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PubMed2003

Emotional responses to antisocial acts in adolescent males with conduct disorder: a link to affective morality.

Examined the role of emotion-based moral processes in the committing of delinquent acts by adolescent males with conduct disorder (CD). An Affective Morality Index (AMI) was developed to assess emotional responses to vignettes of delinquent acts. CD groups, as compared to a non-CD group, reported lower levels of guilt and fear and higher levels of excitement and happiness following described transgressions. Number of CD symptoms and a recidivism-risk item were correlated negatively with reported guilt and fear and positively with happiness and excitement. Trends suggested that youth with childhood-onset CD (CO) show lower levels of affective morality than those with adolescent-onset CD (AO). There were no effects for anger. This research, and in particular the AMI, expands our understanding of affective-based morality, especially in discriminating between CD and non-CD youth.

Adolescent↗
PubMed1992

Depression and conduct disorders in children and adolescents: a review of the literature.

The psychological literature presents three explanatory models of the relationship between childhood or adolescent depression and conduct disorders: (1) a direct causal relationship; (2) an indirect causal relationship, involving a third set of variables (i.e., personality disorders and developmental deficits); and (3) the "final common pathway" hypothesis, which derives a relationship ex post facto. Each of these models has dominated the literature at a different period, each was affected by different research purposes, and each in turn influenced further research. The author describes and critiques the three models and concludes with suggestions for further exploration in the areas of theory and etiology, research, diagnosis, and treatment.

Adolescent↗
PubMed1990

Behavioral correlates of maternal depressive symptomatology in conduct-disorder children: II. Systemic effects involving fathers and siblings.

This study tested a systemic hypothesis of the relation between maternal depressive symptomatology and the behavior of conduct-disordered children (n = 47) toward their mothers, fathers, and siblings. Maternal symptomatology interacted with the children's behavior toward all family members. Children whose mothers were distressed tended to be more compliant and less aversive toward them than toward their fathers, and the opposite applied to children whose mothers were not distressed. Comparable results were obtained in comparisons of child interactions with mothers and siblings, although in the latter case the children's behaviors differed in absolute magnitude as a function of their interaction partner.

Adolescent↗
PubMed1995

Which boys will fare worse? Early predictors of the onset of conduct disorder in a six-year longitudinal study.

OBJECTIVE: This article addresses the following questions: What are the best demographic and psychiatric predictors of the onset of conduct disorder (CD)? Does physical fighting play a role in the transition from oppositional defiant disorder (ODD) to CD? And what are the predictors of an earlier compared with a later onset of CD? METHOD: Data are presented on the follow-up of a clinic-referred sample of 177 preadolescent boys who were studied for a period of 6 years. Psychiatric assessments were based on information from the boys, their parent, and their teacher. RESULTS: Of all CD symptoms, physical fighting best predicted the onset of CD in bivariate analyses. Logistic regression showed that low socioeconomic status of the parent, ODD, and parental substance abuse best predicted the onset of CD. In addition, attention-deficit hyperactivity disorder (ADHD) predicted an early onset of CD. CONCLUSIONS: Parental substance abuse, low socioeconomic status, and oppositional behavior are key factors in boys' progression to CD. Physical fighting, although not a symptom of ODD, should be targeted in preventive interventions along with ODD symptoms. ADHD is implicated in the early onset of CD, but not in later-onset CD.

Adolescent↗
PubMed1985

Comparison of abusive and nonabusive families with conduct-disordered children.

This study set out to define the relative contribution of psychological, sociological, and parent-child interactional variables in 19 abusive and 21 nonabusive families with conduct disordered children. Low family income and mother's report of having been abused as a child were found to be the most potent variables discriminating abusive from nonabusive families. Implications of the study findings are considered.

Adult↗
PubMedDate not supplied

[Early prevention of externalizing disorders--basic principles and parent-centered approaches to prevention of expansive childhood behavior disorders].

Conduct disorder is an area of mental disorder, in which prevention seems to be advisable for different reasons. First, relevant factors that help identifying a population at risk are well-known. Second, a number of research efforts showed negative developmental trajectories for children with early conduct disorder, and third, we have effective treatment programs that facilitate deriving prevention strategies. This paper first describes results which clarify the need for prevention. Then basic principles and contents of effective prevention programs for conduct disorder are described. Finally, four behaviorally oriented examples from the numerous existing universal, selected and indicated prevention programs are illustrated and discussed.

Adolescent↗
PubMed1984

Behavioral efficacy of haloperidol and lithium carbonate. A comparison in hospitalized aggressive children with conduct disorder.

