40 research outputs found
Unique and interactive associations of callous-unemotional traits, impulsivity and narcissism with child and adolescent Conduct Disorder symptoms
The construct of psychopathy remains underrepresented in the clinical diagnosis of Conduct Disorder (CD) as the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) only addresses one out of the three dimensions of child psychopathy, Callous Unemotional (CU) traits. This study tests if and to what extent there are unique and interactive associations of CU traits, impulsivity, and grandiosity with child and adolescent CD symptoms. Data were collected from two separate community samples of children (N = 1599; Mage = 9.46, SD = 1.65; 52% female) and adolescents (N = 2719; Mage = 16.99, SD = 0.99; 49% female), who were followed longitudinally after a year. Hierarchical linear regression analyses were conducted, testing cross-sectional and longitudinal associations with CD symptoms, taking into account all three psychopathy dimensions. The cross-sectional findings indicate that only youth presenting a combination of all three psychopathy dimensions scored above the clinical cut-off score for CD. On the other hand, longitudinal findings provided evidence that the combination of high initial levels of CD and CU traits as well as the combination between CD, grandiosity, and impulsivity can lead to clinical levels of future CD symptoms. Findings also indicated that CU traits and impulsivity more strongly predicted adolescent than child CD symptoms, and that CU traits were more strongly associated with boys' than girls' CD symptoms. Findings support the inclusion of CU traits as a specifier for the diagnosis of CD, and provide evidence that other psychopathy dimensions can also help clinicians to better understand and treat youth with CD, and should be considered for future revisions of the DSM
Classes of oppositional defiant disorder behavior in clinic-referred children and adolescents: concurrent features and outcomes = Classification des comportements dans le trouble oppositionnel avec provocation chez des enfants et des adolescents aiguilles a une clinique: caracteristiques co-occurrentes et resultats
Objective:Oppositional defiant disorder (ODD) consists of irritable and oppositional behaviors, both of which are associated with different problems. However, it is unclear whether irritability and oppositionality enable classification of clinic-referred children and adolescents into mutually exclusive groups (e.g., high in oppositionality, low in irritability), and whether this classification is clinically meaningful.Method:As part of a clinical protocol, ODD behaviors were assessed at referral through a comprehensive diagnostic interview and questionnaire. Parent- and teacher-reported ODD of 2,185 clinic-referred 5- to 18-year-olds (36.9% females) were used in latent class analysis. Resulting ODD classes were compared, concurrently at referral, and, longitudinally at the end of the diagnostic and treatment process, on various clinically relevant measures that were completed by various informants, including mental health problems, global functioning, and Diagnostic and Statistical Manual of Mental Disorders (DSM) classifications.Results:Three classes emerged with high, moderate, and low levels of both irritability and oppositionality. At referral, the high class experienced the highest levels of mental health problems and DSM classifications. Importantly, all ODD classes defined at intake were predictive of diagnostic and treatment outcomes months later. Notably, the high class had higher rates of clinician-based classifications of ODD and conduct disorder, and the lowest levels of pre- and posttreatment global functioning. Additionally, the low class exhibited higher rates of generalized anxiety disorder and fear disorders.Conclusions:Irritability and oppositionality co-occur in clinic-referred youths to such an extent that classification based on these behaviors does not add to clinical inference. Instead, findings suggest that the overall ODD severity at referral should be used as a guidance for treatment.Stress-related psychiatric disorders across the life spa
Towards Integrated Youth Care: a systematic review of facilitators and barriers for professionals
To overcome fragmentation in support for children and their families with multiple and enduring problems across life domains, professionals increasingly try to organize integrated care. However, it is unclear what facilitators and barriers professionals experience when providing this integrated care. Our systematic review, including 55 studies from a broad variety of settings in Youth Care, showed that integrated care on a professional level is a multi-component entity consisting of several facilitators and barriers. Findings were clustered in seven general themes: âChildâs environmentâ, âPreconditionsâ, âCare processâ, âExpertiseâ, âInterprofessional collaborationâ, âInformation exchangeâ, and âProfessional identityâ. The identified facilitators and barriers were generally consistent across studies, indicating broad applicability across settings and professional disciplines. This review clearly shows that when Youth Care professionals address a broad spectrum of problems, a variety of facilitators and barriers should be considered.New methods for child psychiatric diagnosis and treatment outcome evaluatio
Differential Fairness Decisions and Brain Responses After Expressed Emotions of Others in Boys with Autism Spectrum Disorders
Little is known about how emotions expressed
by others influence social decisions and associated brain
responses in autism spectrum disorders (ASD). We investigated the neural mechanisms underlying fairness decisions in response to explicitly expressed emotions of others in boys with ASD and typically developing (TD) boys.
