Interactions between Callous Unemotional Behaviors and Executive Function in Early Childhood Predict later Aggression and Lower Peer-liking in Late-childhood

Callous unemotional (CU) behaviors are linked to aggression, behavior problems, and difficulties in peer relationships in children and adolescents. However, few studies have examined whether early childhood CU behaviors predict aggression or peer-rejection during late-childhood or potential moderation of this relationship by executive function. The current study examined whether the interaction of CU behaviors and executive function in early childhood predicted different forms of aggression in late-childhood, including proactive, reactive, and relational aggression, as well as how much children were liked by their peers. Data from cross-informant reports and multiple observational tasks were collected from a high-risk sample (N = 240; female = 118) at ages 3 and 10 years old. Parent reports of CU behaviors at age 3 predicted teacher reports of reactive, proactive, and relational aggression, as well as lower peer-liking at age 10. Moderation analysis showed that specifically at high levels of CU behaviors and low levels of observed executive function, children were reported by teachers as showing greater reactive and proactive aggression, and were less-liked by peers. Findings demonstrate that early childhood CU behaviors and executive function have unique main and interactive effects on both later aggression and lower peer-liking even when taking into account stability in behavior problems over time. By elucidating how CU behaviors and deficits in executive function potentiate each other during early childhood, we can better characterize the emergence of severe and persistent behavior and interpersonal difficulties across development.     

What do others feel? Cognitive empathy deficits explain the association between callous-unemotional traits and conduct problems among preschool children

Abstract

Callous-unemotional traits (CU) are a risk factor for antisocial behavior, although it is unclear whether deficits in affective or cognitive empathy explain this association. Using a multi-informant approach involving data collection from parents and teachers (N = 167, M age = 4.7 years), the current study aimed to test whether cognitive or affective empathy deficits account for the association between CU traits and antisocial behavior among preschool children. Results revealed that cognitive, but not affective, empathy was associated with both CU and conduct problems, and also mediated the relationship between CU traits and conduct problems. These findings were not replicated for overt and relational aggressive behavior. Our findings suggest that cognitive empathy deficits may be more important than affective empathy in explaining antisocial behavior in preschool children. As a result, interventions aiming to reduce conduct problems early in development may need to target difficulties in understanding what others are thinking or feeling.     

Parent Training Outcomes Among Young Children with Callous–Unemotional Conduct Problems with or at Risk for Developmental Delay

School-aged children with conduct problems and high levels of callous–unemotional (i.e., lack of empathy, guilt, and lack of caring behaviors) traits (CP + CU) tend to yield less benefit from traditional interventions than do their low-CU counterparts, particularly with respect to conduct problem (CP) outcomes. To date, little is known about treatment response among young children with CP + CU, particularly those with or at risk for developmental delay. Components of parent–child interaction therapy (PCIT), a parent training program effective at reducing CP in young children, have compelling theoretical support for addressing core deficits unique to children with CP + CU and have been used successfully with young children with developmental delay. Our first aim was to test the psychometric properties of a measure of CU traits in preschool children with and without developmental delay. Our second aim was to test whether CU traits predicted post-treatment CP after controlling for initial levels of CP. Participants were 63 families of young children (mean age = 3.87 years), with or at risk for developmental delay, who presented with elevated CP and were treated in a hospital-based outpatient clinic. Results indicated that developmentally delayed children with high levels of CU traits, but not children at risk for delay due to premature birth, showed significantly poorer CP outcomes following treatment with PCIT than did children scoring low on CU traits, even after controlling for initial CP severity. The implications of these findings with regard to treating and preventing severe disruptive behaviors among young children with CP + CU are discussed.     

