Conduct problems in adolescence are a serious concern: adolescents are more than three times as likely to commit crimes, including violent crimes, than either pre-adolescent children or adults. But conduct problems in adolescents remain poorly understood and more effective risk assessment and prevention strategies are needed. A suite of temperamental and behavioral traits, referred to as callous-unemotional traits, together constitute a strong risk factor for increases in the severity and frequency of conduct problems and the likelihood that they will persist into adulthood. Callous-unemotional traits include fearlessness, a lack of empathy, and uncaring behaviors like aggression. However, a knowledge gap persists, in that no research has assessed the neural basis of callous-unemotional traits among children with conduct problems. The researchers'long-term goal is to identify the neural basis of empathy in the human brain, and to understand how empathy deficits emerge that place individuals at high risk for antisocial behavior. The objective of this application is to characterize the patterns of neural function that underlie callous-unemotional traits among children with conduct problems, and assess how these neural activation patterns relate to empathy. The first specific aim is to identify the patterns of neural functioning associated with callous-unemotional traits during an emotion processing task among children with conduct problems. Functional magnetic resonance imaging (fMRI) will be used to measure neural activation in healthy children and in children with conduct problems who vary in callous-unemotional traits while the children view fearful facial expressions. Prior research links callous-unemotional traits with impairments in processing fear-relevant stimuli like fearful expressions, which have been demonstrated to elicit empathy. The second specific aim is to identify the patterns of neural functioning associated with empathic responding among children with callous-unemotional traits and conduct problems. fMRI scanning will again be used to measure neural activation while children with conduct problems and healthy children complete a task that assesses their empathic responses to characters experiencing moderate fear in short written scenarios. It is hypothesized that hypoactivation in the amygdala and ventromedial prefrontal cortex and reduced functional connectivity between these structures in response to empathy-relevant stimuli will be correlated with callous-unemotional traits among children with conduct problems. The proposed study not only builds upon the PI's previous research but includes two innovative new directions: 1) identifying differences in neural activity and connectivity that underlie callous-unemotional traits among children with conduct problems, and 2) determining how these differences are related to deficits in empathy. This is important because callous-unemotional traits represent a risk factor for significance increases in the severity and duration of conduct problems, and because success in early risk assessment and prevention can only occur if the distinct causes of conduct problems in adolescence are identified.
The proposed research is expected to have a positive impact on the understanding of the causes of conduct problems in children and adolescents. It will be the first to identify the patterns of neural functioning that are associated with callous-unemotional traits, which constitute a risk factor for increases in the severity, duration, and resistance to treatment of conduct problems. This is a critical step towards identifying the cause of severe conduct problems in adolescence, which is in turn critical to success in the early risk assessment and prevention of conduct problems.