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Matthys W, Schutter DJLG. Involving Parents in Cognitive Behavioral Therapy for Children and Adolescents with Conduct Problems: Goals, Outcome Expectations, and Normative Beliefs About Aggression are Targeted in Sessions with Parents and Their Child. Clin Child Fam Psychol Rev 2024:10.1007/s10567-024-00486-3. [PMID: 38850473 DOI: 10.1007/s10567-024-00486-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2024] [Indexed: 06/10/2024]
Abstract
Children and adolescents with conduct problems participate in Cognitive Behavioral Therapy (CBT), either in individual or group format, in view of learning social problem-solving skills that enable them to behave in more independent and situation-appropriate ways. Parents must support their child's learning processes in everyday life and therefore these processes need attention in CBT sessions in which parents and their child participate. The social problem-solving model of CBT previously described (Matthys & Schutter, Clin Child Fam Psychol Rev 25:552-572, 2022; Matthys & Schutter, Clin Child Fam Psychol Rev 26:401-415, 2023) consists of nine psychological skills. In this narrative review we propose that instead of addressing each skill separately in sessions with both parents and their child, therapists work on three schemas (latent mental structures): (1) goals, (2) outcome expectations, and (3) normative beliefs about aggression. Based on social-cognitive and cognitive neuroscience studies we argue that these three schemas affect five core social problem-solving skills: (1) interpretation, (2) clarification of goals, (3) generations of solutions, (4) evaluation of solutions, and (5) decision-making. In view of tailoring CBT to the individual child's characteristic schemas and associated social problem-solving skills, we suggest that children and adolescents participate in individual sessions with their parents. The therapist uses Socratic questioning in order to find out characteristic schemas of the child, encourage reflection on these schemas, and explore alternative schemas that had previously been outside the child's attention. The therapist functions as a model for parents to ask their child questions about the relevant schemas with a view of achieving changes in the schemas.
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Affiliation(s)
- Walter Matthys
- Department of Clinical Child and Family Studies, Utrecht University, Heidelberglaan 1, 3584, CS, Utrecht, The Netherlands.
| | - Dennis J L G Schutter
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Heidelberglaan 1, 3584, CS, Utrecht, The Netherlands
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2
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Sacu S, Dubois M, Hezemans FH, Aggensteiner PM, Monninger M, Brandeis D, Banaschewski T, Hauser TU, Holz NE. Early-Life Adversities Are Associated With Lower Expected Value Signaling in the Adult Brain. Biol Psychiatry 2024:S0006-3223(24)01249-6. [PMID: 38636886 DOI: 10.1016/j.biopsych.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 04/05/2024] [Accepted: 04/06/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Early adverse experiences are assumed to affect fundamental processes of reward learning and decision making. However, computational neuroimaging studies investigating these circuits in the context of adversity are sparse and limited to studies conducted in adolescent samples, leaving the long-term effects unexplored. METHODS Using data from a longitudinal birth cohort study (n = 156; 87 female), we investigated associations between adversities and computational markers of reward learning (i.e., expected value, prediction errors). At age 33 years, all participants completed a functional magnetic resonance imaging-based passive avoidance task. Psychopathology measures were collected at the time of functional magnetic resonance imaging investigation and during the COVID-19 pandemic. We applied a principal component analysis to capture common variations across 7 adversity measures. The resulting adversity factors (factor 1: postnatal psychosocial adversities and prenatal maternal smoking; factor 2: prenatal maternal stress and obstetric adversity; factor 3: lower maternal stimulation) were linked with psychopathology and neural responses in the core reward network using multiple regression analysis. RESULTS We found that the adversity dimension primarily informed by lower maternal stimulation was linked to lower expected value representation in the right putamen, right nucleus accumbens, and anterior cingulate cortex. Expected value encoding in the right nucleus accumbens further mediated the relationship between this adversity dimension and psychopathology and predicted higher withdrawn symptoms during the COVID-19 pandemic. CONCLUSIONS Our results suggested that early adverse experiences in caregiver context might have a long-term disruptive effect on reward learning in reward-related brain regions, which can be associated with suboptimal decision making and thereby may increase the vulnerability of developing psychopathology.
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Affiliation(s)
- Seda Sacu
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; German Center for Mental Health, Mannheim, Heidelberg, and Ulm, Germany
| | - Magda Dubois
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College London, London, United Kingdom
| | - Frank H Hezemans
- Department of Psychiatry and Psychotherapy, Medical School and University Hospital, Eberhard Karls University of Tübingen, Tübingen, Germany; Department of Computational Neuroscience, Max Planck Institute for Biological Cybernetics, Tübingen, Germany; German Center for Mental Health, Tübingen, Germany
| | - Pascal-M Aggensteiner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; German Center for Mental Health, Mannheim, Heidelberg, and Ulm, Germany
| | - Maximilian Monninger
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zürich, Zurich, Switzerland
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; German Center for Mental Health, Mannheim, Heidelberg, and Ulm, Germany
| | - Tobias U Hauser
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College London, London, United Kingdom; Department of Psychiatry and Psychotherapy, Medical School and University Hospital, Eberhard Karls University of Tübingen, Tübingen, Germany; German Center for Mental Health, Tübingen, Germany; Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom
| | - Nathalie E Holz
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; German Center for Mental Health, Mannheim, Heidelberg, and Ulm, Germany; Donders Institute for Brain, Cognition, and Behaviour, Radboud University Nijmegen, Nijmegen, the Netherlands; Department for Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, the Netherlands.
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Elster EM, Pauli R, Baumann S, De Brito SA, Fairchild G, Freitag CM, Konrad K, Roessner V, Brazil IA, Lockwood PL, Kohls G. Impaired Punishment Learning in Conduct Disorder. J Am Acad Child Adolesc Psychiatry 2024; 63:454-463. [PMID: 37414274 DOI: 10.1016/j.jaac.2023.05.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 05/22/2023] [Accepted: 06/27/2023] [Indexed: 07/08/2023]
Abstract
OBJECTIVE Conduct disorder (CD) has been associated with deficits in the use of punishment to guide reinforcement learning (RL) and decision making. This may explain the poorly planned and often impulsive antisocial and aggressive behavior in affected youths. Here, we used a computational modeling approach to examine differences in RL abilities between CD youths and typically developing controls (TDCs). Specifically, we tested 2 competing hypotheses that RL deficits in CD reflect either reward dominance (also known as reward hypersensitivity) or punishment insensitivity (also known as punishment hyposensitivity). METHOD The study included 92 CD youths and 130 TDCs (aged 9-18 years, 48% girls) who completed a probabilistic RL task with reward, punishment, and neutral contingencies. Using computational modeling, we investigated the extent to which the 2 groups differed in their learning abilities to obtain reward and/or to avoid punishment. RESULTS RL model comparisons showed that a model with separate learning rates per contingency explained behavioral performance best. Importantly, CD youths showed lower learning rates than TDCs specifically for punishment, whereas learning rates for reward and neutral contingencies did not differ. Moreover, callous-unemotional (CU) traits did not correlate with learning rates in CD. CONCLUSION CD youths have a highly selective impairment in probabilistic punishment learning, regardless of their CU traits, whereas reward learning appears to be intact. In summary, our data suggest punishment insensitivity rather than reward dominance in CD. Clinically, the use of punishment-based intervention techniques to achieve effective discipline in patients with CD may be a less helpful strategy than reward-based techniques.
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Affiliation(s)
| | - Ruth Pauli
- University of Birmingham, Birmingham, United Kingdom
| | | | | | | | - Christine M Freitag
- University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Kerstin Konrad
- University Hospital RWTH Aachen, Aachen, Germany; RWTH Aachen and Research Centre Juelich, Juelich, Germany
| | | | | | - Patricia L Lockwood
- University of Birmingham, Birmingham, United Kingdom; University of Oxford, Oxford, United Kingdom
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4
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Sistiaga S, Tseng WL, Zhang L, Rossignol M, Bellaert N. How are irritability and anhedonia symptoms linked? A network approach. J Clin Psychol 2024. [PMID: 38497904 DOI: 10.1002/jclp.23679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/08/2024] [Accepted: 03/06/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Anhedonia and irritability are two prevalent symptoms of major depressive disorder (MDD) that predict greater depression severity and poor outcomes, including suicidality. Although both symptoms have been proposed to result from paradoxical reward processing dysfunctions, the interactions between these symptoms remain unclear. Anhedonia is a multifaceted symptom reflecting impairments in multiple dimensions of reward processing (e.g., pleasure, desire, motivation, and effort) across distinct reward types (e.g., food, sensory experiences, social activities, hobbies) that may differentially interact with irritability. This study investigated the complex associations between anhedonia and irritability using network analysis. METHOD Participants (N = 448, Mage = 33.29, SD = 14.58) reported their symptoms of irritability on the Brief Irritability Test (Holtzman et al., 2015) and anhedonia (i.e., pleasure, desire, motivation, and effort dimensions across four reward types) on the Dimensional Anhedonia Rating Scale (Rizvi et al., 2015). A regularized Gaussian Graphical Model was built to estimate the network structure between items. RESULTS Irritability was negatively related to willingness to expand effort to obtain food/drinks (estimate = -0.18), social activities (-0.13), and hobbies (-0.12) rewards. Irritability was positively associated with a desire for food/drinks (0.12). LIMITATIONS Only a small proportion (5.8%) of our sample was clinical and the study design was cross-sectional. CONCLUSION A specific link between irritability and the effort dimension of the hedonic response across three reward types was identified. Investigating effort expenditure deficits with experimental paradigms may help us understand the mechanisms underlying the comorbidity between irritability and anhedonia in the context of MDD.
