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Zhao Y, Gagne JR, Yu F, Chang CN. Associations Between Maternal Negative Affectivity and Young Children's Disruptive Behavior Problems: The Mediating Effect of Callous-Unemotional Traits. J Genet Psychol 2024; 185:244-255. [PMID: 37975338 DOI: 10.1080/00221325.2023.2280610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023]
Abstract
The current study examined associations between maternal negative affectivity (NA) and child disruptive behavior problems. The mediating role of child callous-unemotional (CU) traits in these relationships was also investigated. A multilevel mediation modeling approach was adopted using a sample of 100 families with children between 2.5 and 5.5 years of age (N = 201; mean age = 3.8, standard deviation = 1.0). The mediation models showed significant mediating effects of maternal NA through CU traits for ADHD (β = 0.12, p<.01), ODD (β =0.13, p<.01), and aggression (β =0.16, p<.001), and a significant direct effect for aggression (β = 0.12, p<.05). A structural equation modeling analysis was also performed, and overall, the results were consistent with that from mediation models, which suggested that child CU traits were significantly correlated with maternal NA (β = 0.252, p<.001), ADHD (β = 0.504, p<.001), ODD (β = 0.545, p<.001), and aggression (β = 0.686, p<.001). Our results indicated that maternal NA could serve as a potential risk factor for child CU, which, in turn, may contribute to disruptive behavior during early childhood.
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Affiliation(s)
- Yingying Zhao
- Educational Psychology, Texas A&M University, College Station, TX, USA
| | - Jeffrey R Gagne
- Educational Psychology, Texas A&M University, College Station, TX, USA
| | - Fanyi Yu
- Educational Psychology, Texas A&M University, College Station, TX, USA
| | - Chi-Ning Chang
- Department of Foundations of Education, Virginia Commonwealth University, Richmond, VA, USA
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Cardoso AR, Costa MJ, Sani AI, Moreira D. Callous and Unemotional Traits as Precursors to the Development of Female Psychopathy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6786. [PMID: 37754645 PMCID: PMC10530721 DOI: 10.3390/ijerph20186786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 09/07/2023] [Accepted: 09/15/2023] [Indexed: 09/28/2023]
Abstract
OBJECTIVE Conduct a systematic review concerning the literature that reflects whether the callous and unemotional traits present in childhood and/or adolescence are precursors in the development of female psychopathy in adulthood. MATERIALS AND METHODS A systematic review involved consulting three databases-EBSCO, the Web of Science, and PubMed-for peer-reviewed and quantitative studies within the period 2000-2023. Nine articles with quality of three and above were included. RESULTS The presence of callous and unemotional traits designates a group of youth that show characteristics associated with psychopathy, specifically when predicting a more severe and chronic pattern of antisocial behaviour. Children with high rates of callous and unemotional traits, who show symptoms of attention deficit hyperactivity disorder in combination with severe conduct problems, are most likely to show features associated with psychopathy. The multidimensional psychopathy construct is considered a better predictor of future and stable antisocial behaviour than the callous and unemotional traits alone model. CONCLUSIONS According to the studies selected, the callous and unemotional traits in childhood seem to be precursors of female psychopathy in adulthood, but only because of the way they seem to enhance conduct problems, disruptive behaviour disorders, and, as a possible outcome, delinquency and antisocial traits, which may be precursors of future psychopathy.
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Affiliation(s)
- Ana Raquel Cardoso
- Faculty of Human and Social Sciences, University Fernando Pessoa (UFP), Praça 9 de Abril, 349, 4249-004 Porto, Portugal; (A.R.C.); (M.J.C.); (A.I.S.)
| | - Maria João Costa
- Faculty of Human and Social Sciences, University Fernando Pessoa (UFP), Praça 9 de Abril, 349, 4249-004 Porto, Portugal; (A.R.C.); (M.J.C.); (A.I.S.)
| | - Ana Isabel Sani
- Faculty of Human and Social Sciences, University Fernando Pessoa (UFP), Praça 9 de Abril, 349, 4249-004 Porto, Portugal; (A.R.C.); (M.J.C.); (A.I.S.)
- Observatory Permanent Violence and Crime (OPVC), FP-I3ID, Fernando Pessoa University, 4249-004 Porto, Portugal
- Research Center on Child Studies (CIEC), University of Minho, 4710-057 Braga, Portugal
| | - Diana Moreira
- Observatory Permanent Violence and Crime (OPVC), FP-I3ID, Fernando Pessoa University, 4249-004 Porto, Portugal
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Educational Sciences, University of Porto, 4200-135 Porto, Portugal
- Projecto Homem, Centro de Solidariedade de Braga, Rua do Alcaide 29/31 Cividade, 4700-024 Braga, Portugal
- IPNP Health, Institute of Psychology and Neuropsychology of Porto, 4000-053 Porto, Portugal
- Centre for Philosophical and Humanistic Studies, Centro Regional de Braga, Universidade Católica Portuguesa, Rua de Camões, 60, 4710-362 Braga, Portugal
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Masi G, Carucci S, Muratori P, Balia C, Sesso G, Milone A. Contemporary diagnosis and treatment of conduct disorder in youth. Expert Rev Neurother 2023; 23:1277-1296. [PMID: 37853718 DOI: 10.1080/14737175.2023.2271169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 10/04/2023] [Indexed: 10/20/2023]
Abstract
INTRODUCTION Conduct disorder (CD) is characterized by repetitive and persistent antisocial behaviors, being among the most frequently reported reasons of referral in youth. CD is a highly heterogeneous disorder, with possible specifiers defined according to age at onset, Limited Prosocial Emotions (LPE) otherwise known as Callous-Unemotional (CU) traits, Emotional Dysregulation (ED), and patterns of comorbidity, each with its own specific developmental trajectories. AREAS COVERED The authors review the evidence from published literature on the clinical presentations, diagnostic procedures, psychotherapeutic and psychoeducational approaches, and pharmacological interventions from RCT and naturalistic studies in youth. Evidence from studies including youths with LPE/CU traits, ED and aggression are also reviewed, as response moderators. EXPERT OPINION Due to its clinical heterogeneity, relevant subtypes of CD should be carefully characterized to gain reliable information on prognosis and treatments. Thus, disentangling this broad category in subtypes is crucial as a first step in diagnosis. Psychosocial interventions are the first option, possibly improving LPE/CU traits and ED, especially if implemented early during development. Instead, limited information, based on low-quality studies, supports pharmacological options. Second-generation antipsychotics, mood stabilizers, and stimulants are first-line medications, according to different target symptoms, such as aggression and emotional reactivity. Developmental pathways including ADHD suggest a specific role of psychostimulants.
