Publications by authors named "Deanna M Barch"

431 Publications

A Brief Early Childhood Screening Tool for Psychopathology Risk in Primary Care: The Moderating Role of Poverty.

J Pediatr 2021 Apr 27. Epub 2021 Apr 27.

Washington University in St. Louis, Department of Psychiatry, St. Louis, Missouri, USA.

Objective(s): To evaluate the Preschool Feeling Checklist (PFC) utility for predicting later mental disorders and functioning for children and assess whether the PFC's predictive utility differs as a function of childhood poverty.

Study Design: We analyzed data from a prospective longitudinal study of preschoolers in St. Louis. Preschoolers (N=287) were recruited from primary care sites and were annually assessed for 10-15 years. The PFC screened for depressive symptoms. Later age-appropriate psychiatric diagnostic interviews were used to derive DSM diagnoses. Regression and moderation analyses, and multilevel modeling were used to test the association between the PFC and later outcomes, and whether this relationship was moderated by income-to-needs.

Results: The PFC predicted MDD (OR: 1.13, p<.001), ADHD (OR: 1.16, p<.001) and Mania (OR: 1.18, p<.05) in adolescence and early adulthood. Income-to-needs was a moderator in the predictive pathway between the PFC and later MDD (OR: 1.10, p<.05) and Mania (OR: 1.19, p<.001) with the measure less predictive for children living in poverty. The PFC predicted worse functioning by the final assessment (b = 1.71, SE = 0.51, p = .001).

Conclusions: The PFC served as an indicator of risk for later ADHD and impairment in all children. It has predictive utility for later mood disorders only in children living above the poverty line. Predicting depression in children living below the poverty line may require consideration of risk factors not covered by the PFC.
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http://dx.doi.org/10.1016/j.jpeds.2021.04.042DOI Listing
April 2021

Reliability and Replicability of Implicit and Explicit Reinforcement Learning Paradigms in People With Psychotic Disorders.

Schizophr Bull 2021 04;47(3):731-739

Department of Psychology, University of Minnesota, Minneapolis, MN.

Background: Motivational deficits in people with psychosis may be a result of impairments in reinforcement learning (RL). Therefore, behavioral paradigms that can accurately measure these impairments and their change over time are essential.

Methods: We examined the reliability and replicability of 2 RL paradigms (1 implicit and 1 explicit, each with positive and negative reinforcement components) given at 2 time points to healthy controls (n = 75), and people with bipolar disorder (n = 62), schizoaffective disorder (n = 60), and schizophrenia (n = 68).

Results: Internal consistency was acceptable (mean α = 0.78 ± 0.15), but test-retest reliability was fair to low (mean intraclass correlation = 0.33 ± 0.25) for both implicit and explicit RL. There were no clear effects of practice for these tasks. Largely, performance on these tasks shows intact implicit and impaired explicit RL in psychosis. Symptom presentation did not relate to performance in any robust way.

Conclusions: Our findings replicate previous literature showing spared implicit RL and impaired explicit reinforcement in psychosis. This suggests typical basal ganglia dopamine release, but atypical recruitment of the orbitofrontal and dorsolateral prefrontal cortices. However, we found that these tasks have only fair to low test-retest reliability and thus may not be useful for assessing change over time in clinical trials.
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http://dx.doi.org/10.1093/schbul/sbaa165DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8084427PMC
April 2021

Neonatal Brain Response to Deviant Auditory Stimuli and Relation to Maternal Trait Anxiety.

Am J Psychiatry 2021 Apr 26:appiajp202020050672. Epub 2021 Apr 26.

Department of Psychiatry (Sylvester, Myers, Perino, T.A. Smyser, Barch, Luby, Rogers), Department of Neurology (Kaplan, Kenley, C.D. Smyser), Department of Pediatrics (Warner, Rogers, C.D. Smyser), Department of Radiology (Barch, C.D. Smyser), and Department of Psychological and Brain Sciences (Barch), Washington University, St. Louis; Emotion and Development Branch, NIMH, Bethesda, Md. (Pine).

Objective: Excessive response to unexpected or "deviant" stimuli during infancy and early childhood represents an early risk marker for anxiety disorders. However, research has yet to delineate the specific brain regions underlying the neonatal response to deviant stimuli near birth and the relation to risk for anxiety disorders. The authors used task-based functional MRI (fMRI) to delineate the neonatal response to deviant stimuli and its relationship to maternal trait anxiety.

Methods: The authors used fMRI to measure brain activity evoked by deviant auditory stimuli in 45 sleeping neonates (mean age, 27.8 days; 60% female; 64% African American). In 41 of the infants, neural response to deviant stimuli was examined in relation to maternal trait anxiety on the State-Trait Anxiety Inventory, a familial risk factor for offspring anxiety.

Results: Neonates manifested a robust and widespread neural response to deviant stimuli that resembles patterns found previously in adults. Higher maternal trait anxiety was related to higher responses within multiple brain regions, including the left and right anterior insula, the ventrolateral prefrontal cortex, and multiple areas within the anterior cingulate cortex. These areas overlap with brain regions previously linked to anxiety disorders and other psychiatric illnesses in adults.

Conclusions: The neural architecture sensitive to deviant stimuli robustly functions in newborns. Excessive responsiveness of some circuitry components at birth may signal risk for anxiety and other psychiatric disorders.
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http://dx.doi.org/10.1176/appi.ajp.2020.20050672DOI Listing
April 2021

Using Computational Modelling to Capture Schizophrenia-Specific Reinforcement Learning Differences and Their Implications on Patient Classification.

Biol Psychiatry Cogn Neurosci Neuroimaging 2021 Apr 17. Epub 2021 Apr 17.

Background: Psychiatric diagnosis and treatment have historically taken a symptom-based approach, with less attention on identifying underlying symptom-producing mechanisms. Recent efforts have illuminated the extent to which different underlying circuitry can produce phenotypically similar symptomatology (e.g. psychosis in bipolar disorder vs schizophrenia). Computational modelling makes it possible to identify and mathematically differentiate behaviorally-unobservable, specific reinforcement-learning (RL) differences in schizophrenia (SZ) patients versus other disorders, likely due to a higher reliance on prediction-error(PE)-driven learning associated with basal ganglia, and under-reliance on explicit value representations associated with OFC.