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Affiliation(s)
- Sonia Sistiaga
- Cognitive Psychology and Neuropsychology Department, University of Mons, Mons, Belgium
| | - Wan-Ling Tseng
- Yale Child Study Center, Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Lanting Zhang
- Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK
| | - Mandy Rossignol
- Cognitive Psychology and Neuropsychology Department, University of Mons, Mons, Belgium
| | - Nellia Bellaert
- Cognitive Psychology and Neuropsychology Department, University of Mons, Mons, Belgium
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Murray L, Lopez-Duran NL, Mitchell C, Monk CS, Hyde LW. Antisocial behavior is associated with reduced frontoparietal activity to loss in a population-based sample of adolescents. Psychol Med 2023; 53:3652-3660. [PMID: 35172913 PMCID: PMC9381639 DOI: 10.1017/s0033291722000307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 01/12/2022] [Accepted: 01/23/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Adolescent antisocial behavior (AB) is a public health concern due to the high financial and social costs of AB on victims and perpetrators. Neural systems involved in reward and loss processing are thought to contribute to AB. However, investigations into these processes are limited: few have considered anticipatory and consummatory components of reward, response to loss, nor whether associations with AB may vary by level of callous-unemotional (CU) traits. METHODS A population-based community sample of 128 predominantly low-income youth (mean age = 15.9 years; 42% male) completed a monetary incentive delay task during fMRI. A multi-informant, multi-method latent variable approach was used to test associations between AB and neural response to reward and loss anticipation and outcome and whether CU traits moderated these associations. RESULTS AB was not associated with neural response to reward but was associated with reduced frontoparietal activity during loss outcomes. This association was moderated by CU traits such that individuals with higher levels of AB and CU traits had the largest reductions in frontoparietal activity. Co-occurring AB and CU traits were also associated with increased precuneus response during loss anticipation. CONCLUSIONS Findings indicate that AB is associated with reduced activity in brain regions involved in cognitive control, attention, and behavior modification during negative outcomes. Moreover, these reductions are most pronounced in youth with co-occurring CU traits. These findings have implications for understanding why adolescents involved in AB continue these behaviors despite severe negative consequences (e.g. incarceration).
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Affiliation(s)
- Laura Murray
- McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | | | - Colter Mitchell
- Survey Research Center of the Institute for Social Research & Population Studies Center of the Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Christopher S. Monk
- Department of Psychology, Survey Research Center of the Institute for Social Research & Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Luke W. Hyde
- Department of Psychology & Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
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Matthys W, Schutter DJLG. Moral Thinking and Empathy in Cognitive Behavioral Therapy for Children and Adolescents with Conduct Problems: A Narrative Review. Clin Child Fam Psychol Rev 2023; 26:401-415. [PMID: 36905479 PMCID: PMC10123041 DOI: 10.1007/s10567-023-00429-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2023] [Indexed: 03/12/2023]
Abstract
Cognitive behavioral therapy (CBT) for conduct problems in children and adolescents aims to decrease behaviors which may be considered moral transgressions (e.g., aggressive and antisocial behavior) and to increase behaviors that benefit others (e.g., helping, comforting). However, the moral aspects underlying these behaviors have received relatively little attention. In view of increasing the effectiveness of CBT for conduct problems, insights into morality and empathy based on studies from developmental psychology and cognitive neuroscience are reviewed and integrated into a previously proposed model of social problem-solving (Matthys & Schutter, Clin Child Fam Psychol Rev 25:552-572, 2022). Specifically, this narrative review discusses developmental psychology studies on normative beliefs in support of aggression and antisocial behavior, clarification of goals, and empathy. These studies are complemented by cognitive neuroscience research on harm perception and moral thinking, harm perception and empathy, others' beliefs and intentions, and response outcome learning and decision-making. A functional integration of moral thinking and empathy into social problem-solving in group CBT may contribute to the acceptance of morality-related issues by children and adolescents with conduct problems.
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Affiliation(s)
- Walter Matthys
- Department of Clinical Child and Family Studies, Utrecht University, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands.
| | - Dennis J L G Schutter
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands
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7
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The computational psychiatry of antisocial behaviour and psychopathy. Neurosci Biobehav Rev 2023; 145:104995. [PMID: 36535376 DOI: 10.1016/j.neubiorev.2022.104995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 11/21/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022]
Abstract
Antisocial behaviours such as disobedience, lying, stealing, destruction of property, and aggression towards others are common to multiple disorders of childhood and adulthood, including conduct disorder, oppositional defiant disorder, psychopathy, and antisocial personality disorder. These disorders have a significant negative impact for individuals and for society, but whether they represent clinically different phenomena, or simply different approaches to diagnosing the same underlying psychopathology is highly debated. Computational psychiatry, with its dual focus on identifying different classes of disorder and health (data-driven) and latent cognitive and neurobiological mechanisms (theory-driven), is well placed to address these questions. The elucidation of mechanisms that might characterise latent processes across different disorders of antisocial behaviour can also provide important advances. In this review, we critically discuss the contribution of computational research to our understanding of various antisocial behaviour disorders, and highlight suggestions for how computational psychiatry can address important clinical and scientific questions about these disorders in the future.
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Skowroński B. The Development and Validation of the Antisocial Preferences Scale. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2366. [PMID: 36767732 PMCID: PMC9916389 DOI: 10.3390/ijerph20032366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/25/2023] [Accepted: 01/26/2023] [Indexed: 06/18/2023]
Abstract
The aim of this study was to create a new instrument measuring antisocial preferences based on the Theory of Social Derailment of Czesław Czapów, who indicated the role of antisocial preferences in predicting antisocial behavior. The measures used were the Antisocial Preferences Scale (APS), BPAQ, Mach-IV, and IVE questionnaires. The participants were 718 prisoners. CFA techniques were used to investigate the construct validity of the Antisocial Preferences Scale. Four alternative models of the APS were specified and tested, namely: one-factor, second-order, multi-factor, and bi-factor. CFA analyses revealed that the best-fitting model was the bifactor. This conceptualization contains seven subscales, namely: aggressiveness, lack of guilt or remorse, breaking legal norms, incapacity for mutually intimate relationships, impulsiveness, risk-taking, and egocentrism.
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Affiliation(s)
- Bartłomiej Skowroński
- Institute of Social Prevention and Resocialization, Faculty of Applied Social Sciences and Resocialization, University of Warsaw, ul. Podchorążych 20, 00-721 Warsaw, Poland
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Deming P, Heilicher M, Koenigs M. How reliable are amygdala findings in psychopathy? A systematic review of MRI studies. Neurosci Biobehav Rev 2022; 142:104875. [PMID: 36116578 DOI: 10.1016/j.neubiorev.2022.104875] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/31/2022] [Accepted: 09/13/2022] [Indexed: 10/31/2022]
Abstract
The amygdala is a key component in predominant neural circuitry models of psychopathy. Yet, after two decades of neuroimaging research on psychopathy, the reproducibility of amygdala findings is questionable. We systematically reviewed MRI studies (81 of adults, 53 of juveniles) to determine the consistency of amygdala findings across studies, as well as within specific types of experimental tasks, community versus forensic populations, and the lowest- versus highest-powered studies. Three primary findings emerged. First, the majority of studies found null relationships between psychopathy and amygdala structure and function, even in the context of theoretically relevant tasks. Second, findings of reduced amygdala activity were more common in studies with low compared to high statistical power. Third, the majority of peak coordinates of reduced amygdala activity did not fall primarily within the anatomical bounds of the amygdala. Collectively, these findings demonstrate significant gaps in the empirical support for the theorized role of the amygdala in psychopathy and indicate the need for novel research perspectives and approaches in this field.
