In Search of Conceptual Clarity About the Structure of Psychopathic Traits in Children: A Network-Based Proposal.

Psychopathic traits in childhood have been revealed as potential identifiers of risk, being predictive of later forms of behavioral maladjustment. Yet, it is still under debate how psychopathic traits in children should be best conceptualized and which are the core dimensions for construct definition and prediction. The present study aims to examine the structure of psychopathic traits in childhood, and its predictive value, by using a combination of traditional factor analysis and more recent network-based methods. Data on psychopathic traits, as measured by the Child Problematic Traits Inventory (CPTI), were collected in a large sample of children (n = 2454; 48.2% girls), aged 3 to 6 at the onset of the study (Mage = 4.26; SD = 0.91), who were followed-up one and two years later using parent- and teacher-reports. Results showed that psychopathic traits measured via CPTI are best conceptualized as five latent factors encompassing grandiosity, deceitfulness, callousness, impulsivity and need of stimulation, a result that converged across informants and time. Callousness and grandiosity emerged as central traits using network analysis of parent-reports, while deceitfulness was most central using teacher-reports. Finally, callousness, impulsivity and deceitfulness emerged as the best predictors of concurrent, prospective and stable conduct problems. These results provide a refined structure of psychopathic traits in children that better accounts for the core elements of the construct. Additional theoretical and practical implications will be discussed in terms of assessment, diagnostic classification and tailored prevention/intervention.

Older and feeling unsafe? Differences in underlying vulnerability, anxiety and life satisfaction among older adults.

Objectives: Feeling safe in the daily environment is important in late life. However, research on configuration of vulnerability factors for perceived unsafety in older adults is scarce. The current study aimed to identify latent subgroups of older adults based on their vulnerability for perceived unsafety.Method: We analyzed the data from a cross-sectional survey of residents in senior apartments in a mid-sized Swedish municipality (N = 622).Results: The results of the latent profile analysis based on frailty, fear of falling, social support, perceived neighborhood problems, and trust in others in the neighborhood indicated the presence of three profiles. These profiles were labelled as compromised body and social networks (7.2%), compromised context (17.9%) and non-vulnerable (74.9%). Profile membership was statistically predicted by age, gender, and family status and profiles differed in perceived unsafety, anxiety and life satisfaction.Conclusion: Overall, the study findings suggested the existence of latent subgroups of older people based on patterns of vulnerability.

VGLUT2 rs2290045 genotype moderates environmental sensitivity to alcohol-related problems in three samples of youths.

The importance of Vesicular Glutamate Transporter 2 (VGLUT2)-mediated neurotransmission has been highlighted in studies on addiction-related phenotypes. The single nucleotide polymorphism rs2290045 in VGLUT2 has been associated with alcohol dependence, but it is unknown whether or how this association is affected by environmental factors. The present study determined whether the association of alcohol-related problems with the rs2290045 in the VGLUT2 gene was modified by negative and positive environmental factors. Three samples were included: a clinical sample of 131 adolescents followed from age 17 to 22; a general population sample of 1794 young adults; and a general population sample of 1687 adolescents followed from age 14 to 17. DNA was extracted from saliva and the rs2290045 (T/C) was genotyped. Alcohol-related problems were assessed using the Alcohol Use Disorders Identification Test. Stressful life events (SLE) and parenting were assessed by questionnaires. Gene-environment interactions were investigated using a dual statistical approach. In all samples (effect sizes 0.6-6.2%), and consistent with the differential susceptibility framework, T carriers exposed to SLE reported more alcohol-related problems if they had experienced poor parenting, and lower alcohol-related problems if they had received supportive parenting. T carriers not exposed to SLE reported higher alcohol-related problems if they had received supportive parenting and lower alcohol-related problems if they had received poor parenting. Among CC carriers, alcohol-related problems did not vary as a function of negative and positive environmental factors. In conclusion, in three samples of youths, alcohol-related problems were associated with an interaction of VGLUT2 rs2290045, SLE, and parenting.

The prospective usefulness of callous-unemotional traits and conduct disorder in predicting treatment engagement among detained girls.

