No file available
To read the file of this research,
you can request a copy directly from the authors.
Early adolescent friendships aid behavioural and neural responses to social exclusion in young adults
Preprints and early-stage research may not have been peer reviewed yet.
Abstract
Childhood adversity (CA) is one of the strongest predictors of poor mental health in adolescents. CA is thought to contribute to mental health vulnerability by increased sensitivity to social rejection in later life. Here, we examined whether in a CA vulnerable group friendship quality at age 14 contributes to resilient functioning by age 24 through reducing emotional and neural stress responses to social rejection. Sixty-six participants aged 24 and from a prospective cohort study (ROOTS, N = 1238) underwent brain imaging while playing Cyberball. Resilient functioning at age 24 was quantified as ‘psychological functioning that was better than in others with similar CA experiences’. We found that friendship quality at 14 years predicted stronger emotional changes and increased dorsomedial prefrontal cortex (DMPFC) responses to peer rejection. Resilient functioning per se was associated with similar increased emotional and DMPFC responses. Exploratory mediation analyses showed that friendship quality predicted resilient functioning through increased emotional responses at the end of the assessment day. Our findings suggest that friendship quality at age 14 contributes to resilient functioning at age 24 by increasing sensitivity to positive experiences and improving brain activity thought to represent emotion regulation in response to negative social experiences in early adulthood.
ResearchGate has not been able to resolve any citations for this publication.
An important task for adolescents is to form and maintain friendships. In this three-wave biannual study, we used a longitudinal neuroscience perspective to examine the dynamics of friendship stability. Relative to childhood and adulthood, adolescence is marked by elevated ventral striatum activity when gaining self-serving rewards. Using a sample of participants between the ages of eight and twenty-eight, we tested age-related changes in ventral striatum response to gaining for stable ( n = 48) versus unstable best friends ( n = 75) (and self). In participants with stable friendships, we observed a quadratic developmental trajectory of ventral striatum responses to winning versus losing rewards for friends, whereas participants with unstable best friends showed no age-related changes. Ventral striatum activity in response to winning versus losing for friends further varied with friendship closeness for participants with unstable friendships. We suggest that these findings may reflect changing social motivations related to formation and maintenance of friendships across adolescence.
We tested whether adolescents differ from each other in the structural development of the social brain, and whether individual differences in social brain development predicted variability in friendship quality development. Adolescents (N = 299, Mage T1 = 13.98 years) were followed across three bi-annual waves. We analysed self-reported friendship quality with the best friend at T1 and T3, and bilateral measures of surface area and cortical thickness of the medial prefrontal cortex (mPFC), posterior superior temporal sulcus (pSTS), temporo-parietal junction (TPJ), and precuneus across all waves. At the group level, growth curve models confirmed non-linear decreases of surface area and cortical thickness in social brain regions. We identified substantial individual differences in levels and change rates of social brain regions, especially for surface area of the mPFC, pSTS, and TPJ. Change rates of cortical thickness varied less between persons. Higher levels of mPFC surface area and cortical thickness predicted stronger increases in friendship quality over time. Moreover, faster cortical thinning of mPFC surface area predicted a stronger increase in friendship quality. Higher levels of TPJ cortical thickness predicted lower friendship quality. Together, our results indicate heterogeneity in social brain development and how this variability uniquely predicts friendship quality development.
Child and adolescent adversity (‘CA’) is a major predictor of mental health problems in adolescence and early adulthood. However, not all young people who have experienced CA develop psychopathology; their mental health functioning can be described as resilient. We previously found that resilient functioning in adolescence following CA is facilitated by adolescent friendships. However, during adolescence, friendships undergo significant change. It is unknown whether resilient functioning after CA fluctuates with these normative changes in friendship quality. We used Latent Change Score Modelling in a large sample of adolescents (i.e. the ROOTS cohort; N = 1238) to examine whether and how emergent friendship quality and resilient functioning at ages 14 and 17 inter-relate and change together. We found that friendships quality and resilient functioning had strong associations at age 14, although friendships at 14 did not predict higher resilient functioning at 17. Higher resilient functioning in 14-year-olds with a history of CA was associated with a positive change in friendships from age 14 to 17. Finally, improvements in friendship quality and resilient functioning went hand-in-hand, even when taking into account baseline levels of both, the change within friendship quality or resilient functioning over time, and the association between resilient functioning and change in friendship quality over time. We show that friendship quality and resilient functioning after CA inter-relate and change together between ages 14 and 17. Our results suggest that improving friendship quality or resilient functioning within this timeframe may benefit this vulnerable adolescent group, and this should be tested in future research.