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Affiliation(s)
- Gabriele Masi
- Department of Child and Adolescent Psychiatry and Psychopharmacology, IRCCS Stella Maris Foundation, Pisa, Italy
| | - Sara Carucci
- Department of Biomedical Science, Section of Neuroscience & Clinical Pharmacology, University of Cagliari, Cagliari, Italy
- Child & Adolescent Neuropsychiatric Unit, "A. Cao" Paediatric Hospital-ARNAS "G. Brotzu" Hospital Trust, Department of Paediatrics, Cagliari, Italy
| | - Pietro Muratori
- Department of Child and Adolescent Psychiatry and Psychopharmacology, IRCCS Stella Maris Foundation, Pisa, Italy
| | - Carla Balia
- Department of Biomedical Science, Section of Neuroscience & Clinical Pharmacology, University of Cagliari, Cagliari, Italy
- Child & Adolescent Neuropsychiatric Unit, "A. Cao" Paediatric Hospital-ARNAS "G. Brotzu" Hospital Trust, Department of Paediatrics, Cagliari, Italy
| | - Gianluca Sesso
- Department of Child and Adolescent Psychiatry and Psychopharmacology, IRCCS Stella Maris Foundation, Pisa, Italy
- Social and Affective Neuroscience Group, Molecular Mind Lab, IMT School for Advanced Studies Lucca, Lucca, Italy
| | - Annarita Milone
- Department of Child and Adolescent Psychiatry and Psychopharmacology, IRCCS Stella Maris Foundation, Pisa, Italy
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Lane C, Hogg E, Karwatowska LA, French L, Ranieri VF, Jesnick LGD, Roberts C, Scott S, Senior R, Skinner GC, Kennedy EMM. Personalised interventions for subgroups of children with conduct problems. Cochrane Database Syst Rev 2023; 4:CD012746. [PMID: 37115724 PMCID: PMC10144971 DOI: 10.1002/14651858.cd012746.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
BACKGROUND Conduct problems are a range of disruptive behaviours in childhood that are associated with long-term adverse outcomes in adolescence and adulthood, including antisocial behaviour, substance misuse, and poor academic achievement. Children with conduct problems can vary according to age of onset, comorbidities, and environmental factors, and it has been suggested that certain groups of children may have different treatment outcomes. Therefore, it is important to assess the extent to which personalised interventions for different groups of children with conduct problems may affect outcomes. To our knowledge, this is the first review to systematically identify and appraise the effectiveness of personalised interventions, adapted, or developed, for prespecified subgroups of children with conduct problems. OBJECTIVES To assess whether personalised interventions, adapted or developed for subgroups of children with conduct problems are effective in improving outcomes. SEARCH METHODS We used standard, extensive Cochrane search methods. The latest search was 1 February 2022. SELECTION CRITERIA We included randomised controlled trials (RCTs), in any setting, in children (aged two to 12 years) with conduct problems and within a prespecified subgroup, comparing a personalised intervention with a non-personalised intervention, waitlist control, or treatment as usual. Personalised interventions included adaptations to standard practice, such as parent-training programmes; other recommended interventions for children with conduct problems; or interventions developed specifically to target subgroups of children with conduct problems. We excluded non-personalised and non-psychological interventions (e.g. pharmacological or dietary intervention). Prespecified subgroups of children with conduct problems, however defined, were eligible for inclusion. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Our primary outcomes were 1. child conduct problems or disruptive behaviour and 2. ADVERSE EVENTS Our secondary outcomes were 3. personalised treatment outcomes relevant to each subgroup, 4. parenting skills and knowledge, 5. family functioning, engagement and decreased dropout, and 6. educational outcomes. We used GRADE to assess the certainty of the evidence. MAIN RESULTS We identified 13 RCTs (858 participants). Seven studies were conducted in the USA, five in Australia, and one in Germany. Eleven studies reported their source of funding, with five studies receiving grants from the National Institute of Mental Health. In total, 15 different funders supported the studies included in the review. We separated subgroups of children with conduct problems into three broad categories: children with co-occurring conditions (e.g. emotional difficulties), parent characteristics (e.g. conflict between parents), or familial/environmental circumstances (e.g. rural families). All studies delivered a personalised intervention that was adapted or developed for a prespecified subgroup of children with conduct problems. We rated all trials at unclear or high risk of bias in most domains. Below, we report the results of improvement in child conduct problems and disruptive behaviour, personalised treatment outcomes, and parenting skills and knowledge for our main comparison: personalised versus non-personalised interventions. Improvement in child conduct problems and disruptive behaviour Compared with a non-personalised intervention, a personalised intervention may result in a slight improvement in child conduct problems or disruptive behaviour measured using the Eyberg Child Behavior Inventory (ECBI) Problem subscale in the short term (mean difference (MD) -3.04, 95% confidence interval (CI) -6.06 to -0.02; 6 studies, 278 participants; P = 0.05), but may have little to no effect on improving child conduct problems or disruptive behaviour measured by the ECBI Intensity subscale (MD -6.25, 95% CI -16.66 to 4.15; 6 studies, 278 participants; P = 0.24), or the Externalising subscale of the Child Behaviour Checklist (CBCL) (MD -2.19, 95% CI -6.97 to 2.59; 3 studies, 189 participants, P = 0.37) in the short term. We graded the certainty of evidence as very low for all three outcomes, meaning any estimate of effect is very uncertain. Personalised treatment outcomes, relevant to each subgroup Although six studies reported personalised treatment outcomes, relevant to each subgroup, we were unable to pool the data due to differences between the measures used in the studies and the heterogeneity this would produce in analysis. The results for this outcome were inconclusive. Parenting skills and knowledge Although seven studies reported parenting skills and knowledge, we were unable to pool the data due to differences between the measures used in the studies and the heterogeneity this would produce in analysis. The results for this outcome were inconclusive. Adverse events None of the trials reported monitoring adverse events. Summary of results In summary, there is limited evidence that personalised intervention improves child conduct problems, personalised treatment outcomes, relevant to each subgroup, or parenting skills and knowledge compared with a non-personalised intervention. AUTHORS' CONCLUSIONS There is limited evidence for the effectiveness of personalised interventions for subgroups of children with conduct problems. The certainty of evidence for all outcomes was very low, meaning that we have very little confidence in the estimated effects and the true effects may be different to our findings, which will limit the relevance of our findings to clinical decisions. To overcome the limitations of the evidence, large-scale RCTs are needed to determine whether personalised interventions, adapted or developed, for subgroups of children with conduct problems are effective in improving outcomes. Consensus on the most appropriate measures to use in these studies is needed in order to facilitate cross-study comparisons. Persistent conduct problems predict a range of adverse long-term outcomes, so future research should investigate the medium- and long-term effects of personalised treatments. Studies are needed in low- and middle-income countries as well as studies recruiting children aged between nine and 12 years, as they were under-represented in the studies.
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Affiliation(s)
- Chloe Lane
- Tavistock Research Unit, Tavistock and Portman NHS Foundation Trust, London, UK
| | - Elizabeth Hogg
- Tavistock Research Unit, Tavistock and Portman NHS Foundation Trust, London, UK
| | - Lucy A Karwatowska
- Tavistock Research Unit, Tavistock and Portman NHS Foundation Trust, London, UK
| | - Lorna French
- Tavistock Research Unit, Tavistock and Portman NHS Foundation Trust, London, UK
| | - Veronica F Ranieri
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Leah G D Jesnick
- Tavistock Research Unit, Tavistock and Portman NHS Foundation Trust, London, UK
| | | | - Stephen Scott
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Robert Senior
- Tavistock Research Unit, Tavistock and Portman NHS Foundation Trust, London, UK
| | - Guy Cm Skinner
- Tavistock Research Unit, Tavistock and Portman NHS Foundation Trust, London, UK
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Eilis M M Kennedy
- Tavistock Research Unit, Tavistock and Portman NHS Foundation Trust, London, UK
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
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Sesso G, Masi G. Pharmacological strategies for the management of the antisocial personality disorder. Expert Rev Clin Pharmacol 2023; 16:181-194. [PMID: 36787887 DOI: 10.1080/17512433.2023.2181159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 02/09/2023] [Indexed: 02/16/2023]
Abstract
INTRODUCTION Antisocial personality disorder (AsPD) is a pervasive pattern of violation of others' rights, related to the concept of psychopathy. AsPD is stable over time from adolescence, with evidence of conduct disorder (CD) before 15 years. DSM-5 included a specifier 'with limited prosocial emotions' (LPE), which characterizes adolescents with higher developmental vulnerability to develop AsPD. Despite being relatively frequent with considerable societal impact, AsPD is a difficult-to-treat condition with high comorbidity rates and poor evidence for effective pharmacological interventions. AREAS COVERED We conducted a narrative review and searched PubMed up to September 2022. We included RCTs and naturalistic studies evaluating pharmacological interventions on AsPD in adults, including those with comorbid substance use disorder or psychopathic traits. Evidence in youths with CD, callous-unemotional (CU) traits and aggression were also reviewed, exploring the role of CU traits as moderators of response. EXPERT OPINION Psychosocial interventions are the first option, with possible improvement of CU traits, beyond behavioral and affective symptoms, particularly if implemented early during development. Limited information, based on low-quality studies, supports the pharmacological options. Second-generation antipsychotics, lithium, anti-epileptic drugs, and stimulants are first-line medications, according to different target symptoms. Developmental pathways including ADHD suggest a specific role of psychostimulants.
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Affiliation(s)
- Gianluca Sesso
- Social and Affective Neuroscience Group, Molecular Mind Lab, IMT School for Advanced Studies Lucca, Lucca, Italy
- Department of Child and Adolescent Psychiatry and Psychopharmacology, IRCCS Stella Maris Foundation, Pisa, Italy
| | - Gabriele Masi
- Department of Child and Adolescent Psychiatry and Psychopharmacology, IRCCS Stella Maris Foundation, Pisa, Italy
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De Wit-De Visser B, Rijckmans M, Vermunt JK, van Dam A. Pathways to antisocial behavior: a framework to improve diagnostics and tailor therapeutic interventions. Front Psychol 2023; 14:993090. [PMID: 36844347 PMCID: PMC9947159 DOI: 10.3389/fpsyg.2023.993090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 01/17/2023] [Indexed: 02/11/2023] Open
Abstract
The Antisocial Personality Disorder (ASPD), and antisocial behavior (ASB) in general, is associated with significant impact on individuals themselves, their environment, and society. Although various interventions show promising results, no evidence-based treatments are available for individuals with ASPD. Therefore, making informed choices about which treatment can be applied to an individual patient is complicated. Furthermore, contradictory findings on therapy effectiveness and underlying factors of ASB, such as cognitive impairments and personality traits, fuel the debate whether the conceptualization of ASPD in the DSM-5 is accurate and whether this population can be seen as homogeneous. A conceptual framework, based on the reciprocal altruism theory, is presented in which we propose different pathways to ASB. These pathways suggest underlying dynamics of ASB and provide an explanation for previous contradictory research outcomes. This framework is intended to serve as a clinically relevant model that provides directions for improving diagnostics and matching treatments to underlying dynamics in the antisocial population.
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Affiliation(s)
- Brenda De Wit-De Visser
- GGZ WNB, Research and Innovation, Halsteren, Netherlands,Tilburg School of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welfare, Tilburg University, Tilburg, Netherlands,*Correspondence: Brenda De Wit-De Visser,
| | - Madeleine Rijckmans
- Fivoor, Fivoor Science and Treatment Innovation, Poortugaal, Netherlands,Clinical and Forensic Psychology, Department of Developmental Psychology, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
| | - Jeroen K. Vermunt
- Department of Methodology and Statistics, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
| | - Arno van Dam
- GGZ WNB, Research and Innovation, Halsteren, Netherlands,Tilburg School of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welfare, Tilburg University, Tilburg, Netherlands
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Perlstein S, Hawes S, Vazquez AY, Pacheco-Colón I, Lehman S, Parent J, Byrd A, Waller R. Genetic versus environmental influences on callous-unemotional traits in preadolescence: The role of parenting and parental psychopathology. Dev Psychopathol 2022; 34:1-16. [PMID: 36229943 PMCID: PMC10102260 DOI: 10.1017/s0954579422000888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Children with callous-unemotional (CU) traits are at risk for severe conduct problems. While CU traits are moderately heritable, parenting also predicts risk. However, few studies have investigated whether parenting factors (e.g., acceptance, conflict, parental psychopathology) moderate the etiology of CU traits, while accounting for gene-environment correlations. To address this knowledge gap, we used data from 772 twin pairs from the Adolescent Brain and Cognitive Development Study to test bivariate models that explored overlapping etiological influences on CU traits and child reports of their parenting environment. We also used gene-by-environment interaction models to test whether parenting moderated genetic versus environmental influences. There were no overlapping etiological influences on CU traits and parental acceptance, but modest genetic and non-shared environmental overlap between CU traits and family conflict. Parental acceptance and psychopathology moderated non-shared environmental influences, with stronger non-shared environmental influences on CU traits among children who experienced lower parental acceptance and greater parental psychopathology. Family conflict only moderated environmental influences when models did not covary for conduct problems. Parental acceptance and parental psychopathology may be specific environmental protective and risk factors for CU traits, whereas family conflict may represent a general environmental risk factor for both CU traits and conduct problems.
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Affiliation(s)
| | - Samuel Hawes
- Department of Psychology, Florida International University
| | | | | | - Sarah Lehman
- Department of Psychology, Florida International University
| | | | - Amy Byrd
- Department of Psychology, University of Pittsburgh
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White BA, Dede B, Heilman M, Revilla R, Lochman J, Hudac CM, Bui C, White SW. Facial Affect Sensitivity Training for Young Children with Emerging CU Traits: An Experimental Therapeutics Approach. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2022; 51:264-276. [PMID: 35486474 PMCID: PMC9531877 DOI: 10.1080/15374416.2022.2056895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
OBJECTIVE This article delineates best practices in the application of the experimental therapeutics framework for evaluating interventions within the context of randomized controlled trials (RCTs), offering a methodological primer and guiding framework for this approach. We illustrate these practices using an ongoing clinical trial conducted within the framework of a National Institute of Mental Health exploratory phased-innovation award for the development of psychosocial therapeutic interventions for mental disorders (R61/R33), describing the implementation of a novel "Facial Affect Sensitivity Training" (FAST) intervention for children with callous-unemotional (CU) traits. CU traits (e.g., lack of guilt or remorse, low empathy, shallow affect) are an established risk factor for persistent and severe youth misconduct, which reflect impairment in identified neurocognitive mechanisms that interfere with child socialization, and predict poor treatment outcomes, even with well-established treatments for disruptive behavior. METHOD We outline the stages, goals, and best practices for an experimental therapeutics framework. In the FAST trial, we assert that impaired sensitivity for emotional distress cues (fear and/or sadness) is mechanistically linked to CU traits in children, and that by targeting sensitivity to facial affect directly via a computerized automated feedback and incentive system, we can exert downstream effects on CU traits. RESULTS In the context of an open pilot trial, we found preliminary support for feasibility and mechanism engagement using FAST. CONCLUSIONS We summarize pilot study limitations and how they are being addressed in the R61/R33 RCTs, as well as challenges and future directions for psychosocial experimental therapeutics.
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Affiliation(s)
- Bradley A. White
- Center for Youth Development and Intervention, University of Alabama, Tuscaloosa, AL, USA
| | - Breanna Dede
- Center for Youth Development and Intervention, University of Alabama, Tuscaloosa, AL, USA
| | - Meagan Heilman
- Center for Youth Development and Intervention, University of Alabama, Tuscaloosa, AL, USA
| | - Rebecca Revilla
- Center for Youth Development and Intervention, University of Alabama, Tuscaloosa, AL, USA
| | - John Lochman
- Center for Youth Development and Intervention, University of Alabama, Tuscaloosa, AL, USA
| | - Caitlin M. Hudac
- Center for Youth Development and Intervention, University of Alabama, Tuscaloosa, AL, USA
| | - Chuong Bui
- Alabama Life Research Institute, University of Alabama, Tuscaloosa, AL, USA
| | - Susan W. White
- Center for Youth Development and Intervention, University of Alabama, Tuscaloosa, AL, USA
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Huffman LG, Oshri A. Neural signatures of the development of antisocial behaviours and callous-unemotional traits among youth: The moderating role of parental support. Int J Dev Neurosci 2022; 82:205-221. [PMID: 35181902 DOI: 10.1002/jdn.10173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 02/10/2022] [Accepted: 02/15/2022] [Indexed: 11/08/2022] Open
Abstract
Comorbidity of antisocial behaviours (AB) and callous-unemotional (CU) traits characterizes a subgroup of youth at risk for chronic and severe AB in adulthood. Although aberrant neural response to facial emotion confers heightened risk for AB and CU traits, the behavioural effect of this neural response varies by family context. The present study examines the effects of neural response to emotional faces, parental support and the interaction between the two as predictors of AB and CU traits in a longitudinal sample of preadolescents (Nbaseline = 11,883; Mage = 9.5; 47.8% female). Low CU youth who evinced attenuated response to fearful faces within the left superior temporal sulcus and fusiform gyrus showed smaller decreases of AB over time; these associations did not extend to high CU youth. Among high CU youth reporting low parental support, blunted response to fearful faces within the bilateral inferior parietal sulcus predicted smaller decreases of AB. Study findings highlight neurobehavioural differences between youth with high and low CU traits, as well as the interacting roles of negative face processing and parental support in the development of AB.
