Conduct Problems in Adolescence: Three Domains of Inhibition and Effect of Gender

Emotion dysregulation and psychopathological symptoms in non-clinical adolescents: The mediating role of boredom and social media use

BACKGROUND

Emotion dysregulation, boredom, and problematic social media use are well-known vulnerability factors for psychopathology during adolescence; nevertheless, the interplay between these factors remains underinvestigated in the literature. Therefore, the present cross-sectional study aimed to explore the mediating role of boredom and problematic social media use in the relations between emotion dysregulation and both internalizing and externalizing problems in a non-clinical group of Italian adolescents.

METHOD

721 students (64.6% girls; Mage = 15.49 years ± 1.82) were involved and completed self-report tools assessing emotion dysregulation, boredom, problematic social media use, and psychopathological symptoms. Path analysis was used to test whether boredom and problematic social media use mediated the relation between emotion dysregulation and psychopathology, distinguishing between internalizing and externalizing problems.

RESULTS

Path models showed that emotion dysregulation predicted both internalizing and externalizing problems, as well as boredom and problematic social media use. Importantly, boredom mediated the associations between emotion dysregulation and both psychopathological dimensions, while problematic social media use mediated only the relation with externalizing problems.

CONCLUSIONS

Our results highlight that the influence of emotion dysregulation on psychopathology can manifest through different paths, leading to specific symptomatology based on interactions between various variables. In particular, boredom seems to be a transdiagnostic factor for psychopathology in adolescence, whereas problematic social media use would be a dimension-specific factor. The practical implications of these findings are discussed.

Gender differences in behavioral inhibitory control under evoked acute stress: An event-related potential study

Purpose

This study investigated gender differences in behavioral inhibitory control among college students under acute stress state by using event-related potential technique.

Methods

Acute stress was evoked in 41 college students (22 males and 19 females) using the Trier Social Stress paradigm, and the neutral state was matched using out-of-speech reading, with subjects completing a two-choice Oddball task in each of the two states. In combination with the ERP technique, the area under the stress curve, reaction time, number of errors, and the difference waves between the two stimulus conditions in the frontal-central region N2 wave amplitude and the parietal-central region P3 wave amplitude were compared between the two groups of subjects in the stressful and neutral state.

Results

The results revealed that the area under the stress curve was larger under the stress condition compared to the neutral condition, and the area under the stress curve was larger in females than in males. Behavioral results showed no statistically significant differences in reaction time and number of errors between the two genders in the acute stress condition. The ERP results showed that the wave amplitudes of N2 and P3 decreased significantly in both genders in the acute stress state. The decrease in N2 amplitude was greater in females during the transition from neutral to stressful condition, while the difference in P3 amplitude was not statistically significant in both genders.

Conclusion

The findings suggest that evoked acute stress can promote behavioral inhibitory control in both genders and that females are more sensitive to acute stress state.

Altered Resting-State Network in Adolescents with Problematic Internet Use

Problematic internet use (PIU) is increasingly recognized as a mental health concern, particularly among adolescents. The resting-state functional connectivity (rsFC) of the triple-network model has been described inconsistently in PIU. Using resting-state fMRI (rsFMRI) and hypothesizing a lower rsFC between default mode (DMN) and central executive networks (CEN) but a higher rsFC within the salience network (SN), this study scrutinized the neural substrates of PIU adolescents. A total of 30 adolescents with PIU and 30 control subjects underwent rsFMRI. The severity of PIU was evaluated by the Internet Addiction Test. Additionally, personality traits as well as emotional and behavioral problems were evaluated by the Temperament and Character Inventory (TCI) and the Strength and Difficulties Questionnaire (SDQ), respectively. Focusing on the DMN, SN, and CEN, we compared rsFC values between PIU and the control. Subsequently, within the combined group of subjects, TCI and SDQ correlation and mediation effects were investigated. Higher rsFC values of the left lateral prefrontal cortex (LPFC(L)) with the left anterior insula (aIns(L)) were observed for PIU than for the control, while rsFCs of the LPFC(L) with the medial PFC (MPFC), LPFC(L), as well as with the right lateral parietal cortex (LP(R)) were lower for PIU. Among these significant group differences, the rsFC between the LPFC(L) and MPFC was mediated by emotional symptoms (standardized β = −0.12, 95% CI −0.29, −0.0052). The dysfunctional attention switching and incentive salience regulated by the SN were implicated as being a neural correlate of PIU, and this relationship would in part be explained by the emotional dysregulation associated with PIU in adolescents.

Development of white matter microstructure and executive functions during childhood and adolescence: a review of diffusion MRI studies

Diffusion magnetic resonance imaging (dMRI) provides indirect measures of white matter microstructure that can be used to make inferences about structural connectivity within the brain. Over the last decade, a growing literature of cross-sectional and longitudinal studies have documented relationships between dMRI indices and cognitive development. In this review, we provide a brief overview of dMRI methods and how they can be used to study white matter and connectivity and review the extant literature examining the links between dMRI indices and executive functions during development. We explore the links between white matter microstructure and specific executive functions: inhibition, working memory and cognitive shifting, as well as performance on complex executive function tasks. Concordance in findings across studies are highlighted, and potential explanations for discrepancies between results, together with challenges with using dMRI in child and adolescent populations, are discussed. Finally, we explore future directions that are necessary to better understand the links between child and adolescent development of structural connectivity of the brain and executive functions.

