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Waaler PM, Bergseth J, Vaskinn L, Espenes K, Holtan T, Kjøbli J, Bjørnebekk G. Identification of treatment elements for adolescents with callous unemotional traits: a systematic narrative review. Child Adolesc Psychiatry Ment Health 2024; 18:110. [PMID: 39227822 PMCID: PMC11373131 DOI: 10.1186/s13034-024-00792-2] [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: 05/09/2024] [Accepted: 07/31/2024] [Indexed: 09/05/2024] Open
Abstract
Adolescents with callous unemotional (CU) traits are at risk for poor quality-of-life outcomes such as incarceration, suicide, and psychopathy. It is currently unknown which treatments are implemented with CU adolescents specifically and which elements make up these interventions. A narrative systematic review was used to identify the treatments and common elements used with CU adolescents (12-18 years). Eligible studies were randomized controlled trials and quasi-experimental studies evaluating psychosocial interventions, delivered within a clinical context, and directed towards the adolescent or their family. Eight studies with 1291 participants were included. Significant decreases in CU traits were demonstrated only in a minority of studies. The most utilized practice elements were set goals for treatment, practice interpersonal/communication skills, prepare for termination, and teach parents skills and strategies; the most utilized process elements were formal therapy, practice exercises, important others, and flexible/adaptive. A majority of the studies did not report an implementation element. While theoretical frameworks for CU children are employed with CU adolescents, there is still uncertainty regarding their suitability for this age group. Given the limited empirical evidence, there is a critical need for further exploration.
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Affiliation(s)
- Pamela M Waaler
- Department of Special Needs Education, University of Oslo, Oslo, Norway.
| | - Josefine Bergseth
- Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | - Linda Vaskinn
- Norwegian Directorate for Children, Youth and Family Affairs (Bufdir), Oslo, Norway
| | - Kristin Espenes
- Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
- Norwegian Office for Children, Youth and Family Affairs (Bufetat), Oslo, Norway
| | - Thale Holtan
- Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | - John Kjøbli
- Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
- Department of Education, University of Oslo, Oslo, Norway
| | - Gunnar Bjørnebekk
- Department of Special Needs Education, University of Oslo, Oslo, Norway
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Perlstein S, Hawes SW, Byrd AL, Barzilay R, Gur RE, Laird AR, Waller R. Unique versus shared neural correlates of externalizing psychopathology in late childhood. JOURNAL OF PSYCHOPATHOLOGY AND CLINICAL SCIENCE 2024; 133:477-488. [PMID: 38869879 PMCID: PMC11293992 DOI: 10.1037/abn0000923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Abstract
Childhood externalizing psychopathology is heterogeneous. Symptom variability in conduct disorder (CD), oppositional defiant disorder (ODD), attention-deficit/hyperactivity disorder (ADHD), and callous-unemotional (CU) traits designate different subgroups of children with externalizing problems who have specific treatment needs. However, CD, ODD, ADHD, and CU traits are highly comorbid. Studies need to generate insights into shared versus unique risk mechanisms, including through the use of functional magnetic resonance imaging (fMRI). In this study, we tested whether symptoms of CD, ODD, ADHD, and CU traits were best represented within a bifactor framework, simultaneously modeling shared (i.e., general externalizing problems) and unique (i.e., symptom-specific) variance, or through a four-correlated factor or second-order factor model. Participants (N = 11,878, age, M = 9 years) were from the Adolescent Brain and Cognitive Development Study. We used questionnaire and functional magnetic resonance imaging data (emotional N-back task) from the baseline assessment. A bifactor model specifying a general externalizing and specific CD, ODD, ADHD, and CU traits factors demonstrated the best fit. The four-correlated and second-order factor models both fit the data well and were retained for analyses. Across models, reduced right amygdala activity to fearful faces was associated with more general externalizing problems and reduced dorsolateral prefrontal cortex activity to fearful faces was associated with higher CU traits. ADHD scores were related to greater right nucleus accumbens activation to fearful and happy faces. Results give insights into risk mechanisms underlying comorbidity and heterogeneity within externalizing psychopathology. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
| | - Samuel W. Hawes
- Department of Psychology, Florida International University, Miami, FL
