The impact of maternal childhood maltreatment on child externalizing behaviour and the mediating factors underlying this association: a three-level meta-analysis and systematic review.

Child maltreatment can negatively impact not only survivors but also survivors' children. However, research on the intergenerational effect of maternal childhood maltreatment on child externalizing behaviour has yielded contradictory results and has not yet been systematically synthesised. The current three-level meta-analysis and systematic review aimed to provide a quantitative estimate of the strength of the association between maternal childhood maltreatment and child externalizing behaviour and to summarise research on potential mediating factors of this association. PsycINFO, PubMed, and Embase were searched and 39 studies with 82 effects sizes were included in the meta-analysis. Results revealed a small significant association between maternal childhood maltreatment and child externalizing behaviour (r = 0.16; 95% CI 0.12-0.19; publication bias-adjusted effect size: r = 0.12, 95% CI 0.08-0.16). Maternal mental health, particularly depressive symptoms, maternal parenting and children's maltreatment exposure were the most frequently examined mediators of this association, with relatively robust mediating effects for children's maltreatment exposure and maternal depressive symptoms, but mixed evidence for the mediating role of maternal parenting. This meta-analysis provides evidence for a small but significant association between maternal childhood maltreatment and children's externalizing behaviour, emphasizing the need to develop effective preventive and intervention strategies to minimise the effects of childhood maltreatment on the next generation.

Alterations of autonomic nervous system and HPA axis basal activity and reactivity to acute stress: a comparison of traumatized adolescents and healthy controls.

Alterations in neurobiological stress systems such as the autonomic nervous system (ANS) and hypothalamic-pituitary-adrenal (HPA) axis contribute to the development and maintenance of psychological and behavioral problems after traumatic experiences. Investigating neurobiological parameters and how these relate to each other may provide insight into the complex mechanisms at play. Whereas the preponderance of studies focuses on either the ANS or the HPA axis separately, the current study is the first to evaluate relations between posttraumatic stress and both basal activity during rest and stress reactivity of the ANS as well as the HPA axis in a sample of traumatized adolescents and healthy controls. The traumatized sample (n = 77), based on clinical levels of posttraumatic stress, was a convenience sample that was recruited within residential institutions, was compared to a healthy control sample (n = 48) recruited within the general community. For the ANS, we expected increased SNS and decreased PNS activity during rest and increased SNS and decreased PNS reactivity to social stress among traumatized adolescents compared to healthy controls. Regarding the HPA axis, we expected increased basal cortisol levels and decreased cortisol reactivity to stress in the traumatized sample. Compared to healthy controls, traumatized adolescents exhibited significantly higher sympathetic and lower parasympathetic activation during rest and increased sympathetic reactivity to acute stress (ANS parameters). Outcomes on the HPA axis (i.e. cortisol) indicated that traumatized adolescents showed increased cortisol levels during rest and blunted cortisol reactivity to acute stress. Implications for clinical relevance and trauma-focused treatment purposes are discussed.

Human responses to Covid-19: The role of optimism bias, perceived severity, and anxiety.

During the Covid-19 pandemic, the governments are trying to contain the spread with non-pharmaceutical interventions (NPIs), such as social distancing rules, restrictions, and lockdowns. In an effort to identify factors that may influence population adherence to NPIs, we examined the role of optimism bias, anxiety, and perceived severity of the situation in relation to engagement in protective behavioral changes and satisfaction with governments' response to this pandemic. We conducted an online survey in 935 participants (M age  = 34.29; 68.88% females) that was disseminated in April and May 2020 in the Netherlands, Germany, Greece, and USA. Individuals with high optimism bias engaged less in behavioral changes, whereas individuals with high levels of anxiety and high perceived severity engaged more in behavioral changes. Individuals with high optimism bias and high levels of anxiety were less satisfied with the governments' response, albeit for different reasons. Individuals who reported low perceived severity and low government satisfaction engaged the least in behavioral changes, whereas participants who reported high perceived severity and low government satisfaction engaged the most in behavioral changes. This study contributes to a better understanding of the psychological factors that influence people's responses to NPIs.

The effect of oxytocin administration on empathy and emotion recognition in residential youth: A randomized, within-subjects trial.

