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NatureNurture Interplay in Aggression and Antisocial Behaviour

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Conduct disorders are the most common group of child psychiatric ... often lies or cheats. steals from home school or elsewhere. Callous/unemotional Antisocial ... – PowerPoint PPT presentation

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Title: NatureNurture Interplay in Aggression and Antisocial Behaviour


1
Nature-Nurture Interplay in Aggression and
Antisocial Behaviour
  • Emily Simonoff
  • Institute of Psychiatry
  • London

2
Size of the Problem
  • Conduct disorders are the most common group of
    child psychiatric disorders
  • In the UK, over one quarter have been to CAMHS
    and three-quarters have sought some professional
    help

3
Comorbidity
  • About one-third of cases have another mental
    disorder
  • About two-thirds have either a physical of
    developmental disorder

4
Costs of Antisocial Behaviour
From Scott, 2001
5
Conduct Disorder is Associated with Many
Psychiatric Outcomes
From Kim-Cohen et al, Arch. Gen Psychiatry., 2003
6
Treatment Effects
  • Community parenting programs of preschoolers
  • non-significant effect favouring intervention
  • Research/academic programs for preschool to
    primary school
  • 0.5-1.0 SD treatment effect
  • Multisystemic therapy
  • 0.5 SD treatment effect

7
Heritabilities for Conduct Disorder
8
What do we know about precursors of antisocial
behaviour?
9
Cognitive Risk Factors for Antisocial Behaviour
  • Low IQ
  • Low verbal skills
  • Deficits in executive functioning, including
    attentional problems
  • Poor academic attainments
  • ? Cause or effect

10
Parental Risk Factors for Antisocial Behaviour
  • Marital discord
  • Paternal criminality
  • Maternal depression
  • Poor parental supervision
  • Harsh and inconsistent discipline

Are family factors environmental or genetic? Are
they causal or responsive?
11
Maternal Depression after Birth Relates to
Conduct Problems
No depression
Before after birth
Before birth
After birth
From Kim-Cohen et al, Arch Gen Psychiat 2005
12
Amount of Maternal Depression and Conduct Problems
Number of depressive episodes
0
1
2
3
13
Contribution of Maternal Disorder to Conduct
Problems
Without ASPD
With ASPD
14
Reciprocal influences of parental discipline and
antisocial behaviour Evocative gene-environment
correlation
Adoptive parents disciplinary practices
Adoptive parents Marital warmth
Adoptees Antisocial behaviour
Biological parents Psychiatric disorder
15
Genetic Effects of Parental Discipline Style
From Lau et al, 2006, JCPP
16
Monoamine Oxidate A
  • X linked
  • Genetic mutation lading to reduced MAO A activity
    associated with mild mental retardation and
    impulsive behaviour
  • No evidence for direct role of MAO A in
    antisocial behaviour

17
Effect of Monoamine Oxidase A on Brain
  • Low MAO A activity associated with
  • Reduced volume of amygdala, cingulate gyrus
    insula and hypothalamus
  • Increased amygdala activation to emotional
    arousal and emotional memory (latter in males
    only)
  • Decreased anterior cingulate activation to
    inhibition in males only

From Meter-Linden berg et al (2006) PNAS
18
Interaction between monoamine oxidase A gene and
maltreatment
from Caspi et al (2002)
19
Social Risk Factors for Antisocial Behaviour
  • Family poverty
  • Minority ethnic status

20
Familial Transmission of Antisocial
BehaviourPassive Gene-Environment Correlation
21
Effect of Neighbourhood on Heritability of
Antisocial Behaviour
From Tuvblad et al, 2006 JCPP
22
Neighbourhood Influences on Antisocial Behaviour
  • Urban environment
  • High crime neighbourhood
  • Neighbourhood with high drug availability
  • Neighbourhood social cohesion
  • Exposure to violence
  • Delinquent peer group

Access to antisocial activities may increase
antisocial behaviour
23
School Effects on Conduct Problems
  • School variation in delinquency, disruptiveness
    and absenteeism, having accounted for intake
    characteristics
  • better behaviour associated with school
    characteristics of
  • Clear leadership
  • Good classroom management
  • Academia emphasis
  • Consistent sanctions for misbehaviour

