Disentangling Antisocial Predispositions in Adolescence

The current fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013) differentiates individuals with conduct disorder according to the presence vs. absence of “limited prosocial emotions,” known in the literature as callous-unemotional (CU) traits. Research suggests that CU traits confer risk for more stable, severe antisocial behavior over the lifetime. However, other trait dispositions may play an important role in understanding the temperamental and neural characteristics underlying this heterogeneous disorder. The current study sought to extend existing knowledge of biobehavioral traits’ contributions to antisocial behavior by examining the relations of adolescent callousness and disinhibition to concurrent neural response and clinical symptoms (e.g., conduct disorder and ADHD). These questions were addressed using existing data from the IMAGEN project, a large (N ~ 2200), longitudinal European adolescent sample with questionnaire, clinical-interview, and neuroimaging data. First, a reliable self-report callousness scale was created from administered questionnaire items and validated in relation to empathy and drug use variables. Second, selective associations were found between callousness and decreased neural activation in empathy-relevant areas while viewing ambiguous and angry facial expressions, over and above the effects of disinhibition. Finally, callousness and disinhibition were independently related to conduct disorder symptoms in the best-fitting negative binomial regression model; disinhibition alone was related to ADHD symptoms and, to a lesser extent, symptoms of distress disorders. The current study advances understanding of the development of antisocial behavior in relation to dispositional traits, in line with recent calls for a multidimensional conceptualization of childhood antisocial tendencies beyond CU traits alone. Results support trait-related revisions to current diagnostic nosology to guide provision of effective treatment.