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1.
Artigo em Inglês | MEDLINE | ID: mdl-33440203

RESUMO

OBJECTIVE: Irritability is a multifaceted construct in pediatric psychopathology. It has been conceptualized as having a 'phasic' dimension and a 'tonic' dimension. Disruptive mood dysregulation disorder (DMDD) is defined by the presence of both dimensions. Severe irritability, or DMDD, is highly comorbid with attention-deficit/hyperactivity disorder (ADHD). However, it is unknown whether the presence of ADHD modulates the expression of phasic and tonic irritability. METHOD: A data-driven, latent variable approach was used to examine irritability and ADHD symptoms in a transdiagnostic pediatric sample (N=489) with primary DMDD, ADHD, subclinical irritability symptoms, or no diagnosis. Using latent profile analyses (LPA), we identified four classes: high levels of both irritability and ADHD symptoms, high levels of irritability and moderate levels of ADHD symptoms, moderate levels of irritability and high levels of ADHD symptoms, and low levels of both irritability and ADHD symptoms. Confirmatory factor analysis operationalized phasic irritability and tonic irritability. RESULTS: As expected, the two latent classes characterized by high overall irritability exhibited the highest levels of both phasic and tonic irritability. However, between these two high irritability classes, highly comorbid ADHD symptoms were associated with significantly greater phasic irritability than were moderately comorbid ADHD symptoms. In contrast, the two high irritability groups did not differ on levels of tonic irritability. CONCLUSION: These findings suggest that phasic, but not tonic, irritability has a significant association with ADHD symptoms, and that phasic and tonic might be distinct, though highly related, irritability dimensions. Future research should investigate potential mechanisms underlying this differential association.

2.
Proc Biol Sci ; 288(1943): 20202651, 2021 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-33499792

RESUMO

The amygdala is a subcortical structure implicated in both the expression of conditioned fear and social fear recognition. Social fear recognition deficits following amygdala lesions are often interpreted as reflecting perceptual deficits, or the amygdala's role in coordinating responses to threats. But these explanations fail to capture why amygdala lesions impair both physiological and behavioural responses to multimodal fear cues and the ability to identify them. We hypothesized that social fear recognition deficits following amygdala damage reflect impaired conceptual understanding of fear. Supporting this prediction, we found specific impairments in the ability to predict others' fear (but not other emotions) from written scenarios following bilateral amygdala lesions. This finding is consistent with the suggestion that social fear recognition, much like social recognition of states like pain, relies on shared internal representations. Preserved judgements about the permissibility of causing others fear confirms suggestions that social emotion recognition and morality are dissociable.

3.
Personal Neurosci ; 3: e12, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33283146

RESUMO

Callous-unemotional (CU) traits are early-emerging personality features characterized by deficits in empathy, concern for others, and remorse following social transgressions. One of the interpersonal deficits most consistently associated with CU traits is impaired behavioral and neurophysiological responsiveness to fearful facial expressions. However, the facial expression paradigms traditionally employed in neuroimaging are often ambiguous with respect to the nature of threat (i.e., is the perceiver the threat, or is something else in the environment?). In the present study, 30 adolescents with varying CU traits viewed fearful facial expressions cued to three different contexts ("afraid for you," "afraid of you," "afraid for self") while undergoing functional magnetic resonance imaging (fMRI). Univariate analyses found that mean right amygdala activity during the "afraid for self" context was negatively associated with CU traits. With the goal of disentangling idiosyncratic stimulus-driven neural responses, we employed intersubject representational similarity analysis to link intersubject similarities in multivoxel neural response patterns to contextualized fearful expressions with differential intersubject models of CU traits. Among low-CU adolescents, neural response patterns while viewing fearful faces were most consistently similar early in the visual processing stream and among regions implicated in affective responding, but were more idiosyncratic as emotional face information moved up the cortical processing hierarchy. By contrast, high-CU adolescents' neural response patterns consistently aligned along the entire cortical hierarchy (but diverged among low-CU youths). Observed patterns varied across contexts, suggesting that interpretations of fearful expressions depend to an extent on neural response patterns and are further shaped by levels of CU traits.