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Affiliation(s)
| | - Assaf Oshri
- Department of Human Development & Family Science, University of Georgia, Athens, Georgia, USA
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Bjørnebekk G, Mørkrid Thøgersen D. Possible Interventions for Preventing the Development of Psychopathic Traits among Children and Adolescents? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010409. [PMID: 35010668 PMCID: PMC8745021 DOI: 10.3390/ijerph19010409] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 12/23/2021] [Accepted: 12/25/2021] [Indexed: 11/23/2022]
Abstract
Individuals with the combination of psychopathy and severe conduct disorder often get in a lot of trouble from their early childhood, and can cause great suffering and problems for other people and their immediate environment. Their antisocial behaviour has a tendency to develop into a chronic pattern early in life, and the treatment prognosis in adulthood is poor. A large proportion of serious violent crimes in society can be attributed to this group of perpetrators. Until recently, it has been unclear whether traits of this type can be prevented or changed, so that these individuals and their surroundings can benefit from targeted treatments at an early stage. To reduce serious crime in a society, it is very important to develop effective measures for this particular group. A lack of empathy, indifference to others, and a lack of concern about their own performance appear to be key early signs in children and adolescents with persistent behavioural problems and more serious norm violations who continue into a criminal career upon reaching adulthood. These characteristics have been termed callous−unemotional (CU) traits, and they are considered to be a precursor to psychopathic traits in adulthood. In recent years, several studies have evaluated the degree to which treatments that have been proved effective for children and adolescents with severe behavioural problems also show effectiveness for children and adolescents with CU traits. Interventions specifically tailored to children with CU traits have also been developed with the aim of directly changing the ongoing development of this precursor to psychopathy. In this paper, we will address the extent to which current evidence-based treatment methods developed for children and adolescents with behavioural difficulties are equally effective when a child has CU traits. We will also take a closer look at the effects of interventions designed to change this trait. There will be a discussion regarding what seems relevant for a change in the trait itself, as well as a change in their antisocial behaviour.
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Affiliation(s)
- Gunnar Bjørnebekk
- Department of Special Needs Education, University of Oslo, P.O. Box 1140, 0318 Oslo, Norway
- The Norwegian Center for Child Behavioral Development, Essendrops gt. 3, 0368 Oslo, Norway;
- Correspondence:
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11
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Robinovitz ML, Montalto GJ, Afzal KI, Lichtor S, Palepu S, Oaklander D, Carollo S, Tutko J, Wildes JE. Anorexia nervosa, conduct disorder, and the juvenile justice system: a case of applying traditional treatment modalities in a non-traditional setting. Biopsychosoc Med 2021; 15:26. [PMID: 34922570 PMCID: PMC8684194 DOI: 10.1186/s13030-021-00227-w] [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: 06/19/2021] [Accepted: 11/16/2021] [Indexed: 11/23/2022] Open
Abstract
Background Anorexia Nervosa is highly comorbid with depressive, anxiety, and obsessive-compulsive spectrum disorders. However, it has not previously been reported as comorbid with antisocial personality traits, except when substance use disorder is also identified. We present an unusual case of a patient with resistant anorexia nervosa and comorbid conduct disorder. This case was also unique in that the juvenile justice system was involved during treatment. Case presentation A 13-year-old female was admitted to our pediatric hospital for the treatment of anorexia nervosa. She had a history of violent behaviors toward family members, often jeopardizing her care. During hospitalization, she physically attacked a physician on her care team shortly before she transitioned to an eating disorders treatment program. She was diagnosed with conduct disorder, and following discharge, she attacked her father in a premeditated act. This led to her entry into the juvenile justice system. While under the custody of the juvenile justice system, she was readmitted to our hospital for further treatment of anorexia nervosa. Our treatment strategy included psychotropics, positive reinforcement, close interdisciplinary coordination among the various hospital teams, and the juvenile justice system. Following discharge from her second hospitalization back to the juvenile detention system, our patient maintained a healthy weight and appeared to show improvements in the cognitive distortions related to her eating disorder. Conclusions To our knowledge, this is the first reported successful treatment of an individual with resistant anorexia nervosa and conduct disorder. It was likely a combination of weight gain, psychotropic medications, and the structured milieu provided by the juvenile justice system that led to the effective treatment of our patient. This case illustrates that a non-traditional healthcare setting can be an asset to treatment through persistence and close collaboration across institutions.
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Fantozzi P, Sesso G, Muratori P, Milone A, Masi G. Biological Bases of Empathy and Social Cognition in Patients with Attention-Deficit/Hyperactivity Disorder: A Focus on Treatment with Psychostimulants. Brain Sci 2021; 11:1399. [PMID: 34827398 PMCID: PMC8615705 DOI: 10.3390/brainsci11111399] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 10/18/2021] [Accepted: 10/22/2021] [Indexed: 12/16/2022] Open
Abstract
In recent years, there has been growing interest in investigating the effect of specific pharmacological treatments for ADHD not only on its core symptoms, but also on social skills in youths. This stands especially true for ADHD patients displaying impulsive aggressiveness and antisocial behaviors, being the comorbidity with Disruptive Behavior Disorders, one of the most frequently observed in clinical settings. This systematic review aimed to synthesize research findings on this topic following PRISMA guidelines and to identify gaps in current knowledge, future directions, and treatment implications. Search strategies included the following terms: ADHD; methylphenidate and other ADHD drugs; empathy, theory of mind and emotion recognition. Full-text articles were retrieved and data from individual studies were collected. Thirteen studies were finally included in our systematic review. Ten studies assessing changes in empathy and/or theory of mind in patients with ADHD treated after pharmacological interventions were identified. Similarly, seven partially overlapping studies assessing changes in emotion recognition were retrieved. Despite a great heterogeneity in the methodological characteristics of the included studies, most of them reported an improvement in emphatic and theory of mind abilities in youths with ADHD treated with psychostimulants and nonstimulant drugs, as well as positive but less consistent results about emotion recognition performances.
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Affiliation(s)
- Pamela Fantozzi
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Department of Child and Adolescent Psychiatry and Psychopharmacology, 56128 Pisa, Italy; (P.F.); (G.S.); (P.M.); (A.M.)
| | - Gianluca Sesso
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Department of Child and Adolescent Psychiatry and Psychopharmacology, 56128 Pisa, Italy; (P.F.); (G.S.); (P.M.); (A.M.)
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Pietro Muratori
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Department of Child and Adolescent Psychiatry and Psychopharmacology, 56128 Pisa, Italy; (P.F.); (G.S.); (P.M.); (A.M.)
| | - Annarita Milone
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Department of Child and Adolescent Psychiatry and Psychopharmacology, 56128 Pisa, Italy; (P.F.); (G.S.); (P.M.); (A.M.)
| | - Gabriele Masi
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Department of Child and Adolescent Psychiatry and Psychopharmacology, 56128 Pisa, Italy; (P.F.); (G.S.); (P.M.); (A.M.)
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Parenting and Sibling Relationships in Family with Disruptive Behavior Disorders. Are Non-Clinical Siblings More Vulnerable for Emotional and Behavioral Problems? Brain Sci 2021; 11:brainsci11101308. [PMID: 34679373 PMCID: PMC8534172 DOI: 10.3390/brainsci11101308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/27/2021] [Accepted: 09/27/2021] [Indexed: 11/17/2022] Open
Abstract
Disruptive Behavior Disorders (DBD) are the most common mental health disorders in the school-aged child population. Although harsh parenting is a key risk factor in the shaping of DBD, studies neglect the presence of siblings and differential parenting. This study aims to compare: (1) parenting style and sibling relationship in sibling dyads of clinical families, composed of a DBD child and a non-clinical sibling, with control families composed of two non-clinical siblings; (2) parenting style, sibling relationship, and emotional and behavioral problems in DBD child, non-clinical sibling, and non-clinical child of control group. Sixty-one families (composed of mother and sibling dyads), divided into clinical (n = 27) and control (n = 34) groups, completed the APQ, SRI, and CBCL questionnaires. Results indicated differential parenting in clinical families, compared to control group families, with higher negative parenting toward the DBD child than the sibling; no difference emerged in sibling relationship within sibling dyads (clinical vs. control). Finally, externalizing and internalizing problems were higher in DBD children and their siblings, compared to control, indicating DBD sibling psychopathology vulnerability. Findings suggest inclusion of siblings in the clinical assessment and rehabilitative intervention of DBD children, given that the promotion of positive parenting could improve mental health in the offspring.
