Early Identification and Treatment of Antisocial Behavior

Selective Amygdala Hypoactivity to Fear in Boys With Persistent Conduct Problems After Parent Training

BACKGROUND

Parenting interventions reduce antisocial behavior (ASB) in some children with conduct problems (CPs), but not others. Understanding the neural basis for this disparity is important because persistent ASB is associated with lifelong morbidity and places a huge burden on our health and criminal justice systems. One of the most highly replicated neural correlates of ASB is amygdala hypoactivity to another person's fear. We aimed to assess whether amygdala hypoactivity to fear in children with CPs is remediated following reduction in ASB after successful treatment and/or if it is a marker for persistent ASB.

METHODS

We conducted a prospective, case-control study of boys with CPs and typically developing (TD) boys. Both groups (ages 5-10 years) completed 2 magnetic resonance imaging sessions (18 ± 5.8 weeks apart) with ASB assessed at each visit. Participants included boys with CPs following referral to a parenting intervention group and TD boys recruited from the same schools and geographical regions. Final functional magnetic resonance imaging data were available for 36 TD boys and 57 boys with CPs. Boys with CPs were divided into those whose ASB improved (n = 27) or persisted (n = 30) following the intervention. Functional magnetic resonance imaging data assessing fear reactivity were then analyzed using a longitudinal group (TD/improving CPs/persistent CPs) × time point (pre/post) design.

RESULTS

Amygdala hypoactivity to fear was observed only in boys with CPs who had persistent ASB and was absent in those whose ASB improved following intervention.

CONCLUSIONS

Our findings suggest that amygdala hypoactivity to fear is a marker for ASB that is resistant to change following a parenting intervention and a putative target for future treatments.

Dysfunctional personality, Dark Triad and moral disengagement in incarcerated offenders: implications for recidivism and violence

It is particularly important to study the underlying processes of the dysfunctional personality patterns and of antisocial behaviour in the prison population, to identify them and to analyse the functioning of the psychological mechanisms involved in these constructs. The main goal of this study was to analyse dysfunctional personality patterns, Dark Triad, moral disengagement mechanisms and their relationship with violence and recidivism. Participants were 63 incarcerated offenders in two prisons. The study found a higher degree of moral disengagement in the participants convicted for crimes involving the use of violence. The results indicated that antisocial and aggressive-sadistic tendencies were the dysfunctional personality traits most strongly associated with moral disengagement. The binary logistic regression analysis showed that the variables, which influenced recidivism in criminal behaviour, were the use of violence in the crime committed, antisocial personality traits, and advantageous comparison and dehumanisation as mechanisms of moral disengagement.

The association between toddlerhood empathy deficits and antisocial personality disorder symptoms and psychopathy in adulthood

The present study examined empathy deficits in toddlerhood (age 14 to 36 months) as predictors of antisocial personality disorder (ASPD) symptoms and psychopathy measured by the Levenson Self-Report Psychopathy scale (Levenson, Kiehl, & Fitzpatrick, 1995) in adulthood (age 23 years) in 956 individuals from the Colorado Longitudinal Twin Study. Consistent with the hypothesis that antisocial behavior is associated with "active" rather than "passive" empathy deficits, early disregard for others, not lack of concern for others, predicted later ASPD symptoms. Early disregard for others was also significantly associated with factor 1 of the Levenson Self-Report Psychopathy Scale, which includes items assessing interpersonal and affective deficits, but not with factor 2, which includes items assessing impulsivity and poor behavioral control. The association between early disregard for others and psychopathy factor 2 was near zero after controlling for the shared variance between psychopathy factors 1 and 2. These results suggest that there is a propensity toward adulthood ASPD symptoms and psychopathy factor 1 that can be assessed early in development, which may help identify individuals most at risk for stable antisocial outcomes.

Neurocognitive predictors of treatment completion and daytime activities at follow-up in multiproblem young adults

Previous research has shown an association between cognitive control deficits and problematic behavior such as antisocial behavior and substance use, but little is known about the predictive value of cognitive control for treatment outcome. The current study tests whether selected markers of baseline cognitive control predict (1) treatment completion of a day treatment program involving a combination of approaches for multiproblem young adults and (2) daytime activities a year after the start of treatment, over and above psychological, social, and criminal characteristics. We assessed individual, neurobiological, and neurobehavioral measures, including functional brain activity during an inhibition task and two electroencephalographic measures of error processing in 127 male multiproblem young adults (age 18-27 years). We performed two hierarchical regression models to test the predictive power of cognitive control for treatment completion and daytime activities at follow-up. The overall models did not significantly predict treatment completion or daytime activities at follow-up. However, activity in the anterior cingulate cortex (ACC) during response inhibition, years of regular alcohol use, internalizing problems, and ethnicity were all significant individual predictors of daytime activity at follow-up. In conclusion, cognitive control could not predict treatment completion or daytime activities a year after the start of treatment over and above individual characteristics. However, results indicate a direct association between brain activity during response inhibition and participation in daytime activities, such as work or school, after treatment. As adequate baseline inhibitory control is associated with a positive outcome at follow-up, this suggests interventions targeting cognitive control might result in better outcomes at follow-up.