Background:
Evidence from epidemiological, clinical and high-risk studies has established that the peak period of risk for onset of bipolar disorder spans late adolescence and early adulthood. However, the proposal of the existence of a pre-pubertal form of bipolar disorder manifesting in early childhood created substantial debate. In this narrative review, the literature and contributing factors pertaining to the controversy surrounding the proposed pre-pubertal bipolar disorder subtype are discussed. The resolution of the debate and lessons learned are highlighted.
Main body:
In the mid 1990s US researchers proposed that chronic irritability and explosive temper in pre-pubertal children with pre-existing ADHD and/or other learning and developmental disorders might represent a variant of mania. A number of factors contributed to this proposal including severely ill children with no diagnostic home given changes in the ADHD DSM diagnostic criteria and over-reliance on symptoms and structured interviews rather than on a clinical assessment incorporating developmental history, social context and clinical course. Prospective studies of children at high familial risk did not support the proposed pre-pubertal bipolar phenotype; but rather provided convergent evidence that bipolar disorder onset in adolescence and early adulthood not uncommonly preceded by sleep and internalizing symptoms and most often debuting as depression in adolescence (after puberty). Epidemiological studies of population and hospital discharge data provided evidence that the pre-pubertal bipolar phenotype was largely a US driven phenomenon.
Conclusions:
Psychiatric diagnosis is particularly challenging given the current lack of objective biomarkers. However, validity and utility of clinical diagnoses can be strengthened if all available predictive information is used to formulate a diagnosis. As in other areas of medicine, critical information required to make a valid diagnosis includes developmental history, clinical course, family history and treatment response-weighed against the known trajectories of classical disorders. Moreover, given that psychiatric disorders are in evolution over childhood and adolescence and symptoms, in of themselves, are often non-specific, a thorough clinical assessment incorporating collateral history and psychosocial context is paramount. Such an approach might have avoided or at least brought a more timely resolution to the debate on pre-pubertal mania.
Background:
Childhood maltreatment has been associated with significant impairment in social, emotional and behavioural functioning later in life. Nevertheless, some individuals who have experienced childhood maltreatment function better than expected given their circumstances.
Main body:
Here, we provide an integrated understanding of the complex, interrelated mechanisms that facilitate such individual resilient functioning after childhood maltreatment. We aim to show that resilient functioning is not facilitated by any single 'resilience biomarker'. Rather, resilient functioning after childhood maltreatment is a product of complex processes and influences across multiple levels, ranging from 'bottom-up' polygenetic influences, to 'top-down' supportive social influences. We highlight the complex nature of resilient functioning and suggest how future studies could embrace a complexity theory approach and investigate multiple levels of biological organisation and their temporal dynamics in a longitudinal or prospective manner. This would involve using methods and tools that allow the characterisation of resilient functioning trajectories, attractor states and multidimensional/multilevel assessments of functioning. Such an approach necessitates large, longitudinal studies on the neurobiological mechanisms of resilient functioning after childhood maltreatment that cut across and integrate multiple levels of explanation (i.e. genetics, endocrine and immune systems, brain structure and function, cognition and environmental factors) and their temporal interconnections.
Conclusion:
We conclude that a turn towards complexity is likely to foster collaboration and integration across fields. It is a promising avenue which may guide future studies aimed to promote resilience in those who have experienced childhood maltreatment.
Background:
Childhood adversity (CA) is strongly associated with mental health problems. Resilience factors (RFs) reduce mental health problems following CA. Yet, knowledge on the nature of RFs is scarce. Therefore, we examined RF mean levels, RF interrelations, RF-distress pathways, and their changes between early (age 14) and later adolescence (age 17).
Methods:
We studied 10 empirically supported RFs in adolescents with (CA+; n = 631) and without CA (CA-; n = 499), using network psychometrics.
