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Developmental models of borderline personality disorder (BPD) emphasize the effects of youths' biological vulnerabilities and their experiences of parental responses to emotion, as well as the interaction between these two elements. The current study evaluated the independent and interactive effects of two indices of autonomic nervous system response and parental responses to youth negative emotions on severity and exacerbation of youths' BPD features during the transition to adolescence. The sample consisted of 162 psychiatric youth (10–14 years; 47.2% female) and their parents. At baseline, youth and their parents completed a lab-based conflict discussion during which parasympathetic and sympathetic nervous system response were measured and indices of sympathetic-parasympathetic balance and coactivation/coinhibition were calculated. Youth also reported on supportive and non-supportive parental responses. At baseline and after 9 months, youth self-reported on their BPD features. Results demonstrated that shifting toward sympathetic dominance independently predicted exacerbation of BPD across 9 months. Additionally, fewer experiences of supportive parental responses and more non-supportive parental responses were associated with greater severity of BPD features in youth. This study highlights the role of autonomic response to parent-child conflict as well as the significance of parental responses to youth emotion for the development of BPD during this developmental window. [ABSTRACT FROM AUTHOR]

Background: Aggression is a transdiagnostic indicator of risk and represents one of the most common reasons children are referred for mental health treatment. Theory and research highlight the impact of maternal invalidation on child aggression and suggest that its influence may vary based on differences in child physiological reactivity. Moreover, the interaction between these risk factors may be particularly pronounced among children of mothers with emotion regulation (ER) difficulties. The current study examined the independent and interactive effects of maternal invalidation and child physiological reactivity to frustration on teacher-reported aggression in an at-risk sample of preschool children. Method: Participants included 77 mothers (M age = 33.17 years, s.d. = 4.83; 35% racial/ethnic minority) and their children (M age = 42.48 months; s.d. = 3.78; 56% female; 47% racial/ethnic minority). Groups of mothers with and without clinician-rated ER difficulties reported on maternal invalidation, and child respiratory sinus arrhythmia (RSA) was assessed continuously during a frustration task as an indicator of physiological reactivity. Teachers or daycare providers reported on child aggression. Results: Results demonstrated positive associations between maternal ER difficulties and both maternal invalidation and child RSA reactivity to frustration. As expected, the interaction between maternal invalidation and child RSA reactivity was significant, such that higher maternal invalidation and greater child RSA reactivity to frustration predicted more aggression in a daycare or preschool setting. Importantly, this effect was demonstrated while controlling for demographic covariates and baseline RSA. Conclusions: Findings are in line with diathesis–stress and biosocial models of risk and point to multiple targets for prevention and early intervention. [ABSTRACT FROM AUTHOR]

Background: While associations between conduct disorder (CD), oppositional defiant disorder (ODD), attention deficit hyperactivity disorder (ADHD), and interpersonal callousness (IC) symptoms and delinquency onset are well established, less is known about whether these characteristics differentiate desisting and persisting delinquency. The current study examined whether childhood and adolescent CD, ODD, ADHD, and IC symptoms uniquely distinguished boys who exhibited persisting versus desisting delinquency from adolescence into adulthood. Methods: Participants were 503 boys (57% African American) repeatedly assessed from ages 7 to 25. Associations between childhood and adolescent CD, ODD, ADHD, and IC symptoms and desisting and persisting delinquency were examined independently and after controlling for their co-occurrence and multiple covariates. Results: Conduct disorder and IC symptoms in childhood and adolescence were higher among boys whose delinquency persisted into adulthood relative to those boys whose delinquency desisted across time. After controlling for the overlap between symptoms of ADHD, ODD, CD and IC, only adolescent CD and IC symptoms emerged as unique predictors of the differentiation between persisters and desisters. Moreover, adolescent CD and IC symptoms continued to contribute unique variance even after childhood levels of these characteristics were accounted for. Conclusions: Boys with elevated levels of CD and IC symptoms in childhood and adolescence are at risk for exhibiting a pattern of delinquency that persists from adolescence into adulthood. Intervention efforts designed to prevent chronic delinquency should target youth with co-occurring CD and IC symptoms in childhood and adolescence.

Background: Children with callous-unemotional (CU) traits may have a particularly malevolent view of social conflicts and a pervasive insensitivity to others' distress. The current study examined whether children with CU traits have unique expectations and values regarding the consequences of aggressive conflicts and a ubiquitous lack of concern for others' feelings independent of co-occurring aggression. Methods: Participants were 96 (46 males, 50 females) children recruited from elementary schools within an urban city. Associations between CU traits and child reports of outcome expectancies/values following aggressive conflicts and facets of empathy were examined after controlling for aggression, academic abilities, and demographic covariates. Results: Children with higher CU traits were less likely to expect that aggression would result in victim suffering and feelings of remorse. After controlling for co-occurring aggression, children with higher CU traits were more likely to expect that aggression would result in peer dominance, while children with higher levels of aggression were more likely to expect that attacking others would reduce their aversive behavior. Children with higher CU traits were less concerned that aggressive behavior would result in punishment, victim suffering, and feelings of remorse. Moreover, children with higher CU traits reported lower levels of empathetic concern and sadness in response to others' distress outside of aggressive conflicts. Conclusions: Children with CU traits tend to minimize the extent to which aggression causes victim suffering and openly acknowledge caring less about distress and suffering in others. They are less intimidated by the possibility of being punished for aggressive behavior and tend to view aggression as an effective means for dominating others. In sum, children with CU traits have a particularly malicious social schema that may be difficult to change using conventional treatment methods.

