Variability of Emotional Resonses in Children with Behavioral Disorders

Children with Attention-Deficit/Hyperactivity Disorder (ADHD) often demonstrate emotional lability, or intense shifts in affect, in addition to their behavioral symptoms. This suggests that they may suffer from deficits in overall self-control, leading to classic symptoms of hyperactivity as well as poor emotion regulation. Deficits in emotion lability have been associated with altered amygdala intrinsic functional connectivity (iFC) in children with ADHD. To date, most studies on emotional lability in children with ADHD rely on parent reports, and thus, are prone to reporting bias. The goal of this study was to investigate emotional lability through objective measures. Specifically, intensity and variability in negative facial expressions calculated based on video observations during a frustrating computer game, in relation to amygdala iFC. Participants included young children (ages 5-9 years old) with ADHD, some of whom exhibited severe temper outbursts (ADHD+STO; n= 33), and some who did not (ADHD; n= 33), as well as typically developing children (TDC; n= 26). Children completed a Balloons Game while videotaped as well as a resting state functional MRI scan. During the balloons game, children were asked to \u27pop\u27 only the green balloons on the screen. In three of the trials, the mouse was programmed to stop working so that the child would fail; thus, inducing frustration expressions. Results indicate the intensity and variability of negative facial expressions were significantly higher in children with ADHD, compared to TDC. Children with ADHD+STO did not differ from those in the ADHD group. Within the ADHD group, intensity of negative facial expressions was associated with greater iFC between the left amygdala and a cluster including the supramarginal gyrus and inferior parietal lobule (SMG/IPL). Children with ADHD and who did not exhibit much negative facial expressions showed negative iFC, which was similar to the connectivity observed in healthy comparisons; while children with ADHD who expressed greater negative facial expressions exhibited a trend toward positive iFC. Reduction of negative amygdala-SMG/IPL iFC may reflect alterations in the top–down effortful regulation of emotion that may lead to, or reflect, emotional lability