Aggression & CD

Question 1

Antagonism is an ancient construct with aggression dating back centuries to the days our ancestors

Answer 1

displayed violence to establish control, an act they considered as assertion of dominance and power

Question 2

Aggressive outbursts can happen suddenly

Answer 2

as an emotional reaction to frustration or upset

Question 3

However, sustained aggression and antisocial behaviour is cause for concern

Answer 3

and can be observed during every stage of human development, from early childhoof through to adult life

Question 4

Aggressive behaviours are rather universal in young children

Answer 4

though as they grow older most children tend to socialise and learn to inhibit these aggressive behaviours

Question 5

The key mechanisms involved in this process of socialisation are

Answer 5

> development of cognitive control of impulses
sensitivity to feedback in particular punishment through conditioning
development of empathy
sense of morality

Question 6

Some children, however, fail to follow this path of socialisation and continue manifesting

Answer 6

aggressive and rule-breaking behaviour

Question 7

These children may fall within the categories of psychiatric disturbance behaviour disorder

Answer 7

of which the most severe is conduct disorder

Question 8

According to DSM-, CD is defined as the repetitive and persistent pattern of antisocial behaviour in children

Answer 8

associated in particular with violation of social norms and basic rights of others

Question 9

Early onset CD can be recognised in children as young as 5 years of age

Answer 9

with diagnosis commonly confirmed between ages of ten to nineteen

Question 10

To qualify for CD diagnosis

Answer 10

deliquent behaviour must be sustained lasting for a period of over six months

Question 11

Specific criteria for CD diagnosis including

Answer 11

aggression towards humans and animals
deceitfulness or theft
destruction of property
serious violation of authority

Question 12

the mechanisms underlying development and progression of such behaviours

Answer 12

include several factors, both biological and environmental

Question 13

development of conduct problems in children can be largely attributed to the environment in which a child has been brought up in

Answer 13

with evidence of certain prenetal factors including smoking and consumption of alcohol shown to have a strong negative impact on the development of CD

Question 14

Exposure of children to negative experiences such as trauma, violence and neglect

Answer 14

during their early years can have drastic consequences on their day to day behaviour

Question 15

Youths diagnosed with such conditions have often not received the level of care and prosocial behaviour that innocent children deserve

Answer 15

instead these individuals have often been subjected to parental rejection, substance abuse or antisocial behaviour at home, leaving children to fend for themselves

Question 16

They feel as if the world is out to get them

Answer 16

and rightly so with the unfortunate circumstances they have been through

Question 17

It can be said therefore that a lack of prosocial behaviour

Answer 17

can lead to antisocial traits

Question 18

Early life stress is a large contributor in the development of CD

Answer 18

with aggressive behaviour shown to increase with heightened stress levels

Question 19

Several animal studies have provided valuable insights into the effects of early stress of development of aggression

Answer 19

whereby separation of young male rats from their mothers has been shown to increase aggressive behaviour

Question 20

Children raised in stressful situations are left feeling constantly threatened therefore

Answer 20

leading to unregulated emotional responses and frustration based reactive aggression

Question 21

So while there should be no excuse for antisocial behaviour

Answer 21

in cases of CD, there often is an environmental explanation for it

Question 22

Furthermore, studies linking ADHD presentations including inattention, impulsivitity and hyperactivity

Answer 22

to conduct problems propose a causal link, suggesting that those with ADHD may be at a higher risk of CD development (Aggressotype consortium, 2013 - 2018)

Question 23

Genetic mechanisms of CD

Answer 23

5-HTT gene SLC6A4
COMT
MAOA

Question 24

The MATRICS project (2013 - 2019)

Answer 24

sought to further understand the neural, genetic and epigenetic mechanisms underlying these psychiatric disruptive behaviour disorders, notably ODD and CD

Question 25

The aim of the project therefore was to identify the factors involved in pathogenesis of aggression and antisocial behaviour in distinct populations

Answer 25

normally developing adolescents
those at high risk (ADHD)
children and adolescents with CD

Question 26

To identify these factors, the project adopted

Answer 26

a translational approach of matching preclinical studies on animals to clinical studies by basing them on identical paradigms and methodology

Question 27

This allowed for optimal cross-validation of findings from

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animal models to humans, and vice versa

Question 28

The BALB/cJ mouse model utilised within the MATRICS study has

Answer 28

provided valuable insights into the mechanisms underlying aggressive behaviour

Question 29

These mice display an aggressive and antisocial phenotype

Answer 29

accompanied by high anxiety, inattention and reversal learning deficits

Question 30

In vivo MRI identified loss of inhibitory GABAergic cingulate cortical control mechanisms in the mouse model

Answer 30

with phenotypic remediation by methylphenidate and oxytocin through fear processing and empathy regulation, respectively

Question 31

Furthermore, the potential role of opioid signalling and RBFOX1 methylation

Answer 31

as key regulators of the aggressive phenotyped were identified through whole genome sequencing analysis

Question 32

Regulation of salience networks by

Answer 32

feedback approaches in human CD may be useful

Question 33

as well as targeting immune-related attentional mechanisms

Answer 33

which appear to be causal to the aggressive phenotype in multiple ODD/CD and population cohorts (MATRICS consortium, 2013 - 2019)