Results:
All inter-personal RFs (e.g. friendships) showed stable mean levels between age 14 and 17, and three of seven intra-personal RFs (e.g. distress tolerance) changed in a similar manner in the two groups. The CA+ group had lower RFs and higher distress at both ages. Thus, CA does not seem to inhibit RF changes, but to increase the risk of persistently lower RFs. At age 14, but not 17, the RF network of the CA+ group was less positively connected, suggesting that RFs are less likely to enhance each other than in the CA- group. Those findings underpin the notion that CA has a predominantly strong proximal effect. RF-distress pathways did not differ in strength between the CA+ and the CA- group, which suggests that RFs have a similarly protective strength in the two groups. Yet, as RFs are lower and distress is higher, RF-distress pathways may overall be less advantageous in the CA+ group. Most RF interrelations and RF-distress pathways were stable between age 14 and 17, which may help explain why exposure to CA is frequently found to have a lasting impact on mental health.
Conclusions:
Our findings not only shed light on the nature and changes of RFs between early and later adolescence, but also offer some accounts for why exposure to CA has stronger proximal effects and is often found to have a lasting impact on mental health.
Given the high prevalence and burden of mental disorders, fostering the understanding of protective factors is an urgent issue for translational medicine in psychiatry. The concept of resilience describes individual and environmental protective factors against the backdrop of established adversities linked to mental illness. There is convergent evidence for a crucial role of direct as well as indirect adversity impacting the developing brain, with persisting effects until adulthood. Direct adversity may include childhood maltreatment and family adversity, while indirect social adversity can include factors such as urban living or ethnic minority status. Recently, research has begun to examine protective factors which may be able to buffer against or even reverse these influences. First evidence indicates that supportive social environments as well as trait-like individual protective characteristics might impact on similar neural substrates, thus strengthening the capacity to actively cope with stress exposure in order to counteract the detrimental effects evoked by social adversity. Here, we provide an overview of the current literature investigating the neural mechanisms of resilience with a putative social background, including studies on individual traits and genetic variation linked to resilience. We argue that the regulatory perigenual anterior cingulate cortex and limbic regions, including the amygdala and the ventral striatum, play a key role as crucial convergence sites of protective factors. Further, we discuss possible prevention and early intervention approaches targeting both the individual and the social environment to reduce the risk of psychiatric disorders and foster resilience.
Resilience is still often viewed as a unitary personality construct that, as a kind of antinosological entity, protects individuals against stress-related mental problems. However, increasing evidence indicates that maintaining mental health in the face of adversity results from complex and dynamic processes of adaptation to stressors that involve the activation of several separable protective factors. Such resilience factors can reside at biological, psychological, and social levels and may include stable predispositions (such as genotype or personality traits) and malleable properties, skills, capacities, or external circumstances (such as gene-expression patterns, emotion-regulation abilities, appraisal styles, or social support). We abandon the notion of resilience as an entity here. Starting from a conceptualization of psychiatric disorders as dynamic networks of interacting symptoms that may be driven by stressors into stable maladaptive states of disease, we deconstruct the maintenance of mental health during stressor exposure into time-variant dampening influences of resilience factors onto these symptom networks. Resilience factors are separate additional network nodes that weaken symptom–symptom interconnections or symptom autoconnections, thereby preventing maladaptive system transitions. We argue that these hybrid symptom-and-resilience-factor networks provide a promising new way of unraveling the complex dynamics of mental health.
Depression is the leading cause of disability worldwide¹. Early life stress exposure increases risk for depression² and has been proposed to sensitize the maturing psychophysiological stress system to stress in later life³. In response to stress, positive memory activation has been found to dampen cortisol responses and improve mood in humans⁴ and to reduce depression-like behaviour in mice⁵. We used path modelling to examine whether recalling specific positive memories predicts reduced vulnerability to depression (high morning cortisol6–9 and negative self-cognitions during low mood10–12) in adolescents at risk due to early life stress (n = 427, age 14 years)⁸. We found that positive memory specificity was associated with lower morning cortisol and fewer negative self-cognitions during low mood over the course of one year. Moderated mediation analyses demonstrated that positive memory specificity was related to lower depressive symptoms through fewer negative self-cognitions in response to negative life events reported in the one-year interval. These findings indicate that recalling specific positive life experiences may be a resilience factor¹³ that helps in lowering depressive vulnerability in adolescents with a history of early life stress. © 2019, The Author(s), under exclusive licence to Springer Nature Limited.
Importance
Being exposed to trauma is a common childhood experience associated with symptoms and impairments in childhood.
Objective
To assess the association between cumulative childhood trauma exposure and adult psychiatric and functional outcomes.
