Conduct Disorder in Girls: A Review of the Literature

The study of Conduct Disorder (CD) has primarily been limited to boys. The lack of research resulted from a premise that CD in girls was rare. However, CD in girls is a relatively common psychiatric diagnosis, and appears to be associated with several serious outcomes, such as Antisocial Personality Disorder and early pregnancy. Understanding gender differences in the course and severity of CD may lead to important information about etiology. Empirical studies on precursors, developmental course, risk factors and treatment for CD in girls are reviewed, while highlighting similarities and differences between girls and boys. Generally, CD symptoms in girls are stable. Precursors to CD in girls probably include Oppositional Defiant Disorder and temperamental factors, but also may include certain negative cognitions. What distinguishes CD in girls is the high risk they have to develop comorbid conditions, especially internalizing disorders. Risk factors for CD in girls partly overlap with those known for boys, but some factors appear to be highly salient for girls. Finally, there may be some significant effects of gender on treatment efficacy. Implications of these findings for future etiologic research are discussed.     

儿童行为抑制性与心理障碍关联的认知神经过程

行为抑制型儿童相较于普通儿童更容易在童年中期和青春期出现心理障碍, 具有更高的发展风险性。此类儿童比非抑制型儿童表现出更多的退缩动机、更长的预期过程与前注意过程、更少的注意控制、对负性信息更多的注意偏向、异常活跃的反应监控过程和更慢的习惯化过程。这些与心理障碍患者相似的认知神经过程是儿童行为抑制性与心理障碍间的重要联系途径, 并能作为预测指标筛选有更高发展风险性的个体。除儿童本身的特质外, 环境因素也能通过塑造认知神经过程, 进而影响儿童的发展结果。因此在未来的研究中, 可以考虑不同文化背景下的儿童行为抑制性与心理障碍关联的认知神经过程差异。进而从个体特质和环境因素两方面寻找行为抑制型儿童发展的保护性因素。     

Birth characteristics and developmental outcomes of infants of Mexican-origin adolescent mothers: Risk and promotive factors

Infants of adolescent mothers are at increased risk for negative developmental outcomes. Given the high rate of pregnancy among Mexican-origin adolescent females in the US, the present study examined health characteristics at birth and developmental functioning at 10 months of age in a sample of 205 infants of Mexican-origin adolescent mothers. Infants were relatively healthy at birth and had near average developmental functioning at 10 months. The educational attainment of adolescents and their mothers, and infants' temperamental regulation, promoted positive developmental functioning, while the combination of low adolescent parental self-efficacy and high infant temperamental negativity was associated with greater developmental delay. Findings are discussed with respect to implications for prevention with this at-risk population of mothers and infants.     

Behavioral Inhibition and Anxiety: The Moderating Roles of Inhibitory Control and Attention Shifting

Behavioral inhibition (BI), a temperament identified in early childhood, is associated with social reticence in childhood and an increased risk for anxiety problems in adolescence and adulthood. However, not all behaviorally inhibited children remain reticent or develop an anxiety disorder. One possible mechanism accounting for the variability in the developmental trajectories of BI is a child’s ability to successfully recruit cognitive processes involved in the regulation of negative reactivity. However, separate cognitive processes may differentially moderate the association between BI and later anxiety problems. The goal of the current study was to examine how two cognitive processes—attention shifting and inhibitory control—laboratory assessed at 48 months of age moderated the association between 24-month BI and anxiety symptoms in the preschool years. Results revealed that high levels of attention shifting decreased the risk for anxiety problems in children with high levels of BI, whereas high levels of inhibitory control increased this risk for anxiety symptoms. These findings suggest that different cognitive processes may influence relative levels of risk or adaptation depending upon a child’s temperamental reactivity.     

Expectation and temperament moderate amygdala and dorsal anterior cingulate cortex responses to fear faces

A chronic tendency to avoid novelty is often the result of a temperamental bias called inhibited temperament, and is associated with increased risk for anxiety disorders. Neuroimaging studies have demonstrated that an inhibited temperament is associated with increased amygdalar blood-oxygenation-level-dependent (BOLD) response to unfamiliar faces that were not expected; however, the effects of variations in expectancy remain unknown. Using functional magnetic resonance imaging (fMRI), we studied BOLD response to infrequently encountered fear faces that were either expected or not expected in 42 adults with an inhibited or an uninhibited temperament. Individuals with an inhibited temperament had greater amygdala, but less dorsal anterior cingulate cortex (dACC), BOLD response when the stimuli were expected. In contrast, those with an uninhibited temperament had a smaller amygdala but larger dorsal anterior cingulate cortex BOLD response when expecting to see fear faces. These findings demonstrate temperament differences in expectancy effects and provide preliminary evidence for the dACC as a neural substrate mediating differences in inhibited temperament. Enhanced amygdala sensitivity coupled with weak inhibitory control from the dACC may form a neural circuit mediating behaviors characteristic of inhibited temperament and risk for anxiety disorders.     

