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Description
Purpose: Irritability and anxiety are transdiagnostic symptoms that often co-occur and are common in healthy youth. While these symptoms are associated with deficits in emotional face processing and impairment at subclinical levels, no study to date has examined the neural correlates of emotional face processing in a community sample of youth with irritability and anxiety. Participants: We examined data from a community sample of 30 adolescents (aged 11-15 years) with varying irritability and anxiety levels. Methodology: Youth performed an emotional face processing task, which involved viewing neutral and emotional face (happy, sad, or threat) pairs using a dot probe paradigm during functional magnetic resonance imaging (fMRI) data acquisition. Child irritability and anxiety symptoms were measured dimensionally using parent reports on the Affective Reactivity Index and Screen for Child Anxiety Related Disorders, respectively. We tested the unique and shared effects of irritability and anxiety on brain and amygdala activation to emotional faces, respectively. Results: We observed altered patterns of activation in motor, occipital, and fronto-parietal regions during emotional face viewing that depended on the interaction between irritability and anxiety levels. Adolescents with both higher irritability and anxiety levels displayed greater activation to negative affect (sad and threat) and decreased activation to happy and neutral faces compared to adolescents with higher irritability and lower anxiety levels. Lower irritability levels predicted no change in activation compared to baseline across emotional faces in all six regions, regardless of anxiety severity. Higher irritability levels predicted increased activation to sad faces compared to the other emotions in four temporal, fronto-parietal, and occipital regions, on average across anxiety levels. Higher anxiety levels were associated with decreased activation to neutral faces compared to the other emotions the right inferior frontal gyrus and right insula, on average across irritability levels. Irritability and anxiety did not relate to amygdala activation while viewing emotional faces. Discussion: Distinct anxiety and irritability symptom profiles predict altered patterns of activation during emotional face processing in a community sample of adolescents. Future work should examine co-occurring symptom dimensions together, which may reveal unique contributions of each symptom dimension to brain activation.