Although treatment engagement (TE) is crucial for treatment success it is not well known how likely detained girls are to engage in treatment and what features may impede them from doing so. This study is the first to examine the prognostic usefulness of two features of potential interest, being callous-unemotional (CU) traits and conduct disorder (CD), in relation to TE. Detained girls and their parents (n = 75) were interviewed with the Diagnostic Interview Schedule for Children to assess CD, and completed the Antisocial Process Screening Device to assess CU traits dimensionally and categorically as in the new diagnostic and statistical manual of mental disorders, fifth edition (DSM-5) CU-based specifier. One to two months later, the girls reported how much they engaged in treatment. At the zero-order level, self-, but not parent-reported CU traits and CD were predictive of lower levels of TE. The incorporation of CU traits into a diagnosis of CD identified girls with lower levels of future TE, a finding that held across different informants. Of note, the aforementioned findings only became apparent when using a dimensional measure of CU traits, and not when using the categorical measure of CU traits currently included in DSM-5. This study showed that CU traits can help developing an understanding of what factors hinder TE among detained girls. Our findings also support recommendations to incorporate CU traits into the CD diagnosis, and suggest that dimensional approaches to do so may yield relevant information about future levels of TE.

Psychopathic personality traits in 5 year old twins: the importance of genetic and shared environmental influences.

There is limited research on the genetic and environmental bases of psychopathic personality traits in children. In this study, psychopathic personality traits were assessed in a total of 1189 5-year-old boys and girls drawn from the Preschool Twin Study in Sweden. Psychopathic personality traits were assessed with the Child Problematic Traits Inventory, a teacher-report measure of psychopathic personality traits in children ranging from 3 to 12 years old. Univariate results showed that genetic influences accounted for 57, 25, and 74 % of the variance in the grandiose-deceitful, callous-unemotional, and impulsive-need for stimulation dimensions, while the shared environment accounted for 17, 48 and 9 % (n.s.) in grandiose-deceitful and callous-unemotional, impulsive-need for stimulation dimensions, respectively. No sex differences were found in the genetic and environmental variance components. The non-shared environment accounted for the remaining 26, 27 and 17 % of the variance, respectively. The three dimensions of psychopathic personality were moderately correlated (0.54-0.66) and these correlations were primarily mediated by genetic and shared environmental factors. In contrast to research conducted with adolescent and adult twins, we found that both genetic and shared environmental factors influenced psychopathic personality traits in early childhood. These findings indicate that etiological models of psychopathic personality traits would benefit by taking developmental stages and processes into consideration.

Dissociable relations between amygdala subregional networks and psychopathy trait dimensions in conduct-disordered juvenile offenders.

Psychopathy is a serious psychiatric phenomenon characterized by a pathological constellation of affective (e.g., callous, unemotional), interpersonal (e.g., manipulative, egocentric), and behavioral (e.g., impulsive, irresponsible) personality traits. Though amygdala subregional defects are suggested in psychopathy, the functionality and connectivity of different amygdala subnuclei is typically disregarded in neurocircuit-level analyses of psychopathic personality. Hence, little is known of how amygdala subregional networks may contribute to psychopathy and its underlying trait assemblies in severely antisocial people. We addressed this important issue by uniquely examining the intrinsic functional connectivity of basolateral (BLA) and centromedial (CMA) amygdala networks in relation to affective, interpersonal, and behavioral traits of psychopathy, in conduct-disordered juveniles with a history of serious delinquency (N = 50, mean age = 16.83 ± 1.32). As predicted, amygdalar connectivity profiles exhibited dissociable relations with different traits of psychopathy. Interpersonal psychopathic traits not only related to increased connectivity of BLA and CMA with a corticostriatal network formation accommodating reward processing, but also predicted stronger CMA connectivity with a network of cortical midline structures supporting sociocognitive processes. In contrast, affective psychopathic traits related to diminished CMA connectivity with a frontolimbic network serving salience processing and affective responding. Finally, behavioral psychopathic traits related to heightened BLA connectivity with a frontoparietal cluster implicated in regulatory executive functioning. We suggest that these trait-specific shifts in amygdalar connectivity could be particularly relevant to the psychopathic phenotype, as they may fuel a self-centered, emotionally cold, and behaviorally disinhibited profile. Hum Brain Mapp 37:4017-4033, 2016. © 2016 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc.

Validation of the Greek Cypriot Translation of the Triarchic Psychopathy Measure.