Enhanced ERPs to visual stimuli in unaffected male siblings of ASD children

Autism spectrum disorders are characterized by deficits in social and communication abilities. While unaffected relatives lack severe deficits, milder impairments have been reported in some first-degree relatives. The present study sought to verify whether mild deficits in face perception are evident among the unaffected younger siblings of children with ASD. Children between 6–9 years of age completed a face-recognition task and a passive viewing ERP task with face and house stimuli. Sixteen children were typically developing with no family history of ASD, and 17 were unaffected children with an older sibling with ASD. Findings indicate that, while unaffected siblings are comparable to controls in their face-recognition abilities, unaffected male siblings in particular show relatively enhanced P100 and P100-N170 peak-to-peak amplitude responses to faces and houses. Enhanced ERPs among unaffected male siblings is discussed in relation to potential differences in neural network recruitment during visual and face processing.     

Aggressive Male Juvenile Offenders with Callous-Unemotional Traits Show Aberrant Attentional Orienting to Distress Cues

Antisocial youth with callous-unemotional (CU) traits exhibit a pattern of severe and persistent conduct problems and deficits in emotional processing that parallels adults with psychopathy. Aberrant emotional attention, particularly among individuals high on aggression, constitutes one such deficit; however, its robustness across race/ethnicity requires further investigation given findings that the psychopathy construct manifests differently across race (Sullivan and Kosson 2006), and emotional attention is susceptible to the influence of adverse environmental factors such as violence exposure that is more common among ethnic minority youth (Kimonis et al. in Development and Psychopathology, 20, 569–589, 2008b). Also, the development of a comprehensive measure of CU traits, the Inventory of Callous-Unemotional Traits (ICU), has identified specific CU dimensions (Uncaring, Callous, Unemotional) that are yet to be investigated in relation to emotional attention deficits. Thus, the purpose of the present study was to examine whether aggressive boys high on total CU traits and specific ICU dimensions show deficits in attentional orienting to negative stimuli on a dot-probe task that are consistent across race/ethnicity. Results from a predominately Latino sample of incarcerated male adolescents (N = 156) showed that aggression moderated the association between CU traits and facilitation to distress stimuli. That is, aggressive boys high on CU traits or the Uncaring dimension showed deficient attentional orienting; a finding that was consistent across racial/ethnic minority groups. Results are consistent with prior research suggesting that the combination of high CU traits and aggression defines a unique subgroup of antisocial individuals that more closely fits with the construct of psychopathy than the presence of CU traits alone.     

Facial Emotion Processing in Borderline Personality Disorder: A Systematic Review and Meta-Analysis

A body of work has developed over the last 20 years that explores facial emotion perception in Borderline Personality Disorder (BPD). We identified 25 behavioural and functional imaging studies that tested facial emotion processing differences between patients with BPD and healthy controls through a database literature search. Despite methodological differences there is consistent evidence supporting a negative response bias to neutral and ambiguous facial expressions in patients. Findings for negative emotions are mixed with evidence from individual studies of an enhanced sensitivity to fearful expressions and impaired facial emotion recognition of disgust, while meta-analysis revealed no significant recognition impairments between BPD and healthy controls for any negative emotion. Mentalizing studies indicate that BPD patients are accurate at attributing mental states to complex social stimuli. Functional neuroimaging data suggest that the underlying neural substrate involves hyperactivation in the amygdala to affective facial stimuli, and altered activation in the anterior cingulate, inferior frontal gyrus and the superior temporal sulcus particularly during social emotion processing tasks. Future studies must address methodological inconsistencies, particularly variations in patients’ key clinical characteristics and in the testing paradigms deployed.     

Inattentive Behavior in Boys with ADHD during Classroom Instruction: the Mediating Role of Working Memory Processes