4.
Artigo em Inglês | MEDLINE | ID: mdl-33095373

RESUMO

This report examines the relationship between pediatric anxiety disorders and implicit bias evoked by threats. To do so, the report uses two tasks that assess implicit bias to negative-valence faces, the first by eye-gaze and the second by measuring body-movement parameters. The report contrasts task performance in 51 treatment-seeking, medication-free pediatric patients with anxiety disorders and 36 healthy peers. Among these youth, 53 completed an eye-gaze task, 74 completed a body-movement task, and 40 completed both tasks. On the eye-gaze task, patients displayed longer gaze duration on negative relative to non-negative valence faces than healthy peers, F(1, 174) = 8.27, p = .005. In contrast, on the body-movement task, patients displayed a greater tendency to behaviorally avoid negative-valence faces than healthy peers, F(1, 72) = 4.68, p = .033. Finally, implicit bias measures on the two tasks were correlated, r(38) = .31, p = .049. In sum, we found an association between pediatric anxiety disorders and implicit threat bias on two tasks, one measuring eye-gaze and the other measuring whole-body movements. Converging evidence for implicit threat bias encourages future research using multiple tasks in anxiety.

5.
J Pers Disord ; 34(5): 628-649, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33074056

RESUMO

Psychopathy is a personality construct characterized by interpersonal callousness, boldness, and disinhibition, traits that vary continuously across the population and are linked to impaired empathic responding to others' distress and suffering. Following suggestions that empathy reflects neural self-other mapping-for example, the similarity of neural responses to experienced and observed pain, measurable at the voxel level-we used a multivoxel approach to assess associations between psychopathy and empathic neural responses to pain. During fMRI scanning, 21 community-recruited participants varying in psychopathy experienced painful pressure stimulation and watched a live video of a stranger undergoing the same stimulation. As total psychopathy, coldheartedness, and self-centered impulsivity increased, multivoxel similarity of vicarious and experienced pain in the left anterior insula decreased, effects that were not observed following an empathy prompt. Our data provide preliminary evidence that psychopathy is characterized by disrupted spontaneous empathic representations of others' pain that may be reduced by instructions to empathize.

6.
J Pers Disord ; : 1-18, 2020 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-32985958

RESUMO

The centrality of a fearless temperament as it relates to the construct of psychopathy remains an area of controversy, with some researchers arguing that the relationship between fearless temperament and psychopathy (and associated antisocial behavior) can be explained by shared associations with other core affective and interpersonal traits of psychopathy such as callous-unemotional (CU) traits. The authors investigated real-world subjectively experienced fear in 306 individuals with varying levels of CU traits and antisocial behavior and found that at low levels of subjective fear experience, decreases in subjective fear were associated with greater antisociality. Even after controlling for the positive relationship between CU traits and antisocial behavior, reduced subjectively experienced fear remained a significant predictor of antisocial behavior. These results provide evidence that experienced fear is related to antisocial behavior at lower than average levels of subjectively experienced fear and that this relationship persists after controlling for CU traits.

7.
Psychol Med ; : 1-11, 2020 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-32787994

RESUMO

BACKGROUND: While taxonomy segregates anxiety symptoms into diagnoses, patients typically present with multiple diagnoses; this poses major challenges, particularly for youth, where mixed presentation is particularly common. Anxiety comorbidity could reflect multivariate, cross-domain interactions insufficiently emphasized in current taxonomy. We utilize network analytic approaches that model these interactions by characterizing pediatric anxiety as involving distinct, inter-connected, symptom domains. Quantifying this network structure could inform views of pediatric anxiety that shape clinical practice and research. METHODS: Participants were 4964 youths (ages 5-17 years) from seven international sites. Participants completed standard symptom inventory assessing severity along distinct domains that follow pediatric anxiety diagnostic categories. We first applied network analytic tools to quantify the anxiety domain network structure. We then examined whether variation in the network structure related to age (3-year longitudinal assessments) and sex, key moderators of pediatric anxiety expression. RESULTS: The anxiety network featured a highly inter-connected structure; all domains correlated positively but to varying degrees. Anxiety patients and healthy youth differed in severity but demonstrated a comparable network structure. We noted specific sex differences in the network structure; longitudinal data indicated additional structural changes during childhood. Generalized-anxiety and panic symptoms consistently emerged as central domains. CONCLUSIONS: Pediatric anxiety manifests along multiple, inter-connected symptom domains. By quantifying cross-domain associations and related moderation effects, the current study might shape views on the diagnosis, treatment, and study of pediatric anxiety.

