Raschle Nora Maria, Borbás Réka, Dimanova Plamina, Unternaehrer Eva, Kohls Gregor, De Brito Stephane, Fairchild Graeme, Freitag Christine M, Konrad Kerstin, Stadler Christina
Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University and ETH Zurich, Zurich, Switzerland.
Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland.
Biol Psychiatry Cogn Neurosci Neuroimaging. 2025 Jan;10(1):80-93. doi: 10.1016/j.bpsc.2024.08.005. Epub 2024 Aug 23.
Emotion regulation skills are linked to corticolimbic brain activity (e.g., dorsolateral prefrontal cortex [dlPFC] and limbic regions) and enable an individual to control their emotional experiences, thus allowing healthy social functioning. Disruptions in emotion regulation skills are reported in neuropsychiatric disorders, including conduct disorder or oppositional defiant disorder (CD/ODD). Clinically recognized means to ameliorate emotion regulation deficits observed in CD/ODD include cognitive or dialectical behavioral skills therapy as implemented in the START NOW program. However, the role of emotion regulation and its neural substrates in symptom severity and prognosis following treatment of adolescent CD/ODD has not been investigated.
Cross-sectional data including functional magnetic resonance imaging responses during emotion regulation (N = 114; average age = 15 years), repeated-measures assessments of symptom severity (pretreatment, posttreatment, long-term follow-up), and functional magnetic resonance imaging data collected prior to and following the START NOW randomized controlled trial (n = 44) for female adolescents with CD/ODD were analyzed using group comparisons and multiple regression.
First, behavioral and neural correlates of emotion regulation were disrupted in female adolescents with CD/ODD. Second, ODD symptom severity was negatively associated with dlPFC/precentral gyrus activity during regulation. Third, treatment-related symptom changes were predicted by pretreatment ODD symptom severity and regulatory dlPFC/precentral activity. Additionally, pretreatment dlPFC/precentral activity and ODD symptom severity predicted long-term reductions in symptom severity following treatment for participants who received the START NOW treatment.
Our findings demonstrate the important role that emotion regulation skills play in the characteristics of CD/ODD and show that regulatory dlPFC/precentral activity is positively associated with treatment response in female adolescents with CD/ODD.
情绪调节技能与皮质边缘脑区活动（如背外侧前额叶皮层[dlPFC]和边缘区域）相关联，使个体能够控制自身的情绪体验，从而实现健康的社交功能。据报道，在包括品行障碍或对立违抗障碍（CD/ODD）在内的神经精神疾病中，情绪调节技能会受到干扰。临床上公认的改善CD/ODD中观察到的情绪调节缺陷的方法包括在“立即开始”计划中实施的认知或辩证行为技能疗法。然而，情绪调节及其神经基础在青少年CD/ODD治疗后的症状严重程度和预后中的作用尚未得到研究。
分析了横断面数据，包括情绪调节期间的功能磁共振成像反应（N = 114；平均年龄 = 15岁）、症状严重程度的重复测量评估（治疗前、治疗后、长期随访），以及在针对患有CD/ODD的女性青少年的“立即开始”随机对照试验（n = 44）之前和之后收集的功能磁共振成像数据，采用组间比较和多元回归分析。
首先，患有CD/ODD的女性青少年的情绪调节的行为和神经关联受到干扰。其次，对立违抗症状的严重程度与调节期间的dlPFC/中央前回活动呈负相关。第三，治疗相关的症状变化可通过治疗前的对立违抗症状严重程度和调节性dlPFC/中央前活动来预测。此外，治疗前的dlPFC/中央前活动和对立违抗症状严重程度预测了接受“立即开始”治疗的参与者治疗后症状严重程度的长期降低。
我们的研究结果表明情绪调节技能在CD/ODD特征中所起的重要作用，并表明调节性dlPFC/中央前活动与患有CD/ODD的女性青少年的治疗反应呈正相关。
