Specific Contributions of Age of Onset, Callous-Unemotional Traits and Impulsivity to Reactive and Proactive Aggression in Youths with Conduct Disorders.

Youths with conduct disorders (CD) are particularly studied for their violent and aggressive behaviors. Many researchers considered aggressive behaviors as being either reactive or proactive. Moreover, factors such as age of CD onset, impulsivity, and callous-unemotional traits, separately, have been related to these different types of aggressive behaviors. However, very few studies addressed the combined contribution of these three factors on proactive and reactive aggression. This question was tested in a sample composed of 43 male adolescents with CD. A single regression analysis including all predictors and outcomes, using Bayesian statistics, was computed. Results indicated that impulsivity was related to reactive aggression, while CU traits were related to proactive aggression. These results suggest first, an important heterogeneity among youth with CD, probably leading to different trajectories and, second, that youths with callous-unemotional traits should receive special attention and care as they are more at risk for proactive aggression

Processus psychologiques de gestion du stress et régulation neuroendocrinienne chez les adolescents délinquants en institution fermée : une étude pilote [Psychological processes of stress management and neuroendocrine regulation in incarcerated adolescent offenders: A pilot study]

Adolescence is a stressful period where important biological, psychological and social changes occur. Adolescents are particularly vulnerable during this developmental period and can use various strategies to deal with daily stress, such as substance use or externalizing behaviors. In previous studies, stress in adolescents with externalizing behaviors was often linked to ineffective cognitive coping strategies (i.e., constructive thinking) and overlooking the biological aspects involved in stress management such as neuroendocrine regulation. Indeed, repeated activation of the hypothalamic-pituitary-adrenal (HPA) axis in chronic stress situations may have long-term effects on subsequent cortisol regulation and lead to psychological difficulties. It was also shown that basal cortisol levels are lower in adolescents with externalizing behaviors. This study aims to assess the links between constructive thinking and neuroendocrine regulation in adolescent offenders and their association with externalizing symptoms (e.g., aggression, delinquency, psychopathic traits, substance use). Identifying particular biopsychological patterns can help to better understand stress management in youth with externalizing behaviors and to improve clinical treatments. Sixteen adolescent males aged from 12 to 18 years were recruited in an institution for juvenile offenders. Exclusion criteria were insufficient reasoning abilities assessed using the Raven Matrices Test. Regarding psychological dimensions, constructive thinking was assessed through the Constructive thinking inventory (CTI), psychopathic traits through the Youth psychopathic traits inventory (YPI), externalizing behaviors through 30 items (out of 113) and 2 subscales (aggressive behavior and delinquency problems) from the Child behavior checklist-youth self-report (CBCL), and substance use through the Dep-ado. Regarding biological dimensions, cortisol daily secretion and regulation were assessed through saliva samples that were collected during 3 consecutive days (4 samples per day: directly after awakening, at 10 a.m., at 4 a.m., and before going to bed). Adolescent offenders presented maladaptative thinking styles and a particular neuroendocrine regulation in their daily management with stress. In particular, their level of cortisol in the morning was higher than those expected in a general population (20.34 nmol/L while the norm is around 10 nmol/L). They also showed more agressive and delinquent behaviors (CBCL) as well as more psychopathic traits (YPI) than the general population. Moreover, constructive thinking style was associated with personality and behavioral dimensions. Indeed, results indicated positive and significant correlations between categorical thinking style (CTI), psychopathic traits (YPI) (r=0.57, P=0.021) and externalizing behaviors (CBCL) (r=0.55, P=0.028). In other words, the more adolescent offenders used categorical thinking, the more they presented psychopathic traits and externalizing behaviors. With respect to the association between psychological and biological dimensions in stress management, we observed a significant and positive correlation between cortisol regulation and esoteric thinking (r=0.57, P=0.028) and a trend with superstitious thinking (r=0.47, P=0.075). The more adolescent offenders used esoteric and superstitious thinking, the poorer was their cortisol regulation. We also observed a trend between the life style scale of the YPI (i.e., impulsive, irresponsible) and the daily secretion of cortisol (r=0.51; P=0.052) as well as cortisol regulation (r=0.49, P=0.065). The more adolescent offenders presented psychopathic traits, the higher tended to be their daily secretion of cortisol and the poorer their cortisol regulation. Finally, cortisol regulation (r=0.54, P=0.038) and secretion (r=0.73, P=0.002) were significantly correlated with the DEP-Ado score. In other words, a poor cortisol regulation and a high secretion of cortisol seem to be associated with substance use. Adolescent offenders face an important amount of daily stress and do not always have the appropriate skills to deal with it. Indeed, we know from clinical experience that they often report a sense of hopelessness toward their lack of professional perspectives as well as familial conflicts which can be important stressors in addition to the incarceration in itself. Therefore, treatment aiming to improve psychic elaboration can help these adolescents to make their thinking styles more flexible and use more appropriate ways of coping with stress instead of externalizing behaviors and substance use. Moreover, considering the complex cases of these adolescents and the many changes of caregivers and institutions where they have lived, which can be important stressors as well, professionals working with these youth should be aware of their emotional reactions toward them and try to encourage continuity of care

Faces presenting sadness enhance self-control abilities in gifted adolescents.

