Description of perinatal adversities in children with attention-deficit/hyperactivity disorder.

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder. According to literature data, perinatal adversities might be associated with the occurrence of ADHD, but the results are inconclusive at the moment. The aim of the present study is to describe perinatal adversities in children with ADHD. METHODS: The data of children in County Fejér Pedagogical Service in three consecutive school years (2012-2015) was analyzed. In the present sample, 219 children with special education needs were diagnosed with ADHD (age: 9.0 years, SD: 3.1 years; 36 girls). The diagnosis was based on ICD-10 criteria. The present analysis is restricted to the presence of preterm birth, complicated/prolonged labor, intrauterine hypoxia and birth asphyxia in children with ADHD from different areas (central, urban or rural) of the county. Logistic regression analysis was performed to assess the effects of gender, age was used as a covariate. RESULTS: Within this sample, the presence of complicated/prolonged labor was significantly lower (OR: 0.378, p<0.039) in girls compared to boys. The other studied variables did not show significant differences regarding gender. Intrauterine hypoxia was registered in 28 cases, while birth asphyxia was registered in 15 cases. The presence of preterm birth was 8.7%, and showed distinctive differences according to living area (central: 3.6% vs rural: 11.3%). CONCLUSIONS: Our results indicate the importance of registering perinatal complications and long term follow up of these children in the direction of neurodevelopmental disorders, however a limitation of the present study is the lack of a control group.

Changes in neuroplasticity following early-life social adversities: the possible role of brain-derived neurotrophic factor.

Social adversities experienced in childhood can have a profound impact on the developing brain, leading to the emergence of psychopathologies in adulthood. Despite the burden this places on both the individual and society, the neurobiological aspects mediating this transition remain unclear. Recent advances in preclinical and clinical research have begun examining neuroplasticity-the nervous system's ability to form adaptive changes in response to new experience-in the context of early-life vulnerability to social adversities and plasticity-related alterations following such traumatic events. A key mediator of plasticity-related molecular processes is the brain-derived neurotrophic factor (BDNF), which has also been implicated in various psychiatric disorders related to childhood social adversities. Preclinical and clinical data suggest early-life social adversities (ELSA) might be associated with accelerated maturation of social network circuitry, a possible ontogenic adaptation to the adverse environment. Neural plasticity decreases by adulthood, lessening the efficacy of treatment in ELSA-related psychiatric disorders. However, literature data suggest that by increasing BDNF/TrkB signalling through antidepressant treatment a juvenile-like plasticity state can be induced, which allows for reorganization of the social circuitry when guided by psychotherapy and surrounded by a safe and positive environment.

[Quality of life of adolescents with conduct disorder: gender differences and comorbidity with oppositional defiant disorder].

BACKGROUND: Quality of life is the individuals' subjective evaluation of their general well-being, including physical and mental health, social relationships and everyday functionality. The aim of our study was to examine conduct disorder in terms of gender differences in prevalence, and relationship to quality of life domains in the presence or absence of comorbid oppositional defiant disorder. METHODS: Altogether 392 adolescents, aged 13-18 years (M=14.5; SD= 1.37), participated in this study. The members of the clinical group were selected from Vadaskert Child and Adolescent Psychiatry Hospital, Budapest, Hungary with externalizing symptoms in their case history. The control group was selected from public schools in Budapest, Hungary. Mini International Neuropsychiatric Interview Kid was used to diagnose conduct disorder and oppositional defiant disorder, and parent and adolescent version of the Inventory of Quality of Life in Children and Adolescents (Inventar zur Erfassung der Lebensqualität bei Kindern und Jugendlichen) was used to measure the children's quality of life. RESULTS: In this sample 8.5% of adolescents were diagnosed with conduct disorder, of which 52.9% had a comorbid oppositional defiant diagnosis. Conduct disorder diagnosis was only present in the clinical group, 9 of participants with such diagnosis were male and 24 were female. Girls with conduct disorder evaluated their family life domain (p<0.01) and their global quality of life (p<0.05) lower than the boys. Compared to adolescents without comorbid oppositional defiant disorder diagnosis, adolescents with conduct disorder and comorbid oppositional defiant disorder had significantly worse quality of life in the domain of time spent alone (p<0.05). CONCLUSIONS: Conduct disorder is associated with decreased quality of life. The presence of comorbid oppositional defiant disorder correlates with lower quality of life in several domains. These findings are considerable for the clinical management of these externalizing disorders.