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Affiliation(s)
- Philip Deming
- Department of Psychology, Northeastern University, 360 Huntington Ave., Boston, MA 02115, USA.
| | - Mickela Heilicher
- Department of Psychiatry, University of Wisconsin-Madison, 6001 Research Park Blvd., Madison, WI 53719, USA
| | - Michael Koenigs
- Department of Psychiatry, University of Wisconsin-Madison, 6001 Research Park Blvd., Madison, WI 53719, USA
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O’Connell K, Walsh M, Padgett B, Connell S, Marsh AA. Modeling Variation in Empathic Sensitivity Using Go/No-Go Social Reinforcement Learning. AFFECTIVE SCIENCE 2022; 3:603-615. [PMID: 36385908 PMCID: PMC9537390 DOI: 10.1007/s42761-022-00119-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 04/10/2022] [Indexed: 06/16/2023]
Abstract
Recent advances in computational behavioral modeling can help rigorously quantify differences in how individuals learn behaviors that affect both themselves and others. But social learning remains understudied in the context of understanding individual variation in social phenomena like aggression, which is defined by persistent engagement in behaviors that harm others. We adapted a go/no-go reinforcement learning task across social and non-social contexts such that monetary gains and losses explicitly impacted the subject, a study partner, or no one. We then quantified participants' (n = 61) sensitivity to others' rewards, sensitivity to others' losses, and the Pavlovian influence of expected outcomes on approach and avoidance behavior. Results showed that subjects learned in response to punishments and rewards that affected their partner in a way that was computationally similar to how they learned for themselves, consistent with the possibility that social learning engages empathic processes. Further supporting this interpretation, an individualized model parameter that indexed sensitivity to others' punishments was inversely associated with trait antisociality. Modeled sensitivity to others' losses also mapped onto post-task motivation ratings, but was not associated with self-reported trait empathy. This work is the first to apply a social reinforcement learning task that spans affect and action requirement (go/no-go) to measure multiple facets of empathic sensitivity. Supplementary Information The online version contains supplementary material available at 10.1007/s42761-022-00119-4.
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Affiliation(s)
- Katherine O’Connell
- Interdisciplinary Program in Neuroscience, Georgetown University, Washington, DC USA
| | - Marissa Walsh
- Department of Psychology, Georgetown University, Washington, DC USA
| | - Brandon Padgett
- Department of Psychology, Georgetown University, Washington, DC USA
| | - Sarah Connell
- Department of Psychology, Georgetown University, Washington, DC USA
| | - Abigail A. Marsh
- Interdisciplinary Program in Neuroscience, Georgetown University, Washington, DC USA
- Department of Psychology, Georgetown University, Washington, DC USA
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White SF, Estrada Gonzalez SM, Moriarty EM. Raging Hormones: Why Age-Based Etiological Conceptualizations of the Development of Antisocial Behavior Are Insufficient. Front Behav Neurosci 2022; 16:853697. [PMID: 35493950 PMCID: PMC9041342 DOI: 10.3389/fnbeh.2022.853697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 03/17/2022] [Indexed: 12/15/2022] Open
Abstract
Developmental science, particularly developmental neuroscience, has substantially influenced the modern legal system. However, this science has typically failed to consider the role of puberty and pubertal hormones on development when considering antisocial behavior. This review describes major theoretical positions on the developmental neuroscience of antisocial behavior and highlights where basic developmental neuroscience suggests that the role of puberty and pubertal hormones should be considered. The implications of the current state of the science with respect to developmental neuroscience is considered, particularly what is known in light of development beyond puberty. This review shows that development continues to an older age for many youth than the legal system typically acknowledges. The plasticity of the brain that this continued development implies has implications for the outcome of interventions in the legal system in ways that have not been explored. Future directions for both developmental scientists and legal professions are recommended.
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Affiliation(s)
- Stuart F. White
- Boys Town National Research Hospital, Omaha, NE, United States
- *Correspondence: Stuart F. White,
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12
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Matthys W, Schutter DJLG. Improving Our Understanding of Impaired Social Problem-Solving in Children and Adolescents with Conduct Problems: Implications for Cognitive Behavioral Therapy. Clin Child Fam Psychol Rev 2022; 25:552-572. [PMID: 35165840 DOI: 10.1007/s10567-021-00376-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2021] [Indexed: 12/14/2022]
Abstract
In cognitive behavioral therapy (CBT) children and adolescents with conduct problems learn social problem-solving skills that enable them to behave in more independent and situation appropriate ways. Empirical studies on psychological functions show that the effectiveness of CBT may be further improved by putting more emphasis on (1) recognition of the type of social situations that are problematic, (2) recognition of facial expressions in view of initiating social problem-solving, (3) effortful emotion regulation and emotion awareness, (4) behavioral inhibition and working memory, (5) interpretation of the social problem, (6) affective empathy, (7) generation of appropriate solutions, (8) outcome expectations and moral beliefs, and (9) decision-making. To improve effectiveness, CBT could be tailored to the individual child's or adolescent's impairments of these psychological functions which may depend on the type of conduct problems and their associated problems.
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Affiliation(s)
- Walter Matthys
- Department of Clinical Child and Family Studies, Utrecht University, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands.
| | - Dennis J L G Schutter
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands
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Wagels L, Habel U, Raine A, Clemens B. Neuroimaging, hormonal and genetic biomarkers for pathological aggression — success or failure? Curr Opin Behav Sci 2022. [DOI: 10.1016/j.cobeha.2021.08.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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White SF, Nusslock R, Miller GE. Low Socioeconomic Status Is Associated with a Greater Neural Response to Both Rewards and Losses. J Cogn Neurosci 2022; 34:1939-1951. [DOI: 10.1162/jocn_a_01821] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Abstract
Low socioeconomic status (SES) has been associated with distinct patterns of reward processing, which appear to have adverse implications for health outcomes, well-being, and human capital. However, most studies in this literature have used complex tasks that engage more than reward processing and/or retrospectively studied childhood SES in samples of adults. To clarify how SES relates to the development of reward processing tendencies, we measured income-to-poverty ratio (IPR) in 172 youth who subsequently underwent functional MRI while completing a passive avoidance task to assess neural responses to reward and loss information. Participants were 12–15 years old (mean = 13.94, SD = .52; 65.7% female) from a sample broadly representative of the Chicago area in terms of SES (IPR range = 0.1–34.53; mean = 3.90; SD = 4.15) and racial makeup (40.1% European-American; 30.8% Black; 29.1% Hispanic). To the extent they had lower IPR, children displayed a trend toward worse behavioral performance on the passive avoidance task. Lower IPR also was associated with a greater response in attention brain regions to reward and loss cues and to reward and loss feedback. Lower IPR also was associated with reduced differentiation between reward and loss feedback in the ventromedial prefrontal and parietal cortex. The current data suggest that both increased salience of reward/loss information and reduced discrimination between reward and loss feedback could be factors linking SES with the development of human capital and health outcomes.
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Affiliation(s)
- Stuart F. White
- Boys Town National Research Hospital & Creighton University School of Medicine, NE
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Neural response to monetary loss among youth with disruptive behavior disorders and callous-unemotional traits in the ABCD study. NEUROIMAGE-CLINICAL 2021; 32:102810. [PMID: 34530359 PMCID: PMC8445885 DOI: 10.1016/j.nicl.2021.102810] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/30/2021] [Accepted: 08/24/2021] [Indexed: 11/23/2022]
Abstract
We leveraged the ABCD Study to derive phenotypically narrow groups of youth with DBD in the largest loss processing functional MRI study to date. We examined neural activity to the anticipation and receipt of monetary loss using group, dimensional, and network-level analyses. There were no significant differences in brain activity to loss anticipation or receipt among youth with DBD with or without CU traits. Null findings were confirmed with and without covariates, using alternative grouping approaches, in dimensional models, and within network-level analyses.
Etiological models highlight reduced punishment sensitivity as a core risk factor for disruptive behavior disorders (DBD) and callous-unemotional (CU) traits. The current study examined neural sensitivity to the anticipation and receipt of loss, one key aspect of punishment sensitivity, among youth with DBD, comparing those with and without CU traits. Data were obtained from the Adolescent Brain and Cognitive Development (ABCD)SM Study (N = 11,874; Mage = 9.51; 48% female). Loss-related fMRI activity during the monetary incentive delay task was examined across 16 empirically-derived a priori brain regions (e.g., striatum, amygdala, insula, anterior cingulate cortex, medial prefrontal cortex) and compared across the following groups: (1) typically developing (n = 693); (2) DBD (n = 995), subdivided into those (3) with CU traits (DBD + CU, n = 198), and (4) without CU traits (DBD-only, n = 276). Latent variable modeling was also employed to examine network-level activity. There were no significant between-group differences in brain activity to loss anticipation or receipt. Null findings were confirmed with and without covariates, using alternative grouping approaches, and in dimensional models. Network-level analyses also demonstrated comparable activity across groups during loss anticipation and receipt. Findings suggest that differences in punishment sensitivity among youth with DBD are unrelated to loss anticipation or receipt. More precise characterizations of other aspects punishment sensitivity are needed to understand risk for DBD and CU traits.
