Differentiating brain function of punishment versus reward processing in conduct disorder with and without attention deficit hyperactivity disorder

The World Journal of Biological Psychiatry, vol. 23, pp. 349–360

Abstract

OBJECTIVES: Conduct disorder (CD) and attention-deficit/hyperactivity disorder (ADHD) are reported to co-occur in about 30-50% of affected individuals. Research suggests that poor reinforcement-based decision-making may contribute to impaired social functioning in both youths with CD and ADHD. Considering its frequent co-occurrence this raises the question whether decision-making deficits in both disorders have a disorder-specific and/or shared neurobiological basis. METHODS: 138 participants with CD, ADHD, or CD + ADHD, and typically developing controls (TDCs) aged 9-18 years (48% girls) were included in the study. Participants completed a reinforcement-based decision-making task in the fMRI scanner, investigating decision-making capabilities under different reinforcement contingencies (i.e. punishment vs. reward). Whole-brain and ROI analyses were used to test for potential group differences. RESULTS: For punishment versus reward contingencies, relative to TDCs, youths with CD + ADHD displayed lower brain activity in dorsal striatum (incl. caudate), middle temporal gyrus (MTG), inferior frontal gyrus (IFG) and lateral occipital cortex, and they showed lower activity in dorsal striatum (incl. putamen), orbitofrontal cortex (OFC) and IFG relative to participants with ADHD. All other group comparisons were found to be non-significant. CONCLUSIONS: Participants with comorbid CD + ADHD are neurobiologically the most severely impaired group regarding reinforcement-based decision-making, particularly in response to punishment.

Authors 8

1. Sarah Baumann corresponding Aachen Department of Child and Adolescent Psychiatry

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Aachen, Germany

2. Arne Hartz Aachen Child Neuropsychology Section Department of Child and Adolescent Psychiatry

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Aachen, Germany

3. Wolfgang Scharke Aachen Cognitive and Experimental Psychology Institute of Psychology

   RWTH Aachen University

   Affiliation as printed

   Cognitive and Experimental Psychology, Institute of Psychology, RWTH Aachen University, Aachen, Germany

4. Stéphane A. De Brito

   University of Birmingham

   Affiliation as printed

   Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK

5. Graeme F. Fairchild

   University of Bath

   Affiliation as printed

   Department of Psychology, University of Bath, Bath, UK

6. Beate Herpertz‐Dahlmann Aachen Department of Child and Adolescent Psychiatry

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Aachen, Germany

7. Kerstin Konrad Aachen Child Neuropsychology Section Department of Child and Adolescent Psychiatry

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Aachen, Germany

8. Gregor Kohls Aachen Child Neuropsychology Section Department of Child and Adolescent Psychiatry

   Universitätsklinikum Aachen · Technische Universität Dresden · RWTH Aachen University

   Affiliation as printed

   Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Aachen, Germany

   Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany