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FemNAT-CD (Neurobiology and Treatment of Adolescent Female Conduct Disorder: The Central Role of Emotion Processing)
The FemNAT-CD study (www. femnat-cd.eu) on “Neurobiology and Treatment of Adolescent Female Conduct Disorder: The Central Role of Emotion Processing” focuses on conduct disorder (CD) in females during late childhood and adolescence by, first, a cross-sectional and, second, a longitudinal approach. It aims at describing phenotypic sub-groups, their underlying neurobiological and neurocognitive mechanisms leading to pathological aggression and delinquent behaviour in females compared to males, the longitudinal course of CD in females during puberty, and to apply a new psychotherapeutic approach in adolescent females within a randomised controlled trial. In addition, innovative pharmaco-challenge studies have been performed in animals and humans. The present consortium com¬prises several highly experienced clinical sites, a core database, monitoring and biostatistics unit as well as several basic scientists from different disciplines who have an outstanding track record on studies related to the aims and topics of this proposal.
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Clarify the phenomenology and neurobiology of female CD from pre-puberty to post-puberty. We study: 1.1 the role of complex main and interacting genetic and environmental risk factors on female CD, related psychopathology, brain function and structure, HPA axis and ANS disturbances to identify CD specific endophe¬notypes and related biomarkers; 1.2 female CD specific epigenetic changes and associated early psychosocial and biological environmental risk factors; 1.3 the clinical, neural and neurocognitive phenotype of female CD from pre- to postpuberty and related neuroendo¬crine and ANS function as well as moderating, mediating and direct risk factors to identify neurobio-logically and phenotypically distinct homogeneous subtypes to guide future, targeted treatment approaches.
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Translate knowledge of neuropsychological and neurobiological characteristics into targeted intervention 2.1 Based on the central role of EP in female CD, we will study the effect of a DBT-CD-A psychological treatment program focusing on improving emotion regulation, emotion recognition, distress tolerance and interpersonal effectiveness. 2.2 Based on the central role of oxytocin and serotonin in emotion recognition, representation and regulation, their differential effects on neural functions underlying emotion processing and aggressive behaviour will be studied in a female animal model, and two proof-of-concept pharmaco-challenge studies with intranasal oxytocin and the serotonin precursor L-tryptophan (TRP) will be performed in human female CD. 2.3 Results of the pharmaco-challenge and epigenetic studies will be explored for their pharmaceutical potential.
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Societal and educational objectives 3.1 Provide clinicians, researchers, youth welfare and forensic services with training on assessment instruments, different CD subtypes, and psychotherapeutic methods, and with information on therapeutic interventions to be effectively used in female CD. 3.2 Provide adolescents with CD and their families with evidence based diagnostic and therapeutic approaches, to explain risk and protective factors to these families, and to improve the long-term course of the disorder by targeted treatment.
Inclusion Criteria
Clinical Measures
In the FemNAT-CD study contained a multitude of questionnaires. The ones included in the dataset here are the following:
- Child Behaviour Checklist (CBCL): The Child Behavior Checklist (CBCL) is a checklist parents complete to detect emotional and behavioural problems in children and adolescents. It consists of 120 questions (numbered 1-113), scored on a three-point Likert scale (0=absent, 1= occurs sometimes, 2=occurs often). The time frame for item responses is the past six months.
- Emotion Regulation Questionnaire (ERQ): The Emotion Regulation Questionnaire is designed to assess individual differences in the habitual use of two emotion regulation strategies: cognitive reappraisal and expressive suppression.
- Inventory of Callous-Unemotional Traits (ICU): A 24 item questionnaire for parents designed to provide a comprehensive assessment of callous and unemotional traits. These traits have proven to be important for designating a distinct subgroup group of antisocial and aggressive youth. The ICU has three subscales: Callousness, Uncaring, and Unemotional as well as a total score. Items are rated on a 4-point Likert scale ranging from 0 (not at all true) to 3 (definitely true).
- Assessment of Relational Aggression (RAQ): An 11 item measure of aggression in relationships with other children assessing the frequency of these symptoms.
- Reactive-Proactive Aggression Questionnaire (RPQ): Questionnaire for subjects with antisocial, psychosocial and personality measures using 23 items.