title: Adolescents' Neural Processing of Risky Decisions: Effects of Sex and Behavioral Disinhibition.
abstract: BACKGROUND
  Accidental injury and homicide, relatively common among adolescents, often follow risky behaviors; those are done more by boys and by adolescents with greater behavioral disinhibition (BD).
  
  
  OBJECTIVE
  Neural processing during adolescents' risky decision-making will differ in youths with greater BD severity, and in males vs. females, both before cautious behaviors and before risky behaviors.
  
  
  RESULTS
  81 adolescents (PATIENTS with substance and conduct problems, and comparison youths (Comparisons)), assessed in a 2 x 2 design (
  
  
  METHODS
  Comparisons x Male:Female) repeatedly decided between doing a cautious behavior that earned 1 cent, or a risky one that either won 5 or lost 10 cents. Odds of winning after risky responses gradually decreased. Functional magnetic resonance imaging captured brain activity during 4-sec deliberation periods preceding responses. Most neural activation appeared in known decision-making structures. PATIENTS, who had more severe BD scores and clinical problems than Comparisons, also had extensive neural hypoactivity. Comparisons' greater activation before cautious responses included frontal pole, medial prefrontal cortex, striatum, and other regions; and before risky responses, insula, temporal, and parietal regions. Males made more risky and fewer cautious responses than females, but before cautious responses males activated numerous regions more than females. Before risky behaviors female-greater activation was more posterior, and male-greater more anterior.
  
  
  CONCLUSIONS
  Neural processing differences during risky-cautious decision-making may underlie group differences in adolescents' substance-related and antisocial risk-taking. Patients reported harmful real-life decisions and showed extensive neural hypoactivity during risky-or-cautious decision-making. Males made more risky responses than females; apparently biased toward risky decisions, males (compared with females) utilized many more neural resources to make and maintain cautious decisions, indicating an important risk-related brain sexual dimorphism. The results suggest new possibilities for prevention and management of excessive, dangerous adolescent risk-taking.
authors.affiliation: Division of Substance Dependence, Psychiatry Department, University of Colorado Denver, Denver, Colorado, United States of America.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Crowley
authors.affiliation: Division of Substance Dependence, Psychiatry Department, University of Colorado Denver, Denver, Colorado, United States of America.
authors.forename: Manish S
authors.initials: MS
authors.lastname: Dalwani
authors.affiliation: Division of Substance Dependence, Psychiatry Department, University of Colorado Denver, Denver, Colorado, United States of America.
authors.forename: Susan K
authors.initials: SK
authors.lastname: Mikulich-Gilbertson
authors.affiliation: Division of Substance Dependence, Psychiatry Department, University of Colorado Denver, Denver, Colorado, United States of America.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Young
authors.affiliation: Division of Substance Dependence, Psychiatry Department, University of Colorado Denver, Denver, Colorado, United States of America.
authors.forename: Joseph T
authors.initials: JT
authors.lastname: Sakai
authors.affiliation: Division of Substance Dependence, Psychiatry Department, University of Colorado Denver, Denver, Colorado, United States of America.
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Raymond
authors.affiliation: Division of Substance Dependence, Psychiatry Department, University of Colorado Denver, Denver, Colorado, United States of America.
authors.forename: Shannon K
authors.initials: SK
authors.lastname: McWilliams
authors.affiliation: Division of Substance Dependence, Psychiatry Department, University of Colorado Denver, Denver, Colorado, United States of America.
authors.forename: Melissa J
authors.initials: MJ
authors.lastname: Roark
authors.affiliation: Institute of Cognitive Science, Departments of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado, United States of America.
authors.forename: Marie T
authors.initials: MT
authors.lastname: Banich
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000502:physiology*; D001921:Brain / Q000000981:diagnostic imaging / Q000502:physiology; D001931:Brain Mapping; D003657:Decision Making; D005260:Female; D005716:Game Theory; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009424:Nervous System Physiological Phenomena; D011859:Radiography; D012309:Risk-Taking; D012737:Sex Factors