Brain regions associated with internalizing and externalizing psychiatric symptoms in patients with penetrating traumatic brain injury

Edward D. Huey*, Seonjoo Lee, Jeffrey A. Lieberman, D. P. Devanand, Adam M. Brickman, Vanessa Raymont, Frank Krueger, Jordan Henry Grafman

*Corresponding author for this work

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

A factor structure underlying DSM-IV diagnoses has been previously reported in neurologically intact patients. The authors determined the brain regions associated with factors underlying DSM-IV diagnoses and compared the ability of DSM-IV diagnoses, factor scores, and self-report measures to account for the neuroanatomical findings in patients with penetrating brain injuries. This prospective cohort study included 254 Vietnam War veterans: 199 with penetrating brain injuries and 55 matched control participants. Measures include DSM-IV diagnoses (from a Structured Clinical Interview for DSM), self-report measures of depression and anxiety, and CT scans. Factors underlying DSM-IV diagnoses were determined using an exploratory factor analysis and correlated with percent of brain regions affected. The ability of the factor scores, DSM-IV diagnoses, and the self-report psychiatric measures to account for the anatomical variance was compared with multiple regressions. Internalizing and externalizing factors were identified in these brain-injured patients. Damage to the left amygdala and bilateral basal ganglia was associated with lower internalizing factor scores, and damage to the left medial orbitofrontal cortex (OFC) with higher, and bilateral hippocampi with lower, externalizing factor scores. Factor scores best predicted left amygdala and bilateral hippocampal involvement, whereas DSM-IV diagnoses best predicted bilateral basal ganglia and left OFC involvement. Damage to the limbic areas involved in the processing of emotional and reward information, including structures involved in the National Institute of Mental Health’s Research Domain Criteria Negative Valence Domain, influences the development of internalizing and externalizing psychiatric symptoms. Self-report measures underperformed DSM-IV and factor scores in predicting neuroanatomical findings.

Original languageEnglish (US)
Pages (from-to)104-111
Number of pages8
JournalJournal of Neuropsychiatry and Clinical Neurosciences
Volume28
Issue number2
DOIs
StatePublished - Mar 1 2016

Fingerprint

Penetrating Head Injuries
Diagnostic and Statistical Manual of Mental Disorders
Psychiatry
Brain
Self Report
Aptitude
Amygdala
Basal Ganglia
Prefrontal Cortex
Traumatic Brain Injury
Vietnam
Veterans
Reward
Statistical Factor Analysis
Hippocampus
Cohort Studies
Anxiety
Prospective Studies
Interviews
Depression

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health

Cite this

Huey, Edward D. ; Lee, Seonjoo ; Lieberman, Jeffrey A. ; Devanand, D. P. ; Brickman, Adam M. ; Raymont, Vanessa ; Krueger, Frank ; Grafman, Jordan Henry. / Brain regions associated with internalizing and externalizing psychiatric symptoms in patients with penetrating traumatic brain injury. In: Journal of Neuropsychiatry and Clinical Neurosciences. 2016 ; Vol. 28, No. 2. pp. 104-111.
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Brain regions associated with internalizing and externalizing psychiatric symptoms in patients with penetrating traumatic brain injury. / Huey, Edward D.; Lee, Seonjoo; Lieberman, Jeffrey A.; Devanand, D. P.; Brickman, Adam M.; Raymont, Vanessa; Krueger, Frank; Grafman, Jordan Henry.

In: Journal of Neuropsychiatry and Clinical Neurosciences, Vol. 28, No. 2, 01.03.2016, p. 104-111.

Research output: Contribution to journalArticle

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