NLM Director’s Comments Transcript
Callous,

Unemotional Youth Behaviors: New Insights – 02/09/2015

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Illustration of group of teenagers gathering.

Photo: Courtesy of
the National Library of Medicine.

Greetings from the National Library of Medicine and MedlinePlus.gov

Regards to all our listeners!

I'm Rob Logan, Ph.D. senior staff U.S. National Library of Medicine for Donald Lindberg, M.D, the Director of the U.S. National Library of Medicine.

Here is what's new this week in MedlinePlus.

Recent findings about brain mechanisms, genetic and environmental risk factors, as well as treatment options provide insights into addressing callous and unemotional behaviors among youth, suggests a stimulating research review recently published in the New England Journal of Medicine.

While the article’s three authors (who are from the National Institute of Mental Health) suggest callous and unemotional behaviors occur in less than half of young persons with conduct disorders, callous and unemotional behavioral patterns are especially challenging. The authors write (and we quote) ‘As compared with youth with conduct disorder who show remorse, empathy, and concern about school performance, those with callous-unemotional traits have a poorer prognosis and treatment response’ (end of quote).

More broadly, the authors write (and we quote) ‘Youth conduct problems are predictive of an increased risk of substance abuse, criminal behavior, and educational disruption; they also incur a considerable societal burden from interpersonal suffering and financial costs’ (end of quote).

The authors explain recent research suggests three neurocognitive (or brain) dysfunctions are linked to youth conduct disorders -- and one may be specifically linked to callous-unemotional traits. The authors write (and we quote): ‘…the hope is further research on these three dysfunctions will generate biologically based diagnostic tests that are analogous to other diagnostic tests in medicine’ (end of quote).

Moreover, the authors explain a dysfunction within an area of the brain called the amygdala may be related to a lack of empathy among youth. The authors note magnetic resonance brain imaging suggests callous-unemotional responses among some young persons is associated with a comparatively reduced response within their amygdala.

Similarly, the authors report previously unknown amygdala activity may explain why young persons differ in how they perceive (and respond to) threatening situations and persons. More specifically, the authors explain callous-unemotional youth exhibit a reduced response to threats within their amygdala compared to their peers.

Besides differences in brain activity, the authors explain the development of callous-unemotional patterns among youth may be associated with genetic and environmental conditions. For example, the authors note there is an inherited susceptibility when a young person’s parents also exhibit callous and unemotional behavioral patterns. The authors add a mother’s diet and smoking habits additionally may be associated with a child’s healthy or unhealthy brain development.

Finally, the authors explain other new research suggests therapy for clinical anxiety, hypersensitivity, and similar challenges may help counter callous and unemotional behaviors among youth. Although some existing medications can be used to reduce some callous and unemotional behaviors, the authors note the current evidence about the clinical efficacy of prescription drug therapy is limited to short term studies.

While there is progress to diagnose, understand, and treat callous and unemotional youth behaviors, the authors conclude there is a pressing need for more research to predict biomarkers for this condition and to tailor future treatments to meet specific patient needs.

Meanwhile, the ‘start here’ section of MedlinePlus.gov’s child behavior disorders health topic page provides some basic information about what you can do to change a child’s behavior (which is provided by the American Academy of Family Physicians).

The ‘specific conditions’ section of MedlinePlus.gov’s child behavior disorders health topic page has helpful links to evidence-based information about responding to: temper tantrums, swearing, stealing, lying, fighting and biting, disruptive behaviors, refusal to go to school, defiance, and violent behaviors.

An overview of children’s conduct disorder (provided by the American Academy of Child and Adolescent Psychiatry) also is found in the ‘specific conditions’ section.

MedlinePlus.gov’s child behavior disorders health topic page additionally provides links to the latest pertinent journal research articles, which are available in the ‘journal articles’ section. Links to clinical trials that may be occurring in your area are available in the ‘clinical trials’ section. You can sign up to receive updates about child behavior disorders as they become available on MedlinePlus.gov.

To find MedlinePlus.gov’s child behavior disorders health topic page, type ‘child conduct disorder’ in the search box on MedlinePlus.gov’s home page, then, click on ‘Child behavior disorders (National Library of Medicine).’ MedlinePlus.gov also has a health topic page devoted to teen mental health.

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Please email Dr. Lindberg anytime at: NLMDirector@nlm.nih.gov

That's NLMDirector (one word) @nlm.nih.gov

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The National Library of Medicine is one of 27 institutes and centers within the National Institutes of Health. The National Institutes of Health is part of the U.S. Department of Health and Human Services.

A disclaimer — the information presented in this program should not replace the medical advice of your physician. You should not use this information to diagnose or treat any disease without first consulting with your physician or other health care provider.

It was nice to be with you. I look forward to meeting you here next week.