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Gao Y, Staginnus M. Cortical structure and subcortical volumes in conduct disorder: a coordinated analysis of 15 international cohorts from the ENIGMA-Antisocial Behavior Working Group. Lancet Psychiatry 2024; 11:620-632. [PMID: 39025633 DOI: 10.1016/s2215-0366(24)00187-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 06/03/2024] [Accepted: 06/04/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND Conduct disorder is associated with the highest burden of any mental disorder in childhood, yet its neurobiology remains unclear. Inconsistent findings limit our understanding of the role of brain structure alterations in conduct disorder. This study aims to identify the most robust and replicable brain structural correlates of conduct disorder. METHODS The ENIGMA-Antisocial Behavior Working Group performed a coordinated analysis of structural MRI data from 15 international cohorts. Eligibility criteria were a mean sample age of 18 years or less, with data available on sex, age, and diagnosis of conduct disorder, and at least ten participants with conduct disorder and ten typically developing participants. 3D T1-weighted MRI brain scans of all participants were pre-processed using ENIGMA-standardised protocols. We assessed group differences in cortical thickness, surface area, and subcortical volumes using general linear models, adjusting for age, sex, and total intracranial volume. Group-by-sex and group-by-age interactions, and DSM-subtype comparisons (childhood-onset vs adolescent-onset, and low vs high levels of callous-unemotional traits) were investigated. People with lived experience of conduct disorder were not involved in this study. FINDINGS We collated individual participant data from 1185 young people with conduct disorder (339 [28·6%] female and 846 [71·4%] male) and 1253 typically developing young people (446 [35·6%] female and 807 [64·4%] male), with a mean age of 13·5 years (SD 3·0; range 7-21). Information on race and ethnicity was not available. Relative to typically developing young people, the conduct disorder group had lower surface area in 26 cortical regions and lower total surface area (Cohen's d 0·09-0·26). Cortical thickness differed in the caudal anterior cingulate cortex (d 0·16) and the banks of the superior temporal sulcus (d -0·13). The conduct disorder group also had smaller amygdala (d 0·13), nucleus accumbens (d 0·11), thalamus (d 0·14), and hippocampus (d 0·12) volumes. Most differences remained significant after adjusting for ADHD comorbidity or intelligence quotient. No group-by-sex or group-by-age interactions were detected. Few differences were found between DSM-defined conduct disorder subtypes. However, individuals with high callous-unemotional traits showed more widespread differences compared with controls than those with low callous-unemotional traits. INTERPRETATION Our findings provide robust evidence of subtle yet widespread brain structural alterations in conduct disorder across subtypes and sexes, mostly in surface area. These findings provide further evidence that brain alterations might contribute to conduct disorder. Greater consideration of this under-recognised disorder is needed in research and clinical practice. FUNDING Academy of Medical Sciences and Economic and Social Research Council.
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Affiliation(s)
- Yidian Gao
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
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Ostrosky F, Decety J, Lozano A, Lujan A, Perez M, Munguia A, Castañeda D, Diaz K, Lara R, Sacristan E, Bobes MA, Borja K, Camarena B, Hernández-Muñoz S, Álvarez A, Franco-Bourland RE. [Formula: see text] Can psychopathy be prevented? Clinical, neuroimaging, and genetic data: an exploratory study. Child Neuropsychol 2024; 30:861-881. [PMID: 37947201 DOI: 10.1080/09297049.2023.2277396] [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: 10/25/2023] [Indexed: 11/12/2023]
Abstract
The aim of the study was to explore the relationship among brain functional activations elicited by an emotional paradigm, clinical scores (PTSD, anxiety, and depression), psychopathic traits, and genetic characteristics (5-HTTLPR) in a group of severely maltreated children compared to a healthy control group before and after the implementation of a Trauma Focused-Cognitive Behavioral Therapy. The final sample consisted of an experimental group of 14 maltreated children (mean age = 8.77 years old, S.D. = 1.83) recruited from a non-governmental shelter in Mexico City for children who had experienced child abuse and a control group of 10 children from the general population (mean age = 9.57 years old, S.D. = 1.91). Both groups were matched according to age and gender and were assessed before and after the implementation of the aforementioned therapy by means of clinical scales and an emotional paradigm that elicited brain activations which were recorded through functional magnetic resonance imaging. Genotyping of the 5-HTTLPR polymorphism was made at first assessment. A region of interest analysis showed amygdala hyperactivation during exposure to fear and anger stimuli in the maltreated children before treatment. Following therapy, a decrease in brain activity as well as a decrease in clinical symptoms were also observed. 5-HTTLPR polymorphism did not show any effect on the severity of clinical symptoms in maltreated children. Trauma-Focused Behavioral Therapy may help reorganize the brain's processing of emotional stimuli. These observations reveal the importance of an early intervention when the mechanisms of neuroplasticity may be still recruited.
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Affiliation(s)
- Feggy Ostrosky
- Facultad de Psicología, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Jean Decety
- Department of Psychology, University of Chicago, Chicago, IL, USA
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago Medicine, Chicago, IL, USA
| | - Azucena Lozano
- Facultad de Psicología, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Angélica Lujan
- Facultad de Psicología, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Martha Perez
- Facultad de Psicología, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Ana Munguia
- Facultad de Psicología, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Dianela Castañeda
- Facultad de Psicología, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Karla Diaz
- Facultad de Psicología, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Rafael Lara
- Centro Nacional de Investigación en Imagenología e Instrumentación Médica, Universidad Autónoma Metropolitana, Ciudad de México, México
| | - Emilio Sacristan
- Centro Nacional de Investigación en Imagenología e Instrumentación Médica, Universidad Autónoma Metropolitana, Ciudad de México, México
| | - Maria A Bobes
- Departamento de Neurociencias Cognitivas, Centro de Neurociencias de Cuba, Cubanacan, Cuba
| | - Karina Borja
- Social Brain Lab, Netherlands Institute for Neuroscience, Amsterdam, Netherlands
| | - Beatriz Camarena
- Departamento de Farmacogenética, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México
| | - Sandra Hernández-Muñoz
- Departamento de Farmacogenética, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México
| | - Aurora Álvarez
- Facultad de Psicología, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Rebecca E Franco-Bourland
- Jefa de Servicio, Laboratorio de Bioquímica, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, México
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3
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Guberman GI, Theaud G, Hawes SW, Ptito A, Descoteaux M, Hodgins S. White matter microstructure, traumatic brain injury, and disruptive behavior disorders in girls and boys. Front Neurosci 2024; 18:1391407. [PMID: 39099631 PMCID: PMC11295658 DOI: 10.3389/fnins.2024.1391407] [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: 02/25/2024] [Accepted: 06/11/2024] [Indexed: 08/06/2024] Open
Abstract
Introduction Girls and boys presenting disruptive behavior disorders (DBDs) display differences in white matter microstructure (WMM) relative to typically developing (TD) sex-matched peers. Boys with DBDs are at increased risk for traumatic brain injuries (TBIs), which are also known to impact WMM. This study aimed to disentangle associations of WMM with DBDs and TBIs. Methods The sample included 673 children with DBDs and 836 TD children, aged 9-10, from the Adolescent Brain Cognitive Development Study. Thirteen white matter bundles previously associated with DBDs were the focus of study. Analyses were undertaken separately by sex, adjusting for callous-unemotional traits (CU), attention-deficit hyperactivity disorder (ADHD), age, pubertal stage, IQ, ethnicity, and family income. Results Among children without TBIs, those with DBDs showed sex-specific differences in WMM of several tracts relative to TD. Most differences were associated with ADHD, CU, or both. Greater proportions of girls and boys with DBDs than sex-matched TD children had sustained TBIs. Among girls and boys with DBDs, those who had sustained TBIs compared to those not injured, displayed WMM alterations that were robust to adjustment for all covariates. Across most DBD/TD comparisons, axonal density scores were higher among children presenting DBDs. Discussion In conclusion, in this community sample of children, those with DBDs were more likely to have sustained TBIs that were associated with additional, sex-specific, alterations of WMM. These additional alterations further compromise the future development of children with DBDs.
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Affiliation(s)
- Guido I. Guberman
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Guillaume Theaud
- Department of Computer Science, Sherbrooke University, Sherbrooke, QC, Canada
| | - Samuel W. Hawes
- Department of Psychology, Center for Children and Families, Florida International University, Miami, FL, United States
| | - Alain Ptito
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Maxime Descoteaux
- Department of Computer Science, Sherbrooke University, Sherbrooke, QC, Canada
| | - Sheilagh Hodgins
- Département de Psychiatrie et Addictologie, Université de Montréal, Montreal, QC, Canada
- Centre de Recherche Institut National de Psychiatrie Légale Philippe-Pinel, Montreal, QC, Canada
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Paz Y, All K, Kohli S, Plate RC, Viding E, Waller R. Why Should I? Examining How Childhood Callous-Unemotional Traits Relate to Prosocial and Affiliative Behaviors and Motivations. Res Child Adolesc Psychopathol 2024; 52:1075-1087. [PMID: 38498231 DOI: 10.1007/s10802-024-01170-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2024] [Indexed: 03/20/2024]
Abstract
Childhood callous-unemotional (CU) traits are characterized by low empathy, limited prosocial behavior, and restricted social affiliation. However, few studies have investigated whether CU traits are associated with different subtypes of prosocial and affiliative behavior or the specific motivational difficulties underlying these behaviors. We addressed these questions using data from 135 young children (M = 5.48 years old; 58% female) who viewed depictions of adults or children in instrumental need, emotional need, or neutral situations. We assessed recognition, suggested initiation of, and motivation for prosocial or affiliative behavior in response to each depiction. We distinguished between subtypes of prosocial (instrumental and emotional) and affiliative (parallel, cooperative, associative) behavior, as well as self- versus other-orientated motivations. Parents reported on child CU traits and conduct problems. Overall, children accurately recognized prosocial and neutral situations, offered help, and expressed other-orientated motivations for prosocial behavior and social motivations for affiliative behavior. Higher CU traits were related to lower overall recognition accuracy, which was more pronounced for emotional need. Higher CU traits were also related to fewer offers of help and more denial of prosocial behavior, particularly for instrumental need. Finally, CU traits were related to lower probability of initiating affiliative behavior. CU traits were not differentially related to self- versus other-orientated motivations for prosocial or affiliative behavior. Findings demonstrate difficulties of children with CU traits in recognizing need and offering help. Interventions for CU traits could include modules that explicitly scaffold and shape prosociality and social affiliation.
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Affiliation(s)
- Y Paz
- Department of Psychology, University of Pennsylvania, Stephen A. Levin Building, 425 S University Ave Stephen A. Levin Building, 425 S University Ave, Philadelphia, PA, 19104, US
| | - K All
- Department of Psychology, University of Pennsylvania, Stephen A. Levin Building, 425 S University Ave Stephen A. Levin Building, 425 S University Ave, Philadelphia, PA, 19104, US
| | - S Kohli
- Department of Psychology, University of Pennsylvania, Stephen A. Levin Building, 425 S University Ave Stephen A. Levin Building, 425 S University Ave, Philadelphia, PA, 19104, US
| | - R C Plate
- Department of Psychology, University of Pennsylvania, Stephen A. Levin Building, 425 S University Ave Stephen A. Levin Building, 425 S University Ave, Philadelphia, PA, 19104, US
| | - E Viding
- Division of Psychology and Language Sciences, University College London, London, UK
| | - R Waller
- Department of Psychology, University of Pennsylvania, Stephen A. Levin Building, 425 S University Ave Stephen A. Levin Building, 425 S University Ave, Philadelphia, PA, 19104, US.
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Wang Y, Becker B, Wang J, Wang Y, Zhang L, Mei Y, Li H, Lei Y. Exaggerated sensitivity to threat and reduced medial prefrontal engagement during threat generalization in reactive aggressive adolescents. Neuroimage 2024; 294:120645. [PMID: 38734156 DOI: 10.1016/j.neuroimage.2024.120645] [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: 04/09/2024] [Revised: 05/07/2024] [Accepted: 05/09/2024] [Indexed: 05/13/2024] Open
Abstract
Aggressive adolescents tend to exhibit abnormal fear acquisition and extinction, and reactive aggressive adolescents are often more anxious. However, the relationship between fear generalization and reactive aggression (RA) remains unknown. According to Reactive-Proactive Aggression Questionnaire (RPQ) scores, 61 adolescents were divided into two groups, namely, a high RA group (N = 30) and a low aggression (LA) group (N = 31). All participants underwent three consecutive phases of the Pavlovian conditioning paradigm (i.e., habituation, acquisition, and generalization), and neural activation of the medial prefrontal cortex (mPFC) was assessed by functional near-infrared spectroscopy (fNIRS). The stimuli were ten circles with varying sizes, including two conditioned stimuli (CSs) and eight generalization stimuli (GSs). A scream at 85 dB served as the auditory unconditioned stimulus (US). The US expectancy ratings of both CSs and GSs were higher in the RA group than in the LA group. The fNIRS results showed that CSs and GSs evoked lower mPFC activation in the RA group compared to the LA group during fear generalization. These findings suggest that abnormalities in fear acquisition and generalization are prototypical dysregulations in adolescents with RA. They provide neurocognitive evidence for dysregulated fear learning in the mechanisms underlying adolescents with RA, highlighting the need to develop emotional regulation interventions for these individuals.
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Affiliation(s)
- Yizhen Wang
- School of Psychology, South China Normal University, Guangzhou, Guangdong, China; Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, Sichuan, China
| | - Benjamin Becker
- State Key Laboratory of Brain and Cognitive Sciences, Department of Psychology, The University of Hong Kong, Hong Kong, China
| | - Jinxia Wang
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, Sichuan, China; Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Yuanyuan Wang
- School of Psychology, South China Normal University, Guangzhou, Guangdong, China
| | - Liangyou Zhang
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, Netherlands
| | - Ying Mei
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, Sichuan, China; Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Hong Li
- School of Psychology, South China Normal University, Guangzhou, Guangdong, China; Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, Sichuan, China
| | - Yi Lei
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, Sichuan, China.
