Emotion Recognition Deficits among Children with Conduct Problems and Callous-Unemotional Behaviors

Unique versus shared neural correlates of externalizing psychopathology in late childhood

Childhood externalizing psychopathology is heterogeneous. Symptom variability in conduct disorder (CD), oppositional defiant disorder (ODD), attention-deficit/hyperactivity disorder (ADHD), and callous-unemotional (CU) traits designate different subgroups of children with externalizing problems who have specific treatment needs. However, CD, ODD, ADHD, and CU traits are highly comorbid. Studies need to generate insights into shared versus unique risk mechanisms, including through the use of functional magnetic resonance imaging (fMRI). In this study, we tested whether symptoms of CD, ODD, ADHD, and CU traits were best represented within a bifactor framework, simultaneously modeling shared (i.e., general externalizing problems) and unique (i.e., symptom-specific) variance, or through a four-correlated factor or second-order factor model. Participants (N = 11,878, age, M = 9 years) were from the Adolescent Brain and Cognitive Development Study. We used questionnaire and functional magnetic resonance imaging data (emotional N-back task) from the baseline assessment. A bifactor model specifying a general externalizing and specific CD, ODD, ADHD, and CU traits factors demonstrated the best fit. The four-correlated and second-order factor models both fit the data well and were retained for analyses. Across models, reduced right amygdala activity to fearful faces was associated with more general externalizing problems and reduced dorsolateral prefrontal cortex activity to fearful faces was associated with higher CU traits. ADHD scores were related to greater right nucleus accumbens activation to fearful and happy faces. Results give insights into risk mechanisms underlying comorbidity and heterogeneity within externalizing psychopathology. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Callous-unemotional behaviors and conduct problems in Chinese preschoolers: the moderating roles of surgency and gender

Introduction

Conduct problems in children are related to callous-unemotional (CU) behaviors. However, results of the relationships between CU behaviors and conduct problems among preschoolers mainly focused on Western countries, no studies have examined whether CU behaviors predict conduct problem in Chinese preschoolers. The primary objective of the current study therefore was to examine the associations between CU behaviors and conduct problems as well as the moderating effects of surgency and child gender in Chinese preschool children.

Methods

The present study randomly selected 2,154 children (1,043 boys, Mage = 56 months, SD = 10.47) from six kindergartens in Shanghai, People's Republic of China. Mothers rated children's surgency and teachers reported children's CU behaviors and conduct problems.

Results

Results demonstrated that CU behaviors were positively associated with conduct problems. Surgency and child gender significantly moderated these associations. Specifically, CU behaviors were positively associated with conduct problems, with a stronger effect found for high levels of surgency. CU behaviors had a positive association with conduct problems, with a stronger effect found for boys.

Discussion

This study indicate that temperament and gender characteristics influence conduct problems in preschoolers who exhibit high levels of CU behaviors. As well, the findings emphasize the significance of considering the meaning and implication of CU behaviors in Chinese culture.

Emotion Recognition Deficits in Children and Adolescents with Psychopathic Traits: A Systematic Review

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.

Parasympathetic Nervous System Functioning Moderates the Associations between Callous-Unemotional Traits and Emotion Understanding Difficulties in Late Childhood

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.

Machine learning classification of conduct disorder with high versus low levels of callous-unemotional traits based on facial emotion recognition abilities

Conduct disorder (CD) with high levels of callous-unemotional traits (CD/HCU) has been theoretically linked to specific difficulties with fear and sadness recognition, in contrast to CD with low levels of callous-unemotional traits (CD/LCU). However, experimental evidence for this distinction is mixed, and it is unclear whether these difficulties are a reliable marker of CD/HCU compared to CD/LCU. In a large sample (N = 1263, 9-18 years), we combined univariate analyses and machine learning classifiers to investigate whether CD/HCU is associated with disproportionate difficulties with fear and sadness recognition over other emotions, and whether such difficulties are a reliable individual-level marker of CD/HCU. We observed similar emotion recognition abilities in CD/HCU and CD/LCU. The CD/HCU group underperformed relative to typically developing (TD) youths, but difficulties were not specific to fear or sadness. Classifiers did not distinguish between youths with CD/HCU versus CD/LCU (52% accuracy), although youths with CD/HCU and CD/LCU were reliably distinguished from TD youths (64% and 60%, respectively). In the subset of classifiers that performed well for youths with CD/HCU, fear and sadness were the most relevant emotions for distinguishing them from youths with CD/LCU and TD youths, respectively. We conclude that non-specific emotion recognition difficulties are common in CD/HCU, but are not reliable individual-level markers of CD/HCU versus CD/LCU. These findings highlight that a reduced ability to recognise facial expressions of distress should not be assumed to be a core feature of CD/HCU.

Callous-unemotional Traits and Emotion Recognition Difficulties: Do Stimulus Characteristics Play a role?

Emotion recognition difficulties are linked to callous-unemotional (CU) traits, which predict risk for severe antisocial behavior. However, few studies have investigated how stimulus characteristics influence emotion recognition performance, which could give insight into the mechanisms underpinning CU traits. To address this knowledge gap, children aged 7-10 years old (N = 45; 53% female, 47% male; 46.3% Black/African-American, 25.9% White, 16.7% Mixed race or Other, 9.3% Asian) completed an emotion recognition task featuring static facial stimuli from child and adult models and facial and full-body dynamic stimuli from adult models. Parents reported on CU traits of children in the sample. Children showed better emotion recognition for dynamic than static faces. Higher CU traits were associated with worse emotion recognition, particularly for sad and neutral expressions. Stimulus characteristics did not impact associations between CU traits and emotion recognition.

Moral reasoning, emotion understanding, and callous-unemotional traits in early-to-middle childhood

Relatively little is known about features of moral reasoning among young children with callous-unemotional (CU) traits (e.g., lack of guilt and empathy). This study tested associations between CU traits and emotion attributions (i.e., identification of others' emotional states) and justifications (i.e., explanations for those emotional states), across social scenarios involving discreet versus salient distress cues. The participants were boys aged 6-to-10 years (N = 50; Mage  = 7 years 7 months), who were interviewed about 12 hypothetical scenarios (eight with discreet and four with salient distress cues). Regression models indicated that CU traits, in interaction with high levels of antisocial behaviour, were associated with reduced emotion attributions of fear in discreet but not salient immoral scenarios. Higher CU traits were also associated with reduced justifications referencing others' welfare in discreet scenarios, and increased references to action-orientated justifications in salient scenarios. These findings suggest that CU traits are associated with early moral reasoning impairments and that salience of distress may be important to these processes.

Attachment quality assessed from children's family drawings links to child conduct problems and callous-unemotional behaviors

OBJECTIVE

Recently, there has been considerable research on the origins of childhood conduct problems (CP) and callous-unemotional (CU) behaviors. This study examined associations between children's attachment representations and CP and CU behaviors during middle childhood.

METHOD

At 1st grade, 1,292 children (57% European American, 42.5% African American, 0.5% other race; 50.9% girls) completed a drawing of their family, which was coded by trained raters to assess attachment representations. Primary caregivers reported on children's CP and CU behaviors.

RESULTS

Children with disorganized representations showed more CP and CU behaviors than children with secure and resistant representations. They were also more likely than those with secure representations to show elevated CP without CU behaviors, CU behaviors only, and co-occurring CP and CU behaviors.

CONCLUSION

These findings provide support for attachment disorganization as a correlate of CP and CU behaviors and suggest that attachment representations are likely important proximal influences on children's behavior.

Facial emotion recognition in children with externalising behaviours: A systematic review

Difficulties in facial emotion recognition (FER) are associated with a range of mental health and antisocial presentations in adolescents and adults. Externalising behaviours in children are often one of the earliest signs of risk for the development of such difficulties. This article systematically reviews the evidence (from both group and correlational studies) for whether there is a relationship between FER and externalising behaviours in pre-adolescent children (aged 12 and under), both across and within externalising behaviour domains (hyperactivity, conduct problems, callous-unemotional traits, and aggression). Four electronic databases were searched producing 1,296 articles. Articles were included if they used validated measures of FER and externalising behaviours. Sixteen articles met criteria for inclusion in the review. Overall, the results suggested FER problems are present in ADHD, CP and callous-unemotional presentations, and in samples of children with higher levels of externalising problems rather than in community samples. However, there was no consistent evidence for specific emotions being implicated in the studies reviewed. Clinically, the findings suggest that FER difficulties are commonly associated with externalising behaviours, and hence this review offers some support that FER deficits could be a relevant target of intervention for externalising behaviours. However, more longitudinal studies are required, that control for other variables that might underlie FER difficulties (e.g. IQ or basic Theory of Mind abilities), to inform our knowledge of whether FER difficulties are a causal factor in externalising behaviours.

