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1.
Psychol Med ; : 1-15, 2024 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-39229691

RESUMO

Much research has focused on executive function (EF) impairments in psychopathy, a severe personality disorder characterized by a lack of empathy, antisocial behavior, and a disregard for social norms and moral values. However, it is still unclear to what extent EF deficits are present across psychopathy factors and, more importantly, which EF domains are impaired. The current meta-analysis answers these questions by synthesizing the results of 50 studies involving 5,694 participants from 12 different countries. Using multilevel random-effects models, we pooled effect sizes (Cohen's d) for five different EF domains: overall EF, inhibition, planning, shifting, and working memory. Moreover, differences between psychopathy factors were evaluated. Our analyses revealed small deficits in overall EF, inhibition, and planning performance. However, a closer inspection of psychopathy factors indicated that EF deficits were specific to lifestyle/antisocial traits, such as disinhibition. Conversely, interpersonal/affective traits, such as boldness, showed no deficits and in some cases even improved EF performance. These findings suggest that EF deficits are not a key feature of psychopathy per se, but rather are related to antisociality and disinhibitory traits. Potential brain correlates of these findings as well as implications for future research and treatment are discussed.

2.
Dev Psychopathol ; 36(1): 454-466, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36744529

RESUMO

While many studies have identified risk and protective factors of substance use (SU), few have assessed the reciprocal associations of child conduct problems (CP) and parenting practices and behaviors in the prediction of SU across development. A greater understanding of how these factors relate over time is needed to improve the timing of targeted prevention efforts. This study examined how child CP, parenting behaviors, and parents' own antisocial behavior relate from preschool to adolescence and eventuate in SU. Participants included 706 youth (70.6% male; 89.7% white) enrolled in the Michigan Longitudinal Study. Data from waves 1 (ages 3-5), 2 (ages 6-8), 3 (ages 9-11), 4 (ages 12-14), and 5 (ages 15-17) were included. A random intercept cross-lagged panel model (RI-CLPM) examined reciprocal associations between parenting practices, parents' antisocial behavior, and child CP over time (waves 1-4) and how these factors contribute to adolescent alcohol, cigarette, and marijuana use (wave 5). At the within-person level, negative parenting and parents' own antisocial behavior had a strong influence in late childhood/early adolescence. Only child CP emerged as a significant predictor of SU. Results highlight the importance of early intervention and the potential influence of parenting and child factors throughout development in the prevention of SU.


Assuntos
Comportamento Problema , Transtornos Relacionados ao Uso de Substâncias , Humanos , Criança , Masculino , Adolescente , Pré-Escolar , Feminino , Poder Familiar , Estudos Longitudinais , Pais
3.
Dev Psychopathol ; : 1-10, 2024 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-38738358

RESUMO

Substance use disorders among juveniles are a major public health concern and are often intertwined with other psychosocial risk factors including antisocial behavior. Identifying etiological risks and mechanisms promoting substance use disorders remains a high priority for informing more focused interventions in high-risk populations. The present study examined brain gray matter structure in relation to substance use severity among n = 152 high-risk, incarcerated boys (aged 14-20). Substance use severity was positively associated with gray matter volume across several frontal/striatal brain regions including amygdala, pallidum, putamen, insula, and orbitofrontal cortex. Effects were apparent when using voxel-based-morphometric analysis, as well as in whole-brain, data-driven, network-based approaches (source-based morphometry). These findings support the hypothesis that elevated gray matter volume in striatal reward circuits may be an endogenous marker for vulnerability to severe substance use behaviors among youth.

