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Díaz-Vázquez B, López-Romero L, Romero E. Emotion Recognition Deficits in Children and Adolescents with Psychopathic Traits: A Systematic Review. Clin Child Fam Psychol Rev 2024; 27:165-219. [PMID: 38240937 PMCID: PMC10920463 DOI: 10.1007/s10567-023-00466-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2023] [Indexed: 03/08/2024]
Abstract
Children and adolescents with psychopathic traits show deficits in emotion recognition, but there is no consensus as to the extent of their generalizability or about the variables that may be moderating the process. The present Systematic Review brings together the existing scientific corpus on the subject and attempts to answer these questions through an exhaustive review of the existing literature according to PRISMA 2020 statement. Results confirmed the existence of pervasive deficits in emotion recognition and, more specifically, on distress emotions (e.g., fear), a deficit that transcends all modalities of emotion presentation and all emotional stimuli used. Moreover, they supported the key role of attention to relevant areas that provide emotional cues (e.g., eye-region) and point out differences according to the presence of disruptive behavior and based on the psychopathy dimension examined. This evidence could advance the current knowledge on developmental models of psychopathic traits. Yet, homogenization of the conditions of research in this area should be prioritized to be able to draw more robust and generalizable conclusions.
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Affiliation(s)
- Beatriz Díaz-Vázquez
- Department of Clinical Psychology and Psychobiology, Facultade de Psicoloxía, Universidade de Santiago de Compostela, Campus Vida, Santiago de Compostela, Spain
| | - Laura López-Romero
- Department of Clinical Psychology and Psychobiology, Facultade de Psicoloxía, Universidade de Santiago de Compostela, Campus Vida, Santiago de Compostela, Spain.
| | - Estrella Romero
- Department of Clinical Psychology and Psychobiology, Facultade de Psicoloxía, Universidade de Santiago de Compostela, Campus Vida, Santiago de Compostela, Spain
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Lynch SF, Perlstein S, Ordway C, Jones C, Lembcke H, Waller R, Wagner NJ. Parasympathetic Nervous System Functioning Moderates the Associations between Callous-Unemotional Traits and Emotion Understanding Difficulties in Late Childhood. CHILDREN (BASEL, SWITZERLAND) 2024; 11:184. [PMID: 38397296 PMCID: PMC10887086 DOI: 10.3390/children11020184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/18/2024] [Accepted: 01/23/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Callous-unemotional (CU) traits are characterized by low empathy, guilt, and prosociality, putting children at risk for lifespan antisocial behavior. Elevated CU traits have been linked separately to difficulties with emotion understanding (i.e., identifying emotional states of others) and disrupted parasympathetic nervous system (PNS) functioning. However, no study has investigated how PNS functioning and emotion understanding are jointly related to CU traits. METHOD We explored associations between CU traits, emotion understanding, and PNS functioning (indexed via respiratory sinus arrhythmia [RSA]) among children aged 7-10 years old (n = 55). We also tested whether deficits in emotion understanding differ across specific emotions (i.e., fear, pain, happiness, anger). Each child's RSA was continuously recorded while they watched a film that included emotionally evocative social interactions. To assess emotion understanding, children identified emotions replayed in 1s animations of scenes from the film. Parents reported on child CU traits, conduct problems, and demographic information. RESULTS Higher CU traits were related to lower emotion understanding (β = -0.43, p = 0.03). PNS activity during the film moderated this association (β = -0.47, p < 0.001), such that CU traits were associated with lower emotion understanding among children with mean (B = -0.01, t = -2.46, p = 0.02) or high (i.e., 1 SD > M; B = -0.02, t = -3.00, p < 0.001) RSA levels during the film, but not among children with low RSA levels (i.e., 1 SD < M; B = 0.00, t = -0.53, p = 0.60). Moreover, we found that the observed moderated associations are driven by deficits in fear, specifically. CONCLUSIONS The link between poorer emotion understanding, fear understanding in particular, and CU traits was attenuated for children who demonstrated patterns of PNS functioning consistent with attentional engagement while viewing the emotion stimuli.
