Maternal metabolic syndrome in pregnancy and child development at age 5: exploring mediating mechanisms using cord blood markers.

BACKGROUND: There is limited evidence on how the classification of maternal metabolic syndrome during pregnancy affects children's developmental outcomes and the possible mediators of this association. This study uses a cohort sample of 12,644 to 13,832 mother-child pairs from the UK Born in Bradford Study to examine the associations between maternal metabolic syndrome classification (MetS) and child development outcomes at age 5, using cord blood markers as candidate mediators. METHODS: Maternal cardiometabolic markers included diabetes, obesity, triglycerides, high-density lipoprotein cholesterol, blood pressure, hypertension, and fasting glucose during pregnancy. Cord blood markers of high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, leptin, and adiponectin were used as child mediators. Child outcomes included two starting school variables: British Picture Vocabulary Scale (BPVS) and the Letter Identification Assessment (LID), and five developmental milestone domains from a national UK framework: (1) communication and language (COM); (2) personal, social, and emotional (PSE); (3) physical development (PHY); (4) literacy (LIT); and (5) mathematics (MAT). Mediation models were used to examine the associations between the classification of maternal metabolic syndrome and child developmental milestones. Models were adjusted for potential maternal, socioeconomic, and child confounders such as maternal education, deprivation, and gestational age. RESULTS: In mediation models, significant total effects were found for MetS associations with children's development in the LIT domain at age 5. MetS predicted individual cord blood mediators of lower HDL and increased leptin levels in both adjusted and unadjusted models. Total indirect effects (effects of all mediators combined) for MetS on a child's COM and PSE domain were significant, through all child cord blood mediators of LDL, HDL, triglycerides, adiponectin, and leptin for adjusted models. CONCLUSIONS: The results support the hypothesis that maternal metabolic syndrome classification during pregnancy is associated with some child developmental outcomes at age 5. After adjusting for maternal, child, and environmental covariates, maternal metabolic syndrome classification during pregnancy was associated with children's LIT domain through direct effects of maternal metabolic health and indirect effects of cord blood markers (total effects), and COM and PSE domains via changes only in a child's cord blood markers (total indirect effects).

Facial reactions to emotional films in young children with conduct problems and varying levels of callous-unemotional traits.

BACKGROUND: Elevated levels of callous-unemotional (CU) traits have proven useful for identifying a distinct subgroup of children whose conduct problems (CP) are early emerging, severe, persistent, and underpinned by aberrant emotional processing. The early childhood emotional experiences and expressions of CP subtypes are poorly understood, despite their importance to understanding the problematic attachments and atypical social affiliation experienced by children with elevated CU traits. The current study aimed to test for differences in facial emotional reactions to mood-inducing film clips in children with CP and varying levels of CU traits. METHOD: We compared facial emotional reactions during a developmentally appropriate mood induction task in a mixed-sex sample of clinic-referred preschool children (Mage = 3.64 years, SD = 0.63, 66.9% male) classified as CP with elevated levels of CU traits (CP + CU; n = 25) versus low CU traits (CP-only; n = 47), and typically developing children (TD; n = 28). RESULTS: Relative to TD children, children with clinical CP showed less congruent and more incongruent facial emotional expressions to sad and happy film clips, controlling for child sex, age, and ethnicity. CONCLUSIONS: Consistent with older samples, young children with CP show atypical facial emotional expressions in response to positive and negative emotional stimuli. Findings have implications for developmental models of childhood antisocial behavior and can inform the development of targeted interventions.

Physiological reactivity to fear moderates the relation between parenting distress with conduct and prosocial behaviors.

This study investigated whether the associations between parental distress with conduct problems (CPs) and prosocial behaviors (PBs) are moderated by children's skin conductance (SC) and heart rate (HR) reactivity to fear. Participants were 147 Greek-Cypriot children (Mage  = 7.30, 44.2% girls), selected from a larger screening sample (data were collected from 2015 to 2018). Longitudinal associations suggested that children with high HR reactivity to fear were more likely to display PB, whereas those with low SC reactivity were more likely to engage in CP behaviors. In contrast, interaction effects suggested that children high on SC reactivity to fear were more susceptible to the effects of parental distress, as indicated by their higher vulnerability to engage in CP (cross-sectionally) behaviors and their lower scores on PB (cross-sectionally and longitudinally).