Participants with ASD adjusted their allocation behavior in
response to the emotions but reacted less unfair than TD
controls in response to happiness. We also found reduced
brain responses in the precental gyrus in the ASD versus
TD group when receiving happy versus angry reactions and
autistic traits were positively associated with activity in the
postcentral gyrus. These results provide indications for a role of precentral and postcentral gyrus in social-affective
difficulties in ASD
Dissociable relations between amygdala subregional networks and psychopathy trait dimensions in conductâdisordered juvenile offenders
Psychopathy is a serious psychiatric phenomenon characterized by a pathological constellation
of affective (e.g., callous, unemotional), interpersonal (e.g., manipulative, egocentric), and behavioral
(e.g., impulsive, irresponsible) personality traits. Though amygdala subregional defects are suggested in
psychopathy, the functionality and connectivity of different amygdala subnuclei is typically disregarded
in neurocircuit-level analyses of psychopathic personality. Hence, little is known of how amygdala
subregional networks may contribute to psychopathy and its underlying trait assemblies in severely
antisocial people. We addressed this important issue by uniquely examining the intrinsic functional
connectivity of basolateral (BLA) and centromedial (CMA) amygdala networks in relation to affective,
interpersonal, and behavioral traits of psychopathy, in conduct-disordered juveniles with a history of
serious delinquency (N 5 50, mean age 5 16.83 6 1.32). As predicted, amygdalar connectivity profiles
exhibited dissociable relations with different traits of psychopathy. Interpersonal psychopathic traits not
only related to increased connectivity of BLA and CMA with a corticostriatal network formation
accommodating reward processing, but also predicted stronger CMA connectivity with a network of cortical midline structures supporting sociocognitive processes. In contrast, affective psychopathic traits
related to diminished CMA connectivity with a frontolimbic network serving salience processing and
affective responding. Finally, behavioral psychopathic traits related to heightened BLA connectivity with
a frontoparietal cluster implicated in regulatory executive functioning. We suggest that these traitspecific shifts in amygdalar connectivity could be particularly relevant to the psychopathic phenotype,
as they may fuel a self-centered, emotionally cold, and behaviorally disinhibited profile. Hum Brain
Mapp 37:4017â4033, 2016
Neural processing of socioemotional content in conduct-disordered juvenile offenders with limited prosocial emotions
Education and Child Studie
Integrative multi-omics analysis of childhood aggressive behavior
This study introduces and illustrates the potential of an integrated multi-omics approach in investigating the underlying biology of complex traits such as childhood aggressive behavior. In 645 twins (cases = 42%), we trained single- and integrative multi-omics models to identify biomarkers for subclinical aggression and investigated the connections among these biomarkers. Our data comprised transmitted and two non-transmitted polygenic scores (PGSs) for 15 traits, 78,772 CpGs, and 90 metabolites. The single-omics models selected 31 PGSs, 1614 CpGs, and 90 metabolites, and the multi-omics model comprised 44 PGSs, 746 CpGs, and 90 metabolites. The predictive accuracy for these models in the test (N = 277, cases = 42%) and independent clinical data (N = 142, cases = 45%) ranged from 43 to 57%. We observed strong connections between DNA methylation, amino acids, and parental non-transmitted PGSs for ADHD, Autism Spectrum Disorder, intelligence, smoking initiation, and self-reported health. Aggression-related omics traits link to known and novel risk factors, including inflammation, carcinogens, and smoking.Analytical BioScience
The DSM-5 With Limited Prosocial Emotions Specifier for Conduct Disorder Among Detained Girls
New methods for child psychiatric diagnosis and treatment outcome evaluatio
The usefulness of DSM-IV and DSM-5 conduct disorder subtyping in detained adolescents
The aim of this study was to test whether the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), and DSM-5 conduct disorder (CD) subtyping approaches identify adolescents with concurrent psychiatric morbidity and an increased risk to reoffend. A diagnostic interview was used to assess childhood-onset CD (CoCD), adolescent-onset CD (AoCD), and concurrent psychiatric morbidity in 223 detained male adolescents. The callous-unemotional (CU) specifier was established through a self-report questionnaire. Two to four years later, information on official criminal recidivism was collected. The CoCD and AoCD youths were different in concurrent psychiatric morbidity but not in their risk to reoffend. The youths with CD and CU (CD+CU) and the CD-only youths did not differ with regard to concurrent psychiatric morbidity. In addition, the CD+CU youths were at risk to reoffend but merely when compared with their counterparts without CD/CU. Although CD subtyping approaches may identify youths with concurrent psychiatric morbidity, the usefulness to predict recidivism in already delinquent youths is limited