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Affiliation(s)
- Sarah F. Lynch
- Developmental Sciences, Department of Psychological and Brain Sciences, Boston University, Boston, MA 02215, USA; (S.F.L.); (C.O.)
| | - Samantha Perlstein
- Clinical Psychology, Department of Psychology, University of Pennsylvania, Philadelphia, PA 19104, USA; (S.P.); (C.J.)
| | - Cora Ordway
- Developmental Sciences, Department of Psychological and Brain Sciences, Boston University, Boston, MA 02215, USA; (S.F.L.); (C.O.)
| | - Callie Jones
- Clinical Psychology, Department of Psychology, University of Pennsylvania, Philadelphia, PA 19104, USA; (S.P.); (C.J.)
| | - Hanna Lembcke
- Department of General Psychology, University of Hagen, 58097 Hagen, Germany;
| | - Rebecca Waller
- Clinical Psychology, Department of Psychology, University of Pennsylvania, Philadelphia, PA 19104, USA; (S.P.); (C.J.)
| | - Nicholas J. Wagner
- Developmental Sciences, Department of Psychological and Brain Sciences, Boston University, Boston, MA 02215, USA; (S.F.L.); (C.O.)
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Kleine Deters R, Naaijen J, Holz NE, Banaschewski T, Schulze UME, Sethi A, Craig MC, Sagar-Ouriaghli I, Santosh P, Rosa M, Castro-Fornieles J, Penzol MJ, Arango C, Brandeis D, Franke B, Glennon JC, Buitelaar JK, Hoekstra PJ, Dietrich A. Emotion recognition profiles in clusters of youth based on levels of callous-unemotional traits and reactive and proactive aggression. Eur Child Adolesc Psychiatry 2023; 32:2415-2425. [PMID: 36127566 PMCID: PMC10682164 DOI: 10.1007/s00787-022-02079-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 09/04/2022] [Indexed: 11/28/2022]
Abstract
Youth with disruptive behavior showing high callous-unemotional (CU) traits and proactive aggression are often assumed to exhibit distinct impairments in emotion recognition from those showing mainly reactive aggression. Yet, reactive and proactive aggression and CU traits may co-occur to varying degrees across individuals. We aimed to investigate emotion recognition in more homogeneous clusters based on these three dimensions. In a sample of 243 youth (149 with disruptive behavior problems and 94 controls) aged 8-18 years, we used model-based clustering on self-report measures of CU traits and reactive and proactive aggression and compared the resulting clusters on emotion recognition (accuracy and response bias) and working memory. In addition to a Low and Low-Moderate symptom cluster, we identified two high CU clusters. The CU-Reactive cluster showed high reactive and low-to-medium proactive aggression; the CU-Mixed cluster showed high reactive and proactive aggression. Both CU clusters showed impaired fear recognition and working memory, whereas the CU-Reactive cluster also showed impaired recognition of disgust and sadness, partly explained by poor working memory, as well as a response bias for anger and happiness. Our results confirm the importance of CU traits as a core dimension along which youth with disruptive behavior may be characterized, yet challenge the view that high CU traits are closely linked to high proactive aggression per se. Notably, distinct neurocognitive processes may play a role in youth with high CU traits and reactive aggression with lower versus higher proactive aggression.
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Affiliation(s)
- Renee Kleine Deters
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
- Accare Child Study Center, Groningen, The Netherlands.