Design, Setting, and Participants
Prospective, population-based cohort study of 1420 participants. A community representative sample of participants was assessed with structured Child and Adolescent Psychiatric Assessment interviews up to 8 times in childhood (ages 9-16 years; 6674 observations; 1993-2000) for lifetime trauma exposure as defined by the Diagnostic and Statistical Manual of Mental Disorders. Participants were followed up 4 times in adulthood (ages 19, 21, 25, and 30 years; 4556 observations of 1336 participants; 1999-2015) with the structured Young Adult Psychiatric Assessment Interview for psychiatric outcomes, functional outcomes, and evidence of a disrupted transition to adulthood. Analysis was completed in 2018.
Exposure
Participants were assessed with the structured Child and Adolescent Psychiatric Assessment interview (parent and self-report) up to 8 times in childhood for lifetime trauma exposure (ages 9-16 years; 6674 observations; 1993-2000).
Main Outcomes and Measures
Participants were assessed up to 4 times with the structured Young Adult Psychiatric Assessment interview (self-report) in adulthood (ages 19, 21, 25, and 30 years; 4556 observations of 1336 participants; 1999-2015) for psychiatric outcomes, functional outcomes, and evidence of a disrupted transition to adulthood.
Results
Among the 1420 study participants, 630 (49.0%) were female and 983 (89.4%) were white. By age 16 years, 30.9% of children (n = 451) were exposed to 1 traumatic event, 22.5% (n = 289) were exposed to 2 such events, and 14.8% (n = 267) were exposed to 3 or more. Cumulative childhood trauma exposure to age 16 years was associated with higher rates of adult psychiatric disorders (odds ratio for any disorder, 1.2; 95% CI, 1.0-1.4) and poorer functional outcomes, including key outcomes that indicate a significantly disrupted transition to adulthood (eg, failure to hold a job and social isolation). Childhood trauma exposure continued to be associated with higher rates of adult psychiatric and functional outcomes after adjusting for a broad range of childhood risk factors, including psychiatric functioning and family adversities and hardships (adjusted odds ratio for any disorder, 1.3; 95% CI, 1.0-1.5).
Conclusions and Relevance
Cumulative childhood trauma exposure was associated with poor adult outcomes even after accounting for many of the childhood and family factors associated with both trauma exposure and poor adult outcomes. Childhood trauma exposures are common, but often preventable, thus providing a clear target for child-focused public health efforts to ameliorate long-term morbidity.
Depression is associated with negative attention and attribution biases and maladaptive emotion responsivity and regulation, which adversely impact self-evaluations and interpersonal relationships. Using fMRI, we investigated the neural substrates of these impairments. We compared neural activity recruited by 126 clinically depressed and healthy adolescents (ages 11-17) during social exclusion (Exclusion>Inclusion) using Cyberball. Results revealed significant interaction effects within left anterior insula/inferior frontal gyrus and left middle temporal gyrus. Insula hyperresponsivity was associated with peer exclusion for depressed adolescents but peer inclusion for healthy adolescents. In additional, healthy adolescents recruited greater lateral temporal activity during peer exclusion. Complementary effect size analyses within independent parcellations offered converging evidence, as well as highlighted medium-to-large effects within subgenual/ventral anterior cingulate cortex and lateral prefrontal, lateral temporal, and lateral parietal regions implicated in emotion regulation. Depressogenic neural patterns were associated with negative self-perceptions and negative information processing biases. These findings suggest a neural mechanism underlying cognitive biases in depression, as reflected by emotional hyperresponsivity and maladaptive regulation/reappraisal of negative social evaluative information. This study lends further support for salience and central executive network dysfunction underlying social threat processing, and in particular, highlights the anterior insula as a key region of disturbance in adolescent depression.
Laboratory models that help us understand the neural mechanisms associated with how stress, particularly interpersonal stress, affects children’s and adolescents’ emotions are paramount but are limited if that understanding lacks validity in adolescents’ daily lives. There is a lack of research that addresses the ecological validity of visual stimuli to induce stress in participants while measuring participants’ neural response to that stimuli. This approach is needed if we are to identify the neural mechanisms that underlie the effect of stressful events on individuals’ emotional functioning. The current study conducted a systematic literature review to identify visual tasks that have been used in laboratory settings to induce stress in participants. The most frequent tasks identified were developed to induce peer rejection/exclusion in youth (e.g., Chatroom and Cyberball). These tasks were generally effective at bringing about a neural response in areas of the brain traditionally associated with social cognitive processing, such as the cingulate cortex, prefrontal cortex, insula, and striatum. In particular, the cingulate cortex and prefrontal cortex are associated with the Social Information Processing Network. Almost entirely absent from the literature are systematic evaluations of ecological validity and parent–child based visual stimuli that approximate the stress that adolescents might experience in their relationships with parents. The present article highlights trends and gaps in the current research, and examines the ecological validity of current stimuli used as laboratory based stressors, which can be used to fuel further investigation into adolescent neural response to stimuli, and further evaluation of the ecological validity of tasks.