Children with ADHD exhibit clinically impairing inattentive behavior during classroom instruction and in other cognitively demanding contexts. However, there have been surprisingly few attempts to validate anecdotal parent/teacher reports of intact sustained attention during ‘preferred’ activities such as watching movies. The current investigation addresses this omission, and provides an initial test of how ADHD-related working memory deficits contribute to inattentive behavior during classroom instruction. Boys ages 8–12 (M = 9.62, SD = 1.22) with ADHD (n = 32) and typically developing boys (TD; n = 30) completed a counterbalanced series of working memory tests and watched two videos on separate assessment days: an analogue math instructional video, and a non-instructional video selected to match the content and cognitive demands of parent/teacher-described ‘preferred’ activities. Objective, reliable observations of attentive behavior revealed no between-group differences during the non-instructional video (d = ?0.02), and attentive behavior during the non-instructional video was unrelated to all working memory variables (r = ?0.11 to 0.19, ns). In contrast, the ADHD group showed disproportionate attentive behavior decrements during analogue classroom instruction (d = ?0.71). Bias-corrected, bootstrapped, serial mediation revealed that 59% of this between-group difference was attributable to ADHD-related impairments in central executive working memory, both directly (ER = 41%) and indirectly via its role in coordinating phonological short-term memory (ER = 15%). Between-group attentive behavior differences were no longer detectable after accounting for ADHD-related working memory impairments (d = ?0.29, ns). Results confirm anecdotal reports of intact sustained attention during activities that place minimal demands on working memory, and indicate that ADHD children’s inattention during analogue classroom instruction is related, in large part, to their underdeveloped working memory abilities.     

Effects of Parent Training on Callous-Unemotional Traits,Effortful Control,and Conduct Problems: Mediation by Parenting

Callous-unemotional (CU) traits and effortful control (EC) are personality and temperament traits implicated in early-onset antisocial trajectories. This secondary analysis of Hitkashrut’s randomized controlled trial first tested parent training’s effects on EC and CU traits while controlling for more general treatment effects on conduct problems (CP), and subsequently tested mediation by parenting. Prekindergarten teachers in three Israeli cities identified 209 3–5 year-old (163 boys; 46 girls) preschoolers with subclinical-clinical range conduct problems. All participants were Jewish ranging from ultra-orthodox to secular. They were assigned to 14-session co-parent training groups (n = 140 couples), or to minimal intervention control groups with referral to local services as necessary (n = 69 couples). We employed averaged indices of pre- and post-intervention questionnaires completed by both parents. The testing of all hypothesized models controlled for treatment effects on CP in order to strengthen the robustness of the analyses. We found significant concurrent treatment effects on CP and on either CU traits or EC. All effects were mediated by ineffective parenting (IP): a latent variable that was indicated by negative/inconsistent practices and perceived parenting inefficacy. This is the first demonstration of parenting mediated treatment effects on both EC and CU traits in a randomized controlled study conducted in everyday practice contexts. This finding supports a disruption model of change: the reduction of IP facilitates a caregiving environment that affects children’s behavior and developing personality. The changing of personality and temperament characteristics implicated in early-onset pathways suggests an innovative prevention strategy for disruptive behavior disorders.     

Callous-Unemotional Traits in Individuals Receiving Accommodations in University

Research with antisocial individuals suggests that callous-unemotional (CU) traits, a dimension of psychopathy, consistently predict severe antisocial behaviours and correlate with deficits in recognizing negative emotions, especially fearful facial expressions. However, the generalizability of these findings to non-antisocial populations remains uncertain and largely unexplored. This small, exploratory study aimed to extend this research by measuring CU traits and facial emotion recognition in university students with Attention-Deficit Hyperactivity Disorder (ADHD), learning disabilities, other psychiatric disorders, and comparison participants with physical/sensory disabilities. As the clinical groups can exhibit deficits in emotion recognition, this study sought to shed light on the candidacy of CU traits as a factor in emotion recognition. Results suggested that individuals in the diagnostic groups possess similar levels of CU traits to the comparison group and that the relationship between CU traits and emotion recognition deficits previously seen in antisocial populations is not present in this sample. Contrary to the hypothesis, those in the diagnostic groups displayed similar levels of accuracy on an emotion recognition task as the comparison group. Recommendations are made for future research to use more specific and representative diagnostic populations to further assess the relationships between CU traits and emotion recognition in non-antisocial populations.     

