Abstract
A major goal of psychiatric neuroscience is to identify brain regions and circuits that underlie clinical phenomena to gain a more precise understanding of their nature and treatment.(1) These are early days in this effort, especially for pediatric mental health, but already there is evidence that brain changes may herald psychosis in youths at genetic risk for schizophrenia(2) or response to therapy in youths with anxiety.(3) Elucidating these brain-behavior relationships requires one to identify a clinically meaningful phenotype and associate it with specific brain regions or circuits that plausibly underlie the phenotype. In their article, Spechler et al.(4) do just that by linking parent reports of broadly defined emotional and behavioral difficulties with gray matter volume in the orbitofrontal cortex (OFC). It is a compelling find because the OFC is thought to play a role in adaptive socioemotional functioning. The OFC is necessary for evaluating what outcome is most desirable in complex situations and is interconnected with other regions, such as the amygdala, that underlie social and emotional responses.