Fear Conditioning Deficits in Children and Adolescents with Psychopathic Traits: a Study in a Clinical Population

Deficits in fear conditioning related to psychopathy have been widely studied in adults. However, evidence in children and adolescents is scarce and inconsistent. This research aimed to expand knowledge about fear conditioning in psychopathy and its dimensions in child and early adolescent clinical populations. Participants were 45 boys (outpatients) aged 6–14 years (M = 10.59, SD = 2.04). They were assessed with the parents’ and teachers’ versions of the Child Problematic Traits Inventory (CPTI). A fear conditioning paradigm (Neumann et al., in Biological Psychology, 79(3), 337–342, 2008) for children and adolescents was used. Conditioned stimuli (CS+ and CS-) were geometric shapes and the unconditioned stimulus (US) was an unpleasant sound of metal scraping on slate (83 dB). Difference scores (CS+ minus CS-) in skin conductance responses (SCR) and self-reported cognitive and affective measures were considered as indices of fear conditioning. Results showed that: a) deficits in fear conditioning were related to some psychopathy dimensions but not to psychopathy as a unitary construct; b) the Impulsivity-Need for Stimulation dimension was a predictor of impaired fear conditioning at a cognitive level; c) the interaction of Callous-Unemotional and Impulsivity-Need for Stimulation dimensions was a significant predictor of impaired electrodermal fear conditioning; d) by contrast, the Grandiose-Deceitful dimension, was marginally associated with a greater electrodermal fear conditioning. In conclusion, psychopathy dimensions and their interactions, but not psychopathy as a whole, predicted deficits in fear conditioning as measured by SCR and cognitive indices. These findings confirm the notion that psychopathic traits are associated with deficits in fear conditioning in child and adolescent clinical populations and provide support for a multidimensional approach to youth psychopathy.

Prevalence Rates and Evolution of Psychiatric Disorders Among Incarcerated Youths in Comparison With Non-incarcerated Youths

Background: Our main objective was to provide estimates of the prevalence rates of psychiatric disorders and comorbidities among youths in a juvenile detention center in Geneva, Switzerland. We also aimed to investigate potential positive effects of intensive psychotherapeutic and educational services this center provides. Finally, we examined psychiatric care prior to and after custody as well as the evolution of the youths' mental health during detention.Methods: We conducted a longitudinal study including a group of incarcerated (n = 86) and a group of non-incarcerated (n = 169) youths (12–18 years old). Measures included diagnoses of psychiatric disorders, cognitive functions, trauma, psychopathic traits and the Youth Self-Report (aggressive behavior, attentional disorders, criminal behavior, social withdrawal, anxiety, depression and somatic complaints) collected at baseline and at discharge for the incarcerated group. Data were analyzed using mixed-effect models.Results: Psychiatric disorders were prevalent in the incarcerated group (82.6, 95% CI: 71.6–90.7%), but young people also often suffered from several disorders simultaneously. Two-thirds of the incarcerated participants had a diagnosis of two or more psychiatric disorders. Regarding health care, most incarcerated participants (79.1%) had psychiatric care prior to detention. The planned care after detention was associated with psychiatric comorbidities, care being more likely planned for those with comorbidities (p = 0.030). Compared to the non-incarcerated group, the incarcerated group had lower scores on cognitive functioning (p < 0.001) and higher scores on trauma (p < 0.021) and psychopathic traits (p < 0.034). The youths' stay in the detention center was associated with a positive change of mental health, with externalized problems being significantly reduced at the end of their stay (p = 0.017).Conclusion: Our findings showed that youths in conflict with the law are characterized by (1) their internal vulnerabilities: a high prevalence of psychiatric disorders and psychiatric comorbidities, lower cognitive functions, externalized problems and psychopathic traits; (2) environmental factors: victims of violence and sexual abuse; and (3) their psychiatric history. Besides, the evolution of the most prevalent issues was favorable over time, which puts into question the usual perspective about the deleterious effect of detention.

Possible Interventions for Preventing the Development of Psychopathic Traits among Children and Adolescents?

Individuals with the combination of psychopathy and severe conduct disorder often get in a lot of trouble from their early childhood, and can cause great suffering and problems for other people and their immediate environment. Their antisocial behaviour has a tendency to develop into a chronic pattern early in life, and the treatment prognosis in adulthood is poor. A large proportion of serious violent crimes in society can be attributed to this group of perpetrators. Until recently, it has been unclear whether traits of this type can be prevented or changed, so that these individuals and their surroundings can benefit from targeted treatments at an early stage. To reduce serious crime in a society, it is very important to develop effective measures for this particular group. A lack of empathy, indifference to others, and a lack of concern about their own performance appear to be key early signs in children and adolescents with persistent behavioural problems and more serious norm violations who continue into a criminal career upon reaching adulthood. These characteristics have been termed callous−unemotional (CU) traits, and they are considered to be a precursor to psychopathic traits in adulthood. In recent years, several studies have evaluated the degree to which treatments that have been proved effective for children and adolescents with severe behavioural problems also show effectiveness for children and adolescents with CU traits. Interventions specifically tailored to children with CU traits have also been developed with the aim of directly changing the ongoing development of this precursor to psychopathy. In this paper, we will address the extent to which current evidence-based treatment methods developed for children and adolescents with behavioural difficulties are equally effective when a child has CU traits. We will also take a closer look at the effects of interventions designed to change this trait. There will be a discussion regarding what seems relevant for a change in the trait itself, as well as a change in their antisocial behaviour.