Neural correlates of social decision-making in severely antisocial adolescents

Roles of empathy in altruistic cooperation in adults with and without autism spectrum disorder

Background

Altruistic cooperation (AC) is essential in human social interactions. Previous studies have investigated AC-related behavior in children with autism spectrum disorder (ASD), revealing that there is considerable individual variability in the behavior. However, this issue is still largely unexplored especially in the adult population.

Aims

To investigate individual differences in AC-related behavior, we conducted the resource allocation task (RAT) and modified version of the ultimatum game (mUG) among adults with and without ASD.

Methods and procedures

The study employed a cross-sectional design, involving 27 adults with ASD (mean age 29.1 ± 4.3 years; three females) and 27 adults with typical development (TD) (mean age 25.8 ± 6.7 years; two females), who completed the RAT and mUG tasks. Beyond clinical characteristics, we assessed three primary psychological metrics: the interpersonal reactivity index (IRI), Barratt impulsiveness scale, and the behavioral inhibition and activation systems.

Outcomes and results

No significant differences were observed in the proportions of participants with high AC when assessed by RAT (p = 0.15) and mUG (p = 0.59) between the TD and ASD groups. Participants with high AC from the RAT demonstrated higher perspective-taking scores on the IRI than those with low AC within both the TD (p = 0.04) and ASD groups (p = 0.03). In the TD group, high AC individuals also scored higher on the IRI's fantasy subscale as per the mUG (p = 0.03); however, this trend was not present in the ASD group.

Conclusions and implications

The present findings indicate that empathy plays an important role in individual differences in AC-related behavior among adults with and without ASD, although the role could be different depending on the types of AC-related behavior between TD and ASD populations.

The science of justice: The neuropsychology of social punishment

The social punishment (SP) of norm violations has received much attention across multiple disciplines. However, current models of SP fail to consider the role of motivational processes, and none can explain the observed behavioral and neuropsychological differences between the two recognized forms of SP: second-party punishment (2PP) and third-party punishment (3PP). After reviewing the literature giving rise to the current models of SP, we propose a unified model of SP which integrates general psychological descriptions of decision-making as a confluence of affect, cognition, and motivation, with evidence that SP is driven by two main factors: the amount of harm (assessed primarily in the salience network) and the norm violator's intention (assessed primarily in the default-mode and central-executive networks). We posit that motivational differences between 2PP and 3PP, articulated in mesocorticolimbic pathways, impact final SP by differentially impacting the assessments of harm and intention done in these domain-general large-scale networks. This new model will lead to a better understanding of SP, which might even improve forensic, procedural, and substantive legal practices.

Moral Thinking and Empathy in Cognitive Behavioral Therapy for Children and Adolescents with Conduct Problems: A Narrative Review

Cognitive behavioral therapy (CBT) for conduct problems in children and adolescents aims to decrease behaviors which may be considered moral transgressions (e.g., aggressive and antisocial behavior) and to increase behaviors that benefit others (e.g., helping, comforting). However, the moral aspects underlying these behaviors have received relatively little attention. In view of increasing the effectiveness of CBT for conduct problems, insights into morality and empathy based on studies from developmental psychology and cognitive neuroscience are reviewed and integrated into a previously proposed model of social problem-solving (Matthys & Schutter, Clin Child Fam Psychol Rev 25:552-572, 2022). Specifically, this narrative review discusses developmental psychology studies on normative beliefs in support of aggression and antisocial behavior, clarification of goals, and empathy. These studies are complemented by cognitive neuroscience research on harm perception and moral thinking, harm perception and empathy, others' beliefs and intentions, and response outcome learning and decision-making. A functional integration of moral thinking and empathy into social problem-solving in group CBT may contribute to the acceptance of morality-related issues by children and adolescents with conduct problems.

