Emotional processing in male adolescents with childhood-onset conduct disorder
Emotional processing in male adolescents with childhood-onset conduct disorder
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DOI：
10.1111/j.1469-7610.2008.01905.x
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发表时间：
2008-07-01
影响因子：
7.6
通讯作者：
Herpertz-Dahlmann, Beate
中科院分区：
文献类型：
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作者：
Herpertz, Sabine C.;Huebner, Thomas;Herpertz-Dahlmann, Beate
背景：患有早发行为障碍（CD）的男孩，其中大多数也符合共病注意力缺陷多动障碍（ADHD）的诊断标准，在整个发育过程中往往表现出高水平的攻击性。虽然已经在反社会成年人中进行了许多关于情绪处理的功能神经影像学研究，但人们对 CD 儿童如何处理情绪信息知之甚少。方法：对 22 名 12 至 17 岁患有儿童期 CD 的男性青少年（其中 16 名患有 ADHD 合并症）的功能磁共振成像数据进行分析，并与 22 名年龄匹配的男性健康对照者进行比较。为了考虑 ADHD 合并症可能导致的结果混杂，我们进行了一项补充研究，纳入了 13 名患有单纯 ADHD 的青少年受试者，并与健康对照组进行了比较。为了挑战刺激的情绪处理，应用了被动观看任务，呈现消极、积极或中性价的图片。结果：当比较 CD/混合性疾病患者与健康对照时，我们发现与中性图片相比，患者组中的左侧杏仁核对阴性图片的反应增强。此外，这些男孩的眶额皮质、前扣带皮层和岛叶皮质的激活没有减少。相比之下，患有单纯注意力缺陷多动症的儿童杏仁核激活没有表现出任何异常，但仅在对负面图片做出反应时才表现出岛叶神经活动减少。结论：我们的研究中发现杏仁核激活增加而不是减少，可能表明患有早发性 CD 的青少年（其中大多数也符合 ADHD 的条件）对环境线索的反应增强，并且与注意社会环境中情感信息的能力降低的假设不一致。需要进一步研究，重点关注情感调节的发展方面，以澄清 CD 和与不同模式的持续反社会行为相关的成人人格病理之间的关系。
Background: Boys with early onset of conduct disorder (CD), most of whom also meet diagnostic criteria of a comorbid attention deficit hyperactivity disorder (ADHD), tend to exhibit high levels of aggression throughout development. While a number of functional neuroimaging studies on emotional processing have been performed in antisocial adults, little is known about how CD children process emotional information. Method: Functional magnetic resonance imaging data were analyzed in 22 male adolescents aged 12 to 17 years with childhood-onset CD (16 of them with comorbid ADHD) compared to 22 age-matched male healthy controls. In order to consider the likely confounding of results through ADHD comorbidity, we performed a supplementary study including 13 adolescent subjects with pure ADHD who were compared with healthy controls. To challenge emotional processing of stimuli, a passive viewing task was applied, presenting pictures of negative, positive or neutral valence. Results: When comparing CD/combined disorder patients with healthy controls, we found enhanced left-sided amygdala activation in response to negative pictures as compared to neutral pictures in the patient group. In addition, these boys exhibited no reduced activation in the orbitofrontal, anterior cingulate and insular cortices. By contrast, children with pure ADHD did not show any abnormalities in amygdala activation but showed decreased neural activity in the insula only in response to negative pictures. Conclusions: Increased rather than reduced amygdala activation found in our study may indicate an enhanced response to environmental cues in adolescents with early-onset CD (most of whom also met the condition of ADHD), and is not consistent with the assumption of a reduced capacity to take note of affective information in the social environment. Further studies with an emphasis on developmental aspects of affect regulation are needed to clarify the relationship between CD and adult personality pathology associated with different modes of persistent antisocial behavior.