[Cross-Informant Agreement Between Parent-Reported and Adolescent Self-Reported Quality of Life in children with externalising symptoms].

BACKGROUND: It is well-known phenomena both in clinical practice and research, that there is a discrepancy between the parents' and children's report about children's Quality of Life (QoL). The purpose of our research was to examine the differences in self and caregiver's proxy report of child's QoL. We also compared mothers', fathers' and other caregivers' reports of children's QoL. METHODS: Patients with externalizing symptoms in their history, aged 13-18 years were selected from the Vadaskert Child and Adolescent Psychiatry Hospital and Outpatient Clinic. We used the Inventory of Quality of Life in Children and Adolescents (QL), parent and children version to measure the children's QoL. We used F-factor analysis (Principal Component Analysis and direct oblimin rotation) and t-tests for data analysis. RESULTS: Altogether 138 caregiver-child dyads filled the QL. The adolescents mean age was 14.47 years (SD=.40). Seventy-four mothers, 37 fathers and 27 other caregivers were included into our study. The caregivers' ratings were settled sorted into three factors, the adolescents' ratings were settled sorted into two factors. We found significant differences between mothers, fathers and other caregivers' ratings in the following domains of QoL: school, loneliness, peer relations, physical health, mental health and problem/illness. The caregivers evaluated adolescents' QoL more positively then the adolescents did (t=761, df=139, p<0,0001). CONCLUSIONS: The caregivers and their children's reported different domains of QoL as problematic. Therefore, it is important to gain information from several sources about the adolescent's QoL.

Short-Term Public Health Impact of the July 22, 2011, Terrorist Attacks in Norway: A Nationwide Register-Based Study.

OBJECTIVES: To examine increases in several health outcomes after the July 22, 2011 terrorist attacks in Norway. METHODS: Retrospective analysis of nationwide registers (n = 4,953,000) where incidences of schizophrenia/psychosis hospitalizations, suicides, acute myocardial infarctions, and preterm births after the terrorist attacks were compared with corresponding periods the previous 3 years. RESULTS: Compared with the same period the preceding 3 years, the observed number of hospitalizations from schizophrenia/psychosis was 14% higher during the first 4 weeks after the terrorist attack (incidence ratio [IR] = 1.14, 95% confidence interval [CI] = 1.07-1.21). The corresponding IRs for the first 3 days and the first week were 1.26 (95% CI = 0.99-1.58) and 1.10 (95% CI = 0.96-1.24). The observed number of suicides was increased by 45% the first 4 weeks (IR = 1.45, 95% CI = 1.12-1.86), 163% the first 3 days (IR = 2.63, 95% CI = 1.15-5.20), and 105% the first week (IR = 2.05, 95% CI = 1.14-3.42). For acute myocardial infarction, there was an increase of 5% the first 4 weeks. There were also more births the 4 weeks (IR = 1.04, 95% CI = 1.01-1.07, but this increase was not seen in preterm births of less than 37 weeks of gestation (IR = 0.93, 95% CI = 0.83-1.04). CONCLUSIONS: We observed a general nationwide increase of health outcomes investigated in this study the first 4 weeks after the terrorist attacks. These results may contribute to the growing body of evidence on the adverse health outcomes that may accompany national stressors.

Potential salivary biomarkers and their genetic effects in a pilot study of adolescent boys with externalizing problems.

