Diminished Neural Responses to Emotionally Valenced Facial Stimuli: A Potential Biomarker for Unemotional Traits in Early Childhood

Meanness and affective processing: A meta-analysis of EEG findings on emotional face processing in individuals with psychopathic traits

BACKGROUND

The triarchic model (Patrick et al., 2009) conceptualizes psychopathy as a multidimensional construct encompassing three biobehavioral dimensions: meanness, boldness, and disinhibition. Meanness entails low empathy, shallow affect, and lack of remorse, and is associated with poor facial emotion recognition; however, the mechanistic processes contributing to these deficits are unclear. Emotional face processing can be examined on a neurophysiological level using event-related potentials (ERPs) such as N170, P200, and LPP. No quantitative review to date has examined the extent to which amplitude of these ERP components may be modulated by psychopathic traits.

METHOD

The current study performed random-effects model meta-analyses of nine studies (N = 1131) which examined affective face processing ERPs in individuals with psychopathic traits to provide an overall effect size for the association between meanness, boldness, and disinhibition and N170, P200, and LPP amplitudes across studies. Analyses were also conducted examining potential moderators and publication bias.

RESULTS

N170 amplitudes were significantly smaller (r =.18) among individuals high in meanness when processing fearful faces. Significant effects were not found for N170 amplitude when processing angry or happy faces, nor for LPP and P200 amplitudes across stimulus types. Additionally, significant effects were not found for the association between N170 amplitude and other dimensions of psychopathy. Meta-regression analyses indicated the manipulation of facial stimuli was significant in explaining some between-study heterogeneity of the meanness N170-fear model. No evidence of publication bias was found.

CONCLUSIONS

Diminished amplitude of the N170 when viewing fear faces appears to be a neurophysiological marker of psychopathic meanness. Deficits in early encoding of faces may account for empathy deficits characteristic of psychopathy.

Newborn Brain Function and Early Emerging Callous-Unemotional Traits

Importance

Children with high callous-unemotional traits are more likely to develop severe and persistent conduct problems; however, the newborn neurobiology underlying early callous-unemotional traits remains unknown. Understanding the neural mechanisms that precede the development of callous-unemotional traits could help identify at-risk children and encourage development of novel treatments.

Objective

To determine whether newborn brain function is associated with early-emerging empathy, prosociality, and callous-unemotional traits.

Design, Setting, and Participants

In this prospective, longitudinal cohort study, pregnant women were recruited from obstetric clinics in St Louis, Missouri, from September 1, 2017, to February 28, 2020, with longitudinal data collected until March 20, 2023. Mothers were recruited during pregnancy. Newborns underwent brain magnetic resonance imaging shortly after birth. Mothers completed longitudinal follow-up when the children were aged 1, 2, and 3 years.

Exposures

The sample was enriched for exposure to socioeconomic disadvantage.

Main Outcome and Measure

Functional connectivity between hypothesized brain regions was assessed using newborn-specific networks and voxel-based connectivity analyses. Children's callous-unemotional traits were measured using the Inventory of Callous-Unemotional Traits. Empathy and prosociality were assessed using the Infant and Toddler Socio-Emotional Assessment.

Results

A total of 283 children (mean [SD] gestational age, 38 [2] weeks; 159 male [56.2%]; 2 Asian [0.7%], 171 Black [60%], 7 Hispanic or Latino [2.5%], 106 White [38%], 4 other racial or ethnic group [1.4%]) were included in the analysis. Stronger newborn functional connectivity between the cingulo-opercular network (CO) and medial prefrontal cortex (mPFC) was associated with higher callous-unemotional traits at age 3 years (β = 0.31; 95% CI, 0.17-0.41; P < .001). Results persisted when accounting for parental callous-unemotional traits and child externalizing symptoms. Stronger newborn CO-mPFC connectivity was also associated with lower empathy and lower prosociality at ages 1, 2, and 3 years using multilevel models (β = -0.12; 95% CI, -0.21 to -0.04; P = .004 and β = -0.20; 95% CI, -0.30 to -0.10; P < .001, respectively).

Conclusions and Relevance

Newborn functional connectivity was associated with early-emerging empathy, prosociality, and callous-unemotional traits, even when accounting for parental callous-unemotional traits and child externalizing symptoms. Understanding the neurobiological underpinnings of empathy, prosociality, and callous-unemotional traits at the earliest developmental point may help early risk stratification and novel intervention development.