Psychopathy is conceived of as a pathological constellation of personality traits, manifested in aberrant behavioral, interpersonal, and emotional tendencies. This study examined within a Greek-speaking nonclinical sample (N = 419) associations between differing phenotypic dimensions of psychopathy (boldness, meanness, disinhibition) assessed via the Triarchic Psychopathy Measure (TriPM) and self-report criterion measures of psychopathology, personality, and history of abuse and neglect. Consistent with predictions of the triarchic model of psychopathy, evidence was found for distinct correlates of the 3 phenotypic dimensions. Boldness was associated with both adaptive (immunity to anxiety/distress, fearlessness, low hostility) and maladaptive tendencies (grandiose manipulative traits, Machiavellian features including desire for control/status, and verbal aggression). Meanness was related to callous and unemotional traits, features of Machiavellianism (e.g., amoral manipulation and distrust of others), physical aggression, and absence of positive parenting. Disinhibition, by contrast, was characterized by anxiety and distress, exposure to violence, and retrospective accounts of abuse history, along with impulsive, irresponsible, and hostile tendencies. These findings indicate that the Greek-Cypriot translation of the TriPM effectively assesses the constructs of the triarchic model and extend what we know about their empirical correlates.

Psychometric Properties of the Original and Short Form of the Inventory of Callous-Unemotional Traits in Detained Female Adolescents.

This study examines the psychometric properties of the self-report version of the Inventory of Callous-Unemotional Traits in 191 detained female adolescents (M = 15.76, SD = 1.02). Evidence supporting the validity of the ICU scores was generally weak, largely due to poor functioning of the Unemotional subscale. Results from confirmatory factor analyses demonstrated support for a recently proposed shortened version of the ICU consisting of two subscales (Callousness and Uncaring). Both subscales showed acceptable to good internal consistency. This short-form version also improved criterion validity, though some issues regarding its convergent validity need further consideration. In conclusion, this study suggests that a short-form version of the ICU that includes a subset of the original items may hold promise as an efficient and valid method for assessing CU traits.

Early Childhood Trajectories of Conduct Problems and Callous-Unemotional Traits: The Role of Fearlessness and Psychopathic Personality Dimensions.

Children with early onset of conduct problems (CP) are at risk for long lasting psychosocial problems, especially if CP co-occurs with callous-unemotional (CU) traits. Joint trajectories of CP and CU traits during early childhood were identified using data from the SOFIA study, following 2031 children longitudinally from ages 3-5 to 5-7 years. The results showed that children exhibiting stable high CP and CU traits were characterized by high levels of fearlessness, and psychopathic traits, including grandiose-deceitfulness, and impulsivity, need for stimulation. Children with decreasing or increasing CP and CU traits were characterized by decreases and increases respectively in their levels of fearlessness and psychopathic traits. Children high on CP and low on CU traits exhibited lower levels of these dimensions. Thus, stability and change of fearlessness and psychopathic traits are associated with stability and change in CP and CU traits, making these temperamental and personality traits promising target candidates for early intervention.

Physical and verbal aggressive behavior and COMT genotype: Sensitivity to the environment.

Catechol-O-methyltransferase (COMT) genotype has been implicated as a vulnerability factor for several psychiatric diseases as well as aggressive behavior, either directly, or in interaction with an adverse environment. The present study aimed at investigating the susceptibility properties of COMT genotype to adverse and favorable environment in relation to physical and verbal aggressive behavior. The COMT Val158Met polymorphism was genotyped in a Swedish population-based cohort including 1,783 individuals, ages 20-24 years (47% males). A significant three-way interaction was found, after correction for multiple testing, between COMT genotype, exposure to violence, and parent-child relationship in association with physical but not verbal aggressive behavior. Homozygous for the Val allele reported lower levels of physical aggressive behavior when they were exposed to violence and at the same time experienced a positive parent-child relationship compared to Met carriers. Thus, susceptibility properties of COMT genotype were observed in relation to physical aggressive behavior supporting the hypothesis that COMT genotypes are modifying the sensitivity to environment that confers either risk or protection for aggressive behavior. As these are novel findings, they warrant further investigation and replication in independent samples. © 2016 Wiley Periodicals, Inc.

Conduct Problems in Childhood and Adolescence: Developmental Trajectories, Predictors and Outcomes in a Six-Year Follow Up.