Previous research has revealed a positive effect of oxytocin administration on several social behaviors especially in individuals with social-affective deficits. However, it is still unknown whether intranasal oxytocin administration (OT-IN) can be beneficial to residential youth who exhibit severe social-affective impairments. We conducted a randomized, double-blind, placebo-controlled, within-subjects, sequential study to examine the effect of OT-IN on empathy and emotion recognition in 100 male adolescents living in residential youth care facilities. We also explored the moderating role of callous-unemotional traits, trauma, and dissociation in the oxytocin effect. Participants self-administered one dose of 24 IU of oxytocin or placebo and performed experimental tasks on empathy and emotion recognition before and after the administration. The same procedure was performed one week later with the other substance. We found that empathy was increased after oxytocin administration compared to placebo and this effect was specific to individuals with high callous-unemotional traits. There was no effect of OT-IN on the overall emotion recognition, but there was a positive effect on accuracy of fear recognition. Trauma and dissociation did not moderate the oxytocin effect on empathy or emotion recognition. Our findings provided evidence of a beneficial effect of OT-IN on empathy and fear recognition in residential youth. We propose that a combination of OT-IN and psychological interventions merits further exploration, as it might be a novel promising direction for more tailored approaches and better treatment outcomes.

Oxytocin Receptor Gene (OXTR) and Deviant Peer Affiliation: A Gene-Environment Interaction in Adolescent Antisocial Behavior.

Although the oxytocin receptor gene (OXTR) is involved in aggression and social affiliation, it has not been examined in gene-environment interaction studies. This longitudinal study examined the effect of genetic variants in OXTR and its gene-environment interaction with perceived deviant peer affiliation in the trajectories of antisocial behavior in 323 adolescents (182 males) from 13 to 18 years. Annual assessments of reactive and proactive aggression, delinquency, and friends' delinquency, as well as DNA at age 17 were collected. Gene-based tests yielded no main effect of OXTR, but revealed a significant gene-environment interaction in proactive aggression and delinquency. Variation in the OXTR might affect the influence of deviant peer affiliation on antisocial behavior, contributing to a better understanding of individual differences in antisocial behavior.

Dissociation and psychopathology in residential youth: a brief report.

Although dissociative symptoms are observed in several psychiatric disorders and linked to antisocial behavior and offending, the relation between dissociation and psychopathology or comorbidity has not been consistently investigated in residential youth yet. This brief report documented prevalence and comorbidity rates of several psychiatric disorders and examined their relation to dissociation in residential youth. The study included 100 male adolescents (Mage = 16.51) admitted to residential youth care facilities. Psychopathology was assessed with the Mini International Neuropsychiatric Interview for children and adolescents (MINI-KID) and dissociation was measured with the Adolescent Dissociative Experiences Scale (A-DES). Externalizing problems (conduct disorder, oppositional defiant disorder, attention deficit hyperactivity disorder) were the most prevalent (81%) followed by substance abuse/dependence (71%), manic/hypomanic symptoms (40%), anxiety (35%), and depression (33%). High comorbidity was also observed in externalizing problems with alcohol/substance abuse/dependence (67%), manic/hypomanic symptoms (35%), depression (31%), and anxiety (30%). Logistic regression analyses revealed a significant link between dissociation and externalizing problems, depression, and manic/hypomanic symptoms, as well as comorbid externalizing problems and depression or manic/hypomanic symptoms. The findings highlight the need to assess dissociation in order to better understand the multifaceted individual profile of residential youth and incorporate it in the treatment plan.

Executive (Dys)Functioning and Impulsivity as Possible Vulnerability Factors for Aggression in Forensic Patients.

This study investigated whether executive dysfunction and impulsivity are both predictors of reactive aggression and is the first to use behavioral assessment of aggression in response to provocation by means of a personalized boxing body opponent bag giving harassing feedback. Aggressive behavior, self-reported aggression, executive functioning (ie, working memory, flexibility, and divided attention), and impulsivity dimensions (i.e., Sensation Seeking, Impulsive Decision Making, and [inadequate] Response Inhibition) were measured in 44 incarcerated psychiatric patients. Results show that both executive functioning (working memory) and impulsivity (Impulsive Decision Making) predicted self-reported reactive aggression, whereas Response Inhibition was the only predictor for reactive aggressive behavioral responses. The study suggests that Response Inhibition is a stronger predictor of reactive aggressive behavior than executive capacities of working memory, flexibility, and divided attention. Therefore, future research should investigate whether (inadequate) Response Inhibition could also be a valuable predictor for violent recidivism.

Modeling Impulsivity in Forensic Patients: A Three-Dimensional Model of Impulsivity.