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Kemp EC, Ray JV, Frick PJ, Robertson EL, Fanti KA, Essau CA, Baroncelli A, Ciucci E, Bijttebier P. Inventory of Callous-Unemotional Traits (ICU) Factor Structure and Measurement Invariance in an Adolescent Multinational Sample. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024; 53:595-606. [PMID: 36450005 DOI: 10.1080/15374416.2022.2148531] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
OBJECTIVE The Inventory of Callous-Unemotional Traits (ICU) is a widely used, comprehensive measure of callous-unemotional (CU) traits. While the ICU total score is used frequently in research, the scale's factor structure remains highly debated. Inconsistencies in past factor structure research appear to be largely due to the use of small non-representative samples and failure to control for method variance (i.e., item wording direction). METHOD The current study used a multitrait-multimethod (MTMM) confirmatory factor analysis (CFA) approach that considers both trait and method variance to test the factor structure of a 22-item version of the self-report ICU in a multinational community sample of 4,683 adolescents (ages 11-17). RESULTS Results showed that a hierarchical four-factor model (i.e., one overarching CU factor, four latent trait factors) that controlled for method variance (i.e., by allowing residuals from positively worded items to covary) provided the best fit (χ2 = 2797.307, df = 160, RMSEA=.059, CFI=.922, TLI=.888, SRMR=.045). CONCLUSIONS After controlling for method variance, the best-fitting factor structure is consistent with how the ICU was developed and corresponds to the four symptoms of Limited Prosocial Emotions (LPE) specifier in the DSM-5 criteria for Conduct Disorder (CD). In addition, measurement invariance of this factor structure across age (i.e., younger versus older adolescents) and sex was supported. As a result, mean differences in ICU total score across age and sex can be interpreted as reflecting true variations in these traits. Further, we documented that boys generally scored higher than girls on the ICU, and this sex difference was larger in later adolescence.
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Affiliation(s)
- Emily C Kemp
- Department of Psychology, Louisiana State University
| | - James V Ray
- Department of Criminal Justice, University of Central Florida
| | - Paul J Frick
- Department of Psychology, Louisiana State University
- Institute for Learning Sciences and Teacher Education, Australian Catholic University
| | | | | | | | - Andrea Baroncelli
- Department of Philosophy, Social Sciences and Education, University of Perugia
| | - Enrica Ciucci
- Department of Education, Languages, Intercultures, Literatures, and Psychology, University of Florence
| | - Patricia Bijttebier
- School Psychology and Development in Context, KU Leuven
- KU Leuven Child and Youth Institute
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Koerner S, Staginnus M, Cornwell H, Smaragdi A, González-Madruga K, Pauli R, Rogers JC, Gao Y, Chester S, Townend S, Bernhard A, Martinelli A, Kohls G, Raschle NM, Konrad K, Stadler C, Freitag CM, De Brito SA, Fairchild G. Does the Relationship between Age and Brain Structure Differ in Youth with Conduct Disorder? Res Child Adolesc Psychopathol 2024; 52:1135-1146. [PMID: 38557727 PMCID: PMC11217071 DOI: 10.1007/s10802-024-01178-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2024] [Indexed: 04/04/2024]
Abstract
Conduct disorder (CD) is characterised by persistent antisocial and aggressive behaviour and typically emerges in childhood or adolescence. Although several authors have proposed that CD is a neurodevelopmental disorder, very little evidence is available about brain development in this condition. Structural brain alterations have been observed in CD, and some indirect evidence for delayed brain maturation has been reported. However, no detailed analysis of age-related changes in brain structure in youth with CD has been conducted. Using cross-sectional MRI data, this study aimed to explore differences in brain maturation in youth with CD versus healthy controls to provide further understanding of the neurodevelopmental processes underlying CD. 291 CD cases (153 males) and 379 healthy controls (160 males) aged 9-18 years (Mage = 14.4) were selected from the European multisite FemNAT-CD study. Structural MRI scans were analysed using surface-based morphometry followed by application of the ENIGMA quality control protocols. An atlas-based approach was used to investigate group differences and test for group-by-age and group-by-age-by-sex interactions in cortical thickness, surface area and subcortical volumes. Relative to healthy controls, the CD group showed lower surface area across frontal, temporal and parietal regions as well as lower total surface area. No significant group-by-age or group-by-age-by-sex interactions were observed on any brain structure measure. These findings suggest that CD is associated with lower surface area across multiple cortical regions, but do not support the idea that CD is associated with delayed brain maturation, at least within the age bracket considered here.
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Affiliation(s)
- Sarah Koerner
- Department of Psychology, University of Bath, Bath, UK
| | | | | | | | | | - Ruth Pauli
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Jack C Rogers
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Yidian Gao
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Sally Chester
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
| | | | - Anka Bernhard
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt Am Main, Germany
| | - Anne Martinelli
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt Am Main, Germany
- School of Psychology, Fresenius University of Applied Sciences, Frankfurt, Germany
| | - Gregor Kohls
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, RWTH Aachen, Aachen, Germany
- Department of Child and Adolescent Psychiatry, Medical Faculty, TU Dresden, Dresden, Germany
| | - Nora Maria Raschle
- Jacobs Center for Productive Youth Development at the University of Zurich, Zurich, Switzerland
- Neuroscience Centre Zurich (ZNZ), University and ETH Zurich, Zurich, Switzerland
| | - Kerstin Konrad
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, RWTH Aachen, Aachen, Germany
- JARA- Brain Institute II, Molecular Neuroscience and Neuroimaging, RWTH Aachen and Research Centre Juelich, Juelich, Germany
| | - Christina Stadler
- Department of Child and Adolescent Psychiatry, Psychiatric University Hospital, University of Basel, Basel, Switzerland
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt Am Main, Germany
| | - Stephane A De Brito
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
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8
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Waller R, Flum M, Paz Y, Perkins ER, Rodriguez Y, Knox A, Pelella MR, Jones C, Sun S, Denham SA, Herrington J, Parish-Morris J. Objective Linguistic Markers Associated with Callous-Unemotional Traits in Early Childhood. Res Child Adolesc Psychopathol 2024:10.1007/s10802-024-01219-4. [PMID: 38874652 DOI: 10.1007/s10802-024-01219-4] [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] [Accepted: 05/24/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND Callous-unemotional (CU) traits are associated with interpersonal difficulties and risk for severe conduct problems (CP). The ability to communicate thoughts and feelings is critical to social success, with language a promising treatment target. However, no prior studies have examined objective linguistic correlates of childhood CU traits in early childhood, which could give insight into underlying risk mechanisms and novel target treatments. METHODS We computed lexical (positive emotion, sad, and anger words) and conversational (interruptions and speech rate) markers produced by 131 children aged 5-6 years (M = 5.98; SD = 0.54, 58.8% female) and their parents while narrating wordless storybooks during two online visits separated by 6-8 weeks (M = 6.56, SD = 1.11; two books, order counterbalanced). Audio recordings were diarized, time-aligned, and orthographically transcribed using WebTrans. Conversational markers were calculated using R and word frequencies were calculated using Linguistic Inquiry and Word Count (LIWC) software. We examined links between child CU traits and linguistic markers, and explored whether relationships were moderated by child sex. RESULTS Higher CU traits were associated with fewer positive emotion words produced by parents and children. Higher CU traits were also associated with greater concordance in the degree of interruptions and expression of anger emotion words by parents and children. CONCLUSIONS Results suggest that objective linguistic correlates of CU traits are detectable during early childhood, which could inform adjunctive treatment modules that improve outcomes by precisely tracking and targeting subtle communication patterns.
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Affiliation(s)
- R Waller
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA.
| | - M Flum
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - Y Paz
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - E R Perkins
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - Y Rodriguez
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - A Knox
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - M R Pelella
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - C Jones
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - S Sun
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - S A Denham
- George Mason University, Fairfax, VA, USA
| | - J Herrington
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Childrens Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylva, Philadelphia, PA, USA
| | - J Parish-Morris
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Childrens Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylva, Philadelphia, PA, USA
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9
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Waschbusch DA, Cao VT, Shroff DM, Bansal PS, Willoughby MT. Measuring Children's Reward and Punishment Sensitivity: An Initial Psychometric Evaluation of the Contingency Response Rating Scale. Assessment 2024:10731911241256536. [PMID: 38869172 DOI: 10.1177/10731911241256536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Abstract
Existing research shows that children's responses to rewards and punishments are essential for understanding attention-deficit/hyperactivity disorder, oppositional defiant disorder, conduct disorder, and callous-unemotional traits. The present study developed the Contingency Response Rating Scale (CRRS) to fulfill the need for a reliable and valid measure of children's contingency response style that is brief, easy to use in applied settings, and provides additional information to existing clinical measures. We examined the psychometric properties of the CRRS in a sample of 196 children (ages 5-12), most of whom were referred to evaluate attention and behavior problems in an outpatient clinic. Using principal axis factoring, we identified five factors: (a) punishment ineffectiveness, (b) reward ineffectiveness, (c) punishment dysregulation, (d) reward dysregulation, and (e) contingency insensitivity. The subscales based on these factors showed acceptable test-retest and internal consistency reliability, and scale intercorrelations varied from low to moderate. The subscales also captured significant variance not explained by child or parent demographics and were associated with measures of psychopathology and impairment. The results provide preliminary evidence that the CRRS may be a helpful tool for assessing reward and punishment sensitivity in children with attention and behavior problems.
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10
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Koyama E, Kant T, Takata A, Kennedy JL, Zai CC. Genetics of child aggression, a systematic review. Transl Psychiatry 2024; 14:252. [PMID: 38862490 PMCID: PMC11167064 DOI: 10.1038/s41398-024-02870-7] [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] [Received: 03/17/2023] [Revised: 03/07/2024] [Accepted: 03/11/2024] [Indexed: 06/13/2024] Open
Abstract
Excessive and persistent aggressiveness is the most common behavioral problem that leads to psychiatric referrals among children. While half of the variance in childhood aggression is attributed to genetic factors, the biological mechanism and the interplay between genes and environment that results in aggression remains elusive. The purpose of this systematic review is to provide an overview of studies examining the genetics of childhood aggression irrespective of psychiatric diagnosis. PubMed, PsycINFO, and MEDLINE databases were searched using predefined search terms for aggression, genes and the specific age group. From the 652 initially yielded studies, eighty-seven studies were systematically extracted for full-text review and for further quality assessment analyses. Findings show that (i) investigation of candidate genes, especially of MAOA (17 studies), DRD4 (13 studies), and COMT (12 studies) continue to dominate the field, although studies using other research designs and methods including genome-wide association and epigenetic studies are increasing, (ii) the published articles tend to be moderate in sizes, with variable methods of assessing aggressive behavior and inconsistent categorizations of tandem repeat variants, resulting in inconclusive findings of genetic main effects, gene-gene, and gene-environment interactions, (iii) the majority of studies are conducted on European, male-only or male-female mixed, participants. To our knowledge, this is the first study to systematically review the effects of genes on youth aggression. To understand the genetic underpinnings of childhood aggression, more research is required with larger, more diverse sample sets, consistent and reliable assessments and standardized definition of the aggression phenotypes. The search for the biological mechanisms underlying child aggression will also benefit from more varied research methods, including epigenetic studies, transcriptomic studies, gene system and genome-wide studies, longitudinal studies that track changes in risk/ameliorating factors and aggression-related outcomes, and studies examining causal mechanisms.
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Affiliation(s)
- Emiko Koyama
- Tanenbaum Centre for Pharmacogenetics, Molecular Brain Science, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Laboratory for Molecular Pathology of Psychiatric Disorders, RIKEN Center for Brain Science, Wako, Japan
| | - Tuana Kant
- Tanenbaum Centre for Pharmacogenetics, Molecular Brain Science, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Atsushi Takata
- Laboratory for Molecular Pathology of Psychiatric Disorders, RIKEN Center for Brain Science, Wako, Japan
| | - James L Kennedy
- Tanenbaum Centre for Pharmacogenetics, Molecular Brain Science, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Clement C Zai
- Tanenbaum Centre for Pharmacogenetics, Molecular Brain Science, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
- Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA.
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11
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Jiang Y, Gao Y, Dong D, Sun X, Situ W, Yao S. The amygdala volume moderates the relationship between childhood maltreatment and callous-unemotional traits in adolescents with conduct disorder. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02482-y. [PMID: 38832960 DOI: 10.1007/s00787-024-02482-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 05/21/2024] [Indexed: 06/06/2024]
Abstract
CU traits, characterized by shallow affect, lack of fear, and absence of remorse, have been moderately associated with childhood maltreatment in a recent meta-analysis. However, the potential impact of brain structures remains undetermined. This paper examines the relationship between callous-unemotional (CU) traits, childhood maltreatment, and amygdala volumes. In this study, we used a region-of-interest (ROI) analysis to explore the interaction between the volumes of the amygdala, childhood maltreatment, and the manifestation of CU traits in adolescents diagnosed with conduct disorder (CD, N = 67), along with a comparison group of healthy-control youths (HCs, N = 89). The ROI analysis revealed no significant group differences in the bilateral amygdalar volumes. Significant positive correlation was discovered between all forms of child maltreatment (except for physical neglect) and CU traits across subjects. But the interaction of physical abuse and amygdala volumes was only significant within CD patients. Notably, a sensitivity analysis suggested that gender significantly influences these findings. These results contribute critical insights into the etiology of CU traits, emphasizing the need for customized clinical assessment tools and intervention strategies.
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Affiliation(s)
- Yali Jiang
- Department of Psychology, School of Education Science, Hunan Normal University, Changsha, People's Republic of China.
- Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, People's Republic of China.
- Institute for Interdisciplinary Studies, Hunan Normal University, Changsha, People's Republic of China.
- Research Base for Mental Health Education of Hunan Province, Hunan Normal University, Changsha, People's Republic of China.
