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Developmental Psychology, 2018
Evidence from physiological studies has been integral in many causal theories of behavioral and emotional problems. However, this evidence is hampered by the heterogeneity characterizing these problems. The current study adds to prior work by identifying neurophysiological markers associated with heterogeneity in conduct problems (CP), callousunemotional (CU) traits and anxiety. Participants were classified into the following groups: a) low risk, b) anxious (predominately high anxiety), c) primary (scored high on CP and CU traits but low on anxiety) and d) secondary (high anxiety, CU traits and CP). Developmental differences were also examined by including two different samples assessed during young adulthood (Study 1: N=88; Mage=19.92; 50% female) and childhood (Study 2: N=72;
Neural Abnormalities in Early-Onset and Adolescence-Onset Conduct Disorder
Archives of General Psychiatry, 2010
Context: Conduct disorder (CD) is characterized by severe antisocial behavior that emerges in childhood (early-onset CD [EO-CD]) or adolescence (adolescenceonset CD [AO-CD]). Early-onset CD is proposed to have a neurodevelopmental basis, whereas AO-CD is thought to emerge owing to social mimicry of deviant peers. However, this developmental taxonomic theory is debated after reports of neuropsychological impairments in both CD subtypes. A critical, although unaddressed, issue is whether these subtypes present similar or distinct neurophysiological profiles. Hence, we investigated neurophysiological responses to emotional and neutral faces in regions associated with antisocial behavior (ie, the amygdala, ventromedial prefrontal cortex, insula, and orbitofrontal cortex) in individuals with EO-CD and AO-CD and in healthy control subjects.
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.
Brain Structure Abnormalities in Early-Onset and Adolescent-Onset Conduct Disorder
American Journal of Psychiatry, 2011
demonstrated similar impairments in fear conditioning (12), affective decision making (13), and facial expression recognition (14) in both conduct disorder subtypes. A recent neuroimaging study also found abnormal activation in brain regions involved in affective behavior, including the amygdala, during facial expression processing in both early-and adolescent-onset conduct disorder (15). Our primary aim in the present study was to examine whether these behavioral and functional neural abnormalities are underpinned by similar changes in brain structure in the two conduct disorder subtypes. On the basis of previous research, we predicted that structural abnormalities in brain regions involved in affective behavior would be observed in both conduct disorder subtypes relative to comparison subjects. A number of studies have reported increased levels of psychopathic or callous-unemotional traits in children and adolescents with conduct problems or conduct disorder diagnoses (13, 16, 17). However, previous structural neuroimaging studies of conduct disorder (10, 11) have not taken psychopathic or callous-unemotional traits into account. In contrast, the only study to have investigated
Amygdala Hypoactivity to Fearful Faces In Boys With Conduct Problems and Callous-Unemotional Traits
American Journal of …, 2009
OBJECTIVE: Although early-onset conduct problems predict both psychiatric and health problems in adult life, little research has been done to index neural correlates of conduct problems. Emerging research suggests that a subgroup of children with conduct problems and elevated levels of callous-unemotional traits may be genetically vulnerable to manifesting disturbances in neural reactivity to emotional stimuli indexing distress. Using functional MRI, the authors evaluated differences in neural response to emotional stimuli between boys with conduct problems and elevated levels of callous-unemotional traits and comparison boys. METHOD: Seventeen boys with conduct problems and elevated levels of callous-unemotional traits and 13 comparison boys of equivalent age (mean=11 years) and IQ (mean=100) viewed blocked presentations of fearful and neutral faces. For each face, participants distinguished the sex of the face via manual response. RESULTS: Relative to the comparison group, boys with conduct problems and elevated levels of callous-unemotional traits manifested lesser right amygdala activity to fearful faces. CONCLUSIONS: This finding is in line with data from studies of adults with antisocial behavior and callous-unemotional traits (i.e., psychopaths), as well as from a recent study of adolescents with callous-unemotional traits, and suggests that the neural substrates of emotional impairment associated with callous-unemotional antisocial behavior are already present in childhood.
Size Matters: Increased Grey Matter In Boys With Conduct Problems and Callous-Unemotional Traits
Brain, 2009
Brain imaging studies of adults with psychopathy have identified structural and functional abnormalities in limbic and prefrontal regions that are involved in emotion recognition, decision-making, morality and empathy. Among children with conduct problems, a small subgroup presents callous-unemotional traits thought to be antecedents of psychopathy. No structural brain imaging study has examined this subgroup of children. The present study used voxel-based morphometry to compare whole brain grey matter volumes and concentrations of boys with elevated levels of callous-unemotional conduct problems and typically developing boys and explored four a priori regions of interest. sMRI scans were collected from 23 boys with elevated levels of callous-unemotional conduct problems (mean age = 11 years 8 months) and 25 typically developing boys (mean age = 11 years 6 months) selected from a community sample of children. Data were analysed using optimized voxel-based morphometry. Study-specific probability maps were created and four a priori regions of interest identified (orbitofrontal, anterior cingulate and anterior insular cortices and amygdala). Both grey matter volume and concentration were examined controlling for cognitive ability and hyperactivity-inattention symptoms. Boys with callous-unemotional conduct problems, as compared with typically developing boys, presented increased grey matter concentration in the medial orbitofrontal and anterior cingulate cortices, as well as increased grey matter volume and concentration in the temporal lobes bilaterally. These findings may indicate a delay in cortical maturation in several brain areas implicated in decision making, morality and empathy in boys with callous-unemotional conduct problems.