| | - Jilly Naaijen
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nathalie E Holz
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
| | - Tobias Banaschewski
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ulrike M E Schulze
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital, University of Ulm, Ulm, Germany
| | - Arjun Sethi
- Department of Forensic & Neurodevelopmental Sciences, Institute of Psychiatry, King's College London, Psychology & Neuroscience, London, UK
| | - Michael C Craig
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, King's College London, Psychology & Neuroscience, London, UK
| | - Ilyas Sagar-Ouriaghli
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, King's College London, Psychology & Neuroscience, London, UK
| | - Paramala Santosh
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, King's College London, Psychology & Neuroscience, London, UK
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases (CIPPRD), National and Specialist Child and Adolescent Mental Health Services, Maudsley Hospital, London, UK
| | - Mireia Rosa
- Department of Child and Adolescent Psychiatry and Psychology, Clínic Institute of Neurosciences, Hospital Clínic de Barcelona, IDIBAPS, Barcelona, Spain
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, Clínic Institute of Neurosciences, Hospital Clínic de Barcelona, CIBERSAM, IDIBAPS, University of Barcelona, 2017SGR881, Barcelona, Spain
| | - María José Penzol
- Child and Adolescent Psychiatry Department, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, IiSGM, CIBERSAM, Universidad Complutense, Madrid, Spain
| | - Celso Arango
- Child and Adolescent Psychiatry Department, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, IiSGM, CIBERSAM, Universidad Complutense, Madrid, Spain
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Barbara Franke
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jeffrey C Glennon
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
- Conway Institute for Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin, Ireland
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry University Center, Nijmegen, The Netherlands
| | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Accare Child Study Center, Groningen, The Netherlands
| | - Andrea Dietrich
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Accare Child Study Center, Groningen, The Netherlands
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Zhu J, Xia X, Wu Q, Zou S, Li Y. Callous-Unemotional Traits and Social Adjustment among Chinese Preschoolers: The Moderating Role of Teacher-Child Relationship. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3426. [PMID: 36834123 PMCID: PMC9966528 DOI: 10.3390/ijerph20043426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 02/14/2023] [Accepted: 02/14/2023] [Indexed: 06/18/2023]
Abstract
Callous-unemotional (CU) traits are associated with social adjustment difficulties, but few studies have examined the underlying mechanisms in Chinese preschoolers. This study examined the relationship between CU traits and social adjustment among Chinese preschoolers as well as the moderating role of the teacher-child relationship in the association. Participants were 484 preschool children aged 3-6 years old from Shanghai, China (Mage = 5.56 years, SD = 0.96 years). Parents reported children's CU traits and teachers reported their relationship with children and rated children's social adjustment as well. The results revealed that (1) children with higher CU traits positively related to aggressive and asocial behavior with peers, but negatively related to prosocial behavior; (2) the teacher-child relationship moderated the relationship between CU traits and social adjustment in children. Specifically, teacher-child conflict exacerbated the aggressive and asocial behavior of children with CU traits and reduced the prosocial behavior of children with CU traits. These findings extended the current research on CU traits and had important implications for early interventions targeted at children with CU traits.
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Affiliation(s)
- Jingjing Zhu
- Shanghai Institute of Early Childhood Education, Shanghai Normal University, Shanghai 200234, China
| | - Xiaoying Xia
- School of Early Childhood Education, Shanghai Normal University Tianhua College, Shanghai 201815, China
| | - Qianqian Wu
- Wuchang Experimental Kindergarten, Wuhan 430061, China
| | - Shiyao Zou
- Shanghai Institute of Early Childhood Education, Shanghai Normal University, Shanghai 200234, China
| | - Yan Li
- Shanghai Institute of Early Childhood Education, Shanghai Normal University, Shanghai 200234, China
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Donohue MR, Hoyniak CP, Tillman R, Barch DM, Luby J. Callous-Unemotional Traits as an Intervention Target and Moderator of Parent-Child Interaction Therapy-Emotion Development Treatment for Preschool Depression and Conduct Problems. J Am Acad Child Adolesc Psychiatry 2021; 60:1394-1403. [PMID: 33865929 PMCID: PMC8689660 DOI: 10.1016/j.jaac.2021.03.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 02/19/2021] [Accepted: 03/17/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Callous-unemotional (CU) traits-characterized by low empathy, prosociality, and guilt-predict severe and persistent conduct problems. Although some interventions for conduct problems have been less effective in children with high levels of CU traits, studies have not examined whether CU traits interfere with treatment for other childhood disorders. Moreover, few treatments have demonstrated efficacy in decreasing CU traits themselves in early childhood. This study examined whether Parent-Child Interaction Therapy-Emotion Development (PCIT-ED), a novel PCIT adaptation that promotes emotional competence with demonstrated efficacy in treating preschool-onset major depressive disorder and oppositional defiant disorder, was also effective in treating these disorders in children displaying higher levels of CU traits. The study also examined whether PCIT-ED treatment produced significant and sustained decreases in CU traits. METHOD This study examined 3- to 5-year-olds (N = 114) with preschool-onset major depressive disorder who completed the PCIT-ED trial. Children were randomly assigned to either immediate PCIT-ED treatment (n = 64) or a waitlist control condition (n = 50) in which they received the active treatment after 18 weeks. Psychiatric diagnoses and severity and CU traits in children were assessed at baseline, immediately after treatment, and 18 weeks after treatment completion. RESULTS Compared with the waitlist, PCIT-ED effectively reduced major depressive disorder and oppositional defiant disorder in preschoolers, regardless of initial levels of CU traits. Moreover, CU traits decreased from before to after treatment, and this treatment effect was sustained 18 weeks after treatment. CONCLUSION Results support that novel interventions that enhance emotional development display significant promise in treating CU traits-behaviors that left untreated predict severe conduct problems, criminality, and substance use. CLINICAL TRIAL REGISTRATION INFORMATION A Randomized Controlled Trial of PCIT-ED for Preschool Depression; https://clinicaltrials.gov; NCT02076425.
