Self-esteem and cortical thickness correlate with aggression in healthy children: A surface-based analysis

Aggressive behavior can have serious physical, psychological, and social consequences. However, little is known about the personality and neurological antecedents underlying aggressive behavior in children. The objective of this study was to investigate the relationship between self-esteem, aggression, and brain structure (i.e., cortical thickness and surface area) in a population of healthy children (N = 78; 9-12 years; mean age: 9.95 +/- 0.90 years). The results revealed that self-esteem showed a negative association with aggression and significantly predicted aggressive behavior. No gender differences were found in aggression and its neural correlates. We performed the cortical parcellation method to further explore the neural foundations underlying the association of self-esteem with aggression. Children with higher aggression had increased cortical thickness in four clusters after multiple comparison correction: right medial orbitofrontal cortex, right lateral orbitofrontal cortex, right superior frontal gyrus, and left insula. In a mediation analysis, cortical thickness in the right medial orbitofrontal cortex contributed to the effect of self-esteem on aggression. These findings extend our understanding of morphological correlates of aggression in children, suggesting that an increased cortical thickness in childhood is a potential mechanism linking low self-esteem to aggression.