The media is full of the rise of anti-social behaviour (e.g. violence, aggression, bullying, fighting, lying, stealing, vandalism, fire-setting, drug and alcohol abuse, cruelty to animals) in children and youth offending, but what is the cause of childhood antisocial behaviour and are all anti-social children the same? What is the role of parenting?
Are all anti-social children the same?
There is evidence that not all children with anti-social behaviour are the same. Some children may show a phase of anti-social behaviour in adolescence but this passes and they settle down in adulthood. Far more concerning are children with a life-long tendency to anti-social behaviour. These children tend to be anti-social from a younger age and behaviour is more extreme (e.g. cruelty to animals at age 5 years), but even amongst these children there is evidence of different subgroups. Much research is focused on differentiating groups of anti-social children to see if we can better understand them.
One differentiating factor found is lack of empathy. Empathy is the ability to share someone else’s feelings and experiences by imagining what it would be like to be in that person’s situation. Psychologically speaking, this requires two different types of processes: a “thinking” part: the ability to see things from another person’s point of view; and secondly a “feeling” part: the ability to recognise emotion in others and to feel it in oneself. People without empathy are described as being callous and unemotional. To be anti-social, violent or aggressive is easy if you do not empathise with the victim, so it is no surprise that >90% of children with callous-unemotional traits are involved in some form of anti-social behaviour.
How does empathy affect anti-social behaviour?
Researchers have been interested in children that lack empathy for a while now because of its links to extreme anti-social behaviour, and the definition of “psychopathy/ sociopathy” (this is a criminal justice not mental health term) includes having this lack of empathy. The childhood precursor to this psychopathy label is “callous-unemotional traits” (as it is pretty harsh and pessimistic to label kids as psychopaths), and even this terminology has recently been rebranded as “limited prosocial intent” so that it sounds less pejorative; but this is just semantics, we are essentially talking about the same thing: people that have shallow feelings with lack of empathy and guilt.
My colleague, Essi Viding does research into these traits and wrote a great summary paper (2012), the findings of which I wanted to share as I thought it was fascinating. It turns out that if you study ASBO kids (kids with anti-social behaviour), you will find that 50% of them have these callous-unemotional traits. These children don’t really care about others’ feelings and tend to show no remorse for wrong-doing. It is this group of kids that have the most serious and long lasting problems.
What is the difference then psychologically and biologically between children that commit antisocial behaviour with and without empathy?
In experiments where anti-social kids are hooked up to show responses (for instance heart, skin and eye-tracking monitors or brain scans) to photos/ voice recordings of other people in pain or grief, the children with callous-unemotional traits showed no or reduced physical or brain response. Most people will wince in shared pain if shown pictures or exposed to sounds of others in pain, but these children don’t. When these children were asked to play a game where not following the rules led to punishment, they continued to flaunt the rules and did not seem to learn from punishment. There is biological support for these findings with differences in brain scans in areas of the brain linked to emotion processing and reinforcement learning pathways in callous anti-social children.
In contrast, the anti-social children with empathy showed the same aversive responses as children not involved in anti-social behaviour to pictures and sounds of pain and grief, and learnt quickly from punishment. However when they are shown threatening faces, they over-respond with emotion and when they are shown neutral and ambiguous facial expressions, they identified them as being threatening. Brain scans back up these differences. The anti-social children with empathy tended to have abnormal amygdala development. This is the area of the brain involved in fear and anxiety processing. These anti-social children have normal empathy but have a heightened awareness of threat, which explains why they perceive neutral faces as threatening. In a world where everyone is viewed as threatening, hostile or an enemy, it can make sense to be combative, aggressive and violent. This is that bully in the playground that says “Are you looking at me?” – when you weren’t even looking at them.
Genetic studies have also supported this divide, finding that there is strong inheritance of callous nature, whereas anti-social behaviour without callousness was not inherited but generated by environmental factors such as harsh or inadequate parenting, or an interplay between these environmental factors and genes associated with anxiety or heightened emotion.
Finally, it has also been found that the children in the different groups respond differently to parenting strategies. Punishment and traditional sanction-based strategies (time-out, withdrawal of privileges) works well for empathic anti-social children, but has no effect on callous children. Callous children only respond to positive reinforcement (praise) and rewards.
What causes anti-social behaviour?
This type of evidence has led to different theoretical models for two groups of children involved in anti-social behaviour.
Group 1: Genetic predisposition. Antisocial and callous kids: these children are thought to lack empathy as they do not find other people’s distress aversive and because they fail to be able to learn from punishment. It is easy to be aggressive and cruel if you are unable to feel guilt and if the suffering of others doesn’t bother you. It is easy to continue to behave in this way life-long if you are unable to learn from punishment. These difficulties are often inherited in brain structure.
Group 2: Environmental Causation: Anti-social but not callous kids: these children have abnormal socialisation because they have a heightened sense of threat, and view the world as hostile towards them. They exhibit aggression and cruelty as a result of living in unstable and threatening environments which has shaped their brains and psychology to respond in this way as a means of coping and survival. Their anti-social behaviour is often in the context of a peer group within which there is support and empathy.
What has this got to do with parenting?
Whether we like it or not, parents are the first line defence against anti-social behaviour in society. By better understanding the causes of anti-social behaviour and by understanding our children, we can best adapt our parenting to prevent our children becoming anti-social. Although children in group 1 with genetic predisposition are the more difficult to help, they can be supported by fostering self-esteem. They will respond better to motivation to act in a pro-social way, rather than harsh punishment which will not deter them. Anti-social behaviour in children with empathy can be prevented by strong loving families that place appropriate boundaries and sanctions. For these children, wider society has a great role to play in generating or preventing anti-social behaviour, as tolerant, peaceful and accepting societies can offer protection whilst violent, unstable and alienating societies can fuel them.
Anti-social behaviour in children with and without callous-unemotional traits. Viding et al. (2012) Journal of the Royal Society of Medicine. 195-200.
What is autism?
When I give people the formal definition of autism, I see their eyes glaze over as it is rather long winded and meaningless to those who know little about autism. So I’m not going to talk about autism diagnosis, which is somewhat complex, but one aspect of autism: empathy.
Many people equate “lack of empathy” with autism, so much so that whenever someone has been inconsiderate, others may joke that they were “being a bit autistic”. Say this around me and I get really annoyed as autism is more than lack of empathy and most inconsiderate people are not autistic. Autistic empathy problems are fairly specific. Hurting other people without remorse is generally considered as “lacking empathy”, although shrinks prefer to use the term “callous and unemotional” as it does not ascribe a cause to the behaviour. This is important as there can be many different causes to this type of behaviour. I will give you 3 adapted real life examples of callous behaviour involving the death of an animal to see whether you can identify the one most likely to be a case of autism.
(a) A 5 year old boy was playing with his pet hamster. The hamster bit him as he was a bit rough. The boy got his baseball bat out and bludgeoned the hamster to death. In explanation of what had happened, he showed no remorse and said “It bit me on purpose, so it deserved to die”.
(b) A 10 year old boy was playing golf. He was very good at golf. A squirrel appeared in his line of sight, and he had the question as to whether his driving accuracy was good enough to hit the squirrel. He hit the squirrel with the golf ball striking the squirrel hard and killing it. In explanation of what happened, he showed no remorse saying “My aim is very good”.
(c) Two 8 year old boys were pulling at a cat’s tail to hear it hiss which they found funny. They tied string to its tail and used that to pull it around. Then they thought it would be funny to set the string alight, which then set the cat alight. In explanation of what happened, they showed no remorse saying “We don’t know what happened to the cat; it had nothing to do with us”.
In Big Sis’s Oxford School Dictionary (apologies, this is sadly the only dictionary our household possesses), empathy is described as “Noun. The ability to understand and share in someone else’s feelings”. In order to empathise, you require the ability to do the following:
1) Be aware that other beings (animals or humans) have independent thought, action and feeling; this is sometimes called having a ‘theory of mind’.
2) Be able to experience and recognize your own emotions and feelings and the situations in which different emotions arise.
3) Be able to imagine that others may have the same feelings, emotions and thoughts that you experience if they were in similar situations.
Autistic “lack of empathy” relates to inability or difficulty with the fundamental step, step 1, which impacts ability to completely master steps 2 and 3. This “step 1” ability is something that you either have, or don’t have. It relates to abnormal brain wiring which goes awry in pregnancy and early infancy. None of us were ever sat down and taught “this is a table: it does not think, act or feel; this is a human, it is able to think, act and feel”, we just realise it ourselves one day, usually in infancy. To an autistic child, something this fundamental is not obvious. A typical complaint from parents of autistic children, and what I imagine would be the most painful as a parent; is that an autistic child may see parents as no different from anyone else, or indeed, any other object. An autistic child may show interest in a parent as a “biscuit dispenser” or “toy-buyer”, but are unlikely ever to have an intimate and confiding relationship with anyone including their parent, due to their inability to recognise other people as thinking, sentient beings. It is hard to comprehend or to believe, but if you are not naturally aware that other people have independent thought or feeling, then the death of a parent would affect you as much as the loss of a toy (provided someone else stepped in to dispense biscuits and buy toys). Classically, without step 1, steps 2 and 3 are impaired. Autistic children find difficulty in describing emotion in themselves as well as others. Some autistic children with good intellect are able to behave empathically. They are able to actively learn that others are thinking sentient beings, and are able to learn what someone would feel and think in a given situation. They learn it in much the same way that we might learn the highway code. It does not come naturally, but we can learn to behave in the way that is required of us. Just as with the highway code learning, actively learnt behaviour can slip in times of tiredness or stress, and is useless in new situations where the rules are unknown.
“Lack of empathy” frequently occurs in children without autism. The work of the clinicians in an autism assessment is to differentiate these children from autistic children.