Parental emotionality is related to preschool children's neural responses to emotional faces

The ability to accurately decode others' facial expressions is essential for successful social interaction. Previous theories suggest that aspects of parental emotionality-the frequency, persistence and intensity of parents' own emotions-can influence children's emotion perception. Through a combination of mechanisms, parental emotionality may shape how children's brains specialize to respond to emotional expressions, but empirical data are lacking. The present study provides a direct empirical test of the relation between the intensity, persistence and frequency of parents' own emotions and children's neural responses to perceiving emotional expressions. Event-related potentials (ERPs) were recorded as typically developing 3- to 5-year-old children (final Ns = 59 and 50) passively viewed faces expressing different emotional valences (happy, angry and fearful) at full and reduced intensity (100% intense expression and 40% intense expression). We examined relations between parental emotionality and children's mean amplitude ERP N170 and negative central responses. The findings demonstrate a clear relation between parental emotionality and children's neural responses (in the N170 mean amplitude and latency) to emotional expressions and suggest that parents may influence children's emotion-processing neural circuitry.

Associations between callous-unemotional traits and psychopathology in a sample of adolescent females

Background

Callous-unemotional (CU) traits (e.g., lack of empathy and guilt, deficient affect) have been associated with severe and persistent patterns of conduct problems and antisocial behaviour as well as with poorer treatment outcomes. They are now a specifier to the diagnosis of conduct disorder.

Objective

To examine the associations between CU traits and a wide set of psychopathological symptoms (e.g., anxiety, conduct disorder) in a sample of adolescent females.

Method

200 adolescent females (M = 15.55 years, SD = 1.64) recruited from French high schools located in Montreal, Quebec, Canada (n = 150) and from units/resources managed by the Montreal Youth Center (n = 50) self-reported on their levels of CU traits and psychopathological symptoms.

Results

Participants recruited from high schools, compared to their counterparts from the youth center, had lower scores on most of the scales and subscales of CU traits and psychopathology. The total score of CU traits as well as the callousness-uncaring dimension were correlated with externalizing symptoms for the participants from the schools and from the youth center. However, the total score of CU traits as well as the unemotional dimension were correlated with internalizing symptoms especially among participants from the schools.

Conclusions

Our analyses revealed differences in the patterns of associations depending on the subscales of CU traits and across sample types (i.e., school subsample versus youth center subsample), which should be considered in the assessment of psychopathology in these populations.

Preschoolers’ Sensitivity to Negative and Positive Emotional Facial Expressions: An ERP Study

The study examined processing differences for facial expressions (happy, angry, or neutral) and their repetition with early (P1, N170) and late (P3) event-related potentials (ERPs) in young children (N = 33). EEG was recorded while children observed sequentially presented pairs of facial expressions, which were either the same (repeated trials) or differed in their emotion (novel trials). We also correlated ERP amplitude differences with parental and child measures of socio-emotional competence (emotion recognition, empathy). P1 amplitudes were increased for angry and happy as compared to neutral expressions. We also detected larger P3 amplitudes for angry expressions as compared to happy or neutral expressions. Repetition effects were evident at early and late processing stages marked by reduced P1 amplitudes for repeated vs. novel happy expressions, but enhanced P3 amplitudes for repeated vs. novel facial expressions. N170 amplitudes were neither modulated by facial expressions nor their repetition. None of the repetition effects were associated with measures of socio-emotional competence. Taken together, negative facial expressions led to increased neural activations in early and later processing stages, indicative of enhanced saliency to potential threating stimuli in young children. Processing of repeated facial expression seem to be differential for early and late neural stages: Reduced activation was detected at early neural processing stages particularly for happy faces, indicative of effective processing for an emotion, which is most familiar within this age range. Contrary to our hypothesis, enhanced activity for repeated vs. novel expression independent of a particular emotion were detected at later processing stages, which may be linked to the creation of new memory traces. Early and late repetition effects are discussed in light of developmental and perceptual differences as well as task-specific load.

Facial Affect Sensitivity Training for Young Children with Emerging CU Traits: An Experimental Therapeutics Approach

OBJECTIVE

This article delineates best practices in the application of the experimental therapeutics framework for evaluating interventions within the context of randomized controlled trials (RCTs), offering a methodological primer and guiding framework for this approach. We illustrate these practices using an ongoing clinical trial conducted within the framework of a National Institute of Mental Health exploratory phased-innovation award for the development of psychosocial therapeutic interventions for mental disorders (R61/R33), describing the implementation of a novel "Facial Affect Sensitivity Training" (FAST) intervention for children with callous-unemotional (CU) traits. CU traits (e.g., lack of guilt or remorse, low empathy, shallow affect) are an established risk factor for persistent and severe youth misconduct, which reflect impairment in identified neurocognitive mechanisms that interfere with child socialization, and predict poor treatment outcomes, even with well-established treatments for disruptive behavior.

