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Evidence of alterations in emotion processing in maltreated youth has been hypothesized to reflect latent vulnerability for psychopathology. However, previous studies have not systematically examined the influence of psychopathology on the results. Here, we examined emotion recognition and learning in youth who differed in terms of presence vs. absence of maltreatment and psychopathology and tested for potential sex effects. Maltreatment and psychopathology were assessed in 828 youth (514 females) aged 9–18 years using diagnostic interviews and self- and parent-report questionnaires. Emotion recognition was assessed via identification of morphed facial expressions of six universal emotions. For emotion learning, reward and punishment values were assigned to novel stimuli and participants had to learn to correctly respond/withhold response to stimuli to maximize points. A three-way interaction of maltreatment by psychopathology by emotion indicated that when psychopathology was low, maltreated youth were less accurate than non-maltreated youth for happy, fear and disgust. A three-way interaction of sex, maltreatment and emotion indicated that maltreated girls and boys were impaired for fear, but girls showed an impairment for happy, while boys for disgust. There were no effects of maltreatment, psychopathology, or sex on reward learning. However, a two-way interaction between sex and maltreatment showed that maltreated girls were worse at learning from punishment relative to non-maltreated girls, while maltreated boys were better than non-maltreated boys. The study provides the first clear evidence of latent-vulnerability in emotion recognition in maltreated youth and suggests that girls and boys might be characterized by distinct profiles of emotion recognition and learning following maltreatment.

BackgroundPrevious studies have reported brain structure abnormalities in conduct disorder (CD), but it is unclear whether these neuroanatomical alterations mediate the effects of familial (genetic and environmental) risk for CD. We investigated brain structure in adolescents with CD and their unaffected relatives (URs) to identify neuroanatomical markers of familial risk for CD.MethodsForty-one adolescents with CD, 24 URs of CD probands, and 38 healthy controls (aged 12–18), underwent structural magnetic resonance imaging. We performed surface-based morphometry analyses, testing for group differences in cortical volume, thickness, surface area, and folding. We also assessed the volume of key subcortical structures.ResultsThe CD and UR groups both displayed structural alterations (lower surface area and folding) in left inferior parietal cortex compared with controls. In contrast, CD participants showed lower insula and pars opercularis volume than controls, and lower surface area and folding in these regions than controls and URs. The URs showed greater folding in rostral anterior cingulate and inferior temporal cortex than controls and greater medial orbitofrontal folding than CD participants. The surface area and volume differences were not significant when controlling for attention-deficit/hyperactivity disorder comorbidity. There were no group differences in subcortical volumes.ConclusionsThese findings suggest that alterations in inferior parietal cortical structure partly mediate the effects of familial risk for CD. These structural changes merit investigation as candidate endophenotypes for CD. Neuroanatomical changes in medial orbitofrontal and anterior cingulate cortex differentiated between URs and the other groups, potentially reflecting neural mechanisms of resilience to CD.

Neighbourhood collective efficacy has been proposed as a protective factor against family violence and youth antisocial behaviour. However, little is known about its impact on parent and child behaviour in non-Western countries. Using data from two population-based prospective cohorts from South Korea, including primary school students aged 10–12 years (N = 2844) and secondary school students aged 15–17 years (N = 3449), we examined the interplay between collective efficacy, family violence, and youth antisocial behaviour, and whether effects vary by SES. In a first series of models, in both samples, higher levels of collective efficacy were associated with lower levels of family violence, whereas higher levels of family violence were associated with higher levels of youth antisocial behaviour. There was no direct effect of collective efficacy on youth antisocial behaviour; however, there was an indirect effect via family violence. Although these effects were more pronounced in low SES children, there was no evidence of moderation by SES. In a second series of models, in primary school students, collective efficacy was not associated with youth antisocial behaviour. However, there was a direct effect of collective efficacy on family violence, even after adjusting for youth antisocial behaviour. Again, there was no evidence of moderation by SES. In secondary school students, the pattern of results was less consistent, however, again, suggesting more pronounced effects of collective efficacy in low SES children. The findings suggest that collective efficacy may influence family violence more directly, whereas youth antisocial behaviour may be affected more indirectly through the family environment.