The current study investigated whether a multidimensional model could underlie impulsivity and its associations with various disorders in a forensic sample. Data were available from self-report and behavioral impulsivity instruments of 87 forensic patients. Principal component analysis (PCA) was used to derive a dimensional impulsivity model, and the relationship between and possible predictive validity of impulsivity dimensions for psychopathology was investigated using product moment correlations and regression analysis. A 3-dimensional model of impulsivity was derived, with factors labeled impulsive decision making, sensation seeking, and response inhibition. Impulsive decision making was a predictor for a history of drug dependence, the impulsive lifestyle facet of psychopathy, and antisocial personality disorder. Sensation seeking was not related to any psychopathology. Inadequate response inhibition was a predictor for drug dependence, psychopathy, and antisocial personality disorder. Given the importance of the concept of impulsivity with regard to forensic risk assessment, the current results replicated earlier impulsivity models and imply that impulsivity is a crucial target for diagnosis and interventions and underlines the importance to consider impulsivity as a multidimensional construct.

The Association Between Callous-Unemotional Traits, Externalizing Problems, and Gender in Predicting Cognitive and Affective Morality Judgments in Adolescence.

Morality deficits have been linked to callous-unemotional traits and externalizing problems in response to moral dilemmas, but these associations are still obscure in response to antisocial acts in adolescence. Limited evidence on young boys suggested that callous-unemotional traits and externalizing problems were associated with affective but not cognitive morality judgments. The present study investigated these associations in a community sample of 277 adolescents (M age  = 15.35, 64 % females). Adolescents with high callous-unemotional traits showed deficits in affective but not cognitive morality, indicating that they can identify the appropriate moral emotions in others, but experience deviant moral emotions when imagining themselves committing antisocial acts. Externalizing problems and male gender were also strongly related to deficits in affective morality, but they had smaller associations with deficits in cognitive morality too. Implications for treatment and the justice system are discussed.

Identifying cognitive predictors of reactive and proactive aggression.

The aim of this study was to identify implicit cognitive predictors of aggressive behavior. Specifically, the predictive value of an attentional bias for aggressive stimuli and automatic association of the self and aggression was examined for reactive and proactive aggressive behavior in a non-clinical sample (N = 90). An Emotional Stroop Task was used to measure an attentional bias. With an idiographic Single-Target Implicit Association Test, automatic associations were assessed between words referring to the self (e.g., the participants' name) and words referring to aggression (e.g., fighting). The Taylor Aggression Paradigm (TAP) was used to measure reactive and proactive aggressive behavior. Furthermore, self-reported aggressiveness was assessed with the Reactive Proactive Aggression Questionnaire (RPQ). Results showed that heightened attentional interference for aggressive words significantly predicted more reactive aggression, while lower attentional bias towards aggressive words predicted higher levels of proactive aggression. A stronger self-aggression association resulted in more proactive aggression, but not reactive aggression. Self-reports on aggression did not additionally predict behavioral aggression. This implies that the cognitive tests employed in our study have the potential to discriminate between reactive and proactive aggression. Aggr. Behav. 41:51-64 2015. © 2014 Wiley Periodicals, Inc.

Validation of the Dutch Reactive Proactive Questionnaire (RPQ): differential Correlates of Reactive and Proactive Aggression from childhood to adulthood.

This study reports reliability and validity of the Dutch Reactive-Proactive Aggression Questionnaire (RPQ). In total, 845 participants completed the RPQ along with other measures of aggression. Groups consisted of non-offender participants, criminal offenders, youngsters (age 6-18), and adults (age above 18). Test-retest stability in a subsample of 324 childhood arrestees was good (all ICC's > 0.41). A confirmatory factor analysis supported the same two-factor structure as in the original RPQ. Convergent validity was adequate (all r's > 0.16). Moreover, results demonstrated that the proactive and reactive subscales were differentially related to measurements of callousness and impulsiveness, respectively. Criterion validity was shown in that non-offender subjects demonstrated significantly lower RPQ scores than offender samples. Finally, construct validity was demonstrated in that violent offenders showed higher aggression scores than non-violent offenders. Proactive aggression showed different developmental trajectories within non-offender versus criminal samples, indicating that this form of aggression may be more pathological.

Knowing right from wrong, but just not always feeling it: relations among callous-unemotional traits, psychopathological symptoms, and cognitive and affective morality judgments in 8- to 12-year-old boys.

The present research expands our understanding of cognitive and affective morality by exploring associations with callous-unemotional (CU) traits and externalizing symptoms. Participants were 46 8- to 12-year-old boys from the community who completed the Affective Morality Index, the Youth Self-Report, and the Inventory of Callous-Unemotional Traits. A pattern of results was found indicating that in particular the combination of high CU traits and high externalizing symptoms was associated with lack of affective morality, and an increased perceived likelihood of recommitting antisocial acts (recidivism). The implications of these findings and suggestions for future research are discussed.

Amygdala connectivity and aggression.