24
Heritability of ADHD
Twin Studies of Parental Reports
Eaves et al
Price et al
Gjone
Goodman
Thaparetal
Gjone
Levy et al
25
Shared genetic effects between ADHD and conduct
disorder
  • ADHD

Conduct disorder
Phenotypic correlation 0.3
26
Shared genetic effects between ADHD and conduct
disorder
Genes
Conduct Disorder
ADHD
Environment
Environment
27
Symptoms of ADHD predisposing to conduct disorder
Genes
Genes
Conduct Disorder
ADHD
Environment
Environment
28
Association of DRD4 with ADHD
Susceptibility genes are neither necessary nor
sufficient to cause disease
from LaHoste et al (1996)
29
Case-control Studies of ADHD DRD4


Thapar (1999)
Swanson (1998)
Rowe (1998)
La Hoste (1996)
Kennedy (1999)
Holmes (1999)
Comings (1999)
Castellanos (1998)
Asherson (1998)
0
1
2
3
4
5
6
7
8
Odds Ratio
N cases 1266 N controls 3068, p0.00000008.
Combined OR 1.9 (1.5 2.2). Genome-wide
significance level (1 per genome scan for
association)
Faraone et al. 2000
30
Molecular Genetics of ADHDGenetic Associations
  • replicated not replicated
  • DRD4 yes yes
  • DAT1 yes yes
  • DßHydroxylase yes yes
  • Dopa decarboxylase no no
  • serotonin transporter yes no
  • serotonin 2A receptor no no
  • COMT no yes
  • MAOA yes yes

31
Implications for Early DetectionShould genetic
tests be used to guide us in determining who is
at risk
  • How sensitive and specific are genetic tests in
    determining who will have disorder?
  • Will early detection alter the prognosis or
    treatment for disorder?
  • Are genetic studies the most efficient in
    identifying at risk populations?

32
Genetic Influences on Antisocial Behaviour
Increase with Age
33
Long-term effect of hyperactivity on antisocial
behaviour
34
Genetic Influences on Psychopathic Behaviour
Minnesota Temperament Inventory
Antisocial scale
Detachment scale
  • Unreliable
  • Untruthful
  • Lack guilt
  • Misbehave for no purpose
  • Do not learn from punishment
  • Poor judgment
  • Dont plan
  • Insincere
  • Self-centered
  • No close relationships
  • No deep emotions
  • Lack personal insight
  • Unresponsive to kindness or praise

From Taylor et al (2003)
35
Genetic Influences on Psychopathic Behaviour
Minnesota Temperament Inventory
36
Callous/unemotional and antisocial behaviour in 7
year olds
Callous/unemotional Antisocial
  • Does not show feelings or emotions
  • helpful if someone is hurt, upset or feeling ill
  • feels bad or guilt when done something wrong
  • considerate of others feelings
  • kind to younger children
  • concerned about how well s/he is doing in school
  • Often has temper tantrums or hot tempers
  • generally obedient, usually does what adults
    request
  • often lies or cheats
  • steals from home school or elsewhere

Viding et al 2005
37
Childhood callous/unemotional traits and
antisocial behaviour
Viding et al, 2005
38
Callous Unemotional Children Make More Errors
Recognizing Sad/Fearful Faces
From Blair et al, 2000
39
Cognitive Dysfunction in Psychopathy
  • Failure to make stimulus-reinforcement
    associations particularly in relation to fearful
    or distressed stimuli
  • Disruption in ability to alter stimulus-response
    associations

40
Similar Communication Profiles in Children with
Conduct Disorder and ASD
41
Deficits in Emotional Recognition in Hard to
Mange Preschoolers
From Hughes et al JCPP, 1998
42
Insensitivity of CU Children to Parenting Programs
From Dadds Hawes, in press
43
Origins of Phenotypic Continuity
Genes time 1
Genes time 2
Genes time 3
Behaviour Time 1
Behaviour Time 2
Behaviour Time 3
Environment time 1
Environment time 2
Environment time 3
44
Implications for Research Directions
  • Studies of antisocial behaviour need to begin
    early in life
  • Risk factor research must start with adequate
    description of the child on a variety of
    dimensions
  • Integration of measurement of risk factors from
    many perspectives is necessary
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