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Li Z, Duan R, Guo Y, Li P, Warren CM. Distinct influence of inter- versus intra-trial feedback on the brain response to subsequent feedback: Evidence from event-related potentials. Biol Psychol 2023; 181:108596. [PMID: 37268264 DOI: 10.1016/j.biopsycho.2023.108596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 05/10/2023] [Accepted: 05/30/2023] [Indexed: 06/04/2023]
Abstract
Substantial evidence indicates that feedback processing not only varies with the valence of feedback, but is also highly dependent on contextual factors. Even so, the influence of prior outcome history on current outcome evaluation is far from clear. To investigate this issue, we conducted two event-related potential (ERP) experiments using a modified gambling task whereby each trial was associated with two consequences. In experiment 1, two instances of feedback indicated participant performance on two dimensions of a single decision, within a trial. In experiment 2, participants made two decisions in each trial, and then received two instances of feedback. We examined the feedback-related negativity (FRN) as an index of feedback processing. When both instances of feedback were relevant to the same trial (intra-trial), the FRN to the second was affected by the valence of the immediately previous feedback: The FRN was amplified to losses following wins. This was observed in both experiment 1 and experiment 2. When two instances of feedback were relevant to two different trials (inter-trial), the effect of immediately previous feedback on the FRN was inconsistent. In experiment 1 there was no effect of feedback from the previous trial on the FRN. However, in Experiment 2 there was an effect of inter-trial feedback on the FRN that was opposite to the effect of intra-trial feedback: The FRN was amplified when losses followed losses. Taken together, the findings suggest that the neural systems involved in reward processing dynamically and continuously integrate preceding feedback for the evaluation of present feedback.
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Affiliation(s)
- Zhurong Li
- Brain Function and Psychological Science Research Center Shenzhen University, Shenzhen, China
| | - Ran Duan
- Brain Function and Psychological Science Research Center Shenzhen University, Shenzhen, China
| | - Yiming Guo
- Brain Function and Psychological Science Research Center Shenzhen University, Shenzhen, China
| | - Peng Li
- Brain Function and Psychological Science Research Center Shenzhen University, Shenzhen, China; Shenzhen Key Laboratory of Affective and Social Cognitive Science Shenzhen University, Shenzhen, China.
| | - Christopher M Warren
- Emma Eccles Jones College of Education and Human Services Utah State University, USA
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Yokota Y, Naruse Y. Effects of subjective and objective task difficulties for feedback- related brain potentials in social situations: An electroencephalogram study. PLoS One 2022; 17:e0277663. [PMID: 36454908 PMCID: PMC9714923 DOI: 10.1371/journal.pone.0277663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 11/01/2022] [Indexed: 12/03/2022] Open
Abstract
In this study, the relationship between two types of feedback task difficulties and feedback-related brain potentials, such as feedback-related negativity (FRN), reward positivity (RewP), and P300, was investigated in social situations where participants performed a task simultaneously by a pair. The electroencephalogram activity was measured while participants answered four-choice questions with their partners. Participants were informed about the general accuracy rate of the question (objective task difficulty) before responding to the questionnaire. The feedback outcome was definitely correct when the participants had the knowledge to answer the questions correctly. Therefore, the subjective task difficulty depended on the knowledge of the participant and differed from the objective task difficulty. In the task, the participants selected the choice they deemed correct. Before checking the answers, participants responded to the preceding question's subjective task difficulty. As one of the social factors, the task consisted of two types of conditions: one, in which one's response affected partner's reward, and another, in which it did not. The second social factor was the order of feedback outcomes; in our experiment, these outcomes were presented sequentially to pairs of participants. The effects of subjective and objective task difficulties and social factors on feedback-related brain potentials were comprehensively analyzed. The study showed that subjective task difficulty sensitively modulated the amplitude of gain-related P300, suggesting that it is sensitive to modulation in the allocation of attentional resources to own feedback outcome. The objective task difficulty sensitively modulated the amplitude of RewP after receiving the partner's incorrect feedback outcome. RewP was more sensitive to positive affective valence, such as feelings of superiority over the partner, than to task-dependent rewards received by the participants themselves. In contrast, FRN was more negative in the joint condition than in the individual condition, suggesting sensitivity to social responsibility felt by participants toward their partners.