8.
Hum Brain Mapp ; 2020 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-32596977

RESUMO

The ENIGMA group on Generalized Anxiety Disorder (ENIGMA-Anxiety/GAD) is part of a broader effort to investigate anxiety disorders using imaging and genetic data across multiple sites worldwide. The group is actively conducting a mega-analysis of a large number of brain structural scans. In this process, the group was confronted with many methodological challenges related to study planning and implementation, between-country transfer of subject-level data, quality control of a considerable amount of imaging data, and choices related to statistical methods and efficient use of resources. This report summarizes the background information and rationale for the various methodological decisions, as well as the approach taken to implement them. The goal is to document the approach and help guide other research groups working with large brain imaging data sets as they develop their own analytic pipelines for mega-analyses.

10.
Cortex ; 127: 67-77, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32169677

RESUMO

Everyday prosociality includes helping behaviors such as holding doors or giving directions that are spontaneous and low-cost and are performed frequently by the average person. Such behaviors promote a wide array of positive outcomes that include increased well-being, trust, and social capital, but the cognitive and neural mechanisms that support these behaviors are not yet well understood. Whereas costly altruistic responding to others' distress is associated with elevated reactivity in the amygdala, we hypothesized that everyday prosociality would be more closely associated with activation in the bed nucleus of the stria terminalis (BNST), a region of the extended amygdala known for its roles in maintaining vigilance for relevant socio-affective environmental cues and in supporting parental care. One previous study of the neural correlates of everyday prosociality highlighted a functional cluster identified as the septal area but which overlapped with established coordinates of BNST. We used an anatomical mask of BNST (Torrisi et al., 2015) to evaluate the association of BNST activation and daily helping in a sample of 25 adults recruited from the community as well as 23 adults who had engaged in acts of extraordinary altruism. Results found that activation in left BNST during an empathy task predicted everyday helping over a subsequent 14-day period in both samples. BNST activation most strongly predicted helping strangers and proactive helping. We conclude that beyond facilitating care for offspring, activation in BNST may provide a basis for the motivation to engage in a broad array of everyday helping behaviors.

11.
Assessment ; 27(1): 57-71, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-29239206

RESUMO

In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, a Limited Prosocial Emotions specifier was added to the conduct disorder diagnostic criteria to designate a subgroup of children who exhibit callous unemotional (CU) traits. The Inventory of Callous Unemotional Traits (ICU) is the only dedicated measure of CU traits and was influential in the development of the Limited Prosocial Emotions specifier. Despite its role in the research and diagnosis of CU traits, some questions have persisted regarding the internal consistency and validity of the ICU and its three subscales: callous, uncaring, and unemotional. Results of a meta-analysis revealed acceptable internal consistency and external validity for total ICU, callous, and uncaring scores, but not unemotional scores. These results support the utility of the total ICU, callous, and uncaring scales, but indicate weaknesses in the scale or construct of unemotionality as it relates to interpersonal callousness, uncaring, and antisociality.

