By Kathryn L. Humphreys, Lucy McGoron, Margaret A. Sheridan, Katie A. McLaughlin, Nathan A. Fox, Charles A. Nelson III, and Charles H. Zeanah | Journal of the American Academy of Child & Adolescent Psychiatry | October 9, 2015

Abstract:

Objective

Callous-unemotional (CU) traits in childhood are a developmental precursor to psychopathy, yet the origins and etiology of CU traits are not known. We examined CU traits among 12-year-old children exposed to severe early deprivation and evaluated whether a high-quality foster care intervention mitigated the development of high levels of CU traits.

Method

Participants were from the Bucharest Early Intervention Project, a randomized controlled trial of foster care for children in institutions. Children were recruited from institutions in Bucharest, Romania, along with age- and sex-matched children who were never institutionalized. Children raised in institutional settings were randomized (M_age=22 months) to either a foster-care group (n=68) or a care-as-usual group (n=68). CU traits were assessed at age 12.75 years in available participants from the randomized trial (n=95) and children who were never institutionalized (n=50).

Results

Children who experienced institutional rearing as young children had significantly higher levels of CU traits in early adolescence compared to children who were never institutionalized. Intent-to-treat analysis indicated that, among boys, CU traits were significantly lower among those who received the foster care intervention compared to those randomized to care as usual. Caregiver responsiveness to distress, but not caregiver warmth, mediated the intervention effect on CU traits in boys.

Conclusion

These findings provide the first evidence to date that psychosocial intervention can prevent the onset of CU traits. Although severe early deprivation predicted increased levels of CU traits, high-quality foster care that emphasized responsive caregiving reduced the impact of deprivation on CU trait development for boys.

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By Katie A. McLaughlin, Matthew Peverill, Andrea L. Gold, Sonia Alves, and Margaret Sheridan | Journal of the American Academy of Child & Adolescent Psychiatry | June 26, 2015

Abstract:

Objective

The strong associations between child maltreatment and psychopathology have generated interest in identifying neurodevelopmental processes that are disrupted following maltreatment. Previous research has largely focused on neural response to negative facial emotion. We determined whether child maltreatment was associated with neural responses during passive viewing of negative and positive emotional stimuli and effortful attempts to regulate emotional responses.

Method

42 adolescents aged 13-19 years, half with exposure to physical and/or sexual abuse, participated. Blood oxygen level-dependent (BOLD) response was measured during passive viewing of negative and positive emotional stimuli and attempts to modulate emotional responses using cognitive reappraisal.

Results

Maltreated adolescents exhibited heightened response in multiple nodes of the salience network, including amygdala, putamen, and anterior insula, to negative relative to neutral stimuli. During attempts to decrease responses to negative stimuli relative to passive viewing, maltreatment was associated with greater recruitment of superior frontal gyrus, dorsal anterior cingulate cortex, and frontal pole; adolescents with and without maltreatment down-regulated amygdala response to a similar degree. No associations were observed between maltreatment and neural response to positive emotional stimuli during passive viewing or effortful regulation.

Conclusion

Child maltreatment heightens the salience of negative emotional stimuli. Although maltreated adolescents modulate amygdala responses to negative cues to a similar degree as non-maltreated youths, they utilize regions involved in effortful control to a greater degree to do so, potentially because greater effort is required to modulate heightened amygdala responses. These findings are promising, given the centrality of cognitive restructuring in trauma-focused treatments for children.

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By Jeff Bostic, Lisa Thurau, Mona Potter, and Stacy Drury | February 2014 | Journal of the American Academy of Child & Adolescent Psychiatry

More than 100 years after the creation of the juvenile court, state juvenile justice policies still promote adult approaches, despite consistent neurobiological evidence that the adolescent brain processes, perceives, and responds differently than adult brains. Although frequently the first responders in youth cases, police officers rarely receive adequate training in effective communication and interaction strategies with youth. Strategies for Youth found that most police academies contacted devote less than 1% of training to interactions with adolescents,¹ yet 20% to 40% of juvenile arrests are for “contempt of cop” offenses, such as questioning or “disrespecting” an officer.² Incarceration of adolescents fails to decrease recidivism and compounds the negative impacts on the 60% to 70%³ of youth in correctional facilities who have significant untreated mental health problems.⁴ We found that police officer training in neurodevelopmentally sensitive techniques markedly decreased teen arrests and improved police–teen interactions in diverse American communities. Continue reading »