Understanding youth conduct problems requires examination from a developmental perspective, analyzing distinctive pathways across childhood and adolescence, and identifying early predictors which will lead to specific adolescent outcomes. Bearing this in mind, developmental trajectories of conduct problems were identified from a person-oriented perspective, and using data collected from three waves over a six-year period, in a sample of Spanish children aged 6-11 at the onset of the study. Conduct problems showed five distinctive trajectories which were grouped into three major pathways in further analyses: Stable low, Stable high, and Decreasing. Associations with early personality and psychopathic traits, as well as with a wide range of adolescent behavioral and psychosocial outcomes were examined, revealing the Stable high group as exhibiting the highest risk profile. These results contribute to improving our knowledge about one of the most relevant problems in youth populations, and will help in refining interventions strategies by recognizing the developmental heterogeneity of the construct.

The DSM-5 with limited prosocial emotions specifier for conduct disorder among detained girls.

The new DSM-5 specifier 'with Limited Prosocial Emotions' (LPE) is expected to provide greater information about impairment of children and adolescents with conduct disorder (CD). This study examined the clinical utility of the LPE specifier symptom threshold among female adolescents being detained in Belgium (n = 191 girls; ages 12-17). Standardized questionnaires and a structured diagnostic interview were used to assess the LPE specifier, CD, and variables of interest. Approximately 62% (n = 118) of the girls met criteria for CD. Depending on the instrument that was used to assess the LPE specifier criteria, 26% to 37% of the girls with CD met criteria for the LPE specifier symptom threshold (CD + LPE). Overall, CD + LPE girls were not significantly different from CD-only girls regarding psychiatric morbidity (i.e., attention-deficit/hyperactivity disorder, oppositional defiant disorder, substance use disorder, major depression, and anxiety disorders). However, CD + LPE girls were more aggressive, rule-breaking, delinquent, and had higher levels of psychopathic traits than CD-only girls. This study supports the view that the LPE specifier identifies a group of seriously antisocial individuals, but could not replicate previous findings that the LPE specifier symptom threshold identifies CD individuals who exhibit more psychiatric morbidity than CD individuals who are without the specifier symptom threshold. These findings altogether suggest that the clinical usefulness of the DSM-5 specifier for the diagnosis of CD is restricted, at least in detained girls. (PsycINFO Database Record

Psychopathic traits as predictors of future criminality, intimate partner aggression, and substance use in young adult men.

This study examined the prospective relation between Youth Psychopathic Traits Inventory (YPI) scores and various negative outcomes in a community sample of young men. Official criminal records and self-reported outcomes, including criminality, physical and relational aggression against intimate partners, and excessive substance use, were obtained on average 5.4 years (records) and 3.5 years (self-reports) after the YPI assessment. Results showed that psychopathic traits measured with the YPI (approximately at age 25) did not significantly contribute to the prediction of future official criminal charges and self-reported crime, physical aggression against intimate partners, and excessive alcohol and marijuana use, after controlling for several covariates. However, results also showed that men with higher scores on the YPI were more likely to commit future acts of relational aggression against their partner, even after controlling for prior relational aggression. This novel finding needs replication, though, and-for now-does not jeopardize the overall conclusion that psychopathic traits as measured with the YPI hardly predict over and above prior criminality and aggression. Altogether, the findings of the present study and their consistency with past research suggest that one should rethink the role of psychopathy measures for risk assessment purposes, at least when these measures do not index prior criminality.

The Prognostic Usefulness of Multiple Specifiers for Subtyping Conduct Problems in Early Childhood.

OBJECTIVE: To better describe and treat children with conduct problems (CP), grandiose-manipulative and daring-impulsive traits are proposed for subtyping CP, instead of using only a callous-unemotional specifier. However, the acclaimed benefits of having multiple specifiers for CP remain largely untested and therefore highly speculative. To fill this gap, this study tested longitudinal relations between these 3 specifiers and developmental outcomes in childhood and adolescence, independent of early childhood CP. METHOD: Longitudinal data from 2 community studies were used. Teacher ratings were used to measure CP and the specifiers in 3- to 5-year-olds from Sweden (n = 2,064) and Spain (n = 2,055). Developmental outcomes were assessed by multiple informants (ie, teachers, parents, and children) 1 to 8 years later. RESULTS: Early childhood CP were predictive of all outcomes. Callous-unemotional traits predicted low levels of social competence and prosocial behavior, independent of CP (and age, sex, and socioeconomic status). Grandiose-manipulative and daring-impulsive traits were predictive of aggression and violent delinquency, respectively, independent of CP, but also of higher levels of prosocial behavior or social competence. CONCLUSION: The 3 specifiers are predictive of different outcomes, independent of CP, which is thought to form the basis for developing specifiers for CP. Findings tentatively challenge the centrality of callous-unemotional traits for subtyping CP, but it is premature to conclude that grandiose-manipulative and daring-impulsive specifiers are needed in future revisions of DSM and ICD. Efforts to systematically evaluate the utility of these specifiers should be welcomed to inform ongoing debates on this matter.

