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Child Neuropsychology

A blog by Dr Jonathan Reed

  • I have been reading an excellent book on personality research called Personality: What makes you the way you are by Daniel Nettle. It is written for the non expert and is easy to read and full of interesting observations. In the UK the psychology of personality has not been very influential on clinical practice. Most Clinical Psychologists do not assess personality, particularly in children and young people. In addition the study of personality has not featured on many university courses and certainly was not part of my undergraduate degree. However, recently I have began to take an interest in this area of psychology because it makes a lot of sense clinically. The children and young people I see have clear personality traits which fit with the current research. Having read Daniel Nettles’ book I believe that there will be a renaissance in personality assessment and understanding over the coming years. There are three key facts driving this, which are:

    1. Researchers studying personality using factor analysis have come to a consensus that there are five main personality factors, which are:

    Extraversion

    Agreeableness

    Conscientiousness

    Openness

    Neuroticism (emotional stability)

    2. The behavioural genetics work fits with the five factor model and also suggests that these traits have a large genetic component.

    3. There is increasing interest in the neuroscience of personality. The five factors are associated with different neural pathways e.g. Neuroticism (amygdala, hippocampus and R dorsolateral prefrontal cortex); Conscientiousness (dorsolateral prefrontal cortex); Extraversion (mid brain dopamine reward systems).

    Given the genetic and neuroscientific evidence it would make sense to consider personality when looking at development, emotional and social difficulties in childhood.

    There are lots of thought provoking issues raised in the book but I will highlight three that I think have major implications:

    Firstly behavioural genetics studies have shown consistently that shared family environment i.e. parents, have little to no effect on development of adult personality (not sure what the Freudians make of this!).

    Secondly that multivariate analysis shows that children’s personality seems to affect the way parent’s treat them rather than the other way round.

    Thirdly : Personality seems to predict quite strongly, certain life experiences. For example high scores on Neuroticism predicts higher likelihood of divorce and low scores on conscientiousness predicts early death. Nettle argues that personality assessment together with IQ are two of the strongest predictors for how you will do in life. It is important to note that the genetics of IQ and personality account for about 50% of variance and environment is also important. There are ways of course that you can alter your environment to influence your life course. However, I think that it is likely that without intervention the genetic biases we all have will lead us in certain directions.

    If you want to find out what your personality is there is a online test at the personality project website where you can take an anonymous personality test as part of an online research study. More information on personality can be found at the main personality project website.

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  • In the past few weeks there have been a number of stories in the UK media about violent behaviour by young people such as Ben Kinsella being stabbed, the robbery, torture and murder of the two French students. In the Times last week there was a story about record numbers of children being excluded from school at a young age for aggressive behaviour. It is difficult to make sense of these stories and they obviously cause concern. I tend to think about the neuropsychological reasons why such behaviour occurs. Obviously there can be a number of explanations for violent behaviour but I thought I would mention three important developmental factors to consider.

    1. Development of Self Regulation. Through development children learn to self regulate their behaviour and emotions. There seems to be a neurological correlate to this. Primitive emotions and behaviours are driven by the brain stem, the hypothalamus and the limbic system, which is present at birth. Over time the cerebral cortex develops to regulate this primitive system. Initially this involves the ventral prefrontal cortex (VPC) and the anterior cingulate cortex (ACC). This process seems to happen in early childhood and is associated with reactive control. This is a more sub conscious control involving inhibiting impulsive emotional responses which would include aggressive outbursts. This normally develops through the experience of being parented, whereby the parent provides external regulation which becomes internalized over time by the child. Later (age 4 to 6) the Dorsal-lateral pre frontal cortex develops allowing self control. This results in more effortful conscious control over emotions and behaviour. Children learn to use internalized strategies to regulate themselves. This development process can go wrong for a variety of reasons including brain injury, developmental ADHD and also lack of adequate parenting. The result is individuals who have poor control over emotional impulses including aggressive impulses. These processes can also be temporarily affected by drugs and alcohol. To read more about this developmental process see chapter 13 self regulation and the developing brain by Rebecca Todd and Marc Lewis in our book Child Neuropsychology: Concepts, Theory, and Practice

    2. Development of Empathy- this is the drive to identify another persons emotions and thoughts and to respond to these with appropriate emotion (Davis 1994 Empathy: A Social Psychological Approach (Social Psychology)
    This seems to develop very early in most children’s lives (at about 14 months). It is different to Theory of Mind which seems to be about understanding other peoples thought’s. The classic disorder of empathy is a person described as a psychopath. They understand other peoples thoughts but feel no emotion in relation to this and as a result have nothing to stop them hurting others. Empathy seems to be related to gender in that males are more likely to show less empathy. A few children in my experience seem to lack empathy as a developmental disorder. Sometimes this seems to occur for children with traumatic childhoods with experience of early violence, but in my experience it is rare. It seems to be associated with the inferior frontal gyrus (IFG), which in turn is associated with a discrete network of brain processes involving face processing (fusiform gyrus, inferior occipital gyrus), emotion (amygdala, insula, ventral stratum and other structures) and with action perception (mirror system). To read more about this see chapter 14 social neuroscience by Simon Baron-Cohen and Bhismadev Chakrabarti in our book Child Neuropsychology: Concepts, Theory, and Practice

    3. The third important factor is social processes. Classic social psychology from H.Tajfel has shown how social identity influences group behaviour. Individual placed in a group would quickly begin to favour and maximise the benefits to their group at the detriment of other groups even when they didn’t know the other members of their group. Group identity is very powerful and may explain some of the gang behaviour in inner cities i.e. why gang members hate members of other gangs. Also there are the studies on social influence by Stanley Milgram. In this study volunteers delivered what they thought where powerful electric shocks to others when told to do so by someone in authority. This authority effect may explain the way that leaders in a group will influence other lower members . This is particularly pertinent in gangs with children- the younger children being influenced by older members. These social influences may also explain state controlled violence where leaders get subordinates to carry out violence on their behalf. It seems to me that social influences can override individual brain processes. This is an important factor in gang related violence – much of which is a problem in London UK at the moment. Children will do what older gang members want through the influence of authority and also start to hate other groups/gangs through social identity processes. There are likely to be wider social influences in society but I will leave that to the sociologists to explain.

