Emotion processing deficits in youth with conduct disorder and youth with autism spectrum disorders: potential transdiagnostic factors and neurobiological correlates

Many disorders exhibit impairments in emotion processing. Yet, studies investigating potentially shared and disorder-specific deficits at the behavioral and neural levels are lacking. The main aim of this study is thus, to compare two disorders showing emotion processing deficits, conduct disorder (CD) and autism spectrum disorder (ASD). Moreover, in CD and ASD, emotion processing deficits are detectable early in life. These include reduced attention to the eye region during facial emotion processing and high prevalence rates of co-occurring callous unemotional (CU) traits. Focusing on these as potential transdiagnostic factors for emotion processing deficits might help to gain deeper knowledge on the shared and disorder specific deficits. The main aim of this thesis is to explore the potential transdiagnostic contribution of atypical eye gaze and co-occurring CU traits at the behavioral and neural level for emotion processing impairments often described in youth with CD and youth with ASD. The second aim was to investigate whether heart rate variability (HRV) influences generic self-regulation or specifically emotion regulation abilities and underlying neural structures in youth with CD compared with typically developing peers (TD). For this, we analyzed gaze behavior during an implicit facial emotion processing paradigm and functional Magnetic Resonance Imaging (MRI). Then, the impact of CU traits on empathy abilities were investigated using psychometric measures of empathy and structural imaging data. Finally, we analyzed the association between baseline HRV indices and task performance during an emotional go/no-go paradigm using data from the multicentered FemNAT-CD project. The findings of the first study suggest that while reduced eye gaze and differences in brain activation may be disorder specific, atypical gaze patterns may be transdiagnostic. In the second study, CU traits have shown both transdiagnostic and disorder specific influences which may partially depend on the disorder, the type of emotion processing and the neural correlate investigated. Thus, gaze behavior and CU traits, although expressed in a disorder specific way, are shown in CD and ASD and impact emotion processing in both disorders. The third study suggests that HRV may be an indicator for potential self-regulation deficits in youth with CD and TD. In sum, this thesis provides evidence for a transdiagnostic and disorder-specific impact of early indicators atypical emotion processing. More studies are needed to explore and compare the underlying mechanisms of atypical gaze patterns and subdimensions of CU traits in disorders with emotion processing deficits. This may help to better understand the disorder specific focus of impairment and to develop tailored treatment options

Linking heart rate variability to psychological health and brain structure in adolescents with and without conduct disorder

AimsHeart rate variability (HRV) measures have been suggested in healthy individuals as a potential index of self-regulation skills, which include both cognitive and emotion regulation aspects. Studies in patients with a range of psychiatric disorders have however mostly focused on the potential association between abnormally low HRV at rest and specifically emotion regulation difficulties. Emotion regulation deficits have been reported in patients with Conduct Disorder (CD) however, the association between these emotion regulation deficits and HRV measures has yet to be fully understood. This study investigates (i) the specificity of the association between HRV and emotion regulation skills in adolescents with and without CD and (ii) the association between HRV and grey matter brain volumes in key areas of the central autonomic network which are involved in self-regulation processes, such as insula, lateral/medial prefrontal cortices or amygdala.MethodsRespiratory sinus arrhythmia (RSA) measures of HRV were collected from adolescents aged between 9–18 years (693 CD (427F)/753 typically developing youth (TD) (500F)), as part of a European multi-site project (FemNAT-CD). The Inverse Efficiency Score, a speed-accuracy trade-off measure, was calculated to assess emotion and cognitive regulation abilities during an Emotional Go/NoGo task. The association between RSA and task performance was tested using multilevel regression models. T1-weighted structural MRI data were included for a subset of 577 participants (257 CD (125F); 320 TD (186F)). The CerebroMatic toolbox was used to create customised Tissue Probability Maps and DARTEL templates, and CAT12 to segment brain images, followed by a 2 × 2 (sex × group) full factorial ANOVA with RSA as regressor of interest.ResultsThere were no significant associations between RSA and task performance, neither during emotion regulation nor during cognitive regulation trials. RSA was however positively correlated with regional grey matter volume in the left insula (pFWE = 0.011) across all subjects.ConclusionRSA was related to increased grey matter volume in the left insula across all subjects. Our results thus suggest that low RSA at rest might be a contributing or predisposing factor for potential self-regulation difficulties. Given the insula’s role in both emotional and cognitive regulation processes, these brain structural differences might impact either of those