Personality to Prescription Drug Misuse in Adolescents: Testing Affect Regulation, Psychological Dysregulation, and Deviance Proneness Pathways

Background: Fifteen to 25-year-olds are the age group most likely to misuse prescription drugs. Few studies have tested theory-driven models of adolescent risk for prescription drug misuse. Moreover, rarely are distinct pathways to different forms of prescription drug misuse considered. Methods: We tested mediational paths from personality to mental health symptoms to prescription drug misuse, informed by etiological models of addiction. We specified pathways from particular personality traits to unique forms of prescription drug misuse via specific mental health symptoms. We used semi-longitudinal data collected across two waves of the Co-Venture Trial. Our sample included students from 31 Canadian high schools tested in Grade 9 (n = 3,024) and again in Grade 10 (n = 2,869; 95% retention). Personality (hopelessness, anxiety sensitivity, impulsivity, sensation seeking) was assessed in Grade 9. Mental health symptoms (depression, anxiety, ADHD, conduct disorder) and prescription drug misuse (opioids, sedatives/tranquilizers, stimulants) were assessed at both time points. Results: Consistent with the negative affect regulation model, hopelessness was specifically associated with opioid misuse via depressive symptoms, and anxiety sensitivity was specifically associated with sedative/tranquilizer misuse via anxiety symptoms. Consistent with positive affect regulation, sensation seeking was directly associated with stimulant misuse. Consistent with the psychological dysregulation model, impulsivity was associated with stimulant misuse via ADHD symptoms. And consistent with the deviance proneness model, impulsivity was also associated with unconstrained (i.e., all three forms of) prescription drug misuse via conduct disorder symptoms. Conclusions: Screening for adolescents high in hopelessness, anxiety sensitivity, sensation seeking, or impulsivity and providing them with personality-matched cognitive-behavioral interventions may be helpful in preventing or mitigating prescription drug misuse. Our results point to the specific mental health symptoms that are important to target in each of these personality-matched interventions.

ADHD symptoms and callous-unemotional traits as predictors of violent media use in adolescence

We investigated ADHD symptoms and CU traits as predictors of violent media use in adolescence, controlling for delinquency and ODD symptoms. The effects on of disinhibition and arousal to negative stimuli, core characteristics of ADHD symptoms and CU traits, and of gender were investigated. At age 15, 88 adolescents, 50 % boys reported on CU traits, ADHD symptoms and delinquency. Parents rated the adolescents' CU traits, ADHD- and ODD symptoms. At age 16, adolescents reported on their media habits and performed tests of disinhibition and arousal to negative stimuli. Boys had higher levels of CU traits and violent media use and girls had higher levels of arousal to negative pictures. CU traits and inattention symptoms predicted violent media use, the latter association applying only to boys, with CU traits being the strongest predictor. Low arousal to threat pictures explained variance in violent media use, above CU traits. Attraction to violent media seems affected by problem behaviors, with CU traits coming forth as especially important.

Validation of the Barratt Impulsiveness Scale- short form among Indian adolescents

BACKGROUND

Impulsivity is widely assessed with a 30 item self-report measure known as the Barrratt Impulsiveness Scale (BIS-11). Further development involved creation of an abbreviated version, called Barratt Impulsiveness Scale- short form (BIS-15; Spinella, 2007) from the original BIS-11. Unlike the original BIS-11, BIS-15 has not undergone sufficient cross cultural validation especially among the adolescent population.

AIM

To evaluate the factor structure and psychometric properties of BIS-15 among school and college attending Indian adolescents.

METHOD

A total of 1806 adolescents (females = 48%, mean age = 17.14 years) completed BIS-15 questionnaire, strengths and difficulties questionnaire (SDQ) and a risk taking questionnaire that assessed adolescents level of involvement in two protypical risky behaviours- substance use and unsafe sexual behaviours.

RESULTS

The results of the principal component analysis of BIS-15 items revealed a three factor structure: attentional, motor and non-planning impulsivity. The internal consistency of BIS-15 was 0.79. The total score on BIS-15 was significantly associated with the externalizing, internalizing and total difficulty score on SDQ. Significant associations were observed between BIS-15 total impulsivity score and the level of risk taking among adolescents. Further, the results also revealed gender variance in impulsivity scores where male adolescents scored higher on attentional and non-planning impulsivity as compared to female adolescents.

CONCLUSION

BIS-15 is a reliable measure of impulsivity that can be used with Indian adolescent population. It would be particularly more suitable for use in settings that require comprehensive assessment of trait impulsivity in shorter time duration and without burdening the participants.

MAOA genotype influences neural response during an inhibitory task in adolescents with conduct disorder

Conduct disorder (CD), a common psychiatric disorder in children and adolescents, is characterized by encroaching upon other rights and violations of age-appropriate social expectations repeatedly and persistently. Individuals with CD often have high aggressiveness and low inhibitory capacity. The monoamine oxidase A (MAOA) gene has long been associated with aggression. Effects of MAOA genotype on inhibitory control have been examined in general population. Several studies had revealed reduced activation in prefrontal areas, especially the anterior cingulate cortex (ACC), in low-expression MAOA (MAOA-L) allele carriers compared to high-expression MAOA (MAOA-H) allele carriers. However, little is known about its genetic risk influences on inhibitory processes in clinical samples. In this study, functional magnetic resonance imaging (fMRI) was administered to a sample of adolescent boys with CD during the performance of a GoStop task, 29 of whom carrying MAOA-L allele and 24 carrying MAOA-H allele. Relative to MAOA-H carriers, MAOA-L carriers in CD showed more pronounced deactivation in the precuneus, supplementary motor area (SMA) and dorsal anterior cingulate cortex (dACC). Deactivation within the default mode network (DMN) and inhibitory-related areas in MAOA-L carriers may be related to compensation for low sensitivity to inhibition and/or an atypical allocation of cognitive resources. The results suggested a possible neural mechanism through which MAOA affects inhibitory processes in a clinical sample.