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Hawes SW, Waller R, Byrd AL, Bjork JM, Dick AS, Sutherland MT, Riedel MC, Tobia MJ, Thomson N, Laird AR, Gonzalez R. Reward Processing in Children With Disruptive Behavior Disorders and Callous-Unemotional Traits in the ABCD Study. Am J Psychiatry 2021; 178:333-342. [PMID: 32731811 PMCID: PMC7855017 DOI: 10.1176/appi.ajp.2020.19101092] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Disrupted reward processing is implicated in the etiology of disruptive behavior disorders (DBDs) and callous-unemotional traits. However, neuroimaging investigations of reward processing underlying these phenotypes remain sparse. The authors examined neural sensitivity in response to reward anticipation and receipt among youths with DBDs, with and without callous-unemotional traits. METHODS Data were obtained from the Adolescent Brain and Cognitive Development Study (mean age=9.51 years [SD=0.50]; 49% female). Reward-related activation during the monetary incentive delay task was examined across 16 brain regions, including the amygdala, anterior cingulate cortex (ACC), nucleus accumbens (NAcc), and orbitofrontal cortex (OFC). Latent variable modeling was used to examine network-level coactivation. The following diagnostic groups were compared: typically developing youths (N=693) and youths with DBDs (N=995), subdivided into those with callous-unemotional traits (DBD+CU, N=198) and without callous-unemotional traits (DBD only, N=276). RESULTS During reward anticipation, youths in the overall DBD group (with and without callous-unemotional traits) showed decreased dorsal ACC activation compared with typically developing youths. The DBD-only group exhibited reduced ventral and dorsal striatal activity compared with the DBD+CU and typically developing groups. During reward receipt, youths with DBDs showed increased cortical (e.g., OFC) and subcortical (e.g., NAcc) regional activation compared with typically developing youths. The DBD+CU group demonstrated greater activation in several regions compared with those in the typically developing (e.g., amygdala) and DBD-only (e.g., dorsal ACC) groups. At the network level, the DBD-only group showed reduced anticipatory reward activation compared with the typically developing and DBD+CU groups, whereas youths in the DBD+CU group showed increased activation during reward receipt compared with those in the typically developing group. CONCLUSIONS These findings advance our understanding of unique neuroetiologic pathways to DBDs and callous-unemotional traits.
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Naim R, Kircanski K, Gold A, German RE, Davis M, Perlstein S, Clayton M, Revzina O, Brotman MA. Across-subjects multiple baseline trial of exposure-based cognitive-behavioral therapy for severe irritability: a study protocol. BMJ Open 2021; 11:e039169. [PMID: 33692176 PMCID: PMC7949376 DOI: 10.1136/bmjopen-2020-039169] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 12/12/2020] [Accepted: 12/19/2020] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Irritability is defined as a tendency towards anger in response to frustration. Clinically, impairing irritability is a significant public health problem. There is a need for mechanism-based psychotherapies targeting severe irritability as it manifests in the context of disruptive mood dysregulation disorder (DMDD). This study protocol describes a randomised multiple baseline design testing the preliminary efficacy of a new treatment, exposure-based cognitive-behavioral therapy for severe irritability in youth, which also integrates components of parent management training. We will investigate associations of this intervention with primary clinical measures, as well as ecological momentary assessment measures. METHODS AND ANALYSIS Forty youth will be enrolled. Participants, aged 8-17 years, must present at least one of two core symptoms of DMDD: abnormal mood or increased reactivity to negative emotional stimuli, with severe impairment in one domain (home, school, peers) and moderate in another, or moderate impairment in at least two domains. Each participant is randomised to a 2-week, 4-week or 6-week baseline observation period, followed by 12 active treatment sessions. Clinical ratings are conducted at baseline, biweekly (clinician), weekly (parent/child) throughout treatment, post-treatment, and 3-month and 6-month follow-up (clinician). Clinician ratings on the Affective Reactivity Index and Clinical Global Impressions-Improvement scale for DMDD are our primary outcome measures. Secondary outcome measures include parent and child reports of irritability. Post hoc additional symptom measures include clinician, parent and self-ratings of depression, anxiety and overall functional impairment. Prospective, digitally based event sampling of symptoms is acquired for a week pre-treatment, mid-treatment and post-treatment. Based on our pathophysiological model of irritability implicating frustrative non-reward, aberrant threat processing and instrumental learning, we probe these three brain-based targets using functional MRI paradigms to assess target engagement. ETHICS AND DISSEMINATION The research project and all related materials were submitted and approved by the appropriate Institutional Review Board (IRB) of the National Institute of Mental Health (NIMH). TRIAL REGISTRATION NUMBERS NCT02531893 and NCT00025935.
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Affiliation(s)
- Reut Naim
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Katharina Kircanski
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Andrea Gold
- Pediatric Anxiety Research Center, Bradley Hospital, Riverside, Rhode Island, USA
- Department of Psychiatry & Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Ramaris E German
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Mollie Davis
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Samantha Perlstein
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Michal Clayton
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Olga Revzina
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Melissa A Brotman
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
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Matthys W, Schutter DJLG. Increasing Effectiveness of Cognitive Behavioral Therapy for Conduct Problems in Children and Adolescents: What Can We Learn from Neuroimaging Studies? Clin Child Fam Psychol Rev 2021; 24:484-499. [PMID: 33683495 PMCID: PMC8324588 DOI: 10.1007/s10567-021-00346-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2021] [Indexed: 11/03/2022]
Abstract
Cognitive behavioral therapy (CBT) is particularly relevant for children from 7 years on and adolescents with clinical levels of conduct problems. CBT provides these children and adolescents with anger regulation and social problem-solving skills that enable them to behave in more independent and situation appropriate ways. Typically, CBT is combined with another psychological treatment such as behavioral parent training in childhood or an intervention targeting multiple systems in adolescence. The effectiveness of CBT, however, is in the small to medium range. The aim of this review is to describe how the effectiveness of CBT may be improved by paying more attention to a series of psychological functions that have been shown to be impaired in neuroimaging studies: (1) anger recognition, (2) the ability to generate situation appropriate solutions to social problems, (3) reinforcement-based decision making, (4) response inhibition, and (5) affective empathy. It is suggested that children and adolescents first become familiar with these psychological functions during group CBT sessions. In individual sessions in which the parents (and/or child care workers in day treatment and residential treatment) and the child or adolescent participate, parents then learn to elicit, support, and reinforce their child’s use of these psychological functions in everyday life (in vivo practice). In these individual sessions, working on the psychological functions is tailored to the individual child’s characteristic impairments of these functions. CBT therapists may also share crucial social-learning topics with teachers with a view to creating learning opportunities for children and adolescents at school.
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Affiliation(s)
- Walter Matthys
- Department of Child and Adolescent Studies, Utrecht University, Heidelberglaan 1, P.O. Box 80140, 3584 CS, Utrecht, The Netherlands. .,Department of Psychiatry, University Medical Center Utrecht, Heidelberglaan 100, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands.
| | - Dennis J L G Schutter
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands
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Dillien T, Goethals K, Sabbe B, Brazil IA. Impairment of Both Reward and Punishment Learning in Males Who Have Sexually Offended Against a Child. SEXUAL ABUSE : A JOURNAL OF RESEARCH AND TREATMENT 2020; 32:931-957. [PMID: 31462171 DOI: 10.1177/1079063219871579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Prior studies suggest that persons with a sexual offense against a child (PSOCs) present with an impairment in learning from reinforcement, which may contribute to the behavioral dysregulation often seen in PSOCs. Therefore, gaining more insight into the nature of this impairment seems essential to better understand child sexual (re)offending. Using a passive avoidance task, we found that PSOCs (n = 57) have difficulties with selecting behaviors that are associated with reward and suppressing behaviors that are associated with punishment relative to nonoffending men (n = 33), but not compared with persons with a nonsexual offense history (n = 31). The latter ability was particularly compromised in nonpedophilic PSOCs. By unraveling a source of pathology in the mechanisms that are involved in behavioral control, this study helps setting a step toward new, more tailored, therapeutic approaches.
