Task-based functional connectivity patterns: Links to adolescent emotion regulation and psychopathology

Adolescence is a developmental period characterized by heightened emotional reactivity, neurobiological changes, and increased rates of anxiety and depression. Emotion regulation (ER) difficulties-or the inability to effectively regulate one's emotions-have been theoretically and empirically conceptualized as a transdiagnostic factor implicated in virtually all forms of psychopathology among youth. The current fMRI study investigates how young adolescents' ER abilities longitudinally mediate the relationship between their task-based (n=67) limbic-prefrontal functional connectivity values and subsequent levels of internalizing and externalizing symptoms. Findings revealed that adolescents with stronger limbic-prefrontal connectivity when viewing negative emotional images reported more ER difficulties one year later which, in turn, predicted higher levels of adolescent-reported internalizing and externalizing symptoms (with the exception of ADHD) two years later. This is the only study to date that provides compelling-albeit preliminary-evidence that ER problems longitudinally mediate the association between task-based functional connectivity patterns and future psychological symptoms among adolescents. Of note, participants were only scanned at baseline, limiting our ability to assess change in adolescents' task-based functional connectivity patterns as a function of developing ER abilities or burgeoning psychological symptomology. In sum, rather than conferring risk for any particular disorder, our results suggest that functional connectivity and subsequent ER abilities may serve a transdiagnostic risk factor for psychopathology. These findings may inform future emotion-focused prevention and intervention efforts aimed at youth susceptible to future internalizing and externalizing problems.

Cardiovascular and affective responses to social stress in adolescents with internalizing and externalizing problems

Behavioral responses to stress and challenge are based in emotional and physiological arousal reactions. Adolescents with maladaptive or problematic behavior patterns, such as internalizing or externalizing problems, are likely to show atypical emotional and physiological reactions to stress. Relations between problems and reactions to stress were examined in a sample of 55 young adolescents with normal to clinical levels of internalizing and externalizing problems. Youth had their self-reported emotional states, heart rate, and blood pressure levels measured before and after engaging in two socially challenging, evaluative manipulations. Internalizing problems were associated with less positive affect but greater anxiety and cardiovascular arousal, whereas externalizing problems predicted greater hostility and positive affect but less cardiovascular arousal. The necessity of recognizing and incorporating comorbid characteristics and multiple response systems into studies of the links between problems and reactivity is emphasized in the discussion.

The Relations of Children’s Situational Empathy-related Emotions to Dispositional Prosocial Behaviour

Although empathy-related responding has frequently been associated with prosocial behaviour directed towards the target of an individual’s vicarious emotional responding, relations between dispositional prosocial behaviour and sympathy or personal distress have seldom been examined, particularly with a multimethod approach. Kindergarten to third-graders’ empathy-related responses to a ”lm were examined as predictors of dispositional prosocial behaviour as reported by teachers, parents, and peers. Teachers’ ratings of dispositional behaviour were related to children’s facial and skin conductance reactions to the ”lm. Parents’ and peers’ ratings of dispositional prosocial behaviour were infrequently associated with children’s empathy-related responding, although peer reports were positively related to heart rate acceleration for boys. Reasons for the differential patterns of relations for different reporters are considered.

Autonomic correlates of children's concern and disregard for others

Psychophysiological research on empathy and prosociality in children has focused most often on cardiac activity, heart rate (HR), and HR deceleration in particular. We examined these processes in 7-year-old children during two empathy mood inductions. We independently assessed children's responses to others' distress in two different contexts: structured probes (simulated pain) and maternal interviews. We identified three groups of children who showed either (1) concern for others in distress (i.e., empathy and prosocial behaviors), (2) active disregard (i.e., anger/hostility and antisocial behavior), or (3) passive disregard (i.e., little or no concern). We compared groups on HR and HR deceleration. The active disregard group consistently showed the lowest HR both when groups were based on structured probes and on mothers' reports. Children who showed passive disregard displayed little self-distress during other's distress and different patterns of association of self-distress and HR than the other two groups. Active and passive disregard thus may reflect two different aspects of lack of concern for others. HR deceleration was seen for all three groups, suggesting it is not necessarily a cardiac index of concern for others. Interdisciplinary approaches and multiple-systems analysis are needed to better understand psychobiological substrates.