12.
Depress Anxiety ; 36(8): 701-711, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31373756

RESUMO

BACKGROUND: Clinical researchers face challenges when trying to quantify diverse processes engaged during social interactions. We report results from two studies, each demonstrating the potential utility of tools for examining processes engaged during social interactions. METHOD: In the first study, youth (n = 57) used a smartphone-based tool to rate mood and responses to social events. A subset (n = 20) completed the second, functional magnetic resonance imaging study. This second study related anxiety to error-evoked brain responses in two social conditions-while being observed and when alone. We also combined these tools to bridge clinical, social-contextual, and neural levels of measurement. RESULTS: Results from the first study showed an association between negatively-perceived social experiences and a range of negative emotions. In the second study there was a positive correlation during error monitoring between social-anxiety severity and context-specific activation of the pregenual anterior cingulate cortex. Finally, during imaging, the perceived quality of peer interactions as assessed using the smartphone-based tool, interacted with social context to predict levels of activation in the hippocampus and superior frontal gyrus. CONCLUSIONS: By improving measurement, enhanced tools may provide new means for studying relationships among anxiety, brain function, and social interactions.


Assuntos
Encéfalo/fisiopatologia , Relações Interpessoais , Imagem por Ressonância Magnética/métodos , Fobia Social/diagnóstico , Fobia Social/psicologia , Adolescente , Mapeamento Encefálico , Criança , Medo/fisiologia , Medo/psicologia , Feminino , Humanos , Masculino , Fobia Social/fisiopatologia , Smartphone
13.
Sci Rep ; 9(1): 10774, 2019 07 24.
Artigo em Inglês | MEDLINE | ID: mdl-31341206

RESUMO

Empathy-affective resonance with others' sensory or emotional experiences-is hypothesized to be an important precursor to altruism. However, it is not known whether real-world altruists' heightened empathy reflects true self-other mapping of multi-voxel neural response patterns. We investigated this relationship in adults who had engaged in extraordinarily costly real-world altruism: donating a kidney to a stranger. Altruists and controls completed fMRI testing while anticipating and experiencing pain, and watching as a stranger anticipated and experienced pain. Machine learning classifiers tested for shared representation between experienced and observed distress. Altruists exhibited more similar representations of experienced and observed fearful anticipation spontaneously and following an empathy prompt in anterior insula and anterior/middle cingulate cortex, respectively, suggesting heightened empathic proclivities and abilities for fear. During pain epochs, altruists were distinguished by spontaneous empathic responses in anterior insula, anterior/mid-cingulate cortex and supplementary motor area, but showed no difference from controls after the empathy prompt. These findings (1) link shared multi-voxel representations of the distress of self and others to real-world costly altruism, (2) reinforce distinctions between empathy for sensory states like pain and anticipatory affective states like fear, and (3) highlight the importance of differentiating between the proclivity and ability to empathize.


Assuntos
Altruísmo , Encéfalo/diagnóstico por imagem , Empatia/fisiologia , Angústia Psicológica , Doadores de Tecidos/psicologia , Adulto , Encéfalo/fisiologia , Feminino , Neuroimagem Funcional , Humanos , Rim , Imagem por Ressonância Magnética , Masculino
14.
Dev Psychopathol ; 31(3): 917-929, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31064595

RESUMO

Irritability and anxiety are two common clinical phenotypes that involve high-arousal negative affect states (anger and fear), and that frequently co-occur. Elucidating how these two forms of emotion dysregulation relate to perturbed neurodevelopment may benefit from alternate phenotyping strategies. One such strategy applies a bifactor latent variable approach that can parse shared versus unique mechanisms of these two phenotypes. Here, we aim to replicate and extend this approach and examine associations with neural structure in a large transdiagnostic sample of youth (N = 331; M = 13.57, SD = 2.69 years old; 45.92% male). FreeSurfer was used to extract cortical thickness, cortical surface area, and subcortical volume. The current findings replicated the bifactor model and demonstrate measurement invariance as a function of youth age and sex. There were no associations of youth's factor scores with cortical thickness, surface area, or subcortical volume. However, we found strong convergent and divergent validity between parent-reported irritability and anxiety factors with clinician-rated symptoms and impairment. A general negative affectivity factor was robustly associated with overall functional impairment across symptom domains. Together, these results support the utility of the bifactor model as an alternative phenotyping strategy for irritability and anxiety, which may aid in the development of targeted treatments.


