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A major paradigm shift in mental health has led to the ascendance of the view that chronic psychopathology results from perturbed neural development. While most work in this area examines schizophrenia, the current report extends the paradigm to bipolar disorder (BD) in youth, thus demonstrating traction (not sure I understand what you mean here) in the developmental-psychobiology perspective. To study the role of amygdala dysfunction, we examined the neural mechanisms mediating face processing in 22 youth (mean age 14.21 + 3.11 years) with BD and 21 controls of comparable age, gender, and IQ. Event-related fMRI compared neural activation when attention was directed to emotional aspects of faces (hostility, subjects’ own fearfulness) vs. non-emotional aspects (nose width). Compared to controls, patients perceived greater hostility in neutral faces, and reported more fear when viewing them. Also, compared to controls, patients had greater activation in the left amygdala, accumbens, putamen, and ventral prefrontal cortex when rating face hostility, and greater activation in the left amygdala and bilateral accumbens when rating their own fear of the face. There were no between-group behavioral or neural differences in the non-emotional conditions. Results implicate deficient emotion-attention interactions in the pathophysiology of BD in youth, and suggest that developmental psychobiology approaches to chronic mental illness have broad applicability.


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Rich, B.A., Vinton, D.T., Roberson-Nay, R., Hommer, R.E., Berghorst, L.H., McClure, E.B., Fromm, S.J., Pine, D.S., Leibenluft, E. (2006). Limbic hyperactivation during processing of neutral facial expressions in children with bipolar disorder. Proceedings of the National Academy of Science, 103(23), 8900-8905. DOI: 10.1073/pnas.0603246103