Methods: We use a well-established probabilistic-RL task to replicate those findings in individuals with schizophrenia both on (N=120) and off (N=44) anti-psychotic medications, and include a patient comparison group of bipolar patients with psychosis (N=60) and healthy controls (n=72).

Results: Using accuracy, there was a main effect of group (F(3,279)=7.87, p<0.001, such that all patients groups were less accurate than controls. Using computationally derived parameters, both medicated and unmediated individuals with SZ, but not bipolar patients, demonstrated a reduced "mixing" parameter (F(3,295)=13.91,p<0.001), indicating less dependence on learning explicit value representations, as well as greater learning decay between training and test (F(1,289)=12.81, p<0.001). Unmedicated SZ also showed greater decision noise (F(3,295)=2.67, p=0.04).

Conclusions: Both medicated and unmedicated patients show overreliance on PE-driven learning, as well as significantly higher noise and value-related memory decay, compared to the healthy controls and the bipolar patients. Additionally, the computational model parameters capturing these processes can significantly improve patient/control classification, potentially providing useful diagnosis insight.
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http://dx.doi.org/10.1016/j.bpsc.2021.03.017DOI Listing
April 2021

Brain network mechanisms of visual shape completion.

Neuroimage 2021 Apr 18;236:118069. Epub 2021 Apr 18.

Center for Molecular and Behavioral Neuroscience, Rutgers, The State University of New Jersey, 197 University Ave 07102, USA.

Visual shape completion recovers object shape, size, and number from spatially segregated edges. Despite being extensively investigated, the process's underlying brain regions, networks, and functional connections are still not well understood. To shed light on the topic, we scanned (fMRI) healthy adults during rest and during a task in which they discriminated pac-man configurations that formed or failed to form completed shapes (illusory and fragmented condition, respectively). Task activation differences (illusory-fragmented), resting-state functional connectivity, and multivariate patterns were identified on the cortical surface using 360 predefined parcels and 12 functional networks composed of such parcels. Brain activity flow mapping (ActFlow) was used to evaluate the likely involvement of resting-state connections for shape completion. We identified 36 differentially-active parcels including a posterior temporal region, PH, whose activity was consistent across 95% of observers. Significant task regions primarily occupied the secondary visual network but also incorporated the frontoparietal, dorsal attention, default mode, and cingulo-opercular networks. Each parcel's task activation difference could be modeled via its resting-state connections with the remaining parcels (r=.62, p<10), suggesting that such connections undergird shape completion. Functional connections from the dorsal attention network were key in modelling task activation differences in the secondary visual network. Dorsal attention and frontoparietal connections could also model activations in the remaining networks. Taken together, these results suggest that shape completion relies upon a sparsely distributed but densely interconnected network coalition that is centered in the secondary visual network, coordinated by the dorsal attention network, and inclusive of at least three other networks.
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http://dx.doi.org/10.1016/j.neuroimage.2021.118069DOI Listing
April 2021

Callous-unemotional Traits as an Intervention Target and Moderator of Parent-Child Interaction Therapy-Emotion Development Treatment for Preschool Depression and Conduct Problems.

J Am Acad Child Adolesc Psychiatry 2021 Apr 12. Epub 2021 Apr 12.

Washington University School of Medicine, Saint Louis, Missouri.

Objective: Callous-unemotional (CU) traits-characterized by low empathy, prosociality, and guilt-predict severe and persistent conduct problems. Although some interventions for conduct problems have been less effective in children with high levels of CU traits, studies have not examined whether CU traits interfere with treatment for other childhood disorders. Moreover, few treatments have demonstrated efficacy in decreasing CU traits themselves in early childhood. This study examined whether Parent-Child Interaction Therapy-Emotion Development (PCIT-ED), a novel PCIT adaptation that promotes emotional competence with demonstrated efficacy in treating preschool-onset Major Depressive Disorder (PO-MDD) and Oppositional Defiant Disorder (ODD), was also effective in treating these disorders in children displaying higher levels of CU traits. The study also examined whether PCIT-ED treatment produced significant and sustained decreases in CU traits.

Method: This study examined 3-to 5-year-olds (N=114) with PO-MDD who completed the PCIT-ED trial. Children were randomized to either immediate PCIT-ED treatment (n=64) or a wait list (WL) control condition (n=50) in which they received the active treatment after 18 weeks. Children's psychiatric diagnoses and severity and CU traits were assessed at baseline, immediately after treatment, and 18 weeks after treatment completion.

Results: Compared to the WL, PCIT-ED effectively reduced MDD and ODD in preschoolers, regardless of initial levels of CU traits. Moreover, CU traits decreased from pre- to post-treatment, and this treatment effect was sustained 18 weeks post-treatment.

Conclusion: Results support that novel interventions that enhance emotional development display significant promise in treating CU traits-behaviors that left untreated predict severe conduct problems, criminality and substance use.
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http://dx.doi.org/10.1016/j.jaac.2021.03.018DOI Listing
April 2021

Evidence for dissociable cognitive and neural pathways from poverty versus maltreatment to deficits in emotion regulation.

Dev Cogn Neurosci 2021 Apr 8;49:100952. Epub 2021 Apr 8.

Department of Psychological & Brain Sciences at Washington University in St. Louis, United States; Department of Psychiatry at Washington University in St. Louis, United States; Department of Radiology at Washington University in St. Louis, United States.