Among youths with conduct disorder, those with callous-unemotional traits are at increased risk for persistent antisocial behaviour. Although callous-unemotional traits have been found to be associated with white-matter brain abnormalities, previous diffusion imaging studies were conducted in small samples, preventing examination of potential sex by callous-unemotional traits interaction effects on white matter. Here, we used tract-based spatial statistics at a whole-brain level and within regions of interest to compare the white matter correlates of callous-unemotional traits in female vs. male youths with conduct disorder, in a sample (n = 124) recruited through a multi-site protocol. A sex-specific association between callous-unemotional traits and white matter was found in the left uncinate fasciculus, where callous-unemotional traits were positively associated with axial diffusivity in males, while an opposite pattern was found in females. These findings are in line with previous studies suggesting that the uncinate fasciculus is a key tract implicated in the development of psychopathy, but also add to recent evidence showing that sexual dimorphism needs to be taken into account when examining the structural correlates of mental disorders in general, and callous-unemotional traits in conduct disorder in particular.

Conduct Disorder (CD) is characterized by severe aggressive and antisocial behavior. The stress hormone system has frequently been investigated as a neurobiological correlate of CD, while other interacting neuroendocrine biomarkers of sex hormone or neuropeptide systems have rarely been studied, especially in females. We examined multiple basal neuroendocrine biomarkers in female and male adolescents with CD compared to healthy controls (HCs), and explored whether they mediate effects of environmental risk factors on CD. Within the FemNAT-CD study, salivary cortisol, alpha-amylase, testosterone, dehydroepiandrosterone-sulfate (DHEA-S), estradiol, progesterone, oxytocin, and arginine-vasopressin were measured under basal conditions in 166 pubertal adolescents with CD, and 194 sex-, age-, and puberty-matched HCs (60% females, 9–18 years). Further, environmental risk factors were assessed. Single hormone analyses showed higher DHEA-S, and lower estradiol and progesterone levels in both females and males with CD relative to HCs. When accounting for interactions between neuroendocrine systems, a male-specific sex hormone factor (testosterone/DHEA-S) predicted male CD, while estradiol and a stress-system factor (cortisol/alpha-amylase) interacting with oxytocin predicted female CD. Estradiol, progesterone, and oxytocin partly explained associations between early environmental risk and CD. Findings provide evidence for sex-specific associations between basal neuroendocrine measures and CD. Especially altered sex hormones (androgen increases in males, estrogen reductions in females) robustly related to CD, while basal stress-system measures did not. Early environmental risk factors for CD may act partly through their effects on the neuroendocrine system, especially in females. Limitations (e.g., basal neuroendocrine assessment, different sample sizes per sex, pubertal participants, exploratory mediation analyses) are discussed.

