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Study uncovers neural connectivity behind emotion dysregulation in anxiety, irritability

Decreased connectivity in the amygdala and medial prefrontal cortex may mediate emotion dysregulation among youth with anxiety and irritability, according to recent findings.

“Irritability and anxiety are two of the most common, frequently co-occurring problems of youth seeking psychiatric care,” Joel Stoddard, MD, of the University of Colorado, Anshutz Medical Campus, and colleagues wrote. “Longitudinal studies have shown that childhood irritability predicts the risk for anxiety in adulthood, whereas cognitive studies have found similar attention biases in youths with irritability and anxiety. However, virtually no research has considered how anxiety and irritability independently and mutually predict brain function.”

To examine associations between irritability and anxiety with neural mechanisms of implicit face emotion processing in youth, researchers conducted cross-sectional functional MRI among 93 individuals aged 8 to 17 years with anxiety, disruptive mood disorder, and/or ADHD and 22 healthy controls. Neural response was measured during gender labeling of varying intensities of angry, happy, or fearful face emotions.

Irritability and anxiety were associated with left amygdala to left medial prefrontal cortex connectivity during face emotion viewing (P < .001).

When viewing intensely angry faces, decreased connectivity was associated with high levels of anxiety and irritability, while increased connectivity was associated with high levels of anxiety but low levels of irritability (P < .001).

Irritability was associated with differences in neural response to face emotions in several areas (P < .001), particularly in ventral visual areas, with a positive association to angry and happy faces vs. fearful faces.

“This could suggest the need for clinicians to attend to the co-occurrence of anxiety and irritability because the presence of both symptoms might have a unique effect on a child’s response to social threat and/or to treatment, including psychotherapeutic treatments focused on social interactions,” the researchers wrote. “These findings also have implications for both clinicians and researchers interested in the [Research Domain Criteria] framework because they suggest that, like comorbidity among DSM-5 diagnoses, co-occurrence of [Research Domain Criteria] traits has important pathophysiological implications that might ultimately affect psychiatric diagnosis.”– by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.