Measuring Antisocial Behaviors in Behavioral Variant Frontotemporal Dementia With a Novel Informant-Based Questionnaire

OBJECTIVE

Antisocial behaviors are common and problematic among patients with behavioral variant frontotemporal dementia (bvFTD). In the present study, the investigators aimed to validate an informant-based questionnaire developed to measure the extent and severity of antisocial behaviors among patients with dementia.

METHODS

The Social Behavior Questionnaire (SBQ) was developed to measure 26 antisocial behaviors on a scale from absent (0) to very severe (5). It was administered to 23 patients with bvFTD, 19 patients with Alzheimer's disease, and 14 patients with other frontotemporal lobar degeneration syndromes. Group-level differences in the presence and severity of antisocial behaviors were measured. Psychometric properties of the SBQ were assessed by using Cronbach's alpha, exploratory factor analysis, and comparisons with a psychopathy questionnaire. Cluster analysis was used to determine whether the SBQ identifies different subgroups of patients.

RESULTS

Antisocial behaviors identified by using the SBQ were common and severe among patients with bvFTD, with at least one such behavior endorsed for 21 of 23 (91%) patients. Antisocial behaviors were more severe among patients with bvFTD, including the subsets of patients with milder cognitive impairment and milder disease severity, than among patients in the other groups. The SBQ was internally consistent (Cronbach's α=0.81). Exploratory factor analysis supported separate factors for aggressive and nonaggressive behaviors. Among the patients with bvFTD, the factor scores for aggressive behavior on the SBQ were correlated with those for antisocial behavior measured on the psychopathy scale, but the nonaggressive scores were not correlated with psychopathy scale measures. The k-means clustering analysis identified a subset of patients with severe antisocial behaviors.

CONCLUSIONS

The SBQ is a useful tool to identify, characterize, and measure the severity of antisocial behaviors among patients with dementia.

Intimate partner violence exposure predicts antisocial behavior via pro-violence attitudes among males with elevated levels of cortisol

The present study tested whether attitudes toward violence mediate the association between intimate partner violence exposure and antisocial behavior across adolescence, and whether cortisol level moderates these pathways in an ethnically diverse sample of 190 boys from low-income, urban families. Results suggest that a pathway from intimate partner violence exposure at age 12 to antisocial behavior at age 17 is explained by pro-violence attitudes at age 15. Boys with greater exposure to intimate partner violence endorsed stronger pro-violence attitudes, which predicted increases in antisocial behavior. Further, the pro-violence attitudes to antisocial behavior pathway was stronger among boys with heightened versus dampened cortisol levels. Results suggest that violent attitudes are important for understanding the cognitive underpinnings of antisocial behavior following intimate partner violence exposure, particularly in youth with high cortisol levels. Implications for prevention and intervention are discussed with respect to targeting malleable child behavior linked to later antisocial behavior.

Variation in SWI/SNF Chromatin Remodeling Complex Proteins is Associated with Alcohol Dependence and Antisocial Behavior in Human Populations

BACKGROUND

Testing for direct gene or single nucleotide polymorphism replication of association across studies may not capture the true importance of a candidate locus; rather, we suggest that relevant replication across studies may be found at the level of a biological process. We previously observed that variation in 2 members of the switching defective/sucrose nonfermenting (SWI/SNF) chromatin remodeling complex is associated with alcohol dependence (AD) in the Irish Affected Sib Pair Study for Alcohol Dependence. Here, we tested for association with alcohol-related outcomes using a set of genes functioning in the SWI/SNF complex in 2 independent samples.

METHODS

We used a set-based analysis to examine the 29 genes of the SWI/SNF complex for evidence of association with (i) AD in the adult Collaborative Study on the Genetics of Alcoholism (COGA) case-control sample and (ii) antisocial behavior, hypothesized to be a genetically related developmental precursor, in a younger population sample (Spit for Science [S4S]).

RESULTS

We found evidence for association of the SWI/SNF complex with AD in COGA (p = 0.0435) and more general antisocial behavior in S4S (p = 0.00026). The genes that contributed most strongly to the signal in COGA were SS18L1, SMARCD1, BRD7, BCL7B, SMARCB1, and BCL11A. In the S4S sample, ACTB, ARID2, BCL11A, BCL11B, BCL7B, BCL7C, DPF2, and DPF3 all contributed strongly to the signal.

