Understanding sex differences in severe antisocial behaviour

Although males and females with Conduct Disorder (CD) differ in terms of risk factors, clinical presentation, and adult outcomes, little research has investigated the neurobiological basis of these sex differences, and most research has focused on males.

Graeme Fairchild 

In this talk, I will discuss our recent findings from the European multi-site FemNAT-CD study (N = 1750) which tested whether males and females with CD show similar or distinct abnormalities in brain structure and function. Surface-based morphometry was used to assess brain structure and an fMRI facial emotion processing task was used to study brain activity. We also investigated sex differences in neuropsychological function (facial emotion recognition and reinforcement learning), psychiatric comorbidity and the developmental course of CD. Males and females with CD showed common reductions in cortical thickness in the orbitofrontal cortex relative to controls, whereas sex-by-diagnosis interactions were observed in anterior insula and amygdala volume, which are involved in empathy and emotion recognition, respectively. These interactions were driven by structural changes in males, but not females, with CD.

In the fMRI study, we found common reductions in amygdala activity in males and females with CD for faces in general, but a sex-by-diagnosis interaction for amygdala activity when processing angry faces (males with CD showed higher, and females with CD lower, responses). Males and females with CD both showed deficits in emotion recognition and reinforcement learning (especially learning from punishment). Males with CD were significantly more likely to have comorbid ADHD than females, whereas females with CD were more likely to have comorbid borderline personality disorder and depression. Finally, females with CD were more likely than males to have adolescent-onset CD and were more likely to show remission at 18-month follow up. This study has provided evidence for sex-specific effects of CD on brain structure and activity during emotion processing, but not neuropsychological performance.


Graeme Fairchild is a Reader (Associate Professor) in Developmental Psychopathology at the Department of Psychology, University of Bath, UK.

He received his PhD from the University of Newcastle in 2004, and worked as a post-doc in the Department of Psychiatry at the University of Cambridge and the MRC Cognition and Brain Sciences Unit before being appointed as a Lecturer (Assistant Professor) at the University of Southampton in 2010. He moved to the University of Bath in 2016 to take up a Readership and is part of the Child Mental Health and Development and Neurostim research groups at Bath. He has received grant funding totalling over 9.5 million Euro from the Medical Research Council, Wellcome Trust, European Commission, and Economic and Social Research Council. Dr Fairchild’s research interests are in the development and neurobiology of antisocial behaviour and violence, and in recent years he has focused on sex differences in antisocial behaviour, helping to set up and design the FemNAT-CD study.

This is a major EU-funded project (N = 1750) investigating the neurobiology, genetics, neuroendocrinology and neuropsychology of Conduct Disorder in female adolescents and sex differences in Conduct Disorder. Together with Stephane De Brito, he recently founded the ENIGMA Antisocial Behavior working group which will pool MRI and diffusion tensor imaging data from research groups across the world to examine whether there are reliable grey- and white-matter structural alterations in the brains of children and adolescents with Conduct Disorder/conduct problems, and adults with Antisocial Personality Disorder or psychopathy. He has published 95 peer-reviewed articles, including a primer on Conduct Disorder in Nature Reviews Disease Primers, and influential articles evaluating the developmental taxonomic theory of antisocial behaviour. He also served as Editor of the journal European Child + Adolescent Psychiatry between 2017-2020.