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Goagoses N, Schipper N. Concurrent Associations between Parenting Dimensions, Callous-Unemotional Traits, and Externalizing Behaviour Problems during Adolescence. EMOTIONAL AND BEHAVIOURAL DIFFICULTIES 2021. [DOI: 10.1080/13632752.2021.1979316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Naska Goagoses
- Carl Von Ossietzky University of Oldenburg,School of Educational and Social Sciences,Department of Special Needs Education and Rehabilitation,Oldenburg, Germany
| | - Neele Schipper
- Carl Von Ossietzky University of Oldenburg,School of Educational and Social Sciences,Department of Special Needs Education and Rehabilitation,Oldenburg, Germany
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Positive and negative parenting in conduct disorder with high versus low levels of callous-unemotional traits. Dev Psychopathol 2021; 33:980-991. [PMID: 32571444 DOI: 10.1017/s0954579420000279] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Less is known about the relationship between conduct disorder (CD), callous-unemotional (CU) traits, and positive and negative parenting in youth compared to early childhood. We combined traditional univariate analyses with a novel machine learning classifier (Angle-based Generalized Matrix Learning Vector Quantization) to classify youth (N = 756; 9-18 years) into typically developing (TD) or CD groups with or without elevated CU traits (CD/HCU, CD/LCU, respectively) using youth- and parent-reports of parenting behavior. At the group level, both CD/HCU and CD/LCU were associated with high negative and low positive parenting relative to TD. However, only positive parenting differed between the CD/HCU and CD/LCU groups. In classification analyses, performance was best when distinguishing CD/HCU from TD groups and poorest when distinguishing CD/HCU from CD/LCU groups. Positive and negative parenting were both relevant when distinguishing CD/HCU from TD, negative parenting was most relevant when distinguishing between CD/LCU and TD, and positive parenting was most relevant when distinguishing CD/HCU from CD/LCU groups. These findings suggest that while positive parenting distinguishes between CD/HCU and CD/LCU, negative parenting is associated with both CD subtypes. These results highlight the importance of considering multiple parenting behaviors in CD with varying levels of CU traits in late childhood/adolescence.
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16
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Fantozzi P, Muratori P, Caponi MC, Levantini V, Nardoni C, Pfanner C, Ricci F, Sesso G, Tacchi A, Milone A, Masi G. Treatment with Methylphenidate Improves Affective but Not Cognitive Empathy in Youths with Attention-Deficit/Hyperactivity Disorder. CHILDREN-BASEL 2021; 8:children8070596. [PMID: 34356575 PMCID: PMC8307630 DOI: 10.3390/children8070596] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/07/2021] [Accepted: 07/13/2021] [Indexed: 12/30/2022]
Abstract
Background: Beside the core symptoms, patients with attention-deficit/hyperactivity disorder (ADHD) frequently show relevant difficulty in developing relationships with peers. Although ADHD symptoms may account for social impairment, deficits in cognitive and/or affective empathy have also been involved. Our aim was to investigate the effect of methylphenidate (MPH) treatment on affective and cognitive empathy. Methods: Sixty-one drug-naïve youths with ADHD (age range 6 to 17 years, mean 10.3 ± 2.8 years, 51 males) naturalistically treated with MPH monotherapy were followed up for 6 months for ADHD symptoms and empathy, measured with the Basic Empathy Scale. Results: After being treated with MPH, the patients showed a significant improvement in affective and cognitive empathy scores. Linear regression models showed that changes in inattention symptoms predicted changes in affective but not in cognitive empathy, while changes in the hyperactivity/impulsivity symptoms did not predict changes in affective or cognitive empathy. Conclusions: Our study provides a further contribution for a better understanding of the possible effects of the MPH on youth’s characteristics.
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Affiliation(s)
- Pamela Fantozzi
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Calambrone, 56128 Pisa, Italy; (P.M.); (M.C.C.); (V.L.); (C.N.); (C.P.); (F.R.); (G.S.); (A.T.); (A.M.); (G.M.)
- Correspondence: ; Tel.: +39-050-886293
| | - Pietro Muratori
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Calambrone, 56128 Pisa, Italy; (P.M.); (M.C.C.); (V.L.); (C.N.); (C.P.); (F.R.); (G.S.); (A.T.); (A.M.); (G.M.)
| | - Maria Celeste Caponi
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Calambrone, 56128 Pisa, Italy; (P.M.); (M.C.C.); (V.L.); (C.N.); (C.P.); (F.R.); (G.S.); (A.T.); (A.M.); (G.M.)
| | - Valentina Levantini
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Calambrone, 56128 Pisa, Italy; (P.M.); (M.C.C.); (V.L.); (C.N.); (C.P.); (F.R.); (G.S.); (A.T.); (A.M.); (G.M.)
| | - Cristina Nardoni
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Calambrone, 56128 Pisa, Italy; (P.M.); (M.C.C.); (V.L.); (C.N.); (C.P.); (F.R.); (G.S.); (A.T.); (A.M.); (G.M.)
| | - Chiara Pfanner
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Calambrone, 56128 Pisa, Italy; (P.M.); (M.C.C.); (V.L.); (C.N.); (C.P.); (F.R.); (G.S.); (A.T.); (A.M.); (G.M.)
| | - Federica Ricci
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Calambrone, 56128 Pisa, Italy; (P.M.); (M.C.C.); (V.L.); (C.N.); (C.P.); (F.R.); (G.S.); (A.T.); (A.M.); (G.M.)
| | - Gianluca Sesso
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Calambrone, 56128 Pisa, Italy; (P.M.); (M.C.C.); (V.L.); (C.N.); (C.P.); (F.R.); (G.S.); (A.T.); (A.M.); (G.M.)
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Annalisa Tacchi
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Calambrone, 56128 Pisa, Italy; (P.M.); (M.C.C.); (V.L.); (C.N.); (C.P.); (F.R.); (G.S.); (A.T.); (A.M.); (G.M.)
| | - Annarita Milone
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Calambrone, 56128 Pisa, Italy; (P.M.); (M.C.C.); (V.L.); (C.N.); (C.P.); (F.R.); (G.S.); (A.T.); (A.M.); (G.M.)
| | - Gabriele Masi
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Calambrone, 56128 Pisa, Italy; (P.M.); (M.C.C.); (V.L.); (C.N.); (C.P.); (F.R.); (G.S.); (A.T.); (A.M.); (G.M.)
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López-Romero L, Cutrín O, Maneiro L, Domínguez-Álvarez B, Romero E. Psychopathic Traits in Childhood: Insights from Parental Warmth and Fearless Temperament via Conscience Development. Brain Sci 2021; 11:brainsci11070923. [PMID: 34356157 PMCID: PMC8304070 DOI: 10.3390/brainsci11070923] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/07/2021] [Accepted: 07/09/2021] [Indexed: 11/16/2022] Open
Abstract
The role of psychopathic traits in predicting more serious and persistent patterns of child conduct problems has been well documented. The jointly presence of interpersonal (grandiose-deceitful), affective (e.g., callous-unemotional), and behavioral psychopathic traits (impulsive-need of stimulation) identifies a group of children at increased risk of psychosocial maladjustment. The present study aims to disentangle the underlying mechanisms by examining how early parenting (i.e., warmth) and child temperament (i.e., fearlessness) predict later psychopathic traits, via conscience development (CD). Data were collected in a large sample of children (n = 2.266; 48.5% girls), aged 3 to 6 at the onset of the study (Mage = 4.25; SD = 0.91), who were followed up one and two years later. The results showed direct effects from fearlessness to interpersonal and behavioral psychopathic traits. Parental warmth, fearless temperament, and their interaction, predicted CD, which, in turn, showed a negative effect on psychopathic traits. The indirect effects indicated significant negative mediation effects of warmth through CD on psychopathic traits, which seem to be stronger when children present lower levels of fearlessness. Overall, these results contribute to better understand the development of child psychopathic traits and provide additional insight on effective strategies that will help to restrain the potential development of a high-risk profile in early childhood.
