Abstract
There is increasing evidence for altered brain resting state functional connectivity in adolescents with disruptive behavior. While a considerable body of behavioral research points to differences between reactive and proactive aggression, it remains unknown whether these two subtypes have dissociable effects on connectivity. Additionally, callous-unemotional traits are important specifiers in subtyping aggressive behavior along the affective dimension. Accordingly, we examined associations between two aggression subtypes along with callous-unemotional traits using a seed-to-voxel approach. Six functionally relevant seeds were selected to probe the salience and the default mode network, based on their presumed role in aggression. The resting state sequence was acquired from 207 children and adolescents of both sexes [mean age (standard deviation) = 13.30 (2.60); range = 8.02–18.35] as part of a Europe-based multi-center study. One hundred eighteen individuals exhibiting disruptive behavior (conduct disorder/oppositional defiant disorder) with varying comorbid attention-deficit/hyperactivity disorder (ADHD) symptoms were studied, together with 89 healthy controls. Proactive aggression was associated with increased left amygdala–precuneus coupling, while reactive aggression related to hyper-connectivities of the posterior cingulate cortex (PCC) to the parahippocampus, the left amygdala to the precuneus and to hypo-connectivity between the right anterior insula and the nucleus caudate. Callous-unemotional traits were linked to distinct hyper-connectivities to frontal, parietal, and cingulate areas. Additionally, compared to controls, cases demonstrated reduced connectivity of the PCC and left anterior insula to left frontal areas, the latter only when controlling for ADHD scores. Taken together, this study revealed aggression-subtype-specific patterns involving areas associated with emotion, empathy, morality, and cognitive control.
Highlights
Aggression is defined as behavior aimed to harm other persons or objects
While cases and controls were matched for age and handedness, there were more males than females in the case group (99–19); cases exhibited a lower IQ than healthy controls and showed a wide distribution of responses to a threat (RA) and predatory action (PA) levels, callous-unemotional traits, and attention-deficit/hyperactivity disorder (ADHD) symptoms
In line with our hypothesis, RA and PA were related to distinct couplings of brain regions implicated in emotion, empathy, and cognitive control
Summary
Aggression is defined as behavior aimed to harm other persons or objects. In young individuals, aggression dimensions partially undercut the normative diagnostic categories [1]. Callous-unemotional traits are reported in a significant percentage of children and adolescents with disruptive behavior disorder [4] and are characterized by callousness, uncaring, and unemotional dimensions [5,6]. Within this complexity of phenotypic manifestation in child and adolescent psychopathology, reactive and proactive aggression (RA and PA, respectively) pertain to distinct functions of aggression, reflecting impulsive and instrumental behaviors, [7]. There is substantial evidence from animal models and research on neurotransmitters that both forms tap into distinct neural circuits and are linked to acute responses to a threat (RA) or a self-initiated, predatory action (PA) [8]
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