Antisocial behaviour and teacher-student relationship quality: The role of emotion-related abilities and callous-unemotional traits

BACKGROUND

Childhood antisocial behaviour has been associated with poorer teacher-student relationship (TSR) quality. It is also well-established that youth with antisocial behaviour have a range of emotion-related deficits, yet the impact of these students' emotion-related abilities on the TSR is not understood. Furthermore, the addition of the Limited Prosocial Emotions Specifier in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) indicates that understanding the role of callous-unemotional (CU) traits for youth with antisocial behaviour problems is of particular importance.

AIMS

The aim of this study was to investigate the association between antisocial behaviour difficulties and the TSR by examining the influence of emotion-related abilities and CU traits.

SAMPLE

Twelve teachers from 10 primary schools provided anonymized information on 108 children aged 6-11 years.

RESULTS

Antisocial behaviour was associated with higher teacher-student conflict (but not closeness) as well as higher emotion lability/negativity and lower emotion understanding/empathy. Emotion lability/negativity was associated with higher teacher-student conflict (but not closeness), and emotion understanding/empathy was associated with lower teacher-student conflict and higher closeness. CU traits were associated with higher teacher-student conflict and lower teacher-student closeness (controlling for antisocial behaviour more broadly). We found no evidence of a moderating effect of CU traits or emotion-related abilities on the association between antisocial behaviour and TSR quality.

CONCLUSIONS

Interventions for behaviour difficulties should consider teacher-student relationships in the classroom. Strategies which aim to improve teacher-student closeness as well as reduce teacher-student conflict may be of particular value to students with high CU traits.

Associations Between Callous-Unemotional Traits and Peer-Rated Social-Behavioral Outcomes in Elementary and Middle School

There is strong evidence that peers are of central importance to children's and adolescents' social and emotional adaptation and success in school. However, it remains an open question as to whether callous-unemotional (CU) traits, or interpersonal and affective deficits that pose risk for antisocial behaviors and psychopathy, are related to social-behavioral outcomes as assessed by those who are believed to have the most accurate perspectives on such outcomes - young adolescents' peers. Using data from a longitudinal and multi-method study of peer relations (N = 379, % female = 51.90, M_age = 10.24 at Time 1), the current study addressed this gap by examining the links between teacher-reports of CU traits and conduct problems (CP) and peer-reports of the extent to which young adolescents are aggressive, victimized, excluded, prosocial, and sociable during the Fall and Spring semesters in Grade 5 (Times 1and 2) and Grade 6 (Times 3 and 4). Results revealed that teacher-rated CP, but not CU traits, was associated positively with peer-reports of aggression. CU traits, but not CP, was associated positively with victimization/exclusion and associated negatively with prosociality. CU traits and CP demonstrated opposite relations with sociability, with CU traits demonstrating a negative association. Findings are discussed in the context of the broader literature examining the social-behavioral correlates of CU traits.

Facial emotion perception and social competence in children (8 to 16 years old) with genetic generalized epilepsy and temporal lobe epilepsy

Facial emotion perception (FEP) impairments are common in adults with epilepsy and associated with impaired psychosocial functioning. Research into the presence of FEP deficits in children with epilepsy and the functional implications of these deficits is limited. The primary aims of this study were to assess FEP abilities in children (8 to 16 years old) with genetic generalized epilepsy (GGE) and temporal lobe epilepsy (TLE) and examine whether FEP is related to everyday social functioning. Forty-four children (8 to 16 years) with epilepsy (22 GGE, 22 TLE) and 22 typically developing controls completed the Pictures of Facial Affect (POFA) battery to assess FEP and a brief test of intellectual functioning (intelligence quotient [IQ]). Parents completed questionnaires assessing social competence of their child. Neurologists completed the Global Assessment of Severity of Epilepsy (GASE) scale as a measure of overall epilepsy severity. Demographic and clinical information was obtained from medical records and clinical interviews with parents. Findings revealed significant, overall FEP impairments and reduced social competence in children with GGE and TLE compared to controls. The magnitude of FEP impairment (i.e., across all emotions) was comparable in the two epilepsy groups, yet different emotions were impaired in each group: children with GGE were impaired in recognizing anger and disgust, whereas children with TLE were impaired in sadness and disgust, compared to controls. Contrary to expectations, total FEP accuracy was not significantly correlated with social competence in either epilepsy group. In conclusion, children with GGE and TLE have significant impairments recognizing emotional expressions on faces. Further research is needed to examine whether underlying FEP impairments relate to social and emotional functioning in children with epilepsy.