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

通过心理健康和司法系统，行为障碍给澳大利亚社会带来了巨大的直接成本，通过与其他心理健康问题、关系问题、社会功能受损和物质使用问题的关联，造成了间接成本。行为-家庭为基础的治疗有良好的成功率幼儿与合作的父母，然而，有少数人谁进展到慢性问题，尽管如此。确定儿童早期慢性模式的风险和复原力因素是早期干预的关键。在之前的研究中，该研究小组首次表明，冷酷无情的性格特征（慢性精神病的一个特征）可以在4岁的儿童中进行测量，并预测一系列负面结果。然而，我们也发现行为问题儿童在青春期之前并不存在精神病态的关键神经精神标记，包括奖励优势-惩罚不敏感和情感共情缺陷。在青春期前后，与成人形式的精神病和反社会行为相关的认知情感处理方式似乎发生了重要变化。因此，这项研究提出了关于严重反社会行为（或精神病）在童年到青少年时期发展的关键问题。我们的证据表明，青春期早期可能是代表慢性风险的心理特征具体化的时期。目前的研究将是第一个绘制通过儿童晚期-青少年时期严重反社会过程的共同神经精神标记（情感共情，惩罚不敏感）的发展图。这一发现将对反社会行为模型和处理有行为问题的儿童和青少年的临床方法产生明确的影响。

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.