| | - Amy L. Byrd
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Ran Barzilay
- Department of Psychiatry and the Lifespan Brain Institute of CHOP-Penn Medicine, Perelman School of Medicine, University of Pennsylvania Philadelphia, PA
| | - Raquel E. Gur
- Department of Psychiatry and the Lifespan Brain Institute of CHOP-Penn Medicine, Perelman School of Medicine, University of Pennsylvania Philadelphia, PA
| | - Angela R. Laird
- Department of Physics, Florida International University, Miami, FL
| | - Rebecca Waller
- Department of Psychology, University of Pennsylvania, Philadelphia, PA
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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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Kary A, Moul C. Meta-analysis of the implied distribution of callous-unemotional traits across sampling methods and informant. Clin Psychol Rev 2024; 109:102407. [PMID: 38479319 DOI: 10.1016/j.cpr.2024.102407] [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: 05/04/2023] [Revised: 02/05/2024] [Accepted: 02/19/2024] [Indexed: 04/06/2024]
Abstract
Callous-unemotional (CU) traits have been measured in a variety of sample-types (e.g., community or forensic) and from the perspective of different informants (e.g., self-report or parent-report) using the inventory of callous-unemotional traits total score (ICU-T). Although the positive association between CU traits and antisocial behavior is uncontroversial, the degree to which sample-types are different from each other has received little attention despite such knowledge being important for generalization and interpretation of research findings. To address this gap in the literature, we estimated the implied distribution of the ICU-T across sample-types, informants, and their interaction using meta-analytic models of sample means and variances. In unconditional models, we found that sample-type significantly moderated mean ICU-T scores but not variance, while informant significantly moderated the variance of ICU-T scores but not means. There was also a significant interaction between sample-type and informant. Mean parent-reported ICU-T scores were significantly lower than self-reported scores in community samples, but not significantly different in samples with elevated levels of antisocial behavior. Implications of our findings include improved research efficiency, the need for different ICU-T norms across informants, and greater understanding of informant biases.
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Affiliation(s)
- Arthur Kary
- School of Psychology, The University of Sydney, Sydney, Australia.
| | - Caroline Moul
- School of Psychology, The University of Sydney, Sydney, Australia
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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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López-Romero L, Andershed H, Romero E, Cervin M. In Search of Conceptual Clarity About the Structure of Psychopathic Traits in Children: A Network-Based Proposal. Child Psychiatry Hum Dev 2024:10.1007/s10578-023-01649-z. [PMID: 38236454 DOI: 10.1007/s10578-023-01649-z] [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: 12/04/2023] [Indexed: 01/19/2024]
Abstract
Psychopathic traits in childhood have been revealed as potential identifiers of risk, being predictive of later forms of behavioral maladjustment. Yet, it is still under debate how psychopathic traits in children should be best conceptualized and which are the core dimensions for construct definition and prediction. The present study aims to examine the structure of psychopathic traits in childhood, and its predictive value, by using a combination of traditional factor analysis and more recent network-based methods. Data on psychopathic traits, as measured by the Child Problematic Traits Inventory (CPTI), were collected in a large sample of children (n = 2454; 48.2% girls), aged 3 to 6 at the onset of the study (Mage = 4.26; SD = 0.91), who were followed-up one and two years later using parent- and teacher-reports. Results showed that psychopathic traits measured via CPTI are best conceptualized as five latent factors encompassing grandiosity, deceitfulness, callousness, impulsivity and need of stimulation, a result that converged across informants and time. Callousness and grandiosity emerged as central traits using network analysis of parent-reports, while deceitfulness was most central using teacher-reports. Finally, callousness, impulsivity and deceitfulness emerged as the best predictors of concurrent, prospective and stable conduct problems. These results provide a refined structure of psychopathic traits in children that better accounts for the core elements of the construct. Additional theoretical and practical implications will be discussed in terms of assessment, diagnostic classification and tailored prevention/intervention.
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Affiliation(s)
- Laura López-Romero
- Departamento de Psicología Clínica y Psicobiología, Facultad de Psicología, Universidade de Santiago de Compostela, Rua Xose María Suárez Núñez S/N, Campus Sur, 15782, Santiago de Compostela, Spain.
| | | | - Estrella Romero
- Departamento de Psicología Clínica y Psicobiología, Facultad de Psicología, Universidade de Santiago de Compostela, Rua Xose María Suárez Núñez S/N, Campus Sur, 15782, Santiago de Compostela, Spain
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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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Perlstein S, Fair M, Hong E, Waller R. Treatment of childhood disruptive behavior disorders and callous-unemotional traits: a systematic review and two multilevel meta-analyses. J Child Psychol Psychiatry 2023; 64:1372-1387. [PMID: 36859562 PMCID: PMC10471785 DOI: 10.1111/jcpp.13774] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/10/2023] [Indexed: 03/03/2023]
Abstract
BACKGROUND Children with callous-unemotional (CU) traits are at high lifetime risk of antisocial behavior. It is unknown if treatments for disruptive behavior disorders are as effective for children with CU traits (DBD+CU) as those without (DBD-only), nor if treatments directly reduce CU traits. Separate multilevel meta-analyses were conducted to compare treatment effects on DBD symptoms for DBD+CU versus DBD-only children and evaluate direct treatment-related reductions in CU traits, as well as to examine moderating factors for both questions. METHODS We systematically searched PsycINFO, PubMed, Cochran Library (Trials), EMBASE, MEDLINE, APA PsycNet, Scopus, and Web of Science. Eligible studies were randomized controlled trials, controlled trials, and uncontrolled studies evaluating child-focused, parenting-focused, pharmacological, family-focused, or multimodal treatments. RESULTS Sixty studies with 9,405 participants were included (Mage = 10.04, SDage = 3.89 years, 25.09% female, 44.10% racial/ethnic minority). First, treatment was associated with similar reductions in DBD symptoms for DBD+CU (SMD = 1.08, 95% CI = 0.45, 1.72) and DBD-only (SMD = 1.01, 95% CI = 0.38, 1.64). However, DBD+CU started (SMD = 1.18, 95% CI = 0.57, 1.80) and ended (SMD = 0.73, p < .001; 95% CI = 0.43, 1.04) treatment with more DBD symptoms. Second, although there was no overall direct effect of treatment on CU traits (SMD = .09, 95% CI = -0.02, 0.20), there were moderating factors. Significant treatment-related reductions in CU traits were found for studies testing parenting-focused components (SMD = 0.21, 95% CI = 0.06, 0.35), using parent-reported measures (SMD = 0.16, 95% CI = 0.04, 0.28), rated as higher quality (SMD = 0.26, 95% CI = 0.13, 0.39), conducted outside the United States (SMD = 0.19, 95% CI = 0.05, 0.32), and with less than half the sample from a racial/ethnic minority group (SMD = 0.15, 95% CI = 0.002, 0.30). CONCLUSIONS DBD+CU children improve with treatment, but their greater DBD symptom severity requires specialized treatment modules that could be implemented alongside parenting programs. Conclusions are tempered by heterogeneity across studies and scant evidence from randomized controlled trials.
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Affiliation(s)
| | - Maddy Fair
- Department of Psychology, University of Pennsylvania
| | - Emily Hong
- Department of Psychology, University of Pennsylvania
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Todorov JJ, Devine RT, De Brito SA. Association between childhood maltreatment and callous-unemotional traits in youth: A meta-analysis. Neurosci Biobehav Rev 2023; 146:105049. [PMID: 36681371 DOI: 10.1016/j.neubiorev.2023.105049] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 12/15/2022] [Accepted: 01/14/2023] [Indexed: 01/21/2023]
Abstract
Callous-unemotional (CU) traits (i.e., lack of remorse or guilt, callous lack of empathy, deficient concern for the feelings of others) in youth with conduct problems confer risk for a particularly severe and persistent form of antisocial behaviour. Previous research has linked childhood maltreatment as a potential risk factor for CU traits, both primary (i.e., genetically underpinned) and secondary (i.e., environmentally influenced) variants, but findings have been inconsistent, and the association has not yet been tested in a meta-analysis. To address this gap, we conducted a meta-analysis to assess the nature and strength of the associations between childhood maltreatment and its subtypes with CU traits and potential variants (i.e., primary and secondary CU traits). A systematic search identified 29 eligible studies including 9,894 participants (42% female) between the ages of 3 and 18 years (Mage=14.22 years, SD = 1.07). Results revealed a significant moderate positive association between childhood maltreatment and CU traits. All subtypes of maltreatment bar sexual abuse were significantly associated with CU traits. However, it was not possible to compare primary and secondary CU traits directly due to inconsistencies in how they are defined. The limitations posed by current research signal the need for clinical and operational guidelines on how to define primary and secondary CU traits. Additionally, prospective longitudinal, genetically informed research is needed to clarify if maltreatment is a causal risk factor for CU traits.
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Affiliation(s)
- Jessica J Todorov
- Centre for Human Brain Health, School of Psychology, University of Birmingham, UK.
| | - Rory T Devine
- Centre for Developmental Science, School of Psychology, University of Birmingham, UK
| | - Stephane A De Brito
- Centre for Human Brain Health, School of Psychology, University of Birmingham, UK.
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Ene I, Wong KKY, Salali GD. Is it good to be bad? An evolutionary analysis of the adaptive potential of psychopathic traits. EVOLUTIONARY HUMAN SCIENCES 2022; 4:e37. [PMID: 37588932 PMCID: PMC10426111 DOI: 10.1017/ehs.2022.36] [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: 11/07/2022] Open
Abstract
Although psychopathy is widely conceptualised as a mental disorder, some researchers question the maladaptive nature of psychopathy, and argue that it might be advantageous from an evolutionary point of view. According to this view, psychopathy can be seen as an evolutionary adaptative strategy that relies on deception and manipulation to gain short-term reproductive benefits. Psychopathy is also identified as a fast life strategy in response to early life stress and an adaptation to harsh environments. This paper investigates the evidence that psychopathic traits are adaptive, while also addressing the limitations of current evolutionary models of psychopathy based on frequency-dependent selection and life history theory. We review recent studies on the fitness correlates of psychopathy and find that psychopathic traits present potential adaptive trade-offs between fertility and mortality, and offspring quantity and quality. On a proximate level, individual differences in stress reactivity and environmental risk factors in early development predispose to psychopathy through gene-environment interactions. We propose that environmental, developmental, social and cultural factors can mediate the relationship between psychopathic traits and fitness and therefore should be considered to make accurate predictions on the adaptive potential of psychopathy. We end by outlining gaps in the literature and making recommendations for future evolutionary research on psychopathy.
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Affiliation(s)
- Ioana Ene
- Department of Anthropology, University College London, 14 Taviton Street, London WC1H 0BW, UK
| | - Keri Ka-Yee Wong
- Department of Psychology and Human Development, University College London, 25 Woburn Square, London WC1H 0AA, UK
| | - Gul Deniz Salali
- Department of Anthropology, University College London, 14 Taviton Street, London WC1H 0BW, UK
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Ručević S, Farrington DP, Andershed H. The role of parental psychopathic traits: longitudinal relations with parenting, child’s psychopathy features and conduct problems. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03452-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Pueyo N, Navarro JB, De La Osa N, Penelo E, Ezpeleta L. Describing Callous Unemotional Traits and Stressful Life Event Trajectories: Differences on Risk Factors and Mental Health Outcomes from the Age of 3 to 10. THE SPANISH JOURNAL OF PSYCHOLOGY 2022; 25:e17. [PMID: 35499095 DOI: 10.1017/sjp.2022.13] [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] [Indexed: 06/14/2023]
Abstract
Callous Unemotional (CU) traits are associated with different environmental risk factors, such as negative stressful life events (SLE). The most common studied SLE associated with CU trait has been childhood maltreatment, but less is known about how other SLE impact the development of CU traits. Therefore, this work examines risk factors, personal factors (executive functioning), and mental health outcomes associated with the trajectories of Callous Unemotional (CU) traits and Stressful Life Events (SLE) in a community sample of children. A cohort of 377 preschoolers were followed up between ages 3 and 10. Several risk factors and outcomes for three trajectory groups (high CU/SLE; high CU/low SLE; and the reference group with low CU/SLE) were analyzed by using multiple post-hoc comparisons. We hypothesized that children with high CU/SLE would face more contextual risk factors, more executive functioning difficulties and more mental health problems than children with high CU/low SLE or the reference group. At the age of 3, children who showed high CU/SLE faced more early contextual adversity, including socioeconomic difficulties and maternal antisocial behavior than the other groups of children. At the age of 10, children with high CU/SLE presented more peer problems and higher psychopathology symptoms than the reference group, but no differences on mental health outcomes in comparison to the high CU/low SLE group. These results have potential implications for clinical practice and studies attempting to identify different CU subtypes in children.
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Affiliation(s)
| | | | | | - Eva Penelo
- Universitat Autònoma de Barcelona (Spain)
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Abstract
Psychopathy is a personality disorder characterized by a constellation of affective, interpersonal, lifestyle and antisocial features whose antecedents can be identified in a subgroup of young people showing severe antisocial behaviour. The prevalence of psychopathy in the general population is thought to be ~1%, but is up to 25% in prisoners. The aetiology of psychopathy is complex, with contributions of both genetic and environmental risk factors, and gene-environment interactions and correlations. Psychopathy is characterized by structural and functional brain abnormalities in cortical (such as the prefrontal and insular cortices) and subcortical (for example, the amygdala and striatum) regions leading to neurocognitive disruption in emotional responsiveness, reinforcement-based decision-making and attention. Although no effective treatment exists for adults with psychopathy, preliminary intervention studies targeting key neurocognitive disturbances have shown promising results. Given that psychopathy is often comorbid with other psychiatric disorders and increases the risk of physical health problems, educational and employment failure, accidents and criminality, the identification of children and young people at risk for this personality disorder and preventative work are important. Indeed, interventions that target the antecedents of psychopathic features in children and adolescents have been found to be effective.
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Hawes SW, Waller R, Byrd AL, Bjork JM, Dick AS, Sutherland MT, Riedel MC, Tobia MJ, Thomson N, Laird AR, Gonzalez R. Reward Processing in Children With Disruptive Behavior Disorders and Callous-Unemotional Traits in the ABCD Study. Am J Psychiatry 2021; 178:333-342. [PMID: 32731811 PMCID: PMC7855017 DOI: 10.1176/appi.ajp.2020.19101092] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Disrupted reward processing is implicated in the etiology of disruptive behavior disorders (DBDs) and callous-unemotional traits. However, neuroimaging investigations of reward processing underlying these phenotypes remain sparse. The authors examined neural sensitivity in response to reward anticipation and receipt among youths with DBDs, with and without callous-unemotional traits. METHODS Data were obtained from the Adolescent Brain and Cognitive Development Study (mean age=9.51 years [SD=0.50]; 49% female). Reward-related activation during the monetary incentive delay task was examined across 16 brain regions, including the amygdala, anterior cingulate cortex (ACC), nucleus accumbens (NAcc), and orbitofrontal cortex (OFC). Latent variable modeling was used to examine network-level coactivation. The following diagnostic groups were compared: typically developing youths (N=693) and youths with DBDs (N=995), subdivided into those with callous-unemotional traits (DBD+CU, N=198) and without callous-unemotional traits (DBD only, N=276). RESULTS During reward anticipation, youths in the overall DBD group (with and without callous-unemotional traits) showed decreased dorsal ACC activation compared with typically developing youths. The DBD-only group exhibited reduced ventral and dorsal striatal activity compared with the DBD+CU and typically developing groups. During reward receipt, youths with DBDs showed increased cortical (e.g., OFC) and subcortical (e.g., NAcc) regional activation compared with typically developing youths. The DBD+CU group demonstrated greater activation in several regions compared with those in the typically developing (e.g., amygdala) and DBD-only (e.g., dorsal ACC) groups. At the network level, the DBD-only group showed reduced anticipatory reward activation compared with the typically developing and DBD+CU groups, whereas youths in the DBD+CU group showed increased activation during reward receipt compared with those in the typically developing group. CONCLUSIONS These findings advance our understanding of unique neuroetiologic pathways to DBDs and callous-unemotional traits.
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Hawes SW, Pacheco-Colón I, Ross JM, Gonzalez R. Adolescent Cannabis Use and Conduct Problems: The Mediating Influence of Callous-Unemotional Traits. Int J Ment Health Addict 2020; 18:613-627. [PMID: 32742245 PMCID: PMC7394462 DOI: 10.1007/s11469-018-9958-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Cannabis use has been linked to an increased risk of engaging in conduct problem behaviors. However, little existing research has considered intervening processes and shared risk factors that may contribute to this association. The current investigation examines whether callous-unemotional traits, which have shown associations with adolescent cannabis use and conduct problem development, may exhibit a mediating influence on this relationship. Using a longitudinal cohort of youth (n = 390) at increased risk for escalating in their use of cannabis, we found that baseline cannabis use (age~15) was associated with higher levels of trait-like conduct problems (ages~16 & 17), even after controlling for important autoregressive and cross-lagged effects, along with a number of other shared risk factors (e.g., co-occuring substance use, age, sex). Findings also revealed that callous-unemotional traits partially mediated this relationship, with the hypothesized model accounting for approximately one-third of the variance in the conduct problem outcome (R2=.34). These results indicate that callous-unemotional traits may play an important intermediary role in the association between cannabis use and the development of problem behaviors.
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Affiliation(s)
- Samuel W Hawes
- Center for Children and Families, Florida International University, Department of Psychology, 11200 S.W. 8 Street, AHC1 Rm 140, Miami, Florida 33199
| | - Ileana Pacheco-Colón
- Center for Children and Families, Florida International University, Department of Psychology, 11200 S.W. 8 Street, AHC1 Rm 140, Miami, Florida 33199
| | - J Megan Ross
- Center for Children and Families, Florida International University, Department of Psychology, 11200 S.W. 8 Street, AHC1 Rm 140, Miami, Florida 33199
| | - Raul Gonzalez
- Center for Children and Families, Florida International University, Department of Psychology, 11200 S.W. 8 Street, AHC1 Rm 140, Miami, Florida 33199
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Miron CD, Satlof-Bedrick E, Waller R. Longitudinal association between callous-unemotional traits and friendship quality among adjudicated adolescents. J Adolesc 2020; 81:19-26. [PMID: 32278252 DOI: 10.1016/j.adolescence.2020.03.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 02/20/2020] [Accepted: 03/30/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Youth with callous-unemotional (CU) traits show severe and chronic forms of antisocial behavior, as well as deficits in socioaffiliative processes, such as empathy, guilt, and prosocial behavior. Adolescence represents a critical developmental window when these socioaffiliative processes can help to deepen the strength of supportive peer friendships. However, few studies have explored the relationship between CU traits and friendship quality during adolescence. In the current study, we used data from the Pathways to Desistance dataset to examine reciprocal and longitudinal associations between CU traits and friendship quality at three assessment points separated by 6 months each during adolescence. METHODS The sample included adolescents who had interacted with the justice system (age at baseline, M = 16.04, SD = 1.14; N = 1354; 13.6% female). CU traits were assessed using the callousness scale of the self-reported Youth Psychopathic Traits Inventory and friendship quality using a scale adapted from the Quality of Relationships Inventory. Models accounted for co-occurring aggression, impulsive-irresponsible traits, grandiose-manipulative traits, age, gender, location, and race. RESULTS At every assessment point, CU traits were uniquely related to lower friendship quality. Moreover, we found evidence for reciprocal effects between the first two assessment points, such that CU traits were related to decreases in friendship quality over time, while lower friendship quality simultaneously predicted increases in CU traits across the same period. CONCLUSIONS Interventions for CU traits could benefit from including specific modules that target the social processes associated with adaptive and successful friendships, including empathic listening and other-orientated thinking.
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Affiliation(s)
- Carly D Miron
- Department of Psychology, University of Pennsylvania, Philadelphia, USA
| | | | - Rebecca Waller
- Department of Psychology, University of Pennsylvania, Philadelphia, USA.
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Docherty M, Beardslee J, Byrd AL, Yang VJH, Pardini D. Developmental trajectories of interpersonal callousness from childhood to adolescence as predictors of antisocial behavior and psychopathic features in young adulthood. JOURNAL OF ABNORMAL PSYCHOLOGY 2019; 128:700-709. [PMID: 31318243 PMCID: PMC6776683 DOI: 10.1037/abn0000449] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Although previous research has established a link between early interpersonal callousness (IC) from childhood to adolescence and later antisocial behavior and psychopathic features, the majority of these studies assess more proximal outcomes (e.g., assessed in adolescence). Thus, it is unclear whether youth with early-onset chronic levels of IC will continue to have negative outcomes into adulthood (i.e., roughly 14 years after IC was assessed). The current study used data from the youngest cohort (N = 503) of the Pittsburgh Youth Study to examine how latent classes of youth with different developmental patterns of IC across a 7-year period (∼ages 8 to 15) differed in their official records of juvenile (∼ages 16-17) and young adult (∼ages 18-31) offending, as well as self-reported psychopathic features and aggression in young adulthood (∼age 29). Results indicated that after adjusting for race, early offending, and externalizing behaviors in adolescence, youth with an early-onset chronic pattern of IC had substantially elevated risk for a serious and persistent pattern of offending, particularly violent offending. However, once these covariates were included, IC class no longer significantly predicted psychopathic features in adulthood. Thus, it is possible that the stability from early patterns of IC to adult psychopathic features may have previously been overstated. Future work could examine whether interventions to reduce IC in childhood and adolescence could successfully result in improved outcomes into adulthood. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Meagan Docherty
- School of Criminology & Criminal Justice, Arizona State University
| | - Jordan Beardslee
- School of Criminology & Criminal Justice, Arizona State University
| | - Amy L. Byrd
- Department of Psychiatry, University of Pittsburgh
| | | | - Dustin Pardini
- School of Criminology & Criminal Justice, Arizona State University
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Grandiose-Manipulative, Callous-Unemotional, and Daring-Impulsive: the Prediction of Psychopathic Traits in Adolescence and their Outcomes in Adulthood. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2018. [DOI: 10.1007/s10862-018-9674-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Masi G, Pisano S, Brovedani P, Maccaferri G, Manfredi A, Milone A, Nocentini A, Polidori L, Ruglioni L, Muratori P. Trajectories of callous-unemotional traits from childhood to adolescence in referred youth with a disruptive behavior disorder who received intensive multimodal therapy in childhood. Neuropsychiatr Dis Treat 2018; 14:2287-2296. [PMID: 30233186 PMCID: PMC6130262 DOI: 10.2147/ndt.s164032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Our aims were to explore the developmental trajectories of callous-unemotional (CU) traits using a growth curve analysis in Italian children with disruptive behavior disorders treated with a multimodal intervention, and to test both predictors and distal outcomes of CU traits trajectories. PATIENTS AND METHOD One hundred and sixty-eight children were enrolled, of whom 24 were lost in the follow-up and 144 were followed up from ages 8-9 to 14-15 years with four assessment points. Patients included 128 males (88.9%) with a mean age of 8.7 years, 96 with oppositional defiant disorder (66.7%) and 48 with conduct disorder (CD) (33.3%). The developmental trajectories of CU traits were assessed with the Inventory of Callous-Unemotional Traits (ICU). RESULTS Our findings revealed that CU features were likely to fit a quadratic model from childhood to adolescence. The CU traits tended to decrease during childhood, with stabilization in adolescence and a significant variability in the growth curves. Pretreatment CD and higher levels of externalizing behavioral problems were associated with higher level of CU traits at baseline, whereas positive parenting was associated with lower levels. No significant effects were found for all the other predictors (socioeconomic status, negative parenting, combined pharmacotherapy). Regarding outcomes into adolescence, both higher levels of CU traits at the baseline and a lower decrease of CU traits across time points predicted a higher risk of CD diagnosis, and higher rate of referrals to mental health services and of substance use. Furthermore, pretreatment CD and negative parenting predicted a higher risk of substance use into adolescence. CONCLUSION Our findings suggest that a close monitoring of CU traits in referred children with disruptive behavior disorders may help to detect the patients at higher risk of poor outcome.
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Affiliation(s)
- Gabriele Masi
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Italy,
| | - Simone Pisano
- Clinic of Child and Adolescent Neuropsychiatry, Department of Medicine and Surgery, University of Salerno, Baronissi, Italy
| | - Paola Brovedani
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Italy,
| | - Gioia Maccaferri
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Italy,
| | - Azzurra Manfredi
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Italy,
| | - Annarita Milone
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Italy,
| | - Annalaura Nocentini
- Department of Sciences of Education and Psychology, University of Florence, Florence, Italy
| | - Lisa Polidori
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Italy,
| | - Laura Ruglioni
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Italy,
| | - Pietro Muratori
- IRCCS Fondazione Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Italy,
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Dotterer HL, Waller R, Cope LM, Hicks BM, Nigg JT, Zucker RA, Hyde LW. Concurrent and developmental correlates of psychopathic traits using a triarchic psychopathy model approach. JOURNAL OF ABNORMAL PSYCHOLOGY 2017; 126:859-876. [PMID: 29106272 PMCID: PMC5687302 DOI: 10.1037/abn0000302] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Psychopathy refers to a heterogeneous set of harmful dark traits and behaviors, including superficial charm, callousness, irresponsibility, and antisocial behavior. The triarchic psychopathy model (TriPM) posits that psychopathy is the combination of 3 traits: boldness, disinhibition, and meanness. However, little research has examined the concurrent and developmental correlates of these traits. We developed TriPM scales from the NEO Personality Inventory-Revised using an empirical-derived approach in a high-risk sample of 561 young adults (ages 17-25; 70.2% male). Concurrent correlates and developmental precursors of each scale were examined longitudinally using cross-informant reports from 3 critical developmental periods (ages 3-5; 9-11; 15-17). Using this approach, we identified consistent developmental precursors and concurrent correlates of boldness, including lower reactive control, fewer internalizing traits, and greater resiliency. Additionally, starting in adolescence we found that disinhibition was related to lower reactive control, more externalizing problems, substance use, and internalizing traits. Finally, although meanness demonstrated some expected concurrent relationships with criterion variables in early adulthood (e.g., lower adaptive functioning), we identified few consistent developmental precursors of meanness. Thus, a NEO-based approach to measuring the TriPM was successful in delineating boldness, disinhibition, and, to a lesser extent, meanness cross-sectionally during early adulthood. However, only boldness showed relative stability from developmental precursors in early childhood to our TriPM scale in early adulthood. (PsycINFO Database Record
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Affiliation(s)
| | | | - Lora M Cope
- Department of Psychiatry, University of Michigan
| | | | - Joel T Nigg
- Department of Psychiatry, Oregon Health and Science University
| | | | - Luke W Hyde
- Department of Psychology, University of Michigan
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Representational Uncertainty in the Brain During Threat Conditioning and the Link With Psychopathic Traits. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2017; 2:689-695. [PMID: 29560903 DOI: 10.1016/j.bpsc.2017.04.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 04/12/2017] [Accepted: 04/12/2017] [Indexed: 12/23/2022]
Abstract
BACKGROUND Psychopathy has repeatedly been linked to disturbed associative learning from aversive events (i.e., threat conditioning). Optimal threat conditioning requires the generation of internal representations of stimulus-outcome contingencies and the rate with which these may change. Because mental representations are imperfect, there will always be uncertainty about the accuracy of representations in the brain (i.e., representational uncertainty). However, it remains unclear 1) to what extent threat conditioning is susceptible to different types of uncertainty in representations about contingencies during the acquisition phase and 2) how representational uncertainty relates to psychopathic features. METHODS A computational model was applied to functional neuroimaging data to estimate uncertainty in representations of contingencies (CoUn) and the rate of change of contingencies (RUn), respectively, from brain activation during the acquisition phase of threat conditioning in 132 adolescents at risk of developing antisocial personality profiles. Next, the associations between these two types of representational uncertainty and psychopathy-related dimensions were examined. RESULTS The left and right amygdala activations were associated with CoUn, while the bilateral insula and the right amygdala were associated with RUn. Different patterns of relationships were found between psychopathic features and each type of uncertainty. Callous-unemotional traits and impulsive-irresponsible traits uniquely predicted increased CoUn, while only impulsive-irresponsible traits predicted increased RUn. CONCLUSIONS The findings suggest that 1) the insula and amygdala differ in how these regions are affected by different types of representational uncertainty during threat conditioning and 2) CoUn and RUn have different patterns of relationships with psychopathy-related dimensions.
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