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The Cognitive, Affective and Somatic Empathy Scales (CASES) assess three forms of empathy, each with subscales for positive and negative empathy. The present study extends this child instrument to adults and examines its factor structure and construct validity. A secondary aim is to investigate the under-researched area of positive empathy. Community samples totaling 2604 adults completed the CASES for adults, together with scales assessing construct validity. Confirmatory factor analysis supported the three-factor cognitive-affective-somatic model and a two-factor positive-negative empathy model. Findings were replicated in a second independent sample. Internal reliabilities ranged from 0.80 to 0.92. Individuals with higher psychopathy and stimulation-seeking scores were less impaired in their empathic reactions to positive relative to negative valence events, suggesting that they are relatively capable of responding emotionally to rewarding events. Somatic empathy was most strongly associated with pleasure in affective touch and with female > male gender differences in empathy. While proactive aggression was associated with reduced cognitive and affective empathy, reactive aggression was associated with increased empathy. Findings provide initial support for the utility of CASES for assessing different forms of empathy and suggest that the balance between positive and negative empathy could provide new insights into psychological traits.

Key Points Question Are there associations among attention-deficit/hyperactivity disorder (ADHD) pharmacotherapy, externalizing symptoms, and childhood suicidality (ie, ideation or attempts)? Findings In this cohort study of 11 878 children aged 9 to 10 years at baseline, externalizing symptoms showed expected associations with suicidality. ADHD pharmacotherapy was associated with less suicidality in children with externalizing symptoms, specifically among those with substantial symptoms burden, both at the baseline and 1-year follow-up assessment. Meaning These findings suggest that in children with substantial externalizing symptoms, ADHD medication use may be associated with less suicidality, in addition to its known clinical benefits in treating externalizing symptoms., This cohort study investigates the associations of attention-deficit/hyperactivity disorder (ADHD) medication with externalizing symptoms and childhood suicidality., Importance Childhood suicidality (ie, suicidal ideation or attempts) rates are increasing, and attention-deficit/hyperactivity disorder (ADHD) and externalizing symptoms are common risk factors associated with suicidality. More data are needed to describe associations of ADHD pharmacotherapy with childhood suicidality. Objective To investigate the associations of ADHD pharmacotherapy with externalizing symptoms and childhood suicidality. Design, Setting, and Participants In this cohort study, cross-sectional and 1-year-longitudinal associations were examined using data (collected during 2016-2019) from the Adolescent Brain Cognitive Development (ABCD) Study, a large, diverse US sample of children aged 9 to 11 years. Data analysis was performed from November to December 2020. Exposures Main and interaction associations of externalizing symptoms (hyperactivity ADHD symptoms, oppositional defiant, and conduct disorder symptoms) and ADHD medication treatment (methylphenidate and amphetamine derivatives, α-2-agonists, and atomoxetine) at baseline assessment. Main Outcomes and Measures Child-reported suicidality (past and present at baseline; current at longitudinal assessment). Covariates were age, sex, race/ethnicity, parents’ education, marital status, and concomitant child psychiatric pharmacotherapy (antidepressants and antipsychotics). Results Among 11 878 children at baseline assessment (mean [SD] age, 9.9 [0.6] years; 6196 boys [52.2%]; 8805 White [74.1%]), 1006 (8.5%) were treated with ADHD medication and 1040 (8.8%) reported past or current suicidality. Externalizing symptoms (median [range], 1 [0-29] symptom count) were associated with suicidality (for a change of 1 SD in symptoms, odds ratio [OR], 1.34; 95% CI, 1.26-1.42; P

The COVID-19 pandemic has dramatically altered family life, but whether family exposures to and worries about the COVID-19 pandemic has impacted child conduct problems (CP) and callous-unemotional (CU) traits is unknown. Thus, we evaluated 303 parents (Mage = 38.04; SD = 5.21; 92.4% biological mothers) and children (Mage = 6.43; SD = 2.13; 51.8% female) during a four-month period early in the pandemic. We examined associations between parental exposures to COVID-19, parental worries about the pandemic, harsh and warm parenting practices, and child CP and CU traits. Although more parental worries were not directly related to parenting practices, more worry about COVID-19 was specifically related to higher levels of child CP, particularly parental worries about themselves or family members contracting the virus. Our findings add to a growing literature demonstrating the burden that the pandemic has placed on families and its implications for children’s mental health. Supplementary Information The online version of this article (10.1007/s10578-020-01109-y) contains supplementary material, which is available to authorized users.