- School of Psychology, South China Normal University, Guangzhou, People's Republic of China.
| | - Yidian Gao
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Daifeng Dong
- Medical Psychological Center, the Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Xiaoqiang Sun
- Medical Psychological Center, the Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Weijun Situ
- Department of Radiology, the Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Shuqiao Yao
- Medical Psychological Center, the Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
- National Clinical Research Center on Psychiatry and Psychology, Changsha, People's Republic of China
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12
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Elster EM, Pauli R, Baumann S, De Brito SA, Fairchild G, Freitag CM, Konrad K, Roessner V, Brazil IA, Lockwood PL, Kohls G. Impaired Punishment Learning in Conduct Disorder. J Am Acad Child Adolesc Psychiatry 2024; 63:454-463. [PMID: 37414274 DOI: 10.1016/j.jaac.2023.05.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 05/22/2023] [Accepted: 06/27/2023] [Indexed: 07/08/2023]
Abstract
OBJECTIVE Conduct disorder (CD) has been associated with deficits in the use of punishment to guide reinforcement learning (RL) and decision making. This may explain the poorly planned and often impulsive antisocial and aggressive behavior in affected youths. Here, we used a computational modeling approach to examine differences in RL abilities between CD youths and typically developing controls (TDCs). Specifically, we tested 2 competing hypotheses that RL deficits in CD reflect either reward dominance (also known as reward hypersensitivity) or punishment insensitivity (also known as punishment hyposensitivity). METHOD The study included 92 CD youths and 130 TDCs (aged 9-18 years, 48% girls) who completed a probabilistic RL task with reward, punishment, and neutral contingencies. Using computational modeling, we investigated the extent to which the 2 groups differed in their learning abilities to obtain reward and/or to avoid punishment. RESULTS RL model comparisons showed that a model with separate learning rates per contingency explained behavioral performance best. Importantly, CD youths showed lower learning rates than TDCs specifically for punishment, whereas learning rates for reward and neutral contingencies did not differ. Moreover, callous-unemotional (CU) traits did not correlate with learning rates in CD. CONCLUSION CD youths have a highly selective impairment in probabilistic punishment learning, regardless of their CU traits, whereas reward learning appears to be intact. In summary, our data suggest punishment insensitivity rather than reward dominance in CD. Clinically, the use of punishment-based intervention techniques to achieve effective discipline in patients with CD may be a less helpful strategy than reward-based techniques.
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Affiliation(s)
| | - Ruth Pauli
- University of Birmingham, Birmingham, United Kingdom
| | | | | | | | - Christine M Freitag
- University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Kerstin Konrad
- University Hospital RWTH Aachen, Aachen, Germany; RWTH Aachen and Research Centre Juelich, Juelich, Germany
| | | | | | - Patricia L Lockwood
- University of Birmingham, Birmingham, United Kingdom; University of Oxford, Oxford, United Kingdom
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13
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Winters DE, Sakai JT. Emotion Identification for Self and Other Associated with Callous-Unemotional Traits and Sex Differences in Early Adolescents. Child Psychiatry Hum Dev 2024; 55:564-574. [PMID: 36088498 DOI: 10.1007/s10578-022-01429-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/28/2022] [Indexed: 11/03/2022]
Abstract
Callous-unemotional traits (CU) associates with impairments in emotional responsivity. However, there is less evidence on associations with specific emotions and sex differences utilizing both self and other oriented emotional stimuli. Given that the nuance of associations with specific emotions (including sex effects) is critical for understanding core impairments of this antisocial phenotype, the current study employed a behavioral paradigm with both self and other emotional stimuli for specific emotions (happy, sad, anger, fear, neutral) with a sample of male and female early adolescents (females = 51%, age = 12.86 ± 0.75). We examined accuracy and reaction times on this task, along with moderating effects of sex, in relation to CU traits. Results indicate CU traits associated with overall self-emotions negatively and sex moderated CU traits negative association with recognizing others overall emotions. CU traits negatively associated with accurate identification of both self and other emotions (happy, sad, and fear). Sex moderated all other emotion identification but only sad emotions for self. No reaction time differences were found. These findings evidence important nuance in CU traits and sex effects with identifying self and other emotions. Results have important implications for clinical understanding of sex differences in CU traits that require further consideration.
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Affiliation(s)
- Drew E Winters
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA.
| | - Joseph T Sakai
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA
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14
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Thomson ND, Kjærvik SL, Blondell VJ, Hazlett LE. The Interplay between Fear Reactivity and Callous-Unemotional Traits Predicting Reactive and Proactive Aggression. CHILDREN (BASEL, SWITZERLAND) 2024; 11:379. [PMID: 38671596 PMCID: PMC11049142 DOI: 10.3390/children11040379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 03/17/2024] [Accepted: 03/18/2024] [Indexed: 04/28/2024]
Abstract
Research has indicated that youths with CU traits are fearless, and this fearlessness plays a bidirectional role in both the development of CU traits and engagement in aggressive behavior. However, research specifically testing the role of fear in the association between CU traits and aggression is scarce. The goal of the current study was to test if fear reactivity, both conscious (self-report) and automatic (skin conductance reactivity; SCR), moderated the association between CU traits and aggression subtypes (reactive and proactive aggression). Participants included 161 adolescents (Mage = 15 years) diagnosed with conduct disorder. CU traits were assessed using the self-report Inventory of Callous-Unemotional Traits. Conscious and automatic fear reactivity were measured during a virtual reality rollercoaster using the Self-Assessment Manikin and skin conductance reactivity (SCR), respectively. Hierarchical regressions found that high fear reactivity on SCR moderated the link between CU traits and reactive aggression, while feeling more excited during fear induction moderated the link between CU traits and proactive aggression. Overall, a possible explanation of our divergent findings between conscious and automatic fear may be the difference between the instinctual biological response to threat versus the cognitive and emotional appraisal and experience of threat. Implications for intervention strategies targeting emotional recognition and regulation in reducing aggression in CD populations are discussed.
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Affiliation(s)
- Nicholas D. Thomson
- Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA
- Department of Surgery, Virginia Commonwealth University, Richmond, VA 23298, USA; (S.L.K.); (V.J.B.); (L.E.H.)
| | - Sophie L. Kjærvik
- Department of Surgery, Virginia Commonwealth University, Richmond, VA 23298, USA; (S.L.K.); (V.J.B.); (L.E.H.)
| | - Victoria J. Blondell
- Department of Surgery, Virginia Commonwealth University, Richmond, VA 23298, USA; (S.L.K.); (V.J.B.); (L.E.H.)
| | - Laura E. Hazlett
- Department of Surgery, Virginia Commonwealth University, Richmond, VA 23298, USA; (S.L.K.); (V.J.B.); (L.E.H.)
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15
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Paz Y, Perkins ER, Colins O, Perlstein S, Wagner NJ, Hawes SW, Byrd A, Viding E, Waller R. Evaluating the sensitivity to threat and affiliative reward (STAR) model in relation to the development of conduct problems and callous-unemotional traits across early adolescence. J Child Psychol Psychiatry 2024. [PMID: 38480986 DOI: 10.1111/jcpp.13976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/24/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND The Sensitivity to Threat and Affiliative Reward (STAR) model proposes low threat sensitivity and low affiliation as risk factors for callous-unemotional (CU) traits. Preliminary evidence for the STAR model comes from work in early childhood. However, studies are needed that explore the STAR dimensions in late childhood and adolescence when severe conduct problems (CP) emerge. Moreover, it is unclear how variability across the full spectrum of threat sensitivity and affiliation gives rise to different forms of psychopathology beyond CU traits. METHODS The current study addressed these gaps using parent- and child-reported data from three waves and a sub-study of the Adolescent Brain Cognitive Development Study® of 11,878 youth (48% female; ages 9-12). RESULTS Consistent with the STAR model, low threat sensitivity and low affiliation were independently related to CU traits across informants and time. Moreover, there was significant interaction between the STAR dimensions, such that children with lower sensitivity to threat and lower affiliation had higher parent-reported CU traits. Unlike CU traits, children with higher threat sensitivity had higher parent-reported CP and anxiety. Finally, children with lower affiliation had higher parent-reported CP, anxiety, and depression. Results largely replicated across informants and time, and sensitivity analysis revealed similar findings in children with and without DSM-5 defined CP. CONCLUSIONS Results support the STAR model hypotheses as they pertain to CU traits and delineate threat sensitivity and affiliation as independent transdiagnostic risk factors for different types of psychopathology. Future research is needed to develop fuller and more reliable and valid measures of affiliation and threat sensitivity across multiple assessment modalities.
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Affiliation(s)
- Yael Paz
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - Emily R Perkins
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - Olivier Colins
- Faculty of Psychology and Educational Sciences, Department of Special Needs Education, Ghent University, Gent, Belgium
| | - Samantha Perlstein
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - Nicholas J Wagner
- Department of Brain and Psychological Science, Boston University, Boston, MA, USA
| | - Samuel W Hawes
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Amy Byrd
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PN, USA
| | - Essi Viding
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Rebecca Waller
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
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16
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Feeney K, Pintos Lobo R, Hare MM, Morris SSJ, Laird AR, Musser ED. Parental Deprivation- and Threat-Based Factors Associated with Youth Emotion-Based Neurocircuitry and Externalizing Behavior: A Systematic Review. Res Child Adolesc Psychopathol 2024; 52:311-323. [PMID: 37831222 DOI: 10.1007/s10802-023-01138-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2023] [Indexed: 10/14/2023]
Abstract
Parental factors, including negative parenting practices (e.g., family conflict, low monitoring), parental depression, and parental substance use, are associated with externalizing behaviors among youth. However, the ways in which these parental factors are associated with youth brain function and consequent externalizing behavior has been less studied. Both the dimensional and stress acceleration models provide frameworks for understanding how parental factors may be associated with frontolimbic and frontoparietal networks implicated in emotional attention and regulation processes. The current review builds upon this work by examining how deprivation- and threat-based parental factors are associated with youth neurocircuitry involved in emotional functioning and externalizing behaviors. A systematic review using PRISMA guidelines was completed and included five studies assessing parenting behaviors, six studies assessing parental depressive symptoms and/or diagnosis, and 12 studies assessing parental history of substance use. Synthesis of reviewed studies discusses support for the dimensional and stress acceleration models within the context of deprivation and threat. Further, a limited number of studies tested (i.e., six studies) and supported (i.e., three studies) youth neural structure and function as a mediator of the association between parental factors and youth externalizing behavior. Specific recommendations for future work include more deliberate planning related to sample composition, improved clarity related to parental constructs, consistency in methodology, and longitudinal study design in order to better understand associations between contextual parental influences and youth neural and behavioral functioning.
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Affiliation(s)
- Kathleen Feeney
- Department of Psychology, Florida International University, Miami, FL, USA.
| | | | - Megan M Hare
- Department of Psychology, Florida International University, Miami, FL, USA
| | | | - Angela R Laird
- Department of Physics, Florida International University, Miami, FL, USA
| | - Erica D Musser
- Department of Psychology, Florida International University, Miami, FL, USA
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17
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Viding E, McCrory E, Baskin-Sommers A, De Brito S, Frick P. An 'embedded brain' approach to understanding antisocial behaviour. Trends Cogn Sci 2024; 28:159-171. [PMID: 37718176 DOI: 10.1016/j.tics.2023.08.013] [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: 03/09/2023] [Revised: 08/14/2023] [Accepted: 08/15/2023] [Indexed: 09/19/2023]
Abstract
Antisocial behaviour (ASB) incurs substantial costs to the individual and society. Cognitive neuroscience has the potential to shed light on developmental risk for ASB, but it cannot achieve this potential in an 'essentialist' framework that focuses on the brain and cognition isolated from the environment. Here, we present the case for studying the social transactional and iterative unfolding of brain and cognitive development in a relational context. This approach, which we call the study of the 'embedded brain', is needed to fully understand how risk for ASB arises during development. Concentrated efforts are required to develop and unify methods to achieve this approach and reap the benefits for improved prevention and intervention of ASB.
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Affiliation(s)
- Essi Viding
- Division of Psychology and Language Sciences, University College London, Gower Street, London, WC1E 6BT, UK.
| | - Eamon McCrory
- Division of Psychology and Language Sciences, University College London, Gower Street, London, WC1E 6BT, UK
| | | | - Stephane De Brito
- School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK
| | - Paul Frick
- Department of Psychology, Louisiana State University, Baton Rouge, LA 70803, USA
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18
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Pauli-Pott U, Skoluda N, Nater UM, Becker K, Derz F, Kaspar E, Kasperzack D, Kehm K, Kött M, Mann C, Schurek P, Pott W, Schloß S. Long-term cortisol secretion in attention deficit hyperactivity disorder: roles of sex, comorbidity, and symptom presentation. Eur Child Adolesc Psychiatry 2024; 33:569-579. [PMID: 36917355 PMCID: PMC10869441 DOI: 10.1007/s00787-023-02180-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 02/27/2023] [Indexed: 03/16/2023]
Abstract
Low activity of the hypothalamic-pituitary-adrenal axis (HPAA) has been found in children with attention deficit hyperactivity disorder (ADHD). The condition may be related to the reduced attention regulation capacity and/or to comorbid oppositional defiant or conduct disorder (ODD/CD). Sex differences are probable but not sufficiently studied. We analyzed the HPAA activity and sympathetic nervous system reactivity (SR) in children with ADHD while accounting for ADHD symptom presentation, comorbidity, and sex differences. The sample comprised 205 children, 98 (61 boys, 37 girls) with ADHD and 107 (48 boys, 59 girls) healthy controls. DSM-5 phenotypic symptom presentation and comorbid ODD/CD were assessed using clinical interviews. Hair cortisol concentration (HCC) was used to assess the long-term, cumulative activity of the HPAA. SR was assessed via skin conductance response (SCR). For control purposes, comorbid internalizing symptoms and indicators of adverse childhood experiences (ACE) were assessed. Children were medication naive. Boys presenting with predominantly inattentive symptoms (ADHD-I) showed lower HCC than healthy boys. Girls presenting with combined symptoms (ADHD-C) showed higher HCC than did healthy girls (p's < 0.05, sex-by-group interaction, F (2,194) = 4.09, p = 0.018). Boys with ADHD plus ODD/CD showed a blunted SR (p < 0.001, sex-by-group interaction, F (2,172) = 3.08, p = 0.048). Adjustment for ACE indicators led to non-significant differences in HCC but did not affect differences in SR. HCC constitutes an easily assessable, reliable, and valid marker of phenotypic ADHD-related features (i.e. symptom presentation and comorbidity). It indicates more homogenous subgroups of ADHD and might point to specifically involved pathophysiological processes.