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Affiliation(s)
- Meghan Rose Donohue
- Drs. Donohue, Hoyniak, Barch, and Luby and Ms. Tillman are with Washington University School of Medicine, St. Louis, Missouri.
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Leveraging parasympathetic nervous system activity to study risk for psychopathology: The special case of callous-unemotional traits. Neurosci Biobehav Rev 2020; 118:175-185. [DOI: 10.1016/j.neubiorev.2020.07.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 06/14/2020] [Accepted: 07/27/2020] [Indexed: 12/14/2022]
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Kyranides MN, Fanti KA, Petridou M, Kimonis ER. In the eyes of the beholder: investigating the effect of visual probing on accuracy and gaze fixations when attending to facial expressions among primary and secondary callous-unemotional variants. Eur Child Adolesc Psychiatry 2020; 29:1441-1451. [PMID: 31811576 PMCID: PMC7501133 DOI: 10.1007/s00787-019-01452-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 11/28/2019] [Indexed: 02/06/2023]
Abstract
Individuals with callous-unemotional (CU) traits show deficits in facial emotion recognition. According to preliminary research, this impairment may be due to attentional neglect to peoples' eyes when evaluating emotionally expressive faces. However, it is unknown whether this atypical processing pattern is unique to established variants of CU traits or modifiable with intervention. This study examined facial affect recognition and gaze patterns among individuals (N = 80; M age = 19.95, SD = 1.01 years; 50% female) with primary vs secondary CU variants. These groups were identified based on repeated measurements of conduct problems, CU traits, and anxiety assessed in adolescence and adulthood. Accuracy and number of fixations on areas of interest (forehead, eyes, and mouth) while viewing six dynamic emotions were assessed. A visual probe was used to direct attention to various parts of the face. Individuals with primary and secondary CU traits were less accurate than controls in recognizing facial expressions across all emotions. Those identified in the low-anxious primary-CU group showed reduced overall fixations to fearful and painful facial expressions compared to those in the high-anxious secondary-CU group. This difference was not specific to a region of the face (i.e. eyes or mouth). Findings point to the importance of investigating both accuracy and eye gaze fixations, since individuals in the primary and secondary groups were only differentiated in the way they attended to specific facial expression. These findings have implications for differentiated interventions focused on improving facial emotion recognition with regard to attending and correctly identifying emotions.
