Anterior Cingulate Cortex Reactivity to Social Stimuli Marks Individual Differences to Peer Victimization on Internalizing Symptoms in Adolescence

<h2>ABSTRACT</h2><h3>Objective</h3> Greater peer victimization predicts more internalizing symptoms, particularly among adolescent girls. However, not all adolescents are equally sensitive to peer interactions; rostral anterior cingulate cortex (rACC) reactivity to social cues may mark these differences in sensitivity. rACC activation to social stimuli may mark individuals for whom peer victimization leads to internalizing symptoms; this effect may vary by sex and level of peer victimization. Understanding unique pathways to internalizing symptoms may provide increasing insight into heterogeneity of emerging internalizing symptoms as well as precision targets for intervention. <h3>Method</h3> Participants (n=1,557; ages 11-12) from the Adolescent Brain Cognitive Development (ABCD) study completed functional neuroimaging and questionnaires. Participants were divided into quartiles of rACC social activation (faces>places) during the Emotional N-back task. <h3>Results</h3> Higher quartiles of left, but not right, rACC social activation were associated with higher levels of internalizing symptoms (<i>b</i>=6.777e-02). In female participants, high rACC social activation related to decreased internalizing symptoms as victimization increased (<i>b</i>=-0.08) compared to female participants with average and low rACC social activation and all male participants. <h3>Conclusion</h3> Lateralized rACC social activation may mark sensitivity to internalizing symptoms and peer victimization. At normative-to-low levels of peer victimization, higher rACC social activation marked a particularly vulnerable group to peer victimization. However, in female participants higher rACC social activation may be protective against high peer victimization where it decreased the association between peer victimization and internalizing symptoms. The rACC may be a treatment target for to reduce internalizing symptoms, but social context is an important factor contributing to heterogeneity.