Brain Responses During Face Processing in Conduct Disorder: Considering Sex and Callous-Unemotional Traits

Area of Science:

• Neuroscience
• Developmental Psychology
• Psychiatry

Background:

• Functional magnetic resonance imaging (fMRI) research on conduct disorder (CD) has predominantly focused on males.
• Understanding sex differences in the neurobiology of CD is crucial for developing targeted interventions.

Purpose of the Study:

• To investigate sex-specific alterations in brain responses to emotional faces in youth with CD.
• To examine the influence of callous-unemotional (CU) traits on these neural responses.

Main Methods:

• fMRI was used to assess brain responses to angry, fearful, and neutral faces in 161 youths with CD (74 females) and 241 typically-developing (TD) youths (139 females), aged 9-18 years.
• Analyses included diagnosis effects (CD vs. TD) and sex-by-diagnosis interactions, considering high (CD/HCU) and low (CD/LCU) CU trait subgroups.

Main Results:

• Youth with CD showed lower amygdala responses to faces overall compared to TD youths, primarily driven by the CD/HCU subgroup.
• Significant sex-by-CU subgroup interactions were found in the amygdala and insula, indicating differing neural responses between sexes and CU trait levels.
• Findings for males align with existing neurocognitive models of CD.

Conclusions:

• The neural underpinnings of conduct disorder, particularly in response to emotional faces, differ between males and females.
• The interaction between CU traits and brain responses varies by sex, suggesting distinct pathophysiological processes in male and female youth with CD.