Background and objectives

Conduct disorder (CD) is associated with deficits in social-emotional behaviour, such as increased levels of aggression. Callous-unemotional (CU-) traits foster those deficits and contribute to severe rates of instrumental aggression in CD. Previous studies of that increase in aggression have mainly focused on intentional aspects of behaviour. Unintentional behaviour, such as automatic approach and avoidance, has not been taken into account despite being highly relevant for behaviour. Therefore, the relevance of CU-traits for automatic actions and the feasibility of an approach-avoidance-task to measure those actions in CD-patients were investigated in a study series.

Methods

Study 1

22 CD-patients executed an approach-avoidance task, where participants pushed or pulled pictures of emotional faces using a joystick. CU-traits were assessed via parent-report.

Study 2

28 CD-patients and 19 typically developing children (TD) executed the AAT. Again, CU-traits were assessed via parent-report.

Results

The AAT was a feasible instrument to measure automatic action tendencies and revealed that, while TD-children showed an avoidance bias towards angry faces, CD-patients showed a lack of automatic avoidance of anger. Across the whole sample (TD and CD combined), CU-traits predicted less threat avoidance.

Limitations

The small sample size may have limited the power to detect smaller approach-avoidance tendencies towards other emotions.

Conclusions

The findings suggest that CD is associated with a lack of automatic avoidance of social threat and that CU-traits predict that lack of avoidance. Divergent automatic threat responding might underlie the extreme levels of instrumentally aggressive behaviour observed in CD-patients with distinctive CU-traits.

中文翻译：

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重症监护病房，但我不在乎：品行障碍中冷酷无情的特征和回避行为

背景和目标

品行障碍 (CD) 与社会情感行为缺陷有关，例如攻击性程度增加。冷酷无情（CU-）特征助长了这些缺陷，并导致 CD 中严重的工具性攻击行为。先前关于攻击性增加的研究主要集中在行为的有意方面。尽管与行为高度相关，但并未考虑无意识行为，例如自动接近和回避。因此，在一系列研究中，研究了 CU 特征与自动行为的相关性以及通过接近-回避-任务来测量 CD 患者的这些行为的可行性。

方法

研究1

22 名患有 CD 的患者执行了一项回避任务，参与者使用操纵杆推动或拉动情绪面孔的图片。CU 特征通过家长报告进行评估。

研究2

28 名 CD 患者和 19 名正常发育儿童 (TD) 执行了 AAT。再次，通过家长报告评估 CU 特征。

结果

AAT 是测量自动行为倾向的可行工具，并显示，虽然 TD 儿童对愤怒的面孔表现出回避偏见，但 CD 患者表现出缺乏对愤怒的自动回避。在整个样本（TD 和 CD 组合）中，CU 特征预测威胁规避程度较低。

局限性

小样本量可能限制了检测对其他情绪的较小接近回避倾向的能力。

结论

研究结果表明，CD 与缺乏自动回避社会威胁有关，而 CU 特征预示着缺乏回避。不同的自动威胁响应可能是在具有独特 CU 特征的 CD 患者中观察到的极端工具性攻击行为的基础。