Probabilistic epigenesis: An alternative causal model for conduct disorders in children and adolescents

Early developmental risks for tobacco addiction: A probabilistic epigenesis framework

Considerable progress has been made in elucidating the relationships between early life psychobiological and environmental risk factors and the development of tobacco addiction. However, a comprehensive understanding of the heterogeneity in tobacco addiction phenotypes requires integrating research findings. The probabilistic epigenesis meta-theory offers a valuable framework for this integration, considering systemic, multilevel, developmental, and evolutionary perspectives. In this paper, we critically review relevant research on early developmental risks associated with tobacco addiction and highlight the integrative heuristic value of the probabilistic epigenesis framework for this research. For this, we propose a four-level systems approach as an initial step towards integration, analyzing complex interactions among different levels of influence. Additionally, we explore a coaction approach to examine key interactions between early risk factors. Moreover, we introduce developmental pathways to understand interindividual differences in tobacco addiction risk during development. This integrative approach holds promise for advancing our understanding of tobacco addiction etiology and informing potentially effective intervention strategies.

Debate: Developmental and integrative approaches in child and adolescent psychiatry inpatient facilities: the case of a tertiary university hospital in Paris

Based on the specific experience of a tertiary university hospital in Paris, France, we propose a theoretical framework encompassing developmental, multidimensional, eco-systemic, and multifactorial perspectives for child and adolescent psychiatry. Consequently, a modern CAPD should be multidisciplinary and implemented in a large medical setting with close disciplines, should promote tailored and integrative treatment, should include some organizational aspects (e.g., tutoring), and should also be opened to cultural and school interventions. Finally, for complex cases, it should keep ambitious goals in terms of both clinical and functional recovery.

Search for the Profile of the Victim of Adolescent Dating Violence: An Intersection of Cognitive, Emotional, and Behavioral Variables

The knowledge of the promoting variables of dating violence has been a topic much studied in the last decade. However, the definition of the profile of this type of victim still presents numerous unknowns that hinder the effectiveness of prevention programs against violence. This study analyzes the interaction of cognitive, emotional and behavioral variables that converge in the victim profile. The sample comprised 2577 adolescents (55.2% girls) of 14 to 18 years in age (M = 15.9, SD = 1.2). The instruments used were the dating violence questionnaire (CUVINO), the scale of detection of sexism in adolescents (DSA), Mechanisms of Moral Disengagement Scale and Child and Adolescent Disposition Scale (CADS). To study the relationship between the different variables considered in this article, a SEM analysis was used. The results show that victims of gender violence and emotional abuse have high scores in benevolent sexism, moral disengagement and emotionally negative behavioral patterns. Likewise, the existence of an interdependent relationship between these three sets of variables was found.

Who are the European youths willing to engage in radicalisation? A multidisciplinary review of their psychological and social profiles

BACKGROUND

A new model of radicalisation has appeared in Western countries since the 2010s. Radical groups are smaller, less hierarchical and are mainly composed of young, homegrown individuals. The aim of this review is to decipher the profiles of the European adolescents and young adults who have embraced the cause of radical Islamism and to define the role of psychiatry in dealing with this issue.

METHODS

We performed a systematic search in several databases from January 2010 to July 2017 and reviewed the relevant studies that included European adolescents and/or young adults and presented empirical data.

RESULTS

In total, 22 qualitative and quantitative studies were reviewed from various fields and using different methodologies. Psychotic disorders are rare among radicalised youths. However, they show numerous risk factors common with adolescent psychopathologies. We develop a comprehensive three-level model to explain the phenomenon of radicalisation among young Europeans: (1) individual risk factors include psychological vulnerabilities such as early experiences of abandonment, perceived injustice and personal uncertainty; (2) micro-environmental risk factors include family dysfunction and friendships with radicalised individuals; (3) societal risk factors include geopolitical events and societal changes such as Durkheim's concept of anomie. Some systemic factors are also implicated as there is a specific encounter between recruiters and the individual. The former use sectarian techniques to isolate and dehumanise the latter and to offer him a new societal model.

CONCLUSION

There are many similarities between psychopathological manifestations of adolescence and mechanisms at stake during the radicalisation process. As a consequence, and despite the rarity of psychotic disorders, mental health professionals have a role to play in the treatment and understanding of radical engagement among European youth. Studies with empirical data are limited, and more research should be promoted (in particular in females and in non-Muslim communities) to better understand the phenomenon and to propose recommendations for prevention and treatment.

