Mediation of the relationship between callous-unemotional traits and proactive aggression by amygdala response to fear among children with conduct problems.
Mediation of the relationship between callous-unemotional traits and proactive aggression by amygdala response to fear among children with conduct problems.
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DOI：
10.1001/jamapsychiatry.2013.4540
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发表时间：
2014-06
期刊：
影响因子：
25.8
通讯作者：
Marsh, Abigail A.
中科院分区：
文献类型：
--
作者：
Lozier, Leah M.;Cardinale, Elise M.;VanMeter, John W.;Marsh, Abigail A.
在有行为问题的青少年中，冷酷无情（CU）的特征被认为是症状严重程度、预后和治疗反应性的重要决定因素。但是行为问题和CU特征之间的正相关导致了抑制效应，这可能掩盖了行为问题儿童亚组之间重要的神经生物学差异。评估青少年行为问题中CU特征和外化行为的独特神经生物学协变量，并确定与CU特征相关的神经功能障碍是否介导了冷酷和主动攻击之间的联系。这项横断面病例对照研究包括在一所大学研究机构进行的行为测试和神经成像。神经影像学采用3-T西门子磁共振成像扫描仪。它包括46名社区招募的10至17岁的男女青少年，其中包括16名健康对照参与者和30名具有低水平和高水平CU特征的行为问题的青少年。内隐面部情绪处理任务中，通过功能磁共振成像测量血氧水平依赖信号，并使用全脑和基于兴趣的区域方差分析和多元回归分析进行分析。方差分析显示，杏仁核没有组间差异。相比之下，与抑制效应的存在一致，多元回归分析发现，当两个变量同时建模时，杏仁核对恐惧表达的反应与CU特征（x = 26, y = 0, z = - 12, k = 1）呈负相关，与外化行为（x = 24, y = 0, z = - 14, k = 8）呈正相关。减少的杏仁核反应介导了CU性状与主动攻击的关系。结果表明，具有CU特征的青少年的主动攻击行为与杏仁核对情绪困扰线索的反应不活跃有关，这与具有这些特征的青少年的外化行为，特别是主动攻击行为源于对痛苦缺乏共情反应的理论一致。杏仁核活性低下可能代表一种中间表型，为行为问题的有效治疗策略提供了新的见解。
Among youths with conduct problems, callous-unemotional (CU) traits are known to be an important determinant of symptom severity, prognosis, and treatment responsiveness. But positive correlations between conduct problems and CU traits result in suppressor effects that may mask important neurobiological distinctions among subgroups of children with conduct problems. To assess the unique neurobiological covariates of CU traits and externalizing behaviors in youths with conduct problems and determine whether neural dysfunction linked to CU traits mediates the link between callousness and proactive aggression. This cross-sectional case-control study involved behavioral testing and neuroimaging that were conducted at a university research institution. Neuroimaging was conducted using a 3-T Siemens magnetic resonance imaging scanner. It included 46 community-recruited male and female juveniles aged 10 to 17 years, including 16 healthy control participants and 30 youths with conduct problems with both low and high levels of CU traits. Blood oxygenation level–dependent signal as measured via functional magnetic resonance imaging during an implicit face-emotion processing task and analyzed using whole-brain and region of interest–based analysis of variance and multiple-regression analyses. Analysis of variance revealed no group differences in the amygdala. By contrast, consistent with the existence of suppressor effects, multiple-regression analysis found amygdala responses to fearful expressions to be negatively associated with CU traits (x = 26, y = 0, z = −12; k = 1) and positively associated with externalizing behavior (x = 24, y = 0, z = −14; k = 8) when both variables were modeled simultaneously. Reduced amygdala responses mediated the relationship between CU traits and proactive aggression. The results linked proactive aggression in youths with CU traits to hypoactive amygdala responses to emotional distress cues, consistent with theories that externalizing behaviors, particularly proactive aggression, in youths with these traits stem from deficient empathic responses to distress. Amygdala hypoactivity may represent an intermediate phenotype, offering new insights into effective treatment strategies for conduct problems.
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