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Affiliation(s)
- Tineke Dillien
- Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Wilrijk, Belgium
- University Forensic Centre, University Hospital Antwerp (UZA), Edegem, Belgium
| | - Kris Goethals
- Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Wilrijk, Belgium
- University Forensic Centre, University Hospital Antwerp (UZA), Edegem, Belgium
| | - Bernard Sabbe
- Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Wilrijk, Belgium
| | - Inti A Brazil
- Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Wilrijk, Belgium
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Forensic Psychiatric Centre Pompestichting, Nijmegen, The Netherlands
- Centre for Advances in Behavioural Science, Coventry University, UK
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Leveraging parasympathetic nervous system activity to study risk for psychopathology: The special case of callous-unemotional traits. Neurosci Biobehav Rev 2020; 118:175-185. [DOI: 10.1016/j.neubiorev.2020.07.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 06/14/2020] [Accepted: 07/27/2020] [Indexed: 12/14/2022]
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Aloi J, Blair KS, Crum KI, Bashford-Largo J, Zhang R, Lukoff J, Carollo E, White SF, Hwang S, Filbey FM, Dobbertin M, Blair RJR. Alcohol Use Disorder, But Not Cannabis Use Disorder, Symptomatology in Adolescents Is Associated With Reduced Differential Responsiveness to Reward Versus Punishment Feedback During Instrumental Learning. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 5:610-618. [PMID: 32299790 DOI: 10.1016/j.bpsc.2020.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 02/11/2020] [Accepted: 02/11/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND The two most commonly used illegal substances by adolescents in the United States are alcohol and cannabis. Alcohol use disorder (AUD) and cannabis use disorder (CUD) have been associated with dysfunction in decision-making processes in adolescents. One potential mechanism for these impairments is thought to be related to abnormalities in reward and punishment processing. However, very little work has directly examined potential differential relationships between AUD and CUD symptom severity and neural dysfunction during decision making in adolescents. METHODS In the current study, 154 youths participated in a passive avoidance learning task during functional magnetic resonance imaging to investigate the relationship between relative severity of AUD/CUD and dysfunction in processing reward and punishment feedback. RESULTS Increasing Alcohol Use Disorder Identification Test scores were associated with reduced neural differentiation between reward and punishment feedback within regions of striatum, posterior cingulate cortex, and parietal cortex. However, increasing Cannabis Use Disorder Identification Test scores were not associated with any neural dysfunction during the passive avoidance task. CONCLUSIONS These data expand on emerging literature that relative severity of AUD is associated with reduced responsivity to rewards in adolescents and that there are differential associations between AUD and CUD symptoms and neurocircuitry dysfunction in the developing adolescent brain.
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Affiliation(s)
- Joseph Aloi
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska; MD/PhD Scholars Program, University of Nebraska Medical Center, Omaha, Nebraska.
| | - Karina S Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
| | - Kathleen I Crum
- Department of Neuroscience, Medical University of South Carolina, Charleston, South Carolina
| | - Johannah Bashford-Largo
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
| | - Ru Zhang
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
| | - Jennie Lukoff
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
| | - Erin Carollo
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
| | - Stuart F White
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
| | - Soonjo Hwang
- Department of Psychiatry, University of Nebraska Medical Center, Omaha, Nebraska
| | - Francesca M Filbey
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas
| | - Matthew Dobbertin
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
| | - R James R Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
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Kircanski K, Craske MG, Averbeck BB, Pine DS, Leibenluft E, Brotman MA. Exposure therapy for pediatric irritability: Theory and potential mechanisms. Behav Res Ther 2019; 118:141-149. [PMID: 31085355 PMCID: PMC6590706 DOI: 10.1016/j.brat.2019.04.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 03/20/2019] [Accepted: 04/17/2019] [Indexed: 01/05/2023]
Abstract
Pediatric irritability is prevalent and impairing, yet little is known about its pathophysiology and treatment. In this article, we build on our and others' previous work to posit core mechanisms of irritability operating across the brain, behavior, and environment. Specifically, we propose proximal processes that surround the symptomatology of irritability and are potential targets for an exposure-based cognitive-behavioral therapy (CBT) for irritability that our group has developed. The heart of this model focuses on neurocognitive processes: youth's encoding of nonreward and threat stimuli, which involves prediction error signaling in the brain, and cognitive control in the context of frustration. Alterations in these processes are theorized to be central to chronic, severe irritability. Environmental responses to youth's symptom expression are also examined. Exposure-based CBT for irritability utilizes controlled, in vivo exposure to nonreward and threat stimuli with the aim to engage cognitive control and target top-down regulation of frustration. This intervention integrates selected parent management training techniques to target symptom reinforcement processes. Continued pathophysiological and treatment studies of irritability will not only refine our emerging understanding of the phenotype, but also inform broader questions on the brain and behavioral mechanisms of CBT efficacy.
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Affiliation(s)
- Katharina Kircanski
- Emotion and Development Branch, National Institute of Mental Health, 9000 Rockville Pike, Building 15K, Bethesda, MD, 20892-2670, USA.
| | - Michelle G Craske
- Department of Psychology, University of California-Los Angeles, 1285 Franz Hall, Los Angeles, CA, 90025, USA
| | - Bruno B Averbeck
- Laboratory of Neuropsychology, National Institute of Mental Health, 9000 Rockville Pike, Building 49, Bethesda, MD, 20892-4415, USA
| | - Daniel S Pine
- Emotion and Development Branch, National Institute of Mental Health, 9000 Rockville Pike, Building 15K, Bethesda, MD, 20892-2670, USA
| | - Ellen Leibenluft
- Emotion and Development Branch, National Institute of Mental Health, 9000 Rockville Pike, Building 15K, Bethesda, MD, 20892-2670, USA
| | - Melissa A Brotman
- Emotion and Development Branch, National Institute of Mental Health, 9000 Rockville Pike, Building 15K, Bethesda, MD, 20892-2670, USA
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Tyler P, White SF, Thompson RW, Blair R. Applying a Cognitive Neuroscience Perspective to Disruptive Behavior Disorders: Implications for Schools. Dev Neuropsychol 2019; 44:17-42. [PMID: 29432037 PMCID: PMC6283690 DOI: 10.1080/87565641.2017.1334782] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
A cognitive neuroscience perspective seeks to understand behavior, in this case disruptive behavior disorders (DBD), in terms of dysfunction in cognitive processes underpinned by neural processes. While this type of approach has clear implications for clinical mental health practice, it also has implications for school-based assessment and intervention with children and adolescents who have disruptive behavior and aggression. This review articulates a cognitive neuroscience account of DBD by discussing the neurocognitive dysfunction related to emotional empathy, threat sensitivity, reinforcement-based decision-making, and response inhibition. The potential implications for current and future classroom-based assessments and interventions for students with these deficits are discussed.
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Affiliation(s)
- Patrick Tyler
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Omaha, Nebraska, USA
- Boys Town National Research Institute, Boys Town, Nebraska, USA
| | - Stuart F. White
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Omaha, Nebraska, USA
| | | | - R.J.R. Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Omaha, Nebraska, USA
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24
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Jusyte A, Pfister R, Gehrer N, Schönenberg M. Risky business! Behavioral bias and motivational salience of rule-violations in children with conduct disorder. Psychiatry Res 2019; 271:740-746. [PMID: 30791350 DOI: 10.1016/j.psychres.2018.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 10/31/2018] [Accepted: 11/01/2018] [Indexed: 10/27/2022]
Abstract
Conduct disorder is characterized by both habitual aggression as well as non-aggressive rule-breaking behavior. While a large body of research has focused on aggressive behavior to date, the subtype of non-aggressive rule-breaking behavior is poorly understood. The current study represents a first attempt to directly assess decision biases toward rule-breaking behavior, their motivational salience, and the association with interpersonal factors in conduct disorder. Participants (n = 20 children with conduct disorder and n = 20 healthy controls) played a video game with the goal to deliver a hot pizza by bicycle to a marked location on a two-dimensional city map. In each trial, participants decided whether to use the regular route (streets) or opt for a potential shortcut that was either permitted (bicycle lane) or prohibited (park). The efficiency of the shortcut was parametrically varied to assess individual decision functions. Consistent with our hypotheses, group differences emerged only when taking a shortcut represented a rule violation (park condition), with the conduct disorder group committing significantly more rule violations than controls. Furthermore, conduct disorder children showed a substantial frequency of rule violations even in the absence of shortcut related gains, indicating a pronounced insensitivity towards sanctions. Importantly, this tendency was associated with self-reported impulsivity and rule violations in real life.
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Affiliation(s)
- Aiste Jusyte
- LEAD Graduate School & Research Network, University of Tübingen, Germany; Department of Clinical Psychology and Psychotherapy, University of Tübingen, Germany.
| | - Roland Pfister
- Department of Psychology, University of Würzburg, Germany
| | - Nina Gehrer
- Department of Clinical Psychology and Psychotherapy, University of Tübingen, Germany
| | - Michael Schönenberg
- Department of Clinical Psychology and Psychotherapy, University of Tübingen, Germany
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Hwang S, Meffert H, VanTieghem MR, Sinclair S, Bookheimer SY, Vaughan B, Blair RJR. Dysfunctional Social Reinforcement Processing in Disruptive Behavior Disorders: An Functional Magnetic Resonance Imaging Study. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2018; 16:449-460. [PMID: 30466217 PMCID: PMC6245284 DOI: 10.9758/cpn.2018.16.4.449] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 09/12/2017] [Accepted: 11/13/2017] [Indexed: 11/25/2022]
Abstract
Objective Prior functional magnetic resonance imaging (fMRI) work has revealed that children/adolescents with disruptive behavior disorders (DBDs) show dysfunctional reward/non-reward processing of non-social reinforcements in the context of instrumental learning tasks. Neural responsiveness to social reinforcements during instrumental learning, despite the importance of this for socialization, has not yet been previously investigated. Methods Twenty-nine healthy children/adolescents and 19 children/adolescents with DBDs performed the fMRI social/non-social reinforcement learning task. Participants responded to random fractal image stimuli and received social and non-social rewards/non-rewards according to their accuracy. Results Children/adolescents with DBDs showed significantly reduced responses within the caudate and posterior cingulate cortex (PCC) to non-social (financial) rewards and social non-rewards (the distress of others). Connectivity analyses revealed that children/adolescents with DBDs have decreased positive functional connectivity between the ventral striatum (VST) and the ventromedial prefrontal cortex (vmPFC) seeds and the lateral frontal cortex in response to reward relative to non-reward, irrespective of its sociality. In addition, they showed decreased positive connectivity between the vmPFC seed and the amygdala in response to non-reward relative to reward. Conclusion These data indicate compromised reinforcement processing of both non-social rewards and social non-rewards in children/adolescents with DBDs within core regions for instrumental learning and reinforcement-based decision-making (caudate and PCC). In addition, children/adolescents with DBDs show dysfunctional interactions between the VST, vmPFC, and lateral frontal cortex in response to rewarded instrumental actions potentially reflecting disruptions in attention to rewarded stimuli.