Childhood trauma is a proposed transdiagnostic risk factor for psychopathology, but epidemiological evidence from low-income and middle-income countries (LMICs) is scarce. We investigated associations between trauma and child psychiatric disorders in a birth cohort in Brazil.The 2004 Pelotas Birth Cohort is an ongoing, population-based, prospective birth cohort, including all hospital births occurring between Jan 1 and Dec 31, 2004, in the city of Pelotas, Brazil. When the children were aged 6 and 11 years, trained psychologists administered the Development and Well-Being Assessment clinical interview to caregivers to assess current child psychiatric disorders (anxiety disorders, mood disorders, ADHD and hyperactivity disorders, and conduct and oppositional disorders), and lifetime trauma exposure (ie, experiencing or witnessing life-threatening events) including interpersonal and non-interpersonal events. Analyses used multiple imputation and logistic regression models.Of 4263 live births, 4231 children were included in the study sample, and 4229 (2195 [51·9%] boys and 2034 [48·1%] girls; 2581 [61·7%] with White mothers and 1600 [38·3%] with Black or mixed race mothers) were included in the imputed analyses. 1154 (34·3%) of 3367 children with complete data at age 11 years had been exposed to trauma by that age. After adjusting for confounders, at age 6 years, trauma was associated with increased odds of anxiety disorders (adjusted odds ratio 1·79 [95% CI 1·33-2·42]) and any psychiatric disorder (1·59 [1·22-2·06]), and at age 11 years, with any psychiatric disorder (1·45 [1·17-1·79]) and all four specific diagnostic classes of anxiety disorders (1·47 [1·04-2·09]), mood disorders (1·66 [1·08-2·55]), ADHD and hyperactivity disorders (1·47 [1·01-2·13]), and conduct and oppositional disorders (1·76 [1·19-2·61]). Interpersonal trauma and non-interpersonal trauma were each associated with increased odds of multiple psychiatric disorders, even when adjusting for their co-occurrence.A considerable mental health burden associated with childhood trauma is already evident by middle childhood in this sample from Brazil. Evidence-based efforts to reduce the incidence of childhood trauma in Brazil and address its consequences are urgently needed.Children's Pastorate, WHO, National Support Program for Centres of Excellence, Brazilian National Research Council, Brazilian Ministry of Health, São Paulo Research Foundation, University of Bath, Wellcome Trust.For the Portuguese translation of the abstract see Supplementary Materials section.

This study investigated whether young adults with ASD (n = 29) had impairments in Cognitive Empathy (CE), Affective Empathy (AE) or Empathic Accuracy (EA; the ability to track changes in others’ thoughts and feelings) compared to typically-developing individuals (n = 31) using the Empathic Accuracy Task (EAT), which involves watching narrators recollecting emotionally-charged autobiographical events. Participants provided continuous ratings of the narrators’ emotional intensity (indexing EA), labelled the emotions displayed (CE) and reported whether they shared the depicted emotions (AE). The ASD group showed deficits in EA for anger but did not differ from typically-developing participants in CE or AE on the EAT. The ASD group also reported lower CE (Perspective Taking) and AE (Empathic Concern) on the Interpersonal Reactivity Index, a self-report questionnaire.

In high-income countries, links between harsh and abusive parenting and child conduct and emotional problems are well-documented. However, less is known about these relationships in low- and middle-income countries, where harsh parenting may be more widely accepted and higher rates of conduct or emotional problems may exist which could influence the strength of these associations. We sought to investigate these relationships in a large population-based, prospective longitudinal study from Brazil, which also allowed us to test for sex differences. Using data from the 2004 Pelotas Birth Cohort Study (N = 4231) at ages 6 and 11 years, we applied cross-lagged path analysis to examine the relationships between harsh parenting (Conflict Tactics Scale Parent–Child version), and child conduct and emotional problems (Strengths and Difficulties Questionnaire). We found reciprocal relationships between harsh parenting and child conduct problems, with harsh parenting at age 6 predicting child conduct problems at age 11, and vice versa, even after adjusting for initial levels of conduct problems and harsh parenting, respectively. For child emotional problems, only unidirectional effects were found, with harsh parenting at age 6 predicting child emotional problems at age 11, after adjusting for initial levels of emotional problems, but not vice versa. No significant sex differences were observed in these relationships. These observations based on a middle-income country birth cohort highlight the potential universality of detrimental effects of harsh parenting on child conduct and emotional problems and affirm the importance of addressing parent- and child-effects in preventive and treatment interventions, especially those targeting conduct problems.

Funder: Kids Company, Adolescents with Conduct Disorder (CD) show deficits in recognizing facial expressions of emotion, but it is not known whether these difficulties extend to other social cues, such as emotional body postures. Moreover, in the absence of eye-tracking data, it is not known whether such deficits, if present, are due to a failure to attend to emotionally informative regions of the body. Male and female adolescents with CD and varying levels of callous-unemotional (CU) traits (n = 45) and age- and sex-matched typically-developing controls (n = 51) categorized static and dynamic emotional body postures. The emotion categorization task was paired with eye-tracking methods to investigate relationships between fixation behavior and recognition performance. Having CD was associated with impaired recognition of static and dynamic body postures and atypical fixation behavior. Furthermore, males were less likely to fixate emotionally-informative regions of the body than females. While we found no effects of CU traits on body posture recognition, the effects of CU traits on fixation behavior varied according to CD status and sex, with CD males with lower levels of CU traits showing the most atypical fixation behavior. Critically, atypical fixation behavior did not explain the body posture recognition deficits observed in CD. Our findings suggest that CD-related impairments in recognition of body postures of emotion are not due to attentional issues. Training programmes designed to ameliorate the emotion recognition difficulties associated with CD may need to incorporate a body posture component.

Objective: Conduct disorder (CD) involves aggressive and antisocial behavior and is associated with blunted cortisol stress response in male youths. Far less is known about cortisol stress responsivity in female youths with CD or other neuroendocrine responses in both sexes. Although CD is linked to early adversity, the possibility that neuroendocrine alterations may mediate the relationship between early adversity and CD has not been systematically investigated. Method: Within the European FemNAT-CD multi-site study, salivary cortisol, testosterone, the testosterone/cortisol ratio, oxytocin, and psychological stress response to a standardized psychosocial stress test (the Trier Social Stress Test [TSST]), together with common pre- and postnatal environmental risk factors, were investigated in 130 pubertal youths with CD (63% female, 9-18 years of age) and 160 sex-, age-, and puberty-matched healthy controls (HCs). Results: The TSST induced psychological stress in both CD and HCs. In contrast, female and male youths with CD showed blunted cortisol, testosterone, oxytocin, and testosterone/cortisol stress responses compared to HCs. These blunted stress responses partly mediated the relationship between environmental risk factors and CD. Conclusion: Findings from this unique sample, including many female youths with CD, provide evidence for a widespread attenuated stress responsivity of not only stress hormones, but also sex hormones and neuropeptides in CD and its subgroups (eg, with limited prosocial emotions). Results are the first to demonstrate blunted neuroendocrine stress responses in both female and male youths with CD. Early adversity may alter neuroendocrine stress responsivity. Biological mechanisms should be investigated further to pave the way for personalized intervention, thereby improving treatments for CD.

Attention-Deficit/Hyperactivity Disorder (ADHD) is increasingly viewed as a disorder of brain connectivity. We review connectivity-based theories of ADHD including the default mode network (DMN) interference and multiple network hypotheses. We outline the main approaches used to study brain connectivity in ADHD: diffusion tensor imaging and resting-state functional connectivity. We discuss the basic principles underlying these methods and the main analytical approaches used and consider what the findings have told us about connectivity alterations in ADHD. The most replicable finding in the diffusion tensor imaging literature on ADHD is lower fractional anisotropy in the corpus callosum, a key commissural tract which connects the brain's hemispheres. Meta-analyses of resting-state functional connectivity studies have failed to identify spatial convergence across studies, with the exception of meta-analyses focused on specific networks which have reported within-network connectivity alterations in the DMN and between the DMN and the fronto-parietal control and salience networks. Overall, methodological heterogeneity between studies and differences in sample characteristics are major barriers to progress in this area. In addition, females, adults and medication-naïve/unmedicated individuals are under-represented in connectivity studies, comorbidity needs to be assessed more systematically, and longitudinal research is needed to investigate whether ADHD is characterized by maturational delays in connectivity.

Theoretical and empirical accounts suggest that adolescence is associated with heightened reward learning and impulsivity. Experimental tasks and computational models that can dissociate reward learning from the tendency to initiate actions impulsively (action initiation bias) are thus critical to characterise the mechanisms that drive developmental differences. However, existing work has rarely quantified both learning ability and action initiation, or it has tested small samples. Here, using computational modelling of a learning task collected from a large sample (N=742, 9-18 years, 11 countries), we tested differences in reward and punishment learning and action initiation from childhood to adolescence. Computational modelling revealed that whilst punishment learning rates increased with age, reward learning remained stable. In parallel, action initiation biases decreased with age. Results were similar when considering pubertal stage instead of chronological age. We conclude that heightened reward responsivity in adolescence can reflect differences in action initiation rather than enhanced reward learning.