Callous-unemotional (CU) traits have been associated with atypical responses to reward and punishment cues, with evidence suggesting that such traits may shape caregiver use of reward and punishment practices over time. To date, research has predominantly focused on parental rewards and discipline, with far less attention paid to teacher behavior management strategies. The first aim of the current study was to investigate the potential moderating effect of CU traits on the relationship between teacher classroom management strategies (rewards and discipline) and two important school-related outcomes: student engagement and academic motivation. The second aim was to examine whether CU traits were related to teachers’ use of discipline and reward strategies over time. Children attending South Korean primary schools (N = 218; aged 10–12 years; 52% boys) reported on CU traits, antisocial behavior, teacher classroom management strategies, school engagement and academic motivation at two time points (the beginning and end of a single academic year). First, harsh teacher discipline predicted lower school engagement, but only for children low in CU traits. Second, cross-lagged longitudinal models showed that CU traits predicted decreased use of teacher rewards, over and above associations with antisocial behavior. CU traits were not related to harsh discipline cross-sectionally or longitudinally in models that accounted for antisocial behavior. Findings show that CU traits are related to reduced sensitivity to teacher discipline, suggesting that teachers may need additional support to implement both discipline and reward-based strategies with children high in these traits. Electronic supplementary material The online version of this article (10.1007/s10802-020-00663-2) contains supplementary material, which is available to authorized users.

The COVID-19 pandemic has disproportionately impacted the well-being of vulnerable populations in the US, including Black people. The impact on pregnant women is of special concern for the intrauterine and post-natal development of their offspring. We evaluated in an online survey a sample of 913 pregnant women, 216 Black, 571 White, 126 Other, during a 2-week stay-at-home mandate in the Philadelphia region. We applied logistic regression models and analysis of covariance to examine general and pregnancy-specific worries and negative consequences arising from the COVID-19 pandemic, symptoms of anxiety and depression, and resilience. Black pregnant women reported greater likelihood of having their employment negatively impacted, more concerns about a lasting economic burden, and more worries about their prenatal care, birth experience, and post-natal needs. In the full sample, 11.1% of women met screening criteria for anxiety and 9.9% met criteria for depression. Black women were more likely to meet criteria for depression than White women, but this difference was not significant accounting for covariates. Resilience factors including self-reliance and emotion regulation were higher in Black women. Racial disparities related to COVID-19 in pregnant women can advance the understanding of pregnancy related stressors and improve early identification of mental health needs.

Objective Callous-unemotional (CU) traits in early childhood explain heterogeneity within conduct problems and are associated with higher risk for later diagnoses of childhood disruptive behavior disorders and antisocial behavior in adulthood. Emerging research implicates impairments in affiliative processes in the etiology of CU traits. The current study tests whether the imitation of intentional actions with no functional significance -a behavior that supports the acquisition of social conventions and affiliative bonds, is a specific developmental precursor to CU traits in early childhood. Methods Data came from a longitudinal twin study of 628 children (Age 2: 47% females; Age 3: 44.9% females) with observations of arbitrary (i.e., nonfunctional actions) and instrumental (i.e., functional actions) imitation and parent reports of CU traits and oppositional defiant (ODD) behaviors at ages 2 and 3. Results Lower arbitrary imitation at age 2, but not instrumental imitation, was related to increases in CU traits from ages 2 to 3 (β = -.10, p = .02). Conclusions These findings establish early social and affiliative processes in the etiology of CU traits, highlighting that novel personalized treatment and intervention strategies for CU traits may benefit from targeting these processes to help reduce CU traits and risk for persistent conduct problems in children.

Functional circuits of the human brain emerge and change dramatically over the second half of gestation. It is possible that variation in neural functional system connectivity in utero predicts individual differences in infant behavioral development, but this possibility has yet to be examined. The current study examines the association between fetal sensorimotor brain system functional connectivity and infant postnatal motor ability. Resting-state functional connectivity data was obtained in 96 healthy human fetuses during the second and third trimesters of pregnancy. Infant motor ability was measured 7 months after birth using the Bayley Scales of Infant Development. Increased connectivity between the emerging motor network and regions of the prefrontal cortex, temporal lobes, posterior cingulate, and supplementary motor regions was observed in infants that showed more mature motor functions. In addition, females demonstrated stronger fetal-brain to infant-behavior associations. These observations extend prior longitudinal research back into prenatal brain development and raise exciting new ideas about the advent of risk and the ontogeny of early sex differences.

