Low heart rate as a risk factor for child and adolescent proactive aggressive and impulsive psychopathic behavior.

Although low resting heart rate has been viewed as a well-replicated biological correlate of child and adolescent antisocial behavior, little is known about how it interacts with psychosocial adversity in predisposing to both reactive-proactive aggression and psychopathy, and whether this relationship generalizes to an East Asian population. This study tests the hypothesis that low resting heart rate will be associated with aggression and psychopathic traits, and that heart rate will interact with adversity in predisposing to these antisocial traits. Resting heart rate was assessed in 334 Hong Kong male and female schoolchildren aged 11-17 years. A social adversity index was calculated from a psychosocial interview of the parent, while parents assessed their children on the Reactive-Proactive Aggression Questionnaire and the Antisocial Personality Screening Device. Low resting heart rate was significantly associated with higher proactive aggression, impulsive features of psychopathy, and total child psychopathy. Low resting heart rate interacted with high psychosocial adversity in explaining higher reactive (but not proactive) aggression, as well as impulsive psychopathy. These findings provide support for a biosocial perspective of reactive aggression and impulsive psychopathy, and document low resting heart rate as a robust correlate of both childhood impulsive psychopathic behavior and proactive aggression. To our knowledge, this study is the first to document low resting heart rate as a correlate of child psychopathy and the second to establish low heart rate as a risk factor of antisocial behavior in an East Asian population. The findings provide further evidence for both low resting heart rate as a potential biomarker for childhood psychopathic and aggressive behavior, and also a biosocial perspective on childhood antisocial behavior.