Inventory of Callous-Unemotional Traits (ICU) Factor Structure and Measurement Invariance in an Adolescent Multinational Sample.

OBJECTIVE: The Inventory of Callous-Unemotional Traits (ICU) is a widely used, comprehensive measure of callous-unemotional (CU) traits. While the ICU total score is used frequently in research, the scale's factor structure remains highly debated. Inconsistencies in past factor structure research appear to be largely due to the use of small non-representative samples and failure to control for method variance (i.e., item wording direction). METHOD: The current study used a multitrait-multimethod (MTMM) confirmatory factor analysis (CFA) approach that considers both trait and method variance to test the factor structure of a 22-item version of the self-report ICU in a multinational community sample of 4,683 adolescents (ages 11-17). RESULTS: Results showed that a hierarchical four-factor model (i.e., one overarching CU factor, four latent trait factors) that controlled for method variance (i.e., by allowing residuals from positively worded items to covary) provided the best fit (χ2 = 2797.307, df = 160, RMSEA=.059, CFI=.922, TLI=.888, SRMR=.045). CONCLUSIONS: After controlling for method variance, the best-fitting factor structure is consistent with how the ICU was developed and corresponds to the four symptoms of Limited Prosocial Emotions (LPE) specifier in the DSM-5 criteria for Conduct Disorder (CD). In addition, measurement invariance of this factor structure across age (i.e., younger versus older adolescents) and sex was supported. As a result, mean differences in ICU total score across age and sex can be interpreted as reflecting true variations in these traits. Further, we documented that boys generally scored higher than girls on the ICU, and this sex difference was larger in later adolescence.

Are Children High on Callous-Unemotional Traits Emotionally Blind? Testing Eye-Gaze Differences.

Callous-unemotional traits have been associated with difficulties in identifying and responding to others' emotions. To inform this line of research, the current study investigated the eye gaze behavior of children (n = 59; mean-age = 6.35) with varying levels of callous-unemotional (CU) traits with the use of eye-tracker methodology, as well as their ability to accurately identify emotional expressions. Participating children were selected from a large screening sample (N = 1283). Main findings supported a reduced fixation rate to the eye-region and an increased fixation in the mouth area of emotional faces among children high on callous-unemotional traits (HCU), irrespective of emotion expressed (i.e., fear, sad, angry and happy) and age of individuals portrayed in images (adult versus child faces). Further, findings suggested that HCU children were less likely to accurately identify facial emotional expressions, which might be due to the identified attentional neglect to the eye region of emotional faces. Current findings support the importance of early prevention and intervention programs that can enhance the emotional development and social adjustment of HCU children.

Physiological reactivity in children with high callous-unemotional and autistic traits: investigating unique and interactive effects.

Empathy deficits are a hallmark sign of both callous-unemotional (CU) and autistic traits. Despite these similarities, prior work did not investigate how these traits relate to physiological reactivity (heart rate and skin conductance) in response to emotional or empathy-eliciting stimuli. Understanding the physiological mechanisms associated with emotional processing deficits among individuals with autistic or CU traits is a critical step for improving both assessment and interventions. The current study was designed to investigate the unique and interactive contributions of CU and autistic traits in predicting physiological reactivity. Heart rate (HR) and skin conductance (SC) activity in response to sad, fearful and happy emotional videos were collected form young children. Participants for the current study (n = 163; Mage = 7.30, SD= 1.42; 44.2% girls) were recruited from a larger community sample of 1652 children and were selected based on their levels of empathy. Regression analysis revealed that boys, but not girls, with high levels of CU traits exhibited low SC reactivity during sad and fearful stimuli. No significant associations were revealed for autistic traits. Finally, an interesting interaction effect suggested that CU traits were associated with stronger HR reactivity to fear stimuli only when autistic traits were low. The identified differences in physiological reactivity can inform etiological hypothesis by providing evidence for the underlying physiological mechanisms related to emotional processing among children high in CU traits but not in autistic traits.

Factorial Structure and Nomological Network of the Inventory of Callous-Unemotional Traits Accounting for Item Keying Variance.