Violent video games stress people out and make them more aggressive

It is well known that violent video games increase aggression, and that stress increases aggression. Many violent video games can be stressful because enemies are trying to kill players. The present study investigates whether violent games increase aggression by inducing stress in players. Stress was measured using cardiac coherence, defined as the synchronization of the rhythm of breathing to the rhythm of the heart. We predicted that cardiac coherence would mediate the link between exposure to violent video games and subsequent aggression. Specifically, we predicted that playing a violent video game would decrease cardiac coherence, and that cardiac coherence, in turn, would correlate negatively with aggression. Participants (N = 77) played a violent or nonviolent video game for 20 min. Cardiac coherence was measured before and during game play. After game play, participants had the opportunity to blast a confederate with loud noise through headphones during a reaction time task. The intensity and duration of noise blasts given to the confederate was used to measure aggression. As expected, violent video game players had lower cardiac coherence levels and higher aggression levels than did nonviolent game players. Cardiac coherence, in turn, was negatively related to aggression. This research offers another possible reason why violent games can increase aggression-by inducing stress. Cardiac coherence can be a useful tool to measure stress induced by violent video games. Cardiac coherence has several desirable methodological features as well: it is noninvasive, stable against environmental disturbances, relatively inexpensive, not subject to demand characteristics, and easy to use.

Concurrent attenuated reactivity of alpha-amylase and cortisol is related to disruptive behavior in male adolescents

Attenuated reactivity of salivary alpha-amylase has been proposed as a specific sympathetic marker of disruptive behavior in juveniles and may have additional value to studying other autonomic parameters and hypothalamic-pituitary-adrenal axis activity. Investigating the interrelationships between neurobiological parameters in relation to juvenile disruptive behavior may enhance insight into the complex mechanisms at play. We investigated salivary alpha-amylase, cortisol, heart rate (HR), and heart rate variability (HRV) in response to a standardized public speaking task, and examined interactions between these parameters in relation to disruptive behavior. Participants were 48 delinquent male adolescents (mean age 18.4 years, SD 0.9), with and without a disruptive behavior disorder (resp. DP+, DP-) and 16 matched normal controls (NC). A structured psychiatric interview as well as the Youth Self Report and Child Behavior Checklist were administered to assess disruptive behavior. Alpha-amylase and cortisol reactivity, but not HR or HRV, showed significant inverse associations with dimensional measures of disruptive behavior. Moreover, both cortisol and alpha-amylase reactivity were significantly lower in the DP+ group as compared to the NC group. The mentioned relationships remained present when nicotine use was entered as a covariate. Combining alpha-amylase and cortisol in one model explained a larger part of the variance of disruptive behavior than either single parameter. There were no interactions between alpha-amylase and cortisol or HRV in relation to disruptive behavior. Attenuated alpha-amylase responsivity to stress is a correlate of disruptive behavior in late-adolescent males. Although nicotine use explains a considerable part of the variance of disruptive behavior, both alpha-amylase and cortisol are related to disruptive behavior, over and above the effect of nicotine use. Combining alpha-amylase and cortisol improved insight into neurobiological mechanisms involved with disruptive behavior; concurrent low reactivity of both parameters was related to higher levels of disruptive behavior.

Emotion regulation via the autonomic nervous system in children with attention-deficit/hyperactivity disorder (ADHD)

Despite growing interest in conceptualizing ADHD as involving disrupted emotion regulation, few studies have examined the physiological mechanisms related to emotion regulation in children with this disorder. This study examined parasympathetic and sympathetic nervous system reactivity via measures of respiratory sinus arrhythmia (RSA) and cardiac pre-ejection period (PEP) in children with ADHD (n=32) and typically developing controls (n=34), using a novel emotion task with four conditions: negative induction, negative suppression, positive induction, and positive suppression of affect. Both groups showed strong task-response effects in RSA. However, typically developing children showed systematic variation in parasympathetic activity (RSA) depending on both emotion valence (more activation for negative emotion, reduced activation for positive emotion) and task demand (more activation for suppression than induction). In contrast, children with ADHD displayed a stable pattern of elevated parasympathetic activity (RSA) across all task conditions compared to baseline. No group differences in sympathetic activity (PEP) were observed. It is concluded ADHD in childhood is associated with abnormal parasympathetic mechanisms involved in emotion regulation.

Prenatal cocaine exposure, gender, and adolescent stress response: a prospective longitudinal study

Prenatal cocaine exposure is associated with alterations in arousal regulation in response to stress in young children. However, relations between cocaine exposure and stress response in adolescence have not been examined. We examined salivary cortisol, self-reported emotion, heart rate, and blood pressure (BP) responses to the Trier Social Stress Test (TSST) in 49 prenatally cocaine and other drug exposed (PCE) and 33 non-cocaine-exposed (NCE) adolescents. PCE adolescents had higher cortisol levels before and after stress exposure than NCE adolescents. PCE girls showed an elevated anxiety response to stress (compared to NCE girls) and PCE boys showed a dampened diastolic BP response (compared to NCE boys). Girls showed higher anger response and lower pre-stress systolic BP than boys. Group differences were found controlling for potential confounding variables and were not moderated by caregiver-child relationship quality (although relationship quality predicted HPA axis and anxiety response). The findings suggest that prenatal drug exposure is associated with altered stress response in adolescence and that gender moderates this association.

