Youth exposed to early life interpersonal violence (IPV) demonstrate heterogeneous clinical symptoms. Studies based on univariate methods suggest that neurocircuitry related to emotion processing explains heterogeneity in internalizing symptoms. Here, we use a multivariate, data-driven method of identifying distinct functional brain activation profiles (i.e., "biotypes") and test whether these biotypes differentiate internalizing symptoms among IPV-exposed youth. 114 adolescent girls (n = 38 with no IPV exposure or psychopathology; n = 76 with IPV exposure and heterogeneous internalizing symptoms), aged 11-17, completed an emotion processing task during fMRI. To identify distinct biotypes of brain engagement profiles, data-driven clustering analysis was applied to patterns of voxel activation, constrained within a mask of distributed regions implicated in emotion processing. Resulting biotypes (BT1-3) were compared on measures of IPV exposure and internalizing symptoms, as well as symptom reduction during Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) among a subset of participants (n = 21). Cluster analyses identified three biotypes, differentiated by engagement of medial prefrontal, anterior insula, hippocampus, parietal, and ventral visual cortex during emotion processing. BT1 exhibited low levels of IPV exposure and internalizing symptoms. BT2 exhibited elevated levels of IPV, except sexual assault, and demonstrated moderate severity across internalizing symptom domains. BT3 exhibited elevated severity across all IPV and internalizing symptom domains. Greater symptom reduction during TF-CBT was associated with increased pre-to post-treatment changes in similarity with BT1. These results demonstrate distinct profiles of emotion processing neurocircuitry that differentiate heterogeneity in internalizing symptoms in IPV-exposed adolescent girls.

中文翻译：

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情绪加工过程中功能性大脑参与的生物型区分了青春期女孩在内部化症状和人际暴力历史方面的异质性。

暴露于早期人际暴力（IPV）的年轻人表现出不同的临床症状。基于单变量方法的研究表明，与情绪处理相关的神经回路解释了内在症状的异质性。在这里，我们使用多变量，数据驱动的方法来识别不同的功能性大脑激活模式（即“生物型”），并测试这些生物型是否可以区分IPV暴露青年中的内在症状。11至17岁的114名青春期女孩（n = 38，没有IPV暴露或精神病理学； n = 76，没有IPV暴露和异质性内在症状）在fMRI期间完成了情绪处理任务。为了识别大脑参与模式的不同生物类型，将数据驱动的聚类分析应用于体素激活的模式，限制在涉及情感处理的分布区域的掩码内。在部分参与者（n = 21）的创伤重点认知行为治疗（TF-CBT）过程中，比较了IPV暴露和内在症状以及症状减轻时所产生的生物型（BT1-3）。聚类分析确定了三种生物类型，在情绪处理过程中通过内侧前额叶，前岛，海马，顶叶和腹侧视觉皮层的参与来区分。BT1表现出低水平的IPV暴露和内在症状。BT2表现出较高的IPV水平（性侵犯除外），并且在内部化症状域中表现出中等严重性。BT3在所有IPV和内在症状域中均表现出较高的严重性。TF-CBT期间更大的症状减轻与治疗前与治疗后与BT1相似的变化增加有关。这些结果证明了情感加工神经回路的独特特征，它们在暴露于IPV的青春期女孩中，在内化症状中区分了异质性。