Social influence occurs when an individual's thoughts or behaviours are affected by other people. There are significant age effects on susceptibility to social influence, typically a decline from childhood to adulthood. Most research has focused on negative aspects of social influence, such as peer influence on risky behaviour, particularly in adolescence. The current study investigated the impact of social influence on the reporting of prosocial behaviour (any act intended to help another person). In this study, 755 participants aged 8–59 completed a computerized task in which they rated how likely they would be to engage in a prosocial behaviour. Afterwards, they were told the average rating (in fact fictitious) that other participants had given to the same question, and then were asked to rate the same behaviour again. We found that participants' age affected the extent to which they were influenced by other people: children (8–11 years), young adolescents (12–14 years) and mid‐adolescents (15–18 years) all significantly changed their ratings, while young adults (19–25 years) and adults (26–59 years) did not. Across the three youngest age groups, children showed the most susceptibility to prosocial influence, changing their reporting of prosocial behaviour the most. The study provides evidence that younger people's increased susceptibility to social influence can have positive outcomes.
The importance of understanding how we anticipate and prepare for social rejection is underscored by the mental and physical toll of continual social vigilance. In this study, we investigate the impact of social rejection on anticipatory attentional processes using the well-known Cyberball task, a paradigm in which participants engage in a game of catch with virtual avatars who after an initial period of fair-play (inclusion condition) then exclude the participant from the game (exclusion condition). The degree of anticipatory attention allocated by subjects towards the avatars was assessed by measuring P3b responses towards the avatars' preparatory actions (i.e. the phase preceding their exclusionary actions) using high density EEG. The results of the study show that relative to the inclusion, participants exhibit elevated levels of anticipatory attentional allocation towards the avatars during the exclusion block. This shift was however significantly moderated by participants' self-reported cognitive regulation tendencies. Participants with higher levels of self-reported cognitive reappraisal tendencies showed larger anticipatory P3b increases from the inclusion to exclusion block relative to participants with reduced levels of reappraisal tendencies. These results highlight the impact of social exclusion on anticipatory neural processing and the moderating role of cognitive reappraisal on these effects.
Adolescents are particularly susceptible to social influence. Here, we investigated the effect of social influence on risk perception in 590 participants aged eight to fifty-nine-years tested in the United Kingdom. Participants rated the riskiness of everyday situations, were then informed about the rating of these situations from a (fictitious) social-influence group consisting of teenagers or adults, and then re-evaluated the situation. Our first aim was to attempt to replicate our previous finding that young adolescents are influenced more by teenagers than by adults. Second, we investigated the social-influence effect when the social-influence group's rating was more, or less, risky than the participants' own risk rating. Younger participants were more strongly influenced by teenagers than by adults, but only when teenagers rated a situation as more risky than did participants. This suggests that stereotypical characteristics of the social-influence group – risk-prone teenagers - interact with social influence on risk perception.
The prefrontal cortex (PFC) plays a critical role in the generation and regulation of emotion. However, we lack an integrative framework for understanding how different emotion-related functions are organized across the entire expanse of the PFC, as prior reviews have generally focused on specific emotional processes (e.g., decision making) or specific anatomical regions (e.g., orbitofrontal cortex). Additionally, psychological theories and neuroscientific investigations have proceeded largely independently because of the lack of a common framework. Here, we provide a comprehensive review of functional neuroimaging, electrophysiological, lesion, and structural connectivity studies on the emotion-related functions of 8 subregions spanning the entire PFC. We introduce the appraisal-by-content model, which provides a new framework for integrating the diverse range of empirical findings. Within this framework, appraisal serves as a unifying principle for understanding the PFC's role in emotion, while relative content-specialization serves as a differentiating principle for understanding the role of each subregion. A synthesis of data from affective, social, and cognitive neuroscience studies suggests that different PFC subregions are preferentially involved in assigning value to specific types of inputs: exteroceptive sensations, episodic memories and imagined future events, viscero-sensory signals, viscero-motor signals, actions, others' mental states (e.g., intentions), self-related information, and ongoing emotions. We discuss the implications of this integrative framework for understanding emotion regulation, value-based decision making, emotional salience, and refining theoretical models of emotion. This framework provides a unified understanding of how emotional processes are organized across PFC subregions and generates new hypotheses about the mechanisms underlying adaptive and maladaptive emotional functioning. (PsycINFO Database Record
Background:
Adolescence is a key time period for the emergence of psychosocial and mental health difficulties. To promote adolescent adaptive ('resilient') psychosocial functioning (PSF), appropriate conceptualisation and quantification of such functioning and its predictors is a crucial first step. Here, we quantify resilient functioning as the degree to which an individual functions better or worse than expected given their self-reported childhood family experiences, and relate this to adolescent family and friendship support.