Decision neuroscience and neuroeconomics: Recent progress and ongoing challenges

In the past decade, decision neuroscience and neuroeconomics have developed many new insights in the study of decision making. This review provides an overarching update on how the field has advanced in this time period. Although our initial review a decade ago outlined several theoretical, conceptual, methodological, empirical, and practical challenges, there has only been limited progress in resolving these challenges. We summarize significant trends in decision neuroscience through the lens of the challenges outlined for the field and review examples where the field has had significant, direct, and applicable impacts across economics and psychology. First, we review progress on topics including reward learning, explore-exploit decisions, risk and ambiguity, intertemporal choice, and valuation. Next, we assess the impacts of emotion, social rewards, and social context on decision making. Then, we follow up with how individual differences impact choices and new exciting developments in the prediction and neuroforecasting of future decisions. Finally, we consider how trends in decision-neuroscience research reflect progress toward resolving past challenges, discuss new and exciting applications of recent research, and identify new challenges for the field. This article is categorized under: Psychology > Reasoning and Decision Making Psychology > Emotion and Motivation.

Improving Our Understanding of Impaired Social Problem-Solving in Children and Adolescents with Conduct Problems: Implications for Cognitive Behavioral Therapy

In cognitive behavioral therapy (CBT) children and adolescents with conduct problems learn social problem-solving skills that enable them to behave in more independent and situation appropriate ways. Empirical studies on psychological functions show that the effectiveness of CBT may be further improved by putting more emphasis on (1) recognition of the type of social situations that are problematic, (2) recognition of facial expressions in view of initiating social problem-solving, (3) effortful emotion regulation and emotion awareness, (4) behavioral inhibition and working memory, (5) interpretation of the social problem, (6) affective empathy, (7) generation of appropriate solutions, (8) outcome expectations and moral beliefs, and (9) decision-making. To improve effectiveness, CBT could be tailored to the individual child's or adolescent's impairments of these psychological functions which may depend on the type of conduct problems and their associated problems.

Intergroup bias in punishing behaviors of adults with autism spectrum disorder

Groups are essential elements of society, and humans, by nature, commonly manifest intergroup bias (i.e., behave more positively toward an ingroup member than toward an outgroup member). Despite the growing evidence of various types of altered decision-making in individuals with autism spectrum disorder (ASD), their behavior under the situation involving group membership remains largely unexplored. By modifying a third-party punishment paradigm, we investigated intergroup bias in individuals with ASD and typical development (TD). In our experiment, participants who were considered as the third party observed a dictator game wherein proposers could decide how to distribute a provided amount of money while receivers could only accept unconditionally. Participants were confronted with two different group situations: the proposer was an ingroup member and the recipient was an outgroup member (IN/OUT condition) or the proposer was an outgroup member and the recipient was an ingroup member (OUT/IN condition). Participants with TD punished proposers more severely when violating social norms in the OUT/IN condition than in IN/OUT condition, indicating that their decisions were influenced by the intergroup context. This intergroup bias was attenuated in individuals with ASD. Our findings deepen the understanding of altered decision-making and socioeconomic behaviors in individuals with ASD.

Neurofunctional abnormalities in antisocial spectrum: A meta-analysis of fMRI studies on Five distinct neurocognitive research domains

Past functional magnetic resonance imaging on antisocial subjects have shown important inconsistencies and methodological problems (e.g. heterogeneity in fMRI tasks domain, small sample sizes, analyses on regions-of-interest). We aimed to conduct a meta-analysis of whole-brain fMRI studies on antisocial individuals based on distinct neurocognitive domains. A voxel-based meta-analysis via permutation of subject images (SDM-PSI) was performed on studies using fMRI tasks in the domains of acute threat response, cognitive control, social cognition, punishment and reward processing. Overall, 83 studies were retrieved. Using a liberal statistical threshold, several key regions were identified in the meta-analysis, principally during acute threat response, social cognition and cognitive control tasks. Additionally, we observed that the right amygdala was negatively associated with both callous-unemotional traits and severity of antisocial behaviors, in meta-analyses on region-of-interest and on dimensional studies, respectively. The findings show that the most prominent functional brain deficits arise during acute threat response, social cognitions and cognitive control neurocognitive domains. These results provide substantial insights for our understanding of aberrant neural processing across specific contexts.

