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Internalizing-externalizing comorbidity and regional brain volumes in the ABCD study.

Elana Schettini1, Sylia Wilson2, Theodore P Beauchaine3

  • 1Department of Psychology, The Ohio State University, Columbus, OH, USA.

Development and Psychopathology
|October 14, 2022
PubMed
Summary

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Internalizing and externalizing disorders frequently co-occur due to shared brain mechanisms. Comorbidity impacts anterior cingulate cortex (ACC) volume differently in boys and girls, suggesting sex-specific neurodevelopmental pathways.

Area of Science:

  • Neuroscience
  • Developmental Psychology
  • Psychiatry

Background:

  • Internalizing and externalizing disorders exhibit significant comorbidity despite distinct diagnostic criteria.
  • This comorbidity is linked to transdiagnostic neuroaffective mechanisms involving the striatum, anterior cingulate cortex (ACC), and amygdala.
  • Previous research highlights structural and functional alterations in these brain regions associated with mood states like anhedonia and irritability.

Purpose of the Study:

  • To investigate the association between internalizing-externalizing disorder comorbidity and brain volumes in the striatum, amygdala, and ACC.
  • To explore potential sex differences in these associations.
  • To utilize a transdiagnostic, Research Domain Criteria (RDoC)-informed approach.

Main Methods:

Keywords:
RDoCamygdalaanterior cingulateheterotypic comorbiditystriatum

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  • Analysis of data from the Adolescent Brain Cognitive Development (ABCD) study (N = 6,971, mean age 9.9 years, 51.6% female).
  • Evaluation of associations between heterotypic symptom interactions (Internalizing × Externalizing) and regional brain volumes.
  • Statistical control for main effects of internalizing and externalizing symptoms.

Main Results:

  • Heterotypic symptom interactions were significantly associated with ACC volumes in both sexes, beyond the main effects of internalizing and externalizing symptoms.
  • A sex-specific pattern emerged: heterotypic comorbidity was linked to larger ACC volumes in girls but smaller ACC volumes in boys.
  • No significant sex differences were reported for striatal or amygdalar volumes in relation to comorbidity.

Conclusions:

  • Internalizing-externalizing comorbidity is associated with ACC volume alterations in adolescents.
  • These associations demonstrate a sexually dimorphic pattern, indicating different neurobiological pathways for comorbidity in boys and girls.
  • Findings underscore the importance of sex-specific considerations in transdiagnostic research and clinical assessment of comorbid disorders.