Community violence exposure and harsh parenting have been linked to maladaptive outcomes, possibly via their effects on social cognition. The Social Information Processing (SIP) model has been used to study distinct socio-cognitive processes, demonstrating links between community violence exposure, harsh parenting, and maladaptive SIP. Though much of this research assumes these associations are causal, genetic confounds have made this assumption difficult to rigorously test. Comparisons of discordant monozygotic (MZ) twins provide one empirical test of possible causality, as differences between MZ twins must be environmental in origin. The present study examined effects of parenting and community violence exposure on SIP - specifically aggressive and avoidant social goals - in a sample of 426 MZ twin dyads (N = 852 twins, 48% female). Phenotypically, we found that lower positive parenting and greater harsh parenting were associated with greater endorsement of dominance and revenge goals. We also found that indirect and direct community violence exposure was associated with greater endorsement of avoidance goals. Using an MZ difference design, we found that the relationships between lower levels of positive parenting and endorsement of dominance and revenge goals were due, in part, to environmental processes. Moreover, the relationships between the impact of indirect and direct community violence exposure and avoidance goals, as well as between the impact of indirect community violence exposure and revenge goals, appeared to be due to non-shared environmental processes. Our results establish social and contextual experiences as important environmental influences on children’s social goals, which may increase risk for later psychopathology.

Antisocial behavior (AB), including violence, criminality, and substance abuse, is often linked to deficits in emotion processing, reward-related learning, and inhibitory control, as well as their associated neural networks. To better understand these deficits, the structural connections between brain regions implicated in AB can be examined using diffusion tensor imaging (DTI), which assesses white matter microstructure. Prior studies have identified differences in white matter microstructure of the uncinate fasciculus (UF), primarily within offender samples. However, few studies have looked beyond the UF or determined whether these relationships are present dimensionally across the range of AB and callous-unemotional (CU) traits. In the current study, we examined associations between AB and white matter microstructure from major fiber tracts, including the UF. Further, we explored whether these associations were specific to individuals high on CU traits. Within a relatively large community sample of young adult men from low-income, urban families (N = 178), we found no direct relations between dimensional, self-report measures of either AB or CU traits and white matter microstructure. However, we found significant associations between AB and white matter microstructure of several tracts only for those with high co-occurring levels of CU traits. In general, these associations did not differ according to race, socioeconomic status, or comorbid psychiatric symptoms. The current results suggest a unique neural profile of severe AB in combination with CU traits, characterized by widespread differences in white matter microstructure, which differs from either AB or CU traits in isolation and is not specific to hypothesized tracts (i.e., the UF). Keywords: Antisocial behavior, Callous-unemotional traits, Diffusion tensor imaging, Income, Race