Re-examining the Epidemiology of Sensory Regulation Dysfunction and Comorbid Psychopathology

The aims of this study were threefold: (1) to compare prevalence of sensory regulation dysfunction based on previously established criteria to rates established with a more representative community sample of 796 4-year-olds; (2) to examine ethnic/racial and gender differences in prevalence according to the different criteria; and (3) to examine the co-occurrence of sensory regulation dysfunction and preschool psychiatric disorders. Prevalence rates ranged from 3.4% (current criteria) to 15.6% (previous criteria). In contrast to previous studies with less representative samples, there were no significant ethnic or racial differences using the current criteria. Boys were more likely to have sensory regulation dysfunction than girls according to all criteria. Depending upon impairment criteria used, 33–63% of children meeting criteria for sensory dysregulation also had a psychiatric disorder; 37–67% had only a sensory dysregulation disorder, indicating that sensory regulation dysfunction exists independent of psychiatric disorder, and is also a significant risk factor for disorder.     

Temperamental profiles and linguistic development: Differences in the quality of linguistic production in relation to temperament in children of 28 months

The temperamental constellations that can be found in the infant population may influence the development trajectories of single domains of knowledge, such as that relative to language. The main objective of this study is to identify temperamental profiles to which one associates different levels of linguistic competence and to identify the profile associated with the highest risk for language acquisition. The temperamental characteristics of a sample of 106 children of 28 months attending day-care centres were surveyed and three temperamental profiles were highlighted: a profile typical of the Italian population which grouped most of the children; another made up of easily distractible and not very persistent children, who show a poor capacity to modulate motor activity and finally, the third with children inhibited in new situations. A comparison of the three groups on the basis of the level of linguistic competence revealed important differences regarding certain indices such as the vocabulary size and composition: in particular, the group of “inattentive” children has a more “immature” vocabulary composition, characterised by the presence of more primitive components of the lexical repertory.     

ADHD and delinquency--a developmental perspective

Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent psychiatric disorders of childhood and adolescence. Until now, it has been unclear whether ADHD by itself constitutes a risk factor for later delinquency or does so only in combination with other disruptive symptoms. This article seeks to give a comprehensive account of the literature to shed light on the developmental pathway from childhood ADHD to adult criminality. Comorbid ADHD and conduct disorder (CD) are significantly related to a range of biological and environmental risk factors such as neurocognitive impairment, high parental psychopathology, poor social functioning, and other comorbid mental disorders, particularly substance abuse, that are described in this review. In addition, the results of treatment studies are presented, with a special focus on the results of the Multimodal Treatment Study of Children with ADHD (MTA). Although treatment programs, including medication and psychosocial treatment, can be very effective in improving the functioning of children with ADHD in the social and academic domains in the short term, there is no conclusive evidence that such treatments lower the risk for developing delinquency in adulthood.     

Temperament theory and the study of cognition–emotion interactions across development

In this paper we review current definitions and measurement approaches used to assess individual differences in children’s temperament. We review the neural bases of temperamental reactivity and self-regulation and propose that these constructs provide a framework for examining individual differences and developmental change in emotion–cognition interactions across development. Studies are reviewed in which some well-documented contextual effects on the expression of temperament can be interpreted in terms of the influence of biological and non-biological factors on CNS functioning. We conclude with ideas regarding future directions for the study of individual differences and developmental change in cognition–emotion interactions as they are shaped throughout development.     

A review on eye movement studies in childhood and adolescent psychiatry

The neural substrates of eye movement measures are largely known. Therefore, measurement of eye movements in psychiatric disorders may provide insight into the underlying neuropathology of these disorders. Visually guided saccades, antisaccades, memory guided saccades, and smooth pursuit eye movements will be reviewed in various childhood psychiatric disorders. The four aims of this review are (1) to give a thorough overview of eye movement studies in a wide array of psychiatric disorders occurring during childhood and adolescence (attention-deficit/hyperactivity disorder, oppositional deviant disorder and conduct disorder, autism spectrum disorders, reading disorder, childhood-onset schizophrenia, Tourette’s syndrome, obsessive compulsive disorder, and anxiety and depression), (2) to discuss the specificity and overlap of eye movement findings across disorders and paradigms, (3) to discuss the developmental aspects of eye movement abnormalities in childhood and adolescence psychiatric disorders, and (4) to present suggestions for future research. In order to make this review of interest to a broad audience, attention will be given to the clinical manifestation of the disorders and the theoretical background of the eye movement paradigms.     