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Affiliation(s)
- Yusuke Yokota
- Center for Information and Neural Networks (CiNet), National Institute of Information and Communications Technology, and Osaka University, Kobe, Japan
| | - Yasushi Naruse
- Center for Information and Neural Networks (CiNet), National Institute of Information and Communications Technology, and Osaka University, Kobe, Japan
- * E-mail:
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Manual action re-planning interferes with the maintenance process of working memory: an ERP investigation. PSYCHOLOGICAL RESEARCH 2022:10.1007/s00426-022-01741-4. [PMID: 36434433 PMCID: PMC10366281 DOI: 10.1007/s00426-022-01741-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 09/14/2022] [Indexed: 11/27/2022]
Abstract
AbstractThe current study investigated the re-planning of the grasping movements, its functional interactions with working memory (WM), and underlying neurophysiological activity. Mainly, the current study investigated the movement re-planning interference with WM domains (verbal, visuospatial) and processes (maintenance, retrieval). We combined a cognitive-motor dual-task paradigm with an EEG setting. Thirty-six participants completed the verbal and visuospatial versions of a WM task concurrently with a manual task which required performing a grasp-and-place movement by keeping the initial movement plan (prepared movement condition) or changing it for reversing the movement direction (re-planned movement condition). ERPs were extracted for the prepared and re-planned conditions in the verbal and visuospatial tasks separately during the maintenance and retrieval processes. ERP analyses showed that during the maintenance process of both the verbal and visuospatial tasks, the re-planned movements compared to the prepared movements generated a larger positive slow wave with a centroparietal maximum between 200 and 700. We interpreted this ERP effect as a P300 component for the re-planned movements. There was no ERP difference between the planned and re-planned movements during the retrieval process. Accordingly, we suggest that re-planning the grasp-and-place movement interfered at least with the maintenance of the verbal and visuospatial domains, resulting in the re-planning costs. More generally, the current study provides the initial neurophysiological investigations of the movement re-planning–WM interactions during grasping movements, and contributes to a better understanding of the neurocognitive mechanisms underlying manual action flexibility.
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Wang X, Wu H, Huang J, Gao C, Yin Y, Tang X, Peng D. Reward mechanism of depressive episodes in bipolar disorder: Enhanced theta power in feedback-related negativity. J Affect Disord 2021; 292:217-222. [PMID: 34130186 DOI: 10.1016/j.jad.2021.05.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 05/08/2021] [Accepted: 05/23/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION This study aimed to explore the reward-related neural mechanism in patients with depressive mood in bipolar disorder (BD) using event-related potentials. It remains unknown whether or not different neurobiological markers underlying depression symptoms in BD depression and major depression disorder (MDD). METHODS 24 patients with BD depression and 20 healthy controls were included. Participants underwent evaluation with the Temporal Experience of Pleasure Scale (TEPS), followed by the classical gambling paradigm, while undergoing 64-channel electroencephalography. The waveform of feedback-related negativity (FRN) was extracted from the 250-350 ms time-window after participants received feedback regarding loss or gain. Event-related potential datasets were obtained using time-frequency analysis. RESULTS (1) The TEPS scores of the patients were significantly lower than those of the controls [t(42) = 5.16, p < 0.01]. (2) The event of loss elicited a deeper FRN in patients than that in controls [t(42) = 2.19, p < 0.05], while no difference was observed in the event of gains (t(42) = 1.12, p > 0.05). (3) Theta power rooted in FRN in patients was significantly higher in loss than in gain [F(1,42) = 30.32, p < 0.01]. (4) Analysis of Variance (ANOVA) illustrated the interaction effect of theta power in gain/loss between two groups [F(1,42) = 3.59, p = 0.06]. LIMITATION Our study did not analyze the effect of different drugs which might affect our results. CONCLUSION The enhanced reflection of negative feedback was consistent with the negative bias, impulse control impairment, and emotional dysregulation observed in the bipolar disorder spectrum. We suggested that the extreme theta power generated from the anterior cingulate gyrus (ACC) might be the main component of abnormal FRN.