4.
Dev Psychopathol ; : 1-13, 2024 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-38329116

RESUMO

Adverse environments are linked to elevated youth antisocial behavior. However, this relation is thought to depend, in part, on genetic susceptibility. The present study investigated whether polygenic risk for antisociality moderates relations between hostile environments and stable as well as dynamic antisocial behaviors across adolescence. We derived two antisocial-linked polygenic risk scores (PRS) (N = 721) based on previous genome-wide association studies. Forms of antisocial behavior (nonaggressive conduct problems, physical aggression, social aggression) and environmental hostility (harsh parenting and school violence) were assessed at age 13, 15, and 17 years. Relations to individual differences stable across adolescence (latent stability) vs. time-specific states (timepoint residual variance) of antisocial behavior were assessed via structural equation models. Higher antisocial PRS, harsh parenting, and school violence were linked to stable elevations in antisocial behaviors across adolescence. We identified a consistent polygenic-environment interaction suggestive of differential susceptibility in late adolescence. At age 17, harsher parenting was linked to higher social aggression in those with higher antisocial PRS, and lower social aggression in those with lower antisocial PRS. This suggests that genetics and environmental hostility relate to stable youth antisocial behaviors, and that genetic susceptibility moderates home environment-antisocial associations specifically in late adolescence.

5.
Eur Child Adolesc Psychiatry ; 33(3): 881-895, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37097345

RESUMO

Conduct problems are associated with an increased risk of a wide range of physical, mental, and social problems. However, there is still uncertainty about how early risk factors differentiate different developmental patterns of conduct problems and whether findings replicate across diverse social contexts. We aimed to identify developmental trajectories of conduct problems, and test early risk factors, in the 2004 Pelotas Birth Cohort in Brazil. Conduct problems were measured at ages 4, 6, 11, and 15 years from caregiver reports on the Child Behaviour Checklist (CBCL) and Strengths and Difficulties Questionnaire (SDQ). Conduct problem trajectories were estimated using group-based semi-parametric modeling (n = 3938). Multinomial logistic regression was used to examine associations between early risk factors and conduct problem trajectories. We identified four trajectories: three with elevated conduct problems, including early-onset persistent (n = 150; 3.8%), adolescence-onset (n = 286; 17.3%), and childhood-limited (n = 697; 17.7%), and one with low conduct problems (n = 2805; 71.2%). The three elevated conduct problem trajectories were associated with a wide range of sociodemographic risk factors, prenatal smoking, maternal mental health, harsh parenting, childhood trauma, and child neurodevelopmental risk factors. Early-onset persistent conduct problems were particularly associated with trauma, living without a father figure, and attention difficulties. The four trajectories of conduct problems from ages 4 to 15 years in this Brazilian cohort have similar longitudinal patterns to those identified in high-income countries. The results confirm previous longitudinal research and developmental taxonomic theories on the etiology of conduct problems in a Brazilian sample.


Assuntos
Transtorno da Conduta , Criança , Feminino , Gravidez , Humanos , Adolescente , Estudos Longitudinais , Brasil/epidemiologia , Transtorno da Conduta/epidemiologia , Transtorno da Conduta/psicologia , Coorte de Nascimento , Fatores de Risco
6.
J Res Adolesc ; 2024 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-38595030

RESUMO

The loss of John Schulenberg reverberates across the developmental and prevention sciences. In honor of his many contributions, this paper applies his ideas of developmental continuity and discontinuity to understand the process by which PROSPER delivered universal prevention programs (delivered in Grades 6 and 7) affect young adult outcomes. Guided by these developmental models, we deconstructed adolescent substance use initiation trajectories into two discrete phases-early and late adolescence, demarcated by substance use initiation levels at the end of 9th grade. We evaluated the effects of PROSPER interventions on these phases, and in turn, the effects of adolescent substance use initiation on young adult antisocial behavior, alcohol and drug use consequences, and depression symptoms. This sample included 1,984 young adults who participated in the PROSPER intervention trial in Grade 6 (two cohorts, 2002 and 2003), followed over 8 adolescent measurement occasions (Fall and Spring of Grade 6; Spring of Grades 7-12). Young adult outcomes were averaged across three waves (collected at ages 20, 23, and 25). PROSPER interventions were associated with reduced substance use initiation in early adolescence, but not escalation during late adolescence. In turn, substance use in both early and late adolescence was uniquely associated with young adult antisocial behavior, depression symptoms, and substance use consequences. PROSPER interventions were associated with young adult antisocial behavior and problematic substance use via reduced risk for early initiation status. Findings are discussed in terms of developmental continuity and discontinuity.