NeuroImage, 2007
The goal of this study was to determine whether brain regions implicated in emotion processing show structural alterations in adolescents with conduct disorder (CD). Using an optimized voxel-based morphometry protocol, we compared grey matter volume in 12 patients with CD and 12 age-, sex-, and intelligence-matched control subjects. Grey matter volume in bilateral anterior insular cortex and the left amygdala was significantly reduced in CD patients compared to healthy control subjects. The insular grey matter abnormalities could be attributed to aggressive behaviour. Moreover, bilateral anterior insular grey matter volume in CD patients correlated significantly with empathy scores. These novel findings point at a joint neuroanatomical substrate underpinning aggressive behaviour and impaired capacity of empathy and suggest a critical role for the anterior insula in regulating social behaviour.
Contextualizing the neurobiology of conduct disorder in an emotion dysregulation framework
Clinical Psychology Review, 2009
Conduct disorder (CD) represents the most common childhood psychiatric disorder found in community and mental health clinics. This paper provides a comprehensive review of the neurobiology of CD; specifically, neurological and neurochemical correlates. Converging evidence suggests that neurological profiles of individuals with CD, compared to peers, are characterized by reduced P300 brain wave amplitude, deactivation of the anterior cingulated cortex and reduced activation in the left amygdala in response to negative stimuli, and reduced right temporal lobe volume. The neurochemical profiles of individuals with CD are characterized by reduced serotonin and cortisol levels (i.e., decreased HPA axis function), as well as attenuated autonomic nervous system functioning. Popular theoretical frameworks cited within the CD literature are limited in their ability to explain and consolidate the neurological and neurochemical findings. We believe that emotion dysregulation theory, though not often used within CD research, may provide the most comprehensive and inclusive framework for understanding neurobiological aspects of this disorder. Limitations within the literature, future directions for research, and implications of the findings will be discussed.
The presence of elevated callous unemotional (CU) traits seems to designate a distinct group of children and adolescents with serious conduct problems. However, the extent to which CU traits impact the aversive reaction to harm is still a contentious issue. Here, we examined the effective connectivity seeded in the anterior insula and anterior cingulate cortex in a large number of children (N = 123, age 9–11, 60 females) with various levels of conduct disorder (CD) symptoms in response to visual stimuli depicting other people being physically injured. Perceiving others being harmed was associated with increased hemodynamic activity in the left amygdala and right temporoparietal junction (rTPJ). Children with higher callous traits showed less functional connectivity seeded in anterior cingulate with left amygdala and anterior insula. Conversely, CD symptoms were positively related to connectivity of insula with rTPJ. Overall, these results suggest that callousness is marked by the disruption of widespread cortical networks responsible for detecting and appropriately responding to important environmental cues, such as the distress of others. Children who exhibit conduct problems (CP), such as aggression, cruelty, and theft, are more likely to behave antisocially and immorally as adults, are at a higher risk of developing psychopathy and present a serious public health challenge 1,2. Moreover, scholars working to extend the specific personality traits which characterize adult psychopathy to younger populations have identified callous-unemotional (CU) traits as another important risk factor for serious conduct problems 3,4. These affective and interpersonal aspects, such as the lack of guilt, remorse, and empathy, are associated with greater delinquency, both in children with and without CP, predictive of adult psychopathy, and are relatively stable across development 5–7. Thus, identifying the impact of CU traits on neural processing during empathy-eliciting tasks in children could provide important insights into the neural mechanisms underlying the development of adult antisocial behaviors 8. Examining the neural response to the observation or imagination of others in distress or physical pain provides one of the most useful models of empathy 9. Perceiving another individual in distress triggers an harm aversion response, which can be coupled with feelings of concern for that person, two basic elements of empathy 10. Neuroscientific investigations, using functional MRI, magnetoencephalography, and electrophysiology have employed this paradigm in adult populations to identify associations between psychopathic traits and atypi-cal neural activation and connectivity when viewing harm to others, both in forensic and nonforensic populations 10–14. However, this work has only recently been extended to children with behavioral problems 15–19 , and it remains unclear to which extent CU traits influence functional connectivity during the perception of pain in preadolescents. Early functional neuroimaging studies of empathy have utilized pain perception tasks, and demonstrated overlapping neural activation in anterior insula (aINS), dorsal anterior cingulate (dACC), brainstem, and cere-bellum, both for the experience of somatic pain and the observation of another in pain or emotional distress 20 (for a meta-analysis). While these regions are reliably recruited in studies of empathy for pain, greater activity in these regions during these tasks may not reflect empathic processing per se, but rather pain recognition 9 and