Attributional and attentional bias in children with conduct problems and callous-unemotional traits: a case-control study

Callous-Unemotional Traits and Emotion Perception Accuracy and Bias in Youths

This study investigated the associations among conduct problems, callous-unemotional (CU) traits, and indices of emotion recognition accuracy and emotion recognition bias obtained from human faces. Impairments in emotion recognition were considered within broader, impaired emotional and social functioning. The sample consisted of 293 middle-school students (51.19% girls; M age = 12.97 years, SD = 0.88 years). In general, CU traits were associated with less accuracy in recognizing emotions, especially fearful and angry faces, and such deficits in emotional recognition were not associated with conduct problems independent of CU traits. These results support the importance of studying potential deficits in the recognition of emotions other than fear. Furthermore, our results support the importance of considering the role of CU traits when studying emotional correlates of conduct problems. For children scoring high on CU traits, the emotion recognition accuracy of anger was low irrespective of the level of conduct problems, whereas in children scoring low on CU traits, less accuracy in recognizing emotions was related to increases in conduct problems. Finally, our results support the need for research to not only focus on accuracy of emotional recognition but also test whether there are specific biases leading to these inaccuracies. Specifically, CU traits were associated not only with lower accuracy in recognizing fearful faces but also with a tendency to interpret fearful faces as angry. This suggests that the emotional deficit associated with CU traits is not just a deficit in empathic concern toward others distress but also includes a tendency to overinterpret emotions as potential threats to oneself.

Hostile and threatening interpretation biases in adolescent inpatients are specific to callous-unemotional traits and social anxiety

Psychopathological syndromes, such as disruptive behavior and anxiety disorders in adolescence, are characterized by distorted cognitions and problematic behavior. Biased interpretations of ambiguous social situations can elicit both aggressive and avoidance behavior. Yet, it is not well understood whether different interpretation biases are specific to different syndromes, or whether they can co-occur. We assessed both hostile and threatening interpretation biases in identical social situations, and proposed that they are uniquely related to callous-unemotional (CU) traits and social anxiety, respectively. We also explored the role of gender and age herein. The sample consisted of 390 inpatients between 10 and 18 years of age with a variety of psychiatric disorders. Hostile and threatening interpretations were assessed with the Ambiguous Social Scenario Task (ASST) consisting of 10 written vignettes. Both CU-traits and social anxiety were assessed with self-report questionnaires. Results showed that, overall, CU-traits were related to more hostile interpretations, whereas social anxiety was related to more threatening interpretations. In addition, in boys, hostile and threatening interpretations correlated significantly positive with each other. Age was not related to interpretation biases. Together, these results generally support the content-specificity of interpretation biases in concepts relevant to disruptive behavior disorders and anxiety disorders, and indicate that different interpretation biases can co-occur specifically in boys.

Variants of Callous-unemotional traits in childhood: investigation of attachment profile and hostile attribution bias

There is increasing evidence of interest in describing two variants of CallousUnemotional (CU) traits based on high (secondary variant) or low (primary variant) levels of anxiety. However, studies are limited in childhood. The present study aimed to further the understanding of the variants, specifically in association with hostile attribution bias (HAB) and attachment. In a community sample of children aged 4 to 9 (N = 70), the study examined whether anxiety moderated the association of CU traits with HAB, secure and disorganized attachment representations. Hierarchical regression analyses revealed that CU traits were positively associated with disorganized attachment, regardless of the anxiety level. In contrast, CU traits were not associated with secure attachment. A significant interaction revealed that CU traits were positively associated with HAB only at high levels of anxiety. Implications for understanding the variants of CU traits and hypotheses regarding their developmental trajectories are discussed.

Cognitive biases in first-episode psychosis with and without attention-deficit/hyperactivity disorder

Introduction

Psychotic disorders such schizophrenia and attention-deficit/hyperactivity disorder (ADHD) are neurodevelopmental disorders with social cognitive deficits. Specifically, biased interpretation of social information can result in interpersonal difficulties. Cognitive biases are prevalent in psychosis, but no previous study has investigated whether the type and severity of cognitive biases differ between subjects experiencing first-episode psychosis (FEP) with (FEP-ADHD⁺) and without ADHD (FEP-ADHD^-).

Methods

A total of 121 FEP outpatients at the Early Intervention Service of Reus were screened for childhood ADHD through the Diagnostic Interview for ADHD (DIVA). Cognitive biases were assessed by the Cognitive Biases Questionnaire for Psychosis (CBQp). CBQp scores of FEPs groups were compared with those of healthy controls (HCs) with an analysis of covariance. Spearman correlation analysis explored associations between CBQp scores and psychopathology.

Results

Thirty-one FEPs met the criteria for childhood ADHD and reported significantly more cognitive bias [median (interquartile range): 47 (38-56)] than FEP-ADHD^- [42 (37-48)] and HCs [38 (35.5-43)]. CBQp scores did not differ between FEP-ADHD-and HCs when adjusted for age and sex. After controlling for clinical differences, Intentionalising (F = 20.97; p < 0.001) and Emotional Reasoning biases (F = 4.17; p = 0.04) were more strongly associated with FEP-ADHD⁺ than FEP-ADHD^-. Cognitive biases were significantly correlated with positive psychotic symptoms in both groups but only with depressive symptoms in FEP-ADHD^- (r = 0.258; p = 0.03) and with poor functioning in FEP-ADHD⁺ (r = -0.504; p = 0.003).

Conclusion

Cognitive bias severity increased from HCs to FEP-ADHD-patients to FEP-ADHD⁺ patients. FEP-ADHD⁺ patients may be a particularly vulnerable group in which metacognitive targeted interventions are needed.

Specific interpretation biases as a function of social anxiety and callous-unemotional traits in a community and a clinical adolescent sample

BACKGROUND

Threatening and hostile interpretation biases are seen as causal and maintaining mechanisms of childhood anxiety and aggression, respectively. However, it is unclear whether these interpretation biases are specific to distinct problems or whether they are general psychopathological phenomena. The specificity versus pervasiveness of interpretation biases could also differ depending on mental health status. Therefore, in the current study, we investigated whether social anxiety and callous-unemotional (CU) traits were uniquely related to threatening and hostile interpretation biases, respectively, in both a community and a clinical sample of adolescents.

METHODS

A total of 161 adolescents between 10 to 15 years of age participated. The community sample consisted of 88 participants and the clinical sample consisted of 73 inpatients with a variety of psychological disorders. Social anxiety and CU-traits were assessed with self-report questionnaires. The Ambiguous Social Scenario Task was used to measure both threatening and hostile interpretations in response to written vignettes.

RESULTS

Results showed that social anxiety was uniquely related to more threatening interpretations, while CU-traits were uniquely related to more hostile interpretations. These relationships were replicated for the community sample. For the clinical sample, only the link between social anxiety and threatening interpretations was significant. Explorative analyses showed that adolescents with externalizing disorders scored higher on hostile interpretations than adolescents with internalizing disorders.

CONCLUSIONS

Overall, these results support the content-specificity of threatening interpretation biases in social anxiety and of hostile interpretation biases in CU-traits. Better understanding the roles of interpretation biases in different psychopathologies might open avenues for tailored prevention and intervention paradigms.

Cognitive deficits for facial emotions among male adolescent delinquents with conduct disorder

According to the social-cognitive theory and the social-information-processing theory, individuals with conduct disorder, a persistent and repetitive pattern of problematic behavior, might have cognitive biases toward hostile facial expressions. However, according to the optimal stimulation/arousal theory, the stimulation-seeking theory and the fearlessness theory, individuals with conduct disorder might have less fear and show less response to hostile or threatening facial expressions. To reconcile the discrepancy, we examined the cognitive biases including attentional processing and working memory processing to emotional faces among adolescents with conduct disorder. 35 male adolescent delinquents with conduct disorder and 35 age-matched delinquents without conduct disorder completed a visual search task and a delayed-match-to-sample task to examine their attentional processing and working memory processing for sad, angry, happy, and fearful faces, respectively. It was found that conduct disordered individuals searched angry and fearful faces, rather than sad and happy faces, more slowly than individuals without conduct disorder. However, no difference in mnemonic processing for facial emotions was found between groups. The results indicated that male adolescent delinquents with conduct disorder showed deficits in attentional orientation to hostile and threatening faces, supporting the optimal stimulation/arousal theory, the stimulation-seeking theory and the fearlessness theory, but not the social-cognitive theory.

Attentional variability and avoidance of hostile stimuli decrease aggression in Chinese male juvenile delinquents

BACKGROUND

As a prominent issue worldwide, juveniles' aggressive and violent crimes have attracted much interest in recent years. Based on the social information processing model, the present study aimed to evaluate the Chinese male juvenile delinquents' attention bias towards hostile stimuli from both static and dynamic perspectives. Additionally, the predictive effect of attention bias on aggressive behavior and the moderating effect of group (juvenile delinquents and the controls with no criminal history) were also investigated.

METHODS

The hostile attention bias and aggressive behavior of 76 juvenile delinquents (M_age = 17.5 years, SD = 0.59 years) and 67 controls (M_age = 18.3 years, SD = 0.73 years) were measured with the emotional dot-probe task, emotional Stroop task, and the Chinese version of the Buss & Perry aggression questionnaire, respectively.

RESULTS

The results showed that compared with controls, juvenile delinquents showed more attention biases towards hostile faces and words, and demonstrated higher levels of physical aggression and anger. Furthermore, the type of participants moderated the relationship between hostile attention bias and aggressive behavior. For juvenile delinquents, attention bias away from hostile stimuli and attention variability negatively predicted anger, while for controls, attention variability positively predicted self-directed aggression.

CONCLUSION

Attentional variability and avoidance of hostile stimuli are expected to reduce the aggressive level of Chinese male juvenile delinquents. The relationship between attention bias and aggression should be further considered and applied in the clinical practice.