Early childhood neglect can impact brain development across the lifespan. Using voxel-based approaches we recently reported that severe and time-limited institutional deprivation in early childhood was linked to substantial reductions in total brain volume in adulthood,20 years later. Here, we extend this analysis to explore deprivation-related regional white matter volume and microstructural organization using diffusion-based techniques. A combination of tensor-based morphometry (TBM) analysis and tractography was conducted on diffusion-weighted imaging (DWI) data from 59 young adults who spent between 3 and 41 months in the severely depriving Romanian institutions of the 1980s before being adopted into United Kingdom families, and 20 nondeprived age-matched United Kingdom controls. Independent of total volume, institutional deprivation was associated with smaller volumes in localized regions across a range of white matter tracts including (1) long-ranging association fibers such as bilateral inferior longitudinal fasciculus (ILF), bilateral inferior fronto-occipital fasciculus (IFOF), left superior longitudinal fasciculi (SLFs), and left arcuate fasciculus; (2) tracts of the limbic circuitry including fornix and cingulum; and (3) projection fibers with the corticospinal tract particularly affected. Tractographic analysis found no evidence of altered microstructural organization of any tract in terms of hindrance modulated orientational anisotropy (HMOA), fractional anisotropy (FA), or mean diffusivity (MD). We provide further evidence for the effects of early neglect on brain development and their persistence in adulthood despite many years of environmental enrichment associated with successful adoption. Localized white matter effects appear limited to volumetric changes with microstructural organization unaffected.

Funder: Economic and Social Research Council; doi: http://dx.doi.org/10.13039/501100000269, Research on empathy in youth with Conduct Disorder (CD) has primarily focused on males, with the few studies that have investigated empathy in females relying on questionnaire measures. Our primary aim was to investigate whether females with CD show empathy deficits when using a more ecologically-valid task. We used an empathic accuracy (EA) paradigm that involved watching videos of actors recalling emotional experiences and providing continuous ratings of emotional intensity (assessing EA), naming the emotion expressed (emotion recognition), and reporting whether they shared the emotion expressed (affective empathy). We compared 23 females with CD and 29 typically-developing (TD) adolescents aged 13–18 years. The CD sample was divided into subgroups with higher (CD/CU+) versus lower (CD/CU−) levels of callous-unemotional traits. Females with CD did not differ from TD females in EA or emotion recognition but exhibited reduced affective empathy responses (ps < 0.01, rs ≥ 0.39). The CD/CU+ and CD/CU− subgroups did not differ on any empathy measure. We also assessed for sex differences in CD-empathy associations by comparing the present data with archive data from males. CD adolescents exhibited impairments in EA relative to their TD counterparts overall (p < 0.05, ηp2 = 0.06), but there was no sex-by-diagnosis interaction. While females with CD were only impaired in affective empathy, males with CD exhibited emotion recognition and affective empathy deficits. This study demonstrates that females with CD show relatively specific impairments in affective empathy on an ecologically-valid task, whereas males with CD display more global empathic difficulties.

Background: Attention-deficit/hyperactivity disorder (ADHD) has been associated with reduced resting state connectivity in the core subsystem of the default mode network (DMN; medial prefrontal cortex – posterior cingulate cortex). However, the neuropsychological consequences of this hypoconnectivity remain to be determined. Building on recent theoretical models of DMN function, we tested the association between DMN hypo-connectivity and three neuropsychological processes previously implicated in ADHD: (i) excessive task-unrelated spontaneous thought (i.e., mind-wandering); (ii) sub-optimal decision-making due to exaggerated temporal discounting; and (iii) delay aversion – a heightened emotional response to the imposition or experience of delay. Methods: Twenty male adolescents with a clinical diagnosis of ADHD and 18 typically developing adolescents (all aged 11–16 years) underwent a resting-state fMRI scan to assess DMN connectivity. An experimental paradigm was used to assess temporal discounting and self-report questionnaires were used to measure mind wandering and delay aversion. Results: ADHD was significantly associated with DMN hypo-connectivity specifically in the core subsystem, elevated levels of mind-wandering, delay aversion, and temporal discounting. Mediation analysis suggested that DMN hypoconnectivity mediated the link between ADHD and delay aversion. Conclusion: The results provide initial evidence that disturbances in the DMN may impair ability to regulate delay-related negative affect in adolescents with ADHD.

