Emotion processing deficits in youths with conduct problems: An fMRI meta-analysis

Abstract Functional magnetic resonance imaging (fMRI) studies consistently indicate emotion processing deficits in youth with conduct problems. However, no prior meta-analysis has investigated emotion-specific responses associated with conduct problems. This meta-analysis aimed to generate an up-to-date assessment of socio-affective neural responding among youths with conduct problems. A systematic literature search was conducted in youths (ages 10-21) with conduct problems. Task-specific analyses examined responses to threatening images, fearful and angry facial expressions, and empathic pain stimuli across the whole brain. Amygdala region of interest (ROI) analyses were also conducted when data were available. Additional analyses explored responding among youths with callous-unemotional traits. Analyses incorporated a total of 23 fMRI studies, which included 606 youths with conduct problems and 459 comparison youths. ROI analyses of responses to negative images and fearful facial expressions showed reduced activation in right amygdala across youths with conduct problems relative to controls. Whole-brain analyses revealed reduced activity in left supplementary motor area and superior frontal gyrus when youths with conduct problems viewed angry facial expressions. Youths with callous-unemotional traits also exhibited reduced activation in left fusiform gyrus, superior parietal gyrus, and middle temporal gyrus when viewing fearful facial expressions. Youths with conduct problems displayed atypical activation in regions that included the amygdala and temporal cortex when viewing socio-affective fear, anger, and empathic pain stimuli. This reduced activation may underpin reduced empathic responding, dysregulated social learning, and heightened risk for aggression.