Do Genetic Factors Explain the Links Between Callous-Unemotional, Attention Hyperactivity and Oppositional Defiant Problems in Toddlers?

Objective: This study utilized a multimodal approach to examine emotion dysregulation (ED) in young children with attention-deficit/hyperactivity disorder (ADHD), ADHD + oppositional defiant disorder (ODD), and typically developing (TD) children. Methods: We sought to explore if specific domains of ED (emotion regulation [ER], negativity/lability [ERNL], emotion knowledge/understanding [ERU], and callous-unemotional [CU] behaviors) were uniquely associated with diagnostic classifications. The final sample consisted of 152 children (75% boys; mean age = 5.52, SD = .84, 83.4% Latinx) with the following group composition: ADHD- Only (n = 24), ADHD + ODD (n = 54), and TD (n = 74). Results: Higher levels of ADHD and ODD symptoms, measured continuously, were significantly associated with poorer EREG, greater ERNL, and higher levels of reported CU behaviors. There were no significant associations between ADHD or ODD symptoms on ERU. Using discriminant analyses, we found that parent/teacher reported EREG, ERNL, and CU were significant predictors of diagnostic classification. These ED domains correctly identified 84.7% of preschoolers. The model was most successful in classifying children with ADHD+ODD (92.3%) and TD (93.2%) children; however, the ADHD-Only group was correctly identified only 41.7% of the time. Conclusions: This is the first study to 1) examine multiple domains of ED in a clinical sample of preschool children with and without ADHD and 2) explore the clinical utility of considering ED when assessing for ADHD and ODD. Our findings suggest that measures of ED are particularly helpful for correctly diagnosing ADHD and co-occurring ODD but not necessarily children with ADHD-Only.

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Callous-unemotional traits in Chinese preschool children with attention-deficit/hyperactivity disorder

Child and Adolescent Psychiatry and Mental Health ◽

10.1186/s13034-021-00388-0 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Jinsong Zhang ◽

Wei Li ◽

Huifeng Zhang ◽

Amanda Wilson ◽

Lan Shuai ◽

...

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Preschool Children ◽

Attention Deficit ◽

Incremental Validity ◽

Behavioural Problems ◽

Hyperactivity Disorder ◽

Cu Traits ◽

Callous Unemotional ◽

Oppositional Defiant ◽

Callous Unemotional Traits

Abstract Background Children with early onset of Callous-Unemotional (CU) traits are at a higher risk for long-term, persistent psychosocial problems. The current study aimed to explore the characteristics of CU in preschool children with Attention Deficit Hyperactivity Disorder (ADHD) and the diagnostic significance of CU traits in ADHD. Methods A total of 176 preschool children (89 with ADHD and 87 Typically Developing Children [TDC]) aged 4–5 years old were recruited to the study. The participants were assessed for CU traits, emotional and behavioral problems, and how their executive functioning was associated with ADHD using multiple assessment scales. Multiple linear regression analysis was performed to assess the incremental validity of the Inventory of Callous-Unemotional Traits (ICU), adjusting for possible covariates by child’s sex, conduct problems, and oppositional defiant symptoms. Results The results showed that there was a significant difference of ICU scores between the ADHD and TDC groups (F = 30.12, P < 0.001). In terms of callousness, ADHD + Oppositional Defiant Disorder (ODD) group showed a significant high score, and the ADHD only group scored significantly higher than the TDC group (F = 20.42, P < 0.001). The ICU was negatively associated with the prosocial behaviour subscale (γ = − 0.57, P < 0.01) and showed low to moderate positive correlations with emotional and behavioural problems, as well as executive function (γ = 0.24–0.67, P < 0.05). The ICU scores explained 6% of the incremental validity in ADHD symptoms. The diagnostic value of the ICU for ADHD was medium and acceptable. Conclusions The current study indicated that early identification of CU traits may help clinicians better understand symptoms and behavioural problems in children with ADHD. CU traits therefore could be considered as a useful assessment tool for ADHD.

