possible covariates by child's sex, conduct problems, and oppositional defiant symptoms. RESULTS The results showed that there was a significant difference of ICU scores between the ADHD and TDC groups (F = 30.12, P < 0.001). In terms of callousness, ADHD + Oppositional Defiant Disorder (ODD) group showed a significant high score, and the ADHD only group scored significantly higher than the TDC group (F = 20.42, P < 0.001). The ICU was negatively associated with the prosocial behaviour subscale (γ = - 0.57, P < 0.01) and showed low to moderate positive correlations with emotional and behavioural problems, as well as executive function (γ = 0.24-0.67, P < 0.05). The ICU scores explained 6% of the incremental validity in ADHD symptoms. The diagnostic value of the ICU for ADHD was medium and acceptable. CONCLUSIONS The current study indicated that early identification of CU traits may help clinicians better understand symptoms and behavioural problems in children with ADHD. CU traits therefore could be considered as a useful assessment tool for ADHD.
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Affiliation(s)
- Jinsong Zhang
- Department of Medical Psychology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China. .,Ministry of Education and Shanghai Key Laboratory of Children's Environment Health, 1665 Kongjiang Road, Shanghai, 200092, China.
| | - Wei Li
- grid.412987.10000 0004 0630 1330Department of Medical Psychology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092 China ,Ministry of Education and Shanghai Key Laboratory of Children’s Environment Health, 1665 Kongjiang Road, Shanghai, 200092 China
| | - Huifeng Zhang
- grid.412987.10000 0004 0630 1330Department of Medical Psychology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092 China ,Ministry of Education and Shanghai Key Laboratory of Children’s Environment Health, 1665 Kongjiang Road, Shanghai, 200092 China
| | - Amanda Wilson
- grid.48815.300000 0001 2153 2936Department of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Lan Shuai
- grid.412987.10000 0004 0630 1330Department of Medical Psychology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092 China
| | - Weiping Xia
- grid.412987.10000 0004 0630 1330Department of Medical Psychology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092 China
| | - Zhouye Wang
- grid.412987.10000 0004 0630 1330Department of Medical Psychology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092 China
| | - Meihui Qiu
- grid.412987.10000 0004 0630 1330Department of Medical Psychology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092 China
| | - Yuanyuan Wang
- grid.48815.300000 0001 2153 2936Department of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
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Chang CL, Liu TL, Hsiao RC, Yang P, Chen YL, Yen CF. Callous-Unemotional Traits among Adolescents with Autism Spectrum Disorder, Attention-Deficit/Hyperactivity Disorder, or Typical Development: Differences between Adolescents' and Parents' Views. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083972. [PMID: 33918812 PMCID: PMC8069479 DOI: 10.3390/ijerph18083972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/18/2021] [Accepted: 04/06/2021] [Indexed: 11/16/2022]
Abstract
This study examined parent-adolescent agreement on the callous, uncaring, and unemotional dimensions of callous-unemotional (CU) traits and the differences in adolescent-reported and parent-reported CU traits among 126 adolescents with autism spectrum disorder (ASD), 207 adolescents with attention-deficit/hyperactivity disorder (ADHD), and 203 typically developing (TD) adolescents. Adolescent-reported and parent-reported CU traits on the three dimensions of the Inventory of Callous and Unemotional Traits were obtained. The strength of CU traits and the differences between adolescent-reported and parent-reported traits were compared among the three groups using analysis of covariance. Parent-adolescent agreement was examined using intraclass correlation. The results reveal that both adolescent-reported and parent-reported callousness and uncaring traits in the ASD and ADHD groups were significantly stronger than those in the TD group. Parent-adolescent agreement on the uncaring trait was fair across the three groups, whereas that on callousness was poor across all three groups. Parent-adolescent agreement on unemotionality was fair in the TD group but poor in the ADHD and ASD groups. ASD and ADHD groups had significantly greater differences in scores reported by parents and adolescents on the callousness trait than the TD group. The parent-adolescent score differences in the uncaring trait were also larger in the ASD group than in the TD group. Thus, these results support the application of a multi-informant approach in CU trait assessment, especially for adolescents with ASD or ADHD.
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Affiliation(s)
- Chen-Lin Chang
- Department of Psychiatry, Kaohsiung Armed Forces General Hospital, Kaohsiung 80284, Taiwan;
- School of Medicine, and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (T.-L.L.); (P.Y.)
| | - Tai-Ling Liu
- School of Medicine, and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (T.-L.L.); (P.Y.)
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
| | - Ray C. Hsiao
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98195-6560, USA;
- Department of Psychiatry, Children’s Hospital and Regional Medical Center, Seattle, WA 98105, USA
| | - Pinchen Yang
- School of Medicine, and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (T.-L.L.); (P.Y.)
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
| | - Yi-Lung Chen
- Department of Healthcare Administration, Asia University, Taichung 41354, Taiwan
- Department of Psychology, Asia University, Taichung 41354, Taiwan
- Correspondence: (Y.-L.C.); (C.-F.Y.); Tel.: +886-4-2332-3456 (ext. 20106) (Y.-L.C.); +886-7-312-1101 (ext. 6822) (C.-F.Y.); Fax: +886-4-2332-1206 (Y.-L.C.); +886-7-313-4761 (C.-F.Y.)
| | - Cheng-Fang Yen
- School of Medicine, and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (T.-L.L.); (P.Y.)
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- Correspondence: (Y.-L.C.); (C.-F.Y.); Tel.: +886-4-2332-3456 (ext. 20106) (Y.-L.C.); +886-7-312-1101 (ext. 6822) (C.-F.Y.); Fax: +886-4-2332-1206 (Y.-L.C.); +886-7-313-4761 (C.-F.Y.)