7.
Prev Sci ; 25(5): 786-797, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38795235

RESUMO

Over a 12-year period, this study examined the effects of the Family Check-Up preventive intervention model on both observed and self-reported parenting behaviors of mothers and fathers as well as how those parenting behaviors were associated with young adult antisocial behavior. Teachers identified 641 early adolescent youth from school settings to be at elevated risk for the development of externalizing behavior and/or substance use. These youth and their families were randomly assigned to the Family Check-Up intervention model (consisting of an adaptive, multi-tiered model of support, including a school-based family resource room, the Family Check-Up, and targeted follow-up services) or a control condition. Using an intent-to-treat approach, the Family Check-Up intervention model positively impacted mothers' observed parenting approximately 5 years later in middle adolescence but was not associated with changes in fathers' observed or self-reported parenting. Mothers' observed adaptive parenting and fathers' self-reported adaptive parenting in middle adolescence were associated with lower risk for young adult antisocial behavior. The cascading effects of brief, family-focused interventions are discussed along with implications for the measurement of parenting in mothers and fathers in the context of preventive intervention trials.


Assuntos
Poder Familiar , Humanos , Feminino , Masculino , Adolescente , Estudos Longitudinais , Autorrelato , Transtorno da Personalidade Antissocial/prevenção & controle , Mães/psicologia , Adulto Jovem , Adulto , Pai/psicologia
8.
J Adolesc ; 96(1): 209-216, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37691514

RESUMO

INTRODUCTION: Adolescent bullying is a complicated behavior that is difficult to prevent. Understanding factors that predict bullying during adolescence can help us minimize such behavior. Classroom incivility is a low-level antisocial behavior that has been discussed in the literature as being a potential predictor of bullying in adolescence. Therefore, the goal of the present study was to examine the longitudinal link between classroom incivility and bullying. METHODS: Data for the current study was collected using quantitative surveys at two-time points, three years apart (November 2019 and November 2022) in southern Ontario, Canada. Our sample comprised 349 adolescents (51.3% boys, 46.4% girls, 0.6% other, and 1.7% preferred not to say) between the ages of 9 and 14 years old (M = 11.92 years; SD = 1.42). We utilized cross-lagged analyses to examine the stability of classroom incivility in adolescence, and the longitudinal association between classroom incivility and bullying. RESULTS: Classroom incivility at Time 1 predicted bullying behavior at Time 2, while bullying at Time 1 did not predict classroom incivility at Time 2. Our results not only support the stability of levels of classroom incivility across time, but also provide empirical support for classroom incivility as a precursor to bullying behavior. CONCLUSION: Our study suggests that classroom incivility can not only negatively impact the learning environment but may also be implicated in contributing to the circumstances that promote bullying behavior in adolescence, highlighting the importance of limiting uncivil behavior before it escalates into more severe forms of behavior.


Assuntos
Bullying , Incivilidade , Masculino , Feminino , Humanos , Adolescente , Criança , Inquéritos e Questionários , Canadá
9.
J Youth Adolesc ; 53(2): 233-257, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37794287

RESUMO

Although both risk and protective factors are important components of etiological theories for antisocial behavior, far less is known about protective factors and their impact. This review summarized primary studies on the impact of different protective factors for antisocial behavior in youth. In total, 305 studies reporting on 1850 potentially protective factors were included. Each extracted factor was first classified into one of 77 mutually exclusive groups of similar factors (referred to as domains), after which a three-level meta-analysis was conducted to determine the protective effect of each domain. A significant and negative effect was found for 50 domains, which were therefore designated as being truly protective. The largest impact (r < -0.20) was found for higher levels of conservativeness, self-transcendence, life satisfaction, involvement in romantic relationships, the capacity to reflect or mentalize, peer relationships quality, prosocial peers, prosocial values, agreeableness, school self-esteem, parental control, general resilience, and social skills. Analyses revealed that the impact of some of the 77 domains was moderated by the youth's age (five domains) and gender (four domains) as well as the severity of antisocial behavior they exhibit (two domains), indicating that the impact of these domains differs across subgroups of antisocial youth. Given the substantial number of factors that were identified as being protective for antisocial behavior in youth, this study discusses implications for future directions, assessment strategies, and (preventive) interventions.


