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Dugré JR, Potvin S. Functional Connectivity of the Nucleus Accumbens across Variants of Callous-Unemotional Traits: A Resting-State fMRI Study in Children and Adolescents. Res Child Adolesc Psychopathol 2024; 52:353-368. [PMID: 37878131 PMCID: PMC10896801 DOI: 10.1007/s10802-023-01143-z] [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] [Accepted: 10/13/2023] [Indexed: 10/26/2023]
Abstract
A large body of literature suggests that the primary (high callousness-unemotional traits [CU] and low anxiety) and secondary (high CU traits and anxiety) variants of psychopathy significantly differ in terms of their clinical profiles. However, little is known about their neurobiological differences. While few studies showed that variants differ in brain activity during fear processing, it remains unknown whether they also show atypical functioning in motivational and reward system. Latent Profile Analysis (LPA) was conducted on a large sample of adolescents (n = 1416) to identify variants based on their levels of callousness and anxiety. Seed-to-voxel connectivity analysis was subsequently performed on resting-state fMRI data to compare connectivity patterns of the nucleus accumbens across subgroups. LPA failed to identify the primary variant when using total score of CU traits. Using a family-wise cluster correction, groups did not differ on functional connectivity. However, at an uncorrected threshold the secondary variant showed distinct functional connectivity between the nucleus accumbens and posterior insula, lateral orbitofrontal cortex, supplementary motor area, and parietal regions. Secondary LPA analysis using only the callousness subscale successfully distinguish both variants. Group differences replicated results of deficits in functional connectivity between the nucleus accumbens and posterior insula and supplementary motor area, but additionally showed effect in the superior temporal gyrus which was specific to the primary variant. The current study supports the importance of examining the neurobiological markers across subgroups of adolescents at risk for conduct problems to precise our understanding of this heterogeneous population.
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Affiliation(s)
- Jules Roger Dugré
- School of Psychology and Centre for Human Brain Health, University of Birmingham, Birmingham, B15 2TT, England.
| | - Stéphane Potvin
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Hochelaga, Montreal, 7331, H1N 3V2, Canada.
- Department of Psychiatry and Addictology, Faculty of medicine, University of Montreal, Montreal, Canada.
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2
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Suk JW, Blair RJR, Vaughan B, Lerdahl A, Garvey WF, Edwards R, Leibenluft E, Hwang S. Mediating effect of amygdala activity on response to fear vs. happiness in youth with significant levels of irritability and disruptive mood and behavior disorders. Front Behav Neurosci 2023; 17:1204574. [PMID: 37901308 PMCID: PMC10602729 DOI: 10.3389/fnbeh.2023.1204574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 09/12/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction Irritability, characterized by a tendency to exhibit increased anger, is a common clinical problem in youth. Irritability is a significant clinical issue in youth with various psychiatric diagnoses, especially disruptive behavior, and mood disorders (Attention-Deficit/Hyperactivity Disorder, Oppositional Defiant Disorder, Conduct Disorder, and Disruptive Mood Dysregulation Disorder). Although there have been previous studies focusing on functional alteration in the amygdala related to irritability, there is no comprehensive model between emotional, neuronal, and behavioral characteristics. Methods Using an functional magnetic resonance imaging (fMRI) procedure, we investigated the relationships between behavioral irritability, selective impairments in processing facial emotions and the amygdala neural response in youth with increased irritability. Fifty-nine youth with disruptive mood and behavior disorder completed a facial expression processing task with an event-related fMRI paradigm. The severity of irritability was evaluated using the Affective Reactivity Index. Results In the result of behavioral data, irritability, and reaction time (RT) differences between interpreting negative (fear) and positive (happiness) facial expressions were positively correlated. In the fMRI result, youth showed higher activation in the right cingulate gyrus, bilateral cerebellum, right amygdala, right precuneus, right superior frontal gyrus, right middle occipital gyrus, and middle temporal gyrus, during the happiness condition vs. fear condition. No brain region exhibited greater activation in the fear than in the happiness conditions. In the result of the mediator analysis, increased irritability was associated with a longer RT toward positive vs. negative facial expressions. Irritability was also positively associated with the difference in amygdala blood oxygen level-dependent responses between the two emotional conditions (happiness > fear). This difference in amygdala activity mediated the interaction between irritability and the RT difference between negative and positive facial expressions. Discussion We suggest that impairment in the implicit processing of facial emotional expressions with different valences causes distinct patterns of amygdala response, which correlate with the level of irritability. These results broaden our understanding of the biological mechanism of irritability at the neural level and provide information for the future direction of the study.
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Affiliation(s)
- Ji-Woo Suk
- Department of Psychiatry, University of Nebraska Medical Center, Omaha, NE, United States
- Digital Health Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Robert J. R. Blair
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Emotion and Development Branch, Copenhagen, Denmark
| | - Brigette Vaughan
- Department of Psychiatry, University of Nebraska Medical Center, Omaha, NE, United States
| | - Arica Lerdahl
- Department of Psychiatry, University of Nebraska Medical Center, Omaha, NE, United States
| | - William F. Garvey
- Department of Psychiatry, University of Nebraska Medical Center, Omaha, NE, United States
| | - Ryan Edwards
- Department of Psychiatry, University of Nebraska Medical Center, Omaha, NE, United States
| | - Ellen Leibenluft
- National Institute of Mental Health, Bethesda, MD, United States
| | - Soonjo Hwang
- Department of Psychiatry, University of Nebraska Medical Center, Omaha, NE, United States
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3
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Sakki H, Clair MS, Hwang S, Allen JL. The association between callous-unemotional traits and substance use in childhood and adolescence: A systematic review and meta-analysis. J Affect Disord 2023; 338:502-517. [PMID: 37390924 DOI: 10.1016/j.jad.2023.06.051] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 06/06/2023] [Accepted: 06/26/2023] [Indexed: 07/02/2023]
Abstract
Callous-unemotional (CU) traits are characterized by a lack of guilt and empathy, restricted affect, and low concern about performance, and are increasingly recognized as co-occurring with substance use in youth. However, there is mixed evidence concerning whether they make a unique contribution to substance use. This systematic review and meta-analysis sought to quantify the association between CU traits and substance use in childhood, accounting for potential moderators including sample characteristics (age, gender, community versus clinical/forensic samples), CU traits measure and informant, and study design (cross-sectional or longitudinal). Separate meta-analyses were conducted for alcohol, cannabis, and a substance use composite. Small, significant associations were found between CU traits and alcohol (θ = 0.17), cannabis (θ = 0.17) and the substance use composite (θ = 0.15), which were present in both community and clinical/forensic samples. Findings suggest that CU traits co-occur with a range of substance use problems, and that CU traits should be considered in assessments of youth presenting with substance use problems regardless of the nature of the setting.
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Affiliation(s)
- Hanna Sakki
- Department of Psychology, University of Bath, 10 West, Claverton Down, Bath BA2 7AY, UK
| | - Michelle St Clair
- Department of Psychology, University of Bath, 10 West, Claverton Down, Bath BA2 7AY, UK
| | - Suhlim Hwang
- Department of Psychology and Human Development, University College London, Institute of Education, 25 Woburn Square, London WC1H 0AA, UK
| | - Jennifer L Allen
- Department of Psychology, University of Bath, 10 West, Claverton Down, Bath BA2 7AY, UK.