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Vasconcelos M, Viding E, Sebastian CL, Faria S, Almeida PR, Gonçalves ÓF, Gonçalves RA, Sampaio A, Seara-Cardoso A. Callous-Unemotional Traits Moderate Anticipated Guilt and Wrongness Judgments to Everyday Moral Transgressions in Adolescents. Front Psychiatry 2021; 12:625328. [PMID: 33762977 PMCID: PMC7982950 DOI: 10.3389/fpsyt.2021.625328] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 02/09/2021] [Indexed: 12/17/2022] Open
Abstract
Callous-unemotional (CU) traits observed during childhood and adolescence are thought to be precursors of psychopathic traits in adulthood. Adults with high levels of psychopathic traits typically present antisocial behavior. Such behavior can be indicative of atypical moral processing. Evidence suggests that moral dysfunction in these individuals may stem from a disruption of affective components of moral processing rather than from an inability to compute moral judgments per se. No study to date has tested if the dissociation between affective and cognitive dimensions of moral processing linked to psychopathic traits in adulthood is also linked to CU traits during development. Here, 47 typically developing adolescents with varying levels of CU traits completed a novel, animated cartoon task depicting everyday moral transgressions and indicated how they would feel in such situations and how morally wrong the situations were. Adolescents with higher CU traits reported reduced anticipated guilt and wrongness appraisals of the transgressions. However, our key finding was a significant interaction between CU traits and anticipated guilt in predicting wrongness judgments. The strength of the association between anticipated guilt and wrongness judgement was significantly weaker for those with higher levels of CU traits. This evidence extends our knowledge on the cognitive-affective processing deficits that may underlie moral dysfunction in youth who are at heightened risk for antisocial behavior and psychopathy in adulthood. Future longitudinal research is required to elucidate whether there is an increased dissociation between different components of moral processing from adolescence to adulthood for those with high psychopathic traits.
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Affiliation(s)
- Margarida Vasconcelos
- Psychological Neuroscience Laboratory, Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
| | - Essi Viding
- Division of Psychology and Language Sciences, University College London, London, United Kingdom
| | | | - Susana Faria
- Department of Mathematics, University of Minho, Braga, Portugal
| | - Pedro R. Almeida
- Faculty of Law, Interdisciplinary Research Centre on Crime Justice and Security, School of Criminology, University of Porto, Porto, Portugal
| | - Óscar F. Gonçalves
- Proaction Laboratory, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Rui A. Gonçalves
- Psychological Neuroscience Laboratory, Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
- School of Psychology, Campus de Gualtar, University of Minho, Braga, Portugal
| | - Adriana Sampaio
- Psychological Neuroscience Laboratory, Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
| | - Ana Seara-Cardoso
- Psychological Neuroscience Laboratory, Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
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Winters DE, Brandon-Friedman R, Yepes G, Hinckley JD. Systematic review and meta-analysis of socio-cognitive and socio-affective processes association with adolescent substance use. Drug Alcohol Depend 2021; 219:108479. [PMID: 33444900 PMCID: PMC7943258 DOI: 10.1016/j.drugalcdep.2020.108479] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 11/25/2020] [Accepted: 12/03/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Social impairments are important features of a substance use disorder diagnosis; and recent models suggest early impairments in socio-cognitive and -affective processes may predict future use. However, no systematic reviews are available on this topic. METHODS We conducted a systematic review and meta-analyses exploring the association between social-cognitive and -affective processes (empathy, callous-unemotional (CU) traits, theory of mind, and social cognition) and substance use frequency (alcohol, cannabis, general drug use). We examined moderating effects of study design, gender, age, and weather conduct problems were controlled for. We also review brain studies related to social cognition and substance use disorder (SUD) risk. RESULTS Systematic review suggested a negative association for positively valenced constructs with substance use but mixed results on the negatively valenced construct CU traits. Meta-analyses revealed moderate positive association between CU traits with alcohol and general drug use but no significance with cannabis use. Moderate effect sizes were found for CU traits in youth predicting severity of substance use by late adolescence and significantly accounted for variance independently of conduct problems. Significant moderators included gender proportions, sample type, and age. Neuroimaging meta-analysis indicated 10 coordinates that were different in youth at a high risk/with SUD compared to controls. Three of these coordinates associate with theory of mind and social cognition. CONCLUSION Socio-cognitive and -affective constructs demonstrate an association with current and future substance use, and neural differences are present when performing social cognitive tasks in regions with strongest associations with theory of mind and social cognition.
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Affiliation(s)
- Drew E Winters
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, United States.
| | | | - Gabriel Yepes
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, United States
| | - Jesse D Hinckley
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, United States
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12
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Adolescent-Parent Agreement on Callous-Unemotional Traits in Adolescents with Attention-Deficit/Hyperactivity Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17113888. [PMID: 32486294 PMCID: PMC7312037 DOI: 10.3390/ijerph17113888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/28/2020] [Accepted: 05/29/2020] [Indexed: 01/27/2023]
Abstract
This study examined the levels of agreement between the reports of 207 adolescents with attention-deficit/hyperactivity disorder (ADHD) and their parents regarding the adolescents' callous-unemotional (CU) traits and investigated the factors influencing adolescent-parent agreement. Adolescent-parent agreement about CU traits in three dimensions according to the Chinese version of the Inventory of Callous and Unemotional Traits was examined. The influence of demographic characteristics, comorbid conduct disorder (CD), oppositional defiant disorder (ODD), and ADHD symptoms on adolescent-parent agreement was also examined. The results indicated that adolescent-parent agreement on the CU trait of uncaringness was moderate, whereas agreement on the CU traits of callousness and unemotionality was poor. Adolescent-parent agreement on the three dimensions of CU traits varied depending on the adolescents' sex and comorbid CD and ODD symptoms as well as parental age. Therefore, multiple sources of information are required when assessing the severity of CU traits in adolescents with ADHD. The factors influencing the levels of the agreement should also be considered.
