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Internalizing–externalizing comorbidity and regional brain volumes in the ABCD study

Published online by Cambridge University Press:  07 December 2021

Elana Schettini*
Affiliation:
Department of Psychology, The Ohio State University, Columbus, OH, USA
Sylia Wilson
Affiliation:
Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
Theodore P. Beauchaine
Affiliation:
Department of Psychology, University of Notre Dame, Notre Dame, IN, USA
*
Author for Correspondence: Elana Schettini, Department of Psychology, The Ohio State University, Psychology, Psychology, Psychology Building 273, 1835 Neil Ave, Columbus, Ohio, 43210-1132; E-mail: schettini.1@buckeyemail.osu.edu

Abstract

Despite nonoverlapping diagnostic criteria, internalizing and externalizing disorders show substantial comorbidity. This comorbidity is attributable, at least in part, to transdiagnostic neuroaffective mechanisms. Both unipolar depression and externalizing disorders are characterized by structural and functional compromises in the striatum and its projections to the anterior cingulate cortex (ACC) and other frontal regions. Smaller volumes and dampened reward responding in these regions are associated with anhedonia and irritability – mood states that cut across the internalizing and externalizing spectra. In contrast, smaller amygdala volumes and dampened amygdala function differentiate externalizing disorders from internalizing disorders. Little is known, however, about associations between internalizing–externalizing comorbidity and brain volumes in these regions, or whether such patterns differ by sex. Using a transdiagnostic, research domain criteria (RDoC)-informed approach, we evaluate associations between heterotypic (Internalizing × Externalizing) symptom interactions and striatal, amygdalar, and ACC volumes among participants in the Adolescent Brain Cognitive Development study (N = 6,971, mean age 9.9 years, 51.6% female). Heterotypic symptoms were associated with ACC volumes for both sexes, over and above the main effects of internalizing and externalizing alone. However, heterotypic comorbidity was associated with larger ACC volumes for girls, but with smaller ACC volumes for boys. These findings suggest a need for further studies and transdiagnostic assessment by sex.

Type
Special Issue Article
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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