AIMS: Beside the well-known stress response marker cortisol, salivary alpha-amylase is receiving increasing attention. Numerous studies have investigated the potential biomarker properties of cortisol mirroring abnormal hypothalamic-pituitary-adrenal axis activity in connection to both internalizing and externalizing behavior problems. The other major physiological system involved in stress reactivity, the sympathetic nervous system activity can be also measured by the surrogate marker of salivary alpha-amylase. Most of the studies applied a stressful situation to obtain inter-individual differences in stress-reactivity, although differences in the baseline level of cortisol have been also shown in relation to externalizing problems. To test the relevance of another (easier) biomarker, we selected to study baseline circadian salivary cortisol and alpha-amylase levels among adolescent boys with externalizing problems. METHODS: Saliva samples were collected at 3 time-points (morning, noon, evening) during 3 consecutive days from 37 inpatient boys (mean age 12.4±1.0). Cortisol and alpha-amylase levels were measured by enzyme-linked immunosorbent and kinetic enzyme assays, respectively. Genetic variants in the hypothalamic-pituitary-adrenal axis and the norepinephrine transporter or catecholamine metabolizing enzymes were tested for potential moderating effects at these salivary biomarkers. RESULTS: Saliva cortisol showed the classical diurnal fluctuation in boys with externalizing problems (possibly from a lower morning level), but it was not modified by the presence of either conduct, oppositional defiant or attention-deficit/hyperactivity disorder. The diurnal fluctuation of the salivary alpha-amylase levels was also typical, but the presence of conduct disorder was associated with significantly lower alpha-amylase activity (p=0.024) among boys with externalizing problems. The catechol-O-methyltransferase Val158Met (rs4680) polymorphism had an additional effect on salivary alpha-amylase: boys with homozygote genotypes had lower alpha-amylase activity at all 3 time-points compared to Val/Met heterozygotes (p=0.045). CONCLUSIONS: Our preliminary data suggest that salivary alpha-amylase might be used to further characterize subgroups within externalizing problems, however, this biomarker might be modified by certain genetic polymorphisms.

[Conduct symptoms and emotional decision making in non-clinical adolescents]. / Viselkedészavar tünetek és érzelmi döntéshozatal kapcsolata serdülokben.

BACKGROUND: In adults with antisocial personality disorder, literature data indicate alterations in emotional decision making and in the working of the prefrontal cortex. Similar alterations were described in adolescents with psychopathic traits, however, a dimensional link was not established between behavioral variables and variables associated with decision making. The aim of the present study was to describe the relationship between externalizing symptoms and emotional decision making in non-clinical adolescents. METHODS: Originally 57, 7th-10th grade students between 13-16 years participated in the study after informed consent, but the data of 4 adolescents were not used because of incomplete data-set (N=53; 24 girls and 29 boys; age=14.7 ± 1.0 years, mean ± SD). The parent version of the Strengths and Difficulties Questionnaire (SDQ) was used to assess behavioral problems. The Iowa Gambling Task (IGT) performance and Raven IQ measures were also assessed. RESULTS: The number of summarized risky choices was positively correlated with Conduct Problems Scale of SDQ (r=0.31, p<0.05). While the number of risky choices was not correlated with conduct problems in the first 20 selections (r=0.11, p=n.s.), a marked positive correlation was present in the above measures in the last 20 selections (r=0.28, p<0.05). The number of risky choices did not depend on Raven IQ, age, and other behavioral scales of SDQ. CONCLUSIONS: Even subthreshold conduct symptoms are associated with altered emotional decision making in adolescents, what might be important in the development of antisocial behavior.

Gender interactions in the recognition of emotions and conduct symptoms in adolescents.

BACKGROUND: According to literature data, impairment in the recognition of emotions might be related to antisocial developmental pathway. In the present study, the relationship between gender-specific interaction of emotion recognition and conduct symptoms were studied in non-clinical adolescents. METHODS: After informed consent, 29 boys and 24 girls (13-16 years, 14 ± 0.1 years) participated in the study. The parent version of the Strengths and Difficulties Questionnaire was used to assess behavioral problems. The recognition of basic emotions was analyzed according to both the gender of the participants and the gender of the stimulus faces via the "Facial Expressions of Emotion- Stimuli and Tests". RESULTS: Girls were significantly better than boys in the recognition of disgust, irrespective from the gender of the stimulus faces, albeit both genders were significantly better in the recognition of disgust in the case of male stimulus faces compared to female stimulus faces. Both boys and girls were significantly better in the recognition of sadness in the case of female stimulus faces compared to male stimulus faces. There was no gender effect (neither participant nor stimulus faces) in the recognition of other emotions. Conduct scores in boys were inversely correlated with the recognition of fear in male stimulus faces (R=-0.439, p<0.05) and with overall emotion recognition in male stimulus faces (R=-0.558, p<0.01). In girls, conduct scores were shown a tendency for positive correlation with disgust recognition in female stimulus faces (R=0.376, p<0.07). CONCLUSIONS: A gender-specific interaction between the recognition of emotions and antisocial developmentalpathway is suggested.

Changes in serum cytokine and cortisol levels in normothermic and hypothermic term neonates after perinatal asphyxia.