A review on eye movement studies in childhood and adolescent psychiatry

The neural substrates of eye movement measures are largely known. Therefore, measurement of eye movements in psychiatric disorders may provide insight into the underlying neuropathology of these disorders. Visually guided saccades, antisaccades, memory guided saccades, and smooth pursuit eye movements will be reviewed in various childhood psychiatric disorders. The four aims of this review are (1) to give a thorough overview of eye movement studies in a wide array of psychiatric disorders occurring during childhood and adolescence (attention-deficit/hyperactivity disorder, oppositional deviant disorder and conduct disorder, autism spectrum disorders, reading disorder, childhood-onset schizophrenia, Tourette’s syndrome, obsessive compulsive disorder, and anxiety and depression), (2) to discuss the specificity and overlap of eye movement findings across disorders and paradigms, (3) to discuss the developmental aspects of eye movement abnormalities in childhood and adolescence psychiatric disorders, and (4) to present suggestions for future research. In order to make this review of interest to a broad audience, attention will be given to the clinical manifestation of the disorders and the theoretical background of the eye movement paradigms.     

Family Functioning and Mental Illness: A Comparison of Psychiatric and Nonclinical Families

The primary objective of the present investigation was to examine adaptive functioning in the families of patients with a wide range of psychiatric disorders. Seven dimensions of family functioning, as measured by the Family Assessment Device (FAD), were compared across families of patients with a schizophrenia spectrum disorder (n = 61 ), bipolar disorder (n = 60 ), major depression (n = 111 ), anxiety disorder (n = 15 ), eating disorder (n = 26 ), substance abuse disorder (n = 48 ), and adjustment disorder (n = 46 ). Families in each psychiatric group were also compared to a control group of nonclinical families (N = 353 ). Results indicated that regardless of specific diagnosis, having a family member in an acute phase of a psychiatric illness was a risk factor for poor family functioning compared to the functioning of control families. However, with few exceptions, the type of the patient's psychiatric illness did not predict significant differences in family functioning. Thus, having a family member with a psychiatric illness is a general stressor for families, and family interventions should be considered for most patients who require a psychiatric hospitalization for either the onset of, or an acute exacerbation of, any psychiatric disorder.     

Risk Factors for Attempting Suicide in Prisoners

We wished to examine determinants of suicidal behavior in prisoners. 903 male prisoners had a psychiatric interview which included various psychometric tests. Suicide attempters were compared with prisoners who had never attempted suicide. Significantly more of the attempters had a history of psychiatric disorder, substance abuse, a family history of suicidal behavior, convictions for violent crime, had exhibited aggressive behavior in jail, and had higher BGLHA aggression scores. A similar pattern of risk factors was found for prisoners with suicidal ideation. A lifetime history of attempting suicide, or of having suicidal ideation, is frequent in prisoners. Risk factors include family, developmental, aggression, personality, psychiatric, and substance abuse factors.     

Childhood Sexual Assault,Quality of Life,and Psychiatric Comorbidity in Veterans With Military and Civilian Sexual Trauma

Veterans with military sexual trauma (MST) are at risk for a variety of psychiatric conditions, including posttraumatic stress disorder (PTSD) and depression. Survivors of MST are also likely to experience diminished quality of life (QoL). Individuals with higher lifetime incidence of sexual trauma may also be at increased risk for poorer outcomes in QoL and psychiatric symptomatology. The differences in psychological sequelae among those who have experienced sexual trauma as children, and those whose sexual trauma exposure is limited to adulthood are relatively understudied. The majority of sexual trauma literature has focused primarily on civilian trauma, and comparatively few studies have specifically examined psychosocial sequelae (e.g., QoL) in veterans with MST. This study examined how childhood sexual abuse (CSA) affects overall QoL as well as severity of PTSD and depressive symptoms. Veterans who reported CSA had significantly greater depression symptom severity than veterans who did not. No significant differences in PTSD symptom severity or QoL were found between veterans who did and did not report CSA. Results highlight the need for further examination of the relationship between CSA and depression in veterans with MST-related PTSD who also report CSA.     

The influence of temperamental reactivity and situational context on the emotion-regulatory abilities of 3-year-old children

Although much research has been conducted on emotion regulation, little work in the preschool period has examined the interrelationships between emotion regulation, temperamental reactivity, and situational context. The authors investigated the temperamental dispositions of fifty-three 3-year-old children (27 boys, 26 girls) and their behavioral responses to several challenging tasks (i.e., stranger-approach situation, busy-caregiver paradigm, and delay-of-gratification task). Results indicated that both situational context and temperamental reactivity influenced the type of emotion-regulatory strategy used and that those relationships were best understood within a developmental framework. Moreover, the authors found that girls displayed more comforting strategies, suggesting that gender differences in emotion regulation may exist.     