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Affiliation(s)
- Soonjo Hwang
- Department of Psychiatry, University of Nebraska Medical Center, Omaha, NE, USA
| | - Harma Meffert
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | | | - Stephen Sinclair
- Department of Health and Human Services, Section on Affective Cognitive Neuroscience, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Susan Y Bookheimer
- University of California and Brain Research Institute, Los Angeles, CA, USA
| | - Brigette Vaughan
- Department of Psychiatry, University of Nebraska Medical Center, Omaha, NE, USA
| | - R J R Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
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Hoffmann F, Puetz VB, Viding E, Sethi A, Palmer A, McCrory EJ. Risk-taking, peer-influence and child maltreatment: a neurocognitive investigation. Soc Cogn Affect Neurosci 2018; 13:124-134. [PMID: 29069467 PMCID: PMC5793726 DOI: 10.1093/scan/nsx124] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 10/16/2017] [Indexed: 11/19/2022] Open
Abstract
Maltreatment is associated with increased risk of a range of psychiatric disorders, many of which are characterized by altered risk-taking propensity. Currently, little is known about the neural correlates of risk-taking in children exposed to maltreatment, nor whether their risk-taking is atypically modulated by peer influence. Seventy-five 10- to 14-year-old children [maltreated (MT) group: N = 41; non-maltreated Group (NMT): N = 34] performed a Balloon Analogue Risk Task (BART), under three different peer influence conditions: while alone, while being observed by a peer and while being encouraged by a peer to take risks. The MT group engaged in less risk-taking irrespective of peer influence. There was no differential effect of peer influence on risk-taking behaviour across groups. At the neural level, the right anterior insula (rAI) exhibited altered risk sensitivity across conditions in the MT group. Across groups and conditions, rAI risk sensitivity was negatively associated with risk-taking and within the MT group greater rAI risk sensitivity was related to more anxiety symptoms. These findings suggest that children with a history of maltreatment show reduced risk-taking but typical responses to peer influence. Abnormal rAI functioning contributes to the pattern of reduced risk-taking and may predispose children exposed to maltreatment to develop future psychopathology.
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Affiliation(s)
- Ferdinand Hoffmann
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Vanessa B Puetz
- Division of Psychology and Language Sciences, University College London, London, UK.,Anna Freud National Centre for Children and Families, London, UK
| | - Essi Viding
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Arjun Sethi
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Amy Palmer
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Eamon J McCrory
- Division of Psychology and Language Sciences, University College London, London, UK.,Anna Freud National Centre for Children and Families, London, UK
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Blair R, Veroude K, Buitelaar J. Neuro-cognitive system dysfunction and symptom sets: A review of fMRI studies in youth with conduct problems. Neurosci Biobehav Rev 2018; 91:69-90. [DOI: 10.1016/j.neubiorev.2016.10.022] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 08/26/2016] [Accepted: 10/25/2016] [Indexed: 12/21/2022]
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Abstract
Psychopathy is an adult condition that incurs substantial societal and individual costs. Here we review neurocognitive and genetically informative studies that shed light on how and why this condition emerges. Children cannot present with psychopathy. However, the presence of callous-unemotional (CU) traits can distinguish a group of children who are at elevated risk of psychopathy in adulthood. These children display diminished empathy and guilt and show attenuated brain activation to distress cues in others. Genetically informative studies indicate that individual differences in CU traits show moderate-to-strong heritability, but that protective environmental factors can counter heritable risk. On the basis of the extant research findings, we speculate on what might represent the priorities for research over the next decade. We also consider the clinical implications of these research findings. In particular, we consider the importance of delineating what precisely works for children with CU traits (and their parents) and the ways in which intervention and prevention programs may be optimized to improve engagement as well as clinical outcomes.
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Affiliation(s)
- E Viding
- Division of Psychology and Language Sciences,University College London,Gower St, London, WC1E 6BT,UK
| | - E J McCrory
- Division of Psychology and Language Sciences,University College London,Gower St, London, WC1E 6BT,UK
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Boys with conduct problems and callous-unemotional traits: Neural response to reward and punishment and associations with treatment response. Dev Cogn Neurosci 2017; 30:51-59. [PMID: 29324299 PMCID: PMC5993203 DOI: 10.1016/j.dcn.2017.12.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 12/12/2017] [Accepted: 12/13/2017] [Indexed: 12/13/2022] Open
Abstract
Abnormalities in reward and punishment processing are implicated in the development of conduct problems (CP), particularly among youth with callous-unemotional (CU) traits. However, no studies have examined whether CP children with high versus low CU traits exhibit differences in the neural response to reward and punishment. A clinic-referred sample of CP boys with high versus low CU traits (ages 8–11; n = 37) and healthy controls (HC; n = 27) completed a fMRI task assessing reward and punishment processing. CP boys also completed a randomized control trial examining the effectiveness of an empirically-supported intervention (i.e., Stop-Now-And-Plan; SNAP). Primary analyses examined pre-treatment differences in neural activation to reward and punishment, and exploratory analyses assessed whether these differences predicted treatment outcome. Results demonstrated associations between CP and reduced amygdala activation to punishment independent of age, race, IQ and co-occurring ADHD and internalizing symptoms. CU traits were not associated with reward or punishment processing after accounting for covariates and no differences were found between CP boys with high versus low CU traits. While boys assigned to SNAP showed a greater reduction in CP, differences in neural activation were not associated with treatment response. Findings suggest that reduced sensitivity to punishment is associated with early-onset CP in boys regardless of the level of CU traits.
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Raschle NM, Menks WM, Fehlbaum LV, Steppan M, Smaragdi A, Gonzalez-Madruga K, Rogers J, Clanton R, Kohls G, Martinelli A, Bernhard A, Konrad K, Herpertz-Dahlmann B, Freitag CM, Fairchild G, De Brito SA, Stadler C. Callous-unemotional traits and brain structure: Sex-specific effects in anterior insula of typically-developing youths. NEUROIMAGE-CLINICAL 2017. [PMID: 29527490 PMCID: PMC5842751 DOI: 10.1016/j.nicl.2017.12.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Callous-unemotional traits are characterized by a lack of empathy, a disregard for others' feelings and shallow or deficient affect, such as a lack of remorse or guilt. Neuroanatomical correlates of callous-unemotional traits have been demonstrated in clinical samples (i.e., adolescents with disruptive behavior disorders). However, it is unknown whether callous-unemotional traits are associated with neuroanatomical correlates within normative populations without clinical levels of aggression or antisocial behavior. Here we investigated the relationship between callous-unemotional traits and gray matter volume using voxel-based morphometry in a large sample of typically-developing boys and girls (N = 189). Whole-brain multiple regression analyses controlling for site, total intracranial volume, and age were conducted in the whole sample and in boys and girls individually. Results revealed that sex and callous-unemotional traits interacted to predict gray matter volume when considering the whole sample. This interaction was driven by a significant positive correlation between callous-unemotional traits and bilateral anterior insula volume in boys, but not girls. Insula gray matter volume explained 19% of the variance in callous-unemotional traits for boys. Our results demonstrate that callous-unemotional traits are related to variations in brain structure beyond psychiatric samples. This association was observed for boys only, underlining the importance of considering sex as a factor in future research designs. Future longitudinal studies should determine whether these findings hold over childhood and adolescence, and whether the neuroanatomical correlates of callous-unemotional traits are predictive of future psychiatric vulnerability. General scientific summary This study suggests that callous-unemotional traits have a neuroanatomical correlate within typically developing boys, but not girls. Bilateral anterior insula volume explains up to 19% of the variance in callous-unemotional traits in boys. Sex-specific correlations between callous-unemotional (CU) traits and insula volume. CU-traits are positively linked to anterior insula in typically-developing boys. Variations in insula volume explained 19% of the variance in CU-traits in boys. Accounting for sex in neuroanatomical studies of individual differences is important.
