The significance of limited prosocial emotions among externalizing disorders in children

Author(s):  
Peter J. Castagna ◽  
Dara E. Babinski ◽  
James G. Waxmonsky ◽  
Daniel A. Waschbusch
Author(s):  
Theodore P. Beauchaine ◽  
Aimee R. Zisner ◽  
Elizabeth P. Hayden

In recent years, it has become increasingly clear that common forms of psychopathology derive from complex interactions among neurobiological vulnerabilities and environmental adversities. These interactions can alter neurobehavioral development to yield progressively intractable forms of psychopathology across childhood and adolescence. This chapter focuses on neurobiological mechanisms of trait impulsivity, trait anxiety, stress reactivity, and emotion regulation/executive function. How these traits confer vulnerability to externalizing disorders, internalizing disorders, heterotypic comorbidity, and heterotypic continuity is described. Next, neurobiological mechanisms of treatment response are considered. Trait impulsivity and trait anxiety are highly heritable and derive initially from subcortical structures that mature early in life. In contrast, emotion regulation and executive function, which modulate trait impulsivity and trait anxiety, are more sensitive to environmental influence and derive from cortical structures that mature into young adulthood. Neurobiological mechanisms of psychosocial treatment response are represented largely in the cortex and its neuromodulatory connections with the subcortex.


Author(s):  
Tiffany M. Shader ◽  
Theodore P. Beauchaine

As described in the literature for many years, a sizable number of children with hyperactive-impulsive and combined subtypes/presentations of attention-deficit/hyperactivity disorder (ADHD)—especially males—progress to more serious externalizing syndromes across development. Such outcomes include oppositional defiant disorder, conduct problems, delinquency, substance use disorders, and in some cases antisocial personality disorder, incarceration, and recidivism. This chapter summarizes a developmental model that emphasizes different contributions of trait impulsivity, a highly heritable, subcortically mediated vulnerability, versus emotion dysregulation, a highly socialized, cortically mediated vulnerability, to externalizing progression. According to this perspective, trait impulsivity confers vulnerability to all externalizing disorders, but this vulnerability is unlikely to progress beyond ADHD in protective environments. In contrast, for children who are reared under conditions of adversity—including poverty, family violence, deviant peer influences, and neighborhood violence/criminality—neurodevelopment of prefrontal cortex structure and function is compromised, resulting in failures to achieve age-expected gains in emotion regulation and other forms of executive control. For these children, subcortical vulnerabilities to trait impulsivity are amplified by deficient cortical modulation, which facilitates progression along the externalizing spectrum.


Emotion dysregulation—which is often defined as the inability to modulate strong affective states including impulsivity, anger, fear, sadness, and anxiety—is observed in nearly all psychiatric disorders. These include internalizing disorders such as panic disorder and major depression, externalizing disorders such as conduct disorder and antisocial personality disorder, and various other disorders including schizophrenia, autism, and borderline personality disorder. Among many affected individuals, precursors to emotion dysregulation appear early in development, and often predate the emergence of diagnosable psychopathology. Collaborative work by Drs. Crowell and Beauchaine, and work by many others, suggests that emotion dysregulation arises from both familial (coercion, invalidation, abuse, neglect) and extrafamilial (deviant peer group affiliations, social reinforcement) mechanisms. These studies point toward strategies for prevention and intervention. The Oxford Handbook of Emotion Dysregulation brings together experts whose work cuts across levels of analysis, including neurobiological, cognitive, and social, in studying emotion dysregulation. Contributing authors describe how early environmental risk exposures shape emotion dysregulation, how emotion dysregulation manifests in various forms of mental illness, and how emotion dysregulation is most effectively assessed and treated. This is the first text to assemble a highly accomplished group of authors to address conceptual issues in emotion dysregulation research; define the emotion dysregulation construct at levels of cognition, behavior, and social dynamics; describe cutting-edge assessment techniques at neural, psychophysiological, and behavioral levels of analysis; and present contemporary treatment strategies. Conceptualizing emotion dysregulation as a core vulnerability to psychopathology is consistent with modern transdiagnostic approaches to diagnosis and treatment, including the Research Domain Criteria and the Unified Protocol, respectively.


Author(s):  
Yoon Ju Bae ◽  
Alexander Gaudl ◽  
Sonia Jaeger ◽  
Stephanie Stadelmann ◽  
Andreas Hiemisch ◽  
...  

AbstractBackground:Dysregulation of the adrenal cortex has been assessed with measurement of salivary cortisol. So far salivary cortisol is routinely measured with immunoassay (IA). However, liquid chromatography-tandem mass spectrometry (MS) is known to offer better specificity. We compared the concentrations of salivary cortisol measured by MS and IA at basal and stress induced conditions and evaluated reasons for the difference in method-dependent cortisol results.Methods:Saliva samples (n=2703) were collected from 169 children (age range: 8–14 years; 81 healthy children; 55 with internalizing and 33 with externalizing disorders) under circadian conditions and during the Trier Social Stress Test for Children (TSST-C). Biochemical analyses were performed with MS for cortisol and cortisone, IA (IBL, RE62011) for cortisol, and enzyme kinetic assay for α-amylase.Results:MS and IA showed mostly comparable results for circadian activity and TSST-C response with similar statistical power. However, IA measured cortisol concentrations about 2.39-fold higher than MS. We found that this difference in measured values between MS and IA was mainly due to different standardization of IA compared to MS. In addition, at cortisol IA concentration below 5 nmol/L, cross-reactivity with cortisone was found to contribute to the lower concordance between MS and IA.Conclusions:Immunoassay and LC-MS/MS were largely comparable in the interpretation of salivary cortisol dynamics in stress research. But the IA method revealed a restricted accuracy in the measuring range below 5 nmol/L.


2021 ◽  
Vol 11 (4) ◽  
pp. 475
Author(s):  
Szabina Velő ◽  
Ágnes Keresztény ◽  
Gyöngyvér Ferenczi-Dallos ◽  
Luca Pump ◽  
Katalin Móra ◽  
...  

Several recent studies confirmed that Attention Deficit Hyperactivity Disorder (ADHD) has a negative influence on peer relationship and quality of life in children. The aim of the current study is to investigate the association between prosocial behaviour, peer relationships and quality of life in treatment naïve ADHD samples. The samples included 79 children with ADHD (64 boys and 15 girls, mean age = 10.24 years, SD = 2.51) and 54 healthy control children (30 boys and 23 girls, mean age = 9.66 years, SD = 1.73). Measurements included: The “Mini International Neuropsychiatric Interview Kid; Strengths and Difficulties Questionnaire” and the “Inventar zur Erfassung der Lebensqualität bei Kindern und Jugendlichen”. The ADHD group showed significantly lower levels of prosocial behaviour and more problems with peer relationships than the control group. Prosocial behaviour has a weak positive correlation with the rating of the child’s quality of life by the parents, both in the ADHD group and in the control group. The rating of quality of life and peer relationship problems by the parents also showed a significant negative moderate association in both groups. The rating of quality of life by the child showed a significant negative weak relationship with peer relationships in the ADHD group, but no significant relationship was found in the control group. Children with ADHD and comorbid externalizing disorders showed more problems in peer relationships than ADHD without comorbid externalizing disorders. Based on these results, we conclude that therapy for ADHD focused on improvement of prosocial behaviour and peer relationships as well as comorbid externalizing disorders could have a favourable effect on the quality of life of these children.


2004 ◽  
Vol 34 (4) ◽  
pp. 613-622 ◽  
Author(s):  
PETER M. LEWINSOHN ◽  
STEWART A. SHANKMAN ◽  
JEFFREY M. GAU ◽  
DANIEL N. KLEIN

Background. In previous studies of subthreshold conditions, co-morbidity has been largely ignored. The purpose was to examine rates of co-morbidity among subthreshold disorders and between subthreshold and full-syndrome disorders for the major non-psychotic classes of disorders from DSM-IV.Method. Participants came from the Oregon Adolescent Depression Project (mean age=16·6 years; females=52·1%). On the basis of a diagnostic interview (K-SADS), participants were assigned to eight subthreshold disorders (MDD, bipolar, eating, anxiety, alcohol use, substance use, conduct, ADHD).Results. Of the 1704 adolescents in the analyses, 52·5% had at least one subthreshood disorder. Of those, 40·0% had also experienced a co-morbid subthreshold condition, and 29·9% of those had a second co-morbid subthreshold condition. Of those with a subthreshold, 36·4% also had a full syndrome. The subthreshold forms of externalizing disorders were co-morbid with each other. As expected, subthreshold anxiety was co-morbid with subthreshold MDD but subthreshold anxiety was also co-morbid with subthreshold alcohol, conduct, and ADHD. The pattern of co-morbidities was nearly identical for males and females.Conclusions. The hypotheses that externalizing disorders would be co-morbid with other externalizing disorders and that internalizing disorders would be co-morbid with other internalizing disorders was partially supported. Co-morbidities between subthreshold disorders and between subthreshold disorders and full syndrome should impact future research and clinical practice. The assessment of subthreshold disorders needs to include the assessment of other subthreshold and full-syndrome conditions.


2002 ◽  
Vol 21 (4) ◽  
pp. 441-468 ◽  
Author(s):  
Todd B. Kashdan ◽  
William E. Pelham ◽  
Alan R. Lang ◽  
Betsy Hoza ◽  
Rolf G. Jacob ◽  
...  

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