Associations between trait anxiety and psychopathological characteristics of children at high risk for severe antisocial development

Abstract

It is thought that among children at a high risk for antisocial personality disorder, the level of individual anxiety might constitute an important marker with respect to symptomatology and prognosis. The aim of the present study was to examine whether associations between anxiety and subtypes of aggression (proactive and reactive) exist in boys with early-onset subtype of conduct disorder (CD) and co-morbid attention-deficit hyperactivity disorder (ADHD). A detailed psychometric characterization of boys with ADHD and the early-onset subtype of CD (n = 33) compared to healthy controls (n = 33) was performed. The assessment included trait anxiety, internalizing and externalizing problems, symptoms of psychopathy and temperament traits, as well as subtypes of aggressive behavior. Descriptive statistics, correlation analyses, and group comparisons were calculated. The clinical group was characterized by higher levels of externalizing and internalizing symptoms. Individual anxiety was positively associated with harm avoidance, symptoms of oppositional defiant disorder (ODD), and by trend with reactive aggression. In contrast, boys with reduced levels of anxiety exhibited more callous-unemotional traits. Our results indicate that children with the early-onset subtype of CD and ADHD constitute a psychopathological heterogeneous group. The associations between individual levels of trait anxiety, temperament traits, and subtypes of aggressive behavior in children with ADHD and severe antisocial behavior emphasize the impact of anxiety as a potential key factor that might also be crucial for improvement in therapeutic strategies and outcome measures. Anxiety should be considered carefully in children with ADHD and the early-onset subtype of CD in order to optimize current therapeutic interventions.

Mediation of the Relationship Between Callous-Unemotional Traits and Proactive Aggression by Amygdala Response to Fear Among Children With Conduct Problems

“…15,16 This is consistent with observations of primarily reactive aggression in these youths 14,17,18 and with hypotheses that externalizing behaviors not linked to high levels of CU traits are more likely to reflect emotional dysregulation and elevated threat sensitivity than reduced empathy. 2 Thus, although CU traits are positively correlated with externalizing behaviors, these variables are, respectively, negatively and positively correlated with amygdala responses to socioaffective stimuli.…”

Comorbidity Among Dimensions of Childhood Psychopathology: Converging Evidence From Behavior Genetics

“…Also, the presence of internalizing symptoms predicted less risk of reoffending among juvenile delinquents . In two other studies, children with reduced levels of anxiety had more callous‐unemotional traits, a strong predictor of antisocial behavior , and social anxiety was associated negatively with symptoms of CD among children and adolescents with ADHD .…”

Atypical mismatch negativity to distressful voices associated with conduct disorder symptoms

“…Higher scores on STAI trait anxiety in delinquents suggested that trait anxiety might contribute to the symptomatology of CD. In parallel, anxiety was reported to have a positive correlation with reactive aggression in boys with early‐onset CD and co‐morbid attention‐deficit hyperactivity disorder (Cosi, Hernandez‐Martinez, Canals & Vigil‐Colet, ; Polier, Herpertz‐Dahlmann, Matthias, Konrad & Vloet, ). Our findings indicated that higher STAI trait anxiety was associated with stronger P3a amplitudes to fearful syllables and higher STAI state anxiety was associated with larger P3a to sad syllables.…”