Maladaptive guilt is a central symptom of preschool-onset depression associated with severe psychopathology in adolescence and adulthood. Although studies have found that maladaptive guilt is associated with structural alterations in the anterior insula (AI) and dorsomedial prefrontal cortex (dmPFC) in middle childhood and adolescence, no study has examined structural neural correlates of maladaptive guilt in preschool, when this symptom first emerges. This study examined a pooled sample of 3-to 6-year-old children (N = 76; 40.8% female) from two studies, both which used the same type of magnetic resonance imaging scanner and conducted diagnostic interviews for depression that included clinician ratings of whether children met criteria for maladaptive guilt. Preschoolers with maladaptive guilt displayed significantly thinner dmPFC than children without this symptom. Neither children's depressive severity nor their vegetative or other emotional symptoms of depression were associated with dmPFC thickness, suggesting that dmPFC thinning is specific to maladaptive guilt. Neither AI gray matter volume or thickness nor dmPFC gray matter volume differed between children with and without maladaptive guilt. This study is the first to identify a structural biomarker for a specific depressive symptom in preschool. Findings may inform neurobiological models of the development of depression and aid in detection of this symptom.

中文翻译：

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患有适应不良内疚的学龄前儿童皮质变薄 患有适应不良内疚的学龄前儿童皮质变薄


适应不良的内疚感是学前抑郁症的主要症状，与青春期和成年期的严重精神病理学相关。尽管研究发现适应不良内疚与儿童中期和青春期的前岛叶 (AI) 和背内侧前额叶皮层 (dmPFC) 的结构改变有关，但没有研究检查学龄前适应不良内疚的结构神经相关性，当这种症状首次出现时。这项研究检查了两项研究中 3 至 6 岁儿童的汇总样本（N = 76；40.8% 为女性），这两项研究都使用相同类型的磁共振成像扫描仪，并进行了抑郁症诊断访谈，其中包括临床医生的评分儿童是否符合适应不良内疚的标准。与没有这种症状的儿童相比，有适应不良内疚感的学龄前儿童的 dmPFC 明显偏薄。儿童的抑郁严重程度及其植物性或其他抑郁情绪症状均与 dmPFC 厚度无关，这表明 dmPFC 变薄是适应不良内疚所特有的。在有和没有适应不良内疚的儿童之间，AI 灰质体积或厚度以及 dmPFC 灰质体积都没有差异。这项研究首次确定了学龄前特定抑郁症状的结构生物标志物。研究结果可能会为神经生物学模型提供有关抑郁症发展的信息，并有助于检测这种症状。