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Fanti KA, Mavrommatis I, Díaz-Vázquez B, López-Romero L, Romero E, Álvarez-Voces M, Colins OF, Andershed H, Thomson N. Fearlessness as an Underlying Mechanism Leading to Conduct Problems: Testing the INTERFEAR Model in a Community Sample in Spain. CHILDREN (BASEL, SWITZERLAND) 2024; 11:546. [PMID: 38790541 PMCID: PMC11119632 DOI: 10.3390/children11050546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 04/26/2024] [Accepted: 04/30/2024] [Indexed: 05/26/2024]
Abstract
Conduct problems (CP) in childhood and adolescence have a significant impact on the individual, family, and community. To improve treatment for CP, there is a need to improve the understanding of the developmental pathways leading to CP in boys and girls. Prior research has linked the child's fearlessness and callous-unemotional (CU) traits, as well as experiences of parental warmth and punitive parenting, to CP. However, few studies have tested the interplay of these factors in contributing to future CP development. The present study aimed to test the InterFear model, which suggests that fearlessness in early childhood leads to CP through an indirect pathway involving low positive parenting, high negative/punitive parenting, and callous-unemotional (CU) traits. The sample included 2467 Spanish children (48.1% girls; Mage = 4.25; SD = 0.91), followed up across a five-year period. Besides a direct association between fearlessness in early childhood and future CP, the results found an indirect pathway whereby fearlessness reduces positive parenting and increases punitive parenting, which contributes to the development of CU traits and sets the stage for CP in later childhood. The specific indirect effect from fearlessness to CP via CU traits accounted for most of the variance, suggesting the existence of a temperamental pathway independent of parental variables. Further, two additional indirect pathways, exclusive of fearlessness, were identified, which started with low parental warmth and positive parenting, leading to CP via CU traits. These findings support the InterFear model, demonstrating multiple pathways to CP with the involvement of fearlessness, parenting practices, and CU traits. This model might play a pivotal role in the development of targeted prevention and intervention strategies for CP.
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Affiliation(s)
- Kostas A. Fanti
- Department of Psychology, Faculty od Social Sciences and Education, University of Cyprus, P.O. Box 20537, Nicosia 1678, Cyprus;
| | - Ioannis Mavrommatis
- Department of Psychology, Faculty od Social Sciences and Education, University of Cyprus, P.O. Box 20537, Nicosia 1678, Cyprus;
| | - Beatriz Díaz-Vázquez
- Instituto de Psicoloxía (IPsiUS), Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain; (B.D.-V.); (L.L.-R.); (E.R.); (M.Á.-V.)
| | - Laura López-Romero
- Instituto de Psicoloxía (IPsiUS), Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain; (B.D.-V.); (L.L.-R.); (E.R.); (M.Á.-V.)
| | - Estrella Romero
- Instituto de Psicoloxía (IPsiUS), Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain; (B.D.-V.); (L.L.-R.); (E.R.); (M.Á.-V.)
| | - María Álvarez-Voces
- Instituto de Psicoloxía (IPsiUS), Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain; (B.D.-V.); (L.L.-R.); (E.R.); (M.Á.-V.)
| | - Olivier F. Colins
- Department of Special Needs Education, Faculty of Psychology and Educational Siences, Ghent University, Dunantlaan 1, 9000 Gent, Belgium;
| | - Henrik Andershed
- School of Behavioural, Social and Legal Sciences, Örebro University, 701 82 Örebro, Sweden;
| | - Nicholas Thomson
- Department of Surgery and Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA;
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Obando D, Hill J, Wright N. The Moderating Role of Maternal Praise and Positivity in the Association Between Callous-Unemotional (CU) Traits and Later Aggression: A Prospective Study in Preschool Children in Colombia. Child Psychiatry Hum Dev 2024; 55:14-23. [PMID: 35708795 PMCID: PMC10796412 DOI: 10.1007/s10578-022-01354-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/19/2022] [Indexed: 11/03/2022]
Abstract
Our previous findings in the UK and Colombia show that CU traits predict later aggression specifically among children who are already aggressive. We hypothesised that this effect would be reduced in the presence of maternal praise and positivity. In a sample of 220 mothers and children from Colombia, mother-child interactions were coded for maternal praise and positivity, and mothers reported on children's CU traits at age 3.5 and aggression at ages 3.5 and 5 years. The results show three-way interactions between CU traits, child aggression and observed parenting at age 3.5 years in the prediction of later child aggression, and two-way interactions indicating a protective effect of positive parenting in the high aggressive children. Based on our finding, it is plausible that positive parenting may modify the effect of CU traits in the highly vulnerable group of children who are already aggressive in early childhood.
