Gregor Kohls1, Graeme Fairchild2, Anka Bernhard3, Anne Martinelli3, Areti Smaragdi4, Karen Gonzalez-Madruga5, Amy Wells6, Jack C Rogers7, Ruth Pauli8, Helena Oldenhof9, Lucres Jansen9, Arthur van Rhijn9, Linda Kersten10, Janine Alfano10, Sarah Baumann11, Beate Herpertz-Dahlmann11, Agnes Vetro12, Helen Lazaratou13, Amaia Hervas14, Aranzazu Fernández-Rivas15, Arne Popma9, Christina Stadler10, Stephane A De Brito8, Christine M Freitag3, Kerstin Konrad1,16. 1. Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Child Neuropsychology Section, University Hospital RWTH Aachen, Aachen, Germany. 2. Department of Psychology, University of Bath, Bath, United Kingdom. 3. Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany. 4. Centre for Addiction and Mental Health, Toronto, ON, Canada. 5. King's College London, London, United Kingdom. 6. School of Psychology, Cardiff University, Cardiff, United Kingdom. 7. School of Psychology, Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom. 8. Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, United Kingdom. 9. Department of Child and Adolescent Psychiatry, Amsterdam Public Health - Mental Health, Vrije Universiteit Amsterdam, Amsterdam, Netherlands. 10. Psychiatric University Clinics, University of Basel, Basel, Switzerland. 11. Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Aachen, Germany. 12. Child and Adolescent Psychiatry Department, Pediatrics and Child Health Center, University of Szeged, Szeged, Hungary. 13. Child and Adolescent Unit of the 1st Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece. 14. Child and Adolescent Mental Health Unit, University Hospital Mutua Terrassa, Barcelona, Spain. 15. Psychiatric Service, Basurto University Hospital, Bilbao, Spain. 16. JARA-Brain Institute II, Molecular Neuroscience and Neuroimaging, RWTH Aachen and Research Centre Juelich, Juelich, Germany.
Abstract
Background: At the group level, youths with conduct disorder (CD) show deficient emotion processing across various tasks compared to typically developing controls (TDC). But little is known about neuropsychological subgroups within the CD population, the clinical correlates of emotion processing deficits [for instance, with regard to the presence or absence of the DSM-5 Limited Prosocial Emotions (LPE) specifier], and associated risk factors. Methods: 542 children and adolescents with CD (317 girls) and 710 TDCs (479 girls), aged 9-18 years, were included from the FemNAT-CD multisite study. All participants completed three neuropsychological tasks assessing emotion recognition, emotion learning, and emotion regulation. We used a self-report measure of callous-unemotional traits to create a proxy for the LPE specifier. Results: Relative to TDCs, youths with CD as a group performed worse in all three emotion domains. But using clinically based cut-off scores, we found poor emotion recognition skills in only 23% of the participants with CD, followed by emotion regulation deficits in 18%, and emotion learning deficits in 13% of the CD group. Critically, the majority of youths with CD (~56%) did not demonstrate any meaningful neuropsychological deficit, and only a very small proportion showed pervasive deficits across all three domains (~1%). Further analyses indicate that established DSM-5 subtypes of CD are not tightly linked to neurocognitive deficits in one particular emotion domain over another (i.e., emotion recognition deficits in CD+LPE vs. emotion regulation deficits in CD-LPE). Conclusions: Findings from this large-scale data set suggest substantial neuropsychological diversity in emotion processing in the CD population and, consequently, only a subgroup of youths with CD are likely to benefit from additional behavioral interventions specifically targeting emotion processing mechanisms.
Background: At the group level, youths with conduct disorder (CD) show deficient emotion processing across various tasks compared to typically developing controls (TDC). But little is known about neuropsychological subgroups within the CD population, the clinical correlates of emotion processing deficits [for instance, with regard to the presence or absence of the DSM-5 Limited Prosocial Emotions (LPE) specifier], and associated risk factors. Methods: 542 children and adolescents with CD (317 girls) and 710 TDCs (479 girls), aged 9-18 years, were included from the FemNAT-CD multisite study. All participants completed three neuropsychological tasks assessing emotion recognition, emotion learning, and emotion regulation. We used a self-report measure of callous-unemotional traits to create a proxy for the LPE specifier. Results: Relative to TDCs, youths with CD as a group performed worse in all three emotion domains. But using clinically based cut-off scores, we found poor emotion recognition skills in only 23% of the participants with CD, followed by emotion regulation deficits in 18%, and emotion learning deficits in 13% of the CD group. Critically, the majority of youths with CD (~56%) did not demonstrate any meaningful neuropsychological deficit, and only a very small proportion showed pervasive deficits across all three domains (~1%). Further analyses indicate that established DSM-5 subtypes of CD are not tightly linked to neurocognitive deficits in one particular emotion domain over another (i.e., emotion recognition deficits in CD+LPE vs. emotion regulation deficits in CD-LPE). Conclusions: Findings from this large-scale data set suggest substantial neuropsychological diversity in emotion processing in the CD population and, consequently, only a subgroup of youths with CD are likely to benefit from additional behavioral interventions specifically targeting emotion processing mechanisms.
Authors: Kurt P Schulz; Jin Fan; Olga Magidina; David J Marks; Bella Hahn; Jeffrey M Halperin Journal: Arch Clin Neuropsychol Date: 2007-01-04 Impact factor: 2.813
Authors: Mark Richard Dadds; Avril Jessica Cauchi; Subodha Wimalaweera; David John Hawes; John Brennan Journal: Psychiatry Res Date: 2012-06-15 Impact factor: 3.222