OBJECTIVE: Perinatal asphyxia is characterized by an inflammatory response that contributes to cerebral injury. Therapeutic hypothermia improves neurological outcome in asphyxiated term neonates, but its clear effect on the inflammatory response is unknown. SUBJECTS AND METHODS: A range of cytokines and cortisol levels were measured at the 6th, 12th and 24th postnatal hours in neonates with hypoxic-ischemic encephalopathy treated with standard intensive care on hypothermia (n = 10) or normothermia (n = 8). The influence of postnatal age and hypothermia on serum cytokine and cortisol levels was evaluated. RESULTS: Interleukin (IL)-6 levels (at 6 h of age) and IL-4 levels (at all time points) were significantly lower in asphyxiated neonates treated with hypothermia compared to normothermic neonates. Vascular endothelial growth factor levels were higher in the hypothermia than in the normothermia group at the 6th and 12th postnatal hours. IL-10 levels decreased significantly between 6 and 24 h of age in both groups. However, no difference of IL-10 levels was observed between the study groups. The duration of hypothermia before 6 hours of age correlated with lower levels of IL-6, interferon-γ and tumor necrosis factor-α measured at 6 h of age and IL-10 levels at 12 h of age. Cortisol levels did not differ between the study groups, but did gradually decrease in both groups during the study period. At 6 and 24 h of age, a positive correlation was observed between cortisol and IL-10 levels. CONCLUSIONS: Therapeutic hypothermia may rapidly suppress and modify the immediate cytokine response to asphyxia. The correlation between cytokine levels and duration of hypothermia suggests that the earlier hypothermia is introduced, the more pronounced its beneficial immunomodulatory effect.

Conduct symptoms and emotion recognition in adolescent boys with externalization problems.

BACKGROUND: In adults with antisocial personality disorder, marked alterations in the recognition of facial affect were described. Less consistent data are available on the emotion recognition in adolescents with externalization problems. The aim of the present study was to assess the relation between the recognition of emotions and conduct symptoms in adolescent boys with externalization problems. METHODS: Adolescent boys with externalization problems referred to Vadaskert Child Psychiatry Hospital participated in the study after informed consent (N = 114, 11-17 years, mean = 13.4). The conduct problems scale of the strengths and difficulties questionnaire (parent and self-report) was used. The performance in a facial emotion recognition test was assessed. RESULTS: Conduct problems score (parent and self-report) was inversely correlated with the overall emotion recognition. In the self-report, conduct problems score was inversely correlated with the recognition of anger, fear, and sadness. Adolescents with high conduct problems scores were significantly worse in the recognition of fear, sadness, and overall recognition than adolescents with low conduct scores, irrespective of age and IQ. CONCLUSIONS: Our results suggest that impaired emotion recognition is dimensionally related to conduct problems and might have importance in the development of antisocial behavior.

[Aggressive and prosocial behavior in childhood psychopathology]. / Az agressziv es proszociális viselkedés megjelenése a gyermekkori pszichopatológiában.

Aggressive/attacking and helpful/emphatic/prosocial behaviors are extremely important in human relationships. Both high levels of aggression and deficits of prosociality play important role in the development and conservation of mental disorders. We review the measurement options and clinical importance of aggressive and prosocial behavior. The typical developmental pathways and the genetic and environmental background of these behaviors are presented. The clinical tools used in the measurement of aggression and prosociality are summarized in the present paper, with specific attention on questionnaires applied in Hungarian practice. The connections between diagnostic categories (conduct disorder, oppositional-defiant disorder, attention deficit and hyperactive disorder, autism spectrum disorders) and the two behaviors are evaluated. In the end, we present those additional research projects that explore the cognitive-emotional background of aggressive or prosocial behavior with clinical relevance either in the diagnosis or in the treatment of child psychiatric diseases.

The relationship between conduct symptoms and the recognition of emotions in non-clinical adolescents.