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4
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Payot M, Monseur C, Stievenart M. Primary and Secondary Variants of Callous-Unemotional Traits in Early and Middle Childhood: Distinction, Evaluation and Empathic Differences. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01576-z. [PMID: 37552334 DOI: 10.1007/s10578-023-01576-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/17/2023] [Indexed: 08/09/2023]
Abstract
Current literature demonstrates the relevance of considering two variants of CU traits based on high or low levels of anxiety. However, there is limited information about these variants in young community samples. The current study used cluster analyses to investigate the primary and the secondary variants of CU traits in two samples of children: preschool (N = 107; Mage = 4.95, SD = 0.62) and school-age (N = 153; Mage = 7.49, SD = 1.11). The identified clusters were compared on empathic dimensions, aggressive behavior and criteria from the "with limited prosocial emotions" specifier from the DSM-V. The primary variant was identified as early as preschool age while the secondary variant was only identified in the school-age sample. In this latter sample, the two variants did not differ on assessed variables, except for aggressive behavior. Despite the similarities between the two variants, these results suggest distinct developmental trajectories.
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Affiliation(s)
- Morgane Payot
- Research Unit for a Life-Course Perspective on Health & Education, University of Liege, Place des Orateurs, 1, 4000, Liège, Belgium.
| | - Christian Monseur
- Research Unit for a Life-Course Perspective on Health & Education, University of Liege, Place des Orateurs, 1, 4000, Liège, Belgium
| | - Marie Stievenart
- Research Unit for a Life-Course Perspective on Health & Education, University of Liege, Place des Orateurs, 1, 4000, Liège, Belgium
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Goulter N, Craig SG, McMahon RJ. Primary and secondary callous-unemotional traits in adolescence are associated with distinct maladaptive and adaptive outcomes in adulthood. Dev Psychopathol 2023; 35:274-289. [PMID: 34009113 DOI: 10.1017/s0954579421000481] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
While phenotypically indistinguishable with respect to callousness, individuals with primary and secondary callous-unemotional (CU) traits may show different developmental outcomes. This research predominantly comprised cross-sectional studies of male participants with a focus on maladaptive correlates. Thus, the present study examined whether youth with primary and secondary CU traits identified in Grade 7 reported distinct maladaptive outcomes (internalizing, externalizing, and substance use problems; criminal offenses; and sexual and partner experiences) and adaptive outcomes (health and wellbeing, education, and employment) in adulthood at age 25. We also examined sex differences. Participants included the high-risk control and normative samples from the Fast Track project (N = 754, male = 58%, Black = 46%). Youth with secondary CU traits reported higher levels of adult internalizing and externalizing psychopathology, a greater number of sexual partners and risky sexual behavior, and a greater number of violent offenses, compared with individuals with primary CU traits and those with low CU and anxiety symptoms. Conversely, youth with primary CU traits and low symptoms had higher wellbeing and happiness scores than those with secondary CU traits. Finally, there was differentiation on outcomes between female primary and secondary CU variants and male primary and secondary CU variants.
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Affiliation(s)
- Natalie Goulter
- Department of Psychology, Simon Fraser University, Burnaby, BC, Canada
- BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Stephanie G Craig
- Department of Psychology, Simon Fraser University, Burnaby, BC, Canada
- LaMarsh Centre for Child and Youth Research, York University, Toronto, ON, Canada
| | - Robert J McMahon
- Department of Psychology, Simon Fraser University, Burnaby, BC, Canada
- BC Children's Hospital Research Institute, Vancouver, BC, Canada
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6
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Halty L, Caperos JM. Anxiety as a differentiating variable in emotional recognition in juvenile offenders with high callous-unemotional traits. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2023; 33:22-32. [PMID: 36722366 PMCID: PMC10108285 DOI: 10.1002/cbm.2276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 01/10/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The presence of so-called callous-unemotional (CU) traits-lack of remorse/empathy, callous use of others and shallow/deficient affect-defines an important subgroup of children and adolescents with more severe and stable antisocial behaviours over time and may be a precursor to so-called psychopathy in adults. There are two main hypotheses to account for such traits, one emphasising deficits in recognition of specific emotions-the distress specific-and the other in aspects of facial recognition-the attention to the eyes hypothesis, but it may be that the manifestation of deficits is affected by the person's own emotional state. AIMS To test the effect of anxiety scores on emotion recognition among young people high scoring for CU traits. METHODS 14- to 21-year-olds serving sentences in youth justice institutions across Spain were invited to participate. Only those scoring above the cut-off on the Kimonis Inventory of Callous and Unemotional Traits were included. Anxiety was measured using the State-Trait Anxiety Inventory. Emotion recognition was assessed using the Emotional Face and Emotional Gaze Tasks. RESULTS Of 91 (90% male) eligible participants, 53 had above threshold anxiety scores. The latter group recognised the emotional expressions of sadness, anger and fear earlier than their non-anxious peers, both when only the eye region was presented and when full faces were presented. There was less difference between groups in the case of the emotions of disgust and happiness, with both groups recognising these emotions earlier and more accurately when a full face was presented. CONCLUSIONS Our findings suggest that 14- to 21-year old who struggle with callous emotional traits should not be treated as a homogenous group but that testing for other relevant problems, including anxiety, may inform optimal routes to the emotion recognition training that is likely to help them relate to others more prosocially.
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Malvaso CG, Cale J, Whitten T, Day A, Singh S, Hackett L, Delfabbro PH, Ross S. Associations Between Adverse Childhood Experiences and Trauma Among Young People Who Offend: A Systematic Literature Review. TRAUMA, VIOLENCE & ABUSE 2022; 23:1677-1694. [PMID: 33960233 DOI: 10.1177/15248380211013132] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This systematic review synthesized current knowledge about the prevalence of adverse childhood experiences (ACEs) among young people known to have offended and examined evidence of associations between ACEs, trauma symptoms, and offending behavior. A systematic search of English-language, peer-reviewed studies published from the year 2000 onwards was conducted. A final pool of 124 studies that reported quantitative data were included in the review. The Cambridge Quality Checklist for the assessment of studies on offending was used to assess methodological quality of included studies. Pooled data indicated that almost 87% of justice-involved young people across 13 countries experienced at least one traumatic event. The odds of experiencing at least one ACE were over 12 times greater for justice-involved young people compared with nonjustice-involved young people. Prevalence of individual ACEs ranged from 12.2% for childhood sexual abuse to 80.4% for parental separation among justice-involved young people. Those who reported both a higher number and multiple types of ACEs were more likely to be diagnosed with post-traumatic stress symptoms. However, when considering only high-quality studies, there was minimal evidence to suggest that a higher incidence of ACEs predicted trauma symptoms or that trauma symptoms mediated the association between ACEs and offending behavior. Further research is needed to elucidate factors that differentiate young people exposed to ACEs who go on to offend from those who do not. This research is essential to understanding whether ACEs and trauma are drivers of offending behavior and for informing prevention and intervention strategies.