Neighbourhood collective efficacy has been proposed as a protective factor against family violence and youth antisocial behaviour. However, little is known about its impact on parent and child behaviour in non-Western countries. Using data from two population-based prospective cohorts from South Korea, including primary school students aged 10-12 years (N = 2844) and secondary school students aged 15-17 years (N = 3449), we examined the interplay between collective efficacy, family violence, and youth antisocial behaviour, and whether effects vary by SES. In a first series of models, in both samples, higher levels of collective efficacy were associated with lower levels of family violence, whereas higher levels of family violence were associated with higher levels of youth antisocial behaviour. There was no direct effect of collective efficacy on youth antisocial behaviour; however, there was an indirect effect via family violence. Although these effects were more pronounced in low SES children, there was no evidence of moderation by SES. In a second series of models, in primary school students, collective efficacy was not associated with youth antisocial behaviour. However, there was a direct effect of collective efficacy on family violence, even after adjusting for youth antisocial behaviour. Again, there was no evidence of moderation by SES. In secondary school students, the pattern of results was less consistent, however, again, suggesting more pronounced effects of collective efficacy in low SES children. The findings suggest that collective efficacy may influence family violence more directly, whereas youth antisocial behaviour may be affected more indirectly through the family environment.

Less is known about the relationship between conduct disorder (CD), callous–unemotional (CU) traits, and positive and negative parenting in youth compared to early childhood. We combined traditional univariate analyses with a novel machine learning classifier (Angle-based Generalized Matrix Learning Vector Quantization) to classify youth (N = 756; 9–18 years) into typically developing (TD) or CD groups with or without elevated CU traits (CD/HCU, CD/LCU, respectively) using youth- and parent-reports of parenting behavior. At the group level, both CD/HCU and CD/LCU were associated with high negative and low positive parenting relative to TD. However, only positive parenting differed between the CD/HCU and CD/LCU groups. In classification analyses, performance was best when distinguishing CD/HCU from TD groups and poorest when distinguishing CD/HCU from CD/LCU groups. Positive and negative parenting were both relevant when distinguishing CD/HCU from TD, negative parenting was most relevant when distinguishing between CD/LCU and TD, and positive parenting was most relevant when distinguishing CD/HCU from CD/LCU groups. These findings suggest that while positive parenting distinguishes between CD/HCU and CD/LCU, negative parenting is associated with both CD subtypes. These results highlight the importance of considering multiple parenting behaviors in CD with varying levels of CU traits in late childhood/adolescence.

Among youths with conduct disorder, those with callous-unemotional traits are at increased risk for persistent antisocial behaviour. Although callous-unemotional traits have been found to be associated with white-matter brain abnormalities, previous diffusion imaging studies were conducted in small samples, preventing examination of potential sex by callous-unemotional traits interaction effects on white matter. Here, we used tract-based spatial statistics at a whole-brain level and within regions of interest to compare the white matter correlates of callous-unemotional traits in female vs. male youths with conduct disorder, in a sample (n = 124) recruited through a multi-site protocol. A sex-specific association between callous-unemotional traits and white matter was found in the left uncinate fasciculus, where callous-unemotional traits were positively associated with axial diffusivity in males, while an opposite pattern was found in females. These findings are in line with previous studies suggesting that the uncinate fasciculus is a key tract implicated in the development of psychopathy, but also add to recent evidence showing that sexual dimorphism needs to be taken into account when examining the structural correlates of mental disorders in general, and callous-unemotional traits in conduct disorder in particular.

