Behavioural and Neuropsychiatric Aspects of Transition to Severe Conduct Disorder In Adolescence.

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Conduct disorder represents an enormous cost to Australian society directly via the mental health and forensic systems, and indirect costs via its associations with other mental health problems, relationship problems, impaired social functioning, and substance use problems. Behavioural-family-based treatment have good success rates with young children with cooperative parents, however, there are a minority who progress to chronic problems despite this. Risk and resilience factors identifying chronic patterns in early childhood are the key to early intervention. In previous research, this research team showed for the first time that callous-unemotional traits, a feature of chronic psychopathy, could be measured in children as young as 4 years, and was predictive of a range of negative outcomes. However, it was also found that the key neuropsychiatric markers characteristic of psychopathy, including reward dominance-punishment insensitivity and deficits in affective empathy, did not exist in conduct problem children prior to adolescence. Around the time of puberty, it appears that important changes occur in cognitive-affective processing styles that are associated with the adult form of psychopathy and antisocial behaviour. Thus, this research raises critical questions about the development of severe antisocial behaviour (or psychopathy) through the childhood to adolescent years. Our evidence indicates that early adolecence may be the period when intrapsychological characteristics representing chronic risk become concrete. The current research will be the first to map the development common neuropsychiatric markers (affective empathy, punishment insensitivity) of severe antisocial processes through the late childhood-adolescent period. The findings will have clear implications for models of antisocial behaviour and clinical approaches to working with conduct problem children and adolescents.