Default mode network activity and neuropsychological profile in male children and adolescents with attention deficit hyperactivity disorder and conduct disorder

It is known that patients with Attention Deficit and Hyperactivity disorder (ADHD) and Conduct disorder (CD) commonly shows greater symptom severity than those with ADHD alone and worse outcomes. This study researches whether Default mode network (DMN) is altered in adolescents with ADHD + CD, relative to ADHD alone and controls or not. Ten medication-naïve boys with ADHD + CD, ten medication-naïve boys with ADHD and 10-age-matched typically developing (TD) controls underwent functional magnetic resonance imaging (fMRI) scans in the resting state and neuropsychological tasks such as the Wisconsin Card Sorting Test (WCST), Stroop Test TBAG Form (STP), Auditory Verbal learning Test (AVLT), Visual Auditory Digit Span B (VADS B) were applied to all the subjects included. fMRI scans can be used only nine patients in each groups. The findings revealed group differences between cingulate cortex and primary mortor cortex; cingulate cortex and somatosensory association cortex; angular gyrus (AG) and dorsal posterior cingulate cortex, in these networks increased activity was observed in participants with ADHD + CD compared with the ADHD. We found that lower resting state (rs)-activity was observed between left AG and dorsal posterior cingulate cortex, whereas higher rs-activity connectivity were detected between right AG and somatosensory association cortex in ADHD relative to the ones with ADHD + CD. In neuropsyhcological tasks, ADHD + CD group showed poor performance in WISC-R, WCST, Stroop, AVLT tasks compared to TDs. The ADHD + CD group displayed rs-functional abnormalities in DMN. Our results suggest that abnormalities in the intrinsic activity of resting state networks may contribute to the etiology of CD and poor prognosis of ADHD + CD.

Self Regulation, Cognitive Capacity and Risk Taking: Investigating Heterogeneity Among Adolescents with Callous-Unemotional Traits

The majority of prior work focuses on understanding the association between callous-unemotional (CU) traits and conduct problems, providing limited information on why some youth who score high on CU traits do not engage in conduct problem behaviors. The current study investigated heterogeneity among a sub-sample of adolescents with CU traits (N = 152; Mage = 13.09, SD = 2.76, 45.6% female) identified from a large community sample. Three groups were compared: control, callous-unemotional traits only (CU-only), and combined callous-unemotional and conduct problems (CU + CP). Participants were administered a battery of neuropsychological computerized tasks assessing risk taking, self-regulation and cognitive capacity. Results indicated that youth high on CU traits and low on CP scored higher on self-regulation and were less likely to make risky decisions compared to youth with combined CU + CP. In general, the findings provided information that heterogeneity within CU traits can be explained based on differences in neuro-cognitive functioning. In addition, the characteristics of youth high on CU traits only can provide information for interventions aiming to decrease conduct problems among youth high on these traits.

Brain-behavior relationships in externalizing: P3 amplitude reduction reflects deficient inhibitory control

The use of endophenotypes to classify individuals at risk for or suffering from psychopathology has been criticized for lacking specificity and predictive utility. This issue is apparent in research on externalizing, a heritable predisposition to disinhibitory psychopathology and personality traits. Numerous studies have shown that P3 amplitude reduction (P3AR) reliably reflects externalizing, implicating P3AR as a candidate endophenotype for externalizing psychopathology. However, this endophenotype has not been connected directly to a key deficit in executive function (e.g., inhibitory control) commonly related to externalizing. Using a modified oddball task in a sample (N=74) of at-risk adolescents and young adults, we examined the associations among externalizing, P3AR, and inhibitory control. We also examined the associations of P3AR and inhibitory control with frequency of real-world disinhibited behavior. Results indicated that externalizing related to P3AR, which in turn related to deficient inhibitory control. Additionally, there were both unique and interactive associations of P3 amplitude and inhibitory control with indicators of real-world behavior. These findings provide the first direct evidence that P3AR reflects deficits in inhibitory control, thus linking this externalizing-related endophenotype to a specific cognitive process. Moreover, the results highlight the value of considering psychobiological measures alongside behavioral measures for indexing risk for externalizing behavior and psychopathology.

Neurocognitive characteristics of youth with noncomorbid and comorbid forms of conduct disorder and attention deficit hyperactivity disorder

OBJECTIVE

Studies investigating neurocognitive deficits in youth with conduct disorder (CD) and attention deficit hyperactivity disorder (ADHD) are often confounded by the high rates of comorbidity between the two.

METHOD

Neurocognitive functioning was examined in three diagnostic groups (ADHD only, CD only, comorbid ADHD and CD) matched by age, sex, IQ, and medication status (n=28-32 per group).

RESULTS

No significant differences emerged between the diagnostic groups on measures of risk-taking or response inhibition. Children with CD performed better on a measure of spatial planning than those with comorbid ADHD and CD, and dimensional analyses in the full sample (n=265) revealed a small association between ADHD symptoms and poorer spatial planning.

CONCLUSION

These results suggest that deficits in spatial planning may be more pronounced in individuals with ADHD, but that the neurocognitive functioning of youth with noncomorbid and comorbid CD and ADHD are largely similar.

Do neurocognitive deficits in decision making differentiate conduct disorder subtypes?