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Affiliation(s)
- Xinyu Wang
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Haiyan Wu
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Jia Huang
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Chenyang Gao
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Ying Yin
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Xiaochen Tang
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
| | - Daihui Peng
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
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Morie KP, Wu J, Potenza MN, Krishnan-Sarin S, Mayes LC, Hammond CJ, Crowley MJ. Daily cannabis use in adolescents who smoke tobacco is associated with altered late-stage feedback processing: A high-density electrical mapping study. J Psychiatr Res 2021; 139:82-90. [PMID: 34052575 PMCID: PMC8314801 DOI: 10.1016/j.jpsychires.2021.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/15/2021] [Accepted: 05/20/2021] [Indexed: 10/21/2022]
Abstract
Impairments in feedback processing, often associated with risk-taking behavior, may have implications for development of substance abuse in adolescents. The most commonly used substances by adolescents include tobacco and cannabis, with some individuals using both substances, potentially heightening risk. Our objective was to examine feedback processing and impulsivity in adolescents who smoke cigarettes and use cannabis daily (N = 21), comparing them with adolescents who smoke cigarettes daily and use cannabis occasionally (N = 18) and non-smoking (N = 27) adolescents. To do this, the Balloon Analog Risk Task (BART) with concurrent EEG was used to measure risk-related feedback processing, and impulsivity was measured using the Barratt's impulsiveness scale (BIS-11). It was found that adolescent daily tobacco/cannabis smoking was associated with higher BIS-11 scores, shortened feedback-related-negativity (FRN) latencies and reduced P300 amplitudes. In addition, FRN latencies during win conditions were inversely associated with tobacco-use severity, indicated by scores on the Fagerstrom Test for Nicotine Dependence (FTND), and with BIS-11 scores. Adolescents with concurrent tobacco and cannabis use show altered feedback processing and higher impulsivity. Future work should disentangle whether the effect reflects risk, consequences of use or both.
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Affiliation(s)
- Kristen P Morie
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA; Child Study Center, Yale University School of Medicine, New Haven, CT, 06510, USA.
| | - Jia Wu
- Child Study Center, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA; Child Study Center, Yale University School of Medicine, New Haven, CT, 06510, USA; Connecticut Mental Health Center, New Haven, CT, 06519, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, 06109, USA; Department of Neuroscience, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Suchitra Krishnan-Sarin
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA; Child Study Center, Yale University School of Medicine, New Haven, CT, 06510, USA; Connecticut Mental Health Center, New Haven, CT, 06519, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, 06109, USA; Department of Neuroscience, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Linda C Mayes
- Child Study Center, Yale University School of Medicine, New Haven, CT, 06510, USA; Department of Pediatrics, Yale University School of Medicine, New Haven, CT, 06519, USA; Department of Psychology, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Christopher J Hammond
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA; Child Study Center, Yale University School of Medicine, New Haven, CT, 06510, USA; Johns Hopkins School of Medicine, Baltimore, MD, 21218, USA
| | - Michael J Crowley
- Child Study Center, Yale University School of Medicine, New Haven, CT, 06510, USA
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Direito B, Ramos M, Pereira J, Sayal A, Sousa T, Castelo-Branco M. Directly Exploring the Neural Correlates of Feedback-Related Reward Saliency and Valence During Real-Time fMRI-Based Neurofeedback. Front Hum Neurosci 2021; 14:578119. [PMID: 33613202 PMCID: PMC7893090 DOI: 10.3389/fnhum.2020.578119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 12/28/2020] [Indexed: 01/04/2023] Open
Abstract
Introduction: The potential therapeutic efficacy of real-time fMRI Neurofeedback has received increasing attention in a variety of psychological and neurological disorders and as a tool to probe cognition. Despite its growing popularity, the success rate varies significantly, and the underlying neural mechanisms are still a matter of debate. The question whether an individually tailored framework positively influences neurofeedback success remains largely unexplored. Methods: To address this question, participants were trained to modulate the activity of a target brain region, the visual motion area hMT+/V5, based on the performance of three imagery tasks with increasing complexity: imagery of a static dot, imagery of a moving dot with two and with four opposite directions. Participants received auditory feedback in the