Neurobiological models propose that reactive aggression is predicated on impairments in amygdala-prefrontal connectivity that subserves moral decision-making and emotion regulation. The amygdala is a key component within this neural network that modulates reactive aggression. We provide a review of amygdala dysfunctional brain networks leading to reactive aggressive behavior. We elaborate on key concepts, focusing on moral decision-making and emotion regulation in a developmental context, and brain network connectivity factors relating to amygdala (dys)function-factors which we suggest predispose to reactive aggression. We additionally discuss insights into the latest treatment interventions, providing the utilization of the scientific findings for practice.

Grandparental Support and Maternal Postpartum Mental Health : A Review and Meta-Analysis.

Support from grandparents plays a role in mothers' perinatal mental health. However, previous research on maternal mental health has mainly focused on influences of partner support or general social support and neglected the roles of grandparents. In this narrative review and meta-analysis, the scientific evidence on the association between grandparental support and maternal perinatal mental health is reviewed. Searches in PubMed, EMBASE, MEDLINE, Scopus, and PsycINFO yielded 11 empirical studies on N = 3381 participants, reporting on 35 effect sizes. A multilevel approach to meta-analysis was applied to test the association between grandparental support and maternal mental health. The results showed a small, statistically significant association (r = .16; 95% CI: 0.09-0.25). A moderator test indicated that the association was stronger for studies reporting on support from the maternal grandmother in particular (r = .23; 95% CI: 0.06-0.29). Our findings suggest that involved grandparents, in particular mother's own mother, constitute a protective factor for the development of maternal postpartum mental health problems. These findings have clear implications for interventions. Future studies should examine whether stimulating high-quality support from grandparents is a fruitful avenue for enhancing maternal postpartum mental health.

Parental protection in fathers with negative caregiving experiences: Heightened amygdala reactivity to infant threatening situations.

Parental protection is an important, yet understudied, aspect of parenting behavior. Predictors of the quality of protection and potential underlying neural mechanisms are still unknown. In this study, we examined whether negative caregiving experiences in fathers' own childhood are related to protective behavior and neural reactivity to infant threatening situations. Paternal protective behavior was measured with self- and partner-reported protective behavior and behavioral observations in an experimental set-up (auditory startling task) in 121 first-time fathers (mean age child = 19.35 weeks, SD = 11.27). Neural activation during exposure to videos of infant-threatening (vs. neutral) situations was measured with functional magnetic resonance imaging (fMRI). We found a significant and positive association between negative caregiving experiences and amygdala reactivity to infant-threatening situations. A history of negative caregiving experiences was not significantly related to reported or observed paternal protective behavior. Our findings suggest that fathers with negative caregiving experiences show emotional hyperreactivity to cues of infant threat.

Differential associations between psychopathy dimensions, types of aggression, and response inhibition.

Findings on executive functioning in psychopathy are inconsistent. Different associations between psychopathy dimensions and executive functioning might explain contradicting findings. This study examined the role of psychopathy dimensions and types of aggression in response inhibition among 117 male adolescents (53 antisocial delinquents and 64 controls). Participants completed a self-report measure of aggression and a GoNoGo task. Psychopathy dimensions were assessed using the Psychopathy Checklist: Youth Version. Although high scores on the antisocial dimension and reactive aggression were associated with poor response inhibition, the affective-interpersonal dimension, proactive aggression, and verbal intelligence (IQ) were related to better response inhibition (two-factor model). Associations with the affective-interpersonal dimensions did not reach significance. Exploratory analyses showed that affective and antisocial facets accounted for the obtained opposing associations of the affective-interpersonal and antisocial psychopathy dimensions with response inhibition. The interpersonal and lifestyle facets (four-facet model) were unrelated to response inhibition. Results could not be explained by Attention Deficit Hyperactivity Disorder (ADHD). Findings suggest differential associations between the psychopathy dimensions, types of aggression, and response inhibition. Therefore, a dimensional approach to psychopathy and related concepts, such as aggression, might strongly improve diagnostic procedures. Global scores could mask important differential associations.

Virtual Reality for Aggression Assessment: The Development and Preliminary Results of Two Virtual Reality Tasks to Assess Reactive and Proactive Aggression in Males.