The efficacy and safety of haloperidol, lithium carbonate, and placebo were critically assessed in 61 treatment-resistant, hospitalized children aged 5.2 to 12.9 years with diagnoses of conduct disorder, aggressive type. In this double-blind and well-controlled study, the optimal dosages of haloperidol ranged from 1.0 to 6.0 mg/day and those of lithium carbonate from 500 to 2,000 mg/day. For the assessment of behavioral changes and untoward effects, various rating scales were used in different settings. Both haloperidol and lithium carbonate were found to be significantly superior to placebo in decreasing behavioral symptoms. Although both medications were clinically effective, haloperidol was associated more often with untoward effects than was lithium carbonate.

Aggression↗
PubMed2002

[Behavior therapy in children with aggressive dyssocial disorders].

Conduct disorder in children and adolescents is prevalent and has a poor prognosis: it is now considered to be a chronic condition that requires treatment as well as life-long monitoring. Two forms of behavior therapy, parent management training and training in problem-solving skills are currently seen as the most effective treatment. Parent management training is the treatment of choice for younger children, while for older children it should be supplemented with training in problem-solving skills. Parent management training is one of the best-researched therapy techniques for conduct disorder, deserving the criterion "empirically supported treatment" defined by the American Psychological Association. Training in problem-solving skills has led to therapeutic change in clinical samples and is qualified as "probably efficacious treatment". Limitations of both treatments include the high drop-out rate among parents and the fact that many youth improve but remain outside the range of normative functioning. To optimize treatment effectiveness, complex prevention programs have been developed in recent years. Results to date are mixed; however, two large ongoing studies, the FAST and the LIFT study, report positive first outcomes. A higher priority of conduct disorder and related problems in child-psychiatric and psychotherapeutic services would be desirable.

Aggression↗
PubMed2003

Response inhibition and disruptive behaviors: toward a multiprocess conception of etiological heterogeneity for ADHD combined type and conduct disorder early-onset type.

Response disinhibition is one of several processes that may account for disruptive behavior problems. It is associated with both attention deficits/hyperactivity (ADHD-C) and early onset, unsocialized conduct disorder (CD-E). Response inhibition is not a unitary construct. It is best understood via a dual process model of regulatory control. Executive inhibition refers to deliberate suppression of immediate motor behavior in the service of a distal goal in working memory, with relatively low anxiety activation. It is instantiated in the same frontal-striatal-thalamic neural loops as executive function and corresponds in temperament theory to effortful control. Motivational or reactive inhibition refers to anxiety-provoked interruption of behavior in the context of unexpected, novel, or punishment-cue indicators. Along with reward-response and hostile/angry response it corresponds to reactivity in temperament theory, and invokes limbic responsivity. With regard to these types of inhibitory control, ADHD-combined type is predominantly associated with dysfunctional executive inhibition. CD-E is predominantly associated with dysfunctions in the motivational inhibition process, with smaller, secondary effects in executive control. However, in both syndromes etiological heterogeneity is notable. For example, recent evidence indicates that executive inhibitory control is familial, but characterizes only a subset of children with ADHD-C. Recent dual-process models for both ADHD-C and CD-E are therefore important; they are noted and integrated. Examination of the correlates of behavioral inhibition in the subgroups with these inhibitory deficits may prove fruitful in clarifying the diverse routes to disruptive psychopathology in children.

Attention Deficit Disorder with Hyperactivity↗
PubMed1993

The effects of maternal depression on child conduct disorder and attention deficit behaviours.

The relationships between maternal history of depressive symptoms during children's middle childhood (8-11 years) and/or concurrent maternal depressive symptoms on the one hand and teacher and self reports of conduct disorder and attention deficit behaviours when the children were 12 and 13 years old on the other were studied in a birth cohort of New Zealand children. Examination of the joint effects of maternal history of depression and concurrent depressive symptoms on child behavior showed consistent and statistically significant associations between maternal history of depression and behaviour reports. However, associations between maternal concurrent depressive symptoms and child behaviour were generally non-significant when the effects of maternal history of depression were controlled. These results persisted when errors of measurement in behaviour reports were taken into account. However, after adjustment for potentially confounding social and contextual factors the correlations between maternal history of depression and child behaviour reduced to the point of both practical and statistical non-significance. We concluded that, for this cohort, the association between maternal depressive symptoms and externalising behaviour in early adolescence arose largely from the effects of common contextual factors (principally social disadvantage and marital instability) that influenced both rates of maternal symptomatology and rates of childhood problem behaviours.