BACKGROUND: In adult individuals with antisocial personality disorder, impairment in the recognition of fear seems established. In adolescents with conduct disorder (antecedent of antisocial personality disorder), only sporadic data were assessed, but literature data indicate alterations in the recognition of emotions. The aim of the present study was to assess the relationship between emotion recognition and conduct symptoms in non-clinical adolescents. METHODS: 53 adolescents participated in the study (13-16 years, boys, n=29, age 14.7±0.2 years; girls, n=24, age=14.7±0.2 years) after informed consent. The parent version of the Strengths and Difficulties Questionnaire was used to assess behavioral problems. The recognition of six basic emotions was established by the "Facial expressions of emotion-stimuli and tests", while Raven IQ measures were also performed. RESULTS: Compared to boys, girls showed significantly better performance in the recognition of disgust (p<0.035), while no significant difference occurred in the recognition of other emotions. In boys, Conduct Problems score was inversely correlated with the recognition of fear (Spearman R=-0.40, p<0.031) and overall emotion recognition (Spearman R=-0.44, p<0.015), while similar correlation was not present in girls. CONCLUSIONS: The relationship between the recognition of emotions and conduct problems might indicate an important mechanism in the development of antisocial behavior.

[Validation of the Hungarian version of the Strengths and Difficulties Questionnaire in an adolescent clinical population]. / A Képességek és Nehézségek Kérdoív (SDQ-Magy) validálása serdülokorú klinikai populációban.

INTRODUCTION: The short Strengths and Difficulties Questionnaire (SDQ) available in parent, teacher and self-report versions, is used world-wide for assessing and screening childhood behavior and mental problems, as part of clinical assessments, therapy outcome evaluations, and research tool. The aim of the present study was to extend the use of Hungarian version to a clinical sample, to examine the clinical cut-off values suggested previously on the basis of a normative sample, and to test the questionnaire's sensitivity in differentiating between different psychiatric disorders. METHOD: The parent and self-report versions of the five scale SDQ-Magy questionnaire was filled in by 716 parents and their children admitted to Vadaskert Child Psychiatry and Outpatient Clinic. Clinical (ICD) diagnoses were determined during psychiatric examination. RESULTS: With a few exceptions, internal consistencies of the scales were satisfactory (0,55-0,79), the parent version showing greater reliability compared to the self-report version. Children's age, gender, and parents' level of education had some effect on the scale scores. The questionnaire's Total problem and symptom scale scores were very effective in discriminating between the control and the clinical sample. In the clinical sample, parents rated their children's behavior and mental problems as more severe. Profiles of scale scores distinguished the wider internalizing, externalizing, and co-morbid diagnostic categories, as well as the eight specific diagnoses. Based on the normal-abnormal cut-off values proposed earlier (Turi et al., 2011), the great majority of clinical cases were screened by the questionnaire. CONCLUSIONS: The Hungarian version of the SDQ proved applicable in a clinical sample. Psychometric properties, variances due to age, gender and informant were consistent with international experiences. SDQ profiles related to clinical diagnoses and their difference from the control group show the sensitivity and discriminative power of the questionnaire, while the screening ability based on clinical cut-offs also supports the clinical use of the questionnaire.

[The relationship between reactive/proactive aggression, callous/unemotional traits and behavioural problems in Hungarian adolescents]. / A reaktiv/proaktiv agresszió, a rideg/érzéketlen vonások és a viselkedési problémák kapcsolata magyar serdüloknél.

INTRODUCTION: The relationship between the type of physical aggressive behavior, callous/unemotional traits and behavioral problems was extensively studied in the literature, but no similar data exist in Hungarian adolescents. AIM: In the present study, the type of aggressive behavior was assessed in adolescents on a normative sample to study its relationship with callous/unemotional traits and behavioral problems. SAMPLE: 223 students were participated in the study after informed consent (girls, n=106, age: 14.2±1.5 years; boys, n=117, age: 13.9±1.6 years) from primary and secondary schools in Miskolc and adjacent areas. METHODS: The Reactive/Proactive Aggression Questionnaire was used to assess the level of aggressive behavior, the Inventory of Callous Unemotional Traits was used to measure callous/unemotional traits, while behavioral problems were established by the means of the Strengths and Difficulties Questionnaire. RESULTS: In the present non-clinical sample, the level of reactive aggression was higher than the level of proactive aggressive behavior. In boys, proactive and total aggression measures were significantly higher compared to girls. In both genders, reactive aggression was specifically associated with emotional and peer-related problems. Proactive aggression was correlated positively with callous traits in both genders, while self-reported prosocial behavior had an inverse correlation with proactive aggressive behavior in boys. Self reported conduct- and hyperactivity problems were positively correlated with both types of aggressive behavior in both genders. The strongest positive correlation was observed between self-reported conduct symptoms and both types of aggressive behavior. CONCLUSIONS: Callous/unemotional traits were related with proactive forms of aggression, similar to literature data. Reactive aggressive behavior was related to peer-related and emotional problems, thus our data outlined the importance of the distinction between the two main types of aggression.