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Affiliation(s)
- Diana Obando
- Department of Psychology, Universidad de La Sabana, Chia, Colombia
| | - Jonathan Hill
- Department of Psychology and Clinical Language Sciences, University of Reading, Reading, UK.
| | - Nicola Wright
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
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López-Romero L, Andershed H, Romero E, Cervin M. In Search of Conceptual Clarity About the Structure of Psychopathic Traits in Children: A Network-Based Proposal. Child Psychiatry Hum Dev 2024:10.1007/s10578-023-01649-z. [PMID: 38236454 DOI: 10.1007/s10578-023-01649-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/04/2023] [Indexed: 01/19/2024]
Abstract
Psychopathic traits in childhood have been revealed as potential identifiers of risk, being predictive of later forms of behavioral maladjustment. Yet, it is still under debate how psychopathic traits in children should be best conceptualized and which are the core dimensions for construct definition and prediction. The present study aims to examine the structure of psychopathic traits in childhood, and its predictive value, by using a combination of traditional factor analysis and more recent network-based methods. Data on psychopathic traits, as measured by the Child Problematic Traits Inventory (CPTI), were collected in a large sample of children (n = 2454; 48.2% girls), aged 3 to 6 at the onset of the study (Mage = 4.26; SD = 0.91), who were followed-up one and two years later using parent- and teacher-reports. Results showed that psychopathic traits measured via CPTI are best conceptualized as five latent factors encompassing grandiosity, deceitfulness, callousness, impulsivity and need of stimulation, a result that converged across informants and time. Callousness and grandiosity emerged as central traits using network analysis of parent-reports, while deceitfulness was most central using teacher-reports. Finally, callousness, impulsivity and deceitfulness emerged as the best predictors of concurrent, prospective and stable conduct problems. These results provide a refined structure of psychopathic traits in children that better accounts for the core elements of the construct. Additional theoretical and practical implications will be discussed in terms of assessment, diagnostic classification and tailored prevention/intervention.
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Affiliation(s)
- Laura López-Romero
- Departamento de Psicología Clínica y Psicobiología, Facultad de Psicología, Universidade de Santiago de Compostela, Rua Xose María Suárez Núñez S/N, Campus Sur, 15782, Santiago de Compostela, Spain.
| | | | - Estrella Romero
- Departamento de Psicología Clínica y Psicobiología, Facultad de Psicología, Universidade de Santiago de Compostela, Rua Xose María Suárez Núñez S/N, Campus Sur, 15782, Santiago de Compostela, Spain
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Masi G, Carucci S, Muratori P, Balia C, Sesso G, Milone A. Contemporary diagnosis and treatment of conduct disorder in youth. Expert Rev Neurother 2023; 23:1277-1296. [PMID: 37853718 DOI: 10.1080/14737175.2023.2271169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 10/04/2023] [Indexed: 10/20/2023]
Abstract
INTRODUCTION Conduct disorder (CD) is characterized by repetitive and persistent antisocial behaviors, being among the most frequently reported reasons of referral in youth. CD is a highly heterogeneous disorder, with possible specifiers defined according to age at onset, Limited Prosocial Emotions (LPE) otherwise known as Callous-Unemotional (CU) traits, Emotional Dysregulation (ED), and patterns of comorbidity, each with its own specific developmental trajectories. AREAS COVERED The authors review the evidence from published literature on the clinical presentations, diagnostic procedures, psychotherapeutic and psychoeducational approaches, and pharmacological interventions from RCT and naturalistic studies in youth. Evidence from studies including youths with LPE/CU traits, ED and aggression are also reviewed, as response moderators. EXPERT OPINION Due to its clinical heterogeneity, relevant subtypes of CD should be carefully characterized to gain reliable information on prognosis and treatments. Thus, disentangling this broad category in subtypes is crucial as a first step in diagnosis. Psychosocial interventions are the first option, possibly improving LPE/CU traits and ED, especially if implemented early during development. Instead, limited information, based on low-quality studies, supports pharmacological options. Second-generation antipsychotics, mood stabilizers, and stimulants are first-line medications, according to different target symptoms, such as aggression and emotional reactivity. Developmental pathways including ADHD suggest a specific role of psychostimulants.
