Practitioners working with children aged 13-18 years may observe some of the key features described in the previous section. Getting help for the child and family as early as possible gives the best chance of a good outcome. Neglect and emotional abuse are often not recognised in teenagers and even where they are they may not be taken seriously by professionals. Not much is known about their personal experiences, as there is a lack of research which identifies the feelings, or experiences of this population. Many of the behaviours exhibited by emotionally abused or neglected teenagers may be interpreted by others as a lifestyle choice or ‘acting out’ when they may in fact be an indicator of neglect or emotional abuse. Consequently their conduct may lead them to enter the juvenile justice system rather than the child protection system. A better understanding of teenage neglect and emotional abuse may enable teenagers to access appropriate and timely help.
• All practitioners coming into contact with teenagers who exhibit the behaviours and issues above must actively consider neglect or emotional maltreatment, rather than simply addressing the problems they present, such as alcohol use.
• Remember, teenagers who have experienced neglect or emotional abuse may be particularly vulnerable to other forms of victimisation; therefore appropriate action should be taken.
• A sensitive exploration of teenagers’ experiences may help professionals understand their situation, and allow the teenagers to access appropriate support themselves.
• Hospital emergency departments and mental health providers need to be particularly aware that teenagers, especially the victims of violence, may be experiencing neglect or emotional maltreatment.
While early recognition and intervention are vital, it is never too late to help a child or teenager. If concerns about possible neglect or emotional abuse arise it is important you take action as soon as possible regardless of the age of the teenager.
If you have a concern you can call the police, social services or the NSPCC (0808 800 5000). And remember that children can contact ChildLine 24/7 (0800 1111; childline.org.uk).
Emotion recognition and empathy
Abnormal patterns of brain activity is observed in children with callous-unemotional
and psychopathic traits when viewing others in painful situations
A large body of research suggests that psychopathy is associated with atypical responses to distress cues (e.g. facial and vocal expressions of fear and sadness), including decreased activation of the fusiform and extrastriate cortical regions, which may partly account for impaired recognition of and reduced autonomic responsiveness to expressions of fear, and impairments of empathy. The underlying biological surfaces for processing expressions of happiness are functionally intact in psychopaths, although less responsive than those of controls. The neuroimaging literature is unclear as to whether deficits are specific to particular emotions such as fear. Some recent fMRI studies have reported that emotion perception deficits in psychopathy are pervasive across emotions (positives and negatives). Studies on children with psychopathic tendencies have also shown such associations. Meta-analyses have also found evidence of impairments in both vocal and facial emotional recognition for several emotions (i.e., not only fear and sadness) in both adults and children/adolescents.
A recent study using offenders with psychopathy found that under certain circumstances they could willfully empathize with others. Functional neuroimaging was performed while the subjects were watching videos of a person harming another individual. While reduced empathic brain activation relative to the controls was observed in the control condition, the empathic reaction of the psychopathic offenders initiated the same way it did for controls when they were instructed to empathize with the harmed individual, and the area of the brain relating to pain was activated when the psychopathic offenders were asked to imagine how the harmed individual felt. The research suggests that individuals with psychopathy could switch empathy on at will, which would enable them to be both callous as well as charming. The team who conducted the study say it is still unknown how to transform this willful empathy into the spontaneous empathy most people have, though they propose it could be possible to bring psychopaths closer to rehabilitation by helping them to activate their “empathy switch”. Others suggested that despite the results of the study, it remained unclear whether the experience of empathy by these psychopathic individuals was the same as that of controls, and also questioned the possibility of devising therapeutic interventions that would make the empathic reactions more automatic.
Work conducted by Jean Decety with large samples of incarcerated offenders with psychopathy offers additional insights. In one study, the offenders were scanned while viewing video clips depicting people being intentionally hurt. They were also tested on their responses to seeing short videos of facial expressions of pain. The participants in the high-psychopathy group exhibited significantly less activation in theventromedial prefrontal cortex, amygdala and periaqueductal gray parts of the brain, but more activity in the striatum and the insula when compared to control participants. In a second study, the subjects with psychopathy exhibited a strong response in pain-affective brain regions when taking an imagine-self perspective, but failed to recruit the neural circuits that were activated in controls during an imagine-other perspective—in particular the ventromedial prefrontal cortex and amygdala—which may contribute to their lack of empathic concern.
Despite studies suggesting deficits in emotion perception and imagining others in pain, professor Simon Baron-Cohen claims psychopathy is associated with intact cognitive empathy, which would imply an intact ability to read and respond to behaviors, social cues and what others are feeling. Psychopathy is, however, associated with impairment in the other major component of empathy—affective (emotional) empathy—which includes the ability to feel the suffering and emotions of others (what scientists would term as emotional contagion), and those with the condition are therefore not distressed by the suffering of their victims. Those with autism, on the other hand, often are impaired in both the affective and cognitive facets of empathy.
Emotion recognition and empathy