Assuntos
Comportamento do Adolescente , Transtorno da Personalidade Antissocial , Humanos , Adolescente , Fatores de Proteção , Grupo Associado , Identidade de Gênero
10.
Adm Policy Ment Health ; 51(3): 393-405, 2024 05.
Artigo em Inglês | MEDLINE | ID: mdl-38427148

RESUMO

Previous research indicates that youth exhibiting antisocial behavior are at risk for utilizing a disproportionate amount of health services compared to youth without these problems. The present study investigates whether being processed by the juvenile justice system and showing callous-unemotional (CU) traits independently predict health service utilization (medical and mental health service use and out-of-home placement) over and above the severity of antisocial behavior across adolescence. A total of 766 participants who had been arrested for the first time in adolescence provided data at ten appointments over a period of seven years. Results showed that self-reported antisocial behavior at the time of arrest predicted increased use of most health service use types over the next seven years (i.e. medicine prescriptions, tests for sexually transmitted infections, mental health service appointments, and out-of-home placements). All except prescription medication use remained significant when controlling for justice system processing and CU traits. Further, justice system processing added significantly to the prediction of medical service appointments. Whereas CU traits were associated with mental health service appointments and out-of-home placements, these did not remain significant when controlling for severity of antisocial behavior. These findings are consistent with prior research documenting the health care costs of antisocial behavior.


Assuntos
Delinquência Juvenil , Serviços de Saúde Mental , Humanos , Adolescente , Masculino , Feminino , Delinquência Juvenil/estatística & dados numéricos , Serviços de Saúde Mental/estatística & dados numéricos , Transtorno da Personalidade Antissocial , Emoções , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos
11.
Psychol Med ; 53(5): 1721-1731, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-34607618

RESUMO

BACKGROUND: Previous studies have reported brain structure abnormalities in conduct disorder (CD), but it is unclear whether these neuroanatomical alterations mediate the effects of familial (genetic and environmental) risk for CD. We investigated brain structure in adolescents with CD and their unaffected relatives (URs) to identify neuroanatomical markers of familial risk for CD. METHODS: Forty-one adolescents with CD, 24 URs of CD probands, and 38 healthy controls (aged 12-18), underwent structural magnetic resonance imaging. We performed surface-based morphometry analyses, testing for group differences in cortical volume, thickness, surface area, and folding. We also assessed the volume of key subcortical structures. RESULTS: The CD and UR groups both displayed structural alterations (lower surface area and folding) in left inferior parietal cortex compared with controls. In contrast, CD participants showed lower insula and pars opercularis volume than controls, and lower surface area and folding in these regions than controls and URs. The URs showed greater folding in rostral anterior cingulate and inferior temporal cortex than controls and greater medial orbitofrontal folding than CD participants. The surface area and volume differences were not significant when controlling for attention-deficit/hyperactivity disorder comorbidity. There were no group differences in subcortical volumes. CONCLUSIONS: These findings suggest that alterations in inferior parietal cortical structure partly mediate the effects of familial risk for CD. These structural changes merit investigation as candidate endophenotypes for CD. Neuroanatomical changes in medial orbitofrontal and anterior cingulate cortex differentiated between URs and the other groups, potentially reflecting neural mechanisms of resilience to CD.