The Role of Social Reward and Corticostriatal Connectivity in Substance Use

This report describes an ongoing R03 grant that explores the links between trait reward sensitivity, substance use, and neural responses to social and nonsocial reward. Although previous research has shown that trait reward sensitivity and neural responses to reward are linked to substance use, whether this relationship is impacted by how people process social stimuli remains unclear. We are investigating these questions via a neuroimaging study with college-aged participants, using individual difference measures that examine the relation between substance use, social context, and trait reward sensitivity with tasks that measure reward anticipation, strategic behavior, social reward consumption, and the influence of social context on reward processing. We predict that substance use will be tied to distinct patterns of striatal dysfunction. Specifically, reward hyposensitive individuals will exhibit blunted striatal responses to social and non-social reward and enhanced connectivity with the orbitofrontal cortex; in contrast, reward hypersensitive individuals will exhibit enhanced striatal responses to social and non-social reward and blunted connectivity with the orbitofrontal cortex. We also will examine the relation between self-reported reward sensitivity, substance use, and striatal responses to social reward and social context. We predict that individuals reporting the highest levels of substance use will show exaggerated striatal responses to social reward and social context, independent of self-reported reward sensitivity. Examining corticostriatal responses to reward processing will help characterize the relation between reward sensitivity, social context and substance use while providing a foundation for understanding risk factors and isolating neurocognitive mechanisms that may be targeted to increase the efficacy of interventions.

Brains of a feather flocking together? Peer and individual neurobehavioral risks for substance use across adolescence

Adolescence is a period of heightened susceptibility to peer influences, and deviant peer affiliation has well-established implications for the development of psychopathology. However, little is known about the role of brain functions in pathways connecting peer contexts and health risk behaviors. We tested developmental cascade models to evaluate contributions of adolescent risk taking, peer influences, and neurobehavioral variables of risk processing and cognitive control to substance use among 167 adolescents who were assessed annually for four years. Risk taking at Time 1 was related to substance use at Time 4 indirectly through peer substance use at Time 2 and insular activation during risk processing at Time 3. Furthermore, neural cognitive control moderated these effects. Greater insular activation during risk processing was related to higher substance use for those with greater medial prefrontal cortex activation during cognitive control, but it was related to lower substance use among those with lower medial prefrontal cortex activation during cognitive control. Neural processes related to risk processing and cognitive control play a crucial role in the processes linking risk taking, peer substance use, and adolescents' own substance use.

Incorporating the social context into neurocognitive models of adolescent decision-making: A neuroimaging meta-analysis

Neurobiological models of adolescent decision-making emphasize developmental changes in brain regions involved in affect (e.g., ventral striatum) and cognitive control (e.g., lateral prefrontal cortex). Although social context plays an important role in adolescent decision-making, current models do not discuss brain regions implicated in processing social information (e.g., dorsomedial prefrontal cortex). We conducted a coordinate-based meta-analysis using the Multilevel peak Kernel Density Analysis (MKDA) method to test the hypothesis that brain regions involved in affect, cognitive control, and social information processing support adolescent decision-making in social contexts (N = 21 functional neuroimaging studies; N = 1292 participants). Results indicated that dorsomedial prefrontal cortex, inferior frontal gyrus/insula and ventral striatum are consistently associated with adolescent decision-making in social contexts. Activity within these regions was modulated by the type of social context and social actors involved. Findings suggest including brain regions involved in social information processing into models of adolescent decision-making. We propose a 'constructionist' model, which describes psychological processes and corresponding neural networks related to affect, cognitive control, and social information processing.

Out of Context, Beyond the Face: Neuroanatomical Pathways of Emotional Face-Body Language Integration in Adolescent Offenders

Background: Adolescent offenders (AOs) are characterized by social-norm transgression and aggressive behaviors. Those traits have been associated with alterations in socio-cognitive processes, including facial emotion recognition. While this would suggest that AOs tend to interpret negative emotional cues as threatening information, most research has relied on context-free stimuli, thus failing to directly track integrative processes typical of everyday cognition.

