title: Internalizing versus externalizing comorbidity: neural circuit hypothesis.
abstract: The aim of the present study was to review and update historical controversies in relation to the limbic system in light of advances in the neuroanatmy and neurobiology of cortico-striatal-thalamic-cortical (CSTC) neural circuits. It is hypothesized that observed comorbidities between internalizing and externalizing childhood syndromes may be better understood in terms of excess communication between subcortical brain circuits. A neuroanatomical understanding of reciprocal and non-reciprocal connections between modular circuits provides a basis for understanding previously puzzling aspects of internalizing, externalizing comorbidity. Function depends on the degree of cooperative integration of goal orientation, Pavlovian stimulus response, and operant processing in cortical-subcortical circuits, and interventions may be targeted at any of these functions.
authors.affiliation: School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia. f.levy@unsw.edu.au
authors.forename: Florence
authors.initials: F
authors.lastname: Levy
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000473:pathology / Q000523:psychology; D002540:Cerebral Cortex / Q000473:pathology* / Q000503:physiopathology; D002648:Child; D002653:Child Behavior Disorders / Q000473:pathology / Q000523:psychology; D015897:Comorbidity; D006801:Humans; D007389:Internal-External Control; D008032:Limbic System / Q000473:pathology; D001523:Mental Disorders / Q000453:epidemiology / Q000473:pathology* / Q000523:psychology*; D017072:Neostriatum / Q000473:pathology* / Q000503:physiopathology; D009434:Neural Pathways / Q000473:pathology* / Q000503:physiopathology; D013313:Stress Disorders, Post-Traumatic / Q000473:pathology / Q000523:psychology; D013788:Thalamus / Q000473:pathology* / Q000503:physiopathology