[To err is human? Interests of chaotic models to study adult psychiatric disorders and developmental disorders]

BACKGROUND

Many clinical and biological parameters have nonlinear chaotic fluctuations. These variations result in unexpected pseudo-random transitions. In these models, few risk factors can lead to unexpected phenomena if oscillations and self-reinforcement patterns occur. Complex rhythms could ease the ability of a physiological system to adapt and react quickly to a constantly changing environment.

OBJECTIVES

It has been proposed that several psychiatric disorders and developmental disorders are characterized by a loss of complex rhythm in favor of a more organized pattern. We examine evidence to support these assumptions in literatures.

METHODS

We performed a literature review of the main computerized databases (Medline, PubMed) and manual searches of the literature concerning non dynamic rhythms in time series analysis, in adults with psychiatric disorder and children with developmental disorder. These results were interpreted through a developmental approach that highlights the role of the learning process in the emergence of abilities.

RESULTS

Analysis of clinical scores and electroencephalographic data have found that subjects with bipolar disorder or schizophrenia, tested over a time series, have lower chaotic rhythms compared with healthy subjects. Growing children share several properties of a complex system: the interdependence of developmental axes (motor, emotional, language, social skills), multiple hierarchical levels (i.e. genetic, biological, environmental, and cultural), the two-way transactions between the child and his environment, and the sensitivity to initial conditions. This could explain the difficulty to predict the emergence of abilities or the long-term prognosis of impairment in children. This limitation is not only due to errors in the explanatory model or the lack of explanatory variable. It is also caused by instability, which is a core characteristic of a chaotic system.

CONCLUSION

The study of chaotic rhythms in time-series clinical and nonclinical data (e.g. EEG, functional neuroimaging) could improve the prediction of an acute event, such as relapse of mood disorder. Moreover, the complex rhythms in children may play a major part in synchronicity during interactions with a caregiver, held as essential for later development of self-regulation skills, such as emotional stability.

A Systematic Review of the Evidence for Impaired Cognitive Theory of Mind in Maltreated Children

Compared to the large number of studies exploring difficulties in emotion recognition in maltreated children, few (N = 12) have explored the cognitive aspect of theory of mind (ToM), i.e., the ability to understand others' thoughts and intentions. A systematic review of these studies shows inconsistent results regarding cognitive ToM tasks. Youths with a history of maltreatment are more likely to fail at false-belief tasks (N = 2). However, results are less conclusive regarding other tasks (perspective-taking tasks, N = 4; and hostile attribution tasks, N = 7). Additionally, only one study controlled for potential psychopathology. Measures of psychopathology and other cognitive abilities, in addition to ToM, are required to establish a specific association between maltreatment and the cognitive dimension of ToM.

The triadic model perspective for the study of adolescent motivated behavior

The triadic neural systems model is a heuristic tool, which was developed with the goal of providing a framework for neuroscience research into motivated behaviors. Unlike dual models that highlight dynamics between approach systems centered on striatal function and control systems centered on prefrontal cortex, the triadic model also includes an avoidance system, centered on amygdala-related circuits. A first application of this model has been to account for adolescent behavior.

Probabilistic perception, empathy, and dynamic homeostasis: insights in autism spectrum disorders and conduct disorders

Homeostasis is not a permanent and stable state but instead results from conflicting forces. Therefore, infants have to engage in dynamic exchanges with their environment, in biological, cognitive, and affective domains. Empathy is an adaptive response to these environmental challenges, which contributes to reaching proper dynamic homeostasis and development. Empathy relies on implicit interactive processes, namely probabilistic perception and synchrony, which will be reviewed in the article. If typically-developed neonates are fully equipped to automatically and synchronously interact with their human environment, conduct disorders (CD) and autism spectrum disorders (ASD) present with impairments in empathetic communication, e.g., emotional arousal and facial emotion processing. In addition sensorimotor resonance is lacking in ASD, and emotional concern and semantic empathy are impaired in CD with Callous-Unemotional traits.