Adolescent↗
PubMed2000

Fenfluramine effects on impulsivity in a sample of adults with and without history of conduct disorder.

RATIONALE: The role of serotonin in impulsivity was examined by administering the serotonin-releasing drug, d,l-fenfluramine, and measuring effects on impulsive responding of male subjects with and without a history of conduct disorder (CD) under controlled laboratory conditions. METHODS: Five adult male subjects with a history of CD and five matched controls were recruited into a study to determine the acute effects of d,l-fenfluramine on a laboratory measure of impulsive behavior. This laboratory measure, based upon delay of gratification, presented subjects with choices between a small reward after a short delay and a larger reward after a longer delay. Impulsive behavior was indicated by frequent choices for the smaller reward. RESULTS: Acute oral doses of d,l-fenfluramine (0.21, 0.42, and 0.85 mg/kg) produced decreases in the number of impulsive choices in all subjects with a history of CD, but had no effect on the control subjects. CONCLUSIONS: This data suggests that a deficit in serotonin and/or dopamine may play a role in impulsivity in CD subjects, and drugs which act to reduce this biological deficit can reduce impulsiveness.

Adult↗
PubMed2004

Adult psychopathic personality with childhood-onset hyperactivity and conduct disorder: a central problem constellation in forensic psychiatry.

To describe lifetime mental disorders among perpetrators of severe inter-personal crimes and to identify the problem domains most closely associated with aggression and a history of repeated violent criminality, we used structured interviews, clinical assessments, analyses of intellectual functioning, medical and social files, and collateral interviews in 100 consecutive subjects of pretrial forensic psychiatric investigations. Childhood-onset neuropsychiatric disorders [attention-deficit/hyperactivity disorder (AD/HD), learning disability, tics and autism spectrum disorders] affected 55% of the subjects and formed complex comorbidity patterns with adult personality disorders [including psychopathic traits according to the Psychopathy Checklist (PCL-R)], mood disorders and substance abuse. The closest psychiatric covariates to high Lifetime History of Aggression (LHA) scores and violent recidivism were the PCL-R scores and childhood conduct disorder (CD). Behavioral and affective PCL-R factors were closely associated with childhood AD/HD, CD, and autistic traits. The results support the notion that childhood-onset social and behavioral problems form the most relevant psychiatric symptom cluster in relation to pervasive adult violent behavior, while late-onset mental disorders are more often associated with single acts of violent or sexual aggression.

Adolescent↗
PubMed1985

[Incidence of heart rhythm and conduction disorders in chronic cor pulmonale among alpine inhabitants].

Electro- and echocardiographic studies were carried out in 708 male mountain-dwellers (at altitudes of 2800--4200 m) and 1047 male dwellers of lower altitudes (700--800 m), aged 30 to 59 years. One-hour ECG monitoring was conducted in 90 mountaineers. The latter population showed a high incidence of echocardiographically-confirmed signs of right-ventricular hypertrophy (RVH) of varying degrees. They also showed relatively high rates of heart rhythm and conductivity disorders (13.7% vs. 3.18% of low-altitude dwellers; p less than 0.001). As RVH gained in markedness, and as the recording time grew longer, the frequency of detected cardiac arrhythmias increased dramatically. RVH, arterial hypoxemia and pulmonary arterial hypertension are risk factors contributing to cardiac arrhythmias.

Adult↗
PubMed1988

Abstracting deficits and childhood conduct disorder as a function of familial alcoholism.

Using a large sample (n = 515), family history-positive male alcoholics (FH+) performed poorer than family history-negative (FH-) alcoholics on a test of abstracting ability. They also reported an earlier age of onset of alcoholism, more symptoms of childhood conduct disorder, and tended to report more depressive symptoms than FH- alcoholics, however, these variables were not significantly related to abstracting score. FH+ and FH- samples did not differ on average amount of ethanol consumed per day, vocabulary, state anxiety, childhood attentional deficit disorder, and childhood learning disability. The significant differences found in this study between FH+ and FH- alcoholics were minimal. With such weak effects, the inconsistent findings in studies that have investigated differences between FH+ and FH- alcoholics are understandable.

Adult↗
PubMed1975

Extracardiac recordings of His-Purkinje activity during conduction disorders and junctional rhythms.