CONCLUSIONS

We detected associations between the SWI/SNF complex and AD in an adult population selected from treatment-seeking probands and antisocial behavior in an adolescent population sample. This provides strong support for a role for SWI/SNF in the development of alcohol-related problems.

Reward-Related Neural Correlates of Antisocial Behavior and Callous-Unemotional Traits in Young Men

BACKGROUND

Individuals involved in antisocial behavior often engage in excessive reward-driven behavior even in the face of severe punishments including incarceration. However, the neural mechanisms of reward processing in antisocial behavior have not been examined while considering the heterogeneity of antisocial behavior and specific phases of reward and loss processing. In this study, we investigate the relationship between antisocial behavior, callous-unemotional traits, and neural activity during the anticipation and receipt of rewards and losses.

METHODS

A community sample of 144 low income, racially diverse, urban males at risk for antisocial behavior completed self-report measures, a clinical interview, and an fMRI scan at age 20. Neural response during the anticipation and receipt of monetary rewards and losses was linked to antisocial behavior and callous-unemotional traits using a priori ventral striatum region of interest analyses and exploratory whole brain analyses.

RESULTS

Antisocial behavior, but not callous-unemotional traits, was related to less ventral striatum response during reward anticipation. There were no significant relationships between neural reactivity and antisocial behavior or callous-unemotional traits during reward or loss outcomes. Antisocial behavior was also related to less ventrolateral prefrontal cortex reactivity during reward and loss anticipation.

CONCLUSIONS

These findings support a hypo-reactivity model of reward and loss anticipation in antisocial behavior. Lower striatal reactivity to cues of reward and lower prefrontal-regulatory recruitment during reward and loss anticipation may contribute to maladaptive reward-related behavior found in antisocial behavior.

Perceived Parent-Child Relations, Conduct Problems, and Clinical Improvement Following the Treatment of Oppositional Defiant Disorder

Our objective in this study was to examine the moderating influence of parent-child relationship quality (as viewed by the child) on associations between conduct problems and treatment responses for children with oppositional defiant disorder (ODD). To date, few studies have considered children's perceptions of relationship quality with parents in clinical contexts even though extant studies show the importance of this factor in children's behavioral adjustment in non-clinical settings. In this study, 123 children (ages 7 - 14 years, 61.8% male, 83.7% white) who fulfilled DSM-IV criteria for ODD received one of two psychosocial treatments: Parent Management Training or Collaborative & Proactive Solutions. In an earlier study, both treatments were found to be effective and equivalent in treatment outcomes (Ollendick et al., in press). In the current study, pre-treatment maternal reports of conduct problems and pre-treatment child reports of relations with parents were used to predict outcomes in ODD symptoms and their severity following treatment. Elevated reports of children's conduct problems were associated with attenuated reductions in both ODD symptoms and their severity. Perceived relationship quality with parents moderated the ties between conduct problems and outcomes in ODD severity but not the number of symptoms. Mother reports of elevated conduct problems predicted attenuated treatment response only when children viewed relationship quality with their parents as poorer. When children viewed the relationship as higher quality, they did not show an attenuated treatment response, regardless of reported conduct problems. The current findings underscore the importance of children's perspectives in treatment response and reductions in externalizing child behaviors.

Persistent cannabis dependence and alcohol dependence represent risks for midlife economic and social problems: A longitudinal cohort study

With the increasing legalization of cannabis, understanding the consequences of cannabis use is particularly timely. We examined the association between cannabis use and dependence, prospectively assessed between ages 18-38, and economic and social problems at age 38. We studied participants in the Dunedin Longitudinal Study, a cohort (n=1,037) followed from birth to age 38. Study members with regular cannabis use and persistent dependence experienced downward socioeconomic mobility, more financial difficulties, workplace problems, and relationship conflict in early midlife. Cannabis dependence was not linked to traffic-related convictions. Associations were not explained by socioeconomic adversity, childhood psychopathology, achievement orientation, or family structure; cannabis-related criminal convictions; early onset of cannabis dependence; or comorbid substance dependence. Cannabis dependence was associated with more financial difficulties than alcohol dependence; no difference was found in risks for other economic or social problems. Cannabis dependence is not associated with fewer harmful economic and social problems than alcohol dependence.