Emotional arousal in cocaine exposed toddlers: prediction of behavior problems

Prenatal cocaine exposure (PCE) may be associated with alterations in children's developing emotional arousal and regulation systems.

OBJECTIVE

We examined emotional responses to a frustrating task and subsequent behavior problems in 225 2 1/2 year olds (129 Prenatally Cocaine and Other Drug Exposed [PCE], 30 Non Cocaine but other drug Exposed [NCE], 66 Non Drug Exposed [NDE]).

METHOD

Children's behaviors in a frustrating toy wait task at age 2 1/2 were coded for emotional arousal and regulation behaviors.

RESULTS

Findings indicated a trend for PCE toddlers to show greater agitated emotional arousal than NCE and NDE toddlers. Further, PCE boys made more references to their caregivers in the task than NDE boys. Higher agitated arousal at age 2 1/2 years was related to greater decreases in externalizing behaviors through age 5 1/2 years.

CONCLUSION

Findings suggest a link between cocaine exposure and emotional arousal and regulation and highlight the need to understand complex relations between emotion and risk for later psychopathology in exposed youth.

Gender, Anxiety, and Depressive Symptoms: A Longitudinal Study of Early Adolescents

Does anxiety lead to depression more for girls than for boys? This study prospectively examines gender differences in the relationship between anxiety and depressive symptoms in early adolescence. One hundred thirteen 11- to 14-year-old middle school students complete questionnaires assessing depressive symptoms and three dimensions of anxiety (worry and oversensitivity, social concerns and concentration, and physiological anxiety) as well as total anxiety symptoms at an initial assessment and 1 year later. Total anxiety and worry and oversensitivity symptoms are found to predict later depressive symptoms more strongly for girls than for boys. There is a similar pattern of results for social concerns and concentration symptoms, although this does not reach statistical significance. Physiological anxiety predicts later depressive symptoms for both boys and girls. These findings highlight the importance of anxiety for the development of depression in adolescence, particularly worry and oversensitivity among girls.

Psychophysiological correlates of empathy and prosocial behaviors in preschool children with behavior problems

This study focused on empathic and prosocial orientations in preschool children who vary in externalizing problems. Children were categorized as low, moderate, or high risk for developing disruptive behavior disorders, depending on severity of current behavior problems. Hypothetical and real encounters with others in distress were used to examine children's affect, behavior, autonomic activity, and social cognitions. When children witnessed someone in distress, empathic concern and prosocial behaviors were present at similar levels for all risk groups. However, moderate and high-risk children were less able than low-risk children to remain positively engaged with distress victims. Girls showed more prosocial behavior than boys, and boys showed more anger than girls. During sadness mood inductions to assess autonomic activity, risk groups did not differ on heart rate or vagal tone. Girls showed higher skin conductance than boys, with high-risk girls showing the highest levels. Higher heart rate (and heart rate deceleration) predicted empathic concern and prosocial behavior, whereas lower heart rate was associated with aggression and avoidance, irrespective of risk. Although biological correlates of emotions and behaviors that reflect caring versus indifference to others' distress are identified, they do not support an early direct link to externalizing psychopathologies.

Longitudinal patterns of physical aggression: Associations with adult social, psychiatric, and personality functioning and testosterone levels

A retrospective longitudinal research design was used to evaluate male adult outcomes associated with four patterns of physical aggression from childhood to adulthood—child-only aggression, child and adult continuity of aggression, adult-onset aggression, and a contrast group with low levels of aggression in childhood and adulthood. The continuity and adult-onset aggression groups had the highest levels of social maladjustment (e.g., marital instability), psychiatric disturbance (e.g., alcohol disorders, major depression), personality dysfunction (e.g., higher prevalence of elevated borderline and narcissistic personality disorder scores), and higher plasma testosterone levels. The child-only aggression group manifested more psychiatric and personality disturbance than the contrast group, but not nearly as much disturbance as the continuity and adult-onset groups. After controlling for age and socioeconomic status (SES) variables, race (White/Black) was typically not a significant predictor of outcome variables. Findings are discussed with regard to life course implications of the physical aggression patterns, and of the support provided for an adult-onset aggressive type.