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13
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Ruisch IH, Dietrich A, Klein M, Faraone SV, Oosterlaan J, Buitelaar JK, Hoekstra PJ. Aggression based genome-wide, glutamatergic, dopaminergic and neuroendocrine polygenic risk scores predict callous-unemotional traits. Neuropsychopharmacology 2020; 45:761-769. [PMID: 31918432 PMCID: PMC7075955 DOI: 10.1038/s41386-020-0608-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 12/03/2019] [Accepted: 12/30/2019] [Indexed: 12/17/2022]
Abstract
Aggression and callous, uncaring, and unemotional (CU) traits are clinically related behavioral constructs caused by genetic and environmental factors. We performed polygenic risk score (PRS) analyses to investigate shared genetic etiology between aggression and these three CU-traits. Furthermore, we studied interactions of PRS with smoking during pregnancy and childhood life events in relation to CU-traits. Summary statistics for the base phenotype were derived from the EAGLE-consortium genome-wide association study of children's aggressive behavior and were used to calculate individual-level genome-wide and gene-set PRS in the NeuroIMAGE target-sample. Target phenotypes were 'callousness', 'uncaring', and 'unemotional' sumscores of the Inventory of Callous-Unemotional traits. A total of 779 subjects and 1,192,414 single-nucleotide polymorphisms were available for PRS-analyses. Gene-sets comprised serotonergic, dopaminergic, glutamatergic, and neuroendocrine signaling pathways. Genome-wide PRS showed evidence of association with uncaring scores (explaining up to 1.59% of variance; self-contained Q = 0.0306, competitive-P = 0.0015). Dopaminergic, glutamatergic, and neuroendocrine PRS showed evidence of association with unemotional scores (explaining up to 1.33, 2.00, and 1.20% of variance respectively; self-contained Q-values 0.037, 0.0115, and 0.0473 respectively, competitive-P-values 0.0029, 0.0002, and 0.0045 respectively). Smoking during pregnancy related to callousness scores while childhood life events related to both callousness and unemotionality. Moreover, dopaminergic PRS appeared to interact with childhood life events in relation to unemotional scores. Our study provides evidence suggesting shared genetic etiology between aggressive behavior and uncaring, and unemotional CU-traits in children. Gene-set PRS confirmed involvement of shared glutamatergic, dopaminergic, and neuroendocrine genetic variation in aggression and CU-traits. Replication of current findings is needed.
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Affiliation(s)
- I Hyun Ruisch
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713GZ, Groningen, The Netherlands.
| | - Andrea Dietrich
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713GZ, Groningen, The Netherlands
| | - Marieke Klein
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525GA, Nijmegen, The Netherlands
- Department of Psychiatry, University Medical Center Utrecht, Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - Stephen V Faraone
- Department of Psychiatry and of Neuroscience and Physiology, State University of New York (SUNY) Upstate Medical University, Syracuse, NY, United States
- K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, Bergen, Norway
| | - Jaap Oosterlaan
- Department of Clinical Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525GA, Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry University Centre, Reinier Postlaan 12, 6525GC, Nijmegen, The Netherlands
| | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713GZ, Groningen, The Netherlands
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14
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Bakker-Huvenaars MJ, Greven CU, Herpers P, Wiegers E, Jansen A, van der Steen R, van Herwaarden AE, Baanders AN, Nijhof KS, Scheepers F, Rommelse N, Glennon JC, Buitelaar JK. Saliva oxytocin, cortisol, and testosterone levels in adolescent boys with autism spectrum disorder, oppositional defiant disorder/conduct disorder and typically developing individuals. Eur Neuropsychopharmacol 2020; 30:87-101. [PMID: 30201120 DOI: 10.1016/j.euroneuro.2018.07.097] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 06/19/2018] [Accepted: 07/08/2018] [Indexed: 11/29/2022]
Abstract
The aim of the current study was to compare levels of oxytocin, cortisol, and testosterone in adolescents with either autism spectrum disorder (ASD), or oppositional defiant disorder (ODD)/conduct disorder (CD), and in typically developing individuals (TDI), and relate hormone levels to severity and subtype of aggression and callous-unemotional (CU) traits. Saliva concentrations of oxytocin, cortisol, and testosterone were assessed in 114 male participants (N = 49 ASD, N = 37 ODD/CD, N = 28 TDI,) aged 12-19 years (M = 15.4 years, SD = 1.9). The ASD and the ODD/CD groups had significantly lower levels of oxytocin than the TDI group, and the ODD/CD group had significantly higher levels of testosterone than the ASD group. There were no group effects on cortisol levels. Group differences remained for oxytocin after correcting for the influence of CU traits, but were not significant after controlling for aggression. Results for testosterone became non-significant after correction for either CU traits or aggression. Across groups, higher levels of CU traits were related to higher levels of cortisol and testosterone, however, proactive and reactive aggression were unrelated to all three hormonal levels. The current findings show that, regardless of cognitive ability or comorbid disorders, the diagnostic groups (ASD, ODD/CD) differ from each other by their hormonal levels, with the ASD group characterized by relative low level of oxytocin, and the ODD/CD group by a relative low level of oxytocin and high level of testosterone. These group effects were partly driven by differences in CU traits between the groups.