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Affiliation(s)
- Nora Maria Raschle
- Department of Child and Adolescent Psychiatry, University of Basel, Psychiatric University Hospital, Basel, Switzerland.
| | - Willeke Martine Menks
- Department of Child and Adolescent Psychiatry, University of Basel, Psychiatric University Hospital, Basel, Switzerland
| | - Lynn Valérie Fehlbaum
- Department of Child and Adolescent Psychiatry, University of Basel, Psychiatric University Hospital, Basel, Switzerland
| | - Martin Steppan
- Department of Child and Adolescent Psychiatry, University of Basel, Psychiatric University Hospital, Basel, Switzerland
| | - Areti Smaragdi
- Academic Unit of Psychology, University of Southampton, Southampton, England, UK
| | | | - Jack Rogers
- School of Psychology, University of Birmingham, Birmingham, England, UK
| | - Roberta Clanton
- School of Psychology, University of Birmingham, Birmingham, England, UK
| | - Gregor Kohls
- Department of Psychiatry, Psychosomatics and Psychotherapy, Child Neuropsychology Section, University Hospital Aachen, Germany
| | - Anne Martinelli
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Anka Bernhard
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Kerstin Konrad
- Department of Psychiatry, Psychosomatics and Psychotherapy, Child Neuropsychology Section, University Hospital Aachen, Germany; JARA-Brain Institute II, Molecular Neuroscience and Neuroimaging, RWTH Aachen & Research Centre Juelich, Germany
| | - Beate Herpertz-Dahlmann
- Department of Psychiatry, Psychosomatics and Psychotherapy, Child Neuropsychology Section, University Hospital Aachen, Germany; Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of the RWTH, Aachen, Germany
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | | | | | - Christina Stadler
- Department of Child and Adolescent Psychiatry, University of Basel, Psychiatric University Hospital, Basel, Switzerland
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White SF, Zhao H, Leong KK, Smetana JG, Nucci LP, Blair RJR. Neural correlates of conventional and harm/welfare-based moral decision-making. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2017; 17:1114-1128. [PMID: 28952137 PMCID: PMC5711614 DOI: 10.3758/s13415-017-0536-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The degree to which social norms are processed by a unitary system or dissociable systems remains debated. Much research on children's social-cognitive judgments has supported the distinction between "moral" (harm/welfare-based) and "conventional" norms. However, the extent to which these norms are processed by dissociable neural systems remains unclear. To address this issue, 23 healthy participants were scanned with functional magnetic resonance imaging (fMRI) while they rated the wrongness of harm/welfare-based and conventional transgressions and neutral vignettes. Activation significantly greater than the neutral vignette baseline was observed in regions implicated in decision-making regions including rostral/ventral medial frontal, anterior insula and dorsomedial frontal cortices when evaluating both harm/welfare-based and social-conventional transgressions. Greater activation when rating harm/welfare-based relative to social-conventional transgressions was seen through much of ACC and bilateral inferior frontal gyrus. Greater activation was observed in superior temporal gyrus, bilateral middle temporal gyrus, left PCC, and temporal-parietal junction when rating social-conventional transgressions relative to harm/welfare-based transgressions. These data suggest that decisions regarding the wrongness of actions, irrespective of whether they involve care/harm-based or conventional transgressions, recruit regions generally implicated in affect-based decision-making. However, there is neural differentiation between harm/welfare-based and conventional transgressions. This may reflect the particular importance of processing the intent of transgressors of conventional norms and perhaps the greater emotional content or salience of harm/welfare-based transgressions.
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Affiliation(s)
- Stuart F White
- Department of Health and Human Services, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA.
- Boys Town National Research Hospital, Omaha, NE, USA.
| | - Hui Zhao
- Department of Health and Human Services, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
- China University of Political Science and Law, Beijing, China
| | - Kelly Kimiko Leong
- Department of Health and Human Services, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
- Tufts University School of Dental Medicine, Boston, MA, USA
| | | | - Larry P Nucci
- University of California, Berkeley, Berkeley, CA, USA
| | - R James R Blair
- Department of Health and Human Services, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
- Boys Town National Research Hospital, Omaha, NE, USA
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Hwang S, Meffert H, VanTieghem MR, White SF, Sinclair S, Bookheimer SY, Blair J. Neurodevelopmental Changes in Social Reinforcement Processing: A Functional Magnetic Resonance Imaging Study. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2017; 15:369-381. [PMID: 29073749 PMCID: PMC5678476 DOI: 10.9758/cpn.2017.15.4.369] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 06/24/2017] [Accepted: 09/04/2017] [Indexed: 01/10/2023]
Abstract
Objective In the current study we investigated neurodevelopmental changes in response to social and non-social reinforcement. Methods Fifty-three healthy participants including 16 early adolescents (age, 10-15 years), 16 late adolescents (age, 15-18 years), and 21 young adults (age, 21-25 years) completed a social/non-social reward learning task while undergoing functional magnetic resonance imaging. Participants responded to fractal image stimuli and received social or non-social reward/non-rewards according to their accuracy. ANOVAs were conducted on both the blood oxygen level dependent response data and the product of a context-dependent psychophysiological interaction (gPPI) analysis involving ventromedial prefrontal cortex (vmPFC) and bilateral insula cortices as seed regions. Results Early adolescents showed significantly increased activation in the amygdala and anterior insula cortex in response to non-social monetary rewards relative to both social reward/non-reward and monetary non-rewards compared to late adolescents and young adults. In addition, early adolescents showed significantly more positive connectivity between the vmPFC/bilateral insula cortices seeds and other regions implicated in reinforcement processing (the amygdala, posterior cingulate cortex, insula cortex, and lentiform nucleus) in response to non-reward and especially social non-reward, compared to late adolescents and young adults. Conclusion It appears that early adolescence may be marked by: (i) a selective increase in responsiveness to non-social, relative to social, rewards; and (ii) enhanced, integrated functioning of reinforcement circuitry for non-reward, and in particular, with respect to posterior cingulate and insula cortices, for social non-reward.
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Affiliation(s)
- Soonjo Hwang
- Department of Psychiatry, University of Nebraska Medical Center, Omaha, NE, USA
| | - Harma Meffert
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | | | - Stuart F White
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Stephen Sinclair
- Section on Affective Cognitive Neuroscience, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Susan Y Bookheimer
- Brain Research Institute, University of California, Los Angeles, Los Angeles, CA, USA
| | - James Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
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A neurocomputational investigation of reinforcement-based decision making as a candidate latent vulnerability mechanism in maltreated children. Dev Psychopathol 2017; 29:1689-1705. [DOI: 10.1017/s095457941700133x] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractAlterations in reinforcement-based decision making may be associated with increased psychiatric vulnerability in children who have experienced maltreatment. A probabilistic passive avoidance task and a model-based functional magnetic resonance imaging analytic approach were implemented to assess the neurocomputational components underlying decision making: (a) reinforcement expectancies (the representation of the outcomes associated with a stimulus) and (b) prediction error signaling (the ability to detect the differences between expected and actual outcomes). There were three main findings. First, the maltreated group (n = 18; mean age = 13), relative to nonmaltreated peers (n = 19; mean age = 13), showed decreased activity during expected value processing in a widespread network commonly associated with reinforcement expectancies representation, including the striatum (especially the caudate), the orbitofrontal cortex, and medial temporal structures including the hippocampus and insula. Second, consistent with previously reported hyperresponsiveness to negative cues in the context of childhood abuse, the maltreated group showed increased prediction error signaling in the middle cingulate gyrus, somatosensory cortex, superior temporal gyrus, and thalamus. Third, the maltreated group showed increased activity in frontodorsal regions and in the putamen during expected value representation. These findings suggest that early adverse environments disrupt the development of decision-making processes, which in turn may compromise psychosocial functioning in ways that increase latent vulnerability to psychiatric disorder.
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Pu W, Luo Q, Jiang Y, Gao Y, Ming Q, Yao S. Alterations of Brain Functional Architecture Associated with Psychopathic Traits in Male Adolescents with Conduct Disorder. Sci Rep 2017; 7:11349. [PMID: 28900210 PMCID: PMC5595864 DOI: 10.1038/s41598-017-11775-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 08/30/2017] [Indexed: 12/05/2022] Open
Abstract
Psychopathic traits of conduct disorder (CD) have a core callous-unemotional (CU) component and an impulsive-antisocial component. Previous task-driven fMRI studies have suggested that psychopathic traits are associated with dysfunction of several brain areas involved in different cognitive functions (e.g., empathy, reward, and response inhibition etc.), but the relationship between psychopathic traits and intrinsic brain functional architecture has not yet been explored in CD. Using a holistic brain-wide functional connectivity analysis, this study delineated the alterations in brain functional networks in patients with conduct disorder. Compared with matched healthy controls, we found decreased anti-synchronization between the fronto-parietal network (FPN) and default mode network (DMN), and increased intra-network synchronization within the frontothalamic-basal ganglia, right frontoparietal, and temporal/limbic/visual networks in CD patients. Correlation analysis showed that the weakened FPN-DMN interaction was associated with CU traits, while the heightened intra-network functional connectivity was related to impulsivity traits in CD patients. Our findings suggest that decoupling of cognitive control (FPN) with social understanding of others (DMN) is associated with the CU traits, and hyper-functions of the reward and motor inhibition systems elevate impulsiveness in CD.
