Unique and Interactive Associations of Callous-Unemotional Traits,Impulsivity and Grandiosity 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.     

The Disruptive Adolescent as a Grown-Up: Predicting Adult Startle Responses to Violent and Erotic Films from Adolescent Conduct Problems and Callous-Unemotional Traits

The current study aimed to identify heterogeneous groups of adolescents differing on their levels of conduct problems (CP) and callous-unemotional (CU) traits, and compare them on startle reactivity to emotional videos (violent/erotic) during young adulthood. A Latent Profile Analysis, conducted among a longitudinal sample of 2306 adolescents, provided evidence for the existence of heterogeneous CP and CU subgroups (i.e., CP-only, CU-only, and CP+CU groups). Three years later, 82 young adults (Mage?=?19.95), randomly selected from the identified groups, participated in an experiment assessing their startle eye-blink responses during violent, erotic and neutral video scenes. Self-report ratings of fear, valence and arousal to affective scenes were also collected. Findings suggested that adolescents high on CP and low on CU traits showed high startle potentiation when viewing violent scenes during young adulthood, while those high on both CP and CU traits showed diminished startle reactivity to violent stimuli. Individuals high on CU traits without CP showed similar startle reactivity to controls. Further, the findings indicate that startle potentiation to violent stimuli can be a reliable physiological marker to distinguish antisocial individuals with and without CU traits. The finding that the CU only group was not differentiated from the control group on startle reactivity when viewing violent stimuli might explain their lower likelihood of engaging in antisocial behavior.     

The Moderating Role of Anxiety in the Associations of Callous-Unemotional Traits with Self-Report and Laboratory Measures of Affective and Cognitive Empathy

In a sample of detained male adolescents (n = 107; Mean age = 15.50; SD = 1.30), we tested whether anxiety moderated the association of CU traits with self-report and computerized measures of affective (emotional reactivity) and cognitive (affective facial recognition and Theory of Mind [ToM]) empathy. Hierarchical regression analyses revealed that CU traits were negatively associated with self-reports of affective empathy and this association was not moderated by level of anxiety. Significant interactions revealed that CU traits were negatively associated with cognitive empathy (self-report) only at high levels of anxiety, whereas CU traits were positively associated with cognitive empathy on the ToM task only at low levels of anxiety. CU traits were also associated with greater fear recognition accuracy at low levels of anxiety. Implications for understanding and treating different variants of CU traits (i.e., primary and secondary) are discussed.     

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.     

Callous-Unemotional Traits Only Versus the Multidimensional Psychopathy Construct as Predictors of Various Antisocial Outcomes During Early Adolescence

The aim of this study was to compare callous-unemotional (CU) traits versus the multidimensional psychopathy construct in their ability to predict future and stable antisocial behavior. At baseline, a community sample of 996 Cypriot 12-year old adolescents (52% girls) completed measures that tap conduct problems (CP) and psychopathic traits, including CU. CP, aggression, and substance use were self-reported at 1–3 year follow-ups. Youths were assigned to six mutually exclusive groups based on their baseline levels of CP and psychopathic traits. Youth with CP scoring high on all three psychopathic traits dimensions (Psychopathic Personality?+?CP) showed the most robust and highest risk for future and stable CP, aggression, and substance use, followed by youth who were high on all three psychopathic traits dimensions but displayed no concurrent CP (Psychopathic Personality Only) and CP youth with low levels of psychopathic traits (CP Only). Youth with CP who merely manifested callous-unemotional traits (Callous-Unemotional?+?CP) were only at risk for future CP. The findings suggest that the CU traits-based approach for subtyping children with CP is less informative compared to a subtyping approach using various psychopathic traits dimensions in predicting future and stable forms of various antisocial outcomes. These findings and their consistency with prior work indicate the need for additional research to examine the various psychopathic traits dimensions rather than focusing solely on CU traits, especially for CP subtyping purposes.     