Self-regulation skills refer to processes allowing emotional and cognitive adaptation of the individual. Some gifted adolescents are known for their imbalance between high intellectual abilities and low emotional skills. Thus, this study aimed at examining the interplay between emotion and cognition in gifted and non-gifted adolescents. A stop-signal task, a response inhibition task including neutral, happy, or sad faces as signal triggering inhibition, was administered to 19 gifted and 20 typically developing male adolescents (12-18 years old). Gifted adolescents showed lower response inhibition abilities than non-gifted adolescents in the neutral and happy face conditions. Sad faces in gifted adolescents were associated with higher response inhibition compared to happy condition. In typically developing adolescents, emotional information (happy or sad faces) was related to lower response inhibition compared to neutral face condition. This study highlights that gifted adolescents present different self-regulation skills than their typically developing peers. Statement of contribution What is already known on this subject? Some gifted adolescents present higher intellectual abilities alongside with lower socio-emotional skills. Self-regulation skills refer to processes allowing emotional and cognitive adaptation. Self-regulation skills might help to understand gifted adolescents, but remain scarcely studied. What does this study adds? Task-relevant emotional information impaired cognitive control in typically developing adolescents. Gifted adolescents are able to use sad faces to enhance their cognitive control abilities

Examination of the importance of age of onset, callous-unemotional traits and anger dysregulation in youths with antisocial behaviors.

Age of onset, callous-unemotional (CU) traits and anger dysregulation have separately been proposed as relevant factors in explaining the heterogeneity of antisocial behaviour (ASB). Taking a dimensional perspective, this study examined the specific contributions and the mutual influences (i.e., interactions) of these three characteristics on specific dimensions of ASB (i.e., criminal behaviours and externalizing symptoms). Assessments were conducted on 536 youths from institutions with the youth psychopathic traits inventory (CU traits), the Massachusetts youth screening instrument-second version (anger dysregulation), the criminology questionnaire (criminal behaviours) and the child behavior checklist (externalizing symptoms), rated by both the youths and their carers. Using Bayes as estimators, the results revealed that the number and frequency of crimes (and, more specifically, damage to property, property offenses and media crimes) were explained by a specific contribution of each factor (age of onset, CU traits and anger dysregulation). Additionally, the interactions between age of onset and CU traits or anger dysregulation were relevant predictors of some types of crimes (i.e., damage to property, property offences and media crimes). Furthermore, when rated by youths, externalizing symptoms were explained by CU traits and anger dysregulation. However, when rated by the carer, anger dysregulation was more important in explaining externalizing symptoms. This study highlights the importance of considering these factors altogether and the value of using a dimensional perspective when examining the structure of ASB in youths. Consequently, future classifications should take into account the mutual account of these characteristics, which were previously studied separately

Low subjective social status in the police is linked to health-relevant changes in diurnal salivary alpha-amylase activity in Swiss police officers.

The objective of this study was to assess basal autonomic nervous system (ANS) activity as a pathway linking subjective social status to health in a high-demand work environment. It was hypothesized that officers with a lower status experienced more chronic stress (higher basal ANS activity) and that chronic stress was related to more health problems. Fifty-six male and female Swiss police officers self-reported on subjective social status (country, community, friends, police) and their health (depression, post-traumatic stress, physical symptoms) and collected 12 saliva samples over two days for basal α-amylase activation (sAA) assessment. Multilevel regression analyses revealed that subjective social status in the police and physical symptoms explained a significant part of the variance in diurnal sAA activity patterns. The current findings support the idea that more narrowly defined subjective social status may be more closely linked to biological stress mechanisms. Additionally, sAA activity was specifically related to physical, but not mental health problems. These results suggest that subjective social status referencing one's work environment may be a promising early indicator of health-relevant changes in stress-related physiological systems

Social integration and substance use: assessing the effects of an early intervention programme for youth.