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Affiliation(s)
- Ursula Pauli-Pott
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps-University of Marburg, Schützenstrasse 45, 35039, Marburg, Germany.
| | - Nadine Skoluda
- Clinical Psychology, Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Liebiggasse 5, 1010, Vienna, Austria
- Research Platform The Stress of Life (SOLE)-Processes and Mechanisms underlying Everyday Life Stress, Vienna, Austria
| | - Urs M Nater
- Clinical Psychology, Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Liebiggasse 5, 1010, Vienna, Austria
- Research Platform The Stress of Life (SOLE)-Processes and Mechanisms underlying Everyday Life Stress, Vienna, Austria
| | - Katja Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps-University of Marburg, Schützenstrasse 45, 35039, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg Justus Liebig University Giessen, Hans-Meerwein-Straße 6, 35032, Marburg, Germany
| | - Friederike Derz
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps-University of Marburg, Schützenstrasse 45, 35039, Marburg, Germany
| | - Elena Kaspar
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps-University of Marburg, Schützenstrasse 45, 35039, Marburg, Germany
| | - Daria Kasperzack
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps-University of Marburg, Schützenstrasse 45, 35039, Marburg, Germany
| | - Kira Kehm
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps-University of Marburg, Schützenstrasse 45, 35039, Marburg, Germany
| | - Marie Kött
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps-University of Marburg, Schützenstrasse 45, 35039, Marburg, Germany
| | - Christopher Mann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps-University of Marburg, Schützenstrasse 45, 35039, Marburg, Germany
| | - Pia Schurek
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps-University of Marburg, Schützenstrasse 45, 35039, Marburg, Germany
| | - Wilfried Pott
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps-University of Marburg, Schützenstrasse 45, 35039, Marburg, Germany
| | - Susan Schloß
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps-University of Marburg, Schützenstrasse 45, 35039, Marburg, Germany
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19
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Zhang R, Blair RJR, Blair KS, Dobbertin M, Elowsky J, Bashford-Largo J, Dominguez AJ, Hatch M, Bajaj S. Reduced grey matter volume in adolescents with conduct disorder: a region-of-interest analysis using multivariate generalized linear modeling. DISCOVER MENTAL HEALTH 2023; 3:25. [PMID: 37975932 PMCID: PMC10656392 DOI: 10.1007/s44192-023-00052-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Conduct disorder (CD) involves a group of behavioral and emotional problems that usually begins during childhood or adolescence. Structural brain alterations have been observed in CD, including the amygdala, insula, ventrolateral and medial prefrontal cortex, anterior cingulate cortex, and fusiform gyrus. The current study developed a multivariate generalized linear model (GLM) to differentiate adolescents with CD from typically developing (TD) adolescents in terms of grey matter volume (GMV). METHODS The whole-brain structural MRI data were collected from 96 adolescents with CD (mean age = [Formula: see text] years; mean IQ = [Formula: see text]; 63 males) and 90 TD individuals (mean age = [Formula: see text] years; mean IQ = [Formula: see text]; 59 males) matched on age, IQ, and sex. Region-wise GMV was extracted following whole-brain parcellation into 68 cortical and 14 subcortical regions for each participant. A multivariate GLM was developed to predict the GMV of the pre-hypothesized regions-of-interest (ROIs) based on CD diagnosis, with intracranial volume, age, sex, and IQ serving as the covariate. RESULTS A diagnosis of CD was a significant predictor for GMV in the right pars orbitalis, right insula, right superior temporal gyrus, left fusiform gyrus, and left amygdala (F(1, 180) = 5.460-10.317, p < 0.05, partial eta squared = 0.029-0.054). The CD participants had smaller GMV in these regions than the TD participants (MCD-MTD = [- 614.898] mm3-[- 53.461] mm3). CONCLUSIONS Altered GMV within specific regions may serve as a biomarker for the development of CD in adolescents. Clinical work can potentially target these biomarkers to treat adolescents with CD.
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Affiliation(s)
- Ru Zhang
- Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA.
| | - R James R Blair
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
| | - Karina S Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Matthew Dobbertin
- Inpatient Psychiatric Care Unit, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Jaimie Elowsky
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | | | - Ahria J Dominguez
- Clinical Health, Emotion, and Neuroscience (CHEN) Laboratory, Department of Neurological Sciences, College of Medicine, University of Nebraska Medical Center (UNMC), Omaha, NE, USA
| | - Melissa Hatch
- Mind and Brain Health Labs (MBHL), Department of Neurological Sciences, College of Medicine, University of Nebraska Medical Center (UNMC), Omaha, NE, USA
| | - Sahil Bajaj
- Department of Cancer Systems Imaging, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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20
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Werhahn JE, Smigielski L, Sacu S, Mohl S, Willinger D, Naaijen J, Mulder LM, Glennon JC, Hoekstra PJ, Dietrich A, Deters RK, Aggensteiner PM, Holz NE, Baumeister S, Banaschewski T, Saam MC, Schulze UME, Lythgoe DJ, Sethi A, Craig M, Mastroianni M, Sagar-Ouriaghli I, Santosh PJ, Rosa M, Bargallo N, Castro-Fornieles J, Arango C, Penzol MJ, Zwiers MP, Franke B, Buitelaar JK, Walitza S, Brandeis D. Different whole-brain functional connectivity correlates of reactive-proactive aggression and callous-unemotional traits in children and adolescents with disruptive behaviors. Neuroimage Clin 2023; 40:103542. [PMID: 37988996 PMCID: PMC10701077 DOI: 10.1016/j.nicl.2023.103542] [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: 07/10/2023] [Revised: 10/20/2023] [Accepted: 11/12/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND Disruptive behavior in children and adolescents can manifest as reactive aggression and proactive aggression and is modulated by callous-unemotional traits and other comorbidities. Neural correlates of these aggression dimensions or subtypes and comorbid symptoms remain largely unknown. This multi-center study investigated the relationship between resting state functional connectivity (rsFC) and aggression subtypes considering comorbidities. METHODS The large sample of children and adolescents aged 8-18 years (n = 207; mean age = 13.30±2.60 years, 150 males) included 118 cases with disruptive behavior (80 with Oppositional Defiant Disorder and/or Conduct Disorder) and 89 controls. Attention-deficit/hyperactivity disorder (ADHD) and anxiety symptom scores were analyzed as covariates when assessing group differences and dimensional aggression effects on hypothesis-free global and local voxel-to-voxel whole-brain rsFC based on functional magnetic resonance imaging at 3 Tesla. RESULTS Compared to controls, the cases demonstrated altered rsFC in frontal areas, when anxiety but not ADHD symptoms were controlled for. For cases, reactive and proactive aggression scores were related to global and local rsFC in the central gyrus and precuneus, regions linked to aggression-related impairments. Callous-unemotional trait severity was correlated with ICC in the inferior and middle temporal regions implicated in empathy, emotion, and reward processing. Most observed aggression subtype-specific patterns could only be identified when ADHD and anxiety were controlled for. CONCLUSIONS This study clarifies that hypothesis-free brain connectivity measures can disentangle distinct though overlapping dimensions of aggression in youths. Moreover, our results highlight the importance of considering comorbid symptoms to detect aggression-related rsFC alterations in youths.
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Affiliation(s)
- Julia E Werhahn
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Lukasz Smigielski
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Seda Sacu
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Susanna Mohl
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - David Willinger
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Jilly Naaijen
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Radboud University, Nijmegen, The Netherlands; Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Leandra M Mulder
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Radboud University, Nijmegen, The Netherlands; Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Jeffrey C Glennon
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Radboud University, Nijmegen, The Netherlands; Conway Institute of Biomedical and Biomolecular Research, School of Medicine, University College Dublin, Dublin, Ireland
| | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Andrea Dietrich
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Renee Kleine Deters
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Pascal M Aggensteiner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Nathalie E Holz
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sarah Baumeister
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Melanie C Saam
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital, University of Ulm, Ulm, Germany
| | - Ulrike M E Schulze
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital, University of Ulm, Ulm, Germany
| | - David J Lythgoe
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Arjun Sethi
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Michael Craig
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Mathilde Mastroianni
- Department of Child Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Ilyas Sagar-Ouriaghli
- Department of Child Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Paramala J Santosh
- Department of Child Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Mireia Rosa
- Child and Adolescent Psychiatry Department, Hospital Clinic of Barcelona, IDIBAPS, Barcelona, Spain
| | - Nuria Bargallo
- Clinic Image Diagnostic Center (CDIC), Hospital Clinic of Barcelona, Magnetic Resonance Image Core Facility, IDIBAPS, Barcelona, Spain
| | - Josefina Castro-Fornieles
- Child and Adolescent Psychiatry and Psychology Department, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Celso Arango
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Maria J Penzol
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Marcel P Zwiers
- Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Barbara Franke
- Departments of Human Genetics and Psychiatry, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center. Radboud University, Nijmegen, The Netherlands
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Radboud University, Nijmegen, The Netherlands; Karakter Child and Adolescent Psychiatry University Center, Radboud University Medical Center, Radboud University, Nijmegen, The Netherlands
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland; Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland.
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21
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Zhang R, Blair RJR, Blair KS, Dobbertin M, Elowsky J, Bashford-Largo J, Dominguez AJ, Hatch M, Bajaj S. Reduced Grey Matter Volume in Adolescents with Conduct Disorder: A Region-of-Interest Analysis Using Multivariate Generalized Linear Modeling. RESEARCH SQUARE 2023:rs.3.rs-3425545. [PMID: 37961148 PMCID: PMC10635381 DOI: 10.21203/rs.3.rs-3425545/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Background Conduct disorder (CD) involves a group of behavioral and emotional problems that usually begins during childhood or adolescence. Structural brain alterations have been observed in CD, including the amygdala, insula, ventrolateral and medial prefrontal cortex, anterior cingulate cortex, and fusiform gyrus. The current study developed a multivariate generalized linear model (GLM) to differentiate adolescents with CD from typically developing (TD) adolescents in terms of grey matter volume (GMV). Methods The whole-brain structural MRI data were collected from 96 adolescents with CD (mean age = years; mean IQ = ; 63 males) and 90 TD individuals (mean age = years; mean IQ = ; 59 males) matched on age, IQ, and sex. Region-wise GMV was extracted following whole-brain parcellation into 68 cortical and 14 subcortical regions for each participant. A multivariate GLM was developed to predict the GMV of the pre-hypothesized regions-of-interest (ROIs) based on CD diagnosis, with intracranial volume, age, sex, and IQ serving as the covariate. Results A diagnosis of CD was a significant predictor for GMV in the right pars orbitalis, right insula, right superior temporal gyrus, left fusiform gyrus, and left amygdala (F(1, 180) = 5.460 - 10.317, p < 0.05, partial eta squared = 0.029 - 0.054). The CD participants had smaller GMV in these regions than the TD participants (MCD - MTD = [-614.898] mm3 - [-53.461] mm3). Conclusions Altered GMV within specific regions may serve as a biomarker for the development of CD in adolescents. Clinical work can potentially target these biomarkers to treat adolescents with CD.
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Affiliation(s)
- Ru Zhang
- University of Southern California
| | | | | | | | | | | | | | | | - Sahil Bajaj
- The University of Texas MD Anderson Cancer Center
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22
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Brady RG, Donohue MR, Waller R, Tillman R, Gilbert KE, Whalen DJ, Rogers CE, Barch DM, Luby JL. Maternal emotional intelligence and negative parenting affect are independently associated with callous-unemotional traits in preschoolers. Eur Child Adolesc Psychiatry 2023; 32:2303-2311. [PMID: 36063216 PMCID: PMC10163950 DOI: 10.1007/s00787-022-02074-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 08/19/2022] [Indexed: 12/15/2022]
Abstract
Deficits in emotion intelligence (EI) are a key component of early-childhood callous-unemotional (CU) traits. Children's EI may be influenced by their mother's EI through both familial genetic and environmental mechanisms; however, no study has directly tested the role of maternal EI in the development of CU traits. This study investigated whether maternal EI had a direct relationship with children's CU traits when controlling for the potential influence of parenting affect and other psychiatric diagnoses. Mothers and their 3- to 5-year-old preschoolers (N = 200) were recruited as part of a parent-child interaction-emotion development therapy treatment trial for preschool clinical depression and comorbid psychopathology. Using data collected prior to treatment, regression models tested whether maternal EI was related to children's CU traits, which specific aspects of maternal EI were most strongly associated with CU traits, and whether associations held after accounting for observed parenting affect. Maternal EI (p < 0.005), specifically the ability to understand others' emotions (p < 0.01), was significantly associated with children's CU traits. This relationship was specific, as maternal EI did not predict depression or oppositional defiant disorder. Both maternal EI and observed negative parenting affect were independently and significantly related to CU traits (p < 0.05) in a combined model. Given that maternal EI and observed negative parenting affect were independent predictors of CU traits in preschoolers with comorbid depression, findings suggest that current treatments for CU traits that focus solely on improving parenting could be made more effective by targeting maternal EI and helping mothers better model emotional competence.
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Affiliation(s)
- Rebecca G Brady
- Division of Biology and Biomedical Sciences, Washington University School of Medicine, 660 South Euclid Ave, Box 8514, St. Louis, MO, 63110, USA.