Theory of mind (ToM), or the ability to infer and predict the intentions, thoughts and beliefs of others, involves cognitive perspective taking (cognitive ToM/cToM) and understanding emotions (affective ToM/aToM). While behavioral evidence indicates that ToM is influenced by sex and age, no study has examined the influence of these variables on the neural correlates of cToM and aToM in late childhood/adolescence. Using fMRI with 35 typically-developing youths (aged 9–18 years, 12 males), we investigated the influence of sex and age on the neural correlates of cToM and aToM. We also examined how callous-unemotional traits, indexing a lack of empathy, were related to brain responses during aToM. Across both conditions, we found convergent activity in ToM network regions, such as superior temporal sulcus/temporoparietal junction (TPJ) and precuneus across males and females, but males recruited the left TPJ significantly more than females during cToM. During aToM, age was negatively correlated with brain responses in frontal, temporal and posterior midline regions, while callous-unemotional traits were positively correlated with right anterior insula responses. These results provide the first evidence in youth that sex influences the neural correlates of cToM, while age and callous-unemotional traits are specifically related to brain responses during aToM.

As most research on conduct disorder (CD) has been conducted on male participants, it has been suggested that female-specific symptoms may be underestimated based on current DSM-5 criteria. In particular, relational aggression, i.e. the hurtful, often indirect, manipulation of relationships with the intention of damaging the other's social position, has been proposed as a characteristic of CD that is more common in females. In addition, sex-specific studies on correlates of relational aggressive behavior are lacking. Relational aggression may be strongly related to the correlates of proactive aggression, namely low affective empathy, and high levels of callous-unemotional (CU) traits and relational victimization. Thus, the present study investigated sex differences in relational aggression, and associations between relational aggression and correlates of proactive aggression in 662 adolescents with CD (403 females) and 849 typically-developing controls (568 females) aged 9-18 years (M = 14.74, SD = 2.34) from the European multi-site FemNAT-CD study. Females with CD showed significantly higher levels of relational aggression compared to males with CD, whereas no sex differences were seen in controls. Relational aggression was only partly related to correlates of proactive aggression in CD: Independent of sex, CU traits showed a positive association with relational aggression. In females only, cognitive, but not affective empathy, was negatively associated with relational aggression. Relational victimization was more strongly associated with relational aggression in males compared to females. Despite interesting sex specific correlates of relational aggression, effects are small and the potential clinical implications should be investigated in future studies.

The journal of child psychology and psychiatry 63(2), 218-228 (2022). doi:10.1111/jcpp.13428, Published by Wiley-Blackwell, Oxford

Oppositional defiant disorder (ODD) and conduct disorder (CD) are together considered as the disruptive behaviour disorders. Children with ODD and CD struggle to respect authority and behave in ways that go against societal rules in ways that disrespect or harm others. These behaviours significantly disrupt family life, schooling and friendships and place these children and young people at high risk of developing later mental health and substance abuse diagnoses. These disorders often lead children and families to present to multiple professional groups and require long-term interventions. Due to the complexity of the aetiology and presentation of ODD and CD these diagnoses should be part of a comprehensive assessment and formulation. This chapter aims to describe the classification and diagnosis of ODD and CD. The prevalence and aetiology of the disorders are presented together with issues of assessment and diagnosis. A brief description of treatment and intervention options is provided.

Introduction: The development of rapid and reliable neural measures of memory is an important goal of cognitive neuroscience research and clinical practice. Fast Periodic Visual Stimulation (FPVS) is a recently developed electroencephalography (EEG) method that involves presenting a mix of novel and previously-learnt stimuli at a fast rate. Recent work has shown that implicit recognition memory can be measured using FPVS, however the role of repetition priming remains unclear. Here, we attempted to separate out the effects of recognition memory and repetition priming by manipulating the degree of repetition of the stimuli to be remembered.Method: Twenty-two participants with a mean age of 20.8 (±4.3) yrs completed an FPVS-oddball paradigm with a varying number of repetitions of the oddball stimuli, ranging from repetition only (pure repetition) to no repetition (pure recognition). In addition to the EEG task, participants completed a behavioural recognition task and visual memory subtests from the Wechsler Memory Scale – 4th edition (WMS-IV). Results: An oddball memory response was observed in all four experimental conditions (pure repetition to pure recognition) compared to the control condition (no oddball stimuli). The oddball memory response was largest in the pure repetition condition and smaller, but still significant, in conditions with less/no oddball repetition (e.g. pure recognition). Behavioural recognition performance was at ceiling, suggesting that all images were encoded successfully. There was no correlation with either behavioural memory performance or WMS-IV scores, suggesting the FPVS-oddball paradigm captures different memory processes than behavioural measures.Conclusion: Repetition priming significantly modulates the FPVS recognition memory response, however recognition is still detectable even in the total absence of repetition priming. The FPVS-oddball paradigm could potentially be developed into an objective and easy-to-administer memory assessment tool.