Children with ADHD, who have a different brain wiring problem have a tendency to impulsivity. They can behave as if they lack empathy as they typically do things without thinking. If someone falls over, it can look very funny. All of us like to laugh when we see people falling over, which is why slapstick comedy is so successful. In real life, most of us would be able to inhibit our impulse to laugh if the person was actually hurt and crying in pain. The ADHD child, cannot inhibit impulses, and therefore will laugh, appearing to “lack empathy”. However, if you question the child afterwards they are able to interpret the situation empathically and realise that they should not have laughed, although they might say “but I couldn’t help it.” Of course some children with ADHD will also have autism spectrum disorder, as one brain wiring problem increases the risk of another.
Other children without brain wiring (neurodevelopmental) problems can develop difficulties with steps 2 and 3. For step 2, I will give two simple examples, but there are likely many permutations for the development of what shrinks call “callous and unemotional” symptoms in the absence of autism. Firstly, Children who are emotionally neglected and not stimulated to interact with others and experience emotion can have difficulty in experiencing and recognising emotions in themselves and others. The classic example of this is from Romanian orphanages. After the fall of the Communist government in Romania in 1989, aid workers found thousands of abandoned children being housed in orphanages in terrible conditions where abuse and neglect were rife. Babies were literally left alone in cots day in and day out with minimal human contact. When discovered, many of these children appeared to be autistic, as they had difficulties with social interaction, communication and empathy. However, the majority of these children, when adopted out to loving families, gradually acquired the ability to empathise and socially interact normally. Their early childhood experiences of neglect had impaired their ability to experience emotion amongst other things, and therefore they had difficulty in understanding emotion in themselves and others. Love, not rote learning of rules was able to restore their empathy as the majority did not have brain wiring problems.
Secondly, young children who suffer emotional abuse (which can occur alone or with physical and sexual abuse) or are constantly witness to violence and trauma, may have had no biological difficulty in experiencing emotions, but as their emotions are too hurtful due to the extremely stressful environment, they may employ a defence mechanism of “blocking out” or “numbing”/ “desensitisation” of emotions in order to survive. Channelling “I am a block of wood” is sometimes your only defence in a situation where you are entirely powerless. These children find allowing themselves to experience emotion difficult or impossible, which limits their ability to understand emotion in others, even long after the abuse/ trauma has ended.
These two groups of children may have “attachment disorders”; some may grow up to develop “personality disorders”. Emotional availability of parents and care givers and exposure to violence lie on a continuum, and it is likely that even within the general population, there is variation in how in tune people are with their own emotions and the emotions of others even if they have not been through abuse and trauma.
There are children who have no difficulty with step 1 and 2, but have problems with step 3. They understand that people have emotions and they experience their own emotions. However, their own emotions are so over-encompassing, often due to insecurity; that they are unable to think about or care about the emotions and feelings of others. These children may have suffered abuse or neglect as children and pushing heavily for their own needs and wants has been the only way they have been able to survive. If these children are asked about emotions, they are able to describe them well. They are able to demonstrate theory of mind in non-emotive tasks and may even, in a hypothetical scenario that does not involve them, have no difficulty in seeing both points of view. However, when the scenario is switched to involve them, their thinking becomes self-focused and there is no room to think about other people’s feelings. Their own feelings are always prioritised over that of others. These children may be thought of as “narcissistic” and may grow up to have personality difficulties.
Finally, there are children who have no problem with empathy but choose to behave in a hurtful way to other people for their own reasons; they gain pleasure from being in power and deliberately causing pain, to gain membership to a culture or subculture, to extort money, to gain respect or retribution to name a few.
Hopefully, by now, you may have a better chance of determining which of our “animal killers” is the most likely to have an autistic spectrum disorder. Scroll down, to see if you are right.
Case (a) by ascribing intent to the hamster is in possession of basic theory of mind (a more clearly autistic response in this situation would have been to say “The hamster was hurting me so I stopped it from hurting me”); in this case additional examples of behaviour would need to be examined to argue a case one way or another. Case (b) has autism. There is clearly no theory of mind going on here, the squirrel was a mere target for target practice and may as well have been an inanimate object. Case (c) is definitely not autism as cooperating to torture a cat requires social skill between the two boys, unless there is a clear “leader” and “follower”. By attempting to deceive people by denying knowledge of what happened implies quite a sophisticated theory of mind. They would need to realise that you did not know what really happened, and that if they denied knowledge, they may be able to convince you that they were not involved.
Autism has several other criteria (the formal definition of autism being of “a triad of difficulties in social interaction, communication and restricted and repetitive interests”), so you would never make a diagnosis based on something as simplistic as the above. It is however useful to illustrate the importance of detailed information in assessment of every single feature of autism as scenarios which present behaviourally in a very similar way (e.g. killing of an animal) may have very different causes. A typical autism assessment involves information gathered from multiple sources and in depth interview and observation by a multi-disciplinary team.