Appropriate social integration has been shown to be a protective factor against substance use among adolescents and associated negative consequences. Promoting social integration through early intervention with adolescents using substances is thus necessary and is the aim of the Identification, Assessment and Follow-up of Adolescents with Substance Use (in French, Dépistage - évaluation - parrainage d'adolescents consommateurs de substances (DEPART) programme. The present study aimed to describe this programme and its participants from 2009 to 2013 as well as to assess its effects on social integration. Data from 398 adolescents using substances who attended the DEPART programme were analysed. The results showed that almost 80% of the adolescents admitted to the DEPART programme were boys, with a large proportion using cannabis. Globally, social integration did not increase from admission to discharge from the programme, but a shift was observed for school and professional integration. Additionally, after the intervention, we observed that social integration was more important in younger patients. This study showed that adolescents with problematic substance use mostly consumed soft drugs and that those who were integrated into the DEPART programme at a younger age were more likely to be socially integrated at the end of the programme

Assessment of Multiple Dimensions of Psychological Well-Being in Swiss Youth Born with a Unilateral Cleft Lip and Palate.

This study examines the psychological well-being of Swiss youths born with a unilateral cleft lip and palate (UCLP), in a multi-dimensional and clinical perspective. Retrospective cross-sectional study. Self-report questionnaires completed by youths born with UCLP, followed at a specialized cleft clinic in Switzerland, and by peers without UCLP, recruited in schools of the Vaud county, Switzerland. Youths aged 7.5 to 16, born with UCLP (clinical group, n = 41, 29.2% female) or without UCLP (control group, n = 56, 49.0% female). Adverse life events (ALE; Adverse Life Events), behavioral and emotional symptoms (Strengths and Difficulties Questionnaire and Post-Traumatic Checklist Scale), bodily self-esteem (Body Esteem Scale), quality of life (Kidscreen-27), emotion regulation (Cognitive Emotion Regulation Questionnaire), social support (Sarason's Social Support Questionnaire). Most outcomes showed no significant group-difference. Compared to matched peers, youths with UCLP reported lower psychological quality of life and social support satisfaction, along with positive factors of fewer ALE and lower non-adaptive emotion regulation. In youths with UCLP, higher scores for ALE were associated with higher total scores for behavioral and emotional symptoms. Higher scores for bodily self-esteem were associated with higher scores for satisfaction of social support and adaptive emotion regulation. Youths with UCLP show globally similar psychological well-being as matched peers. We observed some vulnerabilities but also protective factors, which support the need for psychological perspective within multidisciplinary care. The relationships between dimensions suggest specific targets that may have an impact in context of intervention

Ten considerations for effectively managing the COVID-19 transition

Governments around the world have implemented measures to manage the transmission of coronavirus disease 2019 (COVID-19). While the majority of these measures are proving effective, they have a high social and economic cost, and response strategies are being adjusted. The World Health Organization (WHO) recommends that communities should have a voice, be informed and engaged, and participate in this transition phase. We propose ten considerations to support this principle: (1) implement a phased approach to a 'new normal'; (2) balance individual rights with the social good; (3) prioritise people at highest risk of negative consequences; (4) provide special support for healthcare workers and care staff; (5) build, strengthen and maintain trust; (6) enlist existing social norms and foster healthy new norms; (7) increase resilience and self-efficacy; (8) use clear and positive language; (9) anticipate and manage misinformation; and (10) engage with media outlets. The transition phase should also be informed by real-time data according to which governmental responses should be updated

Vaccination barriers and drivers in Romania: a focused ethnographic study

Background: In 2016-18, a large measles outbreak occurred in Romania identified by pockets of sub-optimally vaccinated population groups in the country. The aim of the current study was to gain insight into barriers and drivers from the experience of measles vaccination from the perspectives of caregivers and their providers. Methods: Data were collected by non-participant observation of vaccination consultations and individual interviews with health workers and caregivers in eight Romanian clinics with high or low measles vaccination uptake. Romanian stakeholders were involved in all steps of the study. The findings of this study were discussed during a workshop with key stakeholders. Results: Over 400 h of observation and 161 interviews were conducted. A clear difference was found between clinics with high and low measles vaccination uptake which indicates that being aware of and following recommended practices for both vaccination service delivery and conveying vaccine recommendations to caregivers may have an impact on vaccine uptake. Barriers identified were related to shortcomings in following recommended practices for vaccination consultations by health workers (e.g. correctly assessing contraindications or providing enough information to allow an informed decision). These observations were largely confirmed in interviews with caregivers and revealed significant knowledge gaps. Conclusions: The identification of key barriers provided an opportunity to design specific interventions to improve vaccination service delivery (e.g. mobile vaccination clinics, use of an electronic vaccination registry system for scheduling of appointments) and build capacity among health workers (e.g. guidance and supporting materials and training programmes)