Brain Associates of Parent Training on Antisocial Behaviour in Children

Lead Research Organisation: King's College London
Department Name: Forensic and Neurodevelopmental Science

Abstract

Children with conduct problems (CP) are repetitively and persistently aggressive, destructive and break rules in social and school settings. Understanding the cause(s) of CP is important as these children are much more likely to have continued problems in adult life. This includes alcoholism, drug abuse, mental illness, criminality, domestic violence, unemployment and early death. They also cost society billions of pounds each year and have significant emotional costs on their victims.

The underlying cause(s) for CP is probably complex but there is compelling evidence that children with CP have differences in brain anatomy and function. However, no-one has analysed whether there are specific brain differences that: a) predict resistance to change; and/or b) are 'reversible'.

To achieve this we will use brain imaging techniques to analyse the brain in CP children before and after a well-validated parent training intervention, which has been demonstrated to effectively reduce antisocial behaviour in CP children.

If successful, our work will help us to: a) better understand the relationship between brain abnormalities in CP and antisocial behaviour and b) identify why antisocial behaviour in some children with CP is more resistant to change than others.

It is also anticipated that our findings will also assist in focusing future research into the molecular basis of CP, and ultimately lead to better treatments.

Technical Summary

Studies have robustly reported that children with CP have anatomical and functional differences in a well-defined network of regions. These include the 1) amygdala (AMG), 2) anterior cingulate (ACC), ventromedial prefrontal (vmPFC) and temporal cortices, and 3) caudate nucleus and 4) their structural and functional connections. However, no-one has determined whether these differences predict 'risk' and 'resilience' to the persistence of antisocial behaviour, or if they are 'fixed' or 'reversible'.

The proposed study will address these key questions by using 'state of the art' imaging techniques to compare brain anatomy, function and 'connectivity' in young CP boys with non-CP controls. We wish to determine if differences in the anatomy and function of AMG, ACC, vmPFC, temporal cortex, caudate, and associated structures in CP boys: a) predict behavioural alteration; and/or b) alter in parallel with reduced antisocial behaviour. To achieve this we will analyse the brain in CP children before and after a well-validated parent training intervention, which has been demonstrated to effectively reduce antisocial behaviour.

We will complete a longitudinal follow-up study of 90 boys (aged 5-7 years old) with CP with data gathered at two time points: before (T1), and on completion (T2) of a standard 14-week IY group-parenting programme. Imaging and behavioural measures will take place at T1 and T2. A group of 90 non-CD control boys (aged 5-7 years old) will also undergo imaging, and behavioural measurements, at T1 and T2 to allow quantification of change in patients as a function of intervention while controlling for test-retest effects.

If successful, our work will increase our current understanding into the association between macroscopic brain differences in children with CP and antisocial behaviour. This will assist in directing future research into the molecular mechanisms that modulate this relationship.

Planned Impact

The beneficiaries of our research will extend beyond the academic environment and will include:

1. Children with CP: Conduct problems (CP) are a very significant burden to the affected individual. Children with severe CP have a 5-10 fold increased risk of subsequent substance abuse, mental illness, criminality, unemployment and early death. It is hoped that increasing our understanding into the biological basis of CP will reduce these risks.

2. Carers of CP: Parents, teachers, clinicians, social workers and other carers of children with CP will also benefit from our research. In the short term the study may have a positive effect by, for example, helping carers understand this condition better. In the longer term it is hoped that our findings will translate into better treatment for CP.

3. Society: CP are the commonest mental disorder in children and a very significant burden to society. Research that enables the development of more effective interventions would therefore also benefit society more widely.

4. Criminal Justice System (CJS): In 2009 the cost of youth crime in the UK was estimated at £8.5-11 billion. In the short term our research has the potential to have a significant impact on the manner in which the CJS perceives children with CP and diverts them following conviction. In the longer term it is hoped that it will reduce the financial and emotional cost of youth crime.

5. Policy-makers: Our team includes individuals that have a track-record of being actively involved in advising governmental and NGO organisations. They will be actively involved in translating findings from our study to relevant policymakers.

Publications

10 25 50
 
Title ABC study database 
Description The ABC database incorporates pre and post intervention data on children with conduct problems. This includes structural and diffusion MRI data as well as fMRI data investigating affective and reward processing using well replicated tasks. In addition, this database contains hair follicle keratinocatyes for the generation of induced pluripotent stem cells, and saliva for assessing both DNA and RNA methylation in these subjects. Finally, these data can be assessed and stratified in accordance to extensive clinical data collected on the children with conduct problems and their families. 
Type Of Material Database/Collection of data 
Year Produced 2016 
Provided To Others? Yes  
Impact This is, to our knowledge, the first database of its type offering a rich dataset of the biological and clinical correlates of persistent and remitting conduct problems. This has already produced two conference proceedings that are in the process of being developed into manuscripts. 
 
Description Personalised Programmes for Children: a National Institute for Health Research Programme grant 
Organisation Tavistock and Portman NHS Foundation Trust
Country United Kingdom 
Sector Public 
PI Contribution Both studies were recruiting the same cohort of children across London at the same. We matched the questionnaires completed and protocols in a manner that enabled us to pool resources. We held joined meeting on a monthly basis to enable this to run smoothly. We have also set up a joint database which was not costed in the current grant and has been a saving to the MRC.
Collaborator Contribution As above.
Impact N/a
Start Year 2015
 
Description Invitation to International Conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The 8th biennial meeting of the Society for the Scientific Study of Psychopathy, Las Vegas R May 2-4, 2019
1. Oral presentation (accepted): "Impaired Pathways to Callous-Unemotional Traits in Children with Conduct Disorders. This will be presented by Suzanne O'Brien (Research Assistant).
2. Poster presentation (accepted): "Brain differences in boys that respond to Parent Training". This will be presented by Dr Arjun Sethi (Postdoctoral Research Assistant).
Year(s) Of Engagement Activity 2019