Background: Individual variability in tonic (resting) and phasic (reactivity) respiratory sinus arrhythmia (RSA) may underlie risk for dysregulated emotion and behavior, two transdiagnostic indicators that permeate most psychological disorders in youth. The interaction between tonic and phasic RSA may specify unique physiological profiles during the transition to adolescence. The current study utilized clinically referred youth (Mage = 12.03; s.d. = 0.92) to examine baseline RSA, RSA reactivity, and their interaction as predictors of dysregulated emotion and behavior in daily life. Method: Participants were 162 youth (47% female; 60% minority) in psychiatric treatment for any mood or behavior problem. RSA was assessed during three, 2-minute baselines and an 8-minute parent-child conflict discussion task. Dysregulated emotion and behavior were assessed during a 4-day ecological momentary assessment protocol that included 10 time-based prompts over a long weekend. Results: Greater RSA withdrawal to the conflict was associated with dysregulated basic emotion (sadness, anger, nervousness, stress) in daily life. Two distinct interactions also emerged, such that baseline RSA was related to dysregulated complex emotion (shame, guilt, loneliness, emptiness) and dysregulated behavior as a function of RSA reactivity to conflict. Lower baseline RSA and greater RSA withdrawal were associated with dysregulated complex emotion, while higher baseline RSA and greater RSA withdrawal were associated with dysregulated behavior. Conclusions: Findings point to physiological profiles that increase the risk of dysregulated emotion and behavior during the transition to adolescence. Excessive RSA withdrawal uniquely, and in combination with baseline RSA, increased risk for dysregulation in daily life, underscoring the role of autonomic stress responding as a risk factor for psychopathology. [ABSTRACT FROM AUTHOR]

Background: Parental invalidation is central to etiological models of borderline personality disorder (BPD). Previous studies relied on retrospective accounts or laboratory observations to examine these associations. There is a dearth of research assessing these constructs in daily life, and limited studies have tested the effect of parental invalidation on BPD symptoms during early adolescence, when BPD onsets. The current study took a dynamic approach to assess parents' validating and invalidating behavior and its effect on youths' BPD symptom expression in daily life, while accounting for parent‐perceived helpfulness of these behaviors and youth‐perceived support. Methods: A psychiatric sample of 162 early adolescents (age range = 10–14 years; 47% female) and their parent completed a four‐day ecological momentary assessment study. Parents reported on the use of validating and invalidating (e.g. punishing and ignoring) behaviors during parent–child conflict, as well as perceived helpfulness of these behaviors. Youth reported on their BPD symptoms and perceived parental support. Multilevel models were used to test the between‐ and within‐person effects of parents' validating and invalidating behaviors, parent‐perceived helpfulness and youth‐perceived support, and their interaction on youth's momentary expression of BPD symptoms. Results: At the between‐person level, invalidating behaviors, specifically punishing behaviors, were related to greater BPD symptoms in daily life, while ignoring behaviors were associated with fewer BPD symptoms. Youth‐perceived support predicted fewer BPD symptoms. Conclusions: Results underscore the importance of parental invalidation for the expression of BPD symptoms in daily life and also highlight the importance of youth's subjective experience of parental support. Findings are discussed in terms of etiological and intervention models that emphasize a dyadic framework. [ABSTRACT FROM AUTHOR]

Early threat exposure is a transdiagnostic risk factor for psychopathology, and evidence suggests that genetic variation in the oxytocin receptor (OXTR) moderates this association. However, it is unclear if this gene-by-environment (G×E) interaction is tied to unique risk for disorder-specific outcomes or instead increases shared risk for general psychopathology. Moreover, little is known about how this G×E interaction increases risk. The current study utilized a prospective, longitudinal sample of females (n = 2,020) to examine: (a) whether the interaction between early threat exposure and OXTR variation (rs53576, rs2254298) confers risk for disorder-specific outcomes (depression, anxiety, borderline and antisocial personality disorders) and/or general psychopathology in early adulthood; and (b) whether social–emotional deficits (emotion dysregulation, callousness, attachment quality) during adolescence constitute mediating mechanisms. Consistent with hypotheses, the interactive effects of early threat exposure and OXTR variation (rs53576) predicted general psychopathology, with threat-exposed women carrying at least one copy of the rs53576 A-allele at greatest risk. This interaction was mediated via emotional dysregulation in adolescence, with threat-exposed A-allele carriers demonstrating greater emotion dysregulation, and greater emotion dysregulation predicting general psychopathology in early adulthood. Findings suggest that this G×E places women at risk for a broad range of psychopathology via effects on emotion dysregulation. [ABSTRACT FROM AUTHOR]