Methods: In this study, we assessed the impact of body language and surrounding context on facial emotion recognition in AOs and non-offenders (NOs). We recruited 35 AOs from a reform school for young male offenders and 30 NOs matched for age and sex with the former group. All participants completed a well-validated task aimed to determine how contextual cues (i.e., emotional body language and surrounding context) influence facial emotion recognition through the use of congruent and incongruent combinations of facial and bodily emotional information.

Results: This study showed that AOs tend to overvalue bodily and contextual signals in emotion recognition, with poorer facial-emotion categorization and increased sensitivity to context information in incongruent face-body scenarios. This pattern was associated with executive dysfunctions and disruptive behaviors, as well as with gray matter (GM) of brain regions supporting body-face recognition [fusiform gyrus (FG)], emotion processing [cingulate cortex (CC), superior temporal gyrus (STG)], contextual integration (precuneus, STG), and motor resonance [cerebellum, supplementary motor area (SMA)].

Discussion: Together, our results pave the way for a better understanding of the neurocognitive association between contextual emotion recognition, behavioral regulation, cognitive control, and externalized behaviors in AOs.

Enhancing activation in the right temporoparietal junction using theta-burst stimulation: Disambiguating between two hypotheses of top-down control of behavioral mimicry

Whereas previous research has focused on the role of the rTPJ when consciously inhibiting mimicry, we test the role of the rTPJ on mimicry within a social interaction, during which mimicking occurs nonconsciously. We wanted to determine whether higher rTPJ activation always inhibits the tendency to imitate (regardless of the context) or whether it facilitates mimicry during social interactions (when mimicking is an adaptive response). Participants received either active or sham intermittent theta-burst stimulation (iTBS: a type of stimulation that increases cortical activation) to the rTPJ. Next, we measured how much participants mimicked the hair and face touching of another person. Participants in the active stimulation condition engaged in significantly less mimicry than those in the sham stimulation condition. This finding suggests that even in a context in which mimicking is adaptive, rTPJ inhibits mimicry rather than facilitating it, supporting the hypothesis that rTPJ enhances representations of self over other regardless of the goals within a given context.

Adolescent Externalizing Problems: Contributions of Community Crime Exposure and Neural Function During Emotion Introspection in Mexican-Origin Youth

Models of the etiology of adolescent antisocial behavior suggest that externalizing problems may reflect a susceptibility to crime exposure and a diminished capacity for emotion introspection. In this study, adolescents of Mexican origin completed a neuroimaging task that involved rating their subjective feelings of sadness in response to emotional facial expressions or a nonemotional aspect of each face. At lower levels of neural activity during sadness introspection in posterior cingulate and left temporoparietal junction, and in left amygdala, brain regions involved in mentalizing and emotion, respectively, a stronger positive association between community crime exposure and externalizing problems was found. The specification of emotion introspection as a psychological process showing neural variation may help inform targeted interventions to positively affect adolescent behavior.

No Change in Social Decision-Making Following Transcranial Direct Current Stimulation of the Right Temporoparietal Junction

The right temporoparietal junction (rTPJ) is thought to play an important role in social cognition and pro-social decision-making. One way to explore this link is through the use of transcranial direct current stimulation (tDCS), a non-invasive brain stimulation method that is able to modulate cortical activity. The aim of this research was therefore to determine whether anodal tDCS to the rTPJ altered response to a social decision-making task. In this study, 34 healthy volunteers participated in a single-center, double-blinded, sham-controlled crossover design. Subjects received 20 min of active/sham anodal tDCS to the rTPJ before undertaking the Ultimatum Game (UG), a neuroeconomics paradigm in which participants are forced to choose between monetary reward and punishing an opponent's unfairness. Contrary to expectations, we found no significant difference between anodal and sham stimulation with regard to either the total number or reaction time of unfair offer rejections in the UG. This study draws attention to methodological issues in tDCS studies of the rTPJ, and highlights the complexity of social decision-making in the UG.