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Affiliation(s)
- Laura López-Romero
- Department of Clinical Psychology and Psychobiology, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain; (O.C.); (L.M.); (B.D.-Á.); (E.R.)
- Correspondence:
| | - Olalla Cutrín
- Department of Clinical Psychology and Psychobiology, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain; (O.C.); (L.M.); (B.D.-Á.); (E.R.)
| | - Lorena Maneiro
- Department of Clinical Psychology and Psychobiology, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain; (O.C.); (L.M.); (B.D.-Á.); (E.R.)
- Institute of Education and Child Studies, Leiden University, 2333 AK Leiden, The Netherlands
| | - Beatriz Domínguez-Álvarez
- Department of Clinical Psychology and Psychobiology, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain; (O.C.); (L.M.); (B.D.-Á.); (E.R.)
| | - Estrella Romero
- Department of Clinical Psychology and Psychobiology, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain; (O.C.); (L.M.); (B.D.-Á.); (E.R.)
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18
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Zhang X, Wang R, Gao Y, Wang MC. Resting Heart Rate Mediates the Relationship between Parenting Style and Callous-Unemotional Traits in Chinese Children. Res Child Adolesc Psychopathol 2021; 49:1419-1430. [PMID: 34128174 DOI: 10.1007/s10802-021-00834-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2021] [Indexed: 12/29/2022]
Abstract
Despite increasing knowledge of social and biological risk factors for callous-unemotional (CU) traits, relatively less is known about how these two sets of risk factors combine to affect these traits. The current longitudinal study investigated pathways from parenting style to CU traits via resting heart rate in a three-year project. Parents of 382 children completed the Parenting Styles and Dimensions Questionnaire at Time 1 (children Mean age = 9.06, SD = 0.94, range = 7-11 years), with the heart rate data collected at Time 2 (M = 10.16, SD = 0.93, range = 8-13 years) and CU traits assessed at Time 3 (M = 11.06, SD = 0.94, range = 9-13 years). We found that parenting style and CU traits were associated with resting heart rate, and that structural equation modeling showed resting heart rate to partially mediate the effect of parenting style on CU traits. Specifically, higher levels of authoritarian parenting were associated with lower resting heart rate, which in turn was linked to higher level of CU traits. On the contrary, children in the context of authoritative parenting showed relatively higher resting heart rate, which was predictive of lower CU traits. Overall, findings have implications for understanding the etiology of CU traits in children and developing effective prevention programs for children with affective deficits.
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Affiliation(s)
- Xintong Zhang
- Department of Psychology, Guangzhou University, Guangzhou, P. R. China
| | - Rongqiang Wang
- Department of Psychology, Guangzhou University, Guangzhou, P. R. China
| | - Yu Gao
- Department of Psychology, Brooklyn College and the Graduate Center of the City University of New York, New York, USA
| | - Meng-Cheng Wang
- Department of Psychology, Guangzhou University, Guangzhou, P. R. China.
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Parent Training and Therapy in Children with Autism. Pediatr Rep 2021; 13:216-226. [PMID: 34063181 PMCID: PMC8162538 DOI: 10.3390/pediatric13020030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/30/2021] [Accepted: 04/08/2021] [Indexed: 11/16/2022] Open
Abstract
With the introduction of the Diagnostic and Statistical Manual of Mental Disorders-5th ed. (DSM-5) autism spectrum disorders (ASD) fall into the category of neurodevelopmental disorders. ASD is characterized by the inhibitory mechanisms responsible for social adaptation and emotional expression being underdeveloped, causing a child's recognition and understanding of emotions to be impaired. Our study hypothesizes that early intervention using behavioral interventions such as Applied Behavior Analysis (ABA) and reflexive functions (RF) training on parents can improve the development of joint attention (JA), a cognitive precursor to the theory of mind (ToM) and mentalization processes. We considered a sample of 84 children aged between 20 and 30 months who had received a diagnosis of risk of autism spectrum disorder (level 1). The sample was divided into two groups of 42 subjects, in the first group we carried out a weekly behavioral parent training (PT) based only on ABA principles, while in the second group we carried out a weekly PT aimed at improving reflective functions and parental awareness according to a model inspired by the model based on emotional mirroring and mentalization of Fonagy. Our study shows that parents who are able to make sense of both their own mental state and that of their child can serve as a protective factor for the child's development even in atypical developmental situations such as in ASD.
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Squillaci M, Benoit V. Role of Callous and Unemotional (CU) Traits on the Development of Youth with Behavioral Disorders: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094712. [PMID: 33925165 PMCID: PMC8125599 DOI: 10.3390/ijerph18094712] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 12/11/2022]
Abstract
Numerous studies have shown that youth with behavioral disorders (BD) present an increased risk for developing severe and persistent antisocial behaviors in adulthood. Retrospective research notes that not all children and adolescents follow a negative trajectory and explains this heterogeneity in particular by the severity of CU traits. Our study examines how these traits affect the functioning of children and adolescents with BD. Method: A systematic literature review conducted through various databases and using different keywords made it possible to analyze 52 studies published from 2015 to 2020 that measured the bidirectional effects of CU traits on the functioning of young. Results: Out of the 52 studies, 47 analyzed links between CU traits and neurobiological or mental health, 20 examined family and school contexts, eight focused on social adjustment, 10 on social interactions and 19 measured links with cognitive functioning, especially executive functions. Conclusion: Consistent with previous recommendations in the field, our findings emphasize the importance of assessing the presence of UC traits in early childhood to prevent the emergence of comorbid disorders and to target multimodal (early) interventions to influence the life trajectories of youth with high CU traits.
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Affiliation(s)
- Myriam Squillaci
- Department of Special Education, University of Fribourg, 1700 Fribourg, Switzerland
- Correspondence:
| | - Valérie Benoit
- Department of Special Education, University of Teacher Education of State of Vaud, 1014 Lausanne, Switzerland;
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Muratori P, Milone A, Levantini V, Pisano S, Spensieri V, Valente E, Thomaes S, Masi G. Narcissistic traits as predictors of emotional problems in children with oppositional defiant disorder: A longitudinal study. J Affect Disord 2020; 274:494-499. [PMID: 32663981 DOI: 10.1016/j.jad.2020.05.075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 05/05/2020] [Accepted: 05/14/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Children's self-views encompass two independent dimensions: self-esteem and narcissism, which recently have received growing attention from researchers and clinicians. The current study sought to test whether these dimensions might predict the developmental course of children with Oppositional Defiant Disorder diagnosis. METHOD The sample (N = 64, M age = 10.1 years, 57 boys) included children with Oppositional Defiant Disorder diagnosis. We examined longitudinal relationships between self-views (both self-esteem and narcissism) and parent-reported internalizing and externalizing behavioral problems. RESULTS The study spanned two time-points, spaced 12 months apart. None of the predictors were longitudinally associated with the levels of externalizing behavioral problems in children. However, narcissism predicted the levels of children's internalizing problems at the follow-up, whereas self-esteem did not. LIMITATIONS The relatively small sample and the lack of assessing causality limit the generalizability of the findings. Results need to be replicated in larger samples. CONCLUSIONS These findings illustrate the value of taking into account children's narcissistic traits in clinical assessment. By broadening knowledge of narcissistic traits in clinical samples of children, we hope to inform assessment procedures in standard clinical practice, as well as the development of tailored interventions to curb the emergence of later negative outcomes related to childhood narcissism, such as internalizing problems.