Ambiguous emotion recognition in temporal lobe epilepsy: The role of expression intensity

The lateralization of emotion processing is currently debated and may be further explored by examining facial expression recognition (FER) impairments in temporal lobe epilepsy (TLE). Furthermore, there is also debate in the literature whether FER deficits in individuals with TLE are more pronounced in the right than in the left hemisphere. Individuals with TLE were tested with an FER task designed to be more sensitive than those classically used to shed light on this issue. A total of 25 right- and 32 left-TLE patients, candidates for surgery, along with controls, underwent an FER task composed of stimuli shown not only at full-blown intensities (100 %), but also morphed to lower-intensity display levels (35 %, 50 %, and 75 %). The results showed that, as compared to controls, right-TLE patients showed deficits in the recognition of all emotional categories. Furthermore, when considering valence, right-TLE patients were impaired only in negative emotion recognition, but no deficits for positive emotions were highlighted in left-TLE patients. Finally, only the right-TLE patients’ impairment was found to be related to the age of epilepsy onset. Our work demonstrates that the FER deficits in TLE span multiple emotional categories and show manifestations dependent on the laterality of the epileptic focus. Taken together, our findings provide the strongest evidence for the right-hemisphere model, but they also partially support the valence model. We suggest that current models are not exhaustive at explaining emotional-processing cerebral control, and further that multistep models should be developed.     

Individual, Social, and Behavioral Factors Associated with Co-Occurring Conduct Problems and Callous-Unemotional Traits

Conduct problems (CP) and callous-unemotional (CU) traits can have a long-lasting negative impact into adulthood. Importantly, among youth with CP, those high on CU traits engage in a more severe, aggressive, and persistent pattern of antisocial behavior. The current study investigates the co-occurrence between CP and CU traits among a large sample of Greek-Cypriot adolescents (N?=?1,674; 50.1 % girls). Five distinct groups were identified with Latent Profile Analysis: low risk (48.7 %), average risk (33.8 %), co-occurring high CP-high CU (5.4 %), high CP-low CU (5.2 %), and low CP-high CU (6.9 %). Although more boys were identified in the higher risk groups, boys and girls within each group were not differentiated on levels of CP or CU traits during early adolescence. Youth in the identified groups were compared on early (Mean age?=?12.12) and middle (Mean age?=?14.02) adolescence individual and contextual factors. Youth with high CP-high CU were at higher risk for behavioral (bullying and substance use), individual (inattention, impulsivity, narcissism), and contextual (low family-support) problems compared to youth in the high CP-low CU and low CP-high CU groups, providing evidence that the combination of CP and CU traits might constitute a pathological group. These findings demonstrate the usefulness of sub-typing CP based on CU traits for the forthcoming fifth edition of the Diagnostic and Statistical Manual. Additional novel findings suggested that adolescents scoring high on CP, irrespective of CU, were not differentiated on hyperactivity, victimization, and anxiety/depression, and adolescents scoring high on CU traits, with or without CP, reported similar low levels of self-esteem and peer and family social-support.     

Heterogeneity in ADHD: Neurocognitive predictors of peer,family, and academic functioning

Childhood attention-deficit/hyperactivity disorder (ADHD) is associated with impairments in peer, family, and academic functioning. Although impairment is required for diagnosis, children with ADHD vary significantly in the areas in which they demonstrate clinically significant impairment. However, relatively little is known about the mechanisms and processes underlying these individual differences. The current study examined neurocognitive predictors of heterogeneity in peer, family, and academic functioning in a well-defined sample of 44 children with ADHD aged 8–13 years (M = 10.31, SD = 1.42; 31 boys, 13 girls; 81% Caucasian). Reliable change analysis indicated that 98% of the sample demonstrated objectively-defined impairment on at least one assessed outcome measure; 65% were impaired in two or all three areas of functioning. ADHD children with quantifiable deficits in academic success and family functioning performed worse on tests of working memory (d = 0.68 to 1.09), whereas children with impaired parent-reported social functioning demonstrated slower processing speed (d = 0.53). Dimensional analyses identified additional predictors of peer, family, and academic functioning. Working memory abilities were associated with individual differences in all three functional domains, processing speed predicted social functioning, and inhibitory control predicted family functioning. These results add to a growing literature implicating neurocognitive abilities not only in explaining behavioral differences between ADHD and non-ADHD groups, but also in the substantial heterogeneity in ecologically-valid functional outcomes associated with the disorder.     