The relations of regulation and emotionality to problem behavior in elementary school children

The relations of regulation and emotionality to elementary school children's problem behavior was examined. Parents and teachers reported on children's problem behavior. One parent and teachers rated children on various measures of regulation (including resiliency) and emotionality; children's baseline heart rate and facial reactivity were assessed; and physiological and facial distress and gaze aversion while viewing a distress film sequence were measured. In general, low regulation, negative emotionality, and general and positive emotional intensity predicted problem behaviors. Teachers' reports of negative emotionality and regulation interacted in their relation to problem behaviors, with regulation apparently buffering the effects of moderate and high negative emotionality. Baseline heart rate and facial distress were related to low levels of problem behavior, and gaze aversion during the distress film segment was associated with low levels of problem behavior.

The influence of deviant peers on the development of boys' disruptive and delinquent behavior: A temporal analysis

The concurrent and predictive influence of deviant peers on boys' disruptive and delinquent behavior was examined in a community sample of fourth- and seventh-grade boys, who were followed-up over six data waves. Analyses were conducted separately for three different types of behavior problems: authority conflict, covert, and overt disruptive behavior. Consistent with the existing literature, concurrent relations between peers' and boys' disruptive behavior were expected to be significant. A more informative test, however, was whether exposure to deviant peers resulted in boys' subsequent initiation of disruptive behavior. Although peer influences were expected in the predictive analyses, the relations were hypothesized to differ by type of behavior. The potential moderating effects of hyperactivity and poor parenting practices were also examined to test the hypothesis that boys who are already at risk for behavior problems will be more susceptible to deviant peer influence. Results supported the significant concurrent and predictive relation between exposure to deviant peers and boys' engagement in disruptive and delinquent behavior. There were no significant moderating effects of attention-deficit hyperactivity disorder (ADHD) or parenting practices on peer influence.

Salivary gonadal and adrenal hormone differences in boys and girls with and without disruptive behavior disorders: Contextual variants

Hormone differences by psychopathology group and gender may have implications for understanding disruptive behavior disorders (DBDs) and complexities of treatment outcomes. Current theoretical models emphasize contextual differences as moderators of hormone-behavior relations. This baseline report examined: (a) hormone differences in youth with and without DBD, and (b) contextual factors as moderators of behavior problems and hormones. 180 children and adolescents were enrolled (141 boys, mean 9.0+/-1.7 years). DBD participants met criteria for conduct disorder (CD) and/or oppositional defiant disorder (ODD) (n=111); 69 were recruited as healthy comparisons (HC). Saliva was collected for testosterone, cortisol, dehydroepiandrosterone and androstenedione. DBD youth had significantly higher androstenedione than the HC group. There was a group by gender interaction for basal cortisol mean with DBD boys and HC girls having lower cortisol. Moderating effects of contextual variables (e.g., family functioning, delinquent peers) were noted for cortisol and adrenal androgens. Findings argue for considering hormones as an influence on DBD beyond simple direct one-to-one associations.

Are there meaningful etiological differences within antisocial behavior? Results of a meta-analysis

There is mounting evidence of etiologically driven distinctions between aggressive (AGG) and non-aggressive rule-breaking (RB) forms of antisocial behavior. To date, however, these differences remain somewhat speculative. The current meta-analysis of twin and adoption studies sought to clarify these distinctions by comparing meta-analytic estimates of genetic, shared environmental, and non-shared environmental influences across AGG and RB to more clearly ascertain whether they evidence differential patterns of genetic and environmental influence. A comprehensive literature search resulted in the collection of 103 twin and adoption studies, of which 15 RB samples and 19 AGG samples were ultimately included in the analyses. Results reveal clear evidence of etiological distinctions between AGG and RB. Namely, AGG appears to be a highly heritable condition (genetic factors account for 65% of the variance), with little role for the shared or common environment, particularly after childhood. By contrast, while genetic influences also contribute to RB (48% of the variance), there is an important role for shared environmental effects as well (18% of the variance). Such findings are indicative of meaningful etiologic distinctions between aggressive and rule-breaking forms of antisocial behavior, and underscore the advantage of differentiating between these behavioral subtypes when studying the causal processes that underlie antisocial behavior.