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Affiliation(s)
- Pietro Muratori
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno 331, 56018 Calambrone Pisa, Italy.
| | - Annarita Milone
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno 331, 56018 Calambrone Pisa, Italy
| | - Valentina Levantini
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno 331, 56018 Calambrone Pisa, Italy
| | - Simone Pisano
- Department of Neuroscience, AORN Santobono-Pausilipon, Naples, Italy.2 Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Valentina Spensieri
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Italy
| | - Elena Valente
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno 331, 56018 Calambrone Pisa, Italy
| | - Sander Thomaes
- Department of Psychology, Utrecht University, The Netherlands
| | - Gabriele Masi
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Viale del Tirreno 331, 56018 Calambrone Pisa, Italy
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Castro E, Cotov M, Brovedani P, Coppola G, Meoni T, Papini M, Terlizzi T, Vernucci C, Pecini C, Muratori P. Associations between Learning and Behavioral Difficulties in Second-Grade Children. CHILDREN-BASEL 2020; 7:children7090112. [PMID: 32859081 PMCID: PMC7552774 DOI: 10.3390/children7090112] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/20/2020] [Accepted: 08/24/2020] [Indexed: 12/15/2022]
Abstract
Learning and behavioral difficulties often emerge during the first years of primary school and are one of the most important issues of concern for families and schools. The study was aimed at investigating the co-occurrence of difficulties between academic learning and emotional-behavioral control in typically developing school children and the moderating role of sex. A sample of 640 second-grade school children participated in the study. This study used the Strengths and Difficulties Questionnaire to measure the emotional and behavioral difficulties and a battery of objective and standardized tests to evaluate the learning skills in children. In this sample 7% to 16% of children performed below the normal range in reading and/or arithmetic tests. Mixed models showed that children’s hyperactive behaviors were positively related to both reading and math difficulties, and emotional problems correlated negatively with reading accuracy. The more children displayed behavioral difficulties, the more they were exposed to the risk of worsening reading and math performance, especially for girls. The result that among different emotional-behavioral problems within the school setting, hyperactivity behaviors and emotional difficulties are related to learning difficulties with a moderate effect of sex, needs to be taken into account in screening and prevention programs for learning difficulties in order to not disregard the complexity of the associated profiles.
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Affiliation(s)
- Emanuela Castro
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry Pisa, 56018 Calambrone, Italy; (M.C.); (P.B.); (M.P.); (C.V.); (P.M.)
- Correspondence:
| | - Maria Cotov
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry Pisa, 56018 Calambrone, Italy; (M.C.); (P.B.); (M.P.); (C.V.); (P.M.)
| | - Paola Brovedani
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry Pisa, 56018 Calambrone, Italy; (M.C.); (P.B.); (M.P.); (C.V.); (P.M.)
| | - Gabrielle Coppola
- Department of Education, Psychology, Communication, University of Bari, 70121 Bari, Italy;
| | - Tania Meoni
- CRED Della Zona Educativa Pisana, 56121 Pisa, Italy; (T.M.); (T.T.)
| | - Marina Papini
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry Pisa, 56018 Calambrone, Italy; (M.C.); (P.B.); (M.P.); (C.V.); (P.M.)
| | - Tania Terlizzi
- CRED Della Zona Educativa Pisana, 56121 Pisa, Italy; (T.M.); (T.T.)
| | - Chiara Vernucci
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry Pisa, 56018 Calambrone, Italy; (M.C.); (P.B.); (M.P.); (C.V.); (P.M.)
| | - Chiara Pecini
- Department of Education, Language, Interculture and Psychology, University of Florence, 50121 Florence, Italy;
| | - Pietro Muratori
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry Pisa, 56018 Calambrone, Italy; (M.C.); (P.B.); (M.P.); (C.V.); (P.M.)
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23
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Cristofani C, Sesso G, Cristofani P, Fantozzi P, Inguaggiato E, Muratori P, Narzisi A, Pfanner C, Pisano S, Polidori L, Ruglioni L, Valente E, Masi G, Milone A. The Role of Executive Functions in the Development of Empathy and Its Association with Externalizing Behaviors in Children with Neurodevelopmental Disorders and Other Psychiatric Comorbidities. Brain Sci 2020; 10:E489. [PMID: 32731515 PMCID: PMC7465618 DOI: 10.3390/brainsci10080489] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 07/21/2020] [Accepted: 07/21/2020] [Indexed: 12/14/2022] Open
Abstract
Executive functions have been previously shown to correlate with empathic attitudes and prosocial behaviors. People with higher levels of executive functions, as a whole, may better regulate their emotions and reduce perceived distress during the empathetic processes. Our goal was to explore the relationship between empathy and executive functioning in a sample of children and adolescents diagnosed with Attention Deficit and Hyperactivity Disorder alone or associated with comorbid Disruptive Behavior Disorders and/or Autism Spectrum Disorder. We also aimed to examine the role of empathic dimensions and executive skills in regulating externalizing behaviors. The 151 participants with ADHD were assigned to four groups according to their psychiatric comorbidity (either "pure" or with ASD and/or ODD/CD) and assessed by means of either parent- or self-reported questionnaires, namely the BRIEF-2, the BES, and the IRI. No questionnaire was found to discriminate between the four groups. Affective Empathy was found to positively correlate with Emotional and Behavioral Regulation competences. Furthermore, Aggressiveness and Oppositional Defiant Problems were positively associated with Executive Emotional and Behavioral Regulation competences. On the other hand, Rule-Breaking Behaviors and Conduct Problems were negatively associated with Affective Empathy and with Behavioral skills. Our study provides an additional contribution for a better understanding of the complex relationship between empathic competence and executive functions, showing that executive functioning and empathic attitudes interact with each other to regulate aggressive behaviors. This study further corroborates developmental models of empathy and their clinical implications, for which externalizing behaviors could be attenuated by enhancing executive functioning skills.
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Affiliation(s)
- Chiara Cristofani
- IRCCS Stella Maris Foundation, 56128 Pisa (Calambrone), Italy; (C.C.); (G.S.); (P.C.); (P.F.); (E.I.); (P.M.); (A.N.); (C.P.); (L.P.); (L.R.); (E.V.); (G.M.)
| | - Gianluca Sesso
- IRCCS Stella Maris Foundation, 56128 Pisa (Calambrone), Italy; (C.C.); (G.S.); (P.C.); (P.F.); (E.I.); (P.M.); (A.N.); (C.P.); (L.P.); (L.R.); (E.V.); (G.M.)
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Paola Cristofani
- IRCCS Stella Maris Foundation, 56128 Pisa (Calambrone), Italy; (C.C.); (G.S.); (P.C.); (P.F.); (E.I.); (P.M.); (A.N.); (C.P.); (L.P.); (L.R.); (E.V.); (G.M.)
| | - Pamela Fantozzi
- IRCCS Stella Maris Foundation, 56128 Pisa (Calambrone), Italy; (C.C.); (G.S.); (P.C.); (P.F.); (E.I.); (P.M.); (A.N.); (C.P.); (L.P.); (L.R.); (E.V.); (G.M.)
| | - Emanuela Inguaggiato
- IRCCS Stella Maris Foundation, 56128 Pisa (Calambrone), Italy; (C.C.); (G.S.); (P.C.); (P.F.); (E.I.); (P.M.); (A.N.); (C.P.); (L.P.); (L.R.); (E.V.); (G.M.)
| | - Pietro Muratori
- IRCCS Stella Maris Foundation, 56128 Pisa (Calambrone), Italy; (C.C.); (G.S.); (P.C.); (P.F.); (E.I.); (P.M.); (A.N.); (C.P.); (L.P.); (L.R.); (E.V.); (G.M.)
| | - Antonio Narzisi
- IRCCS Stella Maris Foundation, 56128 Pisa (Calambrone), Italy; (C.C.); (G.S.); (P.C.); (P.F.); (E.I.); (P.M.); (A.N.); (C.P.); (L.P.); (L.R.); (E.V.); (G.M.)
| | - Chiara Pfanner
- IRCCS Stella Maris Foundation, 56128 Pisa (Calambrone), Italy; (C.C.); (G.S.); (P.C.); (P.F.); (E.I.); (P.M.); (A.N.); (C.P.); (L.P.); (L.R.); (E.V.); (G.M.)
| | - Simone Pisano
- Department of Neuroscience, AORN Santobono-Pausilipon, 80122 Naples, Italy;
- Department of Translational Medical Sciences, Federico II University, 80138 Naples, Italy
| | - Lisa Polidori
- IRCCS Stella Maris Foundation, 56128 Pisa (Calambrone), Italy; (C.C.); (G.S.); (P.C.); (P.F.); (E.I.); (P.M.); (A.N.); (C.P.); (L.P.); (L.R.); (E.V.); (G.M.)