A systematic review of the evidence-based psychosocial risk factors for understanding of borderline personality disorder

Borderline personality disorder (BPD) is a serious personality disorder characterized by affective instability, impulsivity and interpersonal disturbance. Currently, intensive research is being conducted concerning the aetiology of BPD, including research on neurobiological, temperamental, psychosocial and cultural risk factors. This study focuses on psychosocial risk factors while other risk factors are taken into account in the discussion of the development of BPD. To our knowledge, no systematic review of the evidence-based medicine literature concerning this theme has been made thus far. However, understanding psychosocial risk factors of BPD is important in order to develop psychotherapeutic treatment models and methods. We provide a systematic review of the literature focusing on psychosocial risk factors for BPD. Utilizing this knowledge, we discuss how these data may be used when studying the development of borderline personality disorder and the treatment of borderline personality disorder.     

Temperamental emotionality in preschoolers and parental mood disorders

A number of models developed in the adult psychopathology literature (i.e., L. A. Clark & D. Watson, 1991) have asserted that low levels of positive emotionality (PE) are predisposing factors or precursors for depression and represent a form of temperamental risk for depression. Further support for this claim would derive from evidence linking low PE to known indicators of risk for depression. The authors examined the association between temperamental emotionality in young children and parental mood disorders. One hundred unselected preschool-aged children completed a battery of emotion-eliciting tasks tapping aspects of PE, negative emotionality (NE), and behavioral inhibition (BI). Parental psychopathology was assessed with semistructured diagnostic interviews. Low PE in children was associated with maternal, but not paternal, mood disorder. The low PE-maternal depression link was relatively specific, as there were few associations between low PE and other forms of parental psychopathology or between NE and BI and parental mood disorders.     

Maternal Psychopathology and Early Child Temperament Predict Young Children’s Salivary Cortisol 3 Years Later

Neuroendocrine dysfunction is hypothesized to be an early emerging vulnerability marker for depression. We tested whether the main and interactive effects of maternal psychopathology and early child temperamental vulnerability for depression assessed at age three predicted offspring’s basal cortisol function at age 6 years. 228 (122 males) children participated in the baseline and follow-up assessments. At age three, maternal lifetime psychopathology was assessed with a diagnostic clinical interview, and child temperamental positive affectivity (PA) and negative affectivity (NA) were assessed using laboratory observations. At age six, children’s waking and evening cortisol were assessed on 2 days. Maternal lifetime anxiety predicted offspring’s higher morning cortisol at age six. Child temperamental NA at age three predicted higher evening cortisol at age six. There was a significant interaction between maternal lifetime depression and child temperamental PA at age three in predicting offspring’s morning cortisol at age six. For the offspring of mothers with lifetime depression, higher PA at age 3 predicted lower morning cortisol at age 6. These findings highlight the importance of examining the main and interactive effects of maternal psychopathology and early child temperamental vulnerability in predicting the development of offspring’s stress physiology. Findings hold significance in identifying etiological mechanisms of risk and delineating the complex developmental pathways to psychopathology.     

The Differential role of parenting,peers, and temperament for explaining interindividual differences in 18-months-olds’ comforting and helping

This study analyzes temperamental and social correlates of 18-month-olds’ (N = 58) instrumental helping (i.e., handing over out-of-reach objects) and comforting (i.e., alleviating experimenter’s distress). While out-of-reach helping as a basic type of prosocial behavior was not associated with any of the social and temperamental variables, comforting was associated with maternal responsible parenting, day care attendance, and temperamental fear, accounting for 34% of the total variance in a corresponding regression model. The data of the present study suggest that, while simple instrumental helping seems to be a robust developmental phenomenon, comforting is associated with specific social experiences and child temperament that constitute interindividual differences and thereby help to explain the domain-specific development of prosociality.     

A neurodevelopmental perspective on male violence

Research is increasingly documenting a neurobiological basis to violence. This review takes a neurodevelopmental perspective on the very small group of males who grow up to become persistent violent offenders. After outlining six criteria for what constitutes a neurodevelopmental disorder, the extent to which chronic violence meets these definitional criteria is examined, covering the fields of genetics, structural and functional brain imaging, and neuropsychology. Early health risk factors for violence are then outlined, including birth complications, minor physical anomalies, prenatal smoking and alcohol exposure, poor nutrition, lead exposure, and traumatic brain injury. Persistent adult violence is argued to originate in aberrant temperamental behavior in early childhood, to have a stable developmental trajectory, and to be associated with impaired education, social, and occupational functioning. Taken together, it is argued that chronic adult violence meets criterion for being conceptualized as having neurodevelopmental origins and that an important, but not sole, source of neural maldevelopment lies in prenatal and early postnatal risk factors. This review concludes with a recognition of the sociopolitical context within which a neurodevelopmental perspective on chronic violence sits, together with directions for future research, including whether a neurodevelopmental hypothesis is best applied to reactive as opposed to proactive aggression.