Assuntos
Transtorno da Conduta , Humanos , Adolescente , Transtorno da Conduta/diagnóstico por imagem , Predisposição Genética para Doença , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Lobo Parietal/diagnóstico por imagem , Lobo Parietal/patologia , Lobo Temporal/patologia , Imageamento por Ressonância Magnética/métodos
12.
Psychol Med ; 53(8): 3652-3660, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35172913

RESUMO

BACKGROUND: Adolescent antisocial behavior (AB) is a public health concern due to the high financial and social costs of AB on victims and perpetrators. Neural systems involved in reward and loss processing are thought to contribute to AB. However, investigations into these processes are limited: few have considered anticipatory and consummatory components of reward, response to loss, nor whether associations with AB may vary by level of callous-unemotional (CU) traits. METHODS: A population-based community sample of 128 predominantly low-income youth (mean age = 15.9 years; 42% male) completed a monetary incentive delay task during fMRI. A multi-informant, multi-method latent variable approach was used to test associations between AB and neural response to reward and loss anticipation and outcome and whether CU traits moderated these associations. RESULTS: AB was not associated with neural response to reward but was associated with reduced frontoparietal activity during loss outcomes. This association was moderated by CU traits such that individuals with higher levels of AB and CU traits had the largest reductions in frontoparietal activity. Co-occurring AB and CU traits were also associated with increased precuneus response during loss anticipation. CONCLUSIONS: Findings indicate that AB is associated with reduced activity in brain regions involved in cognitive control, attention, and behavior modification during negative outcomes. Moreover, these reductions are most pronounced in youth with co-occurring CU traits. These findings have implications for understanding why adolescents involved in AB continue these behaviors despite severe negative consequences (e.g. incarceration).


Assuntos
Transtorno da Personalidade Antissocial , Transtorno da Conduta , Humanos , Masculino , Adolescente , Feminino , Transtorno da Personalidade Antissocial/diagnóstico por imagem , Transtorno da Personalidade Antissocial/epidemiologia , Transtorno da Personalidade Antissocial/psicologia , Transtorno da Conduta/diagnóstico por imagem , Transtorno da Conduta/epidemiologia , Transtorno da Conduta/psicologia , Encéfalo , Imageamento por Ressonância Magnética , Emoções/fisiologia
13.
J Neuropsychiatry Clin Neurosci ; 35(4): 374-384, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37415501

RESUMO

OBJECTIVE: Antisocial behaviors are common and problematic among patients with behavioral variant frontotemporal dementia (bvFTD). In the present study, the investigators aimed to validate an informant-based questionnaire developed to measure the extent and severity of antisocial behaviors among patients with dementia. METHODS: The Social Behavior Questionnaire (SBQ) was developed to measure 26 antisocial behaviors on a scale from absent (0) to very severe (5). It was administered to 23 patients with bvFTD, 19 patients with Alzheimer's disease, and 14 patients with other frontotemporal lobar degeneration syndromes. Group-level differences in the presence and severity of antisocial behaviors were measured. Psychometric properties of the SBQ were assessed by using Cronbach's alpha, exploratory factor analysis, and comparisons with a psychopathy questionnaire. Cluster analysis was used to determine whether the SBQ identifies different subgroups of patients. RESULTS: Antisocial behaviors identified by using the SBQ were common and severe among patients with bvFTD, with at least one such behavior endorsed for 21 of 23 (91%) patients. Antisocial behaviors were more severe among patients with bvFTD, including the subsets of patients with milder cognitive impairment and milder disease severity, than among patients in the other groups. The SBQ was internally consistent (Cronbach's α=0.81). Exploratory factor analysis supported separate factors for aggressive and nonaggressive behaviors. Among the patients with bvFTD, the factor scores for aggressive behavior on the SBQ were correlated with those for antisocial behavior measured on the psychopathy scale, but the nonaggressive scores were not correlated with psychopathy scale measures. The k-means clustering analysis identified a subset of patients with severe antisocial behaviors. CONCLUSIONS: The SBQ is a useful tool to identify, characterize, and measure the severity of antisocial behaviors among patients with dementia.