Callous-Unemotional Traits and Effortful Control Mediate the Effect of Parenting Intervention on Preschool Conduct Problems

Parenting intervention (PI) is an effective treatment for children’s conduct problems (CP) that has been shown to be mediated by improved parenting practices and parenting self-efficacy. Recently, Hitkashrut’s randomized controlled trial demonstrated that ineffective parenting (IP) mediated effects on callous-unemotional (CU) traits and effortful control (EC), while controlling for more general treatment effects on CP. These temperament and personality-based features predict the formation of early-onset antisocial trajectories with poor long-term prognosis. The objective of this study was to use Hitkashrut’s 3-wave dataset to test posttreatment EC and CU mediation of treatment effect on 1-year follow-up CP, and to determine whether mediation by each child-level potential mediator remains significant when tested concurrently with the parenting mediator. Parents of 209 3–5 year-old preschoolers (163 boys; 46 girls), with subclinical-clinical range CP were assigned to 14-session co-parent training groups (n?=?140 couples), or to minimal intervention control groups (n?=?69 couples). Assessments were based on both parents’ questionnaires. An intent-to-treat analysis showed that EC and CU traits simultaneously mediated treatment effects on CP in one EC/CU mediational model. The concurrent testing of child- and parent-level mediators showed mediation by IP and CU traits in the CU/IP model, and IP mediation in the EC/IP model. Similar results were obtained in mediational analyses that controlled for the shared variance between the mediators and CP at T2. Overall, the findings support an intervention model of coaching parents of high-CP children to promote moral self-regulatory competencies while concurrently applying behavioral methods that directly target CP.     

Preventing Conduct Disorder and Callous Unemotional Traits: Preliminary Results of a School Based Pilot Training Program

This study investigated whether a school-based pilot prevention program is effective in reducing Conduct Disorder (CD) symptoms and callous unemotional (CU) traits (i.e., lack of empathy and guilt) in a community sample of children. A total of 304 children from three schools in Cyprus were randomly assigned at school level to either a prevention group that received a skill building training program (N = 94; M _age  = 7.91, SD = .74; 52.1% female) or a control group that received no training (N = 210; M _age  = 7.82, SD = .81; 50.5% female). To evaluate the effectiveness of the program, CD symptoms and CU traits were assessed before the implementation of the training program and at 3 and 9 months after training. Additionally, the child’s impulsivity, parental involvement and friend support were assessed pre- and post-prevention. Significant post-training reductions in CU traits were identified for the prevention, but not the control, group at both 3-month and 9-month follow-ups and in CD symptoms at the 9 month follow-up. Furthermore, children in the prevention group scored lower on impulsivity and higher on paternal involvement and friend support compared to the control group after participating in the training program. This study provides preliminary evidence that child focused training delivered in the school setting can provide lasting benefits by preventing the development of CU traits, impulsivity, and CD. The program was also successful in improving the child’s social relationships with peers and parents. These findings emphasize the importance of school based prevention efforts.     

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 and Autonomic Functioning in Toddlerhood Interact to Predict Externalizing Behaviors in Preschool

Callous-unemotional (CU) traits are one meaningful risk factor which helps to explain heterogeneity in the emergence of externalizing behavior problems. While the extant literature demonstrates links between early CU traits and later externalizing problems, there is a dearth of research examining for whom early CU traits confer risk. Data from a longitudinal study (n?= 108) were used to examine the extent to which parasympathetic functioning moderated links between CU traits in toddlerhood (m _age ?=?24.99 months) and externalizing behavior problems at preschool-age (m _age ?=?51 months). Neither CU traits nor parasympathetic functioning at age 2 directly predicted later externalizing behaviors. However, results show that high levels of CU traits predict elevated externalizing behavior problems, but only for toddlers exhibiting either high baseline respiratory sinus arrhythmia (RSA) or little to no RSA suppression in response to a fear stimulus.     

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.     

Cognitive profile of adolescents with math disabilities: are the profiles different from those with reading disabilities?