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Affiliation(s)
- M J Bakker-Huvenaars
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Centre, Nijmegen, The Netherlands; Karakter Child and Adolescent Psychiatry University Centre Nijmegen, Nijmegen, The Netherlands
| | - C U Greven
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Centre, Nijmegen, The Netherlands; Karakter Child and Adolescent Psychiatry University Centre Nijmegen, Nijmegen, The Netherlands; King's College London, Medical Research Council Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, UK
| | - P Herpers
- Karakter Child and Adolescent Psychiatry University Centre Nijmegen, Nijmegen, The Netherlands
| | - E Wiegers
- Karakter Child and Adolescent Psychiatry University Centre Nijmegen, Nijmegen, The Netherlands
| | - A Jansen
- Karakter Child and Adolescent Psychiatry University Centre Nijmegen, Nijmegen, The Netherlands
| | - R van der Steen
- Department of Laboratory Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - A E van Herwaarden
- Department of Laboratory Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - A N Baanders
- Stichting Otto Gerhard Heldring, Zetten, The Netherlands
| | - K S Nijhof
- Pluryn, Hoenderloo, The Netherlands; Department of Developmental Psychopathology, Behavioral Science Institute, Radboud University Nijmegen, The Netherlands
| | - F Scheepers
- Brain Centre Rudolf Magnus, UMC Utrecht, Utrecht, The Netherlands
| | - N Rommelse
- Karakter Child and Adolescent Psychiatry University Centre Nijmegen, Nijmegen, The Netherlands; Department of Psychiatry, University Medical Centre Nijmegen, Nijmegen, The Netherlands
| | - J C Glennon
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - J K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Centre, Nijmegen, The Netherlands; Karakter Child and Adolescent Psychiatry University Centre Nijmegen, Nijmegen, The Netherlands.
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15
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Muskens JB, Herpers PCM, Hilderink C, van Deurzen PAM, Buitelaar JK, Staal WG. Intensive home treatment for adolescents in psychiatric crisis. BMC Psychiatry 2019; 19:412. [PMID: 31856770 PMCID: PMC6924140 DOI: 10.1186/s12888-019-2407-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 12/12/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescents with acute psychiatric disorders are typically treated with long-term clinical admission. However, long term admission may be associated with a variety of negative outcomes. This pilot study presents a new model of care, that is, the combined application of intensive home treatment and the possibility of short term stay at a psychiatric high & intensive care. METHODS In total 112 referred adolescents with mixed diagnoses participated in this longitudinal observational design. Clinical outcome was measured by the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) which measures the severity of multiple mental health problems. The HoNOSCA was clinician-rated at intake, after two months and after four months at discharge. Change in HoNOSCA total score was analysed with paired t-tests. Outcome moderators were gender, age, primary diagnosis, clinical admission, home treatment-time, medication and additional therapies. Follow up data were completed for 62 patients after two months and for 53 after four months. RESULTS Participants aged between 11 and 18 years (M = 14.8 years, SD = 0.3; 52% female). Mean HoNOSCA total score at intake was 18.8 (SD = 5.2), after two months 13.0 (SD = 5.0); after four months resulting in a score of 9.3 (SD = 5.2). None of the moderators tested showed a significant effect on HoNOSCA scores. However, a control group could not be used because of the severe psychopathology and high risk for suicidality and the lack of an effective treatment intervention for a comparable study group. CONCLUSION With a symptom decrease of over 50% within four months as measured by the HoNOSCA, including less risk for hospitalization, this new model appears promising and of clinical relevance. Nevertheless, further research regarding stability of treatment outcome is warranted and evaluation of long-term effects of this model in follow-up studies is needed.
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Affiliation(s)
- Jet B. Muskens
- Karakter, Child and Adolescent Psychiatry, University Centre, Reinier Postlaan 12, 6525 GC Nijmegen, The Netherlands
- Department of Psychiatry, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands
| | - Pierre C. M. Herpers
- Karakter, Child and Adolescent Psychiatry, University Centre, Reinier Postlaan 12, 6525 GC Nijmegen, The Netherlands
- Department of Psychiatry, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands
| | - Caroline Hilderink
- Karakter, Child and Adolescent Psychiatry, University Centre, Reinier Postlaan 12, 6525 GC Nijmegen, The Netherlands
| | - Patricia A. M. van Deurzen
- Karakter, Child and Adolescent Psychiatry, University Centre, Reinier Postlaan 12, 6525 GC Nijmegen, The Netherlands
| | - Jan K. Buitelaar
- Karakter, Child and Adolescent Psychiatry, University Centre, Reinier Postlaan 12, 6525 GC Nijmegen, The Netherlands
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboudumc, Nijmegen, The Netherlands
| | - Wouter G. Staal
- Karakter, Child and Adolescent Psychiatry, University Centre, Reinier Postlaan 12, 6525 GC Nijmegen, The Netherlands
- Department of Psychiatry, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboudumc, Nijmegen, The Netherlands
- Faculty of Social Sciences, Leiden Institute for Brain and Cognition, Postzone C2-5, P.O.Box 9600, 2300 RC Leiden, The Netherlands
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16
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Herpers PCM, Bakker-Huvenaars MJ, Greven CU, Wiegers EC, Nijhof KS, Baanders AN, Buitelaar JK, Rommelse NNJ. Emotional valence detection in adolescents with oppositional defiant disorder/conduct disorder or autism spectrum disorder. Eur Child Adolesc Psychiatry 2019; 28:1011-1022. [PMID: 30680520 DOI: 10.1007/s00787-019-01282-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 10/25/2018] [Indexed: 11/28/2022]
Abstract
Oppositional defiant disorder, conduct disorder (ODD/CD), and autism spectrum disorder (ASD) share poor empathic functioning and have been associated with impaired emotional processing. However, no previous studies directly compared similarities and differences in these processes for the two disorders. A two-choice emotional valence detection task requiring differentiation between positive, negative, and neutral IAPS pictures was administered to 52 adolescents (12-19 years) with ODD/CD, 52 with ASD and 24 typically developing individuals (TDI). Callous-unemotional (CU) traits were assessed by self- and parent reports using the Inventory of callous-unemotional traits. Main findings were that adolescents with ODD/CD or ASD both performed poorer than TDI in terms of accuracy, yet only the TDI-not both clinical groups-had relatively most difficulty in discriminating between positive versus neutral pictures compared to neutral-negative or positive-negative contrasts. Poorer performance was related to a higher level of CU traits. The results of the current study suggest youth with ODD/CD or ASD have a diminished ability to detect emotional valence which is not limited to facial expressions and is related to a higher level of CU traits. More specifically, youth with ODD/CD or ASD seem to have a reduced processing of positive stimuli and/or lack a 'positive perception bias' present in TDI that could either contribute to the symptoms and/or be a result of having the disorder and may contribute to the comorbidity of both disorders.