The factorial structure of the Inventory of Callous Unemotional Traits (ICU) is currently under dispute. The present study aims to test the factorial structure of a Greek adaptation of the ICU by considering item keying variance and examining alternative theoretical and empirically derived models. Additionally, it aims to investigate the nomological network of the ICU subscales, after controlling for item keying variance. The sample consisted of 1536 Greek-Cypriot adolescents, who completed a battery of questionnaires, including the ICU. Results showed that the consideration of item keying variance improved the overall fit of all the examined models and led to significant changes in the predictive validity of the subscales, while method factors presented distinct patterns of associations with external variables. Overall, results suggest that ICU is contaminated by item keying variance, which can be filtered out to provide clinically useful insight into the factorial structure of the ICU.

In the eyes of the beholder: investigating the effect of visual probing on accuracy and gaze fixations when attending to facial expressions among primary and secondary callous-unemotional variants.

Individuals with callous-unemotional (CU) traits show deficits in facial emotion recognition. According to preliminary research, this impairment may be due to attentional neglect to peoples' eyes when evaluating emotionally expressive faces. However, it is unknown whether this atypical processing pattern is unique to established variants of CU traits or modifiable with intervention. This study examined facial affect recognition and gaze patterns among individuals (N = 80; M age = 19.95, SD = 1.01 years; 50% female) with primary vs secondary CU variants. These groups were identified based on repeated measurements of conduct problems, CU traits, and anxiety assessed in adolescence and adulthood. Accuracy and number of fixations on areas of interest (forehead, eyes, and mouth) while viewing six dynamic emotions were assessed. A visual probe was used to direct attention to various parts of the face. Individuals with primary and secondary CU traits were less accurate than controls in recognizing facial expressions across all emotions. Those identified in the low-anxious primary-CU group showed reduced overall fixations to fearful and painful facial expressions compared to those in the high-anxious secondary-CU group. This difference was not specific to a region of the face (i.e. eyes or mouth). Findings point to the importance of investigating both accuracy and eye gaze fixations, since individuals in the primary and secondary groups were only differentiated in the way they attended to specific facial expression. These findings have implications for differentiated interventions focused on improving facial emotion recognition with regard to attending and correctly identifying emotions.

Adolescents' cognitive capacity reaches adult levels prior to their psychosocial maturity: Evidence for a "maturity gap" in a multinational, cross-sectional sample.

All countries distinguish between minors and adults for various legal purposes. Recent U.S. Supreme Court cases concerning the legal status of juveniles have consulted psychological science to decide where to draw these boundaries. However, little is known about the robustness of the relevant research, because it has been conducted largely in the U.S. and other Western countries. To the extent that lawmakers look to research to guide their decisions, it is important to know how generalizable the scientific conclusions are. The present study examines 2 psychological phenomena relevant to legal questions about adolescent maturity: cognitive capacity, which undergirds logical thinking, and psychosocial maturity, which comprises individuals' ability to restrain themselves in the face of emotional, exciting, or risky stimuli. Age patterns of these constructs were assessed in 5,227 individuals (50.7% female), ages 10-30 (M = 17.05, SD = 5.91) from 11 countries. Importantly, whereas cognitive capacity reached adult levels around age 16, psychosocial maturity reached adult levels beyond age 18, creating a "maturity gap" between cognitive and psychosocial development. Juveniles may be capable of deliberative decision making by age 16, but even young adults may demonstrate "immature" decision making in arousing situations. We argue it is therefore reasonable to have different age boundaries for different legal purposes: 1 for matters in which cognitive capacity predominates, and a later 1 for matters in which psychosocial maturity plays a substantial role. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Correction to: Age Patterns in Risk Taking Across the World.

In the original publication, the legends for Figs 4 and 5 were incorrect, such that each regression line was mislabeled with the incorrect country. Below are the correctly labeled countries. The authors apologize for any confusion or misinformation this error may have caused.

Around the world, adolescence is a time of heightened sensation seeking and immature self-regulation.

The dual systems model of adolescent risk-taking portrays the period as one characterized by a combination of heightened sensation seeking and still-maturing self-regulation, but most tests of this model have been conducted in the United States or Western Europe. In the present study, these propositions are tested in an international sample of more than 5000 individuals between ages 10 and 30 years from 11 countries in Africa, Asia, Europe and the Americas, using a multi-method test battery that includes both self-report and performance-based measures of both constructs. Consistent with the dual systems model, sensation seeking increased between preadolescence and late adolescence, peaked at age 19, and declined thereafter, whereas self-regulation increased steadily from preadolescence into young adulthood, reaching a plateau between ages 23 and 26. Although there were some variations in the magnitude of the observed age trends, the developmental patterns were largely similar across countries.