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Affiliation(s)
- Melina Nicole Kyranides
- Department of Clinical and Health Psychology, School of Health in Social Science, Medical School (Doorway 6), University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG United Kingdom
| | - Kostas A. Fanti
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
| | - Maria Petridou
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
| | - Eva R. Kimonis
- Department of Psychology, University of New South Wales, Sydney, Australia
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Meidan A, Uzefovsky F. Child maltreatment risk mediates the association between maternal and child empathy. CHILD ABUSE & NEGLECT 2020; 106:104523. [PMID: 32485322 DOI: 10.1016/j.chiabu.2020.104523] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 04/10/2020] [Accepted: 05/02/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Empathy deficits are related to parental maltreatment, and early exposure to maltreatment is associated with later impairments in social and interpersonal skills, possibly as the result of specific deficits in cognitive and emotional empathy. OBJECTIVE To examine the association between maternal and child's emotional and cognitive empathy, and how this relationship is mediated by maltreatment risk. PARTICIPANTS AND SETTING 462 mothers of 4-10 years olds (48 % girls; M = 6.51 ± 1.57) were recruited through an online platform (Prolific Inc.) during 2018. METHODS Mothers were asked to report on their own cognitive and emotional empathy, views related to abuse risk, and their child's cognitive and emotional empathy. RESULTS Findings show that maternal perspective taking (a measure of cognitive empathy), and maternal personal distress predict child's cognitive empathy through abuse risk (beta = -0.29, p value = 0.0002 and beta = 0.22, p value = 0.0001, respectively). Conversely, for child's emotional empathy there was no mediation through abuse risk, rather direct associations were observed for empathic concern (a measure of emotional empathy; beta = 0.36, p value = 0.0197), personal distress (beta = 0.23, p value = 0.0332), and the fantasy scale (another measure of cognitive empathy; beta = 0.36, p value = 0.0019). CONCLUSIONS These findings help clarify the complex links between maternal empathy, abuse risk, and child's empathy, showing that maternal views related to abuse are specifically predictive of child's cognitive but not emotional empathy. As such, these findings raise further questions regarding the mechanism by which maternal characteristics and behavior are associated with child's empathy.
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Affiliation(s)
- Adi Meidan
- Psychology department & Zlotowski center for neuroscience, Ben Gurion University in the Negev, Israel
| | - Florina Uzefovsky
- Psychology department & Zlotowski center for neuroscience, Ben Gurion University in the Negev, Israel.
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Abramson L, Uzefovsky F, Toccaceli V, Knafo-Noam A. The genetic and environmental origins of emotional and cognitive empathy: Review and meta-analyses of twin studies. Neurosci Biobehav Rev 2020; 114:113-133. [PMID: 32353470 DOI: 10.1016/j.neubiorev.2020.03.023] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 02/20/2020] [Accepted: 03/24/2020] [Indexed: 01/10/2023]
Abstract
Empathy is considered a cornerstone of human social experience, and as such has been widely investigated from psychological and neuroscientific approaches. To better understand the factors influencing individual differences in empathy, we reviewed and meta-analyzed the behavioral genetic literature of emotional empathy- sharing others' emotions (k=13), and cognitive empathy- understanding others' emotions (k = 15), as manifested in twin studies. Results showed that emotional empathy is more heritable, 48.3 % [41.3 %-50.6 %], than cognitive empathy, 26.9 % [18.1 %-35.8 %]. Moreover, cognitive empathy as examined by performance tests was affected by the environment shared by family members, 11.9 % [2.6 %-21.0 %], suggesting that emotional understanding is influenced, to some degree, by environmental factors that have similar effects on family members beyond their genetic relatedness. The effects of participants' age and the method used to asses empathy on the etiology of empathy were also examined. These findings have implications for understanding how individual differences in empathy are formed. After discussing these implications, we suggest theoretical and methodological future research directions that could potentially elucidate the relations between genes, brain, and empathy.
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Abstract
This paper is a revised and updated edition of a previous description of the Quebec Newborn Twin Study (QNTS), an ongoing prospective longitudinal follow-up of a birth cohort of twins born between 1995 and 1998 in the greater Montreal area, Québec, Canada. The goal of QNTS is to document individual differences in the cognitive, behavioral, and social-emotional aspects of developmental health across childhood, their early genetic and environmental determinants, as well as their putative role in later social-emotional adjustment, school, health, and occupational outcomes. A total of 662 families of twins were initially assessed when the twins were aged 6 months. These twins and their family were then followed regularly. QNTS now has 16 waves of data collected or planned, including 5 in preschool. Over the last 24 years, a broad range of physiological, cognitive, behavioral, school, and health phenotypes were documented longitudinally through multi-informant and multimethod measurements. QNTS also entails extended and detailed multilevel assessments of proximal (e.g., parenting behaviors, peer relationships) and distal (e.g., family income) features of the child's environment. QNTS children and a subset of their parents have been genotyped, allowing for the computation of a variety of polygenic scores. This detailed longitudinal information makes QNTS uniquely suited for the study of the role of the early years and gene-environment transactions in development.
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