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Affiliation(s)
- Pierre C M Herpers
- Karakter Child and Adolescent Psychiatry, University Centre, Reinier Postlaan 12, 6525 GC, Nijmegen, The Netherlands. .,Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Kapittelweg 29, 6525 EN, Nijmegen, The Netherlands.
| | - Mireille J Bakker-Huvenaars
- Karakter Child and Adolescent Psychiatry, University Centre, Reinier Postlaan 12, 6525 GC, Nijmegen, The Netherlands.,Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Kapittelweg 29, 6525 EN, Nijmegen, The Netherlands
| | - Corina U Greven
- Karakter Child and Adolescent Psychiatry, University Centre, Reinier Postlaan 12, 6525 GC, Nijmegen, The Netherlands.,Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Kapittelweg 29, 6525 EN, Nijmegen, The Netherlands.,Medical Research Council Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Evita C Wiegers
- Karakter Child and Adolescent Psychiatry, University Centre, Reinier Postlaan 12, 6525 GC, Nijmegen, The Netherlands.,Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Karin S Nijhof
- Pluryn, Industrieweg 50, 6541 TW, Nijmegen, The Netherlands.,Behavioural Science Institute, Developmental Psychopathology, Radboud University Nijmegen, Montessorilaan 3, 6500 HE, Nijmegen, The Netherlands
| | - Arianne N Baanders
- Ottho Gerhard Heldring Foundation, Wageningsestraat 104, 6671 DH, Zetten, The Netherlands
| | - Jan K Buitelaar
- Karakter Child and Adolescent Psychiatry, University Centre, Reinier Postlaan 12, 6525 GC, Nijmegen, The Netherlands.,Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Kapittelweg 29, 6525 EN, Nijmegen, The Netherlands
| | - Nanda N J Rommelse
- Karakter Child and Adolescent Psychiatry, University Centre, Reinier Postlaan 12, 6525 GC, Nijmegen, The Netherlands.,Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Kapittelweg 29, 6525 EN, Nijmegen, The Netherlands
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17
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The relation between the age at diagnosis of problem behaviors related to aggression and distal outcomes in Swedish children. Eur Child Adolesc Psychiatry 2019; 28:899-911. [PMID: 30413982 DOI: 10.1007/s00787-018-1250-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 10/31/2018] [Indexed: 01/02/2023]
Abstract
Severe childhood aggressive behaviors are known to predict negative outcomes later in life; however, little is known about the effect of when in childhood aggression problems are diagnosed. While an earlier first diagnosis of problematic aggressive behavior might be associated with increased severity and, thus, worse outcomes, it is also possible that an earlier diagnosis affords an earlier start of treatment programs or indicates that greater attention is being paid to behavioral problems, thus resulting in attenuation of the severity of childhood aggression's impact on distal outcomes. The current study analyzed data from the population-based Swedish Data Registries, which include data on all children formally diagnosed by the Swedish medical system with a wide range of aggression problems between ages 8 and 18 (N = 5816) during the years 1987-2013, along with a matched control. Time-to-event analyses investigated whether the age at time of diagnosis affects later life outcomes while controlling for relevant confounders. Results show that for both boys and girls, those with a later diagnosis had lower average incomes (regression coefficient b = - 0.055, p < 0.005) and a higher probability of having a criminal record (odds ratio 1.126, p < 0.005) than children with earlier diagnoses. The effect on suicide attempts was not significant after correcting for multiple testing (odds ratio 1.264, p = 0.016). Grade score was not significantly affected. The results warrant further research concerning the potential advantage of earlier diagnoses, especially concerning generalizability beyond the Swedish population.
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18
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Bours CCAH, Bakker-Huvenaars MJ, Tramper J, Bielczyk N, Scheepers F, Nijhof KS, Baanders AN, Lambregts-Rommelse NNJ, Medendorp P, Glennon JC, Buitelaar JK. Emotional face recognition in male adolescents with autism spectrum disorder or disruptive behavior disorder: an eye-tracking study. Eur Child Adolesc Psychiatry 2018; 27:1143-1157. [PMID: 29922873 PMCID: PMC6133091 DOI: 10.1007/s00787-018-1174-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 05/22/2018] [Indexed: 01/10/2023]
Abstract
Autism Spectrum Disorder (ASD), Oppositional Defiant Disorder (ODD), and Conduct Disorder (CD) are often associated with emotion recognition difficulties. This is the first eye-tracking study to examine emotional face recognition (i.e., gazing behavior) in a direct comparison of male adolescents with Autism Spectrum Disorder or Oppositional Defiant Disorder/Conduct Disorder, and typically developing (TD) individuals. We also investigate the role of psychopathic traits, callous-unemotional (CU) traits, and subtypes of aggressive behavior in emotional face recognition. A total of 122 male adolescents (N = 50 ASD, N = 44 ODD/CD, and N = 28 TD) aged 12-19 years (M = 15.4 years, SD= 1.9) were included in the current study for the eye-tracking experiment. Participants were presented with neutral and emotional faces using a Tobii 1750 eye-tracking monitor to record gaze behavior. Our main dependent eye-tracking variables were: (1) fixation duration to the eyes of a face and (2) time to the first fixation to the eyes. Since distributions of eye-tracking variables were not completely Gaussian, non-parametric tests were chosen to investigate gaze behavior across the diagnostic groups with Autism Spectrum Disorder, Oppositional Defiant Disorder/Conduct Disorder, and Typically Developing individuals. Furthermore, we used Spearman correlations to investigate the links with psychopathy, callous, and unemotional traits and subtypes of aggression as assessed by questionnaires. The relative total fixation duration to the eyes was decreased in both the Autism Spectrum Disorder group and the Oppositional Defiant Disorder/Conduct Disorder group for several emotional expressions. In both the Autism Spectrum Disorder and the Oppositional Defiant Disorder/Conduct Disorder group, increased time to first fixation on the eyes of fearful faces only was nominally significant. The time to first fixation on the eyes was nominally correlated with psychopathic traits and proactive aggression. The current findings do not support strong claims for differential cross-disorder eye-gazing deficits and for a role of shared underlying psychopathic traits, callous-unemotional traits, and aggression subtypes. Our data provide valuable and novel insights into gaze timing distributions when looking at the eyes of a fearful face.