form of vocalizations with either negative, neutral or positive valence. The modulation thresholds were defined for each participant according to the maximum BOLD signal change of their target region during the localizer run. Results: We found that 4 out of 10 participants were able to modulate brain activity in this region-of-interest during neurofeedback training. This rate of success (40%) is consistent with the neurofeedback literature. Whole-brain analysis revealed the recruitment of specific cortical regions involved in cognitive control, reward monitoring, and feedback processing during neurofeedback training. Individually tailored feedback thresholds did not correlate with the success level. We found region-dependent neuromodulation profiles associated with task complexity and feedback valence. Discussion: Findings support the strategic role of task complexity and feedback valence on the modulation of the network nodes involved in monitoring and feedback control, key variables in neurofeedback frameworks optimization. Considering the elaborate design, the small sample size here tested (N = 10) impairs external validity in comparison to our previous studies. Future work will address this limitation. Ultimately, our results contribute to the discussion of individually tailored solutions, and justify further investigation concerning volitional control over brain activity.
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Affiliation(s)
- Bruno Direito
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal.,Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
| | - Manuel Ramos
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal
| | - João Pereira
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal.,Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
| | - Alexandre Sayal
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal.,Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal.,Siemens Healthineers, Lisbon, Portugal
| | - Teresa Sousa
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal.,Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
| | - Miguel Castelo-Branco
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal.,Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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Paul K, Vassena E, Severo MC, Pourtois G. Dissociable effects of reward magnitude on fronto‐medial theta and FRN during performance monitoring. Psychophysiology 2019; 57:e13481. [DOI: 10.1111/psyp.13481] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 08/09/2019] [Accepted: 08/16/2019] [Indexed: 01/20/2023]
Affiliation(s)
- Katharina Paul
- Cognitive & Affective Psychophysiology Laboratory Department of Experimental, Clinical, and Health Psychology Ghent University Ghent Belgium
| | - Eliana Vassena
- Donders Institute for Brain, Cognition and Behaviour Radboud University Nijmegen Nijmegen The Netherlands
| | - Mario Carlo Severo
- Cognitive & Affective Psychophysiology Laboratory Department of Experimental, Clinical, and Health Psychology Ghent University Ghent Belgium
| | - Gilles Pourtois
- Cognitive & Affective Psychophysiology Laboratory Department of Experimental, Clinical, and Health Psychology Ghent University Ghent Belgium
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Sehrig S, Weiss A, Miller GA, Rockstroh B. Decision- and feedback-related brain potentials reveal risk processing mechanisms in patients with alcohol use disorder. Psychophysiology 2019; 56:e13450. [PMID: 31380569 DOI: 10.1111/psyp.13450] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 06/24/2019] [Accepted: 07/11/2019] [Indexed: 12/15/2022]
Abstract
Individuals with alcohol use disorder (AUD) are aware of the risks of alcohol abuse yet continue risky drinking. Research indicates that dysfunctional decision processes and trait variables such as impulsivity contribute to this awareness-behavior discrepancy. The present study focused on decision-related versus feedback-related processes as potential contributors to decision making in AUD by examining the relationship between decision choices and decision- and feedback-related ERP phenomena in the balloon analogue risk task (BART). N = 39 AUD and n = 35 healthy comparison participants (HC) performed the BART modified for EEG assessment. In each of 100 runs, participants made a series of choices about whether to pump up a virtual balloon, which popped pseudorandomly, ending the run. Alternatively, participants ended the run by pressing a "cash-out" button. Each pump not producing a pop provided .05 €; popping resulted in loss of the run's accumulated gain. Groups made similar choices, though AUD responded more slowly. The decision P3 200-400 ms after decision prompt (balloon) was larger in AUD than in HC, and decision P3 enhancement on high-risk trials predicted choices to pump. Feedback-related negativity (FRN) after loss (relative to cash out) feedback was smaller in AUD than in HC, suggesting indifference to negative feedback. In AUD, high impulsivity was associated with risk-modulated decision P3 but not FRN. Results indicate atypical decision- and feedback-related processes that could contribute to difficulties in engaging with daily challenges effectively.