Startle modulation during violent films: Association with callous–unemotional traits and aggressive behavior

The current study examined the unique and interactive associations of callous–unemotional (CU) traits, impulsive and premeditated aggression with startle modulation to violent films. Eighty-five participants (Mage = 20.52) at differential risk of CU traits, selected from a sample of 1105 young adults, participated in the physiological experiment. Startle eye-blink responses to acoustic probes were recorded during violent, comedy and neutral films. Self-report ratings of valence and arousal were also collected. Findings from regression analysis documented that CU traits were associated with diminished startle potentiation to violent films, whereas impulsive aggression was associated with increases in startle potentiation. Further, the negative association between CU traits with startle potentiation, valence, and arousal ratings to violent films was moderated by impulsive aggression. At the group level, individuals high on impulsive aggression without CU traits were the ones showing the highest levels of startle potentiation to violent films, and scored on the opposite extreme compared to individuals high on both CU traits and impulsive aggression.     

Long-Term Neuropsychological Outcomes of Childhood Onset Acute Disseminated Encephalomyelitis (ADEM): a Meta-Analysis

The long-term neurocognitive prognosis of childhood onset acute disseminated encephalomyelitis (ADEM) is unclear. This review and quantitative synthesis of the available literature examined whether there are long-term impacts of childhood ADEM on neurocognitive functioning. A search of online databases (MEDLINE, EMBASE, EBSCO CINAHL, PsycINFO and the Cochrane Database of Systematic Reviews) from their inception to October 2015 and reference lists identified 13 papers eligible for inclusion in the systematic review; seven of these were eligible for inclusion in meta-analyses. The systematic review indicated that, at a group level there is a positive long-term neuropsychological outcome from childhood onset ADEM. However, despite the apparent absence of long-term negative impacts of ADEM at a group level, at an individual level impairments in the areas of IQ, attention, executive functioning, processing speed, learning and memory, visuospatial skills and internalising symptoms were found in up to 43% of patients when aggregated across the studies. No significant negative effect of ADEM for any of the neuropsychological domains examined was found in meta-analyses. However, the effects for Processing Speed (r _mean = ?0.296 (CI 95% = ?0.605-0.013)) and Internalising symptoms (r _mean = 0.242 (CI 95% = ?0.014-0.564)) approached significance (p = 0.06), suggesting a trend towards ADEM leading to long-term reduced processing speed and elevated internalising symptoms. Together, our findings suggest that despite a generally positive neurocognitive outcome post childhood ADEM there are a subset of individuals who can suffer from ongoing specific cognitive impairments. Clinical implications and research priorities are discussed.     

Grandiose-Manipulative,Callous-Unemotional,and Daring-Impulsive: the Prediction of Psychopathic Traits in Adolescence and their Outcomes in Adulthood

There has been much debate about how to measure psychopathic traits in adolescence. One of the main issues is whether one should focus on callous-unemotional (CU) traits alone, or CU traits in combination with Grandiose-Manipulative (GM) and Daring-Impulsive (DI) traits. The current study first investigates the extent to which youth who are high on CU traits are also high on GM and DI traits. In addition, the study investigates if being high on both CU and GM, and high on both CU and DI, identify groups that are particularly characterized by past and future impairments. To investigate this, data from the Cambridge Study in Delinquent Development (CSDD) was analyzed. The CSDD is a prospective longitudinal study of 411 English boys spanning over 50 years. The information available at age 12–14 was coded on the Antisocial Process Screening Device (APSD). Childhood risk factors were measured at age 8–10 and later life outcomes were measured at age 32. The results indicate that being high on CU in combination with DI delineates a clinically interesting group who are characterized by high childhood risk and poorer adult life outcomes. The same applied to the high CU/high GM group, but to a lesser extent.     