- Department of Neurology, Washington University School of Medicine, St. Louis, USA.
| | - Meghan Rose Donohue
- Department of Psychiatry, Washington University School of Medicine, St. Louis, USA
| | - Rebecca Waller
- Department of Psychology, University of Pennsylvania, Philadelphia, USA
| | - Rebecca Tillman
- Department of Psychiatry, Washington University School of Medicine, St. Louis, USA
| | - Kirsten E Gilbert
- Department of Psychiatry, Washington University School of Medicine, St. Louis, USA
| | - Diana J Whalen
- Department of Psychiatry, Washington University School of Medicine, St. Louis, USA
| | - Cynthia E Rogers
- Department of Psychiatry, Washington University School of Medicine, St. Louis, USA
- Department of Pediatrics, Washington University School of Medicine, St. Louis, USA
| | - Deanna M Barch
- Department of Psychiatry, Washington University School of Medicine, St. Louis, USA
- Mallinckrot Institute of Radiology, Washington University School of Medicine, St. Louis, USA
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, USA
| | - Joan L Luby
- Department of Psychiatry, Washington University School of Medicine, St. Louis, USA
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23
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Winters DE, Dugré JR, Sakai JT, Carter RM. Executive function and underlying brain network distinctions for callous-unemotional traits and conduct problems in adolescents. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.10.31.565009. [PMID: 37961691 PMCID: PMC10635075 DOI: 10.1101/2023.10.31.565009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
The complexity of executive function (EF) impairments in youth antisocial phenotypes of callous-unemotional (CU) traits and conduct problems (CP) challenge identifying phenotypic specific EF deficits. We can redress these challenges by (1) accounting for EF measurement error and (2) testing distinct functional brain properties accounting for differences in EF. Thus, we employed a latent modeling approach for EFs (inhibition, shifting, fluency, common EF) and extracted connection density from matching contemporary EF brain models with a sample of 112 adolescents (ages 13-17, 42% female). Path analysis indicated CU traits associated with lower inhibition. Inhibition network density positively associated with inhibition, but this association was strengthened by CU and attenuated by CP. Common EF associated with three-way interactions between density*CP by CU for the inhibition and shifting networks. This suggests those higher in CU require their brain to work harder for lower inhibition, whereas those higher in CP have difficulty engaging inhibitory brain responses. Additionally, those with CP interacting with CU show distinct brain patterns for a more general EF capacity. Importantly, modeling cross-network connection density in contemporary EF models to test EF involvement in core impairments in CU and CP may accelerate our understanding of EF in these phenotypes.
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Affiliation(s)
- Drew E. Winters
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus
| | - Jules R Dugré
- School of Psychology and Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Joseph T. Sakai
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus
| | - R. McKell Carter
- Department of Psychology & Neuroscience, University of Colorado Boulder, Boulder, CO, USA
- Institute of Cognitive Science, University of Colorado Boulder, Boulder, CO, USA; Department of Electrical, Computer and Energy Engineering, University of Colorado Boulder, Boulder, CO, USA
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24
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Wagner N, Perkins E, Rodriguez Y, Ordway C, Flum M, Hernandez-Pena L, Perelstein P, Sem K, Paz Y, Plate R, Popoola A, Lynch S, Astone K, Goldstein E, Njoroge WFM, Raine A, Pincus D, Pérez-Edgar K, Waller R. Promoting Empathy and Affiliation in Relationships (PEAR) study: protocol for a longitudinal study investigating the development of early childhood callous-unemotional traits. BMJ Open 2023; 13:e072742. [PMID: 37802613 PMCID: PMC10565261 DOI: 10.1136/bmjopen-2023-072742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 09/15/2023] [Indexed: 10/10/2023] Open
Abstract
INTRODUCTION Children with callous-unemotional (CU) traits are at high lifetime risk of antisocial behaviour. Low affiliation (ie, social bonding difficulties) and fearlessness (ie, low threat sensitivity) are proposed risk factors for CU traits. Parenting practices (eg, harshness and low warmth) also predict risk for CU traits. However, few studies in early childhood have identified attentional or physiological markers of low affiliation and fearlessness. Moreover, no studies have tested whether parenting practices are underpinned by low affiliation or fearlessness shared by parents, which could further shape parent-child interactions and exacerbate risk for CU traits. Addressing these questions will inform knowledge of how CU traits develop and isolate novel parent and child targets for future specialised treatments for CU traits. METHODS AND ANALYSIS The Promoting Empathy and Affiliation in Relationships (PEAR) study aims to establish risk factors for CU traits in children aged 3-6 years. The PEAR study will recruit 500 parent-child dyads from two metropolitan areas of the USA. Parents and children will complete questionnaires, computer tasks and observational assessments, alongside collection of eye-tracking and physiological data, when children are aged 3-4 (time 1) and 5-6 (time 2) years. The moderating roles of child sex, race and ethnicity, family and neighbourhood disadvantage, and parental psychopathology will also be assessed. Study aims will be addressed using structural equation modelling, which will allow for flexible characterisation of low affiliation, fearlessness and parenting practices as risk factors for CU traits across multiple domains. ETHICS AND DISSEMINATION Ethical approval was granted by Boston University (#6158E) and the University of Pennsylvania (#850638). Results will be disseminated through conferences and open-access publications. All study and task materials will be made freely available on lab websites and through the Open Science Framework (OSF).
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Affiliation(s)
- Nicholas Wagner
- Department of Brain & Psychological Science, Boston University, Boston, Massachusetts, USA
| | - Emily Perkins
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Yuheiry Rodriguez
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Cora Ordway
- Department of Brain & Psychological Science, Boston University, Boston, Massachusetts, USA
| | - Michaela Flum
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lucia Hernandez-Pena
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany
| | - Polina Perelstein
- Department of Brain & Psychological Science, Boston University, Boston, Massachusetts, USA
| | - Kathy Sem
- Department of Brain & Psychological Science, Boston University, Boston, Massachusetts, USA
| | - Yael Paz
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Rista Plate
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ayomide Popoola
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sarah Lynch
- Department of Brain & Psychological Science, Boston University, Boston, Massachusetts, USA
| | - Kristina Astone
- Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Ethan Goldstein
- Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Wanjikũ F M Njoroge
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Adriane Raine
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Donna Pincus
- Department of Brain & Psychological Science, Boston University, Boston, Massachusetts, USA
| | | | - Rebecca Waller
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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25
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Schütte S, Lohaus A, Symanzik T, Heinrichs N, Konrad K, Reindl V. Longitudinal Associations Between Parenting and Child Behaviour Problems and the Moderating Effect of Child Callous Unemotional Traits in Foster and Biological Families. Child Psychiatry Hum Dev 2023; 54:1274-1286. [PMID: 35239057 PMCID: PMC10435590 DOI: 10.1007/s10578-022-01324-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/30/2022] [Indexed: 11/03/2022]
Abstract
The goals of the current study were to examine (i) differences in parenting between foster and biological parents, (ii) the longitudinal associations with children's internalising and externalising problems and iii) the potential moderation of these by children's callous-unemotional traits (CU traits). Data from 86 foster children (M = 4.44 years, male = 48%) and 148 biological children (M = 3.69 years, male = 49%) with their families were analysed in a longitudinal study with three measurement times. Parenting behaviour did not significantly differ between the foster and biological family groups. Significant longitudinal cross-lagged effects were found for parental warmth and support and children's externalising problems. CU traits moderated the relationship between warmth and support and externalising problems of children. Findings suggest that parenting behaviours and child psychopathology do influence each other over time reciprocally and to a similar extent in both groups. However, there was also evidence for greater temporal stability of psychopathological symptoms and reduced responsivity to parental warmth in children with higher CU traits.
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Affiliation(s)
- Sabrina Schütte
- Developmental Psychology and Developmental Psychopathology, Department of Psychology, University of Bielefeld, P.O. Box 10 01 31, 33501, Bielefeld, Germany.
| | - Arnold Lohaus
- Developmental Psychology and Developmental Psychopathology, Department of Psychology, University of Bielefeld, P.O. Box 10 01 31, 33501, Bielefeld, Germany
| | - Tabea Symanzik
- Developmental Psychology and Developmental Psychopathology, Department of Psychology, University of Bielefeld, P.O. Box 10 01 31, 33501, Bielefeld, Germany
| | - Nina Heinrichs
- Department of Clinical Psychology & Psychotherapy, University of Bremen, Bremen, Germany
| | - Kerstin Konrad
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, RWTH Aachen University, Aachen, Germany
- JARA-Brain Institute II, Molecular Neuroscience and Neuroimaging, RWTH Aachen & Research Centre Juelich, Aachen, Germany
| | - Vanessa Reindl
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, RWTH Aachen University, Aachen, Germany
- JARA-Brain Institute II, Molecular Neuroscience and Neuroimaging, RWTH Aachen & Research Centre Juelich, Aachen, Germany
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26
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Tkalcec A, Bierlein M, Seeger-Schneider G, Walitza S, Jenny B, Menks WM, Felhbaum LV, Borbas R, Cole DM, Raschle N, Herbrecht E, Stadler C, Cubillo A. Empathy deficits, callous-unemotional traits and structural underpinnings in autism spectrum disorder and conduct disorder youth. Autism Res 2023; 16:1946-1962. [PMID: 37548142 DOI: 10.1002/aur.2993] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 07/06/2023] [Indexed: 08/08/2023]
Abstract
Distinct empathy deficits are often described in patients with conduct disorder (CD) and autism spectrum disorder (ASD) yet their neural underpinnings and the influence of comorbid Callous-Unemotional (CU) traits are unclear. This study compares the cognitive (CE) and affective empathy (AE) abilities of youth with CD and ASD, their potential neuroanatomical correlates, and the influence of CU traits on empathy. Adolescents and parents/caregivers completed empathy questionnaires (N = 148 adolescents, mean age = 15.16 years) and T1 weighted images were obtained from a subsample (N = 130). Group differences in empathy and the influence of CU traits were investigated using Bayesian analyses and Voxel-Based Morphometry with Threshold-Free Cluster Enhancement focusing on regions involved in AE (insula, amygdala, inferior frontal gyrus and cingulate cortex) and CE processes (ventromedial prefrontal cortex, temporoparietal junction, superior temporal gyrus, and precuneus). The ASD group showed lower parent-reported AE and CE scores and lower self-reported CE scores while the CD group showed lower parent-reported CE scores than controls. When accounting for the influence of CU traits no AE deficits in ASD and CE deficits in CD were found, but CE deficits in ASD remained. Across all participants, CU traits were negatively associated with gray matter volumes in anterior cingulate which extends into the mid cingulate, ventromedial prefrontal cortex, and precuneus. Thus, although co-occurring CU traits have been linked to global empathy deficits in reports and underlying brain structures, its influence on empathy aspects might be disorder-specific. Investigating the subdimensions of empathy may therefore help to identify disorder-specific empathy deficits.
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Affiliation(s)
- Antonia Tkalcec
- Child and Youth Psychiatry, University Psychiatric Clinic, Basel, Switzerland
| | - Maria Bierlein
- Child and Youth Psychiatry, University Psychiatric Clinic, Basel, Switzerland
| | - Gudrun Seeger-Schneider
- Child and Youth Psychiatry, Psychiatric University Clinic, University of Zurich, Zurich, Switzerland
| | - Susanne Walitza
- Child and Youth Psychiatry, Psychiatric University Clinic, University of Zurich, Zurich, Switzerland
| | - Bettina Jenny
- Child and Youth Psychiatry, Psychiatric University Clinic, University of Zurich, Zurich, Switzerland
| | - Willeke M Menks
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, and Radboud University Medical Centre, Nijmegen, the Netherlands
- Psychology of Language Department, Max Planck Institute for Psycholinguistics, Nijmegen, the Netherlands
| | - Lynn V Felhbaum
- Jacobs Center for Productive Youth, University of Zurich, Zurich, Switzerland
| | - Reka Borbas
- Jacobs Center for Productive Youth, University of Zurich, Zurich, Switzerland
| | - David M Cole
- Translational Psychiatry, University Psychiatric Clinic, Basel, Switzerland
| | - Nora Raschle
- Jacobs Center for Productive Youth, University of Zurich, Zurich, Switzerland
| | - Evelyn Herbrecht
- Child and Youth Psychiatry, University Psychiatric Clinic, Basel, Switzerland
| | - Christina Stadler
- Child and Youth Psychiatry, University Psychiatric Clinic, Basel, Switzerland
| | - Ana Cubillo
- Child and Youth Psychiatry, University Psychiatric Clinic, Basel, Switzerland
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27
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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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28
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Prasad AH, Keevers Y, Kaouar S, Kimonis ER. Conception and Development of the Warmth/Affection Coding System (WACS): A Novel Hybrid Behavioral Observational Tool for Assessing Parent-to-Child Warmth. Res Child Adolesc Psychopathol 2023; 51:1357-1369. [PMID: 37079146 PMCID: PMC10474998 DOI: 10.1007/s10802-023-01055-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2023] [Indexed: 04/21/2023]
Abstract
A vast body of research and theory underscores the importance of parental warmth/affection (hereby 'warmth' and 'warmth/affection' are used interchangeably) as a distinct relational process that is fundamental to core developmental processes including parent-child attachment, socialization, emotion recognition and responsivity, and empathic development. The increasing focus on parental warmth as a viable transdiagnostic and specific treatment target for Callous-Unemotional (CU) traits highlights the critical need for a reliable and valid tool for measuring this construct within clinical contexts. However, existing assessment methods have limitations in their ecological validity, clinical utility, and the comprehensiveness of their coverage of core warmth subcomponents. In response to this clinical and research need, the observational Warmth/Affection Coding System (WACS) was developed to comprehensively measure parent-to-child warmth/affection. This paper chronicles the conception and development of the WACS, which adopts a hybrid approach of utilizing both microsocial and macro-observational coding methods to capture key verbal and non-verbal subcomponents of warmth that are currently underrepresented or poorly captured by existing assessment tools. Recommendations for implementation and future directions are also discussed.