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Affiliation(s)
- Catia G Malvaso
- University of Adelaide, Adelaide, South Australia, Australia
| | - Jesse Cale
- Griffith University, Southport, Queensland, Australia
| | - Tyson Whitten
- University of Adelaide, Adelaide, South Australia, Australia
| | - Andrew Day
- University of Melbourne, Melbourne, Victoria, Australia
| | - Sara Singh
- University of New South Wales, Sydney, New South Wales, Australia
| | - Louisa Hackett
- Department of Human Services, Youth Justice Directorate, Adelaide, South Australia, Australia
| | | | - Stuart Ross
- University of Melbourne, Melbourne, Victoria, Australia
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8
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Pueyo N, Navarro JB, De La Osa N, Penelo E, Ezpeleta L. Describing Callous Unemotional Traits and Stressful Life Event Trajectories: Differences on Risk Factors and Mental Health Outcomes from the Age of 3 to 10. THE SPANISH JOURNAL OF PSYCHOLOGY 2022; 25:e17. [PMID: 35499095 DOI: 10.1017/sjp.2022.13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Callous Unemotional (CU) traits are associated with different environmental risk factors, such as negative stressful life events (SLE). The most common studied SLE associated with CU trait has been childhood maltreatment, but less is known about how other SLE impact the development of CU traits. Therefore, this work examines risk factors, personal factors (executive functioning), and mental health outcomes associated with the trajectories of Callous Unemotional (CU) traits and Stressful Life Events (SLE) in a community sample of children. A cohort of 377 preschoolers were followed up between ages 3 and 10. Several risk factors and outcomes for three trajectory groups (high CU/SLE; high CU/low SLE; and the reference group with low CU/SLE) were analyzed by using multiple post-hoc comparisons. We hypothesized that children with high CU/SLE would face more contextual risk factors, more executive functioning difficulties and more mental health problems than children with high CU/low SLE or the reference group. At the age of 3, children who showed high CU/SLE faced more early contextual adversity, including socioeconomic difficulties and maternal antisocial behavior than the other groups of children. At the age of 10, children with high CU/SLE presented more peer problems and higher psychopathology symptoms than the reference group, but no differences on mental health outcomes in comparison to the high CU/low SLE group. These results have potential implications for clinical practice and studies attempting to identify different CU subtypes in children.
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Affiliation(s)
| | | | | | - Eva Penelo
- Universitat Autònoma de Barcelona (Spain)
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9
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Konrad K, Kohls G, Baumann S, Bernhard A, Martinelli A, Ackermann K, Smaragdi A, Gonzalez-Madruga K, Wells A, Rogers JC, Pauli R, Clanton R, Baker R, Kersten L, Prätzlich M, Oldenhof H, Jansen L, Kleeven A, Bigorra A, Hervas A, Kerexeta-Lizeaga I, Sesma-Pardo E, Angel Gonzalez-Torres M, Siklósi R, Dochnal R, Kalogerakis Z, Pirlympou M, Papadakos L, Cornwell H, Scharke W, Dikeos D, Fernández-Rivas A, Popma A, Stadler C, Herpertz-Dahlmann B, De Brito SA, Fairchild G, Freitag CM. Sex differences in psychiatric comorbidity and clinical presentation in youths with conduct disorder. J Child Psychol Psychiatry 2022; 63:218-228. [PMID: 34008879 DOI: 10.1111/jcpp.13428] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/14/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Conduct disorder (CD) rarely occurs alone but is typically accompanied by comorbid psychiatric disorders, which complicates the clinical presentation and treatment of affected youths. The aim of this study was to investigate sex differences in comorbidity pattern in CD and to systematically explore the 'gender paradox' and 'delayed-onset pathway' hypotheses of female CD. METHODS As part of the FemNAT-CD multisite study, semistructured clinical interviews and rating scales were used to perform a comprehensive phenotypic characterization of 454 girls and 295 boys with CD (9-18 years), compared to 864 sex- and age-matched typically developing controls. RESULTS Girls with CD exhibited higher rates of current major depression, anxiety disorders, post-traumatic stress disorder and borderline personality disorder, whereas boys with CD had higher rates of current attention-deficit/hyperactivity disorder. In line with the 'gender paradox' hypothesis, relative to boys, girls with CD showed significantly more lifetime psychiatric comorbidities (incl. Alcohol Use Disorder), which were accompanied by more severe CD symptoms. Female and male youths with CD also differed significantly in their CD symptom profiles and distribution of age-of-onset subtypes of CD (i.e. fewer girls with childhood-onset CD). In line with the 'delayed-onset pathway' hypothesis, girls with adolescent-onset CD showed similar levels of dimensional psychopathology like boys with childhood-onset CD, while boys with adolescent-onset CD had the lowest levels of internalizing psychopathology. CONCLUSIONS Within the largest study of CD in girls performed to date, we found compelling evidence for sex differences in comorbidity patterns and clinical presentation of CD. Our findings further support aspects of the 'gender paradox' and 'delayed-onset pathway' hypotheses by showing that girls with CD had higher rates of comorbid lifetime mental disorders and functional impairments, and they usually developed CD during adolescence. These novel data on sex-specific clinical profiles of CD will be critical in informing intervention and prevention programmes.
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Affiliation(s)
- Kerstin Konrad
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany.,JARA-Brain Institute II, Molecular Neuroscience and Neuroimaging, RWTH Aachen & Research Centre Juelich, Juelich, Germany
| | - Gregor Kohls
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany
| | - Sarah Baumann
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany
| | - Anka Bernhard
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Anne Martinelli
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Katharina Ackermann
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Areti Smaragdi
- Centre of Addiction and Mental Health, Toronto, ON, Canada
| | | | - Amy Wells
- School of Psychology, Cardiff University, Cardiff, Wales, UK
| | - Jack C Rogers
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Ruth Pauli
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Roberta Clanton
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Rosalind Baker
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Linda Kersten
- Psychiatric University Clinics, University of Basel, Basel, Switzerland
| | - Martin Prätzlich
- Psychiatric University Clinics, University of Basel, Basel, Switzerland
| | - Helena Oldenhof
- Department of Child and Adolescent Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Lucres Jansen
- Department of Child and Adolescent Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Anneke Kleeven
- Department of Child and Adolescent Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Aitana Bigorra
- Child and Adolescent Mental Health Service, University Hospital Mutua Terrassa, Barcelona, Spain
| | - Amaia Hervas
- Child and Adolescent Mental Health Service, 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
| | - Zacharias Kalogerakis
- Child and Adolescent Unit of the 1st Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece
| | - Mara Pirlympou
- Child and Adolescent Unit of the 1st Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece
| | - Leonidas Papadakos
- Child and Adolescent Unit of the 1st Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Wolfgang Scharke
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany.,Cognitive and Experimental Psychology, Institute of Psychology, RWTH Aachen University, Aachen, Germany
| | - Dimitris Dikeos
- Child and Adolescent Unit of the 1st Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Arne Popma
- Department of Child and Adolescent Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Christina Stadler
- Psychiatric University Clinics, University of Basel, Basel, Switzerland
| | - Beate Herpertz-Dahlmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Aachen, Germany
| | - Stephane A De Brito
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
| | | | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
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10
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[Interventions for Children and Adolescents Living in Foster or Institutional Care - A Systematic Review]. Prax Kinderpsychol Kinderpsychiatr 2022; 71:23-38. [PMID: 35023823 DOI: 10.13109/prkk.2022.71.1.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Children or adolescents living in foster or institutional care received so far insufficient consideration in therapy intervention research. At the same time, they are a high-risk group for developing mental illness. The aim of this systematic review is to record evidence-based psychotherapeutic interventions of the past 15 years on a national and international level that address children and young people living in foster care and youth welfare institutions and their mental health. Through a systematic literature research, interventions for the target group described were identified and analyzed about their specificity and evidence. From 170 publications, ten interventions with sufficient evidence could be included in the present analysis. The result of the current literature research shows that further specialized psychiatric-psychotherapeutic interventions for children in foster care and youth welfare institutions are necessary. Regarding the transferability to the German youth welfare and health system, cross-system and interdisciplinary cooperation is needed. Hereafter further research is required to establish specific and evidence-based intervention approaches.