The present study aimed to test whether neurocognitive deficits involved in decision making underlie subtypes of conduct-disorder (CD) differentiated on the basis of callous-unemotional (CU) traits. Eighty-five participants (M age = 10.94 years) were selected from a sample of 1200 children based on repeated assessment of CD and CU traits. Participants completed a multi-method battery of well-validated measures of risky decision making and associated constructs of selective attention and future orientation (Stroop, Stoplight, and Delay-Discounting Tasks). Findings indicated that impaired decision making, selective attention, and future orientation contribute to the antisocial presentations displayed by children with CD, irrespective of level of CU traits. Youth high on CU traits without CD showed less risky decision making, as indicated by their performance on the Stoplight laboratory task, than those high on both CD and CU traits, suggesting a potential protective factor against the development of antisocial behavior.

Impaired Frontal-Basal Ganglia Connectivity in Male Adolescents with Conduct Disorder

Alack of inhibition control has been found in subjects with conduct disorder (CD), but the underlying neuropathophysiology remains poorly understood. The current study investigated the different mechanism of inhibition control in adolescent-onset CD males (n = 29) and well-matched healthy controls (HCs) (n = 40) when performing a GoStop task by functional magnetic resonance images. Effective connectivity (EC) within the inhibition control network was analyzed using a stochastic dynamic causality model. We found that EC within the inhibition control network was significantly different in the CD group when compared to the HCs. Exploratory relationship analysis revealed significant negative associations between EC between the IFG and striatum and behavioral scale scores in the CD group. These results suggest for the first time that the failure of inhibition control in subjects with CD might be associated with aberrant connectivity of the frontal–basal ganglia pathways, especially between the IFG and striatum.

Measuring deviant sexual interest in adolescents using the emotional Stroop task

Adolescent sexual abusers are a heterogeneous group of offenders that often receive generic assessment and treatment services that are modeled on research findings from adult sex offender samples. The emotional Stroop task has been used to measure deviant sexual interest in adult samples. The purpose of the present study was to test whether the emotional Stroop task could also be used to assess deviant sexual interest in adolescent samples. Three groups of adolescents (a) sexual abusers (n = 24); (b) offending controls (n = 21); and (c) nonoffending controls (n = 21) completed two emotional Stroop tasks related to deviant sexual interest and tests of executive function. Adolescent sexual abusers were significantly slower to color-name some word stimuli than both adolescent offending controls and adolescent nonoffending controls. However, the task was unable to differentiate between the groups on most of the Stroop word categories. Very little research has been conducted with adolescent offender samples and the emotional Stroop task. Reaction time (RT) and Stroop bias outcome data for adolescent samples appear to be more unsystematic and weaker than has been observed in previous adult data. Based on potential difficulties with reading and development, the emotional Stroop task may not be a task suitable for measuring deviant sexual interest in adolescent samples.

Neural mechanisms underlying cognitive control of men with lifelong antisocial behavior

Results of meta-analyses suggested subtle deficits in cognitive control among antisocial individuals. Because almost all studies focused on children with conduct problems or adult psychopaths, however, little is known about cognitive control mechanisms among the majority of persistent violent offenders who present an antisocial personality disorder (ASPD). The present study aimed to determine whether offenders with ASPD, relative to non-offenders, display dysfunction in the neural mechanisms underlying cognitive control and to assess the extent to which these dysfunctions are associated with psychopathic traits and trait impulsivity. Participants comprised 21 violent offenders and 23 non-offenders who underwent event-related functional magnetic resonance imaging while performing a non-verbal Stroop task. The offenders, relative to the non-offenders, exhibited reduced response time interference and a different pattern of conflict- and error-related activity in brain areas involved in cognitive control, attention, language, and emotion processing, that is, the anterior cingulate, dorsolateral prefrontal, superior temporal and postcentral cortices, putamen, thalamus, and amygdala. Moreover, between-group differences in behavioural and neural responses revealed associations with core features of psychopathy and attentional impulsivity. Thus, the results of the present study confirmed the hypothesis that offenders with ASPD display alterations in the neural mechanisms underlying cognitive control and that those alterations relate, at least in part, to personality characteristics.

[Impulsivity and externalization and internalization problems in adolescents]

OBJECTIVES

The multidimensional aspect of the concept of impulsivity is proven by the composite structure of the rating scales of impulsivity. Several studies have already found correlations between trait-impulsivity and externalizing disorders. However, the studies interested in the relationship between trait-impulsivity and internalizing problems are rare. We have tried to explore correlations between impulsivity and externalization and internalization problems, in a population of adolescent outpatients.

METHODS

We recruited 31 adolescent out-patients in the child and adolescent psychiatry department in the University Hospital of Monastir, Tunisia. The Barratt Impulsivity Scale (BIS) was used to evaluate a multidimensional concept of trait-impulsivity, including the dimensions of "Motor", "Non-planning" and "Attentional" impulsivities. The Strength and Difficulties Scales (SDQ) was used to assess different domains of externalizing and internalizing problems, including "Emotional symptoms", "Conduct problems", "Hyperactivity" and "Peer problems".

RESULTS

The sex-ratio was 1.21. The mean age was 15.19±1.27 years. All patients but one were attending school. The diagnosis was "Major Depressive Episode" in 32% and "Behavior Disorder" in 38%. The means of the scores of externalizing and internalizing problems were 9.35±4.41 and 9.65±3.26, respectively. The total score of the BIS was significantly related to both scores of externalizing and internalizing problems. The "Motor" impulsivity was specially correlated with the externalizing dimension of the SDQ. The non-planning impulsivity was correlated with both scores of externalizing and internalizing problems, but it was mainly related to internalizing problems. The attentional impulsivity was also correlated with both dimensions of externalizing and internalizing problems.