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Affiliation(s)
- Gabriele Masi
- Department of Child and Adolescent Psychiatry and Psychopharmacology, IRCCS Stella Maris Foundation, Pisa, Italy
| | - Sara Carucci
- Department of Biomedical Science, Section of Neuroscience & Clinical Pharmacology, University of Cagliari, Cagliari, Italy
- Child & Adolescent Neuropsychiatric Unit, "A. Cao" Paediatric Hospital-ARNAS "G. Brotzu" Hospital Trust, Department of Paediatrics, Cagliari, Italy
| | - Pietro Muratori
- Department of Child and Adolescent Psychiatry and Psychopharmacology, IRCCS Stella Maris Foundation, Pisa, Italy
| | - Carla Balia
- Department of Biomedical Science, Section of Neuroscience & Clinical Pharmacology, University of Cagliari, Cagliari, Italy
- Child & Adolescent Neuropsychiatric Unit, "A. Cao" Paediatric Hospital-ARNAS "G. Brotzu" Hospital Trust, Department of Paediatrics, Cagliari, Italy
| | - Gianluca Sesso
- Department of Child and Adolescent Psychiatry and Psychopharmacology, IRCCS Stella Maris Foundation, Pisa, Italy
- Social and Affective Neuroscience Group, Molecular Mind Lab, IMT School for Advanced Studies Lucca, Lucca, Italy
| | - Annarita Milone
- Department of Child and Adolescent Psychiatry and Psychopharmacology, IRCCS Stella Maris Foundation, Pisa, Italy
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Sesso G, Masi G. Pharmacological strategies for the management of the antisocial personality disorder. Expert Rev Clin Pharmacol 2023; 16:181-194. [PMID: 36787887 DOI: 10.1080/17512433.2023.2181159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 02/09/2023] [Indexed: 02/16/2023]
Abstract
INTRODUCTION Antisocial personality disorder (AsPD) is a pervasive pattern of violation of others' rights, related to the concept of psychopathy. AsPD is stable over time from adolescence, with evidence of conduct disorder (CD) before 15 years. DSM-5 included a specifier 'with limited prosocial emotions' (LPE), which characterizes adolescents with higher developmental vulnerability to develop AsPD. Despite being relatively frequent with considerable societal impact, AsPD is a difficult-to-treat condition with high comorbidity rates and poor evidence for effective pharmacological interventions. AREAS COVERED We conducted a narrative review and searched PubMed up to September 2022. We included RCTs and naturalistic studies evaluating pharmacological interventions on AsPD in adults, including those with comorbid substance use disorder or psychopathic traits. Evidence in youths with CD, callous-unemotional (CU) traits and aggression were also reviewed, exploring the role of CU traits as moderators of response. EXPERT OPINION Psychosocial interventions are the first option, with possible improvement of CU traits, beyond behavioral and affective symptoms, particularly if implemented early during development. Limited information, based on low-quality studies, supports the pharmacological options. Second-generation antipsychotics, lithium, anti-epileptic drugs, and stimulants are first-line medications, according to different target symptoms. Developmental pathways including ADHD suggest a specific role of psychostimulants.
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Affiliation(s)
- Gianluca Sesso
- Social and Affective Neuroscience Group, Molecular Mind Lab, IMT School for Advanced Studies Lucca, Lucca, Italy
- Department of Child and Adolescent Psychiatry and Psychopharmacology, IRCCS Stella Maris Foundation, Pisa, Italy
| | - Gabriele Masi
- Department of Child and Adolescent Psychiatry and Psychopharmacology, IRCCS Stella Maris Foundation, Pisa, Italy
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Wu P, Chen S, Gu Y, Tang Y. Correlation of temperament characteristics and early functional exercise compliance in school-age children with limb fractures: Implication for clinical nursing care. Medicine (Baltimore) 2022; 101:e32305. [PMID: 36596054 PMCID: PMC9803482 DOI: 10.1097/md.0000000000032305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Early functional exercise plays a very important role in the rehabilitation and nursing care of children with fractures. We aimed to evaluate the role of temperament characteristics in the early functional exercise compliance in school-age children with limb fractures, to provide evidence to clinical nursing care. School-age children with limb fractures admitted to our hospital from January 1, 2021 to June 30, 2022 were selected. We collected the general information, evaluated the temperament characteristics and their functional exercise compliance in school-age children. Correlation and regression analyses were conducted to assess the correlation of temperament characteristics and early functional exercise compliance. A total of 126 school-age children with limb fractures were finally included. There were 68, 36, and 22 children that were rated as easy-going, troublesome and initiate slow temperament, respectively. The children with easy-going temperament had the best early functional exercise compliance, followed by children with initiate slow temperament, and compliance of children with troublesome temperament was the worst. The reaction intensity factor in the temperament characteristics of school-age children with fracture was negatively correlated with early functional exercise compliance (P = .007). Reaction intensity was a risk factor for early functional exercise compliance in school-age children with fractures (P = .004). Health care providers must consider the influence of temperament characteristics on compliance in school-age children with fractures, and take targeted nursing measures according to different temperament characteristics of children to improve early functional exercise compliance in school-age children with fractures, so as to improve the functional recovery and prognosis of children.
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Affiliation(s)
- Ping Wu
- Department of Orthopedics, Children’s Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Shangju Chen
- Department of Orthopedics, Children’s Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Yi Gu
- Department of Orthopedics, Children’s Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Yuping Tang
- Department of Orthopedics, Children’s Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
- * Correspondence: Yuping Tang, Department of Orthopedics, Children’s Hospital of Nanjing Medical University, No. 72, Guangzhou Road, Gulou District, Nanjing, Jiangsu Province, China (e-mail: )
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Disruptive Behavior Disorders: Symptoms, Evaluation and Treatment. Brain Sci 2022; 12:brainsci12020225. [PMID: 35203988 PMCID: PMC8870689 DOI: 10.3390/brainsci12020225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 01/28/2022] [Indexed: 11/21/2022] Open
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