Poverty and threat exposure (TE) predict deficits in emotion regulation (ER). Effective cognitive ER (i.e., reappraisal) may be supported by: (1) cognitive processes implicated in generating and implementing cognitive reappraisal, supported by activation in brain regions involved in cognitive control (e.g., frontal, insular, and parietal cortices) and (2) emotion processing and reactivity, involving identification, encoding, and maintenance of emotional states and related variation in brain activity of regions involved in emotional reactivity (i.e., amygdala). Poverty is associated with deficits in cognitive control, and TE with alterations in emotion processing and reactivity. Our goal was to identify dissociable emotional and cognitive pathways to ER deficits from poverty and TE. Measures of cognitive ability, emotional processing and reactivity, ER, and neural activity during a sadness ER task, were examined from a prospective longitudinal study of youth at risk for depression (n = 139). Both cognitive ability and left anterior insula extending into the frontal operculum activity during a sadness reappraisal task mediated the relationship between poverty and ER. Emotion processing/reactivity didn't mediate the relationship of TE to ER. Findings support a cognitive pathway from poverty to ER deficits. They also underscore the importance of dissociating mechanisms contributing to ER impairments from adverse early childhood experiences.
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http://dx.doi.org/10.1016/j.dcn.2021.100952DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8050852PMC
April 2021

Contributions from resting state functional connectivity and familial risk to early adolescent-onset MDD: Results from the Adolescent Brain Cognitive Development study.

J Affect Disord 2021 May 16;287:229-239. Epub 2021 Mar 16.

Department of Psychological & Brain Sciences, Washington University, Campus Box 1125, 1 Brookings Drive, St. Louis, MO 63130 USA; Department of Psychiatry, Washington University, St. Louis, MO USA; Department of Radiology, Washington University, St. Louis, MO USA.

Background: Family history of Major Depressive Disorder (MDD) is a robust predictor of MDD onset, especially in early adolescence. We examined the relationships between familial risk for depression and alterations to resting state functional connectivity (rsFC) within the default mode network (wDMN) and between the DMN and the left/right hippocampus (DMN-LHIPP/DMN-RHIPP) to the risk for early adolescent MDD onset.

Methods: We examined 9403 youth aged nine to eleven from the Adolescent Brain Cognitive Development study. Depressive symptoms were measured with the parent-reported Child Behavior Checklist. Both youth and their parents completed the Kiddie Schedule for Affective Disorders and Schizophrenia, which provided MDD diagnoses. A family history screen was administered to determine familial risk for depression. Youth underwent a resting state functional magnetic resonance imaging scan, providing us with rsFC data.

Results: Negative wDMN rsFC was associated with child-reported current depression, both child- and parent-reported past depression, and parent-reported current depressive symptoms. No difference was found in wDMN, DMN-LHIPP or DMN-RHIPP rsFC in children with or without familial risk for depression. Familial risk for depression interacted with wDMN rsFC in association with child-reported past MDD diagnosis and parent-reported current depressive symptoms.

Limitations: Information such as length of depressive episodes and age of onset of depression was not collected.

Conclusions: Altered wDMN rsFC in youth at familial risk for depression may be associated with increased risk for MDD onset in adolescence, but longitudinal studies are needed to test this hypothesis.
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http://dx.doi.org/10.1016/j.jad.2021.03.031DOI Listing
May 2021

Effort in daily life: relationships between experimental tasks and daily experience.

Motiv Sci 2020 Sep 3;6(3):303-308. Epub 2019 Oct 3.

Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO 63130.

Recently, experimental tasks have been developed which index individual differences in willingness to expend effort for reward. However, little is known regarding whether such measures are associated with daily experience of effort. To test this, 31 participants completed an ecological momentary assessment (EMA) protocol, answering surveys regarding the mental and physical demand of their daily activities, and also completed two effort-based decision-making tasks: the Effort Expenditure for Rewards Task (EEfRT) and the Cognitive Effort Discounting (COGED) Task. Individuals who reported engaging in more mentally and physically demanding activities via EMA were also more willing to expend effort in the COGED task. However, EMA variables were not significantly associated with EEfRT decision-making. The results demonstrate the ecological, discriminant, and incremental validity of the COGED task, and provide preliminary evidence that individual differences in daily experience of effort may arise, in part, from differences in trait-level tendencies to weigh the costs versus benefits of actions.
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http://dx.doi.org/10.1037/mot0000159DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7989786PMC
September 2020

Effort, avolition and motivational experience in schizophrenia: Analysis of behavioral and neuroimaging data with relationships to daily motivational experience.

Clin Psychol Sci 2020 May 22;8(3):555-568. Epub 2020 Apr 22.

Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO 63130.

Recent research suggests that schizophrenia is associated with reduced effort allocation. We examined willingness to expend effort, neural correlates of effort allocation, and the relationship of effort to daily motivational experience in schizophrenia. We recruited 28 individuals with schizophrenia and 30 controls to perform an effort task during fMRI. Individuals with schizophrenia also completed an ecological momentary assessment (EMA) protocol. Individuals with schizophrenia with high negative symptoms were less willing to expend effort for rewards. Daily EMA assessments of motivation were positively associated with effort allocation at a trend-level. Individuals with schizophrenia and controls displayed similar increases in BOLD activation in frontal, cingulate, parietal, and insular regions during effort-based decision-making. However, negative symptoms were associated with reduced BOLD activation in bilateral ventral striatum. These results replicate previous reports of reduced effort allocation in schizophrenia patients with severe negative symptoms, and provide evidence for the role of ventral striatum in effort impairments.
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http://dx.doi.org/10.1177/2167702620901558DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7983405PMC
May 2020

Rates of Incidental Findings in Brain Magnetic Resonance Imaging in Children.

JAMA Neurol 2021 May;78(5):578-587

Department of Psychiatry, University of Maryland, Baltimore.

Importance: Incidental findings (IFs) are unexpected abnormalities discovered during imaging and can range from normal anatomic variants to findings requiring urgent medical intervention. In the case of brain magnetic resonance imaging (MRI), reliable data about the prevalence and significance of IFs in the general population are limited, making it difficult to anticipate, communicate, and manage these findings.

Objectives: To determine the overall prevalence of IFs in brain MRI in the nonclinical pediatric population as well as the rates of specific findings and findings for which clinical referral is recommended.

