Brain Associates of Parent Training on Antisocial Behaviour in Children

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.

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.

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.