    These factors don’t explain all the reasons for violent behaviour but they are important and may be helpful in thinking how to prevent violent behaviour developing. Certainly help with early parenting skills for parents with young children at risk would help with development of self regulation. Early identification and treatment for disorders of regulation such as ADHD and brain injury is important. Early screening for signs of empathy disorder is an option to be explored (treatment options for this are at a very early stage). Finally realizing the negative social influences of groups or gangs is important. The social influences surrounding the gang will be more powerful than the individual within the gang (and perhaps by a certain age their parents) can control. To try and prevent violence in inner cities it is necessary to disrupt the gang itself and find other ways for children to meet their social needs. In the meantime unless these issues are addressed in childhood we will continue to have news headlines about young people being killed and others being jailed for life- not a good option for either or for us.

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  • There is an interesting article in the Sunday Times this week entitled ‘how to make your child more intelligent’. It seems to be based in part on a new book by Richard Nisbett entitled ‘Intelligence and How to Get it: Why Schools and Cultures Count. Whilst the article makes a number of important points the overall tone feels a bit like the old nature/ nurture debate, which I thought was over years ago. The article starts by stating that ‘Over recent years most experts have concluded that intelligence is largely genetic in origin, and that nurture does relatively little to raise an individual’s potential’. I am not sure which experts they are referring to here as anyone who knows anything about the genes and IQ literature knows this not to be true. The relationship between IQ and genes has been researched very thoroughly. The consistent finding is that genes account for about 50% of variance, which leaves 50% due to environmental factors. The article seems to try and overemphasize the role of environment and diminish the role of genes. It states ‘demolishing the finding of twin studies is part of the argument against genes controlling intelligence.’ This is the argument that twins who are adopted and reared apart have similar IQ. The article argues that twins who are adopted and reared apart have a similar environment in that adopted parents are highly likely to give their children a good start in life. This seems a highly tenuous argument. Are all adoptive environments the same? Would this produce such consistent findings? Also would this argument hold for all the twin studies looking at heritability in schizophrenia, autism, ADHD etc. Dismissing twin studies is a familiar ploy of people who want to dismiss the genetic factors and one I thought had died years ago. It undermines what is otherwise a good argument. The results for the gene and IQ studies are very consistent and researched in some detail. It seems silly to me to claim that genes don’t have an effect on brain and psychological development. You don’t need to knock the gene studies to show that environment is important. The gene studies already do this.

    Another factor that points to the importance of genes in IQ is that clinical experience and research suggests that IQ is remarkable stable through lifetime. Twins actually become more similar in IQ scores as they get older. Something must be driving this. IQ doesn’t change easily, although there are obvious environmental factors at work. Certainly it is clear from the Flynn effect that IQ has been steadily rising over the last 100 years (obviously genes are not evolving that fast). There is a lot of research on environmental factors influencing IQ. IQ is a complex concept that is not totally understood, but from the research there are some candidates for strong environmental factors that have an impact on IQ development. These include having a stimulating early environment, good early nutrition, an environment rich in language and literacy. There is also research showing how targeted computer games may raise IQ. There are other suggestions in the article although i am not sure about the research to back them up – I am certainly not aware of the value of meditation on IQ, encouraging self control or having bigger babies to name a few mentioned in the article.

    So overall, yes I believe we can encourage children to be more intelligent (although as IQ as currently assessed is a comparison measure it will be difficult to measure this) and I applaud the article for highlighting this. I think we should try. But don’t dismiss the influence of genes. That influence is always there and if ignored can result in my opinion in insidious effects such as a lack of social mobility. Parent’s genes are important in part in determining early child environments (i.e. stimulating, language rich environments with high levels of nutrition) and therefore IQ development. This is a political question. I think that overall improved IQ and literacy should lead to a better society (although many other factors are important too). To achieve this early intervention by the State will be probably be needed. We will need to understand the whole picture if we are to move forward.

    PS the article does contain a good section demolishing the race, genes and IQ argument and should be read for that alone.

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  • One of my favourite columnists from The Times newspaper Daniel Finkelstein has written a thought provoking column today criticizing the latest report The Good Childhood Enquiry. This report was about how unhappy children are today because of selfish parents. In the column Daniel makes some simple points which I often think about myself when seeing children. The key issue is the extent to which parents influence children’s behaviour and personality. The points he makes are 1- children and parents share the same genes and therefore are likely to be somewhat alike to start with. 2- children who are difficult are going to influence the way their parents react to them. It is easy to be an authoritative parent with a child who is easy to manage- the traffic is not all one way. I happen to believe that parents do have an affect on their children but there are so many other issues affecting development as well. The issues about genetics that Daniel raises are penitent as well as the effect of the peer group, diet, sleep, exercise, brain injury, neurodevelopmental issues etc etc. Finally the column ends with an interesting take on the pros and cons of individualism and it’s effect on social relationships – but you will have to read that HERE yourselves.

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