CONCLUSION

The dimensions of trait-impulsivity were correlated with various dimensions of the SDQ concerning externalizing and internalizing problems. That confirms the hypothesis that the impulsiveness is associated with wide domains of the psychopathology of the teenager which are not limited to behavior disorders. We can process these problems by influencing the "Motor impulsivity" and "Non-planning impulsivity". The cognitive and behavioral therapy and the selective serotonin reuptake inhibitor may be efficient.

White matter correlates of cognitive inhibition during development: a diffusion tensor imaging study

Inhibitory control and cognitive flexibility are two key executive functions that develop in childhood and adolescence, increasing one's capacity to respond dynamically to changing external demands and refrain from impulsive behaviors. These gains evolve in concert with significant brain development. Magnetic resonance imaging studies have identified numerous frontal and cingulate cortical areas associated with performance on inhibition tasks, but less is known about the involvement of the underlying anatomical connectivity, namely white matter. Here we used diffusion tensor imaging (DTI) to examine correlations between a DTI-derived parameter, fractional anisotropy (FA) of white matter, and performance on the NEPSY-II Inhibition test (Naming, Inhibition and Switching conditions) in 49 healthy children aged 5-16years (20 females; 29 males). First, whole brain voxel-based analysis revealed several clusters in the frontal projections of the corpus callosum, where higher FA was associated with worse inhibitory performance, as well as several clusters in posterior brain regions and one in the brainstem where higher FA was associated with better cognitive flexibility (in the Switching task), suggesting a dichotomous relationship between FA and these two aspects of cognitive control. Tractography through these clusters identified several white matter tracts, which were then manual traced in native space. Pearson's correlations confirmed associations between higher FA of frontal projections of the corpus callosum with poorer inhibitory performance (independent of age), though associations with Switching were not significant. Post-hoc evaluation suggested that FA of orbital and anterior frontal projections of the corpus callosum also mediated performance differences across conditions, which may reflect differences in self-monitoring or strategy use. These findings suggest a link between the development of inhibition and cognitive control with that of the underlying white matter, and may help to identify deviations of neurobiology in adolescent psychopathology.

Age-related differences in inhibitory control in the early school years

The transition to school is associated with a greater requirement to inhibit irrelevant or inappropriate thought and behavior in order to concentrate on effective learning and to interact successfully with peers. Current knowledge of inhibitory control development in the early school years is limited due to a lack of normative data from age-appropriate, sensitive measures. In this study, three pictorial versions of the Stroop task were administered to investigate inhibitory control development in early school-aged children. Age-related trajectories of inhibition and effects of gender were examined in 80 children (42 boys) aged 5 to 8 years. All children were assessed with the Cognitive Assessment System Expressive Attention subtest (Big-Small Stroop), Fruit Stroop, and Boy-Girl Stroop. The Big-Small Stroop revealed substantial age-related improvement in inhibition from 5 to 7 years with a levelling of performance at 8 years of age, while the Fruit Stroop and Boy-Girl Stroop demonstrated clear but nonsignificant age trends. In particular, older children committed fewer errors and corrected their errors more frequently than younger children. Performance on all Stroop tasks correlated significantly, providing evidence that they tap similar cognitive abilities. Some gender differences were found. This study indicates that inhibitory skills develop rapidly in the early school years and suggests that error awareness may be a useful indicator of the development of cognitive inhibition for this age group.

Unique relations of age and delinquency with cognitive control

Context processing has significant empirical support as an explanation of age- and psychopathology-related deficiencies in cognitive control. We examined whether context processing generalizes to younger individuals who are in trouble with the law. We tested whether age and delinquency might have unique relations to context processing skills in four samples of male participants: adolescent offenders (n = 43), control adolescents (n = 33), young adult offenders (n = 40), and control young adults (n = 31). We used a modified Stroop task to measure context processing (i.e., attention, memory, and response inhibition). Task performance was superior for older participants in conditions most demanding of context processing skills. Adolescent offenders and control adolescents showed difficulties engaging selective attention to filter out irrelevant information, even after controlling for the effects of age. Control adolescents made the most errors in the condition most demanding of context processing, whereas the other three samples showed slower processing but fewer errors in context processing.

Differential associations between psychopathy dimensions, types of aggression, and response inhibition

Findings on executive functioning in psychopathy are inconsistent. Different associations between psychopathy dimensions and executive functioning might explain contradicting findings. This study examined the role of psychopathy dimensions and types of aggression in response inhibition among 117 male adolescents (53 antisocial delinquents and 64 controls). Participants completed a self-report measure of aggression and a GoNoGo task. Psychopathy dimensions were assessed using the Psychopathy Checklist: Youth Version. Although high scores on the antisocial dimension and reactive aggression were associated with poor response inhibition, the affective-interpersonal dimension, proactive aggression, and verbal intelligence (IQ) were related to better response inhibition (two-factor model). Associations with the affective-interpersonal dimensions did not reach significance. Exploratory analyses showed that affective and antisocial facets accounted for the obtained opposing associations of the affective-interpersonal and antisocial psychopathy dimensions with response inhibition. The interpersonal and lifestyle facets (four-facet model) were unrelated to response inhibition. Results could not be explained by Attention Deficit Hyperactivity Disorder (ADHD). Findings suggest differential associations between the psychopathy dimensions, types of aggression, and response inhibition. Therefore, a dimensional approach to psychopathy and related concepts, such as aggression, might strongly improve diagnostic procedures. Global scores could mask important differential associations.

Do executive and reactive disinhibition mediate the effects of familial substance use disorders on adolescent externalizing outcomes?