Predicting cardiac vagal regulation in early childhood from maternal-child relationship quality during toddlerhood

The aim of this study was to examine the influence of maternal-child relationship quality during toddlerhood on early childhood physiological regulation. A community sample of 447 children (215 males) was recruited at age 2 for participation in the study using the Child Behavior Checklist [Achenbach [1992] Manual for the child behavior checklist/2-3 & 1992 profile. Burlington, VT: University of VT Department of Psychiatry]. Mothers and children were observed across several interactions in the laboratory at age 2 and mothers completed the Parenting Stress Index [Abidin [1995] Manual for the parenting stress index. Odessa, FL: Psychological Assessment Resources]. Relationship quality was assessed using laboratory measures of hostility, positive guidance, and stress related to the quality of the relationship as reported by mothers. Cardiac vagal regulation at age 2 was assessed across six challenge tasks, three in which the child and mother worked together and three in which the child worked independently, and was indexed by the magnitude of vagal withdrawal (decrease in respiratory sinus arrhythmia, RSA) to challenge. Results indicated that children displayed greater cardiac vagal regulation and heart rate acceleration during collaborative tasks versus independent tasks. In addition, maternal-child relationship quality predicted the degree of vagal regulation in children at age 5, even after controlling for early and concurrent level of behavior problems as well as 2-year cardiac vagal regulation. Children with poorer quality relationships displayed significantly poorer vagal regulation and lower heart rate acceleration (p < .01). These findings are discussed in terms of the implications of environmental factors for the acquisition of fundamental self-regulatory skills.

From emotion resonance to empathic understanding: A social developmental neuroscience account

The psychological construct of empathy refers to an intersubjective induction process by which positive and negative emotions are shared, without losing sight of whose feelings belong to whom. Empathy can lead to personal distress or to empathic concern (sympathy). The goal of this paper is to address the underlying cognitive processes and their neural underpinnings that constitute empathy within a developmental neuroscience perspective. In addition, we focus on how these processes go awry in developmental disorders marked by impairments in social cognition, such as autism spectrum disorder, and conduct disorder. We argue that empathy involves both bottom-up and top-down information processing, underpinned by specific and interacting neural systems. We discuss data from developmental psychology as well as cognitive neuroscience in support of such a model, and highlight the impact of neural dysfunctions on social cognitive developmental behavior. Altogether, bridging developmental science and cognitive neuroscience helps approach a more complete understanding of social cognition. Synthesizing these two domains also contributes to a better characterization of developmental psychopathologies that impacts the development of effective treatment strategies.

Disorders of childhood and adolescence: gender and psychopathology

Early-onset disorders (e.g., conduct problems, autism) show a marked male preponderance, whereas adolescent-onset disorders (e.g., depression, anxiety) show a marked female preponderance. A developmental psychopathology framework provides a means to investigate complex gender-related etiologies of these different disorders. This review focuses on biological and environmental factors implicated in the development of conduct problems and depression in boys and girls. Boys and girls showed certain differences in types, rates, comorbidities, antecedents, correlates, and trajectories of these problems. Origins of male and female preponderant problems are likely to be rooted, in part, in biological, physical, cognitive, and social-emotional differences in boys and girls that can precede the expression of clinical problems. These male-like and female-like characteristics are considered regarding conduct problems and depression to explore how they inform biological and environmental theories about gender and psychopathology. At the same time, because boys and girls also show many similarities, it is important to avoid sex-stereotyping mental health problems.

Cardiac vagal regulation differentiates among children at risk for behavior problems

A sample of 335 five-year-old children participating in an ongoing longitudinal study was the focus of a study on the effects of emotional and behavioral challenge on cardiac activity in children with different patterns of early childhood behavior problems. The children were placed in one of three behavior problem groups (low behavior problems, risk for externalizing problems, risk for mixed externalizing/internalizing problems) based on their scores on the Child Behavior Checklist for 4-18-year-olds [Achenbach, T.M., 1991. Integrative guide for the 1991 CBCL/4-18, YSR & TRF profiles. University of Vermont Department of Psychiatry, Burlington, VT], completed by their mothers. To assess cardiac vagal regulation, resting measures of respiratory sinus arrhythmia (RSA) and RSA change (vagal withdrawal) to five emotionally and behaviorally challenging tasks were derived. In addition, heart period (HP) and heart period change (HR acceleration) was examined. Results indicated that the behavior problem groups did not differ in terms of resting measures of either RSA or HP. Analyses of the challenge tasks indicated that the children at risk for mixed problems displayed greater cardiac vagal withdrawal across the five tasks than did the other two groups of children. There was a trend for the children at risk for externalizing problems to display less vagal withdrawal than the control group. In addition, the children at risk for mixed problems displayed greater heart rate acceleration to the tasks than did the other two groups of children. Follow-up analyses indicated that the greater cardiac acceleration observed in the mixed group was largely a function of greater vagal withdrawal. These findings are discussed in terms of the emotion regulatory function of cardiac vagal regulation, and its implications for patterns of risk for behavior problems in young children.