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11
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Suk JW, Poppert Cordts KM, Garvey W, Lerdahl A, Soltis-Vaughan B, Bohn A, Edwards R, Blair RJ, Hwang S, Hwang S. Research Audit on Clinical Utility of Dimensional Disruptive Mood and Behavior Psychopathologies in Child and Adolescent Psychiatry Practice. Front Psychiatry 2022; 13:742148. [PMID: 35463527 PMCID: PMC9020472 DOI: 10.3389/fpsyt.2022.742148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 02/15/2022] [Indexed: 11/13/2022] Open
Abstract
To investigate the utility of dimensional psychopathologies of disruptive mood and behavior disorders (DBDs) by applying latent profile analysis (LPA) for characterization of youth referred to the tertiary outpatient clinic of child and adolescent psychiatry clinic and pharmacological treatment choices. One hundred fifty-eight children and adolescents with significant DBDs symptoms participated. Core dimensional psychopathologies of DBDs (irritability, callous-unemotional trait, and reactive-proactive aggressive behavior), DSM diagnoses, prescribed medications, and behavioral and emotional problems (Child Behavior Checklist, CBCL) were measured at baseline (clinic intake) and at 3-month follow-up. Latent Profile Analysis (LPA) was applied to characterize the study population based on the levels and interrelations among the core dimensional DBDs psychopathologies. Following LPA, the differences in clinical and treatment features between the latent classes were analyzed. LPA revealed two latent classes based on severity of DBDs symptoms. Class 1 (the moderate group) was characterized by relatively low scores on all trans-diagnostic indicators, whereas class 2 (the severe/critical group) showed higher levels of the dimensional psychopathologies and the majority of CBCL subscales. In addition, the severe/critical group was more often prescribed antipsychotic medications, and also experienced more frequent medication changes (addition, increasing the dose, and trial of different medications). Our findings suggested that application of LPA to a cluster of dimensional DBDs psychopathologies may provide valuable characterization of the youths referred to a tertiary outpatient child and adolescent psychiatric clinic, and offer insight into the providers' decision making on psychotropic medications, by overall severity of these psychopathologies rather than by single categorical diagnosis or single externalizing psychopathology.
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Affiliation(s)
- Ji-Woo Suk
- Department of Psychiatry, University of Nebraska Medical Center, Omaha, NE, United States
| | | | - William Garvey
- Department of Psychiatry, University of Nebraska Medical Center, Omaha, NE, United States
| | - Arica Lerdahl
- Department of Psychiatry, University of Nebraska Medical Center, Omaha, NE, United States
| | | | - Alexandra Bohn
- Department of Psychiatry, University of Nebraska Medical Center, Omaha, NE, United States
| | - Ryan Edwards
- Department of Psychiatry, University of Nebraska Medical Center, Omaha, NE, United States
| | - Robert James Blair
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
| | - Soonjo Hwang
- Department of Psychiatry, University of Nebraska Medical Center, Omaha, NE, United States
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12
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Rosa-Justicia M, Saam MC, Flamarique I, Borràs R, Naaijen J, Dietrich A, Hoekstra PJ, Banaschewski T, Aggensteiner P, Craig MC, Sethi A, Santosh P, Sagar-Ouriaghli I, Arango C, Penzol MJ, Brandeis D, Werhahn JE, Glennon JC, Franke B, Zwiers MP, Buitelaar JK, Schulze UME, Castro-Fornieles J. Subgrouping children and adolescents with disruptive behaviors: symptom profiles and the role of callous-unemotional traits. Eur Child Adolesc Psychiatry 2022; 31:51-66. [PMID: 33147348 DOI: 10.1007/s00787-020-01662-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 10/09/2020] [Indexed: 10/23/2022]
Abstract
Disruptive behavior during childhood and adolescence is heterogeneous and associated with several psychiatric disorders. The identification of more homogeneous subgroups might help identify different underlying pathways and tailor treatment strategies. Children and adolescents (aged 8-18) with disruptive behaviors (N = 121) and healthy controls (N = 100) were included in a European multi-center cognition and brain imaging study. They were assessed via a battery of standardized semi-structured interviews and questionnaires. K-means cluster-model analysis was carried out to identify subgroups within the group with disruptive behaviors, based on clinical symptom profiles, callous-unemotional (CU) traits, and proactive and reactive aggression. The resulting subgroups were then compared to healthy controls with regard to these clinical variables. Three distinct subgroups were found within the group with disruptive behaviors. The High CU Traits subgroup presented elevated scores for CU traits, proactive aggression and conduct disorder (CD) symptoms, as well as a higher proportion of comorbidities (CD + oppositional defiant disorder + attention deficit hyperactivity disorder (ADHD). The ADHD and Affective Dysregulation subgroup showed elevated scores for internalizing and ADHD symptoms, as well as a higher proportion of females. The Low Severity subgroup had relatively low levels of psychopathology and aggressive behavior compared to the other two subgroups. The High CU Traits subgroup displayed more antisocial behaviors than the Low Severity subgroup, but did not differ when compared to the ADHD and Affective Dysregulation subgroup. All three subgroups differed significantly from the healthy controls in all the variables analyzed. The present study extends previous findings on subgrouping children and adolescents with disruptive behaviors using a multidimensional approach and describes levels of anxiety, affective problems, ADHD, proactive aggression and CU traits as key factors that differentiate conclusively between subgroups.
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Affiliation(s)
- Mireia Rosa-Justicia
- Department of Child and Adolescent Psychiatry and Psychology, Clinic Institute of Neurosciences, Hospital Clínic de Barcelona, IDIBAPS, Barcelona, Spain
| | - Melanie C Saam
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital, University of Ulm, Ulm, Germany
| | - Itziar Flamarique
- Department of Child and Adolescent Psychiatry and Psychology, Clinic Institute of Neurosciences, Hospital Clínic de Barcelona, 2017SGR881, CIBERSAM, Barcelona, Spain
| | - Roger Borràs
- Department of Child and Adolescent Psychiatry and Psychology, Clinic Institute of Neurosciences, Hospital Clínic de Barcelona, IDIBAPS, Barcelona, Spain
| | - Jilly Naaijen
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behavior, Centre for Cognitive Neuroimaging, Radboud University, Nijmegen, The Netherlands
| | - Andrea Dietrich
- Department of Child and Adolescent Psychiatry, University of Groningen Medical Center, Groningen, The Netherlands
| | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, University of Groningen Medical Center, Groningen, The Netherlands
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Pascal Aggensteiner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Michael C Craig
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Arjun Sethi
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Paramala Santosh
- Department of Child Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Ilyas Sagar-Ouriaghli
- Department of Child Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Celso Arango
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - María José Penzol
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry, University of Groningen Medical Center, Groningen, The Netherlands
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Julia E Werhahn
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University and ETH Zurich, Zurich, Switzerland
| | - Jeffrey C Glennon
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Barbara Franke
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marcel P Zwiers
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behavior, Centre for Cognitive Neuroimaging, Radboud University, Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry University Center, Nijmegen, The Netherlands
| | - Ulrike M E Schulze
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital, University of Ulm, Ulm, Germany
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, Clinic Institute of Neurosciences, Hospital Clínic de Barcelona, 2017SGR881, University of Barcelona, CIBERSAM, IDIBAPS, Barcelona, Spain.