Post-weaning social isolation in male mice leads to abnormal aggression and disrupted network organization in the prefrontal cortex: Contribution of parvalbumin interneurons with or without perineuronal nets.

Adverse social experiences during childhood increase the risk of developing aggression-related psychopathologies. The prefrontal cortex (PFC) is a key regulator of social behavior, where experience-dependent network development is tied to the maturation of parvalbumin-positive (PV+) interneurons. Maltreatment in childhood could impact PFC development and lead to disturbances in social behavior during later life. However, our knowledge regarding the impact of early-life social stress on PFC operation and PV+ cell function is still scarce. Here, we used post-weaning social isolation (PWSI) to model early-life social neglect in mice and to study the associated neuronal changes in the PFC, additionally distinguishing between the two main subpopulations of PV+ interneurons, i.e. those without or those enwrapped by perineuronal nets (PNN). For the first time to such detailed extent in mice, we show that PWSI induced disturbances in social behavior, including abnormal aggression, excessive vigilance and fragmented behavioral organization. PWSI mice showed altered resting-state and fighting-induced co-activation patterns between orbitofrontal and medial PFC (mPFC) subregions, with a particularly highly elevated activity in the mPFC. Surprisingly, aggressive interaction was associated with a higher recruitment of mPFC PV+ neurons that were surrounded by PNN in PWSI mice that seemed to mediate the emergence of social deficits. PWSI did not affect the number of PV+ neurons and PNN density, but enhanced PV and PNN intensity as well as cortical and subcortical glutamatergic drive onto mPFC PV+ neurons. Our results suggest that the increased excitatory input of PV+ cells could emerge as a compensatory mechanism for the PV+ neuron-mediated impaired inhibition of mPFC layer 5 pyramidal neurons, since we found lower numbers of GABAergic PV+ puncta on the perisomatic region of these cells. In conclusion, PWSI leads to altered PV-PNN activity and impaired excitatory/inhibitory balance in the mPFC, which possibly contributes to social behavioral disruptions seen in PWSI mice. Our data advances our understanding on how early-life social stress can impact the maturing PFC and lead to the development of social abnormalities in adulthood.

Serum S100B and neuron-specific enolase levels in normothermic and hypothermic infants after perinatal asphyxia.

AIM: Serum S100B and neuron-specific enolase (NSE) levels are elevated after perinatal asphyxia, but the influence of hypothermia on these proteins has not been previously reported. The aim of this study was to evaluate the effect of systemic hypothermia on these protein levels after perinatal asphyxia, time course, and association with perinatal factors and neurodevelopmental outcome at 2 years of age. METHODS: Serum S100B and NSE levels were measured at fixed time points in asphyxiated infants treated with standard intensive care on hypothermia (HT: n = 13) or normothermia (NT: n = 11). RESULTS: Serum S100B and NSE levels were grossly elevated in both HT and NT groups. Compared with the values at 6 h of age, S100B values decreased over time in both groups (NT: p = 0.002, HT: p = 0.04). Serum S100B values were lower in HT infants compared with those in NT infants (p = 0.047 at 48 h). Serum S100B and NSE values were significantly higher in infants who died or developed severe neurological impairment (S100B, p < 0.05 at all time points; NSE, p = 0.036 at 24 h of age). CONCLUSION: Both NSE and S100B levels are highly elevated following asphyxia. Serum S100B levels were lower in the HT group and strongly correlated with the neurodevelopmental outcome.

Reactive and proactive aggression in clinical adolescents with attention-deficit/hyperactivity disorder: The moderating role of gender and comorbidities.

Aggression is well-known problem in adolescent with Attention-Deficit/Hyperactivity Disorder (ADHD), but the precise relation of reactive and proactive aggression by gender and comorbidities has not been characterized in this population. The aim of this study was to assess the level of reactive and proactive aggression in adolescents with ADHD and in matched non-ADHD clinical controls. The level of aggression was assessed by the Reactive and Proactive Aggression Questionnaire in 391 adolescents with ADHD and in 391 matched non-ADHD clinical controls. The selection of adolescents with ADHD was representative for a three-year-long period in Vadaskert Child Psychiatry Hospital. General Linear Model was used to assess the difference by ADHD, gender, and comorbidities on the level of reactive and proactive aggression. The presence of ADHD was associated with higher levels of reactive and proactive aggression. In girls, the effect of ADHD on reactive aggression was more profound. The presence of oppositional defiant disorder or conduct disorder in both groups resulted in higher levels of aggression. Our data suggest that adolescents with ADHD have higher level of aggressive behavior, and girls are especially vulnerable in terms of reactive aggressive behavior.