Prädiktoren dissozialen Verhaltens

Many studies have shown that psychophysiological parameters of processing emotional stimuli are associated with different personality traits in children, adolescents, and adults. Individuals with low autonomic baseline arousal, low orienting reaction, accelerated habituation, and reduced excitability particularly to punishing stimuli are characterised by a reduced experience of anxiety, decreased behaviour inhibition, and increased sensation seeking. These characteristics seem to raise the likelihood of dis-social behavior and are perceived as prognostically favourable for the development of antisocial personality disorders in childhood and adolescence. In contrast, an increased disposition towards anxiety, which is associated with increased autonomic reactivity, is recognised as a protective factor. Current data have shown that through special training, child and adolescent autonomic reactivity could be enhanced. Due to its versatility, this biological marker might be used for prevention in children at greater risk of developing antisocial behaviour.

Mood and hormone responses to psychological challenge in adolescent males with conduct problems

BACKGROUND

Relations between stress hormones and antisocial behavior are understudied.

METHODS

A subsample (n = 335) of at-risk males recruited in first grade for a longitudinal study were recruited at approximately 16 years of age for a laboratory study, including two psychological challenges: describing their worst experience on videotape, and a task in which a loud tone could be avoided. Measures of affect, urine, and saliva were collected multiple times before and after challenges.

RESULTS

Negative affect increased following the worst-event challenge and decreased following the avoidance challenge. Mean conduct problems (CP) across ages 7-17 years were positively related to negative affect and inversely related to positive affect. CP were inversely related to post-challenge urinary epinephrine (E) levels when baseline E and potential confounds were controlled. Cortisol concentrations in saliva collected soon after the first challenge were positively related to CP in a post hoc subset of youths with extreme CP.

CONCLUSIONS

Key findings A) associated persistent CP with more negative affectivity and less positive affectivity, B) replicated and extended prior findings of an inverse association of CP and urinary E, and C) suggested provocative hypotheses for future study relating CP, trauma history, trauma recall, and cortisol reactivity.

The psychophysiology of child misconduct

Psychophysiological evidence supports the notion that serious and persistent childhood misconduct is symptomatic of an internal dysfunction that dynamically interacts with other psychological and social causes. Childhood misconduct is a complex phenomenon with multiple causes and no easy solutions. Rather than think our civilization is doomed, however, we should realize that the great majority of our children grow up to be sociable and law-abiding individuals. For the others, we are afforded optimism that this problem can be minimized as we gain a more complete understanding of the interplay among biological, psychological, and social risks, and through the consequent refinement of interventions.

Temperament and Developmental Pathways to Conduct Problems

This article reviews research linking a number of temperamental vulnerabilities to the development of severe conduct problems in children. Also reviewed are 2 areas of research that focus on important developmental processes that could mediate the relation between temperament and conduct problems. These processes are the development of emotional regulatory abilities and the development of the affective components of conscience. Both of these processes have been associated with certain temperamental vulnerabilities, and they can both place a child at risk for the development of conduct problems. Importantly, these 2 processes may designate children who develop conduct problems through distinct causal pathways and, as a result, could help to explain some of the subtypes of antisocial youth reported in past research.

Violence: concepts of its impact on children and youth

Although nations continue to remain involved in ongoing armed conflicts, the threat of direct exposure to violence for American children and youth is more likely to be from the interpersonal violence that occurs in homes, neighborhoods, and schools. Exposure to interpersonal violence has a very serious impact on most youth. Focusing on violence prevention remains a vital component of providing comprehensive health care for all youth.

Psychopharmacology in the Treatment of Conduct Disorder Children and Adolescents: Rationale, Prospects, and Ethics

The rationale for psychopharmacological treatments of conduct disorder (CD) in children and adolescent is discussed with reference to the presumed neurophysiological basis of the disorder. Specific psychopharmacological treatments for children with CD are identified and briefly evaluated in terms of their empirical foundations. The lack of a secure knowledge base on the biochemical basis of CD and the efficacy of psychopharmacological treatments with children and adolescents suggests the need for caution in the wide use of pharmacotherapy with these populations. Psychopharmacological treatments with children and adolescents with CD are particularly indicated for reactive aggression, and CD with comordid conditions. Conceptual and methodological improvements in use of psychotropic medications with children and adolescents are discussed as well as the associated ethical considerations.

Parent-directed physical aggression by clinic-referred youths

Identified children and young adolescents who engaged in parent-directed physical aggression from a sample of youths referred for outpatient therapy (N = 606, 151 girls, 455 boys); examined the frequency, severity, and characteristics of such behavior; and compared aggressive youths with nonaggressive youths across several domains of functioning. Twelve percent of the children and young adolescents in this clinical sample engaged in parent-directed aggression. Aggressive, compared to nonaggressive, youths had significantly increased oppositional behavior, lower frustration tolerance, less adaptability to stressful situations, and were more demanding of their parents. Aggressive children had families characterized by significantly greater parental stress, poorer interpersonal relationships, and were more likely to be 2-parent, European American families of higher socioeconomic status. Moreover, lower frustration tolerance and adaptability were significant predictors of parent-directed aggression after controlling for demographic differences and overall level of oppositionality and aggressiveness, suggesting a more specific functional impairment in such children. Parent-directed aggression warrants additional study given the limitations in our understanding of these events and the potential for such behaviors to continue into adolescence and adulthood.