Design, Setting, And Participants: This cohort study was based on the April 2019 release of baseline data from 11 810 children aged 9 to 10 years who were enrolled and completed baseline neuroimaging in the Adolescent Brain Cognitive Development (ABCD) study, the largest US population-based longitudinal observational study of brain development and child health, between September 1, 2016, and November 15, 2018. Participants were enrolled at 21 sites across the US designed to mirror the demographic characteristics of the US population. Baseline structural MRIs were centrally reviewed for IFs by board-certified neuroradiologists and findings were described and categorized (category 1, no abnormal findings; 2, no referral recommended; 3; consider referral; and 4, consider immediate referral). Children were enrolled through a broad school-based recruitment process in which all children of eligible age at selected schools were invited to participate. Exclusion criteria were severe sensory, intellectual, medical, or neurologic disorders that would preclude or interfere with study participation. During the enrollment process, demographic data were monitored to ensure that the study met targets for sex, socioeconomic, ethnic, and racial diversity. Data were analyzed from March 15, 2018, to November 20, 2020.

Main Outcomes And Measures: Percentage of children with IFs in each category and prevalence of specific IFs.

Results: A total of 11 679 children (52.1% boys, mean [SD] age, 9.9 [0.62] years) had interpretable baseline structural MRI results. Of these, 2464 participants (21.1%) had IFs, including 2013 children (17.2%) assigned to category 2, 431 (3.7%) assigned to category 3, and 20 (0.2%) assigned to category 4. Overall rates of IFs did not differ significantly between singleton and twin gestations or between monozygotic and dizygotic twins, but heritability analysis showed heritability for the presence or absence of IFs (h2 = 0.260; 95% CI, 0.135-0.387).

Conclusions And Relevance: Incidental findings in brain MRI and findings with potential clinical significance are both common in the general pediatric population. By assessing IFs and concurrent developmental and health measures and following these findings over the longitudinal study course, the ABCD study has the potential to determine the significance of many common IFs.
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http://dx.doi.org/10.1001/jamaneurol.2021.0306DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7985817PMC
May 2021

Amygdala Activation in Cognitive Task fMRI Varies with Individual Differences in Cognitive Traits.

Cogn Affect Behav Neurosci 2021 Feb 8;21(1):254-264. Epub 2021 Mar 8.

Department of Psychiatry, Washington University, 4525 Scott Avenue, St. Louis, MO, 63110, USA.

The amygdala has been implicated in processing threat and learning fear. However, the amygdala also responds to motivationally relevant stimuli even in the absence of explicit emotional content. We investigated the relationship among amygdala activation, cognitive and emotional factors, and fMRI task data in participants from the Young Adult Human Connectome Project. We expected to see variation in amygdala activation that corresponded with variation in traits that could affect the salience of task related stimuli (i.e., internalizing symptoms and fearful faces). We found no relationship between amygdala activation during face viewing and emotion related traits. However, amygdala activation under working memory load was negatively correlated with fluid intelligence and reading level. There also was a negative relationship between task performance and activation in the amygdala. The observed relationship suggests that the role of amygdala is not limited to the processing of emotional content of incoming information but is instead related to salience, which can be influenced by individual differences.
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http://dx.doi.org/10.3758/s13415-021-00863-3DOI Listing
February 2021

Correspondence Between Perceived Pubertal Development and Hormone Levels in 9-10 Year-Olds From the Adolescent Brain Cognitive Development Study.

Front Endocrinol (Lausanne) 2020 18;11:549928. Epub 2021 Feb 18.

Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States.

Aim: To examine individual variability between perceived physical features and hormones of pubertal maturation in 9-10-year-old children as a function of sociodemographic characteristics.

Methods: Cross-sectional metrics of puberty were utilized from the baseline assessment of the Adolescent Brain Cognitive Development (ABCD) Study-a multi-site sample of 9-10 year-olds (n = 11,875)-and included perceived physical features the pubertal development scale (PDS) and child salivary hormone levels (dehydroepiandrosterone and testosterone in all, and estradiol in females). Multi-level models examined the relationships among sociodemographic measures, physical features, and hormone levels. A group factor analysis (GFA) was implemented to extract latent variables of pubertal maturation that integrated both measures of perceived physical features and hormone levels.

Results: PDS summary scores indicated more males (70%) than females (31%) were prepubertal. Perceived physical features and hormone levels were significantly associated with child's weight status and income, such that more mature scores were observed among children that were overweight/obese or from households with low-income. Results from the GFA identified two latent factors that described individual differences in pubertal maturation among both females and males, with factor 1 driven by higher hormone levels, and factor 2 driven by perceived physical maturation. The correspondence between latent factor 1 scores (hormones) and latent factor 2 scores (perceived physical maturation) revealed synchronous and asynchronous relationships between hormones and concomitant physical features in this large young adolescent sample.

Conclusions: Sociodemographic measures were associated with both objective hormone and self-report physical measures of pubertal maturation in a large, diverse sample of 9-10 year-olds. The latent variables of pubertal maturation described a complex interplay between perceived physical changes and hormone levels that hallmark sexual maturation, which future studies can examine in relation to trajectories of brain maturation, risk/resilience to substance use, and other mental health outcomes.
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http://dx.doi.org/10.3389/fendo.2020.549928DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7930488PMC
February 2021

Correction to: Preschool-Onset Major Depressive Disorder is Characterized by Electrocortical Deficits in Processing Pleasant Emotional Pictures.

Res Child Adolesc Psychopathol 2021 Apr;49(4):559-562

Department of Psychiatry, Washington University School of Medicine in St. Louis, 4444 Forest Park, Suite 2100, St. Louis, MO, 63108, USA.

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http://dx.doi.org/10.1007/s10802-021-00776-2DOI Listing
April 2021

Test-Retest Reliability of Neural Correlates of Response Inhibition and Error Monitoring: An fMRI Study of a Stop-Signal Task.

Front Neurosci 2021 28;15:624911. Epub 2021 Jan 28.

Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States.

