Research has shown that youth with disruptive behavior disorder are less likely than others to anticipate the negative consequences of their behaviors, which may contribute to behavioral problems. Studies also show that people with disruptive behavior disorder tend to have lower activity in the amygdala—a brain region known to be involved in emotional learning, including fear response.
Koen Van Lith, M.D., of the Vrije Universiteit Amsterdam and colleagues tested whether MPH might increase amygdala activity in youth with disruptive behavior disorder, including oppositional defiant and/or conduct disorder. The researchers chose MPH since this medication is known to increase amygdala activity in children with attention-deficit/hyperactivity disorder.
Van Lith and colleagues conducted a clinical study of 42 boys aged 14 to 17 who were diagnosed with disruptive behavior disorder. The adolescents completed a fear-learning task (learning to associate a visual stimulus with a mild electric shock) 90 minutes after taking either a single dose of MPH (0.3 mg/kg to 0.4 mg/kg) or placebo. Twenty-one adolescents with no behavioral problems were also included as a comparison group; these participants were given no medication before testing. All the participants underwent functional MRI scanning while performing the fear-learning task to measure amygdala activity.
The adolescents with disruptive behavior disorder who took placebo had much lower amygdala activity during the fear-learning task compared with healthy controls. In contrast, the adolescents with disruptive behavior disorder who took MPH had amygdala activity that was similar to the adolescents with no behavioral problems.
“This is promising for MPH as a possible treatment option in DBD [disruptive behavior disorder],” Van Lith and colleagues wrote. “Because amygdala functioning is important for decision making and moral judgment, MPH might improve clinical outcomes, although future studies should establish whether increased amygdala function after MPH administration indeed improves behavioral outcomes.”
To read more about treating disruptive behaviors in youth, see the Psychiatric News article “Experts Search for Meds to Help Youth With DMDD.”