Previous investigations have demonstrated a surface recording technique using signal averaging to detect electrical activity during the "isoelectric" P-R segment. Various physiological and pharmacological interventions suggest that the source of these potentials isthe His-Purkinje system (HPS). In order to assess the sensitivity of averaged recordings to changes in HPS activation, i.e., conduction defects in the HPS recordings were made directly from the heart surface using a bipolar, anterior-posterior epicardial lead in 15 dogs which underwent thoractomy. The signal was amplified, filtered and averaged using a digital computer for purposes of signal enhancement. The epicardial averaged lead (EAL) contained activity coincident with HPS depolarization and similar to those recorded by leads on the body surface of intact dogs from previous studies. The standard ECG and His bundle electrogram from an electrode catheter served as references in localizing and assessing several conduction disorders experimentally produced by traumatic and ischemic injury. Among the disorders produced were: 1) atrioventricular (A-V) nodal block which resulted in loss of recorded activity in the EAL following the P wave. 2) First and second degree intra-His bundle block produced by anterior septal artery ligation showed split His potentials in the HBE (1 degree) and 2:1 conduction with block in the His bundle (2 degrees). In the blocked beats the EAL showed a reproducible portion of the activity coincident with proximal His bundle activity of the split His potentials in both cases. 3) In four cases of proximal right bundle branch block produced by anterior septal artery ligation the relatively proximal portions of HPS activity in the EAL showed marked diminution. 4) Two cases of distal His bundle or bilateral bundle branch delay were seen as prolonged H-V time and a normal QRS pattern. The early and late portions of the HPS activity in the EAL were not markedly changed while the middle portion was prolonged and fractionated. 5) Junctional rhythms produced by crushing the SA node resulted in no atrial activity occurring prior to HPS depolarization in the EAL. However, the QRS was preceded by HPS activity whose onset was coincident with the H recorded in the His bundle electrogram. The EAL showed consistent and reproducible morphology and timing of HPS activity at different heart rates during normal conduction and consistent alterations of the HPS activity during abnormal conduction.

Animals↗
PubMed1997

Frontal P300 decrements, childhood conduct disorder, family history, and the prediction of relapse among abstinent cocaine abusers.

P300 event related brain potentials were studied in 49 cocaine dependent patients, abstinent for 1-5 months, and 20 healthy, non-drug-dependent controls. Patients were assigned to one of two subgroups based on the presence/absence of a DSM-IIIR diagnosis of antisocial personality disorder (ASPD). Analyses of P300s recorded during a visual selective attention task revealed reduced amplitudes at frontal electrode sites among patients with ASPD, relative to the ASPD negative patient and control groups. The frontal P300 decrement was significantly correlated with the number of childhood conduct disorder symptoms, but not with the presence/absence of a family history of alcoholism. A secondary analysis examined the relationship between P300 amplitude among cocaine dependent patients and their future behavior, i.e., relapse versus continued abstinence. Discriminant function analysis revealed that P300 amplitude alone accurately identified 70.6% of the patients who later relapsed, and 53.3% of the patients who did not.

Adult↗
PubMed1993

The impact of synthesis teaching and parent training with mothers of conduct-disordered children.

A procedure to enhance the impact of parent training with multistressed mother-child dyads was explored with 29 clinic-referred dyads. The procedure, called synthesis teaching, was provided for one randomly selected group of dyads, while the other group was engaged in problem discussions about their children. Both groups received parent training as the principal intervention for the mothers' conduct-disordered children. Results showed that these interventions had no effects on dyads in the clinic setting, but had a progressively more significant effect at home for the synthesis teaching group. That is, mothers in this group showed reductions in their indiscriminate parenting and their children demonstrated behavioral improvements. In contrast, mothers in the control group did not change their behavior and their children did not demonstrate observed behavioral changes. Interpretations of the results center on how synthesis teaching might have produced these effects.

Adult↗
PubMed2005

Low basal salivary cortisol is associated with teacher-reported symptoms of conduct disorder.

Cortisol has been implicated in psychobiological explanations of antisocial behavior. This study measured basal salivary cortisol in a sample of 25 children (age range 6 to 12 years) selected to vary in levels of antisocial behavior. Regression analyses were used to predict cortisol concentrations from parent- and teacher-reported symptoms. Parent-reported symptoms did not predict basal cortisol. Teacher-reported conduct disorder (CD) symptoms explained 38% of the variance in the cortisol concentrations, with high symptom severity associated with low cortisol. When a distinction was made between aggressive and non-aggressive CD symptoms, aggressive CD symptoms were more clearly related to low cortisol than non-aggressive CD symptoms. In contrast to previous research, no evidence was found for a mediating role of anxiety symptoms in the relationship between CD and cortisol. The results support biologically based models of antisocial behavior in children that involve reduced autonomic activity.

Adolescent↗