Empathy deficits, callous‐unemotional traits and structural underpinnings in autism spectrum disorder and conduct disorder youth

Distinct empathy deficits are often described in patients with conduct disorder (CD) and autism spectrum disorder (ASD) yet their neural underpinnings and the influence of comorbid Callous‐Unemotional (CU) traits are unclear. This study compares the cognitive (CE) and affective empathy (AE) abilities of youth with CD and ASD, their potential neuroanatomical correlates, and the influence of CU traits on empathy. Adolescents and parents/caregivers completed empathy questionnaires (N = 148 adolescents, mean age = 15.16 years) and T1 weighted images were obtained from a subsample (N = 130). Group differences in empathy and the influence of CU traits were investigated using Bayesian analyses and Voxel‐Based Morphometry with Threshold‐Free Cluster Enhancement focusing on regions involved in AE (insula, amygdala, inferior frontal gyrus and cingulate cortex) and CE processes (ventromedial prefrontal cortex, temporoparietal junction, superior temporal gyrus, and precuneus). The ASD group showed lower parent‐reported AE and CE scores and lower self‐reported CE scores while the CD group showed lower parent‐reported CE scores than controls. When accounting for the influence of CU traits no AE deficits in ASD and CE deficits in CD were found, but CE deficits in ASD remained. Across all participants, CU traits were negatively associated with gray matter volumes in anterior cingulate which extends into the mid cingulate, ventromedial prefrontal cortex, and precuneus. Thus, although co‐occurring CU traits have been linked to global empathy deficits in reports and underlying brain structures, its influence on empathy aspects might be disorder‐specific. Investigating the subdimensions of empathy may therefore help to identify disorder‐specific empathy deficits

Linking heart rate variability to psychological health and brain structure in adolescents with and without conduct disorder

AimsHeart rate variability (HRV) measures have been suggested in healthy individuals as a potential index of self-regulation skills, which include both cognitive and emotion regulation aspects. Studies in patients with a range of psychiatric disorders have however mostly focused on the potential association between abnormally low HRV at rest and specifically emotion regulation difficulties. Emotion regulation deficits have been reported in patients with Conduct Disorder (CD) however, the association between these emotion regulation deficits and HRV measures has yet to be fully understood. This study investigates (i) the specificity of the association between HRV and emotion regulation skills in adolescents with and without CD and (ii) the association between HRV and grey matter brain volumes in key areas of the central autonomic network which are involved in self-regulation processes, such as insula, lateral/medial prefrontal cortices or amygdala.MethodsRespiratory sinus arrhythmia (RSA) measures of HRV were collected from adolescents aged between 9–18 years (693 CD (427F)/753 typically developing youth (TD) (500F)), as part of a European multi-site project (FemNAT-CD). The Inverse Efficiency Score, a speed-accuracy trade-off measure, was calculated to assess emotion and cognitive regulation abilities during an Emotional Go/NoGo task. The association between RSA and task performance was tested using multilevel regression models. T1-weighted structural MRI data were included for a subset of 577 participants (257 CD (125F); 320 TD (186F)). The CerebroMatic toolbox was used to create customised Tissue Probability Maps and DARTEL templates, and CAT12 to segment brain images, followed by a 2 × 2 (sex × group) full factorial ANOVA with RSA as regressor of interest.ResultsThere were no significant associations between RSA and task performance, neither during emotion regulation nor during cognitive regulation trials. RSA was however positively correlated with regional grey matter volume in the left insula (pFWE = 0.011) across all subjects.ConclusionRSA was related to increased grey matter volume in the left insula across all subjects. Our results thus suggest that low RSA at rest might be a contributing or predisposing factor for potential self-regulation difficulties. Given the insula’s role in both emotional and cognitive regulation processes, these brain structural differences might impact either of those