14.
Eur Arch Psychiatry Clin Neurosci ; 273(2): 411-425, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36094569

RESUMO

Antisocial behavior (ASB) is characterized by frequent violations of the rights and properties of others, as well as aggressive conduct. While ample evidence points to a critical role of serotonin in the emotional modulation of social responses, the implication of this neurotransmitter in ASB is unclear. Here, we performed the first-ever postmortem analysis of serotonergic markers in the orbitofrontal cortex (OFC) of male subjects with ASB (n = 9). We focused on this brain region, given its well-recognized role in social response and ASB pathophysiology. Given that all individuals also had a substance use disorder (SUD) diagnosis, two age-matched control groups were used: SUD only and unaffected controls. Tissues were processed for immunoblotting analyses on eight key serotonergic targets: tryptophan hydroxylase 2 (TPH2), the rate-limiting enzyme of brain serotonin synthesis; serotonin transporter (SERT), the primary carrier for serotonin uptake; monoamine oxidase A (MAOA), the primary enzyme for serotonin catabolism; and five serotonin receptors previously shown to influence social behavior: 5-HT1A, 5-HT1B, 5-HT2A, 5-HT2C, and 5-HT4. Our analyses documented a significant increase in 5-HT2A receptor levels in the ASB + SUD group compared to SUD-only controls. Furthermore, TPH2 levels were significantly reduced in the SUD group (including SUD only and ASB + SUD) compared to unaffected controls. No difference was detected in the expression of any other serotonergic target. These results are in keeping with previous evidence showing high 5-HT2A receptor binding in the OFC of pathologically aggressive individuals and point to this molecule as a potential target for ASB treatment.


Assuntos
Transtorno da Personalidade Antissocial , Córtex Pré-Frontal , Receptor 5-HT2A de Serotonina , Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Transtorno da Personalidade Antissocial/complicações , Transtorno da Personalidade Antissocial/enzimologia , Transtorno da Personalidade Antissocial/metabolismo , Autopsia , Monoaminoxidase/metabolismo , Córtex Pré-Frontal/enzimologia , Córtex Pré-Frontal/metabolismo , Receptor 5-HT2A de Serotonina/metabolismo , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/enzimologia , Transtornos Relacionados ao Uso de Substâncias/metabolismo , Proteínas da Membrana Plasmática de Transporte de Serotonina/metabolismo , Agressão , Estudos de Casos e Controles
15.
BMC Psychiatry ; 23(1): 315, 2023 05 04.
Artigo em Inglês | MEDLINE | ID: mdl-37143003

RESUMO

BACKGROUND: Antisocial behavior during adolescence can have long-lasting negative effects and leads to high societal costs. Forensic Outpatient Systemic Therapy (Forensische Ambulante Systeem Therapie; FAST) is a promising treatment for juveniles aged 12-21 showing severe antisocial behavior. The intensity, content and duration of FAST can be adjusted to the needs of the juvenile and their caregiver(s), which is considered crucial for effective treatment. Next to the regular version of FAST (FASTr), a blended version (FASTb) in which face-to-face contacts are replaced by minimally 50% online contacts over the duration of intervention was developed during the Covid-19 pandemic. The current study will investigate whether FASTb is equally effective as FASTr, and through which mechanisms of change, for whom, and under which conditions FASTr and FASTb work. METHODS: A randomized controlled trial (RCT) will be carried out. Participants (N = 200) will be randomly assigned to FASTb (n = 100) or FASTr (n = 100). Data collection will consist of self-report questionnaires and case file analysis, and include a pre-test at the start of the intervention, a post-test immediately after the intervention, and a six month follow-up. Mechanisms of change will be investigated using monthly questionnaires of key variables during treatment. Official recidivism data will be collected at two-year follow-up. DISCUSSION: This study aims to improve the effectiveness and quality of forensic mental health care for juveniles with antisocial behavior by studying the effectiveness of blended care, which has not been studied before in treatment of externalizing behavior. If found to be at least as effective as face-to-face treatment, blended treatment can help meet the urgent need for more flexible and efficient interventions in this field. In addition, the proposed study aims to unravel what works for whom, knowledge urgently needed in mental health care for juveniles with severe antisocial behavior. TRIAL REGISTRATION: This trial was registered at ClinicalTrials.gov on 07/11/2022, registration number NCT05606978.