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Affiliation(s)
- Weidan Pu
- Medical Psychological Center, the Second Xiangya Hospital, Central South University, Changsha, P.R. China
- Medical Psychological Institute of Central South University, Changsha, P.R. China
| | - Qiang Luo
- School of Life Sciences, Fudan University, Shanghai, P.R. China
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, P.R. China
| | - Yali Jiang
- Medical Psychological Center, the Second Xiangya Hospital, Central South University, Changsha, P.R. China
- Medical Psychological Institute of Central South University, Changsha, P.R. China
| | - Yidian Gao
- Medical Psychological Center, the Second Xiangya Hospital, Central South University, Changsha, P.R. China
- Medical Psychological Institute of Central South University, Changsha, P.R. China
| | - Qingsen Ming
- Medical Psychological Center, the Second Xiangya Hospital, Central South University, Changsha, P.R. China
- Medical Psychological Institute of Central South University, Changsha, P.R. China
| | - Shuqiao Yao
- Medical Psychological Center, the Second Xiangya Hospital, Central South University, Changsha, P.R. China.
- Medical Psychological Institute of Central South University, Changsha, P.R. China.
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Sakai JT, Dalwani MS, Mikulich-Gilbertson SK, Raymond K, McWilliams S, Tanabe J, Rojas D, Regner M, Banich MT, Crowley TJ. Imaging decision about whether to benefit self by harming others: Adolescents with conduct and substance problems, with or without callous-unemotionality, or developing typically. Psychiatry Res 2017; 263:103-112. [PMID: 28371655 PMCID: PMC5705947 DOI: 10.1016/j.pscychresns.2017.03.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 01/26/2017] [Accepted: 03/08/2017] [Indexed: 01/12/2023]
Abstract
We sought to identify brain activation differences in conduct-problem youth with limited prosocial emotions (LPE) compared to conduct-problem youth without LPE and community adolescents, and to test associations between brain activation and severity of callous-unemotional traits. We utilized a novel task, which asks subjects to repeatedly decide whether to accept offers where they will benefit but a beneficent other will be harmed. Behavior on this task has been previously associated with levels of prosocial emotions and severity of callous-unemotional traits, and is related to empathic concern. During fMRI acquisition, 66 male adolescents (21 conduct-problem patients with LPE, 21 without, and 24 typically-developing controls) played this novel game. Within typically-developing controls, we identified a network engaged during decision involving bilateral insula, and inferior parietal and medial frontal cortices, among other regions. Group comparisons using non-parametric (distribution-free) permutation tests demonstrated LPE patients had lower activation estimates than typically-developing adolescents in right anterior insula. Additional significant group differences emerged with our a priori parametric cluster-wise inference threshold. These results suggest measurable functional brain activation differences in conduct-problem adolescents with LPE compared to typically-developing adolescents. Such differences may underscore differential treatment needs for conduct-problem males with and without LPE.
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Affiliation(s)
- Joseph T Sakai
- University of Colorado, School of Medicine, Department of Psychiatry, Aurora, CO, USA.
| | - Manish S Dalwani
- University of Colorado, School of Medicine, Department of Psychiatry, Aurora, CO, USA
| | | | - Kristen Raymond
- University of Colorado, School of Medicine, Department of Psychiatry, Aurora, CO, USA
| | - Shannon McWilliams
- University of Colorado, School of Medicine, Department of Psychiatry, Aurora, CO, USA
| | - Jody Tanabe
- University of Colorado, School of Medicine, Department of Radiology, Aurora, CO, USA
| | - Don Rojas
- Colorado State University, Fort Collins, CO, USA
| | - Michael Regner
- University of Colorado, School of Medicine, Department of Radiology, Aurora, CO, USA
| | - Marie T Banich
- University of Colorado Boulder, Institute of Cognitive Science, Boulder, CO, USA
| | - Thomas J Crowley
- University of Colorado, School of Medicine, Department of Psychiatry, Aurora, CO, USA
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Representational Uncertainty in the Brain During Threat Conditioning and the Link With Psychopathic Traits. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2017; 2:689-695. [PMID: 29560903 DOI: 10.1016/j.bpsc.2017.04.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 04/12/2017] [Accepted: 04/12/2017] [Indexed: 12/23/2022]
Abstract
BACKGROUND Psychopathy has repeatedly been linked to disturbed associative learning from aversive events (i.e., threat conditioning). Optimal threat conditioning requires the generation of internal representations of stimulus-outcome contingencies and the rate with which these may change. Because mental representations are imperfect, there will always be uncertainty about the accuracy of representations in the brain (i.e., representational uncertainty). However, it remains unclear 1) to what extent threat conditioning is susceptible to different types of uncertainty in representations about contingencies during the acquisition phase and 2) how representational uncertainty relates to psychopathic features. METHODS A computational model was applied to functional neuroimaging data to estimate uncertainty in representations of contingencies (CoUn) and the rate of change of contingencies (RUn), respectively, from brain activation during the acquisition phase of threat conditioning in 132 adolescents at risk of developing antisocial personality profiles. Next, the associations between these two types of representational uncertainty and psychopathy-related dimensions were examined. RESULTS The left and right amygdala activations were associated with CoUn, while the bilateral insula and the right amygdala were associated with RUn. Different patterns of relationships were found between psychopathic features and each type of uncertainty. Callous-unemotional traits and impulsive-irresponsible traits uniquely predicted increased CoUn, while only impulsive-irresponsible traits predicted increased RUn. CONCLUSIONS The findings suggest that 1) the insula and amygdala differ in how these regions are affected by different types of representational uncertainty during threat conditioning and 2) CoUn and RUn have different patterns of relationships with psychopathy-related dimensions.
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Leibenluft E. Pediatric Irritability: A Systems Neuroscience Approach. Trends Cogn Sci 2017; 21:277-289. [PMID: 28274677 PMCID: PMC5366079 DOI: 10.1016/j.tics.2017.02.002] [Citation(s) in RCA: 116] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 01/27/2017] [Accepted: 02/02/2017] [Indexed: 02/03/2023]
Abstract
Irritability, defined as an increased propensity to exhibit increased anger relative to one's peers, is a common clinical problem in youth. Irritability can be conceptualized as aberrant responses to frustration (where frustration is the emotional response to blocked goal attainment) and/or aberrant 'approach' responses to threat. Irritable youth show hyper-reactivity to threat mediated by dysfunction in amygdala, medial prefrontal cortex (mPFC), anterior cingulate cortex (ACC), insula, striatum, and association cortex. Irritable youth also show abnormalities in reward learning, cognitive control, and responses to frustration. These abnormalities are mediated by circuitry that includes the inferior frontal gyrus (iFG), striatum, ACC, and parietal cortex. Effective treatments for irritability are lacking, but pathophysiological research could lead to more precisely targeted interventions.
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Affiliation(s)
- Ellen Leibenluft
- Section on Bipolar Spectrum Disorders, Emotion and Development Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA.
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Abstract
PURPOSE OF REVIEW Suicide attempts are usually regretted by people who survive them. Furthermore, addiction and gambling are over-represented among people who attempt or die by suicide, raising the question whether their decision-making is impaired. Advances in decision neuroscience have enabled us to investigate decision processes in suicidal people and to elucidate putative neural substrates of disadvantageous decision-making. RECENT FINDINGS Early studies have linked attempted suicide to poor performance on gambling tasks. More recently, functional MRI augmented with a reinforcement learning computational model revealed that impaired decision-making in suicide attempters is paralleled by disrupted expected value (expected reward) signals in the ventromedial prefrontal cortex. Behavioral studies have linked increased delay discounting to low-lethality/poorly planned attempts, multiple attempts, and the co-occurrence of attempted suicide and addiction. This behavioral tendency may be related to altered integrity of the basal ganglia. By contrast, well-planned, serious suicide attempts were associated with intact/diminished delay discounting. One study has linked high-lethality suicide attempts and impaired social decision-making. SUMMARY This emerging literature supports the notion that various impairments in decision-making - often broadly related to impulsivity - may mark different pathways to suicide. We propose that aggressive and self-destructive responses to social stressors in people prone to suicide result from a predominance of automatic, Pavlovian processes over goal-directed computations.
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Affiliation(s)
- R. James R. Blair
- Section of Affective and Cognitive Neuroscience, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, 20892
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