Self Regulation, Cognitive Capacity and Risk Taking: Investigating Heterogeneity Among Adolescents with Callous-Unemotional Traits.

The majority of prior work focuses on understanding the association between callous-unemotional (CU) traits and conduct problems, providing limited information on why some youth who score high on CU traits do not engage in conduct problem behaviors. The current study investigated heterogeneity among a sub-sample of adolescents with CU traits (N = 152; Mage = 13.09, SD = 2.76, 45.6% female) identified from a large community sample. Three groups were compared: control, callous-unemotional traits only (CU-only), and combined callous-unemotional and conduct problems (CU + CP). Participants were administered a battery of neuropsychological computerized tasks assessing risk taking, self-regulation and cognitive capacity. Results indicated that youth high on CU traits and low on CP scored higher on self-regulation and were less likely to make risky decisions compared to youth with combined CU + CP. In general, the findings provided information that heterogeneity within CU traits can be explained based on differences in neuro-cognitive functioning. In addition, the characteristics of youth high on CU traits only can provide information for interventions aiming to decrease conduct problems among youth high on these traits.

Age Patterns in Risk Taking Across the World.

Epidemiological data indicate that risk behaviors are among the leading causes of adolescent morbidity and mortality worldwide. Consistent with this, laboratory-based studies of age differences in risk behavior allude to a peak in adolescence, suggesting that adolescents demonstrate a heightened propensity, or inherent inclination, to take risks. Unlike epidemiological reports, studies of risk taking propensity have been limited to Western samples, leaving questions about the extent to which heightened risk taking propensity is an inherent or culturally constructed aspect of adolescence. In the present study, age patterns in risk-taking propensity (using two laboratory tasks: the Stoplight and the BART) and real-world risk taking (using self-reports of health and antisocial risk taking) were examined in a sample of 5227 individuals (50.7% female) ages 10-30 (M = 17.05 years, SD = 5.91) from 11 Western and non-Western countries (China, Colombia, Cyprus, India, Italy, Jordan, Kenya, the Philippines, Sweden, Thailand, and the US). Two hypotheses were tested: (1) risk taking follows an inverted-U pattern across age groups, peaking earlier on measures of risk taking propensity than on measures of real-world risk taking, and (2) age patterns in risk taking propensity are more consistent across countries than age patterns in real-world risk taking. Overall, risk taking followed the hypothesized inverted-U pattern across age groups, with health risk taking evincing the latest peak. Age patterns in risk taking propensity were more consistent across countries than age patterns in real-world risk taking. Results suggest that although the association between age and risk taking is sensitive to measurement and culture, around the world, risk taking is generally highest among late adolescents.

Puberty Predicts Approach But Not Avoidance on the Iowa Gambling Task in a Multinational Sample.

According to the dual systems model of adolescent risk taking, sensation seeking and impulse control follow different developmental trajectories across adolescence and are governed by two different brain systems. The authors tested whether different underlying processes also drive age differences in reward approach and cost avoidance. Using a modified Iowa Gambling Task in a multinational, cross-sectional sample of 3,234 adolescents (ages 9-17; M = 12.87, SD = 2.36), pubertal maturation, but not age, predicted reward approach, mediated through higher sensation seeking. In contrast, age, but not pubertal maturation, predicted increased cost avoidance, mediated through greater impulse control. These findings add to evidence that adolescent behavior is best understood as the product of two interacting, but independently developing, brain systems.

Affective startle potentiation differentiates primary and secondary variants of juvenile psychopathy.

Individuals with psychopathic traits show an attenuated emotional response to aversive stimuli. However, recent evidence suggests heterogeneity in emotional reactivity among individuals with psychopathic or callous-unemotional (CU) traits in the identification of primary and secondary subtypes, or variants. We hypothesized that primary CU variants will respond with blunted affect to negatively valenced stimuli, whereas individuals with a history of childhood maltreatment, fitting with theoretical conceptualizations of secondary psychopathy, will display heightened emotional reactivity. To test this hypothesis, we examined fear-potentiated startle between CU variants while viewing aversive, pleasant, and neutral scenes. Two hundred thirty-eight incarcerated adolescent (M age = 16.8 years, SD = 1.11 years) boys completed a picture-startle paradigm and self-report questionnaires assessing CU traits, aggressive behavior, and maltreatment. Latent profile analysis of CU trait, aggression, and maltreatment scores identified four classes: primary psychopathy variants (high CU traits, high aggression, low maltreatment; n = 46), secondary psychopathy variants (high CU traits, high aggression, high maltreatment; n = 42), and two nonpsychopathic groups differentiated on maltreatment experience (n = 148). Primary CU variants displayed reduced startle potentiation to aversive images relative to control, maltreated, and also secondary variants that exhibited greater startle modulation. Findings add to a rapidly growing body of literature supporting the possibility of multiple developmental pathways to psychopathic traits (i.e., equifinality), and extend it by finding support for divergent potential biomarkers between primary and secondary CU variants.