Fearlessness as an Underlying Mechanism Leading to Conduct Problems: Testing the INTERFEAR Model in a Community Sample in Spain.

Conduct problems (CP) in childhood and adolescence have a significant impact on the individual, family, and community. To improve treatment for CP, there is a need to improve the understanding of the developmental pathways leading to CP in boys and girls. Prior research has linked the child's fearlessness and callous-unemotional (CU) traits, as well as experiences of parental warmth and punitive parenting, to CP. However, few studies have tested the interplay of these factors in contributing to future CP development. The present study aimed to test the InterFear model, which suggests that fearlessness in early childhood leads to CP through an indirect pathway involving low positive parenting, high negative/punitive parenting, and callous-unemotional (CU) traits. The sample included 2467 Spanish children (48.1% girls; Mage = 4.25; SD = 0.91), followed up across a five-year period. Besides a direct association between fearlessness in early childhood and future CP, the results found an indirect pathway whereby fearlessness reduces positive parenting and increases punitive parenting, which contributes to the development of CU traits and sets the stage for CP in later childhood. The specific indirect effect from fearlessness to CP via CU traits accounted for most of the variance, suggesting the existence of a temperamental pathway independent of parental variables. Further, two additional indirect pathways, exclusive of fearlessness, were identified, which started with low parental warmth and positive parenting, leading to CP via CU traits. These findings support the InterFear model, demonstrating multiple pathways to CP with the involvement of fearlessness, parenting practices, and CU traits. This model might play a pivotal role in the development of targeted prevention and intervention strategies for CP.

Fearlessness as an Underlying Mechanism Leading to Conduct Problems: Testing the Intermediate Effects of Parenting, Anxiety, and callous-unemotional Traits.

This study investigates whether the longitudinal association between fearlessness and conduct problems (CP) is mediated by warm and harsh parenting, parent-child conflict, anxiety, and callous-unemotional (CU) traits. The constructs under investigation were assessed at five different time points, spanning a period of eight years. A multi-informant approach was followed, collecting data from parents and teachers (N = 2,121; 47% girls). The structural equation model pointed to both direct and indirect pathways between fearlessness and CP. Specifically, findings suggested that Time 1 fearlessness (age 3-5 years) increased the likelihood of Time 2 (age 4-6 years) harsh parenting and Time 3 (age 5-7 years) parent-child conflict. Further, fearlessness was positively associated with Time 4 (age 8-10) callous-unemotional traits and Time 5 (age 11-13) CP. The total indirect effect from fearlessness to CP through these variables was significant, although the specific indirect effect from fearlessness to CU traits to CP accounted for most of the variance. Warm parenting and anxiety did not mediate the association between fearlessness and CP. In addition to the identified pathways connecting fearlessness to CP, findings pointed to the existence of multiple developmental pathways to future CP, as well as gender differences in longitudinal associations.

Externalizing Behaviors and Alzheimer's Disease and Any Dementia: A Multigeneration Cohort Study in Sweden.