Developmental joint trajectories of anxiety-depressive trait and trait-aggression: implications for co-occurrence of internalizing and externalizing problems

BACKGROUND

In youth, anxiety-depressive traits (ADT) and trait-aggression (TA) are important risk factors of exhibiting maladaptive behaviors in adulthood (i.e. violence and substance use). However, the developmental co-occurrence of these traits in youth remains unknown. We thus sought to investigate the developmental trajectories of ADT and TA within a data-driven approach. The aim was two-fold: (i) to examine the developmental trajectories of ADT and TA in youth from ages 10 to 16, and (ii) to investigate both childhood predictors and problematic outcomes of the identified joint trajectories.

METHOD

The sample comprised 1354 children provided from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) Consortium. Group-based trajectory modeling was first employed to identify individual trajectory models of ADT and TA independently (from ages 10 to 16). Then, joint trajectory models were built on the found trajectories. Last, logistic regressions were used to evaluate the childhood characteristics and negative outcomes of the joint trajectory groups.

RESULTS

Our results showed five trajectory groups with varying levels of ADT and TA. A significant co-occurrence between ADT and TA was found in three of the trajectory groups. Notably, higher levels of childhood psychopathology and more severe/frequent childhood abuse were found in the groups with moderate to high ADT and high TA. The groups with higher ADT and high TA were also more likely to exhibit violence and substance use.

CONCLUSIONS

This study exposes the importance of assessing ADT and TA simultaneously and early in childhood to prevent and manage the risk of problematic behaviors in adolescence.

Effects of parental empathy and emotion regulation on social competence and emotional/behavioral problems of school-age children

IMPORTANCE

Parents take the lead in parent-child interactions and their emotion regulation ability and empathy during parenting may be associated with children's emotional/behavioral problems. However, the specific mechanisms underlying these associations remain unclear.

OBJECTIVE

The present study aimed to explore the effect of parental empathy and emotional regulation on social competence and emotional/behavioral problems in school-age children.

METHODS

A questionnaire-based survey was conducted with 274 parents of 8-11-year-old children using Achenbach's Child Behavior Checklist, the Emotion Regulation Questionnaire, and the Questionnaire of Cognitive and Affective Empathy.

RESULTS

Children with emotional/behavioral problems (n = 37) had relatively lower social competence than children in a matched control group (n = 37). Compared with the parents of children in the control group, parents of children with emotional/behavioral problems had significantly lower cognitive empathy scores, mainly manifested by low perspective-taking and online simulation abilities. Mediation analysis showed that parental cognitive empathy had an indirect effect on children's emotional/behavioral problems through children's social competence.

INTERPRETATION

Parental empathy may have a subtle influence on the social competence of school-aged children, which further affects the severity of children's emotional/behavioral problems.

Behavior Disorders: knowledge and actions of health professionals and social work

OBJECTIVE

to identify the knowledge of professionals of mental health services and social work on Behavior Disorders (BD) in childhood and adolescence, and to analyze their actions in care for children and adolescents with such disorders.

METHOD

a qualitative, descriptive-exploratory study with 13 professionals from two mental health services and two tutorial councils. The data were collected in interviews and submitted to thematic content analysis.

RESULTS

three categories emerged from the interviews: "Knowledge about behavior disorders", which defines BD as deviations from normality and lack of limits. "Integrated and group care", which explains the integrated, multidisciplinary and group actions. "Specialized and legal care", which explains the actions through specialized, medical and judicial care.

FINAL CONSIDERATIONS

the results point out weaknesses and knowledge gaps of professionals, causing potential harm in the programming of effective actions, such as identification, referral and therapeutic planning.

Antisocial personality and risks of cause-specific mortality: results from the Epidemiologic Catchment Area study with 27 years of follow-up

PURPOSE

Little is known about the effect of antisocial personality disorder (ASPD) on the risks of cause-specific mortality in the community. This study aimed to close this gap by evaluating if ASPD increases risks of cause-specific mortality in population-based residential and institutionalized samples with 27 years of follow-up.

METHODS

Data were collected in four metropolitan sites as part of the Epidemiologic Catchment Area (ECA) study during 1979-1983. Records were linked to the National Death Index through the end of 2007. Cox proportional hazards models adjusted for propensity weights and sample weights were fitted to estimate the effect of ASPD on the hazard of dying.

RESULTS

420 respondents with ASPD (median survival age 71.0 years) and 15,367 without ASPD (median survival age 84.6 years) were included in this study. Those with ASPD were more likely to die from all causes (HR = 4.46; 95% CI = 2.44-8.16), suicide (HR = 2.81; 95% CI = 1.03-7.65), malignant neoplasms (HR = 4.09; 95% CI = 2.66-6.28), chronic lower respiratory disease (HR = 5.67; 95% CI = 2.92-11.0), and human immunodeficiency virus infection (HR = 8.07; 95% CI = 2.03-32.1), but not from accidents (HR = 0.58; 95% CI = 0.17-1.93) or heart disease (HR = 1.09; 95% CI = 0.43-2.76).