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.

Facial reactions to violent and comedy films: Association with callous-unemotional traits and impulsive aggression.

The current study adds to prior research by investigating specific (happiness, sadness, surprise, disgust, anger and fear) and general (corrugator and zygomatic muscle activity) facial reactions to violent and comedy films among individuals with varying levels of callous-unemotional (CU) traits and impulsive aggression (IA). Participants at differential risk of CU traits and IA were selected from a sample of 1225 young adults. In Experiment 1, participants (N = 82) facial expressions were recorded while they watched violent and comedy films. Video footage of participants' facial expressions was analysed using FaceReader, a facial coding software that classifies facial reactions. Findings suggested that individuals with elevated CU traits showed reduced facial reactions of sadness and disgust to violent films, indicating low empathic concern in response to victims' distress. In contrast, impulsive aggressors produced specifically more angry facial expressions when viewing violent and comedy films. In Experiment 2 (N = 86), facial reactions were measured by monitoring facial electromyography activity. FaceReader findings were verified by the reduced facial electromyography at the corrugator, but not the zygomatic, muscle in response to violent films shown by individuals high in CU traits. Additional analysis suggested that sympathy to victims explained the association between CU traits and reduced facial reactions to violent films.

Factors differentiating callous-unemotional children with and without conduct problems.

BACKGROUND: Callous-unemotional (CU) traits are a risk factor for a severe, aggressive, and persistent pattern of conduct problems (CP). This study investigated characteristics that might differentiate children with elevated CU traits with and without CP in an effort to identify factors that may reduce the risk for CP in children with limited prosocial emotions. METHODS: Utilizing a sample of 1,366 children from Cyprus, five groups were identified for further study based on latent profile analysis: low-risk (67.2%), high-CP/low-CU (7.9%), high-CU (9.4%), moderate-CP/CU (8.4%), and high-CP/CU (7.2%). The identified groups were compared on behavioral and social measures. RESULTS: There were significant main effects of group for: impulsivity and executive functioning; parenting; and connectedness to school. The high-CU group had significantly lower hyperactivity-impulsivity and executive functioning deficits, significantly higher self-regulation, and their mothers reported more maternal involvement and positive parenting than those in the high-CP/CU group. Also, the high-CU group showed more school connectedness than those in the high-CP/CU group. CONCLUSIONS: These findings highlight several factors in the child and in his or her social environment that are associated with CU traits in the absence of serious CP and that may suggest targets for intervention for youth who may lack prosocial emotions.

The better of two evils? Evidence that children exhibiting continuous conduct problems high or low on callous-unemotional traits score on opposite directions on physiological and behavioral measures of fear.

The present study examines whether heterogeneous groups of children identified based on their longitudinal scores on conduct problems (CP) and callous-unemotional (CU) traits differ on physiological and behavioral measures of fear. Specifically, it aims to test the hypothesis that children with high/stable CP differentiated on CU traits score on opposite directions on a fear-fearless continuum. Seventy-three participants (M age = 11.21; 45.2% female) were selected from a sample of 1,200 children. Children and their parents completed a battery of questionnaires assessing fearfulness, sensitivity to punishment, and behavioral inhibition. Children also participated in an experiment assessing their startle reactivity to fearful mental imagery, a well-established index of defensive motivation. The pattern of results verifies the hypothesis that fearlessness, assessed with physiological and behavioral measures, is a core characteristic of children high on both CP and CU traits (i.e., receiving the DSM-5 specifier of limited prosocial emotions). To the contrary, children with high/stable CP and low CU traits demonstrated high responsiveness to fear, high behavioral inhibition, and high sensitivity to punishment. The study is in accord with the principle of equifinality, in that different developmental mechanisms (i.e., extremes of high and low fear) may have the same behavioral outcome manifested as phenotypic antisocial behavior.