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Affiliation(s)
- Ashneeta H Prasad
- School of Psychology, The University of New South Wales, 2052, Sydney, NSW, Australia.
| | - Yvette Keevers
- School of Psychology, The University of New South Wales, 2052, Sydney, NSW, Australia
| | - Silvana Kaouar
- School of Psychology, The University of New South Wales, 2052, Sydney, NSW, Australia
| | - Eva R Kimonis
- School of Psychology, The University of New South Wales, 2052, Sydney, NSW, Australia
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29
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Dugré JR, Potvin S. Altered functional connectivity of the amygdala across variants of callous-unemotional traits: A resting-state fMRI study in children and adolescents. J Psychiatr Res 2023; 163:32-42. [PMID: 37201236 DOI: 10.1016/j.jpsychires.2023.05.002] [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] [Received: 07/24/2022] [Revised: 02/28/2023] [Accepted: 05/01/2023] [Indexed: 05/20/2023]
Abstract
Over the past years, research has shown that primary (high callousness and low anxiety) and secondary (high callousness and anxiety) variants of CU traits may be associated with opposite amygdala activity (hypo- and hyper-reactivity, respectively). However, their differences in amygdala functional connectivity remains largely unexplored. We conducted a Latent Profile Analysis on a large sample of adolescents (n = 1416) to identify homogeneous subgroups with different levels of callousness and anxiety. We then performed a seed-to-voxel connectivity analysis on resting-state fMRI data to compare subgroups on connectivity patterns of the amygdala. We examined the results in relation to conduct problems to identify potential neural risk factors. The Latent Profile Analysis revealed four subgroups, including the primary and secondary variants, anxious, and typically developing adolescents. The seed-to-voxel analyses showed that the primary variant was mainly characterized by increased connectivity between the left amygdala and left thalamus. The secondary variant exhibited deficient connectivity between the amygdala and the dorsomedial prefrontal cortex, temporo-parietal junction, premotor, and postcentral gyrus. Both variants showed increased connectivity between the left amygdala and the right thalamus but exhibited opposite functional connectivity between the left amygdala and the parahippocampal gyrus. Dimensional analyses indicated that conduct problems may play a mediating role between callousness and amygdala-dmPFC functional connectivity across youths with already high levels of callousness. Our study highlights that both variants differ in the functional connectivity of the amygdala. Our results support the importance of disentangling the heterogeneity of adolescents at risk for conduct problems in neuroimaging.
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Affiliation(s)
- Jules R Dugré
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada; Department of Psychiatry and Addictology, Faculty of Medicine, University of Montreal, Montreal, Canada.
| | - Stéphane Potvin
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada; Department of Psychiatry and Addictology, Faculty of Medicine, University of Montreal, Montreal, Canada.
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30
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Mathur A, Bashford-Largo J, Elowsky J, Zhang R, Dobbertin M, Tyler PM, Bajaj S, Blair KS, Blair RJR. Association Between Aggression and Differential Functional Activity of Neural Regions Implicated in Retaliation. J Am Acad Child Adolesc Psychiatry 2023; 62:805-815. [PMID: 36889505 PMCID: PMC10330338 DOI: 10.1016/j.jaac.2023.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/19/2023] [Accepted: 02/27/2023] [Indexed: 03/10/2023]
Abstract
OBJECTIVE The goal of the current study was to determine the extent to which atypical neural responsiveness during retaliation is associated with observed aggression in youth in residential care. METHOD This functional magnetic resonance imaging study involved 83 adolescents (56 male and 27 female; mean age, 16.18 years) in residential care performing a retaliation task. Of the 83 adolescents, 42 displayed aggressive behavior within the first 3 months of residential care, whereas 41 did not. During the retaliation task, participants were offered either fair or unfair divisions of $20 pots (allocation phase) and could either accept the offer or reject it, and, by spending $1, $2, or $3, punish the partner (retaliation phase). RESULTS The study's main findings were that aggressive adolescent showed the following: reduced down-regulation of activity within regions involved in representing the expected value of choice options (left ventromedial prefrontal cortex and left posterior cingulate cortex) as a function of offer unfairness and retaliation level; and reduced recruitment of regions implicated in response control (right inferior frontal gyrus and bilateral anterior insular cortex) and associated fronto-parietal regions as a function of retaliation level. The aggressive adolescents were also significantly more likely to have been aggressive prior to residential care and showed a strong trend for increased retaliation on the task. CONCLUSION We suggest that individuals with a greater propensity for aggression show reduced representation of the negative consequences of retaliation and associated reduced recruitment of regions potentially involved in over-ruling these negative consequences to engage in retaliation. DIVERSITY & INCLUSION STATEMENT We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure sex balance in the selection of non-human subjects. We actively worked to promote sex and gender balance in our author group. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group.
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Affiliation(s)
- Avantika Mathur
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
| | - Johannah Bashford-Largo
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
| | - Jaimie Elowsky
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
| | - Ru Zhang
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
| | - Matthew Dobbertin
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
| | | | - Sahil Bajaj
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
| | - Karina S Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
| | - R James R Blair
- Child and Adolescent Mental Health Center Research Center, Genthofte Hospital, Hellerup, Denmark.
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Cubillo A, Tkalcec A, Oldenhof H, Unternaehrer E, Raschle N, Kohls G, Nauta-Jansen L, Hervas A, Fernandez-Rivas A, Konrad K, Popma A, Freitag C, de Brito S, Fairchild G, Stadler C. Linking heart rate variability to psychological health and brain structure in adolescents with and without conduct disorder. Front Psychiatry 2023; 14:1101064. [PMID: 37441149 PMCID: PMC10333527 DOI: 10.3389/fpsyt.2023.1101064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 05/29/2023] [Indexed: 07/15/2023] Open
Abstract
Aims Heart rate variability (HRV) measures have been suggested in healthy individuals as a potential index of self-regulation skills, which include both cognitive and emotion regulation aspects. Studies in patients with a range of psychiatric disorders have however mostly focused on the potential association between abnormally low HRV at rest and specifically emotion regulation difficulties. Emotion regulation deficits have been reported in patients with Conduct Disorder (CD) however, the association between these emotion regulation deficits and HRV measures has yet to be fully understood. This study investigates (i) the specificity of the association between HRV and emotion regulation skills in adolescents with and without CD and (ii) the association between HRV and grey matter brain volumes in key areas of the central autonomic network which are involved in self-regulation processes, such as insula, lateral/medial prefrontal cortices or amygdala. Methods Respiratory sinus arrhythmia (RSA) measures of HRV were collected from adolescents aged between 9-18 years (693 CD (427F)/753 typically developing youth (TD) (500F)), as part of a European multi-site project (FemNAT-CD). The Inverse Efficiency Score, a speed-accuracy trade-off measure, was calculated to assess emotion and cognitive regulation abilities during an Emotional Go/NoGo task. The association between RSA and task performance was tested using multilevel regression models. T1-weighted structural MRI data were included for a subset of 577 participants (257 CD (125F); 320 TD (186F)). The CerebroMatic toolbox was used to create customised Tissue Probability Maps and DARTEL templates, and CAT12 to segment brain images, followed by a 2 × 2 (sex × group) full factorial ANOVA with RSA as regressor of interest. Results There were no significant associations between RSA and task performance, neither during emotion regulation nor during cognitive regulation trials. RSA was however positively correlated with regional grey matter volume in the left insula (pFWE = 0.011) across all subjects. Conclusion RSA was related to increased grey matter volume in the left insula across all subjects. Our results thus suggest that low RSA at rest might be a contributing or predisposing factor for potential self-regulation difficulties. Given the insula's role in both emotional and cognitive regulation processes, these brain structural differences might impact either of those.
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Affiliation(s)
- Ana Cubillo
- Department of Child and Adolescent Psychiatry (research section), University Psychiatric Clinics, Basel, Switzerland
- Zurich Center for Neuroeconomics, Department of Economics, University of Zurich, Zurich, Switzerland
| | - Antonia Tkalcec
- Department of Child and Adolescent Psychiatry (research section), University Psychiatric Clinics, Basel, Switzerland
| | - Helena Oldenhof
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Child and Adolescent Psychiatry, Amsterdam Public Health, Amsterdam, Netherlands
| | - Eva Unternaehrer
- Department of Child and Adolescent Psychiatry (research section), University Psychiatric Clinics, Basel, Switzerland
| | - Nora Raschle
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
| | - Gregor Kohls
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Lucres Nauta-Jansen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Child and Adolescent Psychiatry, Amsterdam Public Health, Amsterdam, Netherlands
| | - Amaia Hervas
- Hospital Universitario Mutua Terrassa, IGAIN, Barcelona, Spain
| | - Aranzazu Fernandez-Rivas
- Biocruces Bizkaia Health Research Institute, Basurto University Hospital, University of the Basque Country, Bilbao, Spain
| | - Kerstin Konrad
- RWTH Aachen University & JARA-Brain Institute, Aachen, Germany
| | - Arne Popma
- Child and Adolescent Psychiatry Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Christine Freitag
- Child and Adolescent Psychiatry, Goethe University, Frankfurt, Germany
| | | | - Graeme Fairchild
- Developmental Psychopathology, University of Bath, Bath, United Kingdom
| | - Christina Stadler
- Department of Child and Adolescent Psychiatry (research section), University Psychiatric Clinics, Basel, Switzerland
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32
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Tillem S, Dotterer HL, Goetschius LG, Lopez-Duran N, Mitchell C, Monk CS, Hyde LW. Antisocial behavior is associated with reduced frontoparietal network efficiency in youth. Soc Cogn Affect Neurosci 2023; 18:nsad026. [PMID: 37148314 PMCID: PMC10275549 DOI: 10.1093/scan/nsad026] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 04/25/2023] [Accepted: 05/05/2023] [Indexed: 05/08/2023] Open
Abstract
Youth antisocial behavior (AB) is associated with deficits in socioemotional processing, reward and threat processing and executive functioning. These deficits are thought to emerge from differences in neural structure, functioning and connectivity, particularly within the default, salience and frontoparietal networks. However, the relationship between AB and the organization of these networks remains unclear. To address this gap, the current study applied unweighted, undirected graph analyses to resting-state functional magnetic resonance imaging data in a cohort of 161 adolescents (95 female) enriched for exposure to poverty, a risk factor for AB. As prior work indicates that callous-unemotional (CU) traits may moderate the neurocognitive profile of youth AB, we examined CU traits as a moderator. Using multi-informant latent factors, AB was found to be associated with less efficient frontoparietal network topology, a network associated with executive functioning. However, this effect was limited to youth at low or mean levels of CU traits, indicating that these neural differences were specific to those high on AB but not CU traits. Neither AB, CU traits nor their interaction was significantly related to default or salience network topologies. Results suggest that AB, specifically, may be linked with shifts in the architecture of the frontoparietal network.
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Affiliation(s)
- Scott Tillem
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Hailey L Dotterer
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Leigh G Goetschius
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Nestor Lopez-Duran
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Colter Mitchell
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Christopher S Monk
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Luke W Hyde
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA
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Winters DE, Pettine WW, Sakai JT. Cognitive Mechanisms Underlying Prosocial Decision Making in Callous-Unemotional Traits. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2023; 45:308-321. [PMID: 37608928 PMCID: PMC10441623 DOI: 10.1007/s10862-023-10043-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2023] [Indexed: 04/05/2023]
Abstract
Callous-unemotional (CU) traits are characterized by a lack of prosocial emotions, which has been demonstrated with prosocial behavior paradigms. While shaping our understanding of prosocial behavior in youth with CU traits, most of this work relies on outcomes that don't reliably capture cognitive processes during prosocial behavior. Examining prosocial cognitive processes can cue researchers into cognitive mechanisms underlying core impairments of CU traits. Drift diffusion modeling is a valuable tool for elucidating more precise outcomes of latent cognitive processes during forced choice tasks such as drift rate (information accumulation toward a decision boundary) and threshold separation (amount of information considered) as well as metrics outside of the decision-making processing including bias (starting point in decision process) and non-decision time (cognitive processes outside of choice). In a sample of 87 adolescents (12-14, 49% female) we applied diffusion modeling to a prosocial behavior task in which participants either accepted or rejected trials where a real monetary value was given to them and taken away from a charity (self-serving trial) or money was given to a charity and taken from them (donation trial). Results revealed that CU traits associated with information accumulation toward accepting self-serving trials. Exploratory sex differences suggested males trended toward rejecting donation trials and females considered more information during self-serving trials. CU trait associations were independent of conduct problems. Results suggest a unique cognitive profile that are differentiated by sex at higher CU traits when making prosocial decisions involving knowledge accumulation toward self-serving decisions.
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Affiliation(s)
- Drew E. Winters
- Department of Psychiatry, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, United States
| | - Warren W. Pettine
- Yale School of Medicine, Department of Psychiatry, New Haven, United States
| | - Joseph T. Sakai
- Department of Psychiatry, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, United States
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Winters DE, Leopold DR, Carter RM, Sakai JT. Resting-state connectivity underlying cognitive control's association with perspective taking in callous-unemotional traits. Psychiatry Res Neuroimaging 2023; 331:111615. [PMID: 36924739 PMCID: PMC10133184 DOI: 10.1016/j.pscychresns.2023.111615] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 02/03/2023] [Accepted: 02/13/2023] [Indexed: 03/18/2023]
Abstract
Callous-Unemotional (CU) traits are often associated with impairments in perspective taking and cognitive control (regulating goal directed behavior); and adolescents with CU traits demonstrate aberrant brain activation/connectivity in areas underlying these processes. Together cognitive control and perspective taking are thought to link mechanistically to explain CU traits. Because increased cognitive control demands modulate perspective taking ability among both typically developing samples and individuals with elevated CU traits, understanding the neurophysiological substrates of these constructs could inform efforts to alleviate societal costs of antisocial behavior. The present study uses GIMME to examine the heterogenous functional brain properties (i.e., connection density, node centrality) underlying cognitive control's influence on perspective taking among adolescents on a CU trait continuum. Results reveal that cognitive control had a negative indirect association with CU traits via perspective taking; and brain connectivity indirectly associated with lower CU traits - specifically the social network via perspective taking and conflict network via cognitive control. Additionally, less negative connection density between the social and conflict networks was directly associated with higher CU traits. Our results support the growing literature on cognitive control's influence on socio-cognitive functioning in CU traits and extends that work by identifying underlying functional brain properties.
