Emotional stimulation processing and empathy in aggressive adolescents

Dysfunctional emotional processing has a negative impact on human behavior. In children and adolescents, deviant perception and understanding of emotional stimulation and reduced empathic functioning impair the development of important social skills. The present thesis aimed to better understand dysfunctional emotional processing in subgroups of children and adolescents with aggressive and antisocial behavior. We investigated dysfunctions in specific neurocognitive components and their influence on reactive and proactive forms of aggression. Further, characteristics defining subgroups of aggressive and antisocial children and adolescents with distinct dysfunctions in emotional processing were examined. Article 1 addresses the question if cognitive control is more susceptible to the deleterious influence of distressing emotional stimulation in patients with conduct disorder than in healthy controls. In an experimental paradigm we measured performance on a color-word Stroop test under the influence of distressing emotional stimulation. Results indicated that unlike in healthy controls, cognitive control is impaired in reactive aggressive adolescents when subjected to distressing emotional stimulation. In Article 2 we investigated the interrelation of empathy and behavior. In a sample of high-risk adolescent girls and boys we addressed the question whether cognitive and affective facets of empathy are involved in the inhibition of reactive and proactive forms of aggression and the motivation of prosocial behavior. Our data indicated that empathy is only involved in the inhibition of proactive aggression, but not in the inhibition of reactive aggression. Further, results showed that both facets of empathy contribute positively to motivate prosocial behavior. With Article 3, we aimed to identify characteristics which define subgroups of aggressive children and adolescents with specific patterns of dysfunctional emotional processing. Using model-based cluster analysis, we disaggregated variants of adolescents with conduct disorder based on anxiety symptoms and callous-unemotional traits. Variants differed in comorbid psychopathologies and personality development. We also found a gender-specific affiliation to identified variants that supports the assumption of the gender paradox in children and adolescents with conduct disorder. In conclusion, the research presented in this dissertation indicates that reactive and proactive forms of aggression are associated with distinct dysfunctions in emotional processing and supports a better understanding of factors involved in specific phenotypes of aggressive behavior. Based on the results it can be assumed that (1) impaired cognitive control in situations of emotional distress provokes reactive aggression and (2) insufficient understanding of others’ emotions enhances the risk for proactive aggression. Variants of aggressive and antisocial adolescents may by identified based on characteristics associated with these neurocognitive deficits. Findings emphasize the importance of specific treatment approaches tailored to subgroups of aggressive and antisocial children and adolescents with unique characteristics.