Differential adolescent neurodevelopment of emotion processing across internalizing psychopathology and childhood...

Internalizing disorders (IDs) such as anxiety and depression show a peak onset during adolescence, a period characterized by maturation of the frontal lobe. Impaired emotion regulation and elevated reactivity are prominent transdiagnostic symptoms that are further impacted by childhood adversity. However, the mechanisms through which IDs and adversity alter neurodevelopmental trajectories of emotion processing during adolescence are poorly understood, particularly across implicit and explicit regulation strategies.

Utilizing an accelerated longitudinal design, youth (aged 10-17) with IDs (n = 65) and a typically-developing comparison group (CG; n = 74) completed an emotional N-Back (implicit) and cognitive reappraisal (explicit) task during fMRI at baseline and one-year follow-up. Linear mixed effects modeling was used to investigate group and age differences in regional frontal lobe activation, then explored how these effects were moderated by adversity.

As compared to CG-youth, ID-youth showed developmental differences in the left ventral anterior insula during the implicit task, and the left dorsal anterior insula during the explicit task. Across both tasks, ID-youth lacked the increasing differential activation between negative and neutral stimuli across age that CG-youth exhibit. In ID-youth, adversity moderated neural activity during the explicit task, including the developmental trajectory of the dorsal anterior insula, but not the implicit task.

The left anterior insula is a key developmental region with subregion-specificity. These findings highlight the importance of individual neural maturation and carry implications for emotion regulation-based pediatric clinical interventions. Further investigation is necessary to assess whether intervention effectiveness is dependent on adversity history.