Collaborative roles of Temporoparietal Junction and Dorsolateral Prefrontal Cortex in Different Types of Behavioural Flexibility

Behavioural flexibility is essential for everyday life. This involves shifting attention between different perspectives. Previous studies suggest that flexibility is mainly subserved by the dorsolateral prefrontal cortex (DLPFC). However, although rarely emphasized, the temporoparietal junction (TPJ) is frequently recruited during flexible behaviour. A crucial question is whether TPJ plays a role in different types of flexibility, compared to its limited role in perceptual flexibility. We hypothesized that TPJ activity during diverse flexibility tasks plays a common role in stimulus-driven attention-shifting, thereby contributing to different types of flexibility, and thus the collaboration between DLPFC and TPJ might serve as a more appropriate mechanism than DLPFC alone. We used fMRI to measure DLPFC/TPJ activity recruited during moral flexibility, and examined its effect on other domains of flexibility (economic/perceptual). Here, we show the additional, yet crucial role of TPJ: a combined DLPFC/TPJ activity predicted flexibility, regardless of domain. Different types of flexibility might rely on more basic attention-shifting, which highlights the behavioural significance of alternatives.

Imaging decision about whether to benefit self by harming others: Adolescents with conduct and substance problems, with or without callous-unemotionality, or developing typically

We sought to identify brain activation differences in conduct-problem youth with limited prosocial emotions (LPE) compared to conduct-problem youth without LPE and community adolescents, and to test associations between brain activation and severity of callous-unemotional traits. We utilized a novel task, which asks subjects to repeatedly decide whether to accept offers where they will benefit but a beneficent other will be harmed. Behavior on this task has been previously associated with levels of prosocial emotions and severity of callous-unemotional traits, and is related to empathic concern. During fMRI acquisition, 66 male adolescents (21 conduct-problem patients with LPE, 21 without, and 24 typically-developing controls) played this novel game. Within typically-developing controls, we identified a network engaged during decision involving bilateral insula, and inferior parietal and medial frontal cortices, among other regions. Group comparisons using non-parametric (distribution-free) permutation tests demonstrated LPE patients had lower activation estimates than typically-developing adolescents in right anterior insula. Additional significant group differences emerged with our a priori parametric cluster-wise inference threshold. These results suggest measurable functional brain activation differences in conduct-problem adolescents with LPE compared to typically-developing adolescents. Such differences may underscore differential treatment needs for conduct-problem males with and without LPE.

Neural correlates of proactive and reactive aggression in adolescent twins

Verbal and physical aggression begin early in life and steadily decline thereafter in normal development. As a result, elevated aggressive behavior in adolescence may signal atypical development and greater vulnerability for negative mental and health outcomes. Converging evidence suggests that brain disturbances in regions involved in impulse control, emotional regulation, and sensation seeking may contribute to heightened aggression. However, little is known regarding the neural mechanisms underlying subtypes of aggression (i.e., proactive and reactive aggression) and whether they differ between males and females. Using a sample of 106 14-year-old adolescent twins, this study found that striatal enlargement was associated with both proactive and reactive aggression. We also found that volumetric alterations in several frontal regions including smaller middle frontal and larger orbitofrontal cortex were correlated with higher levels of aggression in adolescent twins. In addition, cortical thickness analysis showed that thickness alterations in many overlapping regions including middle frontal, superior frontal, and anterior cingulate cortex and temporal regions were associated with aggression in adolescent twins. Results support the involvement of fronto-limbic-striatal circuit in the etiology of aggression during adolescence. Aggr. Behav. 43:230-240, 2017. © 2016 Wiley Periodicals, Inc.

Neural correlates of affective empathy and reinforcement learning in boys with conduct problems: fMRI evidence from a gambling task

BACKGROUND

Conduct problems (CP) comprise abnormal behaviors associated with aberrant aspects of affective empathy as well as learning. However, behavioral measures for affective empathy are challenging, and previous results concerning learning in patients with CP are inconsistent.

METHODS

Nineteen boys with CP and 24 typically developing (TD) boys aged 11-17 years (M=14.34, SD=1.93) participated in the study. An ultimatum-game was applied in order to elicit the feeling of like or dislike towards the opponent for a subsequent gambling task, which was played by the opponents (OTHER-condition) and by the participants themselves (SELF-condition). Functional MRI data were recorded throughout the experiment.

