Neural Changes Associated with Treatment Outcome in Children with Externalizing Problems

Woltering, Steven; Granic, Isabela; Lamm, Connie; Lewis, Marc D.

doi:10.1016/j.biopsych.2011.05.029

Cited by 62 publications

(72 citation statements)

References 131 publications

(151 reference statements)

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“…Fifteen of the 27 children revealed significant reduction in disruptive behavior that was paralleled by decreased amplitude of the N2 ERP in the emotion regulation condition of the task, suggesting changes in cognitive regulatory processes. These findings were replicated in an open-study of 71 children who received CBT for aggressive behavior and completed the emotion-induction Go-NoGo before and after treatment (Woltering et al 2011). In this larger sample, reduction of aggression was also associated with the reduction of the N2 ERP amplitude.…”

Section: Rationale For Using Both Fmri and Eegsupporting

confidence: 63%

Neural Mechanisms of Cognitive-Behavioral Therapy for Aggression in Children and Adolescents: Design of a Randomized Controlled Trial Within the National Institute for Mental Health Research Domain Criteria Construct of Frustrative Non-Reward

Sukhodolsky

Wyk

Eilbott

et al. 2016

Journal of Child and Adolescent Psychopharmacology

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Objective: We present the rationale and design of a randomized controlled trial of cognitive-behavioral therapy (CBT) for aggression in children and adolescents, which is conducted in response to the National Institute of Mental Health (NIMH) Research Domain Criteria (RDoC) approach initiative. Specifically, the study is focused on the brain-behavior associations within the RDoC construct of frustrative non-reward. On the behavioral level, this construct is defined by reactions elicited in response to withdrawal or prevention of reward, most notably reactive aggression. This study is designed to test the functional magnetic resonance (fMRI) and electrophysiological (EEG) correlates of aggression and its reduction after CBT. Methods: Eighty children and adolescents with high levels of aggression across multiple traditional diagnostic categories, ages 8-16, will be randomly assigned to receive 12 sessions of CBT or 12 sessions of supportive psychotherapy. Clinical outcomes will be measured by the ratings of aggressive behavior collected at baseline, midpoint, and endpoint evaluations, and by the Improvement Score of the Clinical Global Impressions Scale assigned by an independent evaluator (blinded rater). Subjects will also perform a frustration-induction Go-NoGo task and a task of emotional face perception during fMRI scanning and EEG recording at baseline and endpoint. Results: Consistent with the NIMH strategic research priorities, if functional neuroimaging and EEG variables can identify subjects who respond to CBT for aggression, this can provide a neuroscience-based classification scheme that will improve treatment outcomes for children and adolescents with aggressive behavior. Conclusions: Demonstrating that a change in the key nodes of the emotion regulation circuitry is associated with a reduction of reactive aggression will provide evidence to support the validity of the frustrative non-reward construct.

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Section: Rationale For Using Both Fmri and Eegsupporting

confidence: 63%

Neural Mechanisms of Cognitive-Behavioral Therapy for Aggression in Children and Adolescents: Design of a Randomized Controlled Trial Within the National Institute for Mental Health Research Domain Criteria Construct of Frustrative Non-Reward

Sukhodolsky

Wyk

Eilbott

et al. 2016

Journal of Child and Adolescent Psychopharmacology

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“…One plausible hypothesis is that interventions that modulate ACC activity may help to increase cognitive control systems and thereby reduce future recidivism. Initial support for this hypothesis has already been reported in a recent study implicating the ACC in treatment responsiveness among children with externalizing problems (21).…”

Section: Discussionmentioning

confidence: 69%

Neuroprediction of future rearrest

Aharoni

Vincent

Harenski

et al. 2013

Proc. Natl. Acad. Sci. U.S.A.