[Investigation of callous/unemotional traits and interpersonal characteristics among Hungarian adolescents--preliminary research results]. / Rideg/érzékelten vonások és interperszonális jellemzok vizsgálata magyar serdüloknél--elso vizsgálati eredmények.

UNLABELLED: In the understanding of aggressive behaviour an important role is contributed to callous/unemotional (C/U) traits (lack of guilty and empathy, grandiose self, manipulation). C/U traits are parts of psychopathy construct. There were a growing amount of researches in last decades connected to the appearance of C/U traits among children. Cognitive, behavioral and emotional features were identified among children with C/U traits which may contribute to the appearance of aggressive behavior. AIM: Aim of this paper is to examine connection between C/U traits and interpersonal characteristics in normative population. This paper is a part of a publication serial taken by the Institution of Psychology at the University of Debrecen and Vadaskert Child Psychiatry Hospital and Outpatient Clinic about callous/unemotional traits. METHODS AND SAMPLE: We studied 223 elementary and secondary school students using the Inventory of Callous Unemotional Traits and the Strenghts and Difficulties Questionnare. RESULTS: In case of moderate appearance of callous/unemotional traits behavior problems, relationship problems and hyperactivity are more typical furthermore presence of prosocial behavior is less typical. CONCLUSION: Results from normal population confirm assumption that C/U traits contribute to the appearance of juvenile aggression and antisocial behavior.

Brain mechanisms involved in predatory aggression are activated in a laboratory model of violent intra-specific aggression.

Callous-unemotional violence associated with antisocial personality disorder is often called 'predatory' because it involves restricted intention signaling and low emotional/physiological arousal, including decreased glucocorticoid production. This epithet may be a mere metaphor, but may also cover a structural similarity at the level of the hypothalamus where the control of affective and predatory aggression diverges. We investigated this hypothesis in a laboratory model where glucocorticoid production is chronically limited by adrenalectomy with glucocorticoid replacement (ADXr). This procedure was proposed to model important aspects of antisocial violence. Sham and ADXr rats were submitted to resident/intruder conflicts, and the resulting neuronal activation patterns were investigated by c-Fos immunocytochemistry. In line with earlier findings, the share of attacks aimed at vulnerable targets (head, throat and belly) was dramatically increased by ADXr, while intention signaling by offensive threats was restricted. Aggressive encounters activated the mediobasal hypothalamus, a region involved in intra-specific aggression, but sham and ADXr rats did not differ in this respect. In contrast, the activation of the lateral hypothalamus that is tightly involved in predatory aggression was markedly larger in ADXr rats; moreover, c-Fos counts correlated positively with the share of vulnerable attacks and negatively with social signaling. Glucocorticoid deficiency increased c-Fos activation in the central amygdala, a region also involved in predatory aggression. In addition, activation patterns in the periaqueductal gray - involved in autonomic control - also resembled those seen in predatory aggression. These findings suggest that antisocial and predatory aggression are not only similar but are controlled by overlapping neural mechanisms.

Callous-unemotional traits and the attentional bias towards emotional stimuli: Testing the moderating role of emotional and behavioural problems among high-risk adolescents.

Former studies demonstrated that antisocial youth with callous-unemotional (CU) traits are impaired in the processing of negative emotional stimuli. The aim of the current study was to explore the moderating role of different behavioural (i.e. conduct problems, hyperactivity-inattention) and emotional problems (i.e. internalizing symptoms) in the relationship between CU traits and attentional bias towards emotional stimuli. Besides using self-report measures, attentional bias was tested by an affective dot-probe task in a high-risk sample of 102 adolescent boys (M age = 16.34 years; SD = 1.32). CU traits were related to reduced attention to emotionally distressing pictures. Furthermore, conduct problems significantly moderated the relationship between CU traits and attention to distress cues. These findings highlight the importance of considering potential moderators to the well-established link between CU traits and deficits in response to negative emotional cues.