Conduct Disorder Flashcards
What are the risk factor of CD?
Inconsistent or Harsh Parenting Physical Abuse Parental Criminality Poverty Deviant Peer group Genes - serotonin metabolism Hostile Biases Neuropsychological Abnormalities Epigenetic Changes Brain structures
Prevalense of CD:
5% prevalence
Developmental Taxomonic Theory (DTT)
People are most likely to engage in anti-social behaviour in the teenage years
2 types of CD according to Developmental Taxomonic Theory
Adolescence limited
- Social modelling of peers
- No role for neuropsychological/individual characteristics
Life persistent Course
- Childhood onset
Research & DTT in CD
Recent research contradicts the DTT 2 types
- Adolescent not decreasing
- Life persisting can/cannot start in childhood
What are CU
Callous Unemotional Traits
- Subgroup of CD with a distinct neuropsychological profile
Neural distinction in CU
Amygdala & orbitofrontal dysfunction
Emotional distinction between CD+CU and CD -CU
CD+CU+ = Emotionally flat/hypo-responsive
CD & CU- = Hyper-responsive
Brain areas implicated in CD:
- Amygdala
- Insula
- Temporal Lobe
- Orbitofrontal Lobe
- Anterior Cingulate
- Striatum volume
- vmPFC
Amygdala in CU
Reduced Amygdala & insula volume
- Insula: Reduced empathy for pain
- Amygdala: Reduced fear recognition & fear learning
- Amygdala: Experience/recognition of emotions
Childhood onset = reduced R. Amygdala
Adolescent onset = both sides
ACC & OFC in CU vs. CD
-> Increased Anterior cingulate & Orbitofrontal cortex volume in children w/CU traits
Reduced volume in CD: temporal lobe and OFC
TL & OFC in CD
Reduced Temporal Lobe & Orbitofrontal cortex volume
Striatum & CU
Fairchild et al. 2011
Striatal Volume positive correlated with self-reported CU
Implications of structural changes on behaviour in CD:
Reduced emotional recognition & processing
Reduced empathy for pain
Reduced empathic concern
WM tracts implicated in CD
1) Uncinate Fascicle
2) Inferior Occipito-frontal Fascicle
The Uncinate Fascicle in CD
Medial PFC temporal pole
- Increased FA in childhood onset
Esp. Males
and stronger on the left - though not conclusive
No difference in #fibres {streamlines)
- > Emotion regulation
- ->Too much = ?accelerated maturation?
Inferior Occipito-frontal Fascicle in CD
Frontal occipital
- Increased FA in childhood onset
‘control tract’
Deficits in emotional processing in CD in …
Anger
Disgust
Fear
Happy
Emotion Processing deficit in fear associated with:
Reduced Amygdala
Emotion Processing deficit in anger associated with:
- Reduced Amygdala
- Reduced vmPFC
- Left Insula
- Left & Right OFC
Emotion Processing deficit in sadness:
Differences between Childhood onset & Adolescent onset
Childhood onset = less response
Possible neural basis to hostile biases?
Large responses to Neutral Faces
- Perceived social threat where none is present
DTT & Neurological findings
Both subtypes showed a reduced amygdala
Both subtypes show a deficit in neural processing
DTT revised based on current research…
Age of onset differences = interaction between vulnerability & Environment
Neural Distinctions in girls with CU in face processing:
Reduced: Medial OFC
Increased: Anterior Insula
Neural underpinnings in girls with CU in lifetime CD
Negatively correlated with:
- > Amygdala
- > Superior Temporal Cortex
- > Fusiform Gyrus
- > dlPFC
CU traits in girls with CD associated with:
Negatively correlated with R.fusiform gyrus activity
Similarities between CD & Anxiety
Both implicate:
- Amygdala
- Insula
- PFC
Differences between CD and Anxiety
Anxiety
- Increase in Amygdala & Insula volume
- increase responses in Amygdala, insula and PFC in emotion processing
- decrease strength of connection between amygdala & PFC
CD
- Decrease amygdala and insula volume
- Decrease in amygdala, insula & PFC during processing of emotional faces
- Increase strength of connection between amygdala & PFC cortex
CD negative correlation with:
=> Amygdala
=> vmPFC
=> orbitofrontal cortex
=> insula
Significant effect of CU or Psychopathic trait?
None