Annotation: the role of prefrontal deficits, low autonomic arousal, and early health factors in the development of antisocial and aggressive behavior in children

BACKGROUND

This article selectively reviews the biological bases of antisocial and aggressive behavior in children with a focus on low autonomic functioning, prefrontal deficits, and early health factors.

RESULTS

Low resting heart rate is thought to be the best-replicated biological correlate of antisocial and aggressive behavior in child and adolescent populations and may reflect reduced noradrenergic functioning and a fearless, stimulation-seeking temperament. Evidence from neuropsychological, neurological, and brain imaging studies converges on the conclusion that prefrontal structural and functional deficits are related to antisocial, aggressive behavior throughout the lifespan. A prefrontal dysfunction theory of antisocial behavior is advanced. This argues that social and executive function demands of late adolescence overload the late developing prefrontal cortex, giving rise to prefrontal dysfunction and a lack of inhibitory control over antisocial, violent behavior that peaks at this age. Birth complications and minor physical anomalies are selectively associated with later violent behavior, especially when combined with adverse psychosocial risk factors for violence. Cigarette smoking during pregnancy may increase the risk for antisocial and violent behavior in later life by disrupting noradrenergic functioning and enhancement of cholinergic receptors that inhibit cardiac functioning. Malnutrition during pregnancy is associated with later antisocial behavior and may be mediated by protein deficiency.

CONCLUSIONS

It is argued that early health intervention and prevention studies may provide the most effective way of reversing biological deficits that predispose to antisocial and aggressive behavior in children and adults.

The development of concern for others in children with behavior problems

The development of concern for others and externalizing problems were examined in young children with normative, subclinical, or clinical levels of behavior problems. There were no group differences in observable concern for others at 4-5 years of age. Children with clinical behavior problems decreased significantly in their concern by 6-7 years of age and were reported to have less concern at 6-7 years by mothers, teachers, and the children themselves, relative to other groups. Boys with clinical problems were more callous to others' distress at both time points. Girls showed more concern than boys across risk, time, and measures. Greater concern at 4-5 years predicted decreases in the stability and severity of externalizing problems by 6-7 years, and greater concern at 6-7 years predicted decreases in the stability of problems by 9-10 years. Finally, maternal socialization approaches predicted later concerned responding.

Validity of DSM-IV subtypes of conduct disorder based on age of onset

OBJECTIVE

To present data from the DSM-IV field trials that led to the distinction between subtypes of conduct disorder (CD) that emerge in childhood or adolescence. In addition, data from a household sample were used to attempt to cross-validate these findings.

METHOD

Differences between youths who met criteria for the two subtypes of CD were examined in the field trials sample of 440 youths aged 4 through 17 years and in a household sample of 1,285 youths aged 9 through 17 years.

RESULTS

In both samples, there was a steep decline in aggression occurring around an age of onset of 10 years, but the number of nonaggressive behaviors was unrelated to the age of onset of CD. In the field trials sample, youths who met criteria for the adolescent-onset type were more likely to be girls, less likely to meet criteria for oppositional defiant disorder, and less likely to have a family history of antisocial behavior than the childhood-onset type, but these latter findings were not confirmed in the household sample.

CONCLUSIONS

The DSM-IV approach to subtyping CD distinguishes subgroups that differ markedly in level of physical aggression. The advantages of a developmental approach to subtyping are discussed.

Practice parameters for the assessment and treatment of children and adolescents with conduct disorder. American Academy of Child and Adolescent Psychiatry

These practice parameters address the diagnosis, treatment, and prevention of conduct disorder in children and adolescents. Voluminous literature addresses the problem from a developmental, epidemiological, and criminological perspective. Properly designed treatment outcome studies of modern psychiatric modalities are rare. Ethnic issues are mentioned but not fully addressed from a clinical perspective. Clinical features of youth with conduct disorder include predominance in males, low socioeconomic status, and familial aggregation. Important continuities to oppositional defiant disorder and antisocial personality disorder have been documented. Extensive comorbidity, especially with other externalizing disorders, depression, and substance abuse, has been documented and has significance for prognosis. Clinically significant subtypes exist according to age of onset, overt or covert conduct problems, and levels of restraint exhibited under stress. To be effective, treatment must be multimodal, address multiple foci, and continue over extensive periods of time. Early treatment and prevention seem to be more effective than later intervention.

