Reviewbronze2017

The Neurodevelopmental Basis of Early Childhood Disruptive Behavior: Irritable and Callous Phenotypes as Exemplars

Lauren S. Wakschlag · Susan B. Perlman · James Blair · Ellen Leibenluft · Margaret J. Briggs‐Gowan · Daniel S. Pine

187 citations0/0 files storedAmerican Journal of Psychiatry

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Child and Adolescent Psychosocial and Emotional Development Neural and Behavioral Psychology Studies Psychopathy, Forensic Psychiatry, Sexual Offending

Abstract

The arrival of the Journal's 175th anniversary occurs at a time of recent advances in research, providing an ideal opportunity to present a neurodevelopmental roadmap for understanding, preventing, and treating psychiatric disorders. Such a roadmap is particularly relevant for early-childhood-onset neurodevelopmental conditions, which emerge when experience-dependent neuroplasticity is at its peak. Employing a novel developmental specification approach, this review places recent neurodevelopmental research on early childhood disruptive behavior within the historical context of the Journal. The authors highlight irritability and callous behavior as two core exemplars of early disruptive behavior. Both phenotypes can be reliably differentiated from normative variation as early as the first years of life. Both link to discrete pathophysiology: irritability with disruptions in prefrontal regulation of emotion, and callous behavior with abnormal fear processing. Each phenotype also possesses clinical and predictive utility. Based on a nomologic net of evidence, the authors conclude that early disruptive behavior is neurodevelopmental in nature and should be reclassified as an early-childhood-onset neurodevelopmental condition in DSM-5. Rapid translation from neurodevelopmental discovery to clinical application has transformative potential for psychiatric approaches of the millennium. [AJP at 175: Remembering Our Past As We Envision Our Future November 1938: Electroencephalographic Analyses of Behavior Problem Children Herbert Jasper and colleagues found that brain abnormalities revealed by EEG are a potential causal factor in childhood behavioral disorders. (Am J Psychiatry 1938; 95:641-658 )].

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References

2013Diagnostic and Statistical Manual of Mental Disorders 2015Moral Identity and Developmental Theory 2000Effortful control in early childhood: Continuity and change, antecedents, and implications for social development.2013Understanding the Mechanisms Through Which an Influential Early Childhood Program Boosted Adult Outcomes 2006Common emotional and behavioral disorders in preschool children: presentation, nosology, and epidemiology 2014The RDoC framework: facilitating transition from ICD/DSM to dimensional approaches that integrate neuroscience and psychopathology 2005Responding to the emotions of others: Dissociating forms of empathy through the study of typical and psychiatric populations 2008Research Review: The importance of callous‐unemotional traits for developmental models of aggressive and antisocial behavior

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2019Future Directions for Early Childhood Prevention of Mental Disorders: A Road Map to Mental Health, Earlier 2024Irritability in Youths: A Critical Integrative Review 2020Family Environment, Neurodevelopmental Risk, and the Environmental Influences on Child Health Outcomes (ECHO) Initiative: Looking Back and Moving Forward 2017Identifying Clinically Significant Irritability in Early Childhood

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