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Observed parenting behaviors interact with a polymorphism of the brain-derived neurotrophic factor gene to predict the emergence of oppositional defiant and callous–unemotional behaviors at age 3 years

Development and Psychopathology ◽

10.1017/s0954579413000266 ◽

2013 ◽

Vol 25 (4pt1) ◽

pp. 903-917 ◽

Cited By ~ 31

Author(s):

Michael T. Willoughby ◽

Roger Mills-Koonce ◽

Cathi B. Propper ◽

Daniel A. Waschbusch

Keyword(s):

Child Health ◽

Disruptive Behavior ◽

Neurotrophic Factor ◽

Parenting Behaviors ◽

Brain Derived Neurotrophic Factor ◽

Factor Gene ◽

Callous Unemotional ◽

Oppositional Defiant ◽

Health And Development ◽

The Brain

AbstractUsing the Durham Child Health and Development Study, this study (N = 171) tested whether observed parenting behaviors in infancy (6 and 12 months) and toddlerhood/preschool (24 and 36 months) interacted with a child polymorphism of the brain-derived neurotrophic factor gene to predict oppositional defiant disorder (ODD) and callous–unemotional (CU) behaviors at age 3 years. Child genotype interacted with observed harsh and intrusive (but not sensitive) parenting to predict ODD and CU behaviors. Harsh–intrusive parenting was more strongly associated with ODD and CU for children with a methionine allele of the brain-derived neurotrophic factor gene. CU behaviors were uniquely predicted by harsh–intrusive parenting in infancy, whereas ODD behaviors were predicted by harsh–intrusive parenting in both infancy and toddlerhood/preschool. The results are discussed from the perspective of the contributions of caregiving behaviors as contributing to distinct aspects of early onset disruptive behavior.

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Associations between Infant Behaviors during the Face-To-Face Still-Face Paradigm and Oppositional Defiant and Callous-Unemotional Behaviors in Early Childhood

Journal of Abnormal Child Psychology ◽

10.1007/s10802-016-0141-0 ◽

2016 ◽

Vol 44 (8) ◽

pp. 1439-1453 ◽

Cited By ~ 18

Author(s):

Nicholas J. Wagner ◽

W. Roger Mills-Koonce ◽

Cathi B. Propper ◽

Michael T. Willoughby ◽

Pete D. Rehder ◽

...

Keyword(s):

Early Childhood ◽

Face To Face ◽

Callous Unemotional ◽

Oppositional Defiant ◽

The Face ◽

Still Face Paradigm

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Conduct Disorder and Its Clinical Management

10.2310/psych.13010 ◽

2017 ◽

Author(s):

Drew Barzman ◽

Bianca Patel

Keyword(s):

Conduct Disorder ◽

Age At Onset ◽

Parenting Skills ◽

Behavioral Issues ◽

Dsm 5 ◽

Callous Unemotional ◽

Oppositional Defiant ◽

Causative Factors ◽

Persistent Pattern ◽

Age Appropriate

Conduct disorder (CD), a psychiatric condition that is prevalent in some child and adolescent populations, is defined by the DSM-5 as a repetitive and persistent pattern of behavior in which the rights of others and age-appropriate cultural norms are violated. DSM-5 subtypes include childhood-onset, adolescent-onset, and callous-unemotional presentations. The development of CD is affected by gender, age at onset, environmental factors, and genetic factors. Overall, it has been difficult to identify causative factors because there is such a diverse variety of factors and comorbidities involved, although studies to define specific genetic, physiologic, and neurologic links to CD are ongoing. Common comorbidities in CD include oppositional defiant disorder, attention-deficit/hyperactivity disorder (ADHD), major depressive disorder, bipolar disorder, dysthymia, and substance abuse. The most successful treatment involves a multisystemic approach involving medication, family therapy, educational therapy, and parenting skills. Overall, early prevention of CD through treatment is key because the prognosis is poor and can be associated with the development of more severe comorbidities. This review contains 3 tables, and 58 references. Key words: antisocial behavior behavioral issues, ADHD comorbidities, child mental disorders, conduct disorder

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Conduct disorders and antisocial personality disorder in childhood and adolescence

New Oxford Textbook of Psychiatry ◽

10.1093/med/9780198713005.003.0124 ◽

2020 ◽

pp. 1265-1276

Author(s):

Stephen Scott ◽

Melanie Palmer

Keyword(s):

