Hostile and threatening interpretation biases in adolescent inpatients are specific to callous-unemotional traits and social anxiety

Eur Child Adolesc Psychiatry. 2024 Apr;33(4):1143-1150. doi: 10.1007/s00787-023-02227-3. Epub 2023 May 31.

Abstract

Psychopathological syndromes, such as disruptive behavior and anxiety disorders in adolescence, are characterized by distorted cognitions and problematic behavior. Biased interpretations of ambiguous social situations can elicit both aggressive and avoidance behavior. Yet, it is not well understood whether different interpretation biases are specific to different syndromes, or whether they can co-occur. We assessed both hostile and threatening interpretation biases in identical social situations, and proposed that they are uniquely related to callous-unemotional (CU) traits and social anxiety, respectively. We also explored the role of gender and age herein. The sample consisted of 390 inpatients between 10 and 18 years of age with a variety of psychiatric disorders. Hostile and threatening interpretations were assessed with the Ambiguous Social Scenario Task (ASST) consisting of 10 written vignettes. Both CU-traits and social anxiety were assessed with self-report questionnaires. Results showed that, overall, CU-traits were related to more hostile interpretations, whereas social anxiety was related to more threatening interpretations. In addition, in boys, hostile and threatening interpretations correlated significantly positive with each other. Age was not related to interpretation biases. Together, these results generally support the content-specificity of interpretation biases in concepts relevant to disruptive behavior disorders and anxiety disorders, and indicate that different interpretation biases can co-occur specifically in boys.

Keywords: Adolescence; Cognitive distortions; Externalizing disorders; Internalizing disorders; Social information processing.

MeSH terms

  • Adolescent
  • Aggression / psychology
  • Anxiety / psychology
  • Bias
  • Conduct Disorder* / diagnosis
  • Conduct Disorder* / psychology
  • Emotions
  • Humans
  • Inpatients
  • Male