Lucres M. C. Jansen

Neurocognitive functioning has attracted specific attention with regard to its role in externalizing disorders. However, important knowledge gaps remain regarding how studying youth neurocognitive functioning will meaningfully advance our understanding of the role of neurocognition in the development of complex problems and whether it has the potential to improve treatment outcomes. In this issue, three studies may help close these gaps. Focusing on different populations, they all show that neurocognitive functioning in childhood prospectively predicts later externalizing disorders and related behaviours. At the same time, the role of executive functioning varied considerably across outcomes, informants, and assessment methods. Moreover, executive function deficits partly reflected the developmental consequences of early adversity rather than operating as an independent characteristic. Together, these studies provide helpful ground for reflecting on the promise (and perhaps limitations) of the integration of neurocognitive functioning for advancing our knowledge on the development and treatment of externalizing and related problems.

Conduct disorder (CD) is a common psychiatric disorder in youth, characterized by severe and recurrent aggressive and antisocial behaviors and associated with substantial healthcare and societal costs. Rates of CD increase during adolescence in both sexes, with the male‐to‐female ratio narrowing to approximately 1:1. Although earlier work suggested potentially distinct pathways to CD in girls versus boys, few studies were adequately designed to investigate sex differences, limiting generalizability of existing findings from predominantly male samples to girls. Recent large‐scale projects, such as the European multisite FemNAT‐CD study, have addressed these limitations by oversampling girls and explicitly examining sex‐specific characteristics. However, a systematic integration of these findings is lacking. This review therefore aims to synthesize current evidence on sex differences in CD across four core domains: clinical phenotype, risk factors, neurobiology, and treatment. It integrates key findings from FemNAT‐CD alongside other relevant literature, with particular emphasis on implications for theories of (female) CD. Overall, girls and boys with CD appear far more similar than different. Youth with CD of both sexes differ markedly from their typically developing peers in comparable ways, particularly in neurobiological characteristics (e.g. emotion functioning, brain structural changes, neuroendocrine stress responses). Differences between girls and boys with CD are most evident in the clinical phenotype, including age‐of‐onset, callous‐unemotional traits/limited prosocial emotions, aggression subtypes, and cooccurring psychiatric disorders. Overall, sex differences in CD are subtle and difficult to detect. Remaining limitations of the current evidence base and ways to enhance the clinical relevance of research in this field are discussed.

Objective. The COVID-19 pandemic was a major global stressor for children and adolescents, raising concerns about longer-term consequences for mental health and wellbeing. Many studies reported increased mental health problems during and shortly after the pandemic, but less is known about longer-term post-pandemic patterns across domains and informants.Method. We used repeated cross-sectional data from Dutch children and adolescents aged 8-18 years in the Netherlands Twin Register (NTR, N = 39,178, 50% girls) and a representative general-population sample (N = 2,782, 48% girls). Parent- and child-reported mental health problems and wellbeing were assessed using pre-pandemic, pandemic, and post-pandemic data through 2025. Post-pandemic patterns were examined by comparing 2024/2025 outcomes with 2023 and pre-pandemic levels using pre-registered multilevel models.Results. Parent-reported internalizing and externalizing problems in 2024/2025 did not differ from 2023 levels (B = -0.03 to 0.03), but remained higher than pre-pandemic levels (B = 0.28 to 0.31). Child-reported depressive symptoms were lower in 2025 than in 2023 (B =-2.31), anxiety did not differ (B =-0.75), and anger was higher (B =1.13). Compared with pre-pandemic levels, child-reported depression, anxiety, and anger were all higher in 2025 (p <.001). Wellbeing patterns were mixed across informants and samples (B =-1.05 to 0.10).Conclusions. Up to 2025, youth mental health and wellbeing did not show a general return to pre-pandemic levels. Patterns differed across domains and informants, highlighting the importance of continued multi-informant monitoring.

Child psychology and psychiatry have long examined how the environments in which children grow up shape their mental health. Contemporary frameworks on children's mental health emphasize the causal influence of environmental factors and how these influences vary across children by their individual characteristics. The present issue illustrates the breadth of relevant environmental influences, ranging from parental knowledge to neighborhood disadvantage and the COVID‐19 pandemic. Yet, most empirical research in child psychology and psychiatry has focused on proximal environmental factors; broader societal factors – such as geopolitical tensions, climate change, and socioeconomic inequality – remain comparatively underexplored. In addition, most research on societal factors prioritizes societal factors as causes of child mental health. The impact of child mental health on societal developments has received far less attention. This Editorial advocates for greater integration of societal factors into research on child mental health and highlights the urgent need to examine the bidirectional relation between society and children, including how research contributes to societal change.

Multisensory integration (MSI) allows the brain to combine information from different sensory modalities to form a coherent perception of the environment. Externalizing disorders with impulsivity as a key symptom such as Attention-Deficit/Hyperactivity Disorder (ADHD) have been associated with altered sensory processing and decision-making. This study investigated the relationship between impulsivity and impulsivity related behaviours, and multisensory integration. Participants had to discriminate between two visual gratings, and/or two sounds presented to the right and left ear based on respectively contrast and loudness in a two-alternative forced-choice task. The study included 44 participants, 13 of whom were diagnosed with ADHD or Disruptive Behaviour Disorders. Results show similar task performance across participants. Performance accuracies were highest on audiovisual trials and participants responded fastest on auditory trials, independent of impulsivity levels. Examining the timescale of evidence weighting revealed that early sensory information contributed most to decisions, with dynamic dominance switching between visual and auditory modalities. We found no evidence that the temporal dynamics were affected by impulsivity. These findings suggest that impulsivity and impulsivity related behaviours do not significantly affect MSI during our task and that sensory processing mechanisms remain robust against individual impulsivity levels.