CONCLUSIONS

Our findings demonstrate that antisocial personality disorder is a strong predictor of all-cause mortality, and cause-specific mortality. Early identification, treatment, and prevention of ASPD are important public mental health initiatives that could reduce premature mortality among this vulnerable population.

The Role of Callous-Unemotional Traits on Adolescent Positive and Negative Emotional Reactivity: A Longitudinal Community-Based Study

Callous-unemotional (CU) traits are associated with lower emotional reactivity in adolescents. However, since previous studies have focused mainly on reactivity to negative stimuli, it is unclear whether reactivity to positive stimuli is also affected. Further, few studies have addressed the link between CU traits and emotional reactivity in longitudinal community samples, which is important for determining its generalizability and developmental course. In the current study, pupil dilation and self-ratings of arousal and valence were assessed in 100 adolescents (15-17 years) from a community sample, while viewing images with negative and positive valence from the International Affective Pictures System (IAPS). Behavioral traits (CU) were assessed concurrently, as well as at ages 12-15, and 8-9 (subsample, n = 68, low levels of prosocial behavior were used as a proxy for CU traits). The results demonstrate that CU traits assessed at ages 12-15 and 8-9 predicted less pupil dilation to both positive and negative images at ages 15-17. Further, CU traits at ages 12-15 and concurrently were associated with less negative valence ratings for negative images and concurrently to less positive valence ratings for positive images. The current findings demonstrate that CU traits are related to lower emotional reactivity to both negative and positive stimuli in adolescents from a community sample.

Early maltreatment is associated with greater risk of conduct problems and lack of guilt in adolescence

Previous research indicates a link between childhood maltreatment and elevated conduct problems. Yet the literature is less clear on associations between maltreatment and callousness (e.g., lack of empathy or guilt). This is a critical gap given that callousness is a robust predictor of serious aggressive and violent behavior. We examine the association between substantiated maltreatment events in childhood and adolescence (up to age 13) and conduct problems and lack of guilt at age 14. We analyze self- and parent-report data along with official maltreatment records on 557 youth (50% female; 69% non-white) from a larger dataset (Longitudinal Studies on Childhood Abuse and Neglect; N = 1354). Results of multinomial logistic regression models indicate that youth with histories of substantiated maltreatment events are more likely to have elevated conduct problems and decreased guilt at age 14, particularly if they experienced maltreatment before the age of four years old. Youth who exhibit conduct problems and also appear to lack guilt are more likely to have a personal history of substantiated maltreatment. We discuss our results in terms of their implications for theory and practice.

Evaluation of the Parent-Report Inventory of Callous-Unemotional Traits in a Sample of Children Recruited from Intimate Partner Violence Services: A Multidimensional Rasch Analysis

OBJECTIVE

Our study applied multidimensional item response theory (MIRT) to compare structural models of the parent-report version of the Inventory of Callous and Unemotional Traits (ICU; English and North American Spanish translations).

METHOD

A total of 291 maternal caregivers were recruited from community-based domestic violence services and reported on their children (77.9% ethnic minority; 47% female), who ranged in age from 7 to 12 years (mean = 9.07, standard deviation = 1.64). We compared 9 models that were based on prior psychometric evaluations of the ICU.

RESULTS

MIRT analyses indicated that a revised 18-item version comprising 2 factors (callous-unemotional and empathic-prosocial) was more suitable for our sample. Differential item functioning was found for several items across ethnic and language groups, but not for child gender or age. Evidence of construct validity was found.

CONCLUSION

We recommend continued research and revisions to the ICU to better assess the presence of callous-unemotional traits in community samples of school-age children.

Emotion and personal space: Neural correlates of approach-avoidance tendencies to different facial expressions as a function of coldhearted psychopathic traits

In social interactions, humans are expected to regulate interpersonal distance in response to the emotion displayed by others. Yet, the neural mechanisms implicated in approach-avoidance tendencies to distinct emotional expressions have not been fully described. Here, we investigated the neural systems implicated in regulating the distance to different emotions, and how they vary as a function of empathy. Twenty-three healthy participants assessed for psychopathic traits underwent fMRI scanning while they viewed approaching and withdrawing angry, fearful, happy, sad and neutral faces. Participants were also asked to set the distance to those faces on a computer screen, and to adjust the physical distance from the experimenter outside the scanner. Participants kept the greatest distances from angry faces, and shortest from happy expressions. This was accompanied by increased activation in the dorsomedial prefrontal and orbitofrontal cortices, inferior frontal gyrus, and temporoparietal junction for angry and happy expressions relative to the other emotions. Irrespective of emotion, longer distances were kept from approaching faces, which was associated with increased activation in the amygdala and insula, as well as parietal and prefrontal regions. Amygdala activation was positively correlated with greater preferred distances to angry, fearful and sad expressions. Moreover, participants scoring higher on coldhearted psychopathic traits (lower empathy) showed reduced amygdala activation to sad expressions. These findings elucidate the neural mechanisms underlying social approach-avoidance, and how they are related to variations in empathy. Hum Brain Mapp 38:1492-1506, 2017. © 2016 Wiley Periodicals, Inc.