The role of corticolimbic circuitry in the development of anxiety disorders in children and adolescents

Although most individuals progress through the periods of childhood and adolescence without significant disturbance, these developmental stages encompass the peak onset times for many forms of psychopathology related to altered emotion regulation, including anxiety disorders. Understanding the development of neural circuitry associated with emotion regulation may provide important insights into risk factors for psychopathology and how disturbances in function arise. The amygdala and ventral prefrontal cortex are two major nodes of a corticolimbic circuit involved in processing and regulating responses to emotional stimuli. We begin this chapter by reviewing evidence from diffusion tensor imaging and functional magnetic resonance imaging suggesting that changes in the structure and function of this circuitry occur during typical development in childhood and adolescence. Next, we discuss research on the function of this circuitry in pediatric anxiety disorder patients, and how abnormalities may be related to altered neural development. Finally, we illustrate a model for the role of corticolimbic circuitry in examining the development of anxiety disorders by discussing how the structure and function of this circuitry can serve as a neural mediator for linking genetic and environmental influences to the development of anxiety disorders. This model has the potential to inform our understanding of why anxiety disorders typically onset during childhood and adolescence and provides future directions for research that may allow us to better predict or prevent their development..