| | - Laura Ruglioni
- IRCCS Stella Maris Foundation, 56128 Pisa (Calambrone), Italy; (C.C.); (G.S.); (P.C.); (P.F.); (E.I.); (P.M.); (A.N.); (C.P.); (L.P.); (L.R.); (E.V.); (G.M.)
| | - Elena Valente
- IRCCS Stella Maris Foundation, 56128 Pisa (Calambrone), Italy; (C.C.); (G.S.); (P.C.); (P.F.); (E.I.); (P.M.); (A.N.); (C.P.); (L.P.); (L.R.); (E.V.); (G.M.)
| | - Gabriele Masi
- IRCCS Stella Maris Foundation, 56128 Pisa (Calambrone), Italy; (C.C.); (G.S.); (P.C.); (P.F.); (E.I.); (P.M.); (A.N.); (C.P.); (L.P.); (L.R.); (E.V.); (G.M.)
| | - Annarita Milone
- IRCCS Stella Maris Foundation, 56128 Pisa (Calambrone), Italy; (C.C.); (G.S.); (P.C.); (P.F.); (E.I.); (P.M.); (A.N.); (C.P.); (L.P.); (L.R.); (E.V.); (G.M.)
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24
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Owen C. Obscure Dichotomy of Early Childhood Trauma in PTSD Versus Attachment Disorders. TRAUMA, VIOLENCE & ABUSE 2020; 21:83-96. [PMID: 29334032 DOI: 10.1177/1524838017742386] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
There are two competing schools of thoughts involving children who have experienced early childhood trauma. One posture's nosology focuses on the post-traumatic stress responses; the other focuses on the deviant behaviors that ensue from pathogenic care in early childhood. This author sought to review the literature from a holistic perspective, embracing both diagnostic positions. Seventy-three articles addressing childhood trauma and the ensuing emotional or behavioral disturbances were evaluated, mostly empirical-including 16 that specified posttraumatic stress disorder (PTSD), 21 that specified attachment disorders, and 37 that included potential overlaps between both trauma derivatives. An additional 138 studies were reviewed but not included herein because those focused on broader issues. Statistical data, financial and emotional impacts, and the effects of disrupted attachments were addressed-including both children with secure attachments and those with compromised attachments. The critical effect of both positive and negative parental responses was evaluated, as well as correlations or overlaps in the diagnostic criteria and symptom manifestations of the children and any apparent gaps in the current research. The literature details that the prognosis and course of treatment vary significantly between the two etiologies-apparently at least in part due to possible clinician bias in conceptualizations of the two populations. There are clear overlaps in the diagnostic criteria that strongly suggest comorbidity between the disorders, however, which is especially critical to analyze in the future, since there are solid, empirical, evidence-based treatment protocols for PTSD, but not for attachment disorders resulting from pathogenic caregiver maltreatment.
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Affiliation(s)
- Christy Owen
- Liberty University, Lynchburg, VA, USA
- Respite Retreat, Blairsville, GA, USA
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25
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Flom M, White D, Ganiban J, Saudino KJ. Longitudinal Links Between Callous-Unemotional Behaviors and Parenting in Early Childhood: A Genetically Informed Design. J Am Acad Child Adolesc Psychiatry 2019; 59:401-409.e2. [PMID: 30877055 PMCID: PMC6744356 DOI: 10.1016/j.jaac.2019.03.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 01/21/2019] [Accepted: 03/06/2019] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Most research on callous-unemotional behaviors (CU) and parenting does not focus on directions of effect, and work that does so has not been genetically informed. The present study is the first to examine potential reciprocal effects between parenting and CU in a community sample of early childhood. Use of a twin sample also allows us to distinguish child-based genetic effects from environmentally driven effects, which is necessary before translating this research to interventions. METHOD The present study used biometric cross-lagged models to investigate the relation between CU and parenting in twins at 2 and 3 years of age (monozygotic = 145, dizygotic = 169 twin pairs). CU was assessed using the parent-reported Child Behavior Checklist 1.5-5. Scores were residualized to control for conduct problems assessed on the Revised Rutter Parent Scale for Preschool Children. Parents' reports of negative and positive parenting were obtained using parent ratings of discipline and parent feelings from the Parent Feelings Questionnaire. RESULTS CU and negative parenting were significantly correlated at both ages. Cross-lagged analyses revealed a unidirectional effect with CU at age 2 years predicting negative parenting at age 3 years. These child-driven effects were primarily genetically mediated, although there were modest nonshared environmental contributions. CU and positive parenting were not consistently correlated, and further biometric analyses were not performed. CONCLUSION Children's genetically influenced CU behaviors can have an impact on the parenting that they experience. Child-driven CU effects, although less examined in the literature, are important and should receive more attention in future work.
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Affiliation(s)
| | - Dorothy White
- Department of Psychology, George Washington University, Washington, DC 20052
| | - Jody Ganiban
- Department of Psychology, George Washington University, Washington, DC 20052
| | - Kimberly J. Saudino
- Department of Psychological and Brain Sciences, Boston University, Boston, MA 02215
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26
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Pisano S, Muratori P, Gorga C, Levantini V, Iuliano R, Catone G, Coppola G, Milone A, Masi G. Conduct disorders and psychopathy in children and adolescents: aetiology, clinical presentation and treatment strategies of callous-unemotional traits. Ital J Pediatr 2017; 43:84. [PMID: 28931400 PMCID: PMC5607565 DOI: 10.1186/s13052-017-0404-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Accepted: 09/12/2017] [Indexed: 12/14/2022] Open
Abstract
Conduct Disorder (CD) is a psychiatric diagnosis characterized by a repetitive and persistent pattern of behaviour in which the basic rights of others and major age-appropriate social norms or rules are violated. Callous Unemotional (CU) traits are a meaningful specifier in subtyping CD for more severe antisocial and aggressive behaviours in adult psychopathology; they represent the affective dimension of adult psychopathy, but they can be also detected in childhood and adolescence. The CU traits include lack of empathy, sense of guilt and shallow emotion, and their characterization in youth can improve our diagnostic, prognostic and therapeutic abilities. A strong genetic liability, in interaction with parenting and relevant environmental factors, can lead to elevated levels of CU traits in children. We pointed out that CU traits can be detected in early childhood, may remain stable along the adolescence, but a decrease following intensive and specialized treatment is possible. We here provide a narrative review of the available evidences on CU traits in three main domains: aetiology (encompassing genetic liability and environmental risk factors), presentation (early signs and longitudinal trajectories) and treatments.
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Affiliation(s)
- Simone Pisano
- Department of Medicine and Surgery, Clinic of Child and Adolescent Neuropsychiatry, University of Salerno, Baronissi, SA, Italy
| | - Pietro Muratori
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy
| | - Chiara Gorga
- Department of Mental and Physical Health and Preventive Medicine, Child and Adolescent Psychiatry Division, University of Studies of Campania "Luigi Vanvitelli", Naples, Italy
| | - Valentina Levantini
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy
| | | | - Gennaro Catone
- Department of Mental and Physical Health and Preventive Medicine, Child and Adolescent Psychiatry Division, University of Studies of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giangennaro Coppola
- Department of Medicine and Surgery, Clinic of Child and Adolescent Neuropsychiatry, University of Salerno, Baronissi, SA, Italy
| | - Annarita Milone
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy
| | - Gabriele Masi
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy
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27
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Kennedy EMM, French L, Roberts C. Personalised interventions for subgroups of children with conduct problems. Hippokratia 2017. [DOI: 10.1002/14651858.cd012746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Eilis M M Kennedy
- Tavistock Clinic; Children, Young Adults and Families Department; 120 Belsize Lane Hampstead London UK NW3 5BA
- University College London; Research Department of Clinical, Educational and Health Psychology; London UK
| | - Lorna French
- Tavistock Clinic; Children, Young Adults and Families Department; 120 Belsize Lane Hampstead London UK NW3 5BA
| | - Christopher Roberts
- University of Manchester; Division of Population Health; Jean McFarlane Building Oxford Road Manchester UK M3 9PL
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28
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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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