Can Psychopathy be Prevented? Clinical, Neuroimaging and Genetic Data
Condition: Psychopathic Personality Trait
MeSH terms: Antisocial Personality Disorder
Study type: Interventional

Summary: 
      The goal of this clinical trial was to learn about the effect of maltreatment on
      psychological and brain characteristics in a group of children. The main question it aims to
      answer are: which are the clinical characteristics of maltreated children before and after a
      psychological intervention? what changes in brain emotional processing after a psychological
      intervention? and what is the effect of serotonin transporter variants after a psychological
      therapy? Participants were assessed before and after intervention with:

        -  clinical measures of anxiety, depression post-traumatic stress and callous-unemotional
           traits

        -  functional neuroimaging techniques to measure brain activity.

        -  A sample of buccal epithelial cells to obtain information on serotonin transporter.

      Researchers will compare maltreated children with a group on non-maltreated children to see
      if there are differences on psychological characteristics and on brain activity before
      treatment.
    

Detailed description: 
      Participants Twenty-five children who suffered child abuse were initially referred by a
      non-governmental shelter in Mexico City. Children were removed from their homes and placed at
      the shelter because one or both parents were undergoing judicial processes for various
      crimes, including child abuse. None of the children had ever received psychological therapy
      because the shelter did not have a protocol for psychological intervention. After a thorough
      search for the most appropriate therapy, the TF-CBT was chosen. The information was shared
      with the shelter administrative board. Once authorities and health professionals at the
      shelter were informed about the aim of the study, they agreed about the appropriateness of
      the intervention. A group of trained psychologists would apply the TF-CBT as part of the
      research protocol. Only children who met the inclusion criteria would participate. Parents or
      primary caregivers gave their informed written consent for their children to participate in
      the study. Ethical approval of the study was granted, and the research was performed in
      accordance with the Code of Ethics of the World Medical Association Declaration of Helsinki.

      The final sample consisted of an experimental group of 14 MC which included 4 boys and 10
      girls (mean age = 8.77 years old, S.D.=1.83), who had experienced a positive history of
      different types of trauma, and a control group of 10 HC from the general population who were
      developing normally and were age-matched to the MC (4 boys and 6 girls) (mean age = 9.57
      years old, S.D. = 1.91). They were recruited through an advertisement placed at the Faculty
      of Psychology, National Autonomous University of Mexico UNAM or by direct referral from
      parents of previous participants in other studies. All were residents of Mexico City. The
      study protocol was conducted with the approval of the UNAM Institutional Review Board.

      Clinical scales A comprehensive clinical battery was used to assess all participants through
      the administration of the following assessment tools: The Child Depression Inventory-CDI
      Spanish version. The Spence Children's Anxiety Scale-SCAS standardized on a sample of Mexican
      children, the Child PTSD Symptom Scale-CPSS Spanish version, and the Inventory of Callous
      Unemotional Traits-ICU Spanish version.

      Procedure The MC group was assessed before and after the implementation of Trauma
      Focused-Cognitive Behavior Therapy TF-CBT using clinical scales and an emotion paradigm
      through functional magnetic resonance imaging fMRI. The HC group was also assessed and
      scanned twice.

      Of the total sample, 14 MC completed the TF-CBT modules and came in for their post-treatment
      assessment session. In addition, the 10 HC who, according to their parents, had not completed
      any type of psychological intervention during those 4 months, and still met the inclusion
      criteria for the initial control group were selected and returned for their post-evaluation
      session.
    

Intervention name(s): Trauma Focused-Cognitive Behavior Therapy
Intervention type(s): Behavioral
Intervention description(s): TF-CBT consisted of 8 units in which different issues realted to trauma are reviewed. Units are: psychoeducation and parenting skills, relaxation techniques, affective expression and regulation, cognitive coping and processing, trauma narrative and processing, in vivo exposure, co-joint sessions and enhancing safety and future growth.
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Basic Science
Keywords: children maltreatment; neurodevelopmental psychopathy; post-traumatic stress disorder; neuroimaging; brain reorganization