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13
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Muratori P, Paciello M, Castro E, Levantini V, Masi G, Milone A, Senese VP, Pisano S, Catone G. At-risk early adolescents profiles in the community: A cluster analysis using the strengths and difficulties questionnaire. Psychiatry Res 2021; 305:114209. [PMID: 34543850 DOI: 10.1016/j.psychres.2021.114209] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/06/2021] [Accepted: 09/09/2021] [Indexed: 12/13/2022]
Abstract
Early adolescence, with its several changes and demands, represents a delicate period of life. Several studies highlighted that during early adolescence, emotional and behavioral problems tend to increase. Using a person-centered approach, the present study explored the emotional and behavioral functioning profiles in a sample of Italian preadolescent students. Participants were 2959 youths (1533 males and 1426 females; age 10-14 years); they completed the Strengths and Difficulties Questionnaire (SDQ) and the Inventory of Callous Unemotional traits (ICU). Findings revealed four different profiles: "no psychopathology" (41.5%), "low psychopathology with sub-threshold hyperactivity" (33%), "predominantly internalizing" (19%), and "predominantly externalizing" (6.5%). The two latter clusters are characterized by high levels of SDQ Total Score. The "predominantly internalizing" is distinguished by a higher prevalence of females, and the "predominantly externalizing" by a higher prevalence of males and higher CU traits. A person-oriented approach allowed for identifying subgroups of early adolescents who may significantly vary in their configuration of internalizing and externalizing problems. Such subgroups may reflect youths for whom the creation of prevention and intervention programs could be more tailored.
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Affiliation(s)
- Pietro Muratori
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Pisa, Italy.
| | | | - Emanuela Castro
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Pisa, Italy
| | - Valentina Levantini
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Pisa, Italy
| | - Gabriele Masi
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Pisa, Italy
| | - Annarita Milone
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Pisa, Italy
| | | | - Simone Pisano
- Department of Neuroscience, Santobono-Pausilipon Hospital, Naples, Italy; Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Gennaro Catone
- Department of Educational, Psychological and Communication Sciences, Suor Orsola Benincasa University, Italy
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14
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Isdahl-Troye A, Villar P, Domínguez-Álvarez B, Romero E, Deater-Deckard K. The Development of Co-Occurrent Anxiety and Externalizing Problems from Early Childhood: a Latent Transition Analysis Approach. Res Child Adolesc Psychopathol 2021; 50:505-519. [PMID: 34499292 PMCID: PMC8940780 DOI: 10.1007/s10802-021-00865-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2021] [Indexed: 11/30/2022]
Abstract
Research into co-occurrent internalizing and externalizing problems during childhood is flourishing. In particular, investigation on the association between anxiety and externalizing problems has yielded mixed findings, focused mainly on the issue of which problem might precede the other, and what role anxiety plays with respect to externalizing problems. Relatively little attention has been paid to the developmental patterns of these behaviors from early childhood, despite the potential of such knowledge to fully delineate etiological models of co-occurrence. This study aimed to examine the longitudinal association of anxiety and externalizing problems in a community sample of preschoolers (ELISA Project; N = 2,341; 48.2% girls), by identifying empirically derived profiles and then describing their change and stability through the use of Latent Transition Analysis. Gender differences were explored. Four different profiles were identified: “typically developing”, “mainly anxious”, “modestly externalizing” and “co-occurrent”. Membership in these profile groups showed high stability over a two-year period. However, children in the “co-occurrent” profile group were the most likely to show changes, predominantly towards “modestly externalizing”. Furthermore, a significant gender difference for transitions towards the “co-occurrent” profile group was found, with girls showing less likelihood of being assigned to such profile. These findings show that it is possible to identify an early persistent course of co-occurrent anxiety and externalizing problems, as well as observe changes in co-occurrence towards a simpler externalizing behavioral expression. Further research should explore predictors of group membership and changes in membership, that are malleable and therefore open to preventative intervention.
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Affiliation(s)
- Aimé Isdahl-Troye
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Paula Villar
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain.
| | - Beatriz Domínguez-Álvarez
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Estrella Romero
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Kirby Deater-Deckard
- Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, USA
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15
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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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16
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Bégin V, Déry M, Le Corff Y. Variants of Psychopathic Traits Follow Distinct Trajectories of Clinical Features Among Children with Conduct Problems. Res Child Adolesc Psychopathol 2021; 49:775-788. [PMID: 33502717 DOI: 10.1007/s10802-021-00775-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2021] [Indexed: 10/22/2022]
Abstract
Original definitions of psychopathy suggest the existence of two variants that present with distinct clinical features among antisocial adults, but whether these clinical differences originate early in life or emerge at some point during childhood remains uncertain. We examined if primary and secondary variants follow distinct developmental trajectories of theoretically relevant clinical features among children with conduct problems (CP). Participants were 370 children (40.3% girls) with CP initially aged 8.49 years old in average (s.d. = 0.93). Variants indicators (callous-unemotional [CU] traits and anxiety [ANX]) and clinical features were measured at six yearly assessments. A dual trajectory modelling approach was used to identify groups and group memberships were entered in conditional growth models predicting trajectories of clinical features. Four groups were identified: CP-only, anxious (CP + ANX), primary (CP + CU), and secondary (CP + CU + ANX). Both variants showed higher initial levels of impairment than the CP-only group on most features. Compared to the primary variant, membership to the secondary variant was associated with more stable patterns of CP, oppositional problems, narcissism-grandiosity and impulsivity-irresponsibility traits. Moreover, children from the secondary variant showed higher initial levels of impairment in terms of cognitive abilities, depression, victimization, and dependency to teachers, with non-significant effects on the slope parameters suggesting that these early differences persist across development. In addition to showing distinct clinical features relatively early in childhood, children from the secondary variant of psychopathic traits are at high risk of experiencing an increasing psychopathological burden across childhood. The early identification and treatment of these children therefore appears particularly important.
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Affiliation(s)
- Vincent Bégin
- Groupe de recherche et d'intervention sur les adaptations sociales de l'enfance (GRISE), Université de Sherbrooke, Sherbrooke, Canada. .,Département de psychoéducation, Université de Sherbrooke, Sherbrooke, Canada.
| | - Michèle Déry
- Groupe de recherche et d'intervention sur les adaptations sociales de l'enfance (GRISE), Université de Sherbrooke, Sherbrooke, Canada.,Département de psychoéducation, Université de Sherbrooke, Sherbrooke, Canada
| | - Yann Le Corff
- Groupe de recherche et d'intervention sur les adaptations sociales de l'enfance (GRISE), Université de Sherbrooke, Sherbrooke, Canada.,Département d'orientation professionnelle, Université de Sherbrooke, Sherbrooke, Canada.,Département de psychiatrie, Université de Sherbrooke, Sherbrooke, Canada
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17
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A Systematic Review of Primary and Secondary Callous-Unemotional Traits and Psychopathy Variants in Youth. Clin Child Fam Psychol Rev 2020; 24:65-91. [PMID: 33079293 DOI: 10.1007/s10567-020-00329-x] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2020] [Indexed: 12/28/2022]
Abstract
Two variants of callous-unemotional (CU) traits and psychopathy have been proposed, referred to as primary and secondary. Whereas primary variants are thought to be underpinned by insufficient arousal to emotional cues, secondary variants are thought to develop as a coping mechanism in response to trauma exposure. Compared with adult samples, research on primary and secondary variants in children and adolescents under the age of 18 has only emerged in the past decade, and there is ongoing debate with regards to the identification, defining characteristics, and distinct correlates of these variants. The present systematic review synthesizes the current literature on primary and secondary variants in relation to: (1) constructs used to distinguish and define primary and secondary variants; (2) study population characteristics; (3) data analytic techniques to differentiate variants; and (4) differential associations with theoretically relevant indices related to emotional processing, maltreatment, biomarkers, and behavioral outcomes (e.g., substance use, aggression). This is the first systematic review to examine the growing literature on primary and secondary CU and psychopathy variants among youth. Findings support the distinction between youth with primary versus secondary variants and demonstrate that this distinction is related to unique clinical correlates. Recommendations are made for future research in the field.
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18
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Huang J, Fan L, Lin K, Wang Y. Variants of Children with Psychopathic Tendencies in a Community Sample. Child Psychiatry Hum Dev 2020; 51:563-571. [PMID: 31707524 DOI: 10.1007/s10578-019-00939-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
To investigate the heterogeneity of children with psychopathic tendencies, this study identified heterogenous subgroups among a community sample of children based on their callous-unemotional (CU) traits, conduct problems (CP), and anxiety. A latent profile analysis classified 1861 primary school students (age 6-14) into four subgroups based on parent-report CU traits, CP and anxiety: low-risk children (i.e., low in CU traits, CP, and anxiety), anxious children (i.e., high in anxiety, low in CU traits and CP), primary variants of children with psychopathic tendencies (i.e., high in CU traits and CP, low in anxiety), and secondary variants of children with psychopathic tendencies (i.e., high in CU traits, CP, and anxiety). In particular, the secondary variants evidenced higher levels of CU traits, CP, and anxiety than the primary variants. Our findings extend the heterogeneity of psychopathy to childhood and encourage future research to examine the developmental trajectories of psychopathy.
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Affiliation(s)
- Jiasheng Huang
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China
| | - Linlin Fan
- Department of Psychology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Kexiu Lin
- Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Yuyin Wang
- Department of Psychology, Sun Yat-sen University, Guangzhou, Guangdong, China.
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19
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Clemens V, Bürgin D, Eckert A, Kind N, Dölitzsch C, Fegert JM, Schmid M. Hypothalamic-pituitary-adrenal axis activation in a high-risk sample of children, adolescents and young adults in residential youth care - Associations with adverse childhood experiences and mental health problems. Psychiatry Res 2020; 284:112778. [PMID: 32004894 DOI: 10.1016/j.psychres.2020.112778] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 01/06/2020] [Accepted: 01/06/2020] [Indexed: 12/28/2022]
Abstract
Adverse childhood experiences (ACEs) lead to devastating long-term health consequences that are associated with a dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. Children and adolescents living in institutional care have an increased risk to experience ACEs, particularly linked to missing continuity of care, and a higher risk for consequences of ACEs such as mental disorders. In order to improve the overall quality of care, it is important to better understand the stress-physiology of this high-risk sample and to identify specific stressors linked to adverse outcomes. Therefore, we assessed ACEs due to missing continuity of care and their association with hair cortisol and DHEA levels in children, adolescents and young adults in institutional care. Results show that ACEs resulting from the family of origin, in detail maternal mental illness, and ACEs due to out-of-home placement, namely frequent change of caregivers, are associated with HPA axis over-activation. HPA axis activation is associated with enhanced mental health problems. These results point towards an association between continuity of care and the stress system of children and adolescents in this high-risk sample. Care concepts that focus on continuity of care might help to reduce these physiological alterations and devastating long-term consequences following ACEs.
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Affiliation(s)
- Vera Clemens
- Department for Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Steinhövelstr. 5 89073 Ulm Germany.
| | - David Bürgin
- Department of Child and Adolescent Psychiatry, Psychiatric Hospitals of the University of Basel, Switzerland
| | - Anne Eckert
- Neurobiology Lab for Brain Aging and Mental Health, Transfaculty Research Platform Molecular and Cognitive Neuroscience, University of Basel, Switzerland
| | - Nina Kind
- Department of Child and Adolescent Psychiatry, Psychiatric Hospitals of the University of Basel, Switzerland
| | - Claudia Dölitzsch
- Department for Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Steinhövelstr. 5 89073 Ulm Germany
| | - Jörg M Fegert
- Department for Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Steinhövelstr. 5 89073 Ulm Germany
| | - Marc Schmid
- Department of Child and Adolescent Psychiatry, Psychiatric Hospitals of the University of Basel, Switzerland
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20
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Hodgins S. Sex differences in antisocial and aggressive disorders that onset in childhood and persist into adulthood. HANDBOOK OF CLINICAL NEUROLOGY 2020; 175:405-422. [PMID: 33008540 DOI: 10.1016/b978-0-444-64123-6.00027-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
As many as 10.7% of males and 7.5% of females display early-onset, stable, antisocial and aggressive behavior (ESAAB). Most research has focused on males. These individuals are diagnosed with conduct disorder in childhood and antisocial personality disorder in adulthood, and a very few, almost all males, present the syndrome of psychopathy. ESAAB includes three subgroups: (1) conduct problems and callousness; (2) conduct problems, callousness, and anxiety; and (3) conduct problems. Heritability of the first two subtypes is high. This high heritability derives, at least in part, from genes involved in regulating serotonergic functioning early in life and to genotypes that confer sensitivity to trauma. The first subtype is rare and characterized by difficulty in face emotion recognition, especially fear and sadness, and hypoarousal as indexed by both autonomic and neural measures, and by structural brain abnormalities. By contrast, those with conduct problems, callousness, and anxiety are more common. They include a greater proportion of females and show hypersensitivity to threat that triggers reactive aggression and that is reflected in both autonomic and neural functioning. In sum, fewer females than males present ESAAB, but many characteristics, autonomic and neural correlates, and etiology are similar. Importantly, however, females with ESAAB play a critical role in the intergenerational transfer of antisocial behavior. Despite higher prevalence of EASSB in males than females, few sex differences in neural abnormalities have been identified.
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Affiliation(s)
- Sheilagh Hodgins
- Institut Universitaire en Santé Mentale de Montréal, and Department of Psychiatry, University of Montreal, Montréal, QC, Canada.
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21
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Rinnewitz L, Parzer P, Koenig J, Bertsch K, Brunner R, Resch F, Kaess M. A Biobehavioral Validation of the Taylor Aggression Paradigm in Female Adolescents. Sci Rep 2019; 9:7036. [PMID: 31065043 PMCID: PMC6504877 DOI: 10.1038/s41598-019-43456-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 04/18/2019] [Indexed: 01/12/2023] Open
Abstract
This research assessed the behavioral, emotional, endocrinological and autonomic reactivity to the laboratory Taylor Aggression Paradigm (TAP) in a sample of healthy female adolescents. Twenty participants were induced with the TAP to behave aggressively (aggression group) and 20 age-matched participants were not induced to behave aggressively (control group). Regression analysis revealed that the aggression group displayed significant higher levels of aggressive behavior compared to the control group (χ2 (2) = 255.50, p < 0.0001). Aggressive behavior was not related to self-reported measures of trait aggression, impulsiveness or psychopathy features. Regarding the biological responses, regression analysis on cortisol, missed the set level of significance (χ2 (1) = 3.73, p = 0.054), but showed significant effects on heart rate as a function of aggression induction (χ2 (1) = 5.81, p = 0.016). While aggression induction was associated with increased autonomic arousal (heart rate), the interpretation of the effects on cortisol warrant caution, given existing differences between groups at baseline and overly elevated cortisol attributable to the general experimental procedures and not the TAP per se. No differences were found with respect to testosterone. In summary, the present study lends preliminary support for the validity of the TAP and its use in female adolescents on a behavioral and autonomic level.
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Affiliation(s)
- Lena Rinnewitz
- Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Blumenstrasse 8, 69115, Heidelberg, Germany.,Clinic of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Blumenstrasse 8, 69115, Heidelberg, Germany
| | - Peter Parzer
- Clinic of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Blumenstrasse 8, 69115, Heidelberg, Germany
| | - Julian Koenig
- Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Blumenstrasse 8, 69115, Heidelberg, Germany
| | - Katja Bertsch
- Clinic of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Vossstrasse 2, 69115, Heidelberg, Germany
| | - Romuald Brunner
- Clinic of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Blumenstrasse 8, 69115, Heidelberg, Germany.,Department of Child and Adolescent Psychiatry, University of Regensburg, Universitätsstraße 84, 93053, Regensburg, Germany
| | - Franz Resch
- Clinic of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Blumenstrasse 8, 69115, Heidelberg, Germany
| | - Michael Kaess
- Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Blumenstrasse 8, 69115, Heidelberg, Germany. .,Clinic of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Blumenstrasse 8, 69115, Heidelberg, Germany. .,University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland.