The present study examined the potential mediating roles of executive and reactive disinhibition in predicting conduct problems, attention-deficit/hyperactivity disorder (ADHD) symptoms, and substance use among adolescents with and without a family history of substance use disorders. Using data from 247 high-risk adolescents, parents, and grandparents, structural equation modeling indicated that reactive disinhibition, as measured by sensation seeking, mediated the effect of familial drug use disorders on all facets of the adolescent externalizing spectrum. Executive disinhibition, as measured by response disinhibition, spatial short term memory, and "trait" impulsivity, was associated with ADHD symptoms. Moreover, although executive functioning weakness were unrelated to familial substance use disorders, adolescents with familial alcohol use disorders were at risk for "trait" impulsivity marked by a lack of planning. These results illustrate the importance of "unpacking" the broad temperament style of disinhibition and of studying the processes that underlie the commonality among facets of the externalizing spectrum and processes that predict specific externalizing outcomes.

Association analyses of MAOA in Chinese Han subjects with attention-deficit/hyperactivity disorder: family-based association test, case-control study, and quantitative traits of impulsivity

Monoamine oxidase A (MAOA) plays a critical role in the metabolism of monoamine neurotransmitters including serotonin (5-HT), norepinephrine (NE), and dopamine (DA). Genetic studies have found an association between MAOA and attention-deficit/hyperactivity disorder (ADHD), especially impulsivity. However, there has been inconsistency among studies which may be due to the complexity and heterogeneity of ADHD, including its sexual dimorphism and the presence of several subtypes. We conducted transmission disequilibrium tests (TDTs) in 1,253 trios and found no association between five single nucleotide polymorphisms (SNPs) of MAOA with ADHD in general or in the predominantly inattentive (ADHD-I) or combined types (ADHD-C), but with the predominantly hyperactive/impulsivity type (ADHD-HI). The association with MAOA was restricted to males, especially males with ADHD-HI. Logistic regression analyses of data from 1,824 cases and 957 controls did not indicate any association. We used analysis of covariance to analyze the association between MAOA genotype with the "inhibit" factor of the Behavior Rating Inventory of Executive Function (BRIEF) in 640 probands and performance on the Stroop test in 810 probands. Probands homozygous for risk alleles found in the TDT test had higher "inhibit" scores on the BRIEF scale which represents more severe impulsivity; this results also was restricted to males. No association was found with Stroop test performance. In conclusion, our results provide some evidence that MAOA may be associated with the ADHD-HI subtype and support the association between MAOA and impulsivity, which may be a potential endophenotype of ADHD. However, the results were strongly influenced by gender.

Neurocognitive development and externalizing problems: the role of inhibitory control deficits from 4 to 6 years

Executive processes have been posited as important regulators of externalizing problems (EP), but there has been little research on the relation between executive dysfunction and EP in early childhood. During the preschool period, maturation of the prefrontostriatal circuitry parallels increases in inhibitory control (IC). Poor IC development could result in elevated levels of aggressive, disruptive, and impulsive behavior. In this investigation, the development of the relation between IC and EP was examined in preschool and early elementary school children using the Day/Night and Tapping tasks. Children with more EP made more incorrect responses on both IC tasks, consistently across age and sex. The associations between EP and response latencies differed across children, however, with longer latencies on the Tapping task being most characteristic for boys with high levels of EP. This association was not apparent for girls. Two prominent aspects of early EP, aggressive and inattentive behavior, showed only weak unique associations with IC performance. These findings imply that diminished IC accompanies elevated EP as early as the preschool years, and that this decrement persists into the elementary school-age years for both girls and boys, and that accuracy and response latency may confer different information about the development of IC.

"Cool" inferior frontostriatal dysfunction in attention-deficit/hyperactivity disorder versus "hot" ventromedial orbitofrontal-limbic dysfunction in conduct disorder: a review

Attention-deficit/hyperactivity disorder (ADHD) and conduct disorder overlap behaviorally, clinically, and cognitively. An important question of potential future clinical relevance is whether these two overlapping disorders are mediated by similar or distinct underlying brain substrates. This article reviews the modern neuroimaging literature on brain structure, function, and connectivity in both disorders, shaping out commonalities and differences. Findings show that ADHD is characterized predominantly by abnormalities in inferior frontal, striatal, parietotemporal, and cerebellar regions and networks that mediate "cool"-cognitive, i.e., inhibitory, attention and timing functions associated with the disorder. Conduct disorder, by contrast, has consistently been associated with abnormalities of the "hot" paralimbic system that regulates motivation and affect, comprising lateral orbital and ventromedial prefrontal cortices, superior temporal lobes, and underlying limbic structures, most prominently the amygdala. Direct comparisons in functional imaging show that these associations of cool inferior fronto-striato-cerebellar dysfunction in ADHD and of hot orbitofrontal-paralimbic dysfunction in conduct disorder are disorder-specific. There is, hence, evidence for dissociated underlying pathophysiologies for these two disorders that may have implications for future anatomy-based differential diagnosis and prevention and intervention.

Executive functions are impaired in adolescents engaging in non-suicidal self-injury

BACKGROUND

The aim of this study was to investigate three main aspects of executive functions (EFs), i.e. shifting, updating and inhibition, in adolescents engaging in non-suicidal self-injury (NSSI) as compared with healthy controls.

METHOD

EFs were assessed using the Intra/Extradimensional Set Shift, the Spatial Working Memory (SWM) Test and the Stop Signal Test (SST) from the Cambridge Neuropsychological Test Automated Battery (CANTAB), in a high-severity NSSI group (n=33), a low-severity NSSI group (n=29) and a healthy control group (n=35). Diagnostic characteristics were examined using the Kiddie-Sads-Present and Lifetime Version.

RESULTS

There were group differences on the SWM Test. A trend towards an interaction effect of sex revealed that males in the high-severity NSSI group made significantly more errors than males and females in the control group. Both males and females in the high-severity NSSI group made poor use of an efficient strategy in completing the test. The low-severity NSSI group performed poorly on the SST, making more errors than the control group and showing an impaired ability to inhibit initiated responses, as compared with the high-severity NSSI group. There were group differences in frequencies of current and previous major depressive disorder. However, no effects of these diagnoses were found on any of the EF tests.

CONCLUSIONS

This study demonstrates that NSSI subgroups have distinct deficits in EFs. The high-severity NSSI group has working memory deficits, while the low-severity NSSI group has impaired inhibitory control. This supports the emotion regulation hypothesis.

Response inhibition and reward response bias mediate the predictive relationships between impulsivity and sensation seeking and common and unique variance in conduct disorder and substance misuse

BACKGROUND

Disinhibited traits, assessed both at the self-report and at the cognitive/behavioral levels, have been frequently implicated in externalizing behaviors, such as conduct disorder (CD), binge drinking, and drug use. However, self-report measures of disinhibition, such as impulsivity (IMP) and sensation seeking (SS), and cognitive measures of disinhibition are not often studied together in the same participants. Thus, it is still unclear how cognitive measures such as response inhibition and reward response bias relate to self-report measures of IMP and SS, and whether they can explain some of the association found between these self-report measures and specific facets of externalizing problems.

METHODS

The aim of this study was to assess whether cognitive measures of disinhibition relate to self-report measures of disinhibition and can mediate the specific relationships between self-report measures of disinhibition and CD symptoms, binge drinking and drug use in adolescence. Seventy-six adolescents were assessed on personality, substance use, and conduct problems every 6 months from 14 to 16 years of age and completed a test battery that included a Stop task, rewarded go/no-go task, digit span, and intelligence quotient tests at 16 years of age.

RESULTS

Multiple regression analyses showed that self-report IMP at 14 and deficits in response inhibition were associated with a 2-year average CD symptoms score and that deficits in response inhibition partially mediated the association between self-report IMP and CD symptoms (ab = 0.018 CI: 0.00002 to 0.04827). In contrast, SS and reward response bias were significantly associated with the unique variance in binge drinking, and that part of the overlap between SS and binge drinking was mediated by reward response bias (ab = 0.019, CI: 0.00131 to 0.04662).

CONCLUSIONS

Findings show a dissociation between inhibitory measures associated with CD symptoms and those associated with binge drinking, with "cool" inhibitory and executive functions being associated with CD but "hot," reward-related disinhibition measures being specific mediators between SS and binge drinking. The findings support the theoretical conceptualization for dual cognitive/motivational pathways of disinhibition, in this case IMP and SS, and their unique association with externalizing behavior in adolescence.

Maternal Behavior and Children's Early Emotion Regulation Skills Differentially Predict Development of Children's Reactive Control and Later Effortful Control

The role of maternal behavior and children's early emotion regulation skills in the development of children's reactive control, specifically behavioral impulsivity, and later effortful control was examined in a sample of 435 children. HLM analyses indicated significant growth in reactive control across the toddlerhood to early childhood period. Emotion regulation at age-2 positively predicted initial levels of children's reactive control abilities while maternal overcontrol/intrusiveness predicted lower levels of reactive control growth. Maternal behaviors at age-2 predicted children's effortful control abilities at age-5.5. Emotion regulation did not predict effortful control abilities. Maternal behavior and children's early emotion regulation skills may differentially facilitate the development of reactive and effortful control abilities.

Disorder-specific inferior prefrontal hypofunction in boys with pure attention-deficit/hyperactivity disorder compared to boys with pure conduct disorder during cognitive flexibility

BACKGROUND

Problems with cognitive flexibility have been observed in patients with attention deficit hyperactivity disorder (ADHD) and in patients with conduct disorder (CD), characterized by the violation of societal rules and the rights of others. Functional magnetic resonance imaging (fMRI) of cognitive switching, however, has only been investigated in patients with ADHD, including comorbidity with CD, finding frontostriatal and temporoparietal underactivation. This study investigates disorder-specific functional abnormalities during cognitive flexibility between medication-naïve children and adolescents with noncomorbid CD and those with noncomorbid ADHD compared to healthy controls.

METHODS

Event-related fMRI was used to compare brain activation of 14 boys with noncomorbid, childhood-onset CD, 14 boys with noncomorbid ADHD, and 20 healthy comparison boys during a visual-spatial Switch task.

RESULTS

Behaviorally, children with ADHD compared to children with CD had significantly slower reaction times to switch compared to repeat trials. The fMRI comparison showed that the patients with ADHD compared to both controls and patients with CD showed underactivation in right and left inferior prefrontal cortex. No disorder-specific brain underactivation was observed in patients with CD. Only when compared with controls alone, the disruptive behavior group showed reduced activation in bilateral temporoparietal and occipital brain regions.

CONCLUSIONS

The findings extend previous evidence for disorder-specific underactivation in patients with ADHD compared to patients with CD in inferior prefrontal cortex during tasks of inhibitory control to the domain of cognitive flexibility. Inferior prefrontal underactivation thus appears to be a disorder-specific neurofunctional biomarker for ADHD when compared with patients with CD.

Neural circuitry associated with risk for alcohol use disorders

The core features of risk for alcohol use disorders (AUD), including behavioral disinhibition, affective dysregulation, and executive dysfunction, map onto distinct neural circuits that have been found to be abnormal in the offspring of alcohol dependent individuals. Components of the cerebellothalamocortical system and the extended limbic network may provide the underpinnings for the behavioral and emotional dysfunction observed in individuals at heightened risk for AUD. In addition, abnormalities in these structures appear to be altered in individuals with the predisposition for other psychiatric conditions that may share a similar genetic diathesis. This review proposes several neurobehavioral mechanisms of genetic vulnerability that may account for phenotypic characteristics in individuals at risk for AUD.

Shared and disorder-specific prefrontal abnormalities in boys with pure attention-deficit/hyperactivity disorder compared to boys with pure CD during interference inhibition and attention allocation

BACKGROUND

Inhibitory and attention deficits have been suggested to be shared problems of disruptive behaviour disorders. Patients with attention deficit hyperactivity disorder (ADHD) and patients with conduct disorder (CD) show deficits in tasks of attention allocation and interference inhibition. However, functional magnetic resonance imaging (fMRI) of inhibitory and attention control has only been investigated in patients with ADHD, including comorbidity with CD, finding fronto-striatal and temporo-parietal dysfunction. This study investigates differences and commonalities in functional neural networks mediating interference inhibition and attention allocation between medication-naïve children and adolescents with pure CD and those with pure ADHD.

METHODS

Event-related fMRI was used to compare brain activation of 13 boys with non-comorbid CD, 20 boys with non-comorbid ADHD and 20 healthy comparison boys during a Simon task that measures interference inhibition and controls for attention allocation, thus tapping into interference inhibition and selective attention networks.

RESULTS

During interference inhibition, both patient groups shared reduced activation compared to controls in right superior temporal lobe and in predominantly right precuneus. During the oddball condition, both patient groups showed reduced activation compared to healthy control children in right medial prefrontal lobe. However, only ADHD patients showed a disorder-specific under-activation compared to the other two groups in an extensive activation cluster in left inferior prefrontal cortex.

CONCLUSIONS

This study shows shared dysfunction in both patients groups in right hemispheric temporal and parietal brain regions during interference inhibition and in right dorsolateral prefrontal cortex during attention allocation. Ventrolateral prefrontal dysfunction, however, was specific to ADHD and not observed in patients with CD in the context of attention allocation. The findings suggest that the typically reduced functional activation in patients with ADHD in ventrolateral prefrontal cortex may be specific to the disorder, at least when compared to patients with CD.

Reactive and proactive control in incarcerated and community adolescents and young adults

This study compared the cognitive control skills of male incarcerated adolescents (n=44), male control adolescents (n=33), male incarcerated young adults (n=41), and male control young adults (n=35) using the AX-Continuous Performance Task. This task measures proactive control (the ability to maintain a mental representation of goal-related information in preparation for a behavioral response) and reactive control (the ability to activate goal-related information in response to an external trigger). Incarcerated individuals had more difficulty implementing proactive control, whereas control individuals had more difficulty implementing reactive control. Adolescents had more difficulty with both reactive and proactive control compared to young adults, suggesting that both skills improve with age. Additional analyses indicated that the effect of age on proactive control was due to the presence of attention-deficit/hyperactivity disorder, whereas the effect of age on reactive control appeared to be a natural developmental trend that could not be explained by other variables. These findings are considered in relation to the dual mechanisms of control theory (Braver, Gray, & Burgess, 2007).

Neuropsychological function in adolescent girls with conduct disorder

OBJECTIVES

Conduct disorder (CD) in adolescent girls is a significant problem, but few data exist on the neuropsychological function of girls with this disorder. We investigated whether girls with CD have poorer neuropsychological function than girls without any psychiatric disorder, whether these differences remained significant after adjusting for demographics, and whether psychiatric comorbidity, age at onset of CD symptoms, or aggressive CD behaviors were differentially associated with neuropsychological function within the CD group.

METHOD

Ninety-three girls, ages 15 to 17 years, from the community (52 CD; 41 without any disorder [normal controls]) received a neuropsychological battery examining motor/laterality, general intelligence, language, visuospatial, visual-motor, executive function, and academic achievement domains.

RESULTS

Girls with CD had lower general intelligence and poorer performance on visuospatial, executive function, and academic achievement domains. After adjusting for demographic factors, scores in the CD group were worse for general intelligence and in the visuospatial and academic achievement domains. Comorbid substance use disorder was negatively correlated with motor/laterality; no other intra-CD group comparisons were statistically significant.

CONCLUSIONS

Girls with CD had deficits in several domains of neuropsychological function. Possible explanations for the findings and clinical implications are discussed.

Brain activation during the Stroop task in adolescents with severe substance and conduct problems: A pilot study

BACKGROUND

Although many neuroimaging studies have examined changes in brain function in adults with substance use disorders, far fewer have examined adolescents. This study investigated patterns of brain activation in adolescents with severe substance and conduct problems (SCP) compared to controls.

METHODS

Functional magnetic resonance imaging (fMRI) at 1.5Tesla assessed brain activation in 12 adolescent males with SCP, ranging in age from 14 to 18, and 12 controls similar in age, gender, and neighborhood while performing the attentionally demanding Stroop task.

RESULTS

Even though the adolescents with SCP performed as well as the controls, they activated a more extensive set of brain structures for incongruent (e.g., "red" in blue ink) versus congruent (e.g. "red" in red ink) trials. These regions included parahippocampal regions bilaterally, posterior regions involved in language-related processing, right-sided medial prefrontal areas, and subcortical regions including the thalamus and caudate.

CONCLUSION

These preliminary results suggest that the neural mechanisms of attentional control in youth with SCP differ from youth without such problems. This difficulty may prevent SCP youth from ignoring salient but distracting information in the environment, such as drug-related information.