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Affiliation(s)
- Drew E Winters
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, CO, USA.
| | - Daniel R Leopold
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, CO, USA; Department of Psychology & Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | - R McKell Carter
- Department of Psychology & Neuroscience, University of Colorado Boulder, Boulder, CO, USA; Institute of Cognitive Science, University of Colorado Boulder, Boulder, CO, USA, Department of Electrical, Computer and Energy Engineering, University of Colorado Boulder, Boulder, CO, USA
| | - Joseph T Sakai
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, CO, USA
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Ho MH, Kemp BT, Eisenbarth H, Rijnders RJP. Designing a neuroclinical assessment of empathy deficits in psychopathy based on the Zipper Model of Empathy. Neurosci Biobehav Rev 2023; 151:105244. [PMID: 37225061 DOI: 10.1016/j.neubiorev.2023.105244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/02/2023] [Accepted: 05/20/2023] [Indexed: 05/26/2023]
Abstract
Ho, M.H., Kemp, B.T., Eisenbarth, H. & Rijnders, R.J.P. Designing a neuroclinical assessment of empathy deficits in psychopathy based on the Zipper Model of Empathy. NEUROSCI BIOBEHAV REV YY(Y) XXX-XXX, 2023. The heterogeneity of the literature on empathy highlights its multidimensional and dynamic nature and affects unclear descriptions of empathy in the context of psychopathology. The Zipper Model of Empathy integrates current theories of empathy and proposes that empathy maturity is dependent on whether contextual and personal factors push affective and cognitive processes together or apart. This concept paper therefore proposes a comprehensive battery of physiological and behavioral measures to empirically assess empathy processing according to this model with an application for psychopathic personality. We propose using the following measures to assess each component of this model: (1) facial electromyography; (2) the Emotion Recognition Task; (3) the Empathy Accuracy task and physiological measures (e.g., heart rate); (4) a selection of Theory of Mind tasks and an adapted Dot Perspective Task, and; (5) an adjusted Charity Task. Ultimately, we hope this paper serves as a starting point for discussion and debate on defining and assessing empathy processing, to encourage research to falsify and update this model to improve our understanding of empathy.
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Affiliation(s)
- Man Him Ho
- Danish Research Center for Magnetic Resonance, Kettegård Alle 30, 2650 Hvidovre, Capital Region, Denmark; Maastricht University, Psychology Neurosciences Department, Universiteitssingel 40, 6229 ER Maastricht, the Netherlands.
| | - Benjamin Thomas Kemp
- Maastricht University, Psychology Neurosciences Department, Universiteitssingel 40, 6229 ER Maastricht, the Netherlands.
| | - Hedwig Eisenbarth
- School of Psychology, Victoria University of Wellington, PO Box 600, Wellington 6140, New Zealand.
| | - Ronald J P Rijnders
- Netherlands Institute for Forensic Psychiatry and Psychology, Forensic Observation Clinic "Pieter Baan Centrum", Carl Barksweg 3, 1336 ZL, Almere, the Netherlands; Utrecht University, Faculty of Social Sciences, Department of Psychology, Heidelberglaan 8, 3584 CS, Utrecht, the Netherlands.
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36
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Bachmann CJ, Humayun S, Stevens M, O'Connor TG, Scott S. Secure attachment predicts lower societal cost amongst severely antisocial adolescents. Child Adolesc Psychiatry Ment Health 2023; 17:56. [PMID: 37161491 PMCID: PMC10170786 DOI: 10.1186/s13034-023-00598-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 03/27/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Social and economic costs associated with antisocial behaviour are well-established, but little is known about the potential costs savings/benefits of secure attachment in this high-risk group. We aimed to provide the first test of attachment quality as a distinct predictor of economic costs. METHODS 111 adolescents (10-17 years of age, M = 15.0, SD = 1.6; 71% male) referred to young offender services due to high levels of antisocial behaviour were included. Costs were measured by detailed service-use interview, and attachment security to mother and father elicited through the Child Attachment Interview. The level of antisocial behaviour and callous-unemotional traits were assessed. Cost predictors were calculated using generalised linear models. RESULTS Mean 12-months service costs were £5,368 (sd 5,769) per adolescent, with justice system and educational service costs being the main components. After adjusting for covariates, economic costs were predicted by attachment quality to fathers, with a difference of £2,655 per year between those with secure (£3,338) versus insecure attachment (£5,993); significant cost effects were not found for attachment quality to mothers. Higher levels of callous-unemotional traits, lower verbal IQ, higher levels of antisocial behaviour, and older age were also significant cost predictors. CONCLUSIONS Secure attachment to fathers is a predictor of reduced public cost in adolescents with severe antisocial behaviour. This novel finding for severely antisocial youth extends previous findings in less antisocial children and underscores the public health and policy benefits of good caregiving quality and the value of population-level dissemination of evidence-based interventions that improve caregiving quality.
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Affiliation(s)
- Christian J Bachmann
- Department of Child and Adolescent Psychiatry, University of Ulm, Steinhövelstr. 5, 89075, Ulm, Germany.
| | - Sajid Humayun
- School of Human Sciences, Faculty of Education, Health and Human Sciences, University of Greenwich, Avery Hill, London, SE9 92UG, UK
| | - Madeleine Stevens
- London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK
| | - Thomas G O'Connor
- Department of Psychiatry, School of Medicine and Dentistry, University of Rochester Medical Center, 601 Elmwood Ave, Box PSYCH, Rochester, NY, 14642, USA
| | - Stephen Scott
- National Academy for Parenting Research, King's College London, 16 De Crespigny Park, Box 86, London, SE5 8AF, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, Box 86, London, SE5 8AF, UK
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37
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Zhang R, Aloi J, Bajaj S, Bashford-Largo J, Lukoff J, Schwartz A, Elowsky J, Dobbertin M, Blair KS, Blair RJR. Dysfunction in differential reward-punishment responsiveness in conduct disorder relates to severity of callous-unemotional traits but not irritability. Psychol Med 2023; 53:1870-1880. [PMID: 34467836 PMCID: PMC8885913 DOI: 10.1017/s0033291721003500] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 06/29/2021] [Accepted: 08/09/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Conduct disorder (CD) has been associated with dysfunction in reinforcement-based decision-making. Two forms of affective traits that reflect the components of CD severity are callous-unemotional (CU; reduced guilt/empathy) traits and irritability. The form of the reinforcement-based decision-making dysfunction with respect to CD and CU traits remains debated and has not been examined with respect to irritability in cases with CD. The goals of the current study were to determine the extent of dysfunction in differential (reward v. punishment) responsiveness in CD, and CU traits and irritability in participants with CD. METHODS The study involved 178 adolescents [typically developing (TD; N = 77) and cases with CD (N = 101)]. Participants were scanned with fMRI during a passive avoidance task that required participants to learn to respond to (i.e. approach) stimuli that engender reward and refrain from responding to (i.e. passively avoid) stimuli that engender punishment. RESULTS Adolescents with CD showed reduced differential reward-punishment responsiveness within the striatum relative to TD adolescents. CU traits, but not irritability, were associated with reduced differential reward-punishment responsiveness within the striatum, rostromedial, and lateral frontal cortices. CONCLUSIONS The results suggest CD is associated with reduced differential reward-punishment responsiveness and the extent of this dysfunction in participants with CD is associated with the severity of CU traits but not irritability.
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Affiliation(s)
- Ru Zhang
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Joseph Aloi
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Sahil Bajaj
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Johannah Bashford-Largo
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Jennie Lukoff
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Amanda Schwartz
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Jamie Elowsky
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Matthew Dobbertin
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Karina S. Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - R. James R. Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
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38
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Abstract
Functional magnetic resonance imaging (fMRI) studies consistently indicate differences in emotion processing in youth with conduct problems. However, no prior meta-analysis has investigated emotion-specific responses associated with conduct problems. This meta-analysis aimed to generate an up-to-date assessment of socio-affective neural responding among youths with conduct problems. A systematic literature search was conducted in youths (ages 10-21) with conduct problems. Task-specific seed-based d mapping analyses examined responses to threatening images, fearful and angry facial expressions, and empathic pain stimuli from 23 fMRI studies, which included 606 youths with conduct problems and 459 comparison youths. Whole-brain analyses revealed youths with conduct problems relative to typically developing youths, when viewing angry facial expressions, had reduced activity in left supplementary motor area and superior frontal gyrus. Additional region of interest analyses of responses to negative images and fearful facial expressions showed reduced activation in right amygdala across youths with conduct problems. Youths with callous-unemotional traits also exhibited reduced activation in left fusiform gyrus, superior parietal gyrus, and middle temporal gyrus when viewing fearful facial expressions. Consistent with the behavioral profile of conduct problems, these findings suggest the most consistent dysfunction is found in regions associated with empathic responding and social learning, including the amygdala and temporal cortex. Youth with callous-unemotional traits also show reduced activation in the fusiform gyrus, consistent with reduced attention or facial processing. These findings highlight the potential role of empathic responding, social learning, and facial processing along with the associated brain regions as potential targets for interventions.
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Affiliation(s)
- Kathryn Berluti
- Department of Psychology, Georgetown University, Washington, DC, USA.
| | - Montana L Ploe
- Department of Psychology, Washington State University, Pullman, DC, USA
| | - Abigail A Marsh
- Department of Psychology, Georgetown University, Washington, DC, USA
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Boldrini T, Ghiandoni V, Mancinelli E, Salcuni S, Solmi M. Systematic Review and Meta-analysis: Psychosocial Treatments for Disruptive Behavior Symptoms and Disorders in Adolescence. J Am Acad Child Adolesc Psychiatry 2023; 62:169-189. [PMID: 35551985 DOI: 10.1016/j.jaac.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 02/12/2022] [Accepted: 05/02/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Disruptive behavior disorders (DBDs) represent a common motive for referral among youths. This meta-analysis aimed at estimating the efficacy of psychosocial interventions for adolescents with DBDs. METHOD A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-compliant systematic review of MEDLINE/PubMED/PsycINFO/Cochrane Central Register of Controlled Trials was conducted. Eligible studies were randomized controlled trials (RCTs) administering psychosocial interventions to adolescents with DBD, published before April 5, 2020. From the initial set of 6,006 records, 17 RCTs involving 18 cohorts (16 publications) were subjected to a random-effect meta-analysis (involving sensitivity, subgroup, and meta-regression analyses). Primary and secondary outcomes were externalizing symptoms at RCT endpoint (ie, standardized mean difference [SMD]) and acceptability (drop-out odds ratio [OR]), respectively. Risk of bias was assessed using the Risk of Bias 2 tool. RESULTS A total of 17 RCTs, involving 1,954 adolescents, were included. The mean age was 14.09 (SD 1.33) years; 61% were male. The mean RCT duration was 12 weeks, with a mean follow-up of 8 (SD 3.98) months. Concern over risk of bias emerged in 12 studies, with high concern in 6. Psychosocial interventions had a large effect size at RCT endpoint (SMD = 0.98, 95% CI = -0.55 to -1.38, k = 18) and were acceptable (drop-out OR = 1.29, 95% CI = 0.62-2.70, k = 13). However, this beneficial effect did not persist at follow-up (SMD = -0.36, 95% CI = 0.06 to -0.78, k = 10). Family format was the most effective variable. No other clinically significant moderator was found. CONCLUSION Psychosocial interventions involving the families of DBD adolescents are effective and acceptable in the short term. Future studies should focus on strategies to achieve their long-term efficacy.
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Affiliation(s)
| | | | | | | | - Marco Solmi
- University of Ottawa, Ontario, Canada; The Ottawa Hospital, Ontario, Canada; Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program. University of Ottawa, Ontario; and Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
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40
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The social correlates to callous-unemotional traits in a sample of high school students. Behav Ther 2023; 54:595-604. [PMID: 37088513 DOI: 10.1016/j.beth.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 12/23/2022] [Accepted: 01/09/2023] [Indexed: 01/22/2023]
Abstract
Callous-Unemotional (CU) traits are strongly related to early-onset and severe levels of conduct problems. However, much less research has focused on their association with potential problems in adolescents' social relationships. Further, it is important to determine if CU traits explain variance in important social variables, independent of conduct problems or general personality dimensions related to sociability, like agreeableness. In the current study, we examined the association of CU traits with a range of social variables in a community sample of Italian adolescents (N = 563; 460 girls; mean age = 15.80, SD = 1.50). Measures for the social variables included assessment of peer rejection, adolescents' prosocial behaviors, satisfaction in peer relationships, and feelings of connection with school and classmates. We also obtained self-report ratings of CU traits, conduct problems (CP) and agreeableness. Analyses showed that CU traits were significantly associated with all the social variables. After controlling for CP and agreeableness, CU traits were still positively associated with ratings of peer rejection and negatively associated with prosocial behavior and satisfaction in relationships with peers. However, the negative associations with feelings of connection to school and peers were no longer significant. These findings provide further support for the clinical usefulness of CU traits and further evidence for potential targets of intervention, particularly focused on the adolescent's relational skills.
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41
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Jiang Y, Gao Y, Dong D, Sun X, Situ W, Yao S. Structural abnormalities in adolescents with conduct disorder and high versus low callous unemotional traits. Eur Child Adolesc Psychiatry 2023; 32:193-203. [PMID: 34635947 DOI: 10.1007/s00787-021-01890-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 10/01/2021] [Indexed: 10/20/2022]
Abstract
There may be distinct conduct disorder (CD) etiologies and neural morphologies in adolescents with high callous unemotional (CU) traits versus low CU traits. Here, we employed surface-based morphometry methods to investigate morphological differences in adolescents diagnosed with CD [42 with high CU traits (CD-HCU) and 40 with low CU traits (CD-LCU)] and healthy controls (HCs, N = 115) in China. Whole-brain analyses revealed significantly increased cortical surface area (SA) in the left inferior temporal cortex and the right precuneus, but decreased SA in the left superior temporal cortex in the CD-LCU group, compared with the HC group. There were no significant cortical SA differences between the CD-HCU and the HC groups. Compared to the CD-HCU group, the CD-LCU group had a greater cortical thickness (CT) in the left rostral middle frontal cortex. Region-of-interest analyses revealed significant group differences in the right hippocampus, with CD-HCU group having lower right hippocampal volumes than HCs. We did not detect significant group differences in the amygdalar volume, however, the right amygdalar volume was found to be a significant moderator of the correlation between CU traits and the proactive aggression in CD patients. The present results suggested that the manifestations of CD differ between those with high CU traits versus low CU traits, and underscore the importance of sample characteristics in understanding the neural substrates of CD.
