Emotional dysfunction and childhood behavioral disturbance

情绪功能障碍和儿童行为障碍

基本信息

批准号：
7735189
负责人：
James Blair
金额：
$ 83.85万
依托单位：
NATIONAL INSTITUTE OF MENTAL HEALTH
依托单位国家：
美国
项目类别：
财政年份：
资助国家：
美国
起止时间：
至
项目状态：
未结题

项目摘要

In previous work, we primarily used neuropsychological investigations to determine the functional impairments associated with CD+CU. We identified that adolescents with this disorder showed marked difficulties with: (1) the recognition of fearful expressions, a neuropsychological marker of amygdala dysfunction; (2) a basic form of emotional learning, stimulus-reinforcement association, which is critical for socialization (and also is amygdala dependent); (3) decision making reliant on the appropriate representation of outcome reinforcement information, a neuropsychological marker of dysfunction within ventromdial prefrontal cortex. In our most recent work, we have used event related functional Magnetic Resonance Imaging to directly assess whether the amygdala and ventromedial prefrontal cortex is functioning atypically in adolescents with CD+CU. In particular, in one study we specifically addressed the neural responses of adolescents with CD+CU to fearful and angry expressions. An appropriate response to expressions, particularly fearful expressions, is important for moral socialization. This study revealed that adolescents with CD+CU showed reduced amygdala responses to fearful expressions and reduced connectivity between the amygdala and ventromedial prefrontal cortex when processing fearful expressions when compared with both typically developing adolescents and adolescents with Attention Deficit Hyperactivity Disorder (ADHD). Interesting, there were no group differences in the response to angry expressions. The processing of this expression is not typically reliant on the amygdala. In short, this study suggested: First, specificity in the nature of the impairment seen in adolescents with CD+CU the dysfunctional responding was specific for fearful expressions and not seen to neutral or angry expressions. Second, selectivity of the impairment in adolescents with CD+CU comparable impairment was not seen in adolescents with ADHD. In another recent fMRI study with adolescents with CD+CU, we examined the functioning of ventromedial frontal cortex and other frontal systems during reversal learning. Reversal learning indexes the individuals ability to change a response when it is no longer being rewarded. This ability is important because it reduces the probability that the individual with experience frustration and rage on the basis of continuing to do actions that no longer achieve their goals. In our previous neuropsychological work, we had observed that adolescents with CD+CU had marked difficulties with reversal learning. In our recent fMRI study, we identified the neural basis of this difficulty. Specifically, while typically developing adolescents and adolescents with ADHD, as well as healthy adults, show a reduced response within ventromedial frontal cortex when an action results in an unexpected punishment (a cue that behavior should change), adolescents with CD+CU do not. This prediction error signal is particularly important for learning and making sure that the individual does not return to now bad response.

在之前的工作中，我们主要使用神经心理学研究来确定与 CD+CU 相关的功能障碍。我们发现患有这种疾病的青少年在以下方面表现出明显的困难：（1）识别恐惧的表情，这是杏仁核功能障碍的神经心理学标志；（2）情绪学习的基本形式，即刺激强化关联，这对于社会化至关重要（并且依赖于杏仁核）；（3）决策依赖于结果强化信息的适当表示，这是腹内侧前额叶皮层功能障碍的神经心理学标志。在我们最近的工作中，我们使用事件相关的功能磁共振成像来直接评估 CD+CU 青少年的杏仁核和腹内侧前额叶皮层是否功能异常。特别是，在一项研究中，我们专门研究了 CD+CU 青少年对恐惧和愤怒表情的神经反应。对表达，特别是恐惧表达的适当反应对于道德社会化很重要。这项研究表明，与正常发育的青少年和患有注意力缺陷多动障碍 (ADHD) 的青少年相比，患有 CD+CU 的青少年在处理恐惧表达时，杏仁核对恐惧表达的反应减少，杏仁核和腹内侧前额叶皮层之间的连接性减少。有趣的是，对愤怒表情的反应没有群体差异。该表达的处理通常不依赖于杏仁核。简而言之，这项研究表明：首先，在患有 CD+CU 的青少年中观察到的损伤性质具有特异性，功能失调的反应是针对恐惧表情的，而不是针对中性或愤怒表情的。其次，在患有 ADHD 的青少年中，没有发现 CD+CU 青少年的损伤具有可比损伤的选择性。在最近另一项针对患有 CD+CU 的青少年的功能磁共振成像研究中，我们检查了逆转学习过程中腹内侧额叶皮层和其他额叶系统的功能。逆向学习反映了个体在不再获得奖励时改变反应的能力。这种能力很重要，因为它降低了个体因继续做不再实现其目标的行为而感到沮丧和愤怒的可能性。在我们之前的神经心理学工作中，我们观察到患有CD+CU的青少年在逆转学习方面有明显的困难。在我们最近的功能磁共振成像研究中，我们确定了这一困难的神经基础。具体来说，虽然通常患有 ADHD 的青少年和健康成年人在某个行为导致意外惩罚（行为应该改变的提示）时，腹内侧额叶皮质内的反应会减弱，但患有 CD+CU 的青少年则不会。这种预测误差信号对于学习和确保个体不会回到现在的不良反应特别重要。