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22
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Carvalho M, Faria M, Conceição A, de Matos MG, Essau CA. Callous-Unemotional Traits in Children and Adolescents. EUROPEAN JOURNAL OF PSYCHOLOGICAL ASSESSMENT 2018. [DOI: 10.1027/1015-5759/a000449] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. The Inventory of Callous and Unemotional Traits (ICU) was developed to measure callous-unemotional (CU) psychopathic traits in children and adolescents. Studies that have examined the factor structure of ICU showed considerable controversy. The aim of this study was to examine the factor structure and psychometric proprieties of the Portuguese translation of the ICU. A total of 1,011 children and adolescents (495 boys and 516 girls), mean age of 13.36 years, participated in this study. Exploratory factor analysis produced two factors: uncaring and callousness; Cronbach’s α for each of the factor was .83 and .79 for the total score. Significant main gender and interaction between gender and age effects were found; girls reported lower CU traits than boys; children reported higher CU traits compared to preadolescents and adolescents, particularly in boys. CU also correlated with emotional symptoms, conduct problems, and psychosocial impairment. Furthermore, CU traits related to conduct problems both in boys and in girls, although this relationship was higher for boys. To conclude, findings of the present study showed that the Portuguese version of the ICU seems to be a reliable and valid instrument to assess CU traits among children and adolescents in Portugal. However, the original 3-factor model was not supported.
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Affiliation(s)
- Marina Carvalho
- Research Centre in Psychology, ISMAT, Portimao, Portugal
- Psychiatry Department, CHUA, Porto, Portugal
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23
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Fonagy P, Luyten P. Conduct problems in youth and the RDoC approach: A developmental, evolutionary-based view. Clin Psychol Rev 2017; 64:57-76. [PMID: 28935341 DOI: 10.1016/j.cpr.2017.08.010] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 02/25/2017] [Accepted: 08/30/2017] [Indexed: 12/11/2022]
Abstract
Problems related to aggression in young people are traditionally subsumed under the header of conduct problems, which include conduct disorder and oppositional defiant disorder. Such problems in children and adolescents are an important societal and mental health problem. In this paper we present an evolutionarily informed developmental psychopathology view of conduct problems inspired by the NIMH Research Domain Criteria (RDoC) initiative. We assume that while there are many pathways to conduct problems, chronic or temporary impairments in the domain of social cognition or mentalizing are a common denominator. Specifically, we conceptualize conduct problems as reflecting temporary or chronic difficulties with mentalizing, that is, the capacity to understand the self and others in terms of intentional mental states, leading to a failure to inhibit interpersonal violence through a process of perspective-taking and empathy. These difficulties, in turn, stem from impairments in making use of a normally evolutionarily protected social learning system that functions to facilitate intergenerational knowledge transmission and protect social collaborative processes from impulsive and aggressive action. Temperamental, biological, and social risk factors in different combinations may all contribute to this outcome. This adaptation then interacts with impairments in other domains of functioning, such as in negative and positive valence systems and cognitive systems. This view highlights the importance of a complex interplay among biological, psychological, and environmental factors in understanding the origins of conduct problems. We outline the implications of these views for future research and intervention.
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Affiliation(s)
- Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College London, UK.
| | - Patrick Luyten
- Research Department of Clinical, Educational and Health Psychology, University College London, UK; Faculty of Psychology and Educational Sciences, KU Leuven, Belgium
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24
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Lüdtke J, Boonmann C, Dölitzsch C, In-Albon T, Jenkel N, Kölch M, Fegert JM, Schmeck K, Schmid M. Komorbide Angststörungen bei Störungen des Sozialverhaltens. KINDHEIT UND ENTWICKLUNG 2017. [DOI: 10.1026/0942-5403/a000221] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Obwohl Angststörungen (AS) häufig komorbid mit einer Störung des Sozialverhaltens (SSV) auftreten, wurde diese Komorbidität in der Forschung weitgehend vernachlässigt. Komorbide AS wirken sich in Studien sowohl positiv als auch negativ auf den Verlauf einer SSV aus. Diese Studie zielt darauf ab, Heranwachsende mit einer SSV mit und ohne AS hinsichtlich psychischer Belastung, traumatischen Erlebnissen, psychopathischen Persönlichkeitstraits und Legalbewährung zu untersuchen. 207 Heranwachsende mit einer SSV (9 – 25 Jahre; 73.4 % männlich; SSV: N = 180, SSV und AS: N = 27), die zum Zeitpunkt der Untersuchung in Jugendhilfeeinrichtungen lebten, konnten eingeschlossen werden. Es wurden strukturierte klinische Interviews und eine psychometrische Testbatterie eingesetzt. Die Resultate zeigen, dass die Gruppe mit SSV und AS signifikant weniger externalisierende und mehr internalisierende Symptome sowie traumatische Erlebnisse aufweisen. Bezüglich psychopathischer Persönlichkeitsmerkmale und Verurteilungen (>50 % in beiden Gruppen) ergaben sich keine signifikanten Gruppenunterschiede. Die Ergebnisse legen nahe, dass die Ausprägung der SSV für die Kriminalitätsentwicklung bedeutsamer und die spezifische Komorbidität von AS aber doch ätiologisch und symptomatisch von großem Interesse ist. Diese sollte deshalb mit Längsschnittstudien und Therapieprozessanalysen intensiver beforscht werden.