A behavioral neuroenergetics theory of ADHD

Energetic insufficiency in neurons due to inadequate lactate supply is implicated in several neuropathologies, including attention-deficit/hyperactivity disorder (ADHD). By formalizing the mechanism and implications of such constraints on function, the behavioral Neuroenergetics Theory (NeT) predicts the results of many neuropsychological tasks involving individuals with ADHD and kindred dysfunctions, and entails many novel predictions. The associated diffusion model predicts that response times will follow a mixture of Wald distributions from the attentive state, and ex-Wald distributions after attentional lapses. It is inferred from the model that ADHD participants can bring only 75-85% of the neurocognitive energy to bear on tasks, and allocate only about 85% of the cognitive resources of comparison groups. Parameters derived from the model in specific tasks predict performance in other tasks, and in clinical conditions often associated with ADHD. The primary action of therapeutic stimulants is to increase norepinephrine in active regions of the brain. This activates glial adrenoceptors, increasing the release of lactate from astrocytes to fuel depleted neurons. The theory is aligned with other approaches and integrated with more general theories of ADHD. Therapeutic implications are explored.

Does experimental research support psychoanalysis?

The question of whether a psychodynamic view is compatible with experimental research is still a challenging issue-especially for child and adolescent psychopathology-despite the influence of psychoanalytic theory in this field until the 1980s. In this article, is explored the relationship between psychodynamic theory and experimental research using examples of evidence-based studies in the fields of (i) psychotherapeutic intervention assessment, (ii) placebo response in children and adolescents, (iii) unconscious lasting traumatic effects in children and adolescents, (iv) psychodynamic-oriented psychological testing. There are now a sufficient number of evidence-based studies to support the use of psychodynamic therapy in mental disorders, particularly in personality disorder and anxious/depressive disorder. In addition, placebo responses in children and adolescents with internalizing disorders are significantly higher in major depression compared to obsessive-compulsive disorder or other anxiety disorders, which highlights differential psychopathologies regarding the experience of loss. Also, using an experimental task, psychoanalysts are able to identify, without explicit knowledge and above the level of chance, healthy adults whose siblings had experienced cancer during childhood. This experiment suggests that implicit information regarding a participant's history is conveyed in interpersonal exchanges that can be intuitively perceived by judges experienced in listening to free associations from a psychodynamic perspective. Finally, psychodynamic-oriented psychological testing may predict the transition to schizophrenia in adolescents with a history of manic/mixed episodes. It can be concluded that there are no discrepancies between psychodynamic views and experimental data, whether one tests psychotherapeutic approaches, discusses data from other fields such as psychopharmacology, or designs experiments based on psychodynamic theory.

Predictors of nonresponse to psychosocial treatment in children and adolescents with disruptive behavior disorders

OBJECTIVE

A crucial issue in youths with disruptive behavior disorders, including oppositional defiant disorder and conduct disorder, is the refractoriness to treatments. A multimodal approach with individual therapy to improve social skills and self-control and family and school interventions is the best psychosocial treatment. Predictors of poor response to psychosocial treatment remain understudied. We aimed at exploring whether callous (lack of empathy and guilt) and unemotional (shallow emotions) (CU) trait and type of aggression (predatory vs. affective) can affect response to psychosocial treatment in referred youths with disruptive behavior disorders.

METHODS

The sample consisted of 38 youths (28 boys and 10 girls, age range: 6-14 years, mean age: 13.1 ± 2.6 years) diagnosed as having oppositional defiant disorder or conduct disorder according to Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria and a clinical interview (Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version), who completed a 6-month therapeutic program at our hospital. Patients were assessed according to severity and improvement (Clinical Global Impressions-Severity score [CGI-S] and CGI-Improvement score), functional impairment (Children's Global Assessment Scale [C-GAS]), type of aggression, predatory versus affective (Aggression Questionnaire), and CU dimension (Antisocial Process Screening Device and the Inventory of CU Traits).

RESULTS

Among the 38 patients, 21 (55.3%) were responders and 17 (44.7%) were nonresponders, according to CGI-Improvement score and CGI-S. Nonresponders were more impaired at the baseline according to CGI-S and C-GAS. Nonresponders presented higher scores of predatory aggression, whereas affective aggression did not differ between groups. Nonresponders presented higher scores in CU trait of Antisocial Process Screening Device and in Inventory of CU total score (callous trait), but these differences did not survive Bonferroni correction.

CONCLUSIONS

Severity at the baseline and predatory aggression are negative predictors of psychosocial treatment, but the role of the callous trait needs more exploration in larger samples. Further research may increase our diagnostic and prognostic capacities, thus improving our treatment strategies.