Bivariate Trajectories of Substance Use and Antisocial Behavior: Associations with Emerging Adult Outcomes in a High-Risk Sample

Substance use and antisocial behavior are complex, interrelated behaviors. The current study identified model trajectory classes defined by concurrent substance use and antisocial behavior and examined trajectory associations with emerging adult outcomes. Participants from a high-risk sample of youth (n=536; 73% male) completed interviews at baseline (mean age= 16.1 years) and followup (mean age= 22.6 years). Latent class growth analyses identified five trajectory classes based on alcohol/drug use (AOD) and antisocial behavior (ASB): Dual Chronic, Increasing AOD/Persistent ASB, Persistent AOD/Adolescent ASB, Decreasing Drugs/Persistent ASB, and Resolved. Many individuals (56%) exhibited elevated/increasing AOD, and most (91%) reported ASB decreases. Those associated with the Dual Chronic class had the highest rates of substance dependence, antisocial personality disorder (ASPD), and negative psychosocial outcomes. There were no differences in adult role attainment across classes. Conjoint examination of these behaviors provides greater detail regarding clinical course and can inform secondary prevention and intervention efforts.

Externalizing Disorders and Environmental Risk: Mechanisms of Gene-Environment Interplay and Strategies for Intervention

Though heritable, externalizing disorders have a number of robust associations with several environmental risk factors, including family, school, and peer contexts. To account for these associations, we integrate a behavioral genetic perspective with principles of a developmental cascade theory of antisocial behavior. The major environmental contexts associated with child externalizing problems are reviewed, as are the processes of gene-environment interplay underlying these associations. Throughout, we discuss implications for prevention and intervention. Three major approaches designed to reduce child externalizing behavior are reviewed. Prevention and intervention programs appear to be most successful when they target individuals or communities most at risk for developing externalizing disorders, rather than applied universally. We end by commenting on areas in need of additional research concerning environmental influences on persistent externalizing behaviors.

Directional relationships between alcohol use and antisocial behavior across adolescence

BACKGROUND

The co-occurrence of alcohol use and antisocial behavior is well established, but different hypotheses exist regarding the direction of effects between the 2 behaviors. We used longitudinal data to examine the directional relationship between the 2 behaviors across adolescence.

METHODS

A cross-lagged model was applied to longitudinal data from the Avon Longitudinal Study of Parents and Children. The sample used in the present study consisted of 4,354 females and 3,984 males. Alcohol use and antisocial behavior were measured with multiple items collected at 12, 13, 15, and 17 years of age.

RESULTS

Both alcohol use and antisocial behavior were highly stable, as evidenced by highly significant autoregressive paths. Regarding the cross-lagged paths, neither behavior was predictive of the other during early adolescence (between ages 12 and 13). During mid-to late adolescence (from ages 13 to 17), antisocial behavior was predictive of subsequent alcohol use. Alcohol use was predictive of antisocial behavior in late adolescence (between ages 15 and 17), although this relationship was mainly driven by males and was not significant in the female subgroup.

CONCLUSIONS

The result generally supported the direction from antisocial behavior to alcohol use, especially during mid- to late adolescence. However, there was also a suggestion that the direction of relationship between the 2 behaviors changes across adolescence. The results highlight the importance of considering developmental stages to understand the directional relationships between the 2 behaviors.

Evidence for a Heritable Brain Basis to Deviance-Promoting Deficits in Self-Control

PURPOSE

Classic criminological theories emphasize the role of impaired self-control in behavioral deviancy. Reduced amplitude of the P300 brain response is reliably observed in individuals with antisocial and substance-related problems, suggesting it may serve as a neurophysiological indicator of deficiencies in self-control that confer liability to deviancy.

METHODS

The current study evaluated the role of self-control capacity - operationalized by scores on a scale measure of trait disinhibition - in mediating the relationship between P300 brain response and behavioral deviancy in a sample of adult twins (N=419) assessed for symptoms of antisocial/addictive disorders and P300 brain response.

RESULTS

As predicted, greater disorder symptoms and higher trait disinhibition scores each predicted smaller P300 amplitude, and trait disinhibition mediated observed relations between antisocial/addictive disorders and P300 response. Further, twin modeling analyses revealed that trait disinhibition scores and disorder symptoms reflected a common genetic liability, and this genetic liability largely accounted for the observed phenotypic relationship between antisocial-addictive problems and P300 brain response.

CONCLUSIONS

These results provide further evidence that heritable weaknesses in self-control capacity confer liability to antisocial/addictive outcomes and that P300 brain response indexes this dispositional liability.