CANTAB Measures in CD/ODD: Aggressive and disruptive behaviour in children and adolescents with Conduct Disorder /Oppositional Defiant Disorder with and without comorbid Attention Deficit Hyperactivity Disorder.

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Background. The current study aims to investigate the underpinnings of aggressive and disruptive behaviour in children and adolescents with conduct disorder (CD)/oppositional defiant disorder (ODD) with and without comorbid Attention Deficit Hyperactivity Disorder (ADHD) by looking into sustained attention (RVP), visual perception (DMS), and emotion recognition (ERT). The rationale for the choice of these measures sought to clarify the underlying neuropsychological deficits which could lead to aggressive and disruptive behaviour. The RVP, DMS, and ERT have been selected to examine sustained attention, visual and emotional recognition and emotional as exploratory data suggested that (i) the level of aggression was causally associated with (in)attention and (ii) visual processing (eye-tracking) deficits were present in CD/ODD. Methods. In collaboration with nine university medical centres throughout Europe, this study gathered data from 208 children and adolescents of which 126 were diagnosed with CD/ODD, and 82 were TD controls. The breakdown by gender was 62 females and 145 males with the equivalent breakdown by age including 104 children and 104 adolescents. Most participants completed all three CANTAB tests and filled in the RPQ and the ICU. The non-parametric Mann-Whitney-Wilcoxon test was used to analyse the differences between cases and controls, children and adolescents, and males and females on the outcome measures of the three CANTAB tests. Additionally, correlations were performed between the ICU/RPQ and the CANTAB measures (Pearson correlation coefficient). Results. CD/ODD is associated with deficits in neuropsychological performance as measured by the three CANTAB tests. Children and adolescents with CD/ODD are shown to have difficulties with visual perception, visual recognition memory, visual matching ability, sustained attention, response inhibition, working memory, and emotion recognition which are independent of ADHD comorbidity. This provides partial evidence for the (in)attention-aggression theory, where a causal link between (in)attention and aggression is suggested. Correlations were seen between the RPQ / ICU and the outcome measures of the CANTAB tests in typically developing controls which were absent in the ODD/CD cases, indicating that the deficits in neuropsychological performance in ODD/CD disprupt the relationship to behavioural outcome. Conclusion. Clear deficits in neuropsychological performance are seen in ODD/CD independent of comorbid ADHD. CU traits did not seem to influence neuropsychological performance within CD/ODD cases. Aggression and CU traits appear to be differentially related to neuropsychological performance.
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