Personality Disorder ◽

Antisocial Personality Disorder ◽

Academic Failure ◽

Conduct Disorders ◽

Drug Misuse ◽

Antisocial Personality ◽

Callous Unemotional ◽

Oppositional Defiant ◽

Callous Unemotional Traits ◽

Unemotional Traits

Oppositional defiant and conduct disorders are the most common mental health problems in childhood. They have a poor prognosis if left untreated, with increased crime, violence, drug misuse, academic failure, dependence on state welfare, psychosis, and early death. A number of children additionally have callous-unemotional traits, and they are at risk for going on to develop antisocial personality disorder, which has its origins in childhood. Children with comorbid callous-unemotional traits or attention-deficit/hyperactivity disorder (ADHD) symptoms have a high genetic contribution to their problems and reduced functioning in the limbic and prefrontal areas. There have been over 100 randomized controlled trials of interventions, with evidence-based parenting programmes repeatedly being shown to be effective in both the short and the longer term. There is emerging evidence that they may help prevent personality disorder. In the absence of ADHD, medication has no role to play in the routine management of oppositional defiant and conduct disorders.

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Smoking during pregnancy and offspring externalizing problems: An exploration of genetic and environmental confounds

Development and Psychopathology ◽

10.1017/s0954579408000072 ◽

2008 ◽

Vol 20 (1) ◽

pp. 139-164 ◽

Cited By ~ 179

Author(s):

Brian M. D'Onofrio ◽

Carol A. van Hulle ◽

Irwin D. Waldman ◽

Joseph Lee Rodgers ◽

K. Paige Harden ◽

...

Keyword(s):

Externalizing Problems ◽

Genetic Factors ◽

Externalizing Behaviors ◽

Causal Effect ◽

Longitudinal Survey ◽

Teratogenic Effects ◽

Smoking During Pregnancy ◽

Oppositional Defiant ◽

Increase Risk ◽

Prenatal Nicotine

AbstractPrevious studies have documented that smoking during pregnancy (SDP) is associated with offspring externalizing problems, even when measured covariates were used to control for possible confounds. However, the association may be because of nonmeasured environmental and genetic factors that increase risk for offspring externalizing problems. The current project used the National Longitudinal Survey of Youth and their children, ages 4–10 years, to explore the relations between SDP and offspring conduct problems (CPs), oppositional defiant problems (ODPs), and attention-deficit/hyperactivity problems (ADHPs) using methodological and statistical controls for confounds. When offspring were compared to their own siblings who differed in their exposure to prenatal nicotine, there was no effect of SDP on offspring CP and ODP. This suggests that SDP does not have a causal effect on offspring CP and ODP. There was a small association between SDP and ADHP, consistent with a causal effect of SDP, but the magnitude of the association was greatly reduced by methodological and statistical controls. Genetically informed analyses suggest that unmeasured environmental variables influencing both SDP and offspring externalizing behaviors account for the previously observed associations. That is, the current analyses imply that important unidentified environmental factors account for the association between SDP and offspring externalizing problems, not teratogenic effects of SDP.

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Genetic effects on the variation and covariation of attention deficit-hyperactivity disorder (ADHD) and oppositional-defiant disorder/conduct disorder (ODD/CD) symptomatologies across informant and occasion of measurement

Psychological Medicine ◽

10.1017/s0033291701004792 ◽

2002 ◽

Vol 32 (1) ◽

pp. 39-53 ◽

Cited By ~ 110

Author(s):

T. S. NADDER ◽

M. RUTTER ◽

J. L. SILBERG ◽

H. H. MAES ◽

L. J. EAVES

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Conduct Disorder ◽

Oppositional Defiant Disorder ◽

Attention Deficit ◽

Genetic Factors ◽

Multiple Informants ◽

Genetic Liability ◽

Hyperactivity Disorder ◽

Oppositional Defiant ◽

Co Morbidity

Background. Previous studies have shown that the presence of conduct disorder may contribute to the persistence of attention deficit-hyperactivity disorder (ADHD) symptomatology into adolescence; however, the aetiological relationship between the two phenotypes remains undetermined. Furthermore, studies utilizing multiple informants have indicated that teacher ratings of these phenotypes are more valid than maternal reports.Methods. The genetic structure underlying the persistence of ADHD and oppositional-defiant disorder/conduct disorder (ODD/CD) symptomatologies as rated by mothers and teachers at two occasions of measurement was investigated on a sample of 494 male and 603 female same sex adolescent twin pairs participating in the Virginia Twin Study of Adolescent Behavioral Development (VTSABD).Results. Using structural modelling techniques, one common genetic factor was shown to govern the covariation between the phenotypes across informants and occasion of measurement with additional genetic factors specific to ODD/CD symptomatology and persistence of symptomatology at reassessment. Genetic structures underlying the phenotypes were, to some extent, informant dependent.Conclusions. The findings indicate that it is unlikely that the co-morbidity between ADHD and ODD/CD is due to environmental influences that are independent of ADHD. Rather it is likely to be due to a shared genetic liability either operating directly, or indirectly through gene–environment correlations or interactions. The covariation between phenotypes across informants and time is governed by a common set of genes, but it seems that ODD/CD is also influenced by additional genetic factors. Developmentally, different forms of genetic liability control ADHD in males and inattention in females.