Background: Neurocognitive models suggest that callous‐unemotional (CU) traits in youths with conduct disorder (CD) are linked to emotion recognition impairments, particularly in identifying distress emotions like fear and sadness. However, CD may be accompanied by grandiose‐manipulative (GM) and/or impulsive‐irresponsible (II) traits in addition to CU traits, consistent with the notion that psychopathy is a multifaceted construct. It remains unclear whether subgroups of CD youths with GM or II traits, as well as a combination of multiple psychopathic traits, show distinct patterns of emotion recognition impairment. Methods: We therefore assessed emotion recognition accuracy, focusing on the six basic emotions, in 538 youths with CD (315 girls, 9–18 years) who were assigned to one of eight mutually exclusive subgroups based on high or low scores (above/below the 75th percentile cut‐offs) on CU, GM, and II traits as assessed by the Youth Psychopathy Inventory (YPI) self‐report. Results: Support vector machine analyses supported the validity of the subgroup assignment based on YPI cut‐off scores (sensitivities/specificities ≥75%–100%). Multinomial logistic regression models revealed that the CD subgroup with high levels across all three psychopathy traits had the most pervasive impairment in terms of higher error rates for recognizing sadness, disgust, and surprise. Notably, high CU traits were not consistently associated with impairments in fear and sadness recognition. Instead, CD youths with both high GM and II traits, but normal CU traits, showed impaired fear recognition. Conclusion: These findings challenge existing models that prioritize CU traits as the main driver of emotion recognition impairments in CD. Instead, different psychopathy traits appear to contribute distinctively to such impairments, including the recognition of distress emotions. This suggests that CU traits alone may not sufficiently explain the neurocognitive heterogeneity in emotion recognition seen in youths with CD.

Facial emotion recognition (FER) biases refer to systematic tendencies to recognize specific emotions when processing facial expressions. In youths with conduct disorder (CD), who are characterized by highly impairing antisocial behavior, research on FER biases has focused on hostile attribution biases. This work has shown that youths with CD perceive ambiguous social cues as angry. However, youths with CD may not only show biases towards anger, which is why we investigated FER biases in youths with CD towards the six basic emotions. Within the European FemNAT-CD study, we analyzed data from 610 youths with CD (60% female) and 818 typically developing controls (TDCs; 68% female), aged 9 to 18 years ( M = 14.1, SD = 2.41 years). FER biases were assessed using the Emotion Hexagon Task by showing morphed emotional expressions and asking participants to choose the predominant emotion. Biases were calculated as tendency towards an emotion shown at 0%, 10%, 30%, or 50% intensity. Our findings from hierarchical linear modelling indicate that youths with CD exhibited stronger FER biases than TDCs across all emotions, meaning that they misclassified each emotion more often. However, this difference varied by intensity, with youths with CD displaying weaker biases at higher intensity levels and a smaller increase in bias with increasing intensity level. Our findings indicate that youths with CD not only show a hostile attribution bias but rather misclassify emotions as predominant when they are present at low intensity, regardless of type of emotion.

What factors contribute to the increased risk of antisocial behavior in youth, and more importantly, what explains why most of them desist when they grow older? In the Growing Up Together in Society (GUTS) research program, we aim to answer these vital questions from a biopsychosocial perspective in a longitudinal cohort study. The GUTSGO cohort specifically focuses on youth at risk who have difficulties in pursuing personal and societal goals. The main objective of this study is to explore why, even with initial high-risk factors, most adolescents do not continue to display antisocial behavior. We will examine the social, contextual, biological, and behavioral mechanisms involved in the persistence or desistance of antisocial behavior, with main focus on the role of self-regulation, empathy and trust. We aim to assess the impact on adolescents’ functioning in various societal contexts, including educational settings, social relationships, and adherence to societal norms. In this paper, we describe in detail the design of this study, the included population, the determinants, intermediate neurocognitive measures, and outcomes. Furthermore, we provide a detailed description of the procedures for inclusion, informed consent, recruitment, and our collaboration with network partners.

Child and adolescent mental health problems stem from an interaction between biological and environmental factors. In the past decades, conceptualizations of genetic and neurobiological factors have become increasingly detailed. Development of our conceptualizations of environmental factors, in contrast, is lacking behind. Environmental adversity is usually conceptualized as one rather global factor, including, for example, both structural factors (e.g. poverty and racism) and psychosocial factors (e.g. parental violence or neglect). Or, as Chow et al. (2025) in this issue put it ‘There is not yet a consensus on the best way to conceptualise adverse childhood experience’. In this Editorial, we call for clearer, more specific conceptualizations of family adversity in biosocial research. This development is essential for unravelling the mechanisms that shape child and adolescent mental health problems.