ADHD Symptoms in Post-Institutionalized Children Are Partially Mediated by Altered Frontal EEG Asymmetry

Individual differences in the propensity for left versus right frontal electroencephalogram (EEG) asymmetry may underlie differences in approach/withdrawal tendencies and mental health deficits. Growing evidence suggests that early life adversity may shape brain development and contribute to the emergence of mental health problems. The present study examined frontal EEG asymmetry (FEA) following the transition to family care in children adopted internationally from institutional care settings between 15 and 36 months of age (N = 82; 46 female, 36 male). Two comparison groups were included: an international adoption control consisting of children adopted from foster care with little to no institutional deprivation (N = 45; 17 female, 28 male) and a post-adoption condition control consisting of children reared in birth families of the same education and income as the adoptive families (N = 48; 23 female, 25 male). Consistent with evidence of greater approach and impulsivity-related behavior problems in post-institutionalized (PI) children, PI status was associated with greater left FEA than found in the other two groups. In addition, left FEA served as a mediator between institutionalization and age 5 ADHD symptoms for girls. Age at adoption and other preadoption factors were examined with results suggesting that earlier adoption into a supportive family resulted in a more typical pattern of brain functioning. Findings support the idea that the capacity of brain activity to evidence typical functioning following perturbation may differ in relation to the timing of intervention and suggest that the earlier the intervention of adoption, the better.     

Examination of the Association Among Personality Traits,Anxiety Sensitivity,and Cannabis Use Motives in a Community Sample

Personality factors, such as neuroticism, are important for understanding motives for cannabis use; however, few studies have examined the role of neuroticism in the context of other personality factors, or possible mechanisms accounting for an association between neuroticism and motives for use. The present study examined concurrent associations between personality traits (i.e., conscientiousness, extraversion, agreeableness, and neuroticism) and cannabis use motives, and the role of anxiety sensitivity (AS) in the association between neuroticism and coping cannabis use motives. Seventy young adults endorsing past-month cannabis use (58.6 % female, M _age = 20.91) completed self-report measures. Linear regressions were conducted to examine the concurrent associations between personality factors and cannabis use motives. Higher levels of neuroticism, but no other personality traits, were significantly associated with greater coping (β = 45, p < .01) and expansion (β = 0.29, p = <.05) motives. Bootstrap analysis (10,000 re-samples) revealed that a significant portion of the relationship between neuroticism and coping motives was explained by AS (point estimate = 0.029, PB 95 % CI: 0.0089 to 0.0615). Greater neuroticism may result in heightened sensitivity to arousal, which may then increase motivation to use cannabis to alleviate such arousal.     

Attentional Orienting to Emotional Faces Moderates the Association Between Callous-Unemotional Traits and Peer-Nominated Aggression in Young Adolescent School Children

Callous-unemotional (CU) traits are associated with aggressive behavior but preliminary research suggests this relationship is modified by patterns of emotional processing. This study examined whether attentional orienting to emotional faces moderated the association between CU traits and peer-nominated aggression in 251 middle school students (53% females, mean age = 13.24 years, SD = 0.73). Attentional orienting was assessed using an emotional faces (i.e., angry, fearful, happy, sad, and neutral) variant of the dot-probe task. Students also completed a self-report measure of CU traits and their classmates made peer nominations of aggression. Logistic regression analyses showed that peer-nominated aggression was positively related to CU traits at low levels of attentional orienting to angry faces, whereas aggression was unrelated to CU traits at high levels of attentional orienting to angry faces. That is, peer-nominated aggression was greatest for youth high on CU traits who were not engaged by angry faces. These findings support the importance of considering different patterns of emotional responding when studying the association between CU traits and aggressive behavior in youth.