Background: Callous-unemotional (CU) traits are critical to developmental, diagnostic, and clinical models of antisocial behaviors (AB). However, assessments of CU traits within large-scale longitudinal and neurobiologically focused investigations remain remarkably sparse. We sought to develop a brief measure of CU traits using items from widely administered instruments that could be linked to neuroimaging, genetic, and environmental data within already existing datasets and future studies. Methods: Data came from a large and diverse sample (n = 4525) of youth (ages~9–11) taking part in the Adolescent Brain and Cognitive Development (ABCD) Study. Moderated nonlinear factor analysis was used to assess measurement invariance across sex, race, and age. We explored whether CU traits were distinct from other indicators of AB, investigated unique links with theoretically-relevant outcomes, and replicated findings in an independent sample. Results: The brief CU traits measure demonstrated strong psychometric properties and evidence of measurement invariance across sex, race, and age. On average, boys endorsed higher levels of CU traits than girls and CU traits were related to, yet distinguishable from other indicators of AB. The CU traits construct also exhibited expected associations with theoretically important outcomes. Study findings were also replicated across an independent sample of youth. Conclusions: In a large, multi-site study, a brief measure of CU traits can be measured distinctly from other dimensions of AB. This measure provides the scientific community with a method to assess CU traits in the ABCD sample, as well as in other studies that may benefit from a brief assessment of CU. [ABSTRACT FROM AUTHOR]

Childhood externalizing psychopathology is heterogeneous. Symptom variability in conduct disorder (CD), oppositional defiant disorder (ODD), attention-deficit/hyperactivity disorder (ADHD), and callous–unemotional (CU) traits designate different subgroups of children with externalizing problems who have specific treatment needs. However, CD, ODD, ADHD, and CU traits are highly comorbid. Studies need to generate insights into shared versus unique risk mechanisms, including through the use of functional magnetic resonance imaging (fMRI). In this study, we tested whether symptoms of CD, ODD, ADHD, and CU traits were best represented within a bifactor framework, simultaneously modeling shared (i.e., general externalizing problems) and unique (i.e., symptom-specific) variance, or through a four-correlated factor or second-order factor model. Participants (N = 11,878, age, M = 9 years) were from the Adolescent Brain and Cognitive Development Study. We used questionnaire and functional magnetic resonance imaging data (emotional N-back task) from the baseline assessment. A bifactor model specifying a general externalizing and specific CD, ODD, ADHD, and CU traits factors demonstrated the best fit. The four-correlated and second-order factor models both fit the data well and were retained for analyses. Across models, reduced right amygdala activity to fearful faces was associated with more general externalizing problems and reduced dorsolateral prefrontal cortex activity to fearful faces was associated with higher CU traits. ADHD scores were related to greater right nucleus accumbens activation to fearful and happy faces. Results give insights into risk mechanisms underlying comorbidity and heterogeneity within externalizing psychopathology. General Scientific Summary: Decreased amygdala reactivity to fearful emotion faces may represent a general neural risk marker for externalizing psychopathology. Decreased dorsolateral prefrontal cortex reactivity to fearful faces may be a specific neural marker for callous–unemotional traits, while increased right nucleus accumbens activation to happy faces may relate specifically to attention-deficit hyperactivity disorder symptoms, over and above externalizing psychopathology severity. [ABSTRACT FROM AUTHOR]

Research consistently demonstrates that common polymorphic variation in monoamine oxidase A (MAOA) moderates the influence of childhood maltreatment on later antisocial behavior, with growing evidence that the "risk" allele (high vs. low activity) differs for females. However, little is known about how this Gene × Environment interaction functions to increase risk, or if this risk pathway is specific to antisocial behavior. Using a prospectively assessed, longitudinal sample of females (n = 2,004), we examined whether changes in emotional reactivity (ER) during adolescence mediated associations between this Gene × Environment and antisocial personality disorder in early adulthood. In addition, we assessed whether this putative risk pathway also conferred risk for borderline personality disorder, a related disorder characterized by high ER. While direct associations between early maltreatment and later personality pathology did not vary by genotype, there was a significant difference in the indirect path via ER during adolescence. Consistent with hypotheses, females with high-activity MAOA genotype who experienced early maltreatment had greater increases in ER during adolescence, and higher levels of ER predicted both antisocial personality disorder and borderline personality disorder symptom severity. Taken together, findings suggest that the interaction between MAOA and early maltreatment places women at risk for a broader range of personality pathology via effects on ER. [ABSTRACT FROM AUTHOR]