METHOD

We outline the stages, goals, and best practices for an experimental therapeutics framework. In the FAST trial, we assert that impaired sensitivity for emotional distress cues (fear and/or sadness) is mechanistically linked to CU traits in children, and that by targeting sensitivity to facial affect directly via a computerized automated feedback and incentive system, we can exert downstream effects on CU traits.

RESULTS

In the context of an open pilot trial, we found preliminary support for feasibility and mechanism engagement using FAST.

CONCLUSIONS

We summarize pilot study limitations and how they are being addressed in the R61/R33 RCTs, as well as challenges and future directions for psychosocial experimental therapeutics.

Facial emotion processing and language during early-to-middle childhood development: An event related potential study

Facial emotion processing (FEP) is critical to social cognitive ability. Developmentally, FEP rapidly improves in early childhood and continues to be fine-tuned throughout middle childhood and into adolescence. Previous research has suggested that language plays a role in the development of social cognitive skills, including non-verbal emotion recognition tasks. Here we investigated whether language is associated with specific neurophysiological indicators of FEP. One hundred and fourteen children (4-12 years) completed a language assessment and a FEP task including stimuli depicting anger, happiness, fear, and neutrality. EEG was used to record key event related potentials (ERPs; P100, N170, LPP at occipital and parietal sites separately) previously shown to be sensitive to faces and facial emotion. While there were no main effects of language, the P100 latency to negative expressions appeared to increase with language, while LPP amplitude increased with language for negative and neutral expressions. These findings suggest that language is linked to some early physiological indicators of FEP, but this is dependent on the facial expression. Future studies should explore the role of language in later stages of neural processing, with a focus on processes localised to ventromedial prefrontal regions.

The development of neural responses to emotional faces: A review of evidence from event-related potentials during early and middle childhood

Facial emotion processing (FEP) develops throughout childhood and provides crucial social information necessary for the interpretation and prediction of others' behaviour. This systematic review, which includes a meta-regression component, sought to explore the development of FEP event-related potentials (P100, N170, and late positive potential [LPP]) in children aged three to twelve years. Thirty-four studies, representing data from 1511 children, were included in the review. The combination of meta-regression and systematic review suggest that P100 amplitude decreases with increasing age in response to emotional facial stimuli. P100 latency may show a gradual decrease around the age of ten. In terms of the N170, it is suggested that amplitude follows a non-linear trend with age, and latency may decrease in early childhood before plateauing during middle childhood. Of note, review of the literature indicates that substantial methodological differences and high levels of heterogeneity exist. We suggest future research considers these results within the context of emotion-specific development, whilst also acknowledging how this may relate to individual social functioning skills across early-to-middle childhood.

A process model linking physiological arousal and fear recognition to aggression via guilt in middle childhood

Aggression coincides with emotional underarousal in childhood, but we still lack an understanding of how underarousal contributes to aggression. With an ethnically diverse sample of 8-year-olds (N = 150), we tested whether physiological underarousal and lower fear recognition were indirectly associated with heightened aggression through dampened guilt feelings. Caregivers rated children's aggressive behavior. We assessed children's skin conductance (SC) and respiratory sinus arrhythmia (RSA) while they imagined transgressing norms and measured their fear recognition with a facial morph task. Children reported guilt or lack thereof after hypothetically transgressing. The interaction of decreasing SC and increasing RSA (i.e., physiological underarousal) and poor fear recognition were indirectly associated with higher aggression through their associations with lower guilt. Emotional underarousal may contribute to aggression by disrupting the normative development of guilt. We discuss strategies to improve social-emotional acuity and reduce aggression in children with blunted physiological arousal and fear recognition.

Aware and tuned to care: Children with better distress recognition and higher sympathy anticipate more guilt after harming others

Helping children recognize the distress of their victims and feel sympathy may facilitate the optimal socialization of ethical guilt. With a sample of 150 eight-year-olds, we tested the main and interactive relations of distress recognition and sympathy to ethical guilt after hypothetically stealing and pushing. Better fear recognition and higher sympathy were uniquely associated with higher ethical guilt. The link between fear recognition and ethical guilt was stronger in children with higher sympathy. Beyond their unique contributions, distress recognition and sympathy may work in concert to facilitate ethical guilt after harming others. Statement of contribution What is already known on this subject Children are thought to express more guilt if they recognize their victims' distress and feel sympathy for them. However, there is little evidence for the direct roles of distress recognition and sympathy in children's guilt, and none for their joint contribution. What the present study adds The link between fear recognition and guilt was stronger in children with higher sympathy. Sympathy may help children harness and translate the awareness afforded by distress recognition into feelings of accountability and regret. This study was the first to clarify the main and additive roles of sympathy and distress recognition in children's anticipation of guilt after harming others. Promoting distress recognition and sympathy may represent a viable two-step approach to inducing guilt in children after they violate others' welfare.