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Affiliation(s)
- Sarah Sehrig
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Andreas Weiss
- Department of Psychology, University of Konstanz, Konstanz, Germany.,Department of Biological Psychology and Neuropsychology, University of Hamburg, Hamburg, Germany
| | - Gregory A Miller
- Department of Psychology, University of California Los Angeles, Los Angeles, California.,Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California
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Neural correlates of feedback processing during a sensory uncertain speech - nonspeech discrimination task. Biol Psychol 2019; 144:103-114. [DOI: 10.1016/j.biopsycho.2019.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 01/17/2019] [Accepted: 03/26/2019] [Indexed: 11/23/2022]
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Morie KP, Wu J, Landi N, Potenza MN, Mayes LC, Crowley MJ. Feedback processing in adolescents with prenatal cocaine exposure: an electrophysiological investigation. Dev Neuropsychol 2018; 43:183-197. [PMID: 29461102 DOI: 10.1080/87565641.2018.1439945] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Impaired cognitive control is a consequence of cocaine exposure. Difficulty with feedback processing may underlie this impairment. We examined neural correlates of feedback processing using event-related potentials (ERPs) in 49 prenatally cocaine-exposed (PCE) and 34 nondrug exposed (NDE) adolescents. Adolescents performed a reward-feedback task with win/no-win feedback in a chance-based task. We investigated amplitude and latency of the feedback-related negativity (FRN) and P300 ERP components and source-based estimates elicited during feedback processing. PCE adolescents had smaller P300 amplitudes for no-win feedback, and source analysis in the P300 time window revealed differences between groups localized to the dorsal anterior cingulate cortex.
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Affiliation(s)
- Kristen P Morie
- a Department of Psychiatry , Yale University School of Medicine , New Haven , CT , USA.,d Department of Psychiatry, Child Study Center , Yale University School of Medicine , New Haven , CT , USA
| | - Jia Wu
- a Department of Psychiatry , Yale University School of Medicine , New Haven , CT , USA.,d Department of Psychiatry, Child Study Center , Yale University School of Medicine , New Haven , CT , USA
| | - Nicole Landi
- d Department of Psychiatry, Child Study Center , Yale University School of Medicine , New Haven , CT , USA.,g Haskins Laboratories , New Haven , CT , USA
| | - Marc N Potenza
- a Department of Psychiatry , Yale University School of Medicine , New Haven , CT , USA.,b National Center on Addictions and Substance Abuse , Yale University School of Medicine , New Haven , CT , USA.,c Department of Psychology , University of Maryland , College Park , MD , USA.,d Department of Psychiatry, Child Study Center , Yale University School of Medicine , New Haven , CT , USA.,e Department of Neuroscience , Yale University School of Medicine , New Haven , CT , USA.,f Department of Psychiatry, Connecticut Mental Health Center , New Haven , CT , USA
| | - Linda C Mayes
- c Department of Psychology , University of Maryland , College Park , MD , USA.,d Department of Psychiatry, Child Study Center , Yale University School of Medicine , New Haven , CT , USA
| | - Michael J Crowley
- a Department of Psychiatry , Yale University School of Medicine , New Haven , CT , USA.,d Department of Psychiatry, Child Study Center , Yale University School of Medicine , New Haven , CT , USA
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