Severe conduct disorder--some key issues

OBJECTIVE

To examine the state of knowledge about clinically severe conduct disorder and identify key issues.

METHOD

This paper surveys the literature on conduct disorder and delineates and discusses the critical issues.

RESULTS

Conduct disorder is the subject of a vast and growing amount of research on taxonomy, correlates, etiology, outcome, management, and prevention. There are 2 distinctive types: childhood and adolescent onset. Comorbidity with other disorders is common. It remains a costly disorder, however, with a generally poor prognosis for the childhood-onset type. The validity of the separation of conduct and antisocial personality disorder is questionable.

CONCLUSIONS

In view of its huge cost, chronicity, and generally poor outcome, childhood-onset or severe conduct disorder should be considered one of if not the major public health problems of our time, and resources for its study and management should reflect this. The disorder is poorly defined and inadequately studied in females.

Behavioral changes in Anolis carolinensis following injection with fluoxetine

Eight adult male lizards of the genus and species Anolis carolinensis were used in this experiment. In order to induce aggressive responding, animals were caged separately and daily underwent pairing with another male, during which aggressive responses and changes in skin color were measured. After obtaining a baseline measure of aggressive responding, animals were injected either with fluoxetine or vehicle-controls in a cross-over design. Subjects were then exposed to five more days of (non drug) pairing with the intruder male, after which they underwent a second trial with fluoxetine/vehicle. Finally, two post-drug paired-trials were obtained. Fluoxetine injection significantly reduced the aggressive responding in the males while causing the postorbital eyespot to significantly darken. Subjects also showed increased aggressivity and skin-color reactivity subsequent to the two drug trials, although it is unclear if the fluoxetine, or non-specific factors of the injection paradigm, accounted for these changes. These results suggest that serotonergic CNS systems tonically regulate aggression in Anolis carolinesis, similar to that seen in many other species. They further suggest that eyespot-darkening and aggressive responding can be pharmacologically dissociated, implicating serotonin in the regulation of this phenomenon.

Attention deficit hyperactivity disorder and whole-blood serotonin levels: effects of comorbidity

Whole-blood serotonin (5-hydroxytryptamine, 5-HT) levels were measured in children with attention deficit hyperactivity disorder (ADHD) with and without comorbid conduct disorder (CD) or oppositional-defiant disorder (ODD). It was hypothesized that the whole-blood 5-HT levels of ADHD probands would be significantly correlated with the whole-blood 5-HT levels of their mothers. Fifty-two children who met DSM-III-R criteria for ADHD were selected consecutively from an ADHD clinic (47 males--35 Caucasians, 10 African-Americans, and 2 Hispanics; 10 females--all Caucasians). Whole-blood 5-HT was assayed by high performance liquid chromatography and compared between ADHD children with and without comorbid CD or ODD. The familiality of whole-blood 5-HT levels was studied by Spearman's rank-order correlation. There were no significant age, race, or sex effects. There was no significant difference in whole-blood 5-HT levels between children with ADHD only (n = 22; 190 +/- 45 ng/ml) and ADHD with CD or ODD (n = 30; 212 +/- 67). However, 7 out of 30 (23%) children with ADHD+CD/ODD had whole-blood 5-HT levels > 270 ng/ml, while none of the ADHD-only children had whole-blood 5-HT levels > 270 ng/ml, a statistically significant difference. Whole-blood 5-HT levels showed significant positive correlations between 36 children with disruptive behavior disorders and their biological mothers (rs = 0.47). There was no difference in mean levels of whole-blood 5-HT between subgroups of children with ADHD with or without comorbid CD or ODD.(ABSTRACT TRUNCATED AT 250 WORDS)

Individual differences in preschoolers' physiological and verbal responses to videotaped angry interactions

Individual differences in selection of intensity of angry interactions and physiological and self-reported responses to interadult anger were examined in preschoolers (N = 34). Children watched two videotaped angry interactions between adults, while their heart rates and skin conductance responses and levels were monitored; then they were interviewed. Before the second argument, children were given the perceived choice of watching an intense or mild angry exchange. Individual differences in responding to the angry interactions were found. Both (a) children with relatively higher externalizing behavior problems and (b) boys who chose to watch intense anger had lower tonic heart rates; 80% of boys with externalizing problems chose to watch intense anger. Further, children who chose to watch intense anger (a) exhibited lower declines in heart rates upon the presentation of the argument, (b) perceived the actors as more angry, and (c) reported lower amounts of distress during the argument than those who chose mild anger.