Neural responses to affective and cognitive theory of mind in children with conduct problems and varying levels of callous-unemotional traits

CONTEXT

Reduced neural responses to others' distress is hypothesized to play a critical role in conduct problems coupled with callous-unemotional traits, whereas increased neural responses to affective stimuli may accompany conduct problems without callous-unemotional traits. Heterogeneity of affective profiles in conduct problems may account for inconsistent neuroimaging findings in this population.

OBJECTIVES

To broaden understanding of neural processing in conduct problems using an affective processing task including an empathy component as well as to explore dimensional contributions of conduct problems symptoms and callous-unemotional traits to variance in affective neural responses.

DESIGN

Case-control study.

SETTING

On-campus neuroimaging facility.

PARTICIPANTS

Thirty-one boys with conduct problems (mean age, 14.34 years) and 16 typically developing control subjects (mean age, 13.51 years) matched for age (range, 10-16 years), IQ, socioeconomic status, handedness, and race/ethnicity. Participants were recruited using screening questionnaires in a community-based volunteer sample.

MAIN OUTCOME MEASURES

Functional magnetic resonance imaging of a task contrasting affective and cognitive theory of mind judgments.

RESULTS

Relative to typically developing children, children with conduct problems showed reduced activation in right amygdala and anterior insula for affective vs cognitive theory of mind judgments. Furthermore, in the right amygdala, regression analysis within the conduct-problems group showed suppressor effects between ratings of conduct problems and callous-unemotional traits. Specifically, unique variance associated with conduct problems was positively correlated with amygdala reactivity, whereas unique variance associated with callous-unemotional traits was negatively correlated with amygdala reactivity. These associations were not explained by hyperactivity, depression/anxiety symptoms, or alcohol use ratings.

CONCLUSIONS

Childhood conduct problems are associated with amygdala and anterior insula hypoactivity during a complex affective processing task including an empathy component. Suppressor effects between conduct problems and callous-unemotional traits in the amygdala suggest a potential neural substrate for heterogeneity in affective profiles associated with conduct problems.

Neural processing associated with cognitive and affective Theory of Mind in adolescents and adults

Theory of Mind (ToM) is the ability to attribute thoughts, intentions and beliefs to others. This involves component processes, including cognitive perspective taking (cognitive ToM) and understanding emotions (affective ToM). This study assessed the distinction and overlap of neural processes involved in these respective components, and also investigated their development between adolescence and adulthood. While data suggest that ToM develops between adolescence and adulthood, these populations have not been compared on cognitive and affective ToM domains. Using fMRI with 15 adolescent (aged 11-16 years) and 15 adult (aged 24-40 years) males, we assessed neural responses during cartoon vignettes requiring cognitive ToM, affective ToM or physical causality comprehension (control). An additional aim was to explore relationships between fMRI data and self-reported empathy. Both cognitive and affective ToM conditions were associated with neural responses in the classic ToM network across both groups, although only affective ToM recruited medial/ventromedial PFC (mPFC/vmPFC). Adolescents additionally activated vmPFC more than did adults during affective ToM. The specificity of the mPFC/vmPFC response during affective ToM supports evidence from lesion studies suggesting that vmPFC may integrate affective information during ToM. Furthermore, the differential neural response in vmPFC between adult and adolescent groups indicates developmental changes in affective ToM processing.

Etiology of different developmental trajectories of callous-unemotional traits

OBJECTIVE

To investigate the longitudinal development of callous-unemotional traits (CU) in middle childhood using developmental trajectory analyses in a large twin dataset and examine the degree to which genetic and environmental influences contributed to the CU trajectory-group membership in children.

METHOD

The study included 9,462 youths from the Twins Early Development Study, a population-based sample of twins from the United Kingdom. Developmental trajectories were described using teachers' ratings of CU at 7, 9, and 12 years old.

RESULTS

We identified four trajectories of CU through general growth mixture modeling: stable high, increasing, decreasing, and stable low. In most cases, the trajectory-group membership was largely driven by genetic and to a lesser extent by nonshared environmental influences for boys and girls. The most notable exception was a strong contribution of shared environment for the girls in the stable-high trajectory group.

CONCLUSIONS

Our findings suggest distinct developmental trajectories of CU from childhood to early adolescence, which are in most cases influenced by genetic factors and, to a lesser degree, by nonshared environmental factors. Highest heritability was observed for boys on a stable-high CU trajectory. Interestingly, the trajectory-group membership for girls on a stable-high CU trajectory appeared to be almost entirely driven by shared environmental influences. These differences in the etiology of stable-high CU in boys and girls have potential implications for clinical practice and studies attempting to identify genetic and environmental risk factors for high CU.