title: Brain response to viewing others being harmed in children with conduct disorder symptoms.
abstract: BACKGROUND
  Deficient empathic processing is thought to foster conduct disorder (CD). It is important to determine the extent to which neural response associated with perceiving harm to others predicts CD symptoms and callous disregard for others.
  
  
  METHODS
  A total of 107 9- to 11-year-old children (52 female) were recruited from pediatric and mental health clinics, representing a wide range of CD symptoms. Children were scanned with functional magnetic resonance imaging while viewing brief video clips of persons being harmed intentionally or accidentally.
  
  
  RESULTS
  Perceiving harm evoked increased hemodynamic response in the anterior insula (aINS), anterior cingulate cortex (ACC), amygdala, periaqueductal gray (PAG), caudate, and inferior parietal lobe (IPL) across all participants. Intentionally caused, relative to unintentional harm was associated with greater activity in the aINS, amygdala, and temporal pole. There was an inverse association of number of CD symptoms with right posterior insula in both the Harm > No Harm and the Intentional > Unintentional Harm contrasts. Furthermore, an inverse association between callousness and posterior insula activation was found in the Harm > No Harm contrast, with the opposite pattern for reactive aggression scores. An interaction revealed a stronger association in girls between CD symptoms and the right posterior superior temporal sulcus (pSTS) in the Intentional Harm versus Unintentional Harm contrast.
  
  
  CONCLUSIONS
  Children with greater CD and callousness exhibit dampened hemodynamic response to viewing others being harmed in the insula, a region which plays a key role in empathy and emotional awareness. Sex differences in the neural correlates of CD were observed.
authors.affiliation: Department of Psychology, University of Chicago, Chicago, IL, USA.|National Institute of Mental Health, Bethesda, MD, USA.|Department of Human Development, University of Maryland, College Park, MD, USA.
authors.forename: Kalina J
authors.initials: KJ
authors.lastname: Michalska
authors.affiliation: Neural Systems Group, Massachusetts General Hospital, Charlestown, MA, USA.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Zeffiro
authors.affiliation: Department of Psychology, University of Chicago, Chicago, IL, USA.|Department of Psychiatry and Behavioral Neuroscience, University of Chicago Medicine, Chicago, IL, USA.
authors.forename: Jean
authors.initials: J
authors.lastname: Decety
mesh_terms: D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping / Q000379:methods*; D002540:Cerebral Cortex / Q000503:physiopathology*; D002648:Child; D019955:Conduct Disorder / Q000503:physiopathology*; D004645:Empathy / Q000502:physiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D012737:Sex Factors
keywords: Conduct disorder; affective arousal; anterior cingulate cortex; callousness; emotional empathy; insula