Adolescents (ages 14-17) with math disabilities (MD, n=12), reading disabilities (RD, n=19), math+reading disabilities (MD+RD, n=12), and average achievers (n=15) were compared on measures of visual-spatial processing, random generation (inhibition), writing speed, short-term memory (STM), and working memory (WM). Adolescents with MD performed significantly lower than adolescents with RD on measures of visual-spatial processing and visual WM. Adolescents with MD outperformed adolescents with RD +MD on measures of random generation and motor speed. Performance of all three low-achieving groups was inferior to average achievers on measures of random generation, motor speed, and verbal WM. The results were interpreted within a multicomponent model that attributed deficits related to MD in adolescents to deficits related the visual-spatial sketchpad of WM.     

Parenting Behavior and Conduct Problems in Children with and Without Attention-Deficit/Hyperactivity Disorder (ADHD): Moderation by Callous-Unemotional Traits

There is evidence that negative parenting positively predicts oppositional defiant disorder (ODD) and conduct disorder (CD) and that children’s callous-unemotional (CU) traits may moderate this association. However, it is largely unknown if CU traits show similar interactive effects with positive parenting for ODD/CD. 208 ethnically diverse (56% Caucasian) 6–9 year-old children with and without attention-deficit/hyperactivity disorder (ADHD) were ascertained using multiple methods and informants for ODD, CD, and CU traits. CU traits, corporal punishment, positive parenting, and each of their interactions with CU traits were unrelated to parent- and teacher-rated ODD. Corporal punishment and CU traits were similarly unrelated to parent- and teacher-rated CD. However, positive parenting inversely predicted parent-reported CD symptoms and it was significantly moderated by CU traits. Positive parenting was negatively associated with CD at low to moderate levels of CU traits, but it was unrelated to CD at high levels of CU traits. Children with elevated levels of CU traits exhibited significantly higher levels of CD symptoms that were largely independent of positive parenting behavior. We discuss these findings within a developmental psychopathology framework to provide further perspectives on reciprocal influences between parenting behavior and CU traits in the development of ODD and CD.     

Low Maternal Warmth Mediates the Relationship Between Emotional Neglect and Callous-Unemotional Traits Among Male Juvenile Offenders

Callous-unemotional traits (CU) are thought to be the developmental precursor to adult psychopathy, and identify antisocial youth at risk for persistent, aggressive conduct problems. Accumulating research supports the importance of parenting factors in the development of CU traits. The overlapping but distinct constructs, parental neglect and low warmth, are both associated with CU/psychopathic traits; however, research is yet to examine the relative contribution of these constructs. The purpose of the present study was to examine the unique contributions of parental neglect and low warmth to CU traits among 227 incarcerated male juvenile offenders (M?=?15.73, SD?=?1.27 years). Results indicated that low levels of maternal warmth were more strongly associated with CU traits than emotional and physical neglect. Maternal warmth also significantly mediated the association between emotional neglect and CU traits. Findings from this cross-sectional study suggest that parental neglect influences CU traits at least partly through experiences with unresponsive and emotionally “cold” parenting. The findings also support a movement within the field towards addressing parental warmth as a treatment target for antisocial youth with CU traits.     

Verbal, Facial and Autonomic Responses to Empathy-Eliciting Film Clips by Disruptive Male Adolescents with High Versus Low Callous-Unemotional Traits

This study examined empathy-related responding in male adolescents with disruptive behavior disorder (DBD), high or low on callous-unemotional (CU) traits. Facial electromyographic (EMG) and heart rate (HR) responses were monitored during exposure to empathy-inducing film clips portraying sadness, anger or happiness. Self-reports were assessed afterward. In agreement with expectations, DBD adolescents with high CU traits showed significantly lower levels of empathic sadness than healthy controls across all response systems. Between DBD subgroups significant differences emerged at the level of autonomic (not verbal or facial) reactions to sadness, with high CU respondents showing less HR change from baseline than low CU respondents. The study also examined basal patterns of autonomic function. Resting HR was not different between groups, but resting respiratory sinus arrhythmia (RSA) was significantly lower in DBD adolescents with high CU traits compared to controls. Results support the notion that CU traits designate a distinct subgroup of DBD individuals.     