RESULTS

In accordance with the model of insensitivity to punishment, hypo-activation of the left amygdala, left anterior insula, ventral medial prefrontal cortex (MPFC), and bilateral temporo-parietal junction (TPJ) was observed as a response to losing in participants with CP during the SELF-condition. Callous-unemotional (CU)-traits correlated negatively with activation of amygdala and right TPJ. During the OTHER-condition, TD participants showed activation in brain areas associated with theory of mind (right TPJ, left IFG), and affect regulation (right DLPFC) rather than areas associated with affective empathy. This pattern was not found in adolescents with CP. Moreover, and independently of individual characteristics of their opponents, adolescents with CP demonstrated reward-associated activation (ventral striatum) observing others win, which was positively correlated with CU-traits. This may be interpreted in line with the theory of reward dominance.

CONCLUSIONS

The current study provides support for the theory of abnormal learning processing in adolescents with CP which yields implications for further research as well as clinical practice. The gambling task did not activate affective empathy networks, but was specific for cognitive empathy, inhibition, and affect regulation.

Prosocial Reward Learning in Children and Adolescents

Adolescence is a period of increased sensitivity to social contexts. To evaluate how social context sensitivity changes over development—and influences reward learning—we investigated how children and adolescents perceive and integrate rewards for oneself and others during a dynamic risky decision-making task. Children and adolescents (N = 75, 8–16 years) performed the Social Gambling Task (SGT, Kwak et al., 2014) and completed a set of questionnaires measuring other-regarding behavior. In the SGT, participants choose amongst four card decks that have different payout structures for oneself and for a charity. We examined patterns of choices, overall decision strategies, and how reward outcomes led to trial-by-trial adjustments in behavior, as estimated using a reinforcement-learning model. Performance of children and adolescents was compared to data from a previously collected sample of adults (N = 102) performing the identical task. We found that that children/adolescents were not only more sensitive to rewards directed to the charity than self but also showed greater prosocial tendencies on independent measures of other-regarding behavior. Children and adolescents also showed less use of a strategy that prioritizes rewards for self at the expense of rewards for others. These results support the conclusion that, compared to adults, children and adolescents show greater sensitivity to outcomes for others when making decisions and learning about potential rewards.

Neural Correlates of the Propensity for Retaliatory Behavior in Youths With Disruptive Behavior Disorders

OBJECTIVE

Youths with disruptive behavior disorders (DBD) (conduct disorder and oppositional defiant disorder) have an elevated risk for maladaptive reactive aggression. Theory suggests that this is due to an elevated sensitivity of basic threat circuitry implicated in retaliation (amygdala/periaqueductal gray) in youths with DBD and low levels of callous-unemotional traits and dysfunctional regulatory activity in the ventromedial prefrontal cortex in youths with DBD irrespective of callous-unemotional traits.

METHOD

A total of 56 youths 10-18 years of age (23 of them female) participated in the study: 30 youths with DBD, divided by median split into groups with high and low levels of callous-unemotional traits, and 26 healthy youths. All participants completed an ultimatum game task during functional MRI.

RESULTS

Relative to the other groups, youths with DBD and low levels of callous-unemotional traits showed greater increases in activation of basic threat circuitry when punishing others and dysfunctional down-regulation of the ventromedial prefrontal cortex during retaliation. Relative to healthy youths, all youths with DBD showed reduced amygdala-ventromedial prefrontal cortex connectivity during high provocation. Ventromedial prefrontal cortex responsiveness and ventromedial prefrontal cortex-amygdala connectivity were related to patients' retaliatory propensity (behavioral responses during the task) and parent-reported reactive aggression.

CONCLUSIONS

These data suggest differences in the underlying neurobiology of maladaptive reactive aggression in youths with DBD who have relatively low levels of callous-unemotional traits. Youths with DBD and low callous-unemotional traits alone showed significantly greater threat responses during retaliation relative to comparison subjects. These data also suggest that ventromedial prefrontal cortex-amygdala connectivity is critical for regulating retaliation/reactive aggression and, when dysfunctional, contributes to reactive aggression, independent of level of callous-unemotional traits.