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Adolescent callous–unemotional traits and conduct disorder in adoptees exposed to severe early deprivation

The British Journal of Psychiatry ◽

10.1192/bjp.bp.110.089441 ◽

2012 ◽

Vol 200 (3) ◽

pp. 197-201 ◽

Cited By ~ 43

Author(s):

Robert Kumsta ◽

Edmund Sonuga-Barke ◽

Michael Rutter

Keyword(s):

Conduct Disorder ◽

Self Report ◽

Central Component ◽

Disruptive Behaviour ◽

Prospective Longitudinal Study ◽

Callous Unemotional ◽

Oppositional Defiant ◽

Callous Unemotional Traits ◽

Unemotional Traits ◽

Prospective Longitudinal

BackgroundThere is a debate over whether disruptive behaviour should be regarded as a central component of, or rather as an epiphenomenon with little diagnostic value for, psychopathy.AimsTo test whether callous–unemotional traits and conduct disorder can be dissociated in the English and Romanian Adoptee Study, a prospective longitudinal study of adopted individuals with a history of severe early institutional deprivation.MethodThe Child and Adolescent Psychiatric Assessment was used to establish DSM-IV diagnoses for conduct disorder (and also oppositional defiant disorder) at the 15-year follow-up stage. The Inventory of Callous–Unemotional Traits questionnaire was administered to assess psychopathy traits.ResultsThere was no significant association between callous–unemotional traits and conduct disorder, both according to parent and youth self-report assessed categorically and dimensionally after controlling for confounds.ConclusionsThe majority of individuals with high callous–unemotional traits did not show conduct disorder in this special sample of children. This supports the view that, while common, an overlap between these aspects of psychopathology is not inevitable and so provides evidence for the dissociation of these two concepts. In terms of classification, we argue for a diagnostic scheme where psychopathy can be diagnosed independently of conduct disorder.

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Reward-Related Dysfunctions in Children Developing Attention Deficit Hyperactivity Disorder—Roles of Oppositional and Callous-Unemotional Symptoms

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.738368 ◽

2021 ◽

Vol 12 ◽

Author(s):

Susan Schloß ◽

Friederike Derz ◽

Pia Schurek ◽

Alisa Susann Cosan ◽

Katja Becker ◽

...

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Attention Deficit ◽

Electrodermal Activity ◽

Externalizing Disorders ◽

Approach Motivation ◽

Autonomic Reactivity ◽

Hyperactivity Disorder ◽

Cu Traits ◽

Callous Unemotional ◽

Oppositional Defiant

Objectives: Neurocognitive functions might indicate specific pathways in developing attention deficit hyperactivity disorder (ADHD). We focus on reward-related dysfunctions and analyze whether reward-related inhibitory control (RRIC), approach motivation, and autonomic reactivity to reward-related stimuli are linked to developing ADHD, while accounting for comorbid symptoms of oppositional defiant disorder (ODD), and callous-unemotional (CU) traits.Methods: A sample of 198 preschool children (115 boys; age: m = 58, s = 6 months) was re-assessed at age 8 years (m = 101.4, s = 3.6 months). ADHD diagnosis was made by clinical interviews. We measured ODD symptoms and CU traits using a multi-informant approach, RRIC (Snack-Delay task, Gift-Bag task) and approach tendency using neuropsychological tasks, and autonomic reactivity via indices of electrodermal activity (EDA).Results: Low RRIC and low autonomic reactivity were uniquely associated with ADHD, while longitudinal and cross-sectional links between approach motivation and ADHD were completely explained by comorbid ODD and CU symptoms.Conclusion: High approach motivation indicated developing ADHD with ODD and CU problems, while low RRIC and low reward-related autonomic reactivity were linked to developing pure ADHD. The results are in line with models on neurocognitive subtypes in externalizing disorders.

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