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Affiliation(s)
- C C A H Bours
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Centre, Nijmegen, The Netherlands.
| | - M J Bakker-Huvenaars
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - J Tramper
- Centre for Cognition, Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - N Bielczyk
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - F Scheepers
- Brain Center Rudolf Magnus, UMC Utrecht, Utrecht, The Netherlands
| | - K S Nijhof
- Pluryn, Hoenderloo, The Netherlands
- Department of Developmental Psychology, Radboud University, Nijmegen, The Netherlands
| | - A N Baanders
- Stichting Otto Gerhard Heldring, Zetten, The Netherlands
| | - N N J Lambregts-Rommelse
- Karakter Child and Adolescent Psychiatry University Centre Nijmegen, Nijmegen, The Netherlands
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - P Medendorp
- Centre for Cognition, Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - J C Glennon
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - J K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Centre, Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry University Centre Nijmegen, Nijmegen, The Netherlands
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19
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Greven CU, Buitelaar JK, Salum GA. From positive psychology to psychopathology: the continuum of attention-deficit hyperactivity disorder. J Child Psychol Psychiatry 2018; 59:203-212. [PMID: 28731214 DOI: 10.1111/jcpp.12786] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/14/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Integration of positive psychology into clinical research and treatment has been slow. This integration can be facilitated by the conceptualisation of mental disorders as the high, symptomatic extreme of continuous normal variation. This assumes that there is also a low, positive extreme, which is, however, unchartered territory. This study aims to examine how well current measures capture the low extreme of mental disorder continua, using attention-deficit hyperactivity disorder (ADHD) as an example. METHODS The ability of three validated scales to capture ADHD as a continuous trait was examined using Item Response Theory in a sample of 9,882 adolescents from the UK population-representative Twins Early Development Study. These scales were: the Strengths and Weakness of ADHD Symptoms and Normal behaviour scale (SWAN), Strength and Difficulties Questionnaire (SDQ - hyperactivity subscale), and Conners' Parent Rating Scale (Conners). RESULTS Only the SWAN reliably differentiated interindividual differences between participants lying at any level of the continuous ADHD latent trait, including the extreme low, positive end (z-scores from -3 to +3). The SDQ showed low reliability across the ADHD latent trait. In contrast, the Conners performed best at differentiating individuals scoring at or above the mean to the high symptomatic range (z-scores from 0 to +3). The SWAN was the only measure to provide indicators of 'positive mental health', endorsed in the presence of particularly good attentive abilities. CONCLUSIONS Scales such as the SWAN that reliably capture ADHD as a continuous trait, including the positive end, are important for not missing meaningful variation in population-based studies. Indicators of positive mental health may be helpful in clinical practice, as positive attributes have been shown to directly influence as well as buffer negative effects of psychiatric symptoms.
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Affiliation(s)
- Corina U Greven
- Department of Cognitive Neuroscience, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.,Karakter Child and Adolescent Psychiatry University Center, Nijmegen, The Netherlands.,Medical Research Council Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.,Karakter Child and Adolescent Psychiatry University Center, Nijmegen, The Netherlands
| | - Giovanni A Salum
- Section on Negative Affect and Social Processes, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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20
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Raschle NM, Menks WM, Fehlbaum LV, Steppan M, Smaragdi A, Gonzalez-Madruga K, Rogers J, Clanton R, Kohls G, Martinelli A, Bernhard A, Konrad K, Herpertz-Dahlmann B, Freitag CM, Fairchild G, De Brito SA, Stadler C. Callous-unemotional traits and brain structure: Sex-specific effects in anterior insula of typically-developing youths. NEUROIMAGE-CLINICAL 2017. [PMID: 29527490 PMCID: PMC5842751 DOI: 10.1016/j.nicl.2017.12.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Callous-unemotional traits are characterized by a lack of empathy, a disregard for others' feelings and shallow or deficient affect, such as a lack of remorse or guilt. Neuroanatomical correlates of callous-unemotional traits have been demonstrated in clinical samples (i.e., adolescents with disruptive behavior disorders). However, it is unknown whether callous-unemotional traits are associated with neuroanatomical correlates within normative populations without clinical levels of aggression or antisocial behavior. Here we investigated the relationship between callous-unemotional traits and gray matter volume using voxel-based morphometry in a large sample of typically-developing boys and girls (N = 189). Whole-brain multiple regression analyses controlling for site, total intracranial volume, and age were conducted in the whole sample and in boys and girls individually. Results revealed that sex and callous-unemotional traits interacted to predict gray matter volume when considering the whole sample. This interaction was driven by a significant positive correlation between callous-unemotional traits and bilateral anterior insula volume in boys, but not girls. Insula gray matter volume explained 19% of the variance in callous-unemotional traits for boys. Our results demonstrate that callous-unemotional traits are related to variations in brain structure beyond psychiatric samples. This association was observed for boys only, underlining the importance of considering sex as a factor in future research designs. Future longitudinal studies should determine whether these findings hold over childhood and adolescence, and whether the neuroanatomical correlates of callous-unemotional traits are predictive of future psychiatric vulnerability. General scientific summary This study suggests that callous-unemotional traits have a neuroanatomical correlate within typically developing boys, but not girls. Bilateral anterior insula volume explains up to 19% of the variance in callous-unemotional traits in boys. Sex-specific correlations between callous-unemotional (CU) traits and insula volume. CU-traits are positively linked to anterior insula in typically-developing boys. Variations in insula volume explained 19% of the variance in CU-traits in boys. Accounting for sex in neuroanatomical studies of individual differences is important.
