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Review article

Internalizing versus externalizing comorbidity: neural circuit hypothesis

Pages 399-409 | Received 30 Aug 2009, Accepted 11 Nov 2009, Published online: 16 Apr 2010
 

Abstract

The aim of the present study was to review and update historical controversies in relation to the limbic system in light of advances in the neuroanatmy and neurobiology of cortico-striatal–thalamic–cortical (CSTC) neural circuits. It is hypothesized that observed comorbidities between internalizing and externalizing childhood syndromes may be better understood in terms of excess communication between subcortical brain circuits. A neuroanatomical understanding of reciprocal and non-reciprocal connections between modular circuits provides a basis for understanding previously puzzling aspects of internalizing, externalizing comorbidity. Function depends on the degree of cooperative integration of goal orientation, Pavlovian stimulus response, and operant processing in cortical–subcortical circuits, and interventions may be targeted at any of these functions.

Declaration of interest: The author reports no conflicts of interest. The author alone is responsible for the content and writing of the paper.

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