Validly measuring aggression is challenging because self-reports are plagued with biased answer tendencies and behavioral measures with ethical concerns and low ecological validity. The current study, therefore, introduces a novel virtual reality (VR) aggression assessment tool, differentially assessing reactive and proactive aggression. Two VR tasks were developed, one in an alley environment (N = 24, all male, Mage = 23.88, 83.3% students) and an improved second one in a bar (N = 50, all male, Mage = 22.54, 90% students). In this bar VR task, participants were randomly assigned to either the reactive condition where they were triggered by a cheating and insulting dart-player or to the proactive condition where they could earn extra money by aggressing. Participants' level of self-reported aggression and psychopathy was assessed, after which they engaged in either the reactive or proactive VR task. Changes in affect and blood pressure were also measured. Aggression in the reactive VR task was evidenced to mostly display convergent validity because it positively correlated with self-reported aggression and total and fearless dominance factor scores of psychopathy, and there was a trend relationship with increased systolic blood pressure. The validity of the proactive aggression variant of our VR bar paradigm received less support, and needs more refinement. It can be concluded that VR is a potentially promising tool to experimentally induce and assess (reactive) aggression, which has the potential to provide aggression researchers and clinicians with a realistic and modifiable aggression assessment environment.

A soft baby carrier intervention enhances amygdala responses to infant crying in fathers: A randomized controlled trial.

New fathers may grow into their parental role through active involvement in childcare. Spending time in physical contact with the child may promote an adaptive transition to fatherhood. In this randomized controlled trial, we tested the effects of a baby carrier intervention on fathers' hormonal and neural functioning. Using functional magnetic resonance imaging (fMRI), we examined whether infant carrying affects neural reactivity to infant crying in first-time fathers, taking into account the role of the hormone oxytocin as a mediating mechanism and fathers' own childhood experiences as a potential moderating factor. Sixty first-time fathers (infant age M = 11.18 weeks, SD = 2.08) were randomly assigned to a baby carrier intervention group (n = 32 fathers) or a control group (n = 28 fathers). Fathers in the intervention group were instructed to use a baby carrier for three weeks, whereas fathers in the control group were instructed to use a baby seat. Before and after the intervention salivary oxytocin was measured and neural reactivity to infant crying was assessed using fMRI. Results showed that the infant carrier intervention increased amygdala reactivity to infant crying compared to the infant seat users. This effect was most pronounced in fathers with experiences of childhood abuse. The carrier intervention did not affect fathers' oxytocin levels. Our findings indicate that spending time in physical contact with the infant may promote attention to and accurate perception of infant signals, in particular in fathers with more adverse childhood experiences. Soft baby carriers may, therefore, facilitate an adaptive transition to fatherhood.

Salivary oxytocin after oxytocin administration: Examining the moderating role of childhood trauma.

Although oxytocin administration influences behavior, its effects on peripheral oxytocin concentrations are mixed and derived from studies on healthy subjects. Additionally, trauma attenuates the behavioral effects of oxytocin, but it is unknown whether it also influences its effect on peripheral circulation. This study examined whether salivary oxytocin increased after oxytocin administration and whether trauma attenuated this effect. We conducted a randomized, double-blind, placebo-controlled, within-subjects study in 100 male adolescents living in residential youth care facilities. Participants self-administered intranasally 24 IU of oxytocin and placebo (one week later) and provided a saliva sample before and 15 min after administration. Salivary oxytocin increased significantly after oxytocin administration, but this effect might be inflated by exogenous oxytocin reaching the throat. Trauma did not moderate this effect. Our findings suggest that trauma did not attenuate the effect of oxytocin administration on salivary oxytocin, but more robust methodologies are recommended to draw more solid conclusions.

Daily oxytocin patterns in relation to psychopathy and childhood trauma in residential youth.

Inconsistent findings have been found on the relation between oxytocin levels and psychopathy or callous-unemotional (CU) traits in humans, potentially because the role of trauma in oxytocin secretion and the distinction between primary and secondary psychopathy have been overlooked so far. Primary psychopathy has a stronger biological background, whereas secondary psychopathy mainly develops due to environmental adversity, such as childhood trauma. This study investigated the interaction effects of CU traits and childhood trauma on daily salivary oxytocin levels in 57 males living in residential youth care facilities. Participants provided six saliva samples (morning, afternoon, and evening for two consecutive days) and completed self-report questionnaires on CU traits and childhood trauma. A mean daily oxytocin and an oxytocin pattern across the day were examined. A significant interaction between CU traits and one trauma category (emotional neglect) on mean daily oxytocin was observed, demonstrating that subjects with high CU traits and low levels of emotional neglect (primary psychopathy) exhibited lower daily oxytocin secretion compared to subjects with high CU traits and high levels of emotional neglect (secondary psychopathy). There were no significant interactions with the other trauma types or in daily oxytocin patterns. Our findings provided a first insight into the potentially distinct oxytocin concentrations in primary and secondary psychopathy, suggesting that primary psychopathy might be linked to lower daily oxytocin output. Future longitudinal studies are required to unravel the developmental patterns of oxytocin secretion and determine whether lower oxytocin output might be a biomarker of primary psychopathy.