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Emotions are complex, multi-system psychological states comprised of neural and peripheral physiological responses, behavioral tendencies, cognitive appraisals, and subjective experiences. When poorly regulated, however, emotions can lead to a myriad of negative psychological outcomes, including depression and anxiety. Adolescence is a developmental period characterized by heightened emotional reactivity, neurobiological changes, and increased rates of anxiety and depression. The current fMRI study investigates how early adolescents’ emotion regulation (ER) abilities longitudinally mediate the relationship between early adolescents’ task-based (n=67) limbic-prefrontal functional connectivity values and subsequent levels of internalizing symptoms.
Participants included 67 adolescents ages 12-14 (M age = 12.63; 53.1% boys; 82.7% White) recruited from a larger longitudinal study on adolescent development to participate in an fMRI session at baseline. Adolescents’ neural responses were assessed during an emotion task that employed positive, negative, and neutral pictures from the International Affective Picture System (IAPS). The task was a rapid event-related design comprising 81 trials presented across 3 runs. Seed-based ROI analyses examined functional connectivity in fronto-limbic networks thought to be involved in the regulation of negative emotional reactivity (amygdala to dACC, amygdala to dlPFC, anterior insula to dACC, anterior insula to dlPFC) using FSL.
Adolescents reported on their ER difficulties on the Difficulties in Emotion Regulation Scale (Gratz & Roemer 2004) at one-year follow-up. Adolescents reported on their symptoms of anxiety and depression at both baseline and a two-year follow-up on the Children’s Depression Inventory (Kovacs 2004) and Revised Children’s Manifest Anxiety Scale (Reynolds & Richmond, 1985); participants’ scores were highly correlated and were averaged into a single internalizing symptom composite. Mediation analyses were conducted using the PROCESS macro for SPSS and controlled for baseline internalizing symptoms.
Results showed that that greater amygdala-dACC, amygdala-dlPFC, and insula-dACC connectivity predicted increased adolescent-reported ER difficulties at one-year follow-up, which, in turn, predicted greater adolescent-reported internalizing symptoms at two-year follow-up (F’s (3,62) = 5.14-5.23, p = .003, R-squared = .20; indirect effects point estimates = .77–1.15, SE = .44-.75, 95% BCa CI = .0415–3.2034). The model from adolescents’ insula-dlPFC connectivity to two-year child-reported internalizing symptoms through ER difficulties was non-significant.
These findings suggest that youth who eventually evidence symptoms of anxiety and depression may engage both limbic and prefrontal regions in concert to a greater extent than their healthy counterparts when engaging in emotion-processing tasks. When emotionally aroused, youth susceptible to future internalizing problems may be more emotionally reactive, showing exaggerated amygdala and insula activation in response to negatively-valenced stimuli; at the same time, they may involuntarily engage in more automatic ER efforts, which may be reflected by higher recruitment of prefrontal regions involved in the down-regulation of their heightened emotional arousal. This is the only study to date that provides compelling—albeit preliminary—evidence that self-reported ER problems longitudinally mediate the association between limbic-prefrontal functional connectivity patterns in the context of an affective paradigm and future internalizing symptoms across adolescence. These findings may inform future emotion-focused prevention and intervention efforts aimed at youth susceptible to future internalizing problems.