The distinction between low-anxious primary versus high-anxious secondary psychopathy is well-established among incarcerated adults and adolescents. However, no studies have used a prospective longitudinal approach to explore whether primary versus secondary psychopathy variants have different rates of alcohol and marijuana use across adolescence, and what mechanisms account for these differences. The sample was 1,170 male adolescents who had interacted with the justice system, with data collected as part of the Pathways to Desistance project. We used interviewer assessments of psychopathy and self-reported anxiety at baseline to identify primary and secondary psychopathy subgroups. We explored subgroup differences via self-reported measures of psychopathic traits and anxiety, aggression, depression, and posttraumatic stress disorder symptoms at baseline and a 6-month follow-up. Finally, we tested whether groups had different trajectories of alcohol and marijuana use over 4 years, and whether poor impulse control or anxiety mediated these differences. Latent profile analysis identified four groups: low-anxious primary psychopathy, high-anxious secondary psychopathy, anxious only, and low risk. The secondary group had similar levels of aggression and psychopathy to the primary group, but more depression, anxiety, and posttraumatic stress symptoms. The primary and secondary psychopathy variants did not differ in rates of alcohol or marijuana use across adolescence, but alcohol use among secondary variants was specifically mediated via poor impulse control. The findings establish two psychopathy groups that differ meaningfully in their internalizing psychopathology and pathways to alcohol use. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Antisocial Behavior (AB) has a tremendous societal cost, motivating investigation of the mechanisms that cause individuals to engage and persist in AB. Recent theories of AB emphasize the role of reward-related neural processes in the etiology of severe and chronic forms of AB, including antisocial personality disorder and psychopathy. However, no systematic reviews have evaluated the hypothesis that reward-related neural dysfunction is an etiologic factor in AB in adult samples. Moreover, it is unclear whether AB is linked to a hyper- or hyposensitive reward system and whether AB is related to neural sensitivity to losses. Thus, the current systematic review examined whether AB (including antisocial personality disorder) and psychopathic traits are related to neural reactivity during reward processing, loss processing, or both. Our review identified seven task-based functional MRI or functional connectivity studies that examined associations between neural response to reward and loss, and dimensional and categorical measures of adult AB and/or psychopathy. Across studies, there was evidence that AB is associated with variability in neural functioning during both reward and loss processing. In particular, impulsive-antisocial traits appeared to be specifically associated with hypersensitivity in the ventral striatum during the anticipation, but not the receipt, of rewards. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Functional connectivity between the amygdala and the prefrontal cortex is critical for socioemotional processing, particularly during face processing. Though processing others' emotions is important for a myriad of complex social behaviors, more research is needed to understand how different types of emotional facial expressions differentially elicit connectivity of the amygdala with widespread neural regions. Moreover, though prior studies have reported cross-sectional associations between altered amygdala-prefrontal cortex functional connectivity and internalizing symptoms (e.g., depression, anxiety), few studies have examined whether amygdala functional connectivity is prospectively related to changes in these symptoms, with little work focusing on low-income men living in stressful contexts. The current study used psycho-physiological interaction analyses at the within-subjects level to examine how amygdala connectivity differed while participants viewed fearful, angry, and neutral faces. We used structural equation modeling at the between-subjects level, using extracted parameter estimates, to test whether amygdala connectivity during face processing predicted increases in internalizing psychopathology over time, controlling for earlier symptoms. An urban sample of 167 young men from low-income families was employed. Results indicated that negative connectivity between the amygdala and prefrontal regions was modulated by emotional face type. Neuronal activity in the cingulate and frontal cortices was connected to amygdala reactivity during fearful and neutral, but not angry, face processing. Moreover, weaker left amygdala-left middle frontal gyrus negative connectivity when viewing fearful faces and stronger right amygdala-left inferior frontal gyrus negative connectivity when viewing neutral faces at age 20 both predicted increases in internalizing behaviors from age 20 to age 22. Our findings show that amygdala-prefrontal cortex connectivity can predict the persistence of internalizing symptoms among high-risk participants over time but suggest that these patterns may differ depending on the emotional stimuli examined.

Callous-unemotional (CU) behavior has been linked to behavior problems in children and adolescents. However, few studies have examined whether CU behavior in early childhood predicts behavior problems or CU behavior in late childhood. This study examined whether indicators of CU behavior at ages 2-4 predicted aggression, rule-breaking, and CU behavior across informants at age 9.5. To test the unique predictive and convergent validity of CU behavior in early childhood, we accounted for stability in behavior problems and method effects to rule out the possibility that rater biases inflated the magnitude of any associations found. Cross-informant data were collected from a multiethnic, high-risk sample (N = 731; female = 49%) at ages 2-4 and again at age 9.5. From age 3, CU behavior uniquely predicted aggression and rule-breaking across informants. There were also unique associations between CU behavior assessed at ages 3 and 4 and CU behavior assessed at age 9.5. Findings demonstrate that early childhood indicators of CU behavior account for unique variance in later childhood behavior problems and CU behavior, taking into account stability in behavior problems over time and method effects. Convergence with a traditional measure of CU behavior in late childhood provides support for the construct validity of a brief early childhood measure of CU behavior. (PsycINFO Database Record

Coercion theory posits a cyclical relationship between harsh and coercive parent-child interactions and problem behavior beginning in early childhood. As coercive interactions have been theorized and found to facilitate the development and growth of early conduct problems, early interventions often target parenting to prevent or reduce early disruptive problem behavior. This study utilizes direct observations of parent-child interactions from the Early Steps Multisite study (N = 731; 369 boys) to examine the effect of the Family Check-Up, a family-centered intervention program, on measures of parent-child positive engagement and coercion from age 2 through 5, as well as on childhood problem behavior at age 5. Results indicate that high levels of parent-child positive engagement were associated with less parent-child coercion the following year, but dyadic coercion was unrelated to future levels of positive engagement. In addition, families assigned to the Family Check-Up showed increased levels of positive engagement at ages 3 and 5, and the association between positive engagement at age 3 and child problem behavior at age 5 was mediated by reductions in parent-child coercion at age 4. These findings provide longitudinal confirmation that increasing positive engagement in parent-child interaction can reduce the likelihood of coercive family dynamics in early childhood and growth in problem behavior.