Fairness decisions in response to emotions: a functional MRI study among criminal justice-involved boys with conduct disorder

Research suggests that individuals with conduct disorder (CD) are marked by social impairments, such as difficulties in processing the affective reactions of others. Little is known, though, about how they make decisions during social interactions in response to emotional expressions of others. In this study, we therefore investigated the neural mechanisms underlying fairness decisions in response to communicated emotions of others in aggressive, criminal justice-involved boys with CD (N = 32) compared with typically developing (TD) boys (N = 33), aged 15-19 years. Participants received written emotional responses (angry, disappointed or happy) from peers in response to a previous offer and then had to make fairness decisions in a version of the Dictator Game. Behavioral results showed that CD boys did not make differential fairness decisions in response to the emotions, whereas the TD boys did show a differentiation and also responded more unfair to happy reactions than the CD boys. Neuroimaging results revealed that when receiving happy vs disappointed and angry reactions, the CD boys showed less activation than the TD boys in the temporoparietal junction and supramarginal gyrus, regions involved in perspective taking and attention. These results suggest that boys with CD have difficulties with processing explicit emotional cues from others on behavioral and neural levels.

Emotion Regulation in Adolescent Males with Attention-Deficit Hyperactivity Disorder: Testing the Effects of Comorbid Conduct Disorder

Although attention-deficit hyperactivity disorder (ADHD) has been linked to emotion dysregulation, few studies have experimentally investigated this whilst controlling for the effects of comorbid conduct disorder (CD). Economic decision-making games that assess how individuals respond to offers varying in fairness have been used to study emotion regulation. The present study compared adolescent boys with ADHD (n = 90), ADHD + CD (n = 94) and typical controls (n = 47) on the Ultimatum Game and examined the contribution of ADHD and CD symptom scores and callous and unemotional traits to acceptance levels of unfair offers. There were no significant differences in acceptance rates of fair and highly unfair offers between groups, and only boys with ADHD did not significantly differ from the controls. However, the subgroup of boys with ADHD and additional high levels of aggressive CD symptoms rejected significantly more ambiguous (i.e., moderately unfair) offers than any other subgroup, suggesting impaired emotion regulation in those with ADHD and aggressive CD. Correlations within the CD group showed that the rejection rate to moderately unfair offers was predicted by aggressive CD symptom severity, but not callous and unemotional traits. These findings highlight the fact that ADHD is a heterogeneous condition from an emotion regulation point of view.

No evidence that MDMA-induced enhancement of emotional empathy is related to peripheral oxytocin levels or 5-HT1a receptor activation

The present study aimed at investigating the effect of MDMA on measures of empathy and social interaction, and the roles of oxytocin and the 5-HT_1A receptor in these effects. The design was placebo-controlled within-subject with 4 treatment conditions: MDMA (75 mg), with or without pindolol (20 mg), oxytocin nasal spray (40 IU+16 IU) or placebo. Participants were 20 healthy poly-drug MDMA users, aged between 18–26 years. Cognitive and emotional empathy were assessed by means of the Reading the Mind in the Eyes Test and the Multifaceted Empathy Test. Social interaction, defined as trust and reciprocity, was assessed by means of a Trust Game and a Social Ball Tossing Game. Results showed that MDMA selectively affected emotional empathy and left cognitive empathy, trust and reciprocity unaffected. When combined with pindolol, these effects remained unchanged. Oxytocin did not affect measures of empathy and social interaction. Changes in emotional empathy were not related to oxytocin plasma levels. It was concluded that MDMA (75 mg) selectively enhances emotional empathy in humans. While the underlying neurobiological mechanism is still unknown, it is suggested that peripheral oxytocin does not seem to be the main actor in this; potential candidates are the serotonin 2A and the vasopressin 1A receptors.

Trial Registration

MDMA & PSB NTR 2636