229

198

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Identification of factors that predict recurrent antisocial behavior is integral to the social sciences, criminal justice procedures, and the effective treatment of high-risk individuals. Here we show that error-related brain activity elicited during performance of an inhibitory task prospectively predicted subsequent rearrest among adult offenders within 4 y of release (N = 96). The odds that an offender with relatively low anterior cingulate activity would be rearrested were approximately double that of an offender with high activity in this region, holding constant other observed risk factors. These results suggest a potential neurocognitive biomarker for persistent antisocial behavior.R isk assessment is a major component of criminal justice and treatment decisions. One crucial application of such predictions is the ability to identify, manage, and remediate antisocial behavior. Decisions that rely on antisocial risk prediction pervade the justice system, beginning with recommendations for bail, jail, and probation to sentencing, civil commitment, parole decisions, diversion, and treatment program assignments, to name a few. Initial attempts to predict future antisocial behavior based purely on clinicians' opinions have been shown to be highly inaccurate (1). Subsequent research that used evidence-based static (e.g., age, sex, criminal history) and dynamic (e.g., impulsivity, drug use, social support) risk factors have led to significant improvements in predicting future antisocial behavior (2-4).One of the strongest and most widely studied risk factors for recidivism is impulsivity, or behavioral disinhibition, the persistent lack of restraint and consideration of consequences (3). Risk assessments, personality tests, and neuropsychological measures have been used to assess impulsivity and have demonstrated the ability to predict future antisocial behavior. However, these latter measures serve only as proxies for direct measurement of the brain's inhibitory and cognitive control systems. Indeed, neuroscientists have suggested that endophenotypes carry the potential to characterize underlying traits and abnormalities independently of behavioral phenotypes (5). This stance has been supported by recent functional MRI (fMRI) studies that have, for instance, accurately predicted choices in a motor-decision task (6), substance abuse relapse (7-10), and consumer purchases (i.e., neuromarketing) (11). These results raise the possibility that more direct measures of brain activity associated with impulse control may lend incremental utility to the prediction of future antisocial behavior.The brain regions associated with impulse control have been well characterized. Consistent among these regions is the anterior cingulate cortex (ACC), a limbic region associated with error processing, conflict monitoring, response selection, and avoidance learning (12-16). Neurobiological models suggest that the ACC is central to an error-monitoring circuit wherein it relays error information from the basal ganglia and inferior fron...

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“…In a sample of children in treatment for externalizing behavior problems, Woltering et al. (2011) found that larger N200 amplitudes and smaller frontal P300 amplitudes characterized the clinical children, and reflected less efficient response inhibition (N200) and less efficient processing of context updating or response control (P300). After treatment, treatment effects were specific to N200.…”

Section: Introductionmentioning

confidence: 99%

Brain potentials predict substance abuse treatment completion in a prison sample

et al. 2016

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IntroductionNational estimates suggest that up to 80% of prison inmates meet diagnostic criteria for a substance use disorder. Because more substance abuse treatment while incarcerated is associated with better post‐release outcomes, including a reduced risk of accidental overdose death, the stakes are high in developing novel predictors of substance abuse treatment completion in inmate populations.MethodsUsing electroencephalography (EEG), this study investigated stimulus‐locked ERP components elicited by distractor stimuli in three tasks (VO‐Distinct, VO‐Repeated, Go/NoGo) as a predictor of treatment discontinuation in a sample of male and female prison inmates. We predicted that those who discontinued treatment early would exhibit a less positive P3a amplitude elicited by distractor stimuli.ResultsOur predictions regarding ERP components were partially supported. Those who discontinued treatment early exhibited a less positive P3a amplitude and a less positive PC4 in the VO‐D task. In the VO‐R task, however, those who discontinued treatment early exhibited a more negative N200 amplitude rather than the hypothesized less positive P3a amplitude. The discontinuation group also displayed less positive PC4 amplitude. Surprisingly, there were no time‐domain or principle component differences among the groups in the Go/NoGo task. Support Vector Machine (SVM) models of the three tasks accurately classified individuals who discontinued treatment with the best model accurately classifying 75% of inmates. PCA techniques were more sensitive in differentiating groups than the classic time‐domain windowed approach.ConclusionsOur pattern of findings are consistent with the context‐updating theory of P300 and may help identify subtypes of ultrahigh‐risk substance abusers who need specialized treatment programs.

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Neural Changes Associated with Treatment Outcome in Children with Externalizing Problems

Abstract: The current thesis directly investigated whether changes in the neural correlates

Cited by 62 publications

References 131 publications

Neural Mechanisms of Cognitive-Behavioral Therapy for Aggression in Children and Adolescents: Design of a Randomized Controlled Trial Within the National Institute for Mental Health Research Domain Criteria Construct of Frustrative Non-Reward

Neural Mechanisms of Cognitive-Behavioral Therapy for Aggression in Children and Adolescents: Design of a Randomized Controlled Trial Within the National Institute for Mental Health Research Domain Criteria Construct of Frustrative Non-Reward

Neuroprediction of future rearrest

Brain potentials predict substance abuse treatment completion in a prison sample

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