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Affiliation(s)
- Yali Jiang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, South China Normal University, Guangzhou, People's Republic of China
- School of Psychology, South China Normal University, Guangzhou, People's Republic of China
- Center for Studies of Psychological Application, South China Normal University, Guangzhou, People's Republic of China
- Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, People's Republic of China
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Yidian Gao
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Daifeng Dong
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Xiaoqiang Sun
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Weijun Situ
- Department of Radiology, the Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Shuqiao Yao
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China.
- National Clinical Research Center on Psychiatry and Psychology, Changsha, People's Republic of China.
- Medical Psychological Institute of Central South University, Changsha, People's Republic of China.
- National Clinical Research Center for Mental Disorders, Changsha, People's Republic of China.
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42
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Serum oxytocin levels in adolescents with conduct disorder associated with callous-unemotional traits. MIDDLE EAST CURRENT PSYCHIATRY 2022. [DOI: 10.1186/s43045-022-00218-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Conduct disorder (CD) is a serious and common psychiatric disorder affecting children and adolescents. “Callous-unemotional traits” is a new specifier added to the diagnosis of CD in the DSM-5. The new specifier is thought to be associated with more severity and higher genetic load. Oxytocin is known to be related to interpersonal sympathy and social affection, and so its deficiency might be related to unemotionality. This work aims to explore the levels of serum oxytocin in adolescents with CD associated with callous-unemotional (CU) traits as compared to healthy control subjects. Twenty patients aged 12–18 years and 20 controls of the same age range were recruited. An Arabic-translated and validated version of Mini International Neuropsychiatric Interview for kids (MINI-kid) was used to confirm the diagnosis. The Youth Psychopathic Inventory-short version (YPI-short version) and the Inventory of Callous-Unemotional Traits (ICU), both parent and self-reports, were all translated into Arabic and validated by the authors and used to evaluate the sample. Evaluation of serum oxytocin level using ELISA technique was done.
Results
After statistical adjustment for differences in socioeconomic status, an adolescent with CD associated with CU traits showed low levels of serum oxytocin level as compared with the control group. Serum oxytocin levels were negatively correlated in a statistically significant degree with the unemotional, the callousness, and the uncaring subscores of ICU—self-report.
Conclusions
Low levels of serum oxytocin might play a potential role as a biomarker for CU traits and CD severity in adolescents with CD.
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43
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Winters DE, Hyde LW. Associated functional network connectivity between callous-unemotionality and cognitive and affective empathy. J Affect Disord 2022; 318:304-313. [PMID: 36063973 PMCID: PMC10039983 DOI: 10.1016/j.jad.2022.08.103] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 05/21/2022] [Accepted: 08/26/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Low empathy is one component of affective impairments defining the antisocial youth phenotype callous-unemotional (CU) traits. Research suggests CU traits may be negatively associated with neural networks that are positively associated with cognitive and affective empathy - specifically the default mode (DMN), frontoparietal (FPN), and salience (SAL) networks. Determining which functional network connections are shared between CU traits and empathy could elucidate the extent to which CU traits shares neural substrates with cognitive versus affective empathy. The present study tested whether CU traits and both cognitive and affective empathy share network connections within and between the DMN, FPN, and SAL. METHODS Participants (n = 112, aged 13-17, 43 % female) completed resting-state functional magnetic resonance imaging and self-reports for CU traits and empathy as part of a Nathan-Kline Institute study. RESULTS Analyses revealed inverse associations with shared network connections between CU traits and both cognitive and affective empathy. Specifically, within-DMN connectivity negatively associated with CU traits, but positively associated with cognitive empathy; and between DMN-SAL connectivity positively associated with CU traits, but negatively associated with both cognitive and affective empathy. However, joint models revealed little variance explained by CU traits and empathy overlapped. LIMITATIONS The sample was cross-sectional collection with limited participants (n = 112) from the community that may not generalize to incarcerated adolescents. CONCLUSIONS Results demonstrate CU traits inversely associated with similar connectivity patterns as cognitive and affective empathy though prediction among constructs did not significantly overlap. Further investigation of these connections can inform a mechanistic understanding of empathy impairments in CU traits.
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Affiliation(s)
- Drew E Winters
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, United States of America.
| | - Luke W Hyde
- Department of Psychology and Survey Research Center at the Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
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44
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Kant T, Koyama E, Zai CC, Beitchman JH, Kennedy JL. Association of the MAOA-uVNTR polymorphism with psychopathic traits may change from childhood to adolescence. Eur Arch Psychiatry Clin Neurosci 2022; 272:1517-1521. [PMID: 35038001 DOI: 10.1007/s00406-021-01370-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 12/10/2021] [Indexed: 01/17/2023]
Abstract
Psychopathic traits can lead to violence, making it a serious public health concern. Genetic factors contribute to the aetiology of psychopathy. We examined whether monoamine oxidase A (MAOA-uVNTR) was associated with psychopathic traits measured quantitatively from controls through clinically aggressive youth (n = 336). Subjects were sub-categorized into at or above, and below age 13 years. Results reveal that males below age 13 were more likely to display psychopathic traits with the MAOA long variant, whereas males above age 13 years were more likely to display with the short variant. This suggests that developmental factors may be crucial for understanding the role of the MAOA polymorphism in psychopathic traits in males.
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Affiliation(s)
- Tuana Kant
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada. .,Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.
| | - Emiko Koyama
- Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,The Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Clement C Zai
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Joseph H Beitchman
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,The Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - James L Kennedy
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada. .,Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada. .,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
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45
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Hyde LW, Dotterer HL. The Nature and Nurture of Callous-Unemotional Traits. CURRENT DIRECTIONS IN PSYCHOLOGICAL SCIENCE 2022. [DOI: 10.1177/09637214221121302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Callous-unemotional (CU) traits, a risk factor for psychopathy, delineate youths with relatively low empathy and guilt, and identify youths with high risk for chronic and severe antisocial behavior (e.g., rule breaking, aggression). We describe work identifying nature and nurture influences on the development of CU traits. Additionally, we clarify the relationship between CU traits and psychopathy, highlight potential misinterpretations of findings on influences of “nature” versus “nurture,” and discuss treatment implications.
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Affiliation(s)
- Luke W. Hyde
- Department of Psychology, University of Michigan
- Survey Research Center at the Institute for Social Research, University of Michigan
| | - Hailey L. Dotterer
- Department of Psychology, University of Michigan
- Department of Psychiatry, School of Medicine, Johns Hopkins University
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46
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Kuay HS, Boothroyd LG, Towl GJ, Tiffin PA, Muñoz LC. Callous-Unemotional Traits are Associated With Child-to-Parent Aggression. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2022; 66:1603-1626. [PMID: 34605308 DOI: 10.1177/0306624x211049190] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This study examined the relations between callous-unemotional traits and perpetration of aggression toward parents in two separate studies, while also considering motivation for aggression and parenting styles experienced among young people. Study 1 involved 60 parents of children aged between 11 and 17 years old. The online study found high callous-unemotional traits, as reported by parents, to be associated with aggression toward both parents. Both types of motivation (proactive and reactive, as reported by parents) were associated with aggression toward parents. Study 2 involved 42 youths from an alternative education sample (between 11 and 16 years old). Youths with higher self-reported callous-unemotional traits reported more aggression toward both parents. Both studies, which had different reporters and different samples, showed youths with higher callous-unemotional traits were more aggressive toward their parents. In discussing the results, we note the importance of including callous-unemotional traits in future research on parent-directed aggression and in studies on domestic violence more broadly.
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Affiliation(s)
- Hue San Kuay
- Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
- Durham University, Durham, UK
| | | | | | - Paul A Tiffin
- University of York, Heslington, York, UK
- Forensic Child and Adolescent Mental Health Services for Yorkshire and Humber, CAMHS, York, UK
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47
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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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48
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Sethi A, O'Brien S, Blair J, Viding E, Mehta M, Ecker C, Blackwood N, Doolan M, Catani M, Scott S, Murphy DGM, Craig MC. Selective Amygdala Hypoactivity to Fear in Boys With Persistent Conduct Problems After Parent Training. Biol Psychiatry 2022:S0006-3223(22)01658-4. [PMID: 36642564 DOI: 10.1016/j.biopsych.2022.09.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 08/23/2022] [Accepted: 09/30/2022] [Indexed: 01/17/2023]
Abstract
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.
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Affiliation(s)
- Arjun Sethi
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Suzanne O'Brien
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom. suzanne.o'
| | - James Blair
- Child and Adolescent Mental Health Centre, Mental Health Services, Copenhagen, Capital Region of Denmark, Denmark
| | - Essi Viding
- Division of Psychology and Language Sciences, University College London, London, United Kingdom
| | - Mitul Mehta
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Christine Ecker
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Nigel Blackwood
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Moira Doolan
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Marco Catani
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Stephen Scott
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Declan G M Murphy
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Michael C Craig
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; National Female Hormone Clinic Maudsley Hospital, London, United Kingdom; National Autism Unit, Bethlem Royal Hospital, London, United Kingdom
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49
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Drent HM, van den Hoofdakker B, Buitelaar JK, Hoekstra PJ, Dietrich A. Factors Related to Perceived Stigma in Parents of Children and Adolescents in Outpatient Mental Healthcare. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912767. [PMID: 36232067 PMCID: PMC9566109 DOI: 10.3390/ijerph191912767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/24/2022] [Accepted: 09/28/2022] [Indexed: 06/01/2023]
Abstract
Little is known about factors contributing to perceived stigma in parents of children and adolescents with behavioral and emotional problems in outpatient mental healthcare. We aimed to identify the most relevant factors related to perceived parental stigma using least absolute shrinkage and selection operator (LASSO) regression including a broad range of factors across six domains: (1) child characteristics, (2) characteristics of the primary parent, (3) parenting and family characteristics, (4) treatment-related characteristics, (5) sociodemographic characteristics, and (6) social-environmental characteristics. We adapted the Parents' Perceived Stigma of Service Seeking scale to measure perceived public stigma and affiliate stigma in 312 parents (87.8% mothers) during the first treatment year after referral to an outpatient child and adolescent clinic. We found that the six domains, including 45 individual factors, explained 34.0% of perceived public stigma and 19.7% of affiliate stigma. Child and social-environmental characteristics (social relations) explained the most deviance in public stigma, followed by parental factors. The strongest factors were more severe problems of the child (especially callous-unemotional traits and internalizing problems), mental healthcare use of the parent, and lower perceived parenting competence. The only relevant factor for affiliate stigma was lower perceived parenting competence. Our study points to the multifactorial nature of perceived stigma and supports that parents' perceived public stigma is susceptible to social influences, while affiliate stigma relates to parents' self-evaluation. Increasing parents' perceived parenting competence may help mitigate perceived stigma. Future studies should explore how stigma relates to treatment outcomes.
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Affiliation(s)
- Halewijn M. Drent
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, 9723 HE Groningen, The Netherlands
- Accare Child Study Center, 9723 HE Groningen, The Netherlands
| | - Barbara van den Hoofdakker
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, 9723 HE Groningen, The Netherlands
- Accare Child Study Center, 9723 HE Groningen, The Netherlands
| | - Jan K. Buitelaar
- Department of Cognitive Neuroscience, Radboud University Medical Center, Donders Institute for Brain Cognition and Behaviour, 6525 AJ Nijmegen, The Netherlands
| | - Pieter J. Hoekstra
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, 9723 HE Groningen, The Netherlands
- Accare Child Study Center, 9723 HE Groningen, The Netherlands
| | - Andrea Dietrich
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, 9723 HE Groningen, The Netherlands
- Accare Child Study Center, 9723 HE Groningen, The Netherlands
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50
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Tillem S, Conley MI, Baskin-Sommers A. Conduct disorder symptomatology is associated with an altered functional connectome in a large national youth sample. Dev Psychopathol 2022; 34:1573-1584. [PMID: 33851904 PMCID: PMC8753609 DOI: 10.1017/s0954579421000237] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Conduct disorder (CD), characterized by youth antisocial behavior, is associated with a variety of neurocognitive impairments. However, questions remain regarding the neural underpinnings of these impairments. To investigate novel neural mechanisms that may support these neurocognitive abnormalities, the present study applied a graph analysis to resting-state functional magnetic resonance imaging (fMRI) data collected from a national sample of 4,781 youth, ages 9-10, who participated in the baseline session of the Adolescent Brain Cognitive DevelopmentSM Study (ABCD Study®). Analyses were then conducted to examine the relationships among levels of CD symptomatology, metrics of global topology, node-level metrics for subcortical structures, and performance on neurocognitive assessments. Youth higher on CD displayed higher global clustering (β = .039, 95% CIcorrected [.0027 .0771]), but lower Degreesubcortical (β = -.052, 95% CIcorrected [-.0916 -.0152]). Youth higher on CD had worse performance on a general neurocognitive assessment (β = -.104, 95% CI [-.1328 -.0763]) and an emotion recognition memory assessment (β = -.061, 95% CI [-.0919 -.0290]). Finally, global clustering mediated the relationship between CD and general neurocognitive functioning (indirect β = -.002, 95% CI [-.0044 -.0002]), and Degreesubcortical mediated the relationship between CD and emotion recognition memory performance (indirect β = -.002, 95% CI [-.0046 -.0005]). CD appears associated with neuro-topological abnormalities and these abnormalities may represent neural mechanisms supporting CD-related neurocognitive disruptions.
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Affiliation(s)
- Scott Tillem
- Department of Psychology, Yale University, New Haven, CT, USA
| | - May I Conley
- Department of Psychology, Yale University, New Haven, CT, USA
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