Assuntos
COVID-19 , Pacientes Ambulatoriais , Adolescente , Humanos , Transtorno da Personalidade Antissocial/terapia , Resultado do Tratamento , Ensaios Clínicos Controlados Aleatórios como Assunto
16.
Compr Psychiatry ; 127: 152428, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37778180

RESUMO

BACKGROUND: Patients in the forensic mental health services (FMHS) with a mental disorder, a co-occurring substance use disorder (SUD), and high risk of aggressive antisocial behavior (AAB) are sometimes referred to as the 'triply troubled'. They suffer poor treatment outcomes, high rates of criminal recidivism, and increased risk of drug related mortality. To improve treatment for this heterogeneous patient group, more insight is needed concerning their co-occurring mental disorders, types of substances used, and the consequent risk of AAB. METHODS: A three-step latent class analysis (LCA) was used to identify clinically relevant subgroups in a sample of patients (n = 98) from a high-security FMHS clinic in Sweden based on patterns in their history of mental disorders, SUD, types of substances used, and AAB. RESULTS: A four-class model best fit our data: class 1 (42%) had a high probability of SUD, psychosis, and having used all substances; class 2 (26%) had a high probability of psychosis and cannabis use; class 3 (22%) had a high probability of autism and no substance use; and class 4 (10%) had a high probability of personality disorders and having used all substances. Both polysubstance classes (1 and 4) had a significantly more extensive history of AAB compared to classes 2 and 3. Class 3 and class 4 had extensive histories of self-directed aggression. CONCLUSIONS: The present study helps disentangle the heterogeneity of the 'triply troubled' patient group in FMHS. The results provide an illustration of a more person-oriented perspective on patient comorbidity and types of substances used which could benefit clinical assessment, treatment planning, and risk-management among patients in forensic psychiatric care.


Assuntos
Transtornos Mentais , Transtornos Relacionados ao Uso de Substâncias , Humanos , Transtorno da Personalidade Antissocial/diagnóstico , Transtorno da Personalidade Antissocial/epidemiologia , Transtorno da Personalidade Antissocial/psicologia , Suécia/epidemiologia , Análise de Classes Latentes , Transtornos Mentais/diagnóstico , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Comorbidade , Agressão
17.
Dev Psychopathol ; : 1-12, 2023 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-38073592

RESUMO

Research has suggested that childhood-onset conduct problems (CPs) are more strongly related to individual predispositions, whereas adolescent-onset CP is more strongly associated with social factors, such as peer delinquency. Neighborhood disadvantage (ND) increases the risk for associating with deviant peers. Thus, peer delinquency could mediate the relationship between ND and adolescent-onset CP. This mediational hypothesis has not been tested previously. We tested this hypothesis in 1,127 justice-involved adolescent males using self-reported delinquency and official arrest records over 3 years after the youth's first arrest as outcomes. Predictors were self-reported and census-derived indicators of ND and self-reported peer delinquency. Age of onset moderated the associations between self-reported ND and arrests and between self-report of peer delinquency and arrests. In both cases, the association was stronger for those with adolescent-onset CP. Peer delinquency mediated all relationships between ND and CP. Our results also showed some unexpected differences in associations depending on whether self-reported ND or census-derived indicators were used as predictors. Specifically, census-derived ND was negatively related to self-reported offending, which could be due to the use of an arrested sample and the need for youth in more advantaged neighborhoods to show a more severe pattern of antisocial behavior to be arrested.

18.
J Res Adolesc ; 33(1): 216-229, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36103289

RESUMO

Adolescents' antisocial behavior and negative conflict management styles are each associated with adverse romantic relationship outcomes, yet little research exists on their associations. We investigated whether adolescents' antisocial behavior was associated with conflict management styles, and whether it predicted breakup 3 months later. In total, 91 adolescent couples (Mage = 16.43, SD = 0.99; 41.2% Hispanic/Latinx) participated in videotaped conflict discussions coded for negotiation, coercion, and avoidance. Actor-partner interdependence models suggest adolescents' antisocial behavior is associated with decreased use of negotiation (couple pattern) and increased use of coercion (actor pattern). No significant associations were found for avoidance. Neither antisocial behavior nor conflict management styles predicted breakup. Findings are discussed in light of the unique developmental importance of adolescents' romantic relationships.


