Individuals with antisocial behavior (AB) show aggressive, deceptive, rule-violating, and destructive behaviors. AB is a hallmark feature of disruptive disorders, such as oppositional defiant disorder (ODD) and conduct disorder (CD). Since AB is only moderately heritable, the environment is suggested to play an important role in the etiology of AB, possibly affecting neural networks that trigger aggressive behavior. In terms of treatment, only limited efficacy has been reported, possibly attributable to the presence of distinct (e.g. arousal- specific) subgroups within AB, which are not yet very well characterized and would need more individualized treatments.
In the first project, the impact of early adversities and positive environments on neural networks implicated in social behavior will be investigated in 280 young adults from an epidemiological cohort study followed since birth. In detail, risk and protective factors, focusing on psychosocial and socioeconomic environments, personality factors, hormone levels, and genetic make-up that favor aggression and AB will be investigated. Using different fMRI paradigms involved in motivation, social cognition, social interactions and their modulation, the neurobiology involved in aggressive behavior will be characterized and how that is changed as a function of adverse environments. In addition, real-time smartphone-based assessments of social interactions and mood will further elucidate how daily-life social encounters may present risk or resilience factors for the development of AB.
In a second, already ongoing EU project, neural activity during reward-based decision making and emotion processing is investigated in 180 CD patients versus 90 controls. To shed light on the neural markers that differentiate between different CD groups, subtype-specific analyses based on the presence of callous-unemotional (CU) traits will be conducted. To extend the findings from project 1 to a clinically severe group of CD patients, it will be disentangled how environmental adversity may have affected these circuits and how this aberrant functioning contributes to the emergence of aggressive behavior. Moreover, specific arousal patterns have been shown to distinguish CD patients with and without CU traits, which paves the way for an individualized treatment. Through innovative, individualized biofeedback training protocols, young patients are learning how to self-regulate their arousal level (up- or downwards), depending on their “aggressotype”. This personalized, deficit-specific biofeedback training for both CD patients is currently evaluated in a controlled multicenter trial.
In sum, the results of this habilitation may help to establish more effective ways of diagnosing, preventing and treating individuals with AB.