Deficits in facial expression recognition in male adolescents with early-onset or adolescence-onset conduct disorder.

BACKGROUND: We examined whether conduct disorder (CD) is associated with deficits in facial expression recognition and, if so, whether these deficits are specific to the early-onset form of CD, which emerges in childhood. The findings could potentially inform the developmental taxonomic theory of antisocial behaviour, which suggests that early-onset and adolescence-limited forms of CD are subject to different aetiological processes. METHOD: Male adolescents with either early-onset CD (n = 42) or adolescence-onset CD (n = 39), and controls with no history of serious antisocial behaviour and no current psychiatric disorder (n = 40) completed tests of facial expression and facial identity recognition. Dependent measures were: (a) correct recognition of facial expressions of anger, disgust, fear, happiness, sadness, and surprise, and (b) the number of correct matches of unfamiliar faces. RESULTS: Relative to controls, recognition of anger, disgust, and happiness in facial expressions was disproportionately impaired in participants with early-onset CD, whereas recognition of fear was impaired in participants with adolescence-onset CD. Participants with CD who were high in psychopathic traits showed impaired fear, sadness, and surprise recognition relative to those low in psychopathic traits. There were no group differences in facial identity recognition. CONCLUSIONS: Both CD subtypes were associated with impairments in facial recognition, although these were more marked in the early-onset subgroup. Variation in psychopathic traits appeared to exert an additional influence on the recognition of fear, sadness and surprise. Implications of these data for the developmental taxonomic theory of antisocial behaviour are discussed.

Decision making and executive function in male adolescents with early-onset or adolescence-onset conduct disorder and control subjects.

BACKGROUND: Although conduct disorder (CD) is associated with an increased susceptibility to substance use disorders, little is known about decision-making processes or reward mechanisms in CD. This study investigated decision making under varying motivational conditions in CD. METHODS: Performances on the Risky Choice Task (RCT) and the Wisconsin Card Sorting Test (WCST) were assessed in 156 adolescents (84 control subjects, 34 with adolescence-onset CD, and 38 with early-onset CD). The RCT was performed twice, once under normal motivational conditions and once under conditions of increased motivation and psychosocial stress. RESULTS: Increased motivation and stress led to more cautious decision making and changes in framing effects on the RCT in all groups, although such effects were least pronounced in the early-onset CD group. Participants from both CD subgroups selected the risky choice more frequently than control subjects. Under normal motivational conditions, early-onset CD participants chose the risky choice more frequently in trials occurring after small gains, relative to control subjects and adolescence-onset CD participants. Following adjustment for IQ differences, the groups did not differ significantly in terms of WCST performance. CONCLUSIONS: Differences in decision making between control subjects and individuals with CD suggest that the balance between sensitivity to reward and punishment is shifted in this disorder, particularly the early-onset form. Our data on modulation of decision making according to previous outcomes suggest altered reward mechanisms in early-onset CD. The WCST data suggest that impairments in global executive function do not underlie altered decision making in CD.

Cortisol diurnal rhythm and stress reactivity in male adolescents with early-onset or adolescence-onset conduct disorder.

BACKGROUND: Previous studies have reported lower basal cortisol levels and reduced cortisol responses to stress in children and adolescents with conduct disorder (CD). It is not known whether these findings are specific to early-onset CD. This study investigated basal and stress-induced cortisol secretion in male participants with early-onset and adolescence-onset forms of CD. METHODS: Forty-two participants with early-onset CD, 28 with adolescence-onset CD, and 95 control subjects participated in the study. They collected saliva across the day to assess their cortisol awakening response and diurnal rhythm. Subsequently, salivary cortisol was measured before, during, and after a psychosocial stress procedure designed to elicit frustration. Cardiovascular activity and subjective mood states were also assessed during stress exposure. RESULTS: There were no group differences in morning cortisol levels or the size of the cortisol awakening response. Basal cortisol levels in the evening and at 11 am during the laboratory visit were higher in both CD subgroups relative to control subjects. In contrast, cortisol and cardiovascular responses to psychosocial stress were reduced in both CD subgroups compared with control subjects. All groups reported similar increases in negative mood states during stress. CONCLUSIONS: Our findings suggest that group differences in cortisol secretion are most pronounced during stress exposure, when participants with CD show cortisol hyporeactivity compared with control subjects. There was no evidence for reduced basal cortisol secretion in participants with CD, but rather increased secretion at specific time points. The results do not support developmentally sensitive differences in cortisol secretion between CD subtypes.

Fear conditioning and affective modulation of the startle reflex in male adolescents with early-onset or adolescence-onset conduct disorder and healthy control subjects.

BACKGROUND: Impairments in emotional processing may play an etiological role in the development of aggressive or antisocial behavior such as is seen in conduct disorder (CD). These findings may be developmentally sensitive, with neuropsychological impairments confined to those with the early-onset form of CD, which emerges in childhood. We investigated whether adolescents with early- or adolescence-onset CD would acquire fear conditioned responses to a visual conditioned stimulus and show a normal pattern of affective modulation of the startle reflex. METHODS: Electrodermal activity was measured during the fear conditioning process, and electromyographic recording methods were used to assess blink magnitudes elicited by acoustic startle probes during the viewing of emotionally valenced pictures. Forty-one early-onset CD, 28 adolescence-onset CD, and 54 healthy control adolescents participated in the study. RESULTS: Both CD groups showed impaired differential fear conditioning relative to control subjects, while retaining the ability to generate normal skin conductance responses to the aversive unconditioned stimulus. There was a similar relationship between emotional valence of the slides and startle magnitude in CD and control adolescents, but startle-elicited blinks were lower across all emotion categories in both CD subtypes. CONCLUSIONS: Fear conditioning deficits and reduced startle amplitudes were observed in participants with early- and adolescence-onset forms of CD. These findings are consistent with impairments in neural systems subserving emotion and involving the amygdala in CD, regardless of age of onset.