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Affiliation(s)
- Nora Maria Raschle
- Department of Child and Adolescent Psychiatry, University of Basel, Psychiatric University Hospital, Basel, Switzerland.
| | - Willeke Martine Menks
- Department of Child and Adolescent Psychiatry, University of Basel, Psychiatric University Hospital, Basel, Switzerland
| | - Lynn Valérie Fehlbaum
- Department of Child and Adolescent Psychiatry, University of Basel, Psychiatric University Hospital, Basel, Switzerland
| | - Martin Steppan
- Department of Child and Adolescent Psychiatry, University of Basel, Psychiatric University Hospital, Basel, Switzerland
| | - Areti Smaragdi
- Academic Unit of Psychology, University of Southampton, Southampton, England, UK
| | | | - Jack Rogers
- School of Psychology, University of Birmingham, Birmingham, England, UK
| | - Roberta Clanton
- School of Psychology, University of Birmingham, Birmingham, England, UK
| | - Gregor Kohls
- Department of Psychiatry, Psychosomatics and Psychotherapy, Child Neuropsychology Section, University Hospital Aachen, Germany
| | - Anne Martinelli
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Anka Bernhard
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Kerstin Konrad
- Department of Psychiatry, Psychosomatics and Psychotherapy, Child Neuropsychology Section, University Hospital Aachen, Germany; JARA-Brain Institute II, Molecular Neuroscience and Neuroimaging, RWTH Aachen & Research Centre Juelich, Germany
| | - Beate Herpertz-Dahlmann
- Department of Psychiatry, Psychosomatics and Psychotherapy, Child Neuropsychology Section, University Hospital Aachen, Germany; Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of the RWTH, Aachen, Germany
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | | | | | - Christina Stadler
- Department of Child and Adolescent Psychiatry, University of Basel, Psychiatric University Hospital, Basel, Switzerland
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21
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Aghajani M, Klapwijk ET, van der Wee NJ, Veer IM, Rombouts SARB, Boon AE, van Beelen P, Popma A, Vermeiren RRJM, Colins OF. Disorganized Amygdala Networks in Conduct-Disordered Juvenile Offenders With Callous-Unemotional Traits. Biol Psychiatry 2017; 82:283-293. [PMID: 27502216 DOI: 10.1016/j.biopsych.2016.05.017] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 05/16/2016] [Accepted: 05/18/2016] [Indexed: 01/21/2023]
Abstract
BACKGROUND The developmental trajectory of psychopathy seemingly begins early in life and includes the presence of callous-unemotional (CU) traits (e.g., deficient emotional reactivity, callousness) in conduct-disordered (CD) youth. Though subregion-specific anomalies in amygdala function have been suggested in CU pathophysiology among antisocial populations, system-level studies of CU traits have typically examined the amygdala as a unitary structure. Hence, nothing is yet known of how amygdala subregional network function may contribute to callous-unemotionality in severely antisocial people. METHODS We addressed this important issue by uniquely examining the intrinsic functional connectivity of basolateral amygdala (BLA) and centromedial amygdala (CMA) networks across three matched groups of juveniles: CD offenders with CU traits (CD/CU+; n = 25), CD offenders without CU traits (CD/CU-; n = 25), and healthy control subjects (n = 24). We additionally examined whether perturbed amygdala subregional connectivity coincides with altered volume and shape of the amygdaloid complex. RESULTS Relative to CD/CU- and healthy control youths, CD/CU+ youths showed abnormally increased BLA connectivity with a cluster that included both dorsal and ventral portions of the anterior cingulate and medial prefrontal cortices, along with posterior cingulate, sensory associative, and striatal regions. In contrast, compared with CD/CU- and healthy control youths, CD/CU+ youths showed diminished CMA connectivity with ventromedial/orbitofrontal regions. Critically, these connectivity changes coincided with local hypotrophy of BLA and CMA subregions (without being statistically correlated) and were associated to more severe CU symptoms. CONCLUSIONS These findings provide unique insights into a putative mechanism for perturbed attention-emotion interactions, which could bias salience processing and associative learning in youth with CD/CU+.
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Affiliation(s)
- Moji Aghajani
- Department of Child and Adolescent Psychiatry, Curium-Leiden University Medical Center, Leiden; Leiden Institute for Brain and Cognition, Leiden.
| | - Eduard T Klapwijk
- Department of Child and Adolescent Psychiatry, Curium-Leiden University Medical Center, Leiden; Leiden Institute for Brain and Cognition, Leiden
| | - Nic J van der Wee
- Department of Psychiatry, Leiden University Medical Center, Leiden; Leiden Institute for Brain and Cognition, Leiden
| | - Ilya M Veer
- Department of Psychiatry and Psychotherapy, Division of Mind and Brain Research, Charité Universitätsmedizin, Berlin, Germany
| | - Serge A R B Rombouts
- Department of Radiology, Leiden University Medical Center, Leiden; Institute of Psychology, Leiden University, Leiden; Leiden Institute for Brain and Cognition, Leiden
| | - Albert E Boon
- Department of Child and Adolescent Psychiatry, Curium-Leiden University Medical Center, Leiden; Lucertis Child and Adolescent Psychiatry, Rotterdam
| | - Peter van Beelen
- Forensic Psychiatry Unit Het Palmhuis, De Jutters Institute for Mental Health Care, The Hague, The Netherlands
| | - Arne Popma
- Institute of Criminal Law and Criminology, Leiden University, Leiden; Department of Child and Adolescent Psychiatry, VU University Medical Center, Amsterdam
| | - Robert R J M Vermeiren
- Department of Child and Adolescent Psychiatry, Curium-Leiden University Medical Center, Leiden; Leiden Institute for Brain and Cognition, Leiden
| | - Olivier F Colins
- Department of Child and Adolescent Psychiatry, Curium-Leiden University Medical Center, Leiden; Leiden Institute for Brain and Cognition, Leiden
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22
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Herpers PCM, Klip H, Rommelse NNJ, Taylor MJ, Greven CU, Buitelaar JK. Taxometric analyses and predictive accuracy of callous-unemotional traits regarding quality of life and behavior problems in non-conduct disorder diagnoses. Psychiatry Res 2017; 253:351-359. [PMID: 28427034 DOI: 10.1016/j.psychres.2017.04.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 03/19/2017] [Accepted: 04/02/2017] [Indexed: 11/18/2022]
Abstract
Callous-unemotional (CU) traits have mainly been studied in relation to conduct disorder (CD), but can also occur in other disorder groups. However, it is unclear whether there is a clinically relevant cut-off value of levels of CU traits in predicting reduced quality of life (QoL) and clinical symptoms, and whether CU traits better fit a categorical (taxonic) or dimensional model. Parents of 979 youths referred to a child and adolescent psychiatric clinic rated their child's CU traits on the Inventory of Callous-Unemotional traits (ICU), QoL on the Kidscreen-27, and clinical symptoms on the Child Behavior Checklist. Experienced clinicians conferred DSM-IV-TR diagnoses of ADHD, ASD, anxiety/mood disorders and DBD-NOS/ODD. The ICU was also used to score the DSM-5 specifier 'with limited prosocial emotions' (LPE) of Conduct Disorder. Receiver operating characteristic (ROC) analyses revealed that the predictive accuracy of the ICU and LPE regarding QoL and clinical symptoms was poor to fair, and similar across diagnoses. A clinical cut-off point could not be defined. Taxometric analyses suggested that callous-unemotional traits on the ICU best reflect a dimension rather than taxon. More research is needed on the impact of CU traits on the functional adaptation, course, and response to treatment of non-CD conditions.
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Affiliation(s)
- Pierre C M Herpers
- Karakter, Child and Adolescent Psychiatry, University Center, Reinier Postlaan 12, 6525 GC Nijmegen, The Netherlands; Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Psychiatry, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands.
| | - Helen Klip
- Karakter, Child and Adolescent Psychiatry, University Center, Reinier Postlaan 12, 6525 GC Nijmegen, The Netherlands
| | - Nanda N J Rommelse
- Karakter, Child and Adolescent Psychiatry, University Center, Reinier Postlaan 12, 6525 GC Nijmegen, The Netherlands; Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Psychiatry, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands
| | - Mark J Taylor
- Karolinska Institutet, Department of Medical Epidemiology & Biostatistics, Nobels väg 12A, Stockholm 17177, Sweden
| | - Corina U Greven
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Cognitive Neuroscience, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands; King's College London, Medical Research Council Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, United Kingdom
| | - Jan K Buitelaar
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Cognitive Neuroscience, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands
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23
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Masi G, Milone A, Brovedani P, Pisano S, Muratori P. Psychiatric evaluation of youths with Disruptive Behavior Disorders and psychopathic traits: A critical review of assessment measures. Neurosci Biobehav Rev 2016; 91:21-33. [PMID: 27677830 DOI: 10.1016/j.neubiorev.2016.09.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 08/12/2016] [Accepted: 09/23/2016] [Indexed: 12/29/2022]
Abstract
Disruptive Behavior Disorders (DBDs) are stable and impairing disorders, heterogeneous in presentation, developmental pathways, and treatment needs. Disentangling subtypes according to psychopathological dimensions is helpful for timely diagnoses, precise prognoses and tailored interventions. Psychopathic traits are relevant in subtyping DBDs with severe antisocial and aggressive behaviors. Three psychopathy dimensions have been found: 1) an affective dimension, the callous-unemotional (CU) trait, with lack of empathy and remorse, and with short-lived emotions; 2) an interpersonal dimension, the narcissistic domain, with manipulative abilities, superficial charm, egocentricity and grandiosity; 3) a behavioral dimension, the impulsivity or impulsive-irresponsibility, with irresponsibility, proneness to boredom, and novelty seeking. Recently, research suggests that youth with CU traits, similarly to adults with psychopathy, can present a low-anxious "primary" and high-anxious "secondary" variants. Our aim is to critically review the main measures of psychopathic traits, including the three main dimensions (with specific emphasis on CU traits), and the "primary/secondary" distinction, focusing on the assessment in clinical settings. An assessment procedure is proposed, based on previous literature and personal clinical experience.
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Affiliation(s)
- Gabriele Masi
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy.
| | - Annarita Milone
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy
| | - Paola Brovedani
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy
| | - Simone Pisano
- Department of Mental and Physical Health and Preventive Medicine, Child and Adolescent Psychiatry Division, Second University of Naples, Italy
| | - Pietro Muratori
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy
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