Clin Psychopharmacol Neurosci 2018; 16(4): 449-460  
Dysfunctional Social Reinforcement Processing in Disruptive Behavior Disorders: An Functional Magnetic Resonance Imaging Study
Soonjo Hwang1, Harma Meffert2, Michelle R. VanTieghem3, Stephen Sinclair4, Susan Y. Bookheimer5, Brigette Vaughan1, R. J. R. Blair2
1Department of Psychiatry, University of Nebraska Medical Center, Omaha, NE, 2Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, 3Department of Psychology, Columbia University, New York, NY, 4Department of Health and Human Services, Section on Affective Cognitive Neuroscience, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, 5University of California and Brain Research Institute, Los Angeles, CA, USA
Correspondence to: Soonjo Hwang, MD
985578 Nebraska Medical Center, Omaha, NE 68198-5578, USA
Tel: +1-402-552-6351, Fax: +1-402-552-6035
Received: July 14, 2017; Revised: September 12, 2017; Accepted: November 13, 2017; Published online: November 30, 2018.
© The Korean College of Neuropsychopharmacology. All rights reserved.

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Objective: Prior functional magnetic resonance imaging (fMRI) work has revealed that children/adolescents with disruptive behavior disorders (DBDs) show dysfunctional reward/non-reward processing of non-social reinforcements in the context of instrumental learning tasks. Neural responsiveness to social reinforcements during instrumental learning, despite the importance of this for socialization, has not yet been previously investigated.
Methods: Twenty-nine healthy children/adolescents and 19 children/adolescents with DBDs performed the fMRI social/non-social reinforcement learning task. Participants responded to random fractal image stimuli and received social and non-social rewards/non-rewards according to their accuracy.
Results: Children/adolescents with DBDs showed significantly reduced responses within the caudate and posterior cingulate cortex (PCC) to non-social (financial) rewards and social non-rewards (the distress of others). Connectivity analyses revealed that children/adolescents with DBDs have decreased positive functional connectivity between the ventral striatum (VST) and the ventromedial prefrontal cortex (vmPFC) seeds and the lateral frontal cortex in response to reward relative to non-reward, irrespective of its sociality. In addition, they showed decreased positive connectivity between the vmPFC seed and the amygdala in response to non-reward relative to reward.
Conclusion: These data indicate compromised reinforcement processing of both non-social rewards and social non-rewards in children/adolescents with DBDs within core regions for instrumental learning and reinforcement-based decision- making (caudate and PCC). In addition, children/adolescents with DBDs show dysfunctional interactions between the VST, vmPFC, and lateral frontal cortex in response to rewarded instrumental actions potentially reflecting disruptions in attention to rewarded stimuli.
Keywords: Disruptive behavior disorder; Social reward; Ventral striatum; Posterior cingulate cortex; Caudate; Ventro-medial prefrontal cortex.

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