Assuntos
Comportamento do Adolescente , Transtorno da Personalidade Antissocial , Humanos , Adolescente , Negociação , Psicologia do Adolescente
19.
Prev Sci ; 2023 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-37940781

RESUMO

Adolescence is a critical period during which youth develop and shape their behaviors. Because differences between youths are strongly connected to environmental factors, we aimed to elucidate possible pathways from home-school regulation and atmosphere to youths' prosocial and antisocial behaviors. Data were derived from the China Education Panel Survey. This study involved a total of 9291 students aged 14-15 years (4834 boys, 4457 girls). We used structural equation modeling (SEM) with LISREL 8.80 and Monte Carlo resampling with R to conduct the analysis strategy. In the home-school regulation, parental supervision on the one hand and teacher criticism on the other hand have direct positive and negative predictive effects on youths' prosocial behaviors, respectively, while their direct effects on antisocial behavior are the opposite; teachers praise does not directly affect adolescents' prosocial and antisocial behaviors. In the home-school atmosphere, family interaction and perceived good class climate directly positively affect youths' prosocial behaviors, while the direct effects of both on antisocial behavior are not significant. The SEM results reveal that academic self-efficacy and depressive symptoms may be underlying mediating mechanisms through which home-school regulation and atmosphere during adolescence affect students' prosocial and antisocial behaviors. Intervention programs targeting home-school supportive environments and prevention programs targeting positive emotion and self-awareness may yield benefits for proper social behavior in adolescents. For example, by enhancing the way and frequency of parent-child interaction, teachers and students jointly create a good class climate of care and friendship to strengthen a home-school supportive environment. Improve adolescents' positive emotions such as contentment, optimism, and hope to reduce the possibility of depression.

20.
Prev Sci ; 24(4): 739-751, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36515774

RESUMO

Possessing informative tools to predict who is most at risk for antisocial behavior in adolescence is important to help identify families most in need of early intervention. Polygenic risk scores (PRSs) have been shown to predict antisocial behavior, but it remains unclear whether PRSs provide additional benefit above more conventional tools to early risk detection for antisocial behavior. This study examined the utility of a PRS in predicting adolescents' antisocial behavior after accounting for a broad index of children's contextual and individual risk factors for antisocial behavior. Participants were drawn from a longitudinal family-based prevention study (N = 463; Ncontrol = 224; 48.8% girls; 45.1% White; 30.2% Black; 12.7% Hispanic/Latino, 10.4% biracial; 0.2% Native American). Participants were recruited from US-based Women, Infants, and Children Nutritional Supplement programs. A risk tolerance PRS was created from a genome-wide association study. We created a robust measure capturing additive effects of 22 conventional measures of a risk of antisocial behavior assessed at child age 2 (before intervention). A latent variable capturing antisocial behavior (ages 10.5-16) was created. After accounting for intervention status and the conventional risk index, the risk tolerance PRS predicted independent variance in antisocial behavior. A PRS-by-conventional risk interaction showed that the conventional risk measure only predicted antisocial behavior at high levels of the PRS. Thus, the risk tolerance PRS provides unique predictive information above conventional screening tools and, when combined with them, identified a higher-risk subgroup of children. Integrating PRSs could facilitate risk identification and, ultimately, prevention screening, particularly in settings unable to serve all individuals in need.


Assuntos
Transtorno da Personalidade Antissocial , Estudo de Associação Genômica Ampla , Criança , Lactente , Humanos , Feminino , Adolescente , Pré-Escolar , Masculino , Transtorno da Personalidade Antissocial/genética , Fatores de Risco , Herança Multifatorial
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