Background and Objectives: We examined the extent to which externalizing behaviors such as violent and nonviolent criminal behavior, and substance use disorders (SUD) are associate with the onset of Alzheimer's disease (AD) and any dementia in prior generations. Research Design and Methods: A nationwide cohort of 2,463,033 individuals born between 1973 and 1997 (index persons) were linked to their biological relatives (parents, grandparents, and uncles/aunts) using Swedish national registers. Cox regression models were used to examine the association between each measure of externalizing behaviors with AD and any dementia in each of the relative cohorts. Results: Parents of index persons with externalizing behaviors had an increased risk for AD compared with parents of index persons without externalizing behaviors-nonviolent criminal behavior: Hazard Ratio (HR) = 1.16, 95% Confidence Intervals (CI) 1.10-1.22; violent criminal behavior: HR = 1.32 (95% CI: 1.19-1.45); SUD: HR = 1.28 (95% CI: 1.17, 1.40). The associations attenuated with decreasing familial relatedness. Relatives of individuals with externalizing behaviors compared with relatives of individuals without, showed an increased risk of having both early-onset and late-onset AD but the strength of the associations was higher for early-onset AD than for late-onset AD. A similar pattern of results was observed for the association with any dementia. Discussion and Implications: Externalizing behaviors are associated with AD and any dementia in prior generations. The associations were stronger for parents in comparison with grandparents and uncles/aunts, suggesting shared familial risks between conditions. This warrants further studies examining common genetic and family-wide environmental factors that may contribute to identifying common underlying mechanisms to the development of externalizing behaviors, AD, and any dementia.

Risk of dementia and mild cognitive impairment in older adults with a criminal background: a population-based register study in Sweden.

Criminal behaviour has previously been associated with an increased risk for several mental health problems, but little is known about the association between criminal behaviour and dementia. We aimed to examine how the criminal background (type of crime, number of convictions, length of the sentence) is associated with dementia and mild cognitive impairment (MCI), and how mental and physical health disorders and educational attainment influenced these associations. A nationwide cohort of 3,617,028 individuals born between 1932 and 1962 were linked with criminal and medical records using Swedish national registers. We used Cox regression models to examine the associations. Increased risks for dementia (Hazard ratios (HRs) 1.54, 95% confidence interval (CI) 1.50-1.57) and MCI (1.55, 1.50-1.61) were found in individuals with criminal background, particularly among those who committed violent or several crimes, or with long sentences. After full adjustment of covariates, the associations attenuated but remained statistically significant for dementia (1.25, 1.22-1.28) and MCI (1.27, 1.22-1.32). The attenuation was mostly explained by mental health problems -depression, anxiety, schizophrenia spectrum disorders, substance use disorder (SUD), and bipolar disorder- (dementia: 1.34, 1.31-1.37; MCI: 1.35, 1.30-1.40). SUD contributed the most to attenuate the associations. Our results may provide important insights to health and penal systems by showing the importance of considering the severity of the criminal background and life-course mental health when assessing the risk of neurodegenerative disorders.

Psychopathic Personality Configurations in Early Childhood: A Response to Dvoskin et al. (2022).

Dvoskin et al. (2022) offered a cautionary comment on an article published in the Journal of Personality Disorders (López-Romero et al., 2021). This comment was focused on the scientific and policy grounds of our study, and cautioned against the use of the "putative psychopathic personality" label for applied purposes. While we agree with most of their concerns and cautions, we aim to provide additional clarification on the raised concerns, noting that the purpose of our study is purely exploratory, and that its findings are not intended for applied purposes. We do expect that our study and this commentary will further clarify the importance of examining psychopathic personality from a developmental perspective, opening new ways of discussion regarding how to best conceptualize and study a construct that, while waiting for additional longitudinal research, has been shown as relevant in identifying a group of children and adolescents at increased risk for maladjustment.

The Persian version of the Youth Psychopathic Traits Inventory-Short Version (YPI-S): A psychometric evaluation.

Studies on the psychopathy construct are mostly limited to Western cultures, and there is a lack of research in this area in non-Western countries, specifically in Iran. The present study aimed to examine the factor structure, internal consistency, and convergent validity of the Persian version of the Youth Psychopathic Traits Inventory-Short Version (YPI-S) with a sample of 668 school-attending adolescents in Iran (46% girls; Mage = 16.35). Confirmatory factor analysis supported the proposed three-factor model. While the internal consistency of some YPI-S scores was unsatisfactory, the YPI-S scores showed the expected relations with external correlates (e.g., aggression, hyperactivity), supporting the validity of YPI-S scores. The authors' results supported the YPI-S for assessing psychopathic traits in Iranian adolescents. The modification of the YPI-S factor structure, the low factor loadings of some YPI-S items, and the inadequate internal consistency of some YPI-S dimensions indicate cultural influences on the assessment of cross-cultural traits.