Method:
We used Principal Component and regression analyses to investigate the relationship between childhood family experiences and PSF (psychiatric symptomatology, personality traits and mental wellbeing) in healthy adolescents (the Neuroscience in Psychiatry Network; N = 2389; ages 14-24). Residuals from the relation between childhood family experiences and PSF reflect resilient functioning; the degree to which an individual is functioning better, or worse, than expected given their childhood family experiences. Next, we relate family and friendship support with resilient functioning both cross-sectionally and 1 year later.
Results:
Friendship and family support were positive predictors of immediate resilient PSF, with friendship support being the strongest predictor. However, whereas friendship support was a significant positive predictor of later resilient functioning, family support had a negative relationship with later resilient PSF.
Conclusions:
We show that friendship support, but not family support, is an important positive predictor of both immediate and later resilient PSF in adolescence and early adulthood. Interventions that promote the skills needed to acquire and sustain adolescent friendships may be crucial in increasing adolescent resilient PSF.
Social exclusion has a profound emotional impact on children. However, there is still limited and partly conflicting experimental evidence for the possible effect of social exclusion on children’s cognitive performance. In the present study, we tested the possibility that some children are more vulnerable than others to the negative effects of social exclusion on cognitive performance. We selected 4 potential candidates that could moderate the effects of social exclusion: relational self-esteem, peer ratings of popularity, rejection sensitivity and nonverbal intelligence. Individual differences in these 4 potential moderating factors were first assessed in a sample of 318 children (45.6 % females; mean age = 9.92 years). Then, in a subsequent experimental session, the participants were either socially included or excluded using a typical manipulation (i.e., the Cyberball paradigm). Following the manipulation, the children’s cognitive performance was assessed using a logical reasoning test. The results showed that the children with lower scores for relational self-esteem (the bottom 37.46 % of the sample), lower popularity (43.49 %) or weaker nonverbal intelligence (37.80 %) performed worse on the logical reasoning test following social exclusion. Moreover, children with combined low self-esteem, popularity and nonverbal intelligence were the most affected by social exclusion. This study identified factors that make some children more vulnerable to the negative effects of social exclusion. Overall, the present work underscores the value of considering basic cognitive and relational individual differences when developing interventions aimed at preventing the negative effects of social exclusion among children.
Background
Early life stress (ELS) consists of child family adversities (CFA: negative experiences that happened within the family environment) and/or peer bullying. ELS plays an important role in the development of adolescent depressive symptoms and clinical disorders. Identifying factors that may reduce depressive symptoms in adolescents with ELS may have important public mental health implications.
Methods
We used structural equation modelling and examined the impact of adolescent friendships and/or family support at age 14 on depressive symptoms at age 17 in adolescents exposed to ELS before age 11. To this end, we used structural equation modelling in a community sample of 771 adolescents (322 boys and 477 girls) from a 3 year longitudinal study. Significant paths in the model were followed-up to test whether social support mediated or moderated the association between ELS and depressive symptoms at age 17.
Results
We found that adolescent social support in adolescence is negatively associated with subsequent depressive symptoms in boys and girls exposed to ELS. Specifically, we found evidence for two mediational pathways: In the first pathway family support mediated the link between CFA and depressive symptoms at age 17. Specifically, CFA was negatively associated with adolescent family support at age 14, which in turn was negatively associated with depressive symptoms at age 17. In the second pathway we found that adolescent friendships mediated the path between peer bullying and depressive symptoms. Specifically, relational bullying was negatively associated with adolescent friendships at age 14, which in turn were negatively associated with depressive symptoms at age 17. In contrast, we did not find a moderating effect of friendships and family support on the association between CFA and depressive symptoms.