Assuntos
Transtornos de Ansiedade/psicologia , Ansiedade/psicologia , Humor Irritável/fisiologia , Adolescente , Ira/fisiologia , Ansiedade/diagnóstico por imagem , Transtornos de Ansiedade/diagnóstico por imagem , Nível de Alerta/fisiologia , Córtex Cerebral/diagnóstico por imagem , Criança , Medo/fisiologia , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Modelos Psicológicos , Tamanho do Órgão
15.
Dev Psychopathol ; 31(3): 859-869, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30968800

RESUMO

While emotional dysregulation is a broad construct, the current paper adopts a narrow approach to facilitate translational neuroscience research on pediatric anxiety. The paper first presents data on an adapted version of the antisaccade task and then integrates these data into a research framework. Data on an adapted version of the antisaccade task were collected in 57 youth, including 35 seeking treatment for an anxiety disorder. Associations were examined between performance on the antisaccade task and (a) age, (b) performance on other cognitive-control tasks (i.e., the stop-signal delay and flanker tasks), and (c) level of anxiety symptoms. Better performance on the antisaccade task occurred in older relative to younger subjects and correlated with better performance on the flanker task. Across the 57 youth, higher levels of anxiety correlated with shorter latency for correct antisaccades. These data can be placed within a three-step framework for translational neuroscience research. In the first step, a narrow index of emotion dysregulation is targeted. In the second step, this narrow index is linked to other correlated indicators of the same underlying narrow latent construct. In the third and final step, associations are examined with clinical outcomes and response to treatment.


Assuntos
Transtornos de Ansiedade/psicologia , Ansiedade/psicologia , Emoções/fisiologia , Função Executiva/fisiologia , Inibição Psicológica , Movimentos Sacádicos/fisiologia , Adolescente , Criança , Feminino , Humanos , Masculino , Tempo de Reação/fisiologia
16.
Psychol Med ; 49(9): 1449-1458, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30139402

RESUMO

BACKGROUND: The emergence of callous unemotional (CU) traits, and associated externalizing behaviors, is believed to reflect underlying dysfunction in the amygdala. Studies of adults with CU traits or psychopathy have linked characteristic patterns of amygdala dysfunction to reduced amygdala volume, but studies in youths have not thus far found evidence of similar amygdala volume reductions. The current study examined the association between CU traits and amygdala volume by modeling CU traits and externalizing behavior as independent continuous variables, and explored the relative contributions of callous, uncaring, and unemotional traits. METHODS: CU traits and externalizing behavior problems were assessed in 148 youths using the Inventory of Callous Unemotional Traits (ICU) and the Child Behavior Checklist (CBCL). For a subset of participants (n = 93), high-resolution T1-weighted images were collected and volume estimates for the amygdala were extracted. RESULTS: Analyses revealed that CU traits were associated with increased externalizing behaviors and decreased bilateral amygdala volume. These results were driven by the callous and uncaring sub-factors of CU traits, with unemotional traits unrelated to either externalizing behaviors or amygdala volume. Results persisted after accounting for covariation between CU traits and externalizing behaviors. Bootstrap mediation analyses indicated that CU traits mediated the relationship between reduced amygdala volume and externalizing severity. CONCLUSIONS: These findings provide evidence that callous-uncaring traits account for reduced amygdala volume among youths with conduct problems. These findings provide a framework for further investigation of abnormal amygdala development as a key causal pathway for the development of callous-uncaring traits and conduct problems.


Assuntos
Tonsila do Cerebelo/patologia , Transtornos do Comportamento Infantil/fisiopatologia , Transtorno da Conduta/fisiopatologia , Adolescente , Tonsila do Cerebelo/diagnóstico por imagem , Criança , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino
17.
Psychol Sci ; 29(10): 1631-1641, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30130165

RESUMO

Shared neural representations during experienced and observed distress are hypothesized to reflect empathic neural simulation, which may support altruism. But the correspondence between real-world altruism and shared neural representations has not been directly tested, and empathy's role in promoting altruism toward strangers has been questioned. Here, we show that individuals who have performed costly altruism (donating a kidney to a stranger; n = 25) exhibit greater self-other overlap than matched control participants ( n = 27) in neural representations of pain and threat (fearful anticipation) in anterior insula (AI) during an empathic-pain paradigm. Altruists exhibited greater self-other correspondence in pain-related activation in left AI, highlighting that group-level overlap was supported by individual-level associations between empathic pain and firsthand pain. Altruists exhibited enhanced functional coupling of left AI with left midinsula during empathic pain and threat. Results show that heightened neural instantiations of empathy correspond to real-world altruism and highlight limitations of self-report.


Assuntos
Altruísmo , Empatia/fisiologia , Individualidade , Doadores de Tecidos/psicologia , Adulto , Mapeamento Encefálico , Estudos de Casos e Controles , Comportamento de Escolha/fisiologia , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Princípios Morais , Dor/fisiopatologia
18.
Dev Psychopathol ; 30(1): 191-201, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-28535830

RESUMO

Callous-unemotional (CU) traits characterize a subgroup of youths with conduct problems who exhibit low empathy, fearlessness, and elevated externalizing behaviors. The current study examines the role of aberrant amygdala activity and functional connectivity during a socioemotional judgment task in youths with CU traits, and links these deficits to externalizing behaviors. Functional magnetic resonance imaging was used to compare neural responses in 18 healthy youths and 30 youths with conduct problems and varying levels of CU traits as they evaluated the acceptability of causing another person to experience each of several emotions, including fear. Neuroimaging analyses examined blood oxygenation level dependent responses and task-dependent functional connectivity. High-CU youths exhibited left amygdala hypoactivation relative to healthy controls and low-CU youths primarily during evaluations of causing others fear. CU traits moderated the relationship between externalizing behavior and both amygdala activity and patterns of functional connectivity. The present data suggest that CU youths' aberrant amygdala activity and connectivity affect how they make judgments about the acceptability of causing others emotional distress, and that these aberrations represent risk factors for externalizing behaviors like rule breaking and aggression. These findings suggest that reducing externalizing behaviors in high-CU youths may require interventions that influence affective sensitivity.


Assuntos
Tonsila do Cerebelo/diagnóstico por imagem , Transtorno da Conduta/diagnóstico por imagem , Empatia/fisiologia , Medo/fisiologia , Julgamento , Adolescente , Agressão/fisiologia , Agressão/psicologia , Tonsila do Cerebelo/fisiopatologia , Criança , Transtorno da Conduta/fisiopatologia , Transtorno da Conduta/psicologia , Emoções/fisiologia , Medo/psicologia , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Comportamento Problema/psicologia
20.
Proc Biol Sci ; 284(1865)2017 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-29070724

RESUMO

Costly altruism benefitting a stranger is a rare but evolutionarily conserved phenomenon. This behaviour may be supported by limbic and midbrain circuitry that supports mammalian caregiving. In rodents, reciprocal connections between the amygdala and the midbrain periaqueductal grey (PAG) are critical for generating protective responses toward vulnerable and distressed offspring. We used functional and structural magnetic resonance imaging to explore whether these regions play a role in supporting costly altruism in humans. We recruited a rare population of altruists, all of whom had donated a kidney to a stranger, and measured activity and functional connectivity of the amygdala and PAG as altruists and matched controls responded to care-eliciting scenarios. When these scenarios were coupled with pre-attentive distress cues, altruists' sympathy corresponded to greater activity in the left amygdala and PAG, and functional connectivity analyses revealed increased coupling between these regions in altruists during this epoch. We also found that altruists exhibited greater fractional anisotropy within the left amygdala-PAG white matter tract. These results, coupled with previous evidence of altruists' increased amygdala-linked sensitivity to distress, are consistent with costly altruism resulting from enhanced care-oriented responses to vulnerability and distress that are supported by recruitment of circuitry that supports mammalian parental care.


Assuntos
Altruísmo , Tonsila do Cerebelo/fisiologia , Substância Cinzenta Periaquedutal/fisiologia , Adolescente , Adulto , Animais , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Mamíferos , Comportamento Materno , Comportamento Paterno , Adulto Jovem
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