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Affiliation(s)
- Janine Lüdtke
- Universitäre Psychiatrische Kliniken Basel, Kinder- und Jugendpsychiatrische Klinik, Universität Basel
| | - Cyril Boonmann
- Universitäre Psychiatrische Kliniken Basel, Kinder- und Jugendpsychiatrische Klinik, Universität Basel
| | - Claudia Dölitzsch
- Universitätsklinikum Ulm, Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie
| | - Tina In-Albon
- Universität Koblenz-Landau, Klinische Psychologie und Psychotherapie des Kindes- und Jugendalters
| | - Nils Jenkel
- Universitäre Psychiatrische Kliniken Basel, Kinder- und Jugendpsychiatrische Klinik, Universität Basel
| | - Michael Kölch
- Klinik für Kinder- und Jugendpsychiatrie/-psychotherapie der Ruppiner Kliniken Hochschulklinik Medizinischen Hochschule Brandenburg
| | - Jörg M. Fegert
- Universitätsklinikum Ulm, Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie
| | - Klaus Schmeck
- Universitäre Psychiatrische Kliniken Basel, Kinder- und Jugendpsychiatrische Klinik, Universität Basel
| | - Marc Schmid
- Universitäre Psychiatrische Kliniken Basel, Kinder- und Jugendpsychiatrische Klinik, Universität Basel
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25
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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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26
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Meehan AJ, Maughan B, Cecil CAM, Barker ED. Interpersonal callousness and co-occurring anxiety: Developmental validity of an adolescent taxonomy. JOURNAL OF ABNORMAL PSYCHOLOGY 2016; 126:225-236. [PMID: 27977232 PMCID: PMC5305415 DOI: 10.1037/abn0000235] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Growing evidence suggests heterogeneity within interpersonal-callous (IC) youth based on co-occurring anxiety. The developmental validity of this proposed taxonomy remains unclear however, as most previous research is cross-sectional and/or limited to adolescence. We aimed to identify low-anxiety (IC/ANX-) and high-anxiety (IC/ANX+) IC variants, and compare these groups on (a) early risk exposures, (b) psychiatric symptoms from midchildhood to early adolescence, and (c) school-based functioning. Using the Avon Longitudinal Study of Parents and Children (ALSPAC), a prospective epidemiological birth cohort, model-based cluster analysis was performed on children with complete age-13 IC and anxiety scores (n = 6,791). Analysis of variance was used to compare resulting clusters on (a) prenatal and postnatal family adversity and maternal psychopathology, and harsh parenting; (b) developmental differences in attention-deficit/hyperactivity disorder (ADHD), conduct disorder (CD), oppositional defiant disorder (ODD), emotional difficulties, and low pro-social behavior at 7, 10, and 13 years; and (c) teacher-reported discipline problems, along with standardized test performance. We identified a 4-cluster solution: "typical," "low," "IC/ANX-", and "IC/ANX+." IC/ANX+ youth showed the highest prenatal and postnatal levels of family adversity and maternal psychopathology, highest levels of ADHD, CD, ODD, and emotional difficulties, greatest discipline problems, and lowest national test scores (all p < .001). IC/ANX+ also showed a distinct pattern of increasing psychopathology from age 7 to 13 years. Adolescent IC subtypes were successfully validated in ALSPAC across multiple raters using prenatal and early postnatal risk, repeated measures of psychopathology, and school-based outcomes. Greater prenatal environmental risk among IC/ANX+ youth suggests an important target for early intervention. (PsycINFO Database Record
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Affiliation(s)
- Alan J Meehan
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London
| | - Barbara Maughan
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London
| | - Charlotte A M Cecil
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London
| | - Edward D Barker
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London
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27
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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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28
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Vanwoerden S, Reuter T, Sharp C. Exploring the clinical utility of the DSM-5 conduct disorder specifier of 'with limited prosocial emotions' in an adolescent inpatient sample. Compr Psychiatry 2016; 69:116-31. [PMID: 27423352 DOI: 10.1016/j.comppsych.2016.05.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 04/21/2016] [Accepted: 05/14/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND With the recent addition of a callous-unemotional (CU) specifier to the diagnosis of conduct disorder (CD) in the DSM-5, studies are needed to evaluate the clinical utility of this specifier and the best ways to identify youth meeting criteria for this specifier in clinical samples. METHODS To this end, the current study examined cross-sectional correlates and treatment response across four groups of inpatient adolescents (N=382, ages 12-17): those with CD without the specifier, with CD and the CU specifier, CU alone, and a group of psychiatric controls. We used two different measures to identify adolescents with high levels of CU traits: the Antisocial Process Screening Device (APSD) [1] and the Inventory of Callous-Unemotional Traits (ICU) [2]. Questionnaires and structured interviews were used to evaluate a range of outcomes including presence of baseline levels and treatment outcomes of both externalizing and internalizing problems. FINDINGS Results indicated that the ICU, but not the APSD differentiated between conduct disordered youth with and without the specifier on externalizing behaviors in both cross-sectional relations and treatment response. CONCLUSIONS The results of the current study caution the use of the most frequently used measure to identify the CU specifier, and make suggestions about alternatives.
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Affiliation(s)
| | - Tyson Reuter
- University of Houston, 126 Heyne Building, Houston, TX 77204, USA
| | - Carla Sharp
- University of Houston, 126 Heyne Building, Houston, TX 77204, USA; The Menninger Clinic, 12301 Main Street, Houston, TX 77035, USA; Centre for Development Support, University of the Free State, South Africa.
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29
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Fragkaki I, Cima M, Meesters C. The Association Between Callous-Unemotional Traits, Externalizing Problems, and Gender in Predicting Cognitive and Affective Morality Judgments in Adolescence. J Youth Adolesc 2016; 45:1917-30. [PMID: 27334400 PMCID: PMC4982886 DOI: 10.1007/s10964-016-0527-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 06/14/2016] [Indexed: 11/28/2022]
Abstract
Morality deficits have been linked to callous-unemotional traits and externalizing problems in response to moral dilemmas, but these associations are still obscure in response to antisocial acts in adolescence. Limited evidence on young boys suggested that callous-unemotional traits and externalizing problems were associated with affective but not cognitive morality judgments. The present study investigated these associations in a community sample of 277 adolescents (M age = 15.35, 64 % females). Adolescents with high callous-unemotional traits showed deficits in affective but not cognitive morality, indicating that they can identify the appropriate moral emotions in others, but experience deviant moral emotions when imagining themselves committing antisocial acts. Externalizing problems and male gender were also strongly related to deficits in affective morality, but they had smaller associations with deficits in cognitive morality too. Implications for treatment and the justice system are discussed.
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Affiliation(s)
- Iro Fragkaki
- Behavioural Science Institute, Radboud University Nijmegen, Montessorilaan 3, 6525 HE, Nijmegen, The Netherlands.
| | - Maaike Cima
- Behavioural Science Institute, Radboud University Nijmegen, Montessorilaan 3, 6525 HE, Nijmegen, The Netherlands
| | - Cor Meesters
- Department of Clinical Psychological Science, Maastricht University, Minderbroedersberg 4-6, 6211 LK, Maastricht, The Netherlands
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30
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Raschle NM, Menks WM, Fehlbaum LV, Tshomba E, Stadler C. Structural and Functional Alterations in Right Dorsomedial Prefrontal and Left Insular Cortex Co-Localize in Adolescents with Aggressive Behaviour: An ALE Meta-Analysis. PLoS One 2015; 10:e0136553. [PMID: 26339798 PMCID: PMC4560426 DOI: 10.1371/journal.pone.0136553] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 08/04/2015] [Indexed: 01/27/2023] Open
Abstract
Recent neuroimaging work has suggested that aggressive behaviour (AB) is associated with structural and functional brain abnormalities in processes subserving emotion processing and regulation. However, most neuroimaging studies on AB to date only contain relatively small sample sizes. To objectively investigate the consistency of previous structural and functional research in adolescent AB, we performed a systematic literature review and two coordinate-based activation likelihood estimation meta-analyses on eight VBM and nine functional neuroimaging studies in a total of 783 participants (408 [224AB/184 controls] and 375 [215 AB/160 controls] for structural and functional analysis respectively). We found 19 structural and eight functional foci of significant alterations in adolescents with AB, mainly located within the emotion processing and regulation network (including orbitofrontal, dorsomedial prefrontal and limbic cortex). A subsequent conjunction analysis revealed that functional and structural alterations co-localize in right dorsomedial prefrontal cortex and left insula. Our results are in line with meta-analytic work as well as structural, functional and connectivity findings to date, all of which make a strong point for the involvement of a network of brain areas responsible for emotion processing and regulation, which is disrupted in AB. Increased knowledge about the behavioural and neuronal underpinnings of AB is crucial for the development of novel and implementation of existing treatment strategies. Longitudinal research studies will have to show whether the observed alterations are a result or primary cause of the phenotypic characteristics in AB.
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Affiliation(s)
- Nora Maria Raschle
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics Basel, Basel, Switzerland
- * E-mail:
| | - Willeke Martine Menks
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics Basel, Basel, Switzerland
| | - Lynn Valérie Fehlbaum
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics Basel, Basel, Switzerland
| | - Ebongo Tshomba
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics Basel, Basel, Switzerland
| | - Christina Stadler
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics Basel, Basel, Switzerland
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31
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Gill AD, Stickle TR. Affective Differences Between Psychopathy Variants and Genders in Adjudicated Youth. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2015; 44:295-307. [DOI: 10.1007/s10802-015-9990-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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