Predicting Risky Sexual Behavior: the Unique and Interactive Roles of Childhood Conduct Disorder Symptoms and Callous-Unemotional Traits

Conduct disorder (CD) symptoms and callous-unemotional (CU) traits have been shown to be uniquely associated with risky sexual behavior (RSB) in adolescence and early adulthood, yet their interactive role in predicting RSB remains largely unknown. This study aimed to investigate the predictive value of CD symptoms and CU traits, as well as their interaction, on several RSB outcomes in adolescence and early adulthood. A total of 683 participants (41.7 % female, 47.4 % African American) were followed annually and self-reported age of first sexual intercourse, frequency of condom use, pregnancy, contraction of sexually transmitted infections, and engagement in sexual solicitation from grade 7 to 2-years post-high school. CD symptoms predicted age of first sexual intercourse, condom use, and sexual solicitation. CU traits predicted age of first sexual intercourse and pregnancy. Their interaction predicted a composite score of these RSBs such that CD symptoms positively predicted the composite score among those with high levels of CU traits but not among those with low levels of CU traits. The current findings provide information regarding the importance of both CD symptoms and CU traits in understanding adolescent and early adulthood RSB, as well as the benefits of examining multiple RSB outcomes during this developmental period. These findings have implications for the development and implementation of preventive efforts to target these risky behaviors among adolescents and young adults.     

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.     

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.     

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.     

Sex differences in the IQ-white matter microstructure relationship: A DTI study

Sex differences in the relationship between general intelligence and brain structure are a topic of increasing research interest. Early studies focused mainly on gray and white matter differences using voxel-based morphometry, while more recent studies investigated neural fiber tracts using diffusion tensor imaging (DTI) to analyze the white matter microstructure. In this study we used tract-based spatial statistics (TBSS) on DTI to test how intelligence is associated with brain diffusion indices and to see whether this relationship differs between men and women. 63 Men and women divided into groups of lower and higher intelligence were selected. Whole-brain DTI scans were analyzed using TBSS calculating maps of fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD). The results reveal that the white matter microstructure differs between individuals as a function of intelligence and sex. In men, higher intelligence was related to higher FA and lower RD in the corpus callosum. In women, in contrast, intelligence was not related to the white matter microstructure. The higher values of FA and lower values of RD suggest that intelligence is associated with higher myelination and/or a higher number of axons particularly in men. This microstructural difference in the corpus callosum may increase cognitive functioning by reducing inter-hemispheric transfer time and thus account for more efficient brain functioning in men.     

A Systematic Review and Meta-analysis of Neuroimaging in Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) Taking Attention-Deficit Hyperactivity Disorder (ADHD) Into Account

Oppositional defiant disorder (ODD) and conduct disorder (CD) are common behavioural disorders in childhood and adolescence and are associated with brain abnormalities. This systematic review and meta-analysis investigates structural (sMRI) and functional MRI (fMRI) findings in individuals with ODD/CD with and without attention-deficit hyperactivity disorder (ADHD). Online databases were searched for controlled studies, resulting in 12 sMRI and 17 fMRI studies. In line with current models on ODD/CD, studies were classified in hot and cool executive functioning (EF). Both the meta-analytic and narrative reviews showed evidence of smaller brain structures and lower brain activity in individuals with ODD/CD in mainly hot EF-related areas: bilateral amygdala, bilateral insula, right striatum, left medial/superior frontal gyrus, and left precuneus. Evidence was present in both structural and functional studies, and irrespective of the presence of ADHD comorbidity. There is strong evidence that abnormalities in the amygdala are specific for ODD/CD as compared to ADHD, and correlational studies further support the association between abnormalities in the amygdala and ODD/CD symptoms. Besides the left precuneus, there was no evidence for abnormalities in typical cool EF related structures, such as the cerebellum and dorsolateral prefrontal cortex. Resulting areas are associated with emotion-processing, error-monitoring, problem-solving and self-control; areas associated with neurocognitive and behavioural deficits implicated in ODD/CD. Our findings confirm the involvement of hot, and to a smaller extent cool, EF associated brain areas in ODD/CD, and support an integrated model for ODD/CD (e.g. Blair, Development and Psychopathology, 17(3), 865-891, 2005).