Search

Background Callous-unemotional (CU) traits are associated with chronic and escalating trajectories of antisocial behavior. Extant etiologic studies suggest that heritability estimates for CU traits vary substantially, while also pointing to an environmental association between parenting and CU traits. Methods We used twin modeling to estimate additive genetic (A), shared environmental (C), and nonshared environmental (E) influences on CU traits, measured with the Inventory of Callous-Unemotional Traits (ICU) and its subscales. Our sample included 600 twin pairs (age 6-11, 230 monozygotic) from neighborhoods with above-average levels of family poverty, a risk factor for antisocial behavior. We examined the extent to which correlations between parenting, measured via parent and child report on the Parental Environment Questionnaire, and CU traits reflected genetic versus environmental factors. Then, we tested whether parenting moderated the heritability of CU traits. Results In the context of lower-income neighborhoods, CU traits were moderately to highly heritable (A = 54%) with similar moderate-to-high nonshared environmental influences (E = 46%). Bivariate models revealed that associations between CU traits and warm parenting were genetic (rA = .22) and environmental (rE = .19) in origin, whereas associations between CU traits and harsh parenting were largely genetic in origin (rA = .70). The heritability of CU traits decreased with increasing parental warmth and decreasing harshness. Conclusions Callous-unemotional traits are both genetic and environmental in origin during middle childhood, but genetic influences are moderated by parenting quality. Parenting may be an important target for interventions, particularly among youth with greater genetic risk.

The novel coronavirus (COVID-19) pandemic has caused widespread disruption to our traditional way of life and mental health therapy has not been spared. A combination of increased anxiety, diminished social opportunities, and the shift to telehealth service provision presents particular challenges for the treatment of social anxiety in youth, which relies heavily on exposures to social situations with peers, adults, or other feared social stimuli. The objective of this commentary is to provide guidance to clinicians working with youth with social anxiety on how to maintain ethical, evidence-informed provision of exposure therapy in light of these unusual circumstances. We first present an overview of how COVID-19 may uniquely impact youth with social anxiety and highlight the importance of continuing to provide exposure-based treatments during this time. We then discuss guiding principles for delivering exposure therapy during COVID-19. We focus on providing practical examples of how common social anxiety exposures can be adapted and delivered successfully through telehealth while abiding by COVID-19 social distancing guidelines. Finally, we discuss key recommendations to assist clinicians in moving treatment forward while considering changing safety guidelines pertaining to COVID-19.

OBJECTIVE: The relative contribution of individual cognitive behavioral therapy (CBT) components to treatment outcomes for child anxiety disorders (CADs) is unclear. Recent meta-analyses suggest that exposure may be the primary active ingredient in CBT for CADs, and that relaxation may be relatively less effective. This brief report tests the hypothesis that exposure-focused CBT (EF-CBT) would outperform a relaxation-based active therapy control (Relaxation Mentorship Training; RMT) for the treatment of CADs. METHOD: Participants were 102 youth with CADs (mean age=11.91, 26 males; 76.4% White, 14.7% Multiracial, 3.9% Black, 3.9% Asian, 0.9% other/do not wish to identify) as part of an ongoing neuroimaging randomized controlled trial. Participants were randomly assigned (ratio 2:1) to receive 12 sessions of EF-CBT (n=70) or RMT (n=32). Clinical improvement was measured at Week 12 (Clinical Global Impression – Improvement scale; CGI-I); treatment response was defined as receiving a rating of ‘very much’ or ‘much improved’ on the CGI-I. Anxiety severity was measured at Weeks 1, 6, 9, 12 (Pediatric Anxiety Rating Scale; PARS). Outcome measures were completed by an independent evaluator unaware of condition. RESULTS: EF-CBT exhibited 2.98 times higher odds of treatment completion than RMT; 13 treatment non-completers were included in analyses. Estimated treatment response rates were higher for EF-CBT (57.3%) than for RMT (19.2%). Longitudinal analyses indicated that EF-CBT was associated with faster and more pronounced anxiety reductions than RMT on the PARS (Hedges’ g=.77). CONCLUSIONS: Results suggest that EF-CBT without relaxation is effective for CADs, and more effective than a relaxation-based intervention.

Socioeconomic disadvantage during childhood is associated with a myriad of negative adult outcomes. One mechanism through which disadvantage undermines positive outcomes may be by disrupting the development of self-control. The goal of the present study was to examine pathways from three key indicators of socioeconomic disadvantage – low family income, low maternal education, and neighborhood poverty – to neural and behavioral measures of response inhibition. We utilized data from a representative cohort of 215 twins (ages 7–18 years, 70% male) oversampled for exposure to disadvantage, who participated in the Michigan Twins Neurogenetics Study (MTwiNS), a study within the Michigan State University Twin Registry (MSUTR). Our child-friendly Go/No-Go task activated the bilateral inferior frontal gyrus (IFG), and activation during this task predicted behavioral inhibition performance, extending prior work on adults to youth. Critically, we also found that neighborhood poverty, assessed via geocoding, but not family income or maternal education, was associated with IFG activation, a finding that we replicated in an independent sample of disadvantaged youth. Further, we found that neighborhood poverty predicted response inhibition performance via its effect on IFG activation. These results provide the first mechanistic evidence that disadvantaged contexts may undermine self-control via their effect on the brain. The broader neighborhood, beyond familial contexts, may be critically important for this association, suggesting that contexts beyond the home have profound effects on the developing brain and behaviors critical for future health, wealth, and wellbeing.

The approximate number system (ANS) is widely considered to be a foundation for the acquisition of uniquely human symbolic numerical capabilities. However, the mechanism by which the ANS may support symbolic number representations and mathematical thought remains poorly understood. In the present study, we investigated two pathways by which the ANS may influence early math abilities: variability in the acuity of the ANS representations, and children’s’ ability to manipulate ANS representations. We assessed the relation between 4-year-old children’s performance on a non-symbolic numerical comparison task, a non-symbolic approximate addition task, and a standardized symbolic math assessment. Our results indicate that ANS acuity and ANS manipulability each contribute unique variance to preschooler’s early math achievement, and this result holds after controlling for both IQ and executive functions. These findings suggest that there are multiple routes by which the ANS influences math achievement. Therefore, interventions that target both the precision and manipulability of the ANS may prove to be more beneficial for improving symbolic math skills compared to interventions that target only one of these factors.