Neural correlates of affective empathy and reinforcement learning in boys with conduct problems: fMRI evidence from a gambling task.

BACKGROUND: Conduct problems (CP) comprise abnormal behaviors associated with aberrant aspects of affective empathy as well as learning. However, behavioral measures for affective empathy are challenging, and previous results concerning learning in patients with CP are inconsistent.

METHODS: Nineteen boys with CP and 24 typically developing (TD) boys aged 11-17 years (M=14.34, SD=1.93) participated in the study. An ultimatum-game was applied in order to elicit the feeling of like or dislike towards the opponent for a subsequent gambling task, which was played by the opponents (OTHER-condition) and by the participants themselves (SELF-condition). Functional MRI data were recorded throughout the experiment.

RESULTS: In accordance with the model of insensitivity to punishment, hypo-activation of the left amygdala, left anterior insula, ventral medial prefrontal cortex (MPFC), and bilateral temporo-parietal junction (TPJ) was observed as a response to losing in participants with CP during the SELF-condition. Callous-unemotional (CU)-traits correlated negatively with activation of amygdala and right TPJ. During the OTHER-condition, TD participants showed activation in brain areas associated with theory of mind (right TPJ, left IFG), and affect regulation (right DLPFC) rather than areas associated with affective empathy. This pattern was not found in adolescents with CP. Moreover, and independently of individual characteristics of their opponents, adolescents with CP demonstrated reward-associated activation (ventral striatum) observing others win, which was positively correlated with CU-traits. This may be interpreted in line with the theory of reward dominance.

CONCLUSIONS: The current study provides support for the theory of abnormal learning processing in adolescents with CP which yields implications for further research as well as clinical practice. The gambling task did not activate affective empathy networks, but was specific for cognitive empathy, inhibition, and affect regulation.