Neural Correlates of the Propensity for Retaliatory Behavior in Youths With Disruptive Behavior Disorders.
Neural Correlates of the Propensity for Retaliatory Behavior in Youths With Disruptive Behavior Disorders.
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DOI：
10.1176/appi.ajp.2015.15020250
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发表时间：
2016-03-01
期刊：
影响因子：
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通讯作者：
Blair RJ
中科院分区：
文献类型：
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作者：
White SF;VanTieghem M;Brislin SJ;Sypher I;Sinclair S;Pine DS;Hwang S;Blair RJ
具有破坏性行为障碍（DBD：行为障碍/对立违抗障碍）的青少年发生适应不良反应性攻击的风险增加。理论表明，这是由于在DBD青年中涉及报复（杏仁核/导水管周围灰质）的基本威胁回路的敏感性增加，以及DBD青年中无论冷酷无情特征如何，冷酷无情特征和腹内侧前额叶皮层（vmPFC）内功能失调的调节活动。五十六名10-18岁的青少年（23名女性）（26名健康，30名DBD [15名高，15名低冷酷无情特质]）在功能性MRI期间完成了最后通牒游戏。与对照组相比，具有DBD和低冷酷无情特征的青少年在惩罚他人时，基本威胁回路的激活增加更大，并且在报复过程中vmPFC功能失调。与健康青年相比，所有患有DBD的青年在高激发期间表现出杏仁核-vmPFC连接性降低。VMPFC反应性和VMPFC-杏仁核连接与患者的报复倾向（任务期间的行为反应）和父母报告的反应性攻击有关。这些数据表明，DBD青年的适应不良反应性攻击的潜在神经生物学差异，以及相对于高水平的冷酷无情的特征。与DBD和低冷酷无情的特质单独显示出显着更大的威胁反应，在报复相对于比较个人的青年。此外，这些数据表明，vmPFC-杏仁核连接是至关重要的调节报复/反应性攻击和功能障碍时，有助于反应性攻击，独立于水平的冷酷无情的特征。
Youth with Disruptive Behavior Disorders (DBD: Conduct Disorder/Oppositional Defiant Disorder) are at increased risk for maladaptive reactive aggression. Theory suggests this is due to increased sensitivity of basic threat circuitry implicated in retaliation (amygdala/periaqueductal gray) in youth with DBD and low levels of Callous-Unemotional Traits and dysfunctional regulatory activity within ventromedial prefrontal cortex (vmPFC) in youth with DBD irrespective of callous-unemotional traits. Fifty-six youths participated (23 female) aged 10–18 (26 healthy and 30 with DBD [15 with high and 15 with low callous-unemotional traits]) who completed an Ultimatum Game during functional MRI. Youth with DBD and low callous-unemotional traits showed greater increases in activation of basic threat circuitry when punishing others relative to comparison groups and dysfunctional down regulation of vmPFC during retaliation. All youth with DBD showed reduced amygdala-vmPFC connectivity during high provocation relative to healthy youth. VmPFC responsiveness and vmPFC-amygdala connectivity were related to patients’ retaliatory propensity (behavioral responses during task) and parent reported reactive aggression. These data suggest differences in the underlying neurobiology of maladaptive reactive aggression in youth with DBD and low relative to high levels of callous-unemotional traits. Youth with DBD and low callous-unemotional traits alone show significantly greater threat responses during retaliation relative to comparison individuals. Moreover, these data suggest that vmPFC-amygdala connectivity is critical for regulating retaliation/reactive aggression and when dysfunctional, contributes to reactive aggression, independent of level of callous-unemotional traits.