Response inhibition (RI) and error monitoring (EM) are important processes of adaptive goal-directed behavior, and neural correlates of these processes are being increasingly used as transdiagnostic biomarkers of risk for a range of neuropsychiatric disorders. Potential utility of these purported biomarkers relies on the assumption that individual differences in brain activation are reproducible over time; however, available data on test-retest reliability (TRR) of task-fMRI are very mixed. This study examined TRR of RI and EM-related activations using a stop signal task in young adults ( = 56, including 27 pairs of monozygotic (MZ) twins) in order to identify brain regions with high TRR and familial influences (as indicated by MZ twin correlations) and to examine factors potentially affecting reliability. We identified brain regions with good TRR of activations related to RI (inferior/middle frontal, superior parietal, and precentral gyri) and EM (insula, medial superior frontal and dorsolateral prefrontal cortex). No subcortical regions showed significant TRR. Regions with higher group-level activation showed higher TRR; increasing task duration improved TRR; within-session reliability was weakly related to the long-term TRR; motion negatively affected TRR, but this effect was abolished after the application of ICA-FIX, a data-driven noise removal method.
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http://dx.doi.org/10.3389/fnins.2021.624911DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7875883PMC
January 2021

Editorial: The Centrality of Both Hyper- and Hypo-thalamocortical Connectivity in Psychosis.

Authors:
Deanna M Barch

J Am Acad Child Adolesc Psychiatry 2021 04 2;60(4):438-440. Epub 2021 Feb 2.

Washington University in St. Louis, Missouri. Electronic address:

Long-standing hypotheses about schizophrenia as a "dysconnection" syndrome are consistent with the idea that mental illness arises in part from brain circuit disruptions, with impairments in cognition and behavior occurring because of a failure of coordinated action across multiple brain regions. One such theory, put forth by Andreasen and colleagues, suggested that schizophrenia involves a disruption in the integration of cortical-striatal-thalamic-cerebellar circuits. Anatomical work in primates has shown that the thalamus is topographically organized into parallel pathways connecting specific thalamic nuclei to different regions of cortex. The medial dorsal and anterior nuclei of the thalamus project to the dorsolateral prefrontal cortex (dlPFC), whereas the lateral nuclei project more to sensorimotor regions, with similar findings in functional brain connectivity studies in humans. A large body of evidence has shown reduced connectivity from bilateral thalamic regions, medial dorsal, and anterior nuclei in particular, to the bilateral dlPFC, dorsal anterior cingulate, parts of the striatum, and bilateral cerebellum in schizophrenia. This is often coupled increased connectivity between the thalamus, lateral nuclei in particular, and motor, visual, and/or auditory sensory regions..
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http://dx.doi.org/10.1016/j.jaac.2021.01.018DOI Listing
April 2021

The Relationship Between Depression Symptoms and Adolescent Neural Response During Reward Anticipation and Outcome Depends on Developmental Timing: Evidence From a Longitudinal Study.

Biol Psychiatry Cogn Neurosci Neuroimaging 2021 May 11;6(5):527-535. Epub 2020 Nov 11.

Department of Psychological and Brain Sciences, Washington University School of Medicine, St. Louis, Missouri; Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri.

Background: Blunted neural reward responsiveness (RR) is observed in youth depression. However, it is unclear whether symptoms of depression experienced early in development relate to adolescent RR beyond current symptoms and, further, whether such relationships with RR differ during two key components of reward processing: anticipation and outcome.

Methods: Within a prospective longitudinal study oversampled for early depression, children and caregivers completed semiannual diagnostic assessments beginning in preschool. In later adolescence, mean age = 16.49 years (SD = 0.94), youths' (N = 100) neurophysiological responses to cues signaling likely win and loss and these outcomes were assessed. Longitudinally assessed dimensional depression and externalizing symptoms (often comorbid with depression as well as associated with RR) experienced at different developmental periods (preschool [age 3-5.11 years], school age [6-9.11 years], early adolescence [10-14.11 years], current) were used as simultaneous predictors of event-related potentials indexing anticipatory cue processing (cue-P3) and outcome processing (reward positivity/feedback negativity and feedback-P3).

Results: Blunted motivated attention to cues signaling likely win (cue-P3) was specifically predicted by early-adolescent depression symptoms. Blunted initial response to win (reward positivity) and loss (feedback negativity) outcomes was specifically predicted by preschool depression symptoms. Blunted motivational salience of win and loss outcomes (feedback-P3) was predicted by cumulative depression, not specific to any developmental stage.

Conclusions: Although blunted anticipation and outcome RR is a common finding in depression, specific deficits related to motivated attention to cues and initial outcome processing may map onto the developmental course of these symptoms.
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http://dx.doi.org/10.1016/j.bpsc.2020.11.001DOI Listing
May 2021

Classification and prediction of post-trauma outcomes related to PTSD using circadian rhythm changes measured via wrist-worn research watch in a large longitudinal cohort.

IEEE J Biomed Health Inform 2021 Jan 22;PP. Epub 2021 Jan 22.

Post-Traumatic Stress Disorder (PTSD) is a psychiatric condition resulting from threatening or horrifying events. We hypothesized that circadian rhythm changes, measured by a wrist-worn research watch are predictive of post-trauma outcomes.

Approach: 1618 post-trauma patients were enrolled after admission to emergency departments (ED). Three standardized questionnaires were administered at week eight to measure post-trauma outcomes related to PTSD, sleep disturbance, and pain interference with daily life. Pulse activity and movement data were captured from a research watch for eight weeks. Standard and novel movement and cardiovascular metrics that reflect circadian rhythms were derived using this data. These features were used to train different classifiers to predict the three outcomes derived from week-eight surveys. Clinical surveys administered at ED were also used as features in the baseline models.

Results: The highest cross-validated performance of research watch-based features was achieved for classifying participants with pain interference by a logistic regression model, with an area under the receiver operating characteristic curve (AUC) of 0.70. The ED survey-based model achieved an AUC of 0.77, and the fusion of research watch and ED survey metrics improved the AUC to 0.79.

Significance: This work represents the first attempt to predict and classify post-trauma symptoms from passive wearable data using machine learning approaches that leverage the circadian desynchrony in a potential PTSD population.
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http://dx.doi.org/10.1109/JBHI.2021.3053909DOI Listing
January 2021

Prognostic neuroimaging biomarkers of trauma-related psychopathology: resting-state fMRI shortly after trauma predicts future PTSD and depression symptoms in the AURORA study.

