title: Punishment Insensitivity in Early Childhood: A Developmental, Dimensional Approach.
abstract: Impairment in learning from punishment ("punishment insensitivity") is an established feature of severe antisocial behavior in adults and youth but it has not been well studied as a developmental phenomenon. In early childhood, differentiating a normal: abnormal spectrum of punishment insensitivity is key for distinguishing normative misbehavior from atypical manifestations. This study employed a novel measure, the Multidimensional Assessment Profile of Disruptive Behavior (MAP-DB), to examine the distribution, dimensionality, and external validity of punishment insensitivity in a large, demographically diverse community sample of preschoolers (3-5 years) recruited from pediatric clinics (N = 1,855). Caregivers completed surveys from which a seven-item Punishment Insensitivity scale was derived. Findings indicated that Punishment Insensitivity behaviors are relatively common in young children, with at least 50 % of preschoolers exhibiting them sometimes. Item response theory analyses revealed a Punishment Insensitivity spectrum. Items varied along a severity continuum: most items needed to occur "Often" in order to be severe and behaviors that were qualitatively atypical or intense were more severe. Although there were item-level differences across sociodemographic groups, these were small. Construct, convergent, and divergent validity were demonstrated via association to low concern for others and noncompliance, motivational regulation, and a disruptive family context. Incremental clinical utility was demonstrated in relation to impairment. Early childhood punishment insensitivity varies along a severity continuum and is atypical when it predominates. Implications for understanding the phenomenology of emergent disruptive behavior are discussed.
authors.affiliation: Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 633 St. N. Clair St, 19th Floor, Chicago, IL, 60611, USA.
authors.forename: Sara R
authors.initials: SR
authors.lastname: Nichols
authors.forename: Margaret J
authors.initials: MJ
authors.lastname: Briggs-Gowan
authors.forename: Ryne
authors.initials: R
authors.lastname: Estabrook
authors.forename: James L
authors.initials: JL
authors.lastname: Burns
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Kestler
authors.forename: Grace
authors.initials: G
authors.lastname: Berman
authors.forename: David B
authors.initials: DB
authors.lastname: Henry
authors.forename: Lauren S
authors.initials: LS
authors.lastname: Wakschlag
mesh_terms: D002653:Child Behavior Disorders / Q000175:diagnosis*; D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D011594:Psychometrics / Q000295:instrumentation*; D011678:Punishment / Q000523:psychology*; D015203:Reproducibility of Results