Journal of the American Heart Association 10(4), e017405 (2021). doi:10.1161/JAHA.120.017405, Published by American Heart Association, New York, NY

Translational Psychiatry 11(1), 492 (2021). doi:10.1038/s41398-021-01609-y, Published by Nature Publishing Group, London

Conduct disorder (CD) with high levels of callous-unemotional traits (CD/HCU) has been theoretically linked to specific difficulties with fear and sadness recognition, in contrast to CD with low levels of callous-unemotional traits (CD/LCU). However, experimental evidence for this distinction is mixed, and it is unclear whether these difficulties are a reliable marker of CD/HCU compared to CD/LCU. In a large sample (N = 1263, 9–18 years), we combined univariate analyses and machine learning classifiers to investigate whether CD/HCU is associated with disproportionate difficulties with fear and sadness recognition over other emotions, and whether such difficulties are a reliable individual-level marker of CD/HCU. We observed similar emotion recognition abilities in CD/HCU and CD/LCU. The CD/HCU group underperformed relative to typically developing (TD) youths, but difficulties were not specific to fear or sadness. Classifiers did not distinguish between youths with CD/HCU versus CD/LCU (52% accuracy), although youths with CD/HCU and CD/LCU were reliably distinguished from TD youths (64% and 60%, respectively). In the subset of classifiers that performed well for youths with CD/HCU, fear and sadness were the most relevant emotions for distinguishing them from youths with CD/LCU and TD youths, respectively. We conclude that non-specific emotion recognition difficulties are common in CD/HCU, but are not reliable individual-level markers of CD/HCU versus CD/LCU. These findings highlight that a reduced ability to recognise facial expressions of distress should not be assumed to be a core feature of CD/HCU.

Background: At the group level, youths with conduct disorder (CD) show deficient emotion processing across various tasks compared to typically developing controls (TDC). But little is known about neuropsychological subgroups within the CD population, the clinical correlates of emotion processing deficits [for instance, with regard to the presence or absence of the DSM-5 Limited Prosocial Emotions (LPE) specifier], and associated risk factors.Methods: 542 children and adolescents with CD (317 girls) and 710 TDCs (479 girls), aged 9–18 years, were included from the FemNAT-CD multisite study. All participants completed three neuropsychological tasks assessing emotion recognition, emotion learning, and emotion regulation. We used a self-report measure of callous-unemotional traits to create a proxy for the LPE specifier.Results: Relative to TDCs, youths with CD as a group performed worse in all three emotion domains. But using clinically based cut-off scores, we found poor emotion recognition skills in only 23% of the participants with CD, followed by emotion regulation deficits in 18%, and emotion learning deficits in 13% of the CD group. Critically, the majority of youths with CD (~56%) did not demonstrate any meaningful neuropsychological deficit, and only a very small proportion showed pervasive deficits across all three domains (~1%). Further analyses indicate that established DSM-5 subtypes of CD are not tightly linked to neurocognitive deficits in one particular emotion domain over another (i.e., emotion recognition deficits in CD+LPE vs. emotion regulation deficits in CD–LPE).Conclusions: Findings from this large-scale data set suggest substantial neuropsychological diversity in emotion processing in the CD population and, consequently, only a subgroup of youths with CD are likely to benefit from additional behavioral interventions specifically targeting emotion processing mechanisms.