Neuropsychopharmacology 2021 Jan 21. Epub 2021 Jan 21.

Department of Emergency Medicine, Boston Medical Center, Boston, MA, USA.

Neurobiological markers of future susceptibility to posttraumatic stress disorder (PTSD) may facilitate identification of vulnerable individuals in the early aftermath of trauma. Variability in resting-state networks (RSNs), patterns of intrinsic functional connectivity across the brain, has previously been linked to PTSD, and may thus be informative of PTSD susceptibility. The present data are part of an initial analysis from the AURORA study, a longitudinal, multisite study of adverse neuropsychiatric sequalae. Magnetic resonance imaging (MRI) data from 109 recently (i.e., ~2 weeks) traumatized individuals were collected and PTSD and depression symptoms were assessed at 3 months post trauma. We assessed commonly reported RSNs including the default mode network (DMN), central executive network (CEN), and salience network (SN). We also identified a proposed arousal network (AN) composed of a priori brain regions important for PTSD: the amygdala, hippocampus, mamillary bodies, midbrain, and pons. Primary analyses assessed whether variability in functional connectivity at the 2-week imaging timepoint predicted 3-month PTSD symptom severity. Left dorsolateral prefrontal cortex (DLPFC) to AN connectivity at 2 weeks post trauma was negatively related to 3-month PTSD symptoms. Further, right inferior temporal gyrus (ITG) to DMN connectivity was positively related to 3-month PTSD symptoms. Both DLPFC-AN and ITG-DMN connectivity also predicted depression symptoms at 3 months. Our results suggest that, following trauma exposure, acutely assessed variability in RSN connectivity was associated with PTSD symptom severity approximately two and a half months later. However, these patterns may reflect general susceptibility to posttraumatic dysfunction as the imaging patterns were not linked to specific disorder symptoms, at least in the subacute/early chronic phase. The present data suggest that assessment of RSNs in the early aftermath of trauma may be informative of susceptibility to posttraumatic dysfunction, with future work needed to understand neural markers of long-term (e.g., 12 months post trauma) dysfunction. Furthermore, these findings are consistent with neural models suggesting that decreased top-down cortico-limbic regulation and increased network-mediated fear generalization may contribute to ongoing dysfunction in the aftermath of trauma.
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http://dx.doi.org/10.1038/s41386-020-00946-8DOI Listing
January 2021

Adolescent Brain Development and Psychopathology: Introduction to the Special Issue.

Biol Psychiatry 2021 01;89(2):93-95

Departments of Psychological and Brain Sciences, Psychiatry, and Radiology, Washington University in St. Louis, St. Louis, Missouri.

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http://dx.doi.org/10.1016/j.biopsych.2020.11.002DOI Listing
January 2021

Adolescent Brain Development and Psychopathology: Introduction to the Special Issue.

Biol Psychiatry 2021 01;89(2):93-95

Departments of Psychological and Brain Sciences, Psychiatry, and Radiology, Washington University in St. Louis, St. Louis, Missouri.

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http://dx.doi.org/10.1016/j.biopsych.2020.11.002DOI Listing
January 2021

Labeling Emotional Stimuli in Early Childhood Predicts Neural and Behavioral Indicators of Emotion Regulation in Late Adolescence.

Biol Psychiatry Cogn Neurosci Neuroimaging 2021 Jan 11;6(1):89-98. Epub 2020 Sep 11.

Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, Missouri; Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri; Department of Radiology, Washington University in St. Louis, St. Louis, Missouri.

Background: Effective emotion regulation (ER) may be supported by 1) accurate emotion identification, encoding, and maintenance of emotional states and related brain activity of regions involved in emotional response (i.e., amygdala, ventral/posterior insula) and 2) cognitive processes that implement reframing, supported by activation in cognitive control brain regions (e.g., frontal, insular, and parietal cortices). The purpose of this project was to examine how emotion labeling ability in early childhood is related to ER concurrently and prospectively.

Methods: Data from a prospective longitudinal study of youths at risk for depression, including measures of emotion labeling (i.e., Facial Affect Comprehension Evaluation) and ER ability (i.e., Emotion Regulation Checklist) and strategy use (i.e., Cognitive Emotion Regulation Questionnaire, Children's Response Style Questionnaire), and functional magnetic resonance imaging data during a sadness ER task (N = 139) were examined.

Results: Findings from multilevel modeling and linear regression suggested that greater emotion labeling ability of more difficult emotions in early childhood was associated with enhanced parent-reported ER in adolescence, but not with a tendency to engage in adaptive or maladaptive ER strategies. Recognition of fear and surprise predicted greater activation in cortical regions involved in cognitive control during an ER of sadness task, including in the insula, anterior cingulate cortex, dorsal medial prefrontal cortex, and inferior frontal gyrus.

Conclusions: These findings suggest that early ability to identify and label difficult facial emotions in early childhood is associated with better ER in adolescence and enhanced activity of cognitive control regions of the brain.
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http://dx.doi.org/10.1016/j.bpsc.2020.08.018DOI Listing
January 2021

Associations Between Resting-State Functional Connectivity and a Hierarchical Dimensional Structure of Psychopathology in Middle Childhood.

Biol Psychiatry Cogn Neurosci Neuroimaging 2021 May 17;6(5):508-517. Epub 2020 Sep 17.

Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri; Department of Psychology, Washington University, St. Louis, Missouri.

Background: Previous research from the Adolescent Brain Cognitive Development (ABCD) Study delineated and validated a hierarchical 5-factor structure with a general psychopathology (p) factor at the apex and 5 specific factors (internalizing, somatoform, detachment, neurodevelopmental, externalizing) using parent-reported child symptoms. The present study is the first to examine associations between dimensions from a hierarchical structure and resting-state functional connectivity (RSFC) networks.

Methods: Using 9- to 11-year-old children from the ABCD Study baseline sample, we examined the variance explained by each hierarchical structure level (p-factor, 2-factor, 3-factor, 4-factor, and 5-factor models) in associations with RSFC. Analyses were first conducted in a discovery dataset (n = 3790), and significant associations were examined in a replication dataset (n = 3791).

Results: There were robust associations between the p-factor and lower connectivity within the default mode network, although stronger effects emerged for the neurodevelopmental factor. Neurodevelopmental impairments were also related to variation in RSFC networks associated with attention to internal states and external stimuli. Analyses revealed robust associations between the neurodevelopmental dimension and several RSFC metrics, including within the default mode network, between the default mode network with cingulo-opercular and "Other" (unassigned) networks, and between the dorsal attention network with the Other network.

Conclusions: The hierarchical structure of psychopathology showed replicable links to RSFC associations in middle childhood. The specific neurodevelopmental dimension showed robust associations with multiple RSFC metrics. These results show the utility of examining associations between intrinsic brain architecture and specific dimensions of psychopathology, revealing associations especially with neurodevelopmental impairments.
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http://dx.doi.org/10.1016/j.bpsc.2020.09.008DOI Listing
May 2021

Introducing a New Journal, Biological Psychiatry: Global Open Science.

Biol Psychiatry 2020 12 13;88(12):890. Epub 2020 Oct 13.

Departments of Psychiatry and Psychology and the Imaging Research Center, University of California, Davis, Davis, California.

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http://dx.doi.org/10.1016/j.biopsych.2020.10.005DOI Listing
December 2020

Neural Indicators of Anhedonia: Predictors and Mechanisms of Treatment Change in a Randomized Clinical Trial in Early Childhood Depression.

Biol Psychiatry 2020 12;88(11):879-887

Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri.

Background: Early childhood depression is associated with anhedonia and reduced event-related potential (ERP) responses to rewarding or pleasant stimuli. Whether these neural measures are indicators of target engagement or treatment outcome is not yet known.

Methods: We measured ERP responses to win and loss feedback in a guessing task and to pleasant versus neutral pictures in young (4.0-6.9 years of age) depressed children before and after randomization to either 18 weeks of Parent-Child Interaction Therapy-Emotion Development (PCIT-ED) or waitlist.

Results: Analyses included reward positivity (RewP) data from 118 children randomly assigned to PCIT-ED (n = 60) or waitlist (n = 58) at baseline and late positive potential (LPP) data from 99 children (44 assigned to PCIT-ED vs. 55 assigned to waitlist) at baseline. Children undergoing PCIT-ED showed a greater reduction in anhedonia (F = 10.32, p = .002, partial η = .09). RewP reward responses increased more (F = 5.98, p = .02, partial η = .07) for PCIT-ED, but a greater change in RewP was not significantly associated with a greater reduction in major depressive disorder symptoms (r = -.12, p > .4). Baseline RewP did not predict treatment change. LPPs to positive pictures did not change across treatment, but greater baseline LPPs to positive pictures predicted a higher likelihood of remission from major depressive disorder in children undergoing PCIT-ED (B = 0.14; SE = 0.07; odds ratio = 1.15; p = .03).

Conclusions: The ERP reward response improved in young children with depression during a treatment designed to enhance emotion development, providing evidence of target engagement of the neural systems associated with reward. Further, greater baseline LPP responses to positive pictures was associated with a greater likelihood of depression remission, suggesting that this ERP measure can predict which children are most likely to respond to treatment.
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http://dx.doi.org/10.1016/j.biopsych.2020.06.032DOI Listing
December 2020

Assessment of Neighborhood Poverty, Cognitive Function, and Prefrontal and Hippocampal Volumes in Children.

JAMA Netw Open 2020 11 2;3(11):e2023774. Epub 2020 Nov 2.

Department of Psychological and Brain Sciences, Washington University, St Louis, Missouri.

Importance: The association between poverty and unfavorable cognitive outcomes is robust, but most research has focused on individual household socioeconomic status (SES). There is increasing evidence that neighborhood context explains unique variance not accounted for by household SES.

Objective: To evaluate whether neighborhood poverty (NP) is associated with cognitive function and prefrontal and hippocampal brain structure in ways that are dissociable from household SES.

Design, Setting, And Participants: This cross-sectional study used a baseline sample of the ongoing longitudinal Adolescent Brain Cognitive Development (ABCD) Study. The ABCD Study will follow participants for assessments each year for 10 years. Data were collected at 21 US sites, mostly within urban and suburban areas, between September 2019 and October 2018. School-based recruitment was used to create a participant sample reflecting the US population. Data analysis was conducted from March to June 2019.

Main Outcomes And Measures: NP and household SES were included as factors potentially associated with National Institutes of Health Toolbox Cognitive Battery subtests and hippocampal and prefrontal (dorsolateral prefrontal cortex [DLPFC], dorsomedial PFC [DMPFC], superior frontal gyrus [SFG]) volumes. Independent variables were first considered individually and then together in mixed-effects models with age, sex, and intracranial volume as covariates. Structural equation modeling (SEM) was used to assess shared variance in NP to brain structure and cognitive task associations. The tested hypotheses were formulated after data collection.

Results: A total of 11 875 children aged 9 and 10 years (5678 [47.8%] girls) were analyzed. Greater NP was associated with lower scores across all cognitive domains (eg, total composite: β = -0.18; 95% CI, -0.21 to -0.15; P < .001) and with decreased brain volume in the DLPFC (eg, right DLPFC: β = -0.09; 95% CI, -0.12 to -0.07; P < .001), DMPFC (eg, right DMPC: β = -0.07; 95% CI, -0.09 to -0.05; P < .001), SFG (eg, right SFG: β = -0.05; 95% CI, -0.08 to -0.03; P < .001), and right hippocampus (β = -0.04; 95% CI, -0.06 to -0.01; P = .01), even when accounting for household income. Greater household income was associated with higher scores across all cognitive domains (eg, total composite: β = 0.30; 95% CI, 0.28 to 0.33; P < .001) and larger volume in all prefrontal and hippocampal brain regions (eg, right hippocampus: β = 0.04; 95% CI, 0.02 to 0.07; P < .001) even when accounting for NP. The SEM model was a good fit across all cognitive domains, with prefrontal regions being associated with NP relations to language (picture vocabulary: estimate [SE], -0.03 [0.01]; P < .001; oral reading: estimate [SE], -0.02 [0.01]; P < .001), episodic memory (picture sequence: estimate [SE], -0.02 [0.01]; P = .008), and working memory (dimensional card sort: estimate [SE], -0.02 [0.01]; P = .001; flanker inhibitory control: estimate [SE], -0.01 [0.01]; P = .01; list sorting: estimate [SE], -0.03 [0.01]; P < .001) and hippocampal regions being associated with NP associations with language (picture vocabulary: estimate [SE], -0.01 [0.004]; P < .001) and episodic memory (picture sequence: estimate [SE], -0.01 [0.004]; P < 0.001).

Conclusions And Relevance: In this study, NP accounted for unique variance in cognitive function and prefrontal and right hippocampal brain volume. These findings demonstrate the importance of including broader environmental influences when conceptualizing early life adversity.
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http://dx.doi.org/10.1001/jamanetworkopen.2020.23774DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7610187PMC
November 2020

Cognitive Subtyping in Schizophrenia: A Latent Profile Analysis.

Schizophr Bull 2021 04;47(3):712-721

Research Division, Institute of Mental Health, Singapore, Singapore.

Cognitive dysfunction is a core feature of schizophrenia. The subtyping of cognitive performance in schizophrenia may aid the refinement of disease heterogeneity. The literature on cognitive subtyping in schizophrenia, however, is limited by variable methodologies and neuropsychological tasks, lack of validation, and paucity of studies examining longitudinal stability of profiles. It is also unclear if cognitive profiles represent a single linear severity continuum or unique cognitive subtypes. Cognitive performance measured with the Brief Assessment of Cognition in Schizophrenia was analyzed in schizophrenia patients (n = 767). Healthy controls (n = 1012) were included as reference group. Latent profile analysis was performed in a schizophrenia discovery cohort (n = 659) and replicated in an independent cohort (n = 108). Longitudinal stability of cognitive profiles was evaluated with latent transition analysis in a 10-week follow-up cohort. Confirmatory factor analysis (CFA) was carried out to investigate if cognitive profiles represent a unidimensional structure. A 4-profile solution was obtained from the discovery cohort and replicated in an independent cohort. It comprised of a "less-impaired" cognitive subtype, 2 subtypes with "intermediate cognitive impairment" differentiated by executive function performance, and a "globally impaired" cognitive subtype. This solution showed relative stability across time. CFA revealed that cognitive profiles are better explained by distinct meaningful profiles than a severity linear continuum. Associations between profiles and negative symptoms were observed. The subtyping of schizophrenia patients based on cognitive performance and its associations with symptomatology may aid phenotype refinement, mapping of specific biological mechanisms, and tailored clinical treatments.
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http://dx.doi.org/10.1093/schbul/sbaa157DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8084446PMC
April 2021

Socio-demographic and trauma-related predictors of PTSD within 8 weeks of a motor vehicle collision in the AURORA study.

Mol Psychiatry 2020 Oct 19. Epub 2020 Oct 19.

Department of Psychological Sciences, University of Missouri - St. Louis, St. Louis, MO, USA.

This is the initial report of results from the AURORA multisite longitudinal study of adverse post-traumatic neuropsychiatric sequelae (APNS) among participants seeking emergency department (ED) treatment in the aftermath of a traumatic life experience. We focus on n = 666 participants presenting to EDs following a motor vehicle collision (MVC) and examine associations of participant socio-demographic and participant-reported MVC characteristics with 8-week posttraumatic stress disorder (PTSD) adjusting for pre-MVC PTSD and mediated by peritraumatic symptoms and 2-week acute stress disorder (ASD). Peritraumatic Symptoms, ASD, and PTSD were assessed with self-report scales. Eight-week PTSD prevalence was relatively high (42.0%) and positively associated with participant sex (female), low socioeconomic status (education and income), and several self-report indicators of MVC severity. Most of these associations were entirely mediated by peritraumatic symptoms and, to a lesser degree, ASD, suggesting that the first 2 weeks after trauma may be a uniquely important time period for intervening to prevent and reduce risk of PTSD. This observation, coupled with substantial variation in the relative strength of mediating pathways across predictors, raises the possibility of diverse and potentially complex underlying biological and psychological processes that remain to be elucidated with more in-depth analyses of the rich and evolving AURORA data.
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http://dx.doi.org/10.1038/s41380-020-00911-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8053721PMC
October 2020

Cortical thinning in preschoolers with maladaptive guilt.

Psychiatry Res Neuroimaging 2020 Sep 17;305:111195. Epub 2020 Sep 17.

Department of Psychology and Neuroscience, Duke University, Durham, NC, USA.

Maladaptive guilt is a central symptom of preschool-onset depression associated with severe psychopathology in adolescence and adulthood. Although studies have found that maladaptive guilt is associated with structural alterations in the anterior insula (AI) and dorsomedial prefrontal cortex (dmPFC) in middle childhood and adolescence, no study has examined structural neural correlates of maladaptive guilt in preschool, when this symptom first emerges. This study examined a pooled sample of 3-to 6-year-old children (N = 76; 40.8% female) from two studies, both which used the same type of magnetic resonance imaging scanner and conducted diagnostic interviews for depression that included clinician ratings of whether children met criteria for maladaptive guilt. Preschoolers with maladaptive guilt displayed significantly thinner dmPFC than children without this symptom. Neither children's depressive severity nor their vegetative or other emotional symptoms of depression were associated with dmPFC thickness, suggesting that dmPFC thinning is specific to maladaptive guilt. Neither AI gray matter volume or thickness nor dmPFC gray matter volume differed between children with and without maladaptive guilt. This study is the first to identify a structural biomarker for a specific depressive symptom in preschool. Findings may inform neurobiological models of the development of depression and aid in detection of this symptom.
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http://dx.doi.org/10.1016/j.pscychresns.2020.111195DOI Listing
September 2020