title: Reduced amygdala response to fearful expressions in children and adolescents with callous-unemotional traits and disruptive behavior disorders.
abstract: OBJECTIVE
  Extensive work implicates abnormal amygdala activation in emotional facial expression processing in adults with callous-unemotional traits. However, no research has examined amygdala response to emotional facial expressions in adolescents with disruptive behavior and callous-unemotional traits. Moreover, despite high comorbidity of callous-unemotional traits and attention deficit hyperactivity disorder (ADHD), no research has attempted to distinguish neural correlates of pediatric callous-unemotional traits and ADHD.
  
  
  METHODS
  Participants were 36 children and adolescents (ages 10-17 years); 12 had callous-unemotional traits and either conduct disorder or oppositional defiant disorder, 12 had ADHD, and 12 were healthy comparison subjects. Functional MRI was used to assess amygdala activation patterns during processing of fearful facial expressions. Patterns in the callous-unemotional traits group were compared with those in the ADHD and comparison groups.
  
  
  RESULTS
  In youths with callous-unemotional traits, amygdala activation was reduced relative to healthy comparison subjects and youths with ADHD while processing fearful expressions, but not neutral or angry expressions. Functional connectivity analyses demonstrated greater correlations between the amygdala and the ventromedial prefrontal cortex in comparison subjects and youths with ADHD relative to those with callous-unemotional traits. Symptom severity in the callous-unemotional traits groups was negatively correlated with connectivity between amygdala and ventromedial prefrontal cortex.
  
  
  CONCLUSIONS
  This is the first study to demonstrate reduced amygdala responsiveness in youths with callous-unemotional traits. These findings support the contention that callous and unemotional personality traits are associated with reduced amygdala response to distress-based social cues.
authors.affiliation: Mood and Anxiety Program, NIMH, 15K North Dr., MSC 2670, Bethesda, MD 20892, USA. amarsh@post.harvard.edu
authors.forename: Abigail A
authors.initials: AA
authors.lastname: Marsh
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Finger
authors.forename: Derek G V
authors.initials: DG
authors.lastname: Mitchell
authors.forename: Marguerite E
authors.initials: ME
authors.lastname: Reid
authors.forename: Courtney
authors.initials: C
authors.lastname: Sims
authors.forename: David S
authors.initials: DS
authors.lastname: Kosson
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Towbin
authors.forename: Ellen
authors.initials: E
authors.lastname: Leibenluft
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Pine
authors.forename: R J R
authors.initials: RJ
authors.lastname: Blair
mesh_terms: D000293:Adolescent; D000679:Amygdala / Q000503:physiopathology*; D000786:Anger / Q000502:physiology; D001143:Arousal / Q000502:physiology; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D002648:Child; D003463:Cues; D004645:Empathy; D005149:Facial Expression; D005239:Fear / Q000502:physiology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D009434:Neural Pathways / Q000502:physiology; D010100:Oxygen / Q000097:blood; D010364:Pattern Recognition, Visual / Q000502:physiology*; D018187:Personal Construct Theory; D017397:Prefrontal Cortex / Q000503:physiopathology; D012016:Reference Values
chemical_list: D010100:Oxygen