Conclusions
Friendships and/or family support in adolescence mediate the relationship between ELS and late adolescent depressive symptoms in boys and girls. Therefore, enhancing affiliate relationships and positive family environments may benefit the mental health of vulnerable youth that have experienced CFA and/or primary school bullying.
Previous research has demonstrated that before puberty, parents are able to buffer, and often completely block, cortisol responses to social evaluative stressors (e.g., Trier Social Stress Test; TSST). However, after puberty, parents no longer provide a powerful buffer of the HPA axis from a social-evaluative stressor. The current study investigates whether friends can buffer the HPA axis in both children and adolescents compared to parents and whether similar stress-ameliorating patterns can also be observed in oxytocin activity. A total of 109 participants (54 children aged 9–10 and 55 adolescents aged 15–16; half of each sex) completed the TSST and were randomly assigned to prepare for their speech with their parent or friend for 5 minutes beforehand. Salivary cortisol and urinary oxytocin were measured before and after the TSST. For children, cortisol responses were comparable regardless of who helped the child prepare the speech. For adolescents, however, friends actually amplified the cortisol response compared to parents. In addition, adolescents produced less oxytocin than children, as did males compared to females. Notably, for boys, oxytocin levels decreased across the session if participants prepared with a friend rather than their parent. The mean change was in the same direction but not significant for girls. These results indicate that friends do not take over the social buffering role by age 15–16, which may inform interventions in at-risk children and adolescents.
Purpose:
The purpose of this study is to review longitudinal findings on adolescent mental health from the 'ROOTS study', and provide directions and recommendations for future longitudinal research. To do this, we discuss relevant findings from the ROOTS study, and review its strengths and limitations.
Methods:
We examined all publications from the ROOTS study up to July 2015, selected those examining adolescent mental health, and classified them as investigating (a) childhood risk factors for adolescent depression, (b) genetic and cognitive vulnerability to depression in adolescence, (c) genetic markers, childhood adversities, and neuroendophenotypes, (d) morning cortisol and depression, (e) physical activity and depression symptoms, and (f) the underlying structure of mental health in adolescence. We reviewed the strengths and limitations of the ROOTS study, and how they feed into recommendations for future longitudinal research.
Results:
There was evidence supporting a putative hormonal biomarker for the emergence of depression in boys. Environmental pathways from child adversity to adolescent depression were confirmed in girls, partly accounted for by negative life events in early adolescence. The preceding role of automatic cognitive biases assessed using behavioural tasks was substantiated, with evidence for genetic susceptibility. Novel latent statistical models of child adversity, depression, anxiety, and psychotic experiences were produced, with concurrent and prospective validity. Our experiences conducting the ROOTS study resulted in a set of strengths, limitations, and recommendations for future longitudinal studies.
Conclusions:
The ROOTS study has advanced knowledge on the aetiology of adolescent depression by investigating environmental, genetic, hormonal, and neural risk factors. Findings provide a foundation for future research integrating cognitive neuroscience with epidemiology.
Social buffering, a subset of social support, is the process through which the availability of a conspecific reduces the activity of stress-mediating neurobiological systems. While its role in coping and resilience is significant, we know little about its developmental history in humans. This brief review presents an integrative developmental account of the social buffering of hypothalamic-pituitary-adrenocortical (HPA) stress reactivity in humans, from infancy to adulthood. During infancy, parents are powerful stress-regulators for children, but child temperament also plays a role and interacts with parenting quality to predict the magnitude of stress responses to fear or pain stimuli. Recent work indicates that parental support remains a potent stress buffer into late childhood, but that it loses its effectiveness as a buffer of the HPA axis by adolescence. Puberty may be the switch that alters the potency of parental buffering. In Beginning in middle childhood, friends may serve as stress buffers, particularly when other peers are the source of stress. By adulthood romantic partners assume this protective role, though studies often reveal sex differences that are currently not well understood. Translational research across species will be critical for developing a mechanistic understanding of social buffering and the processes involved in developmental changes noted in this review.
Social exclusion affects mental and physical health. The ability to regulate emotional responses to social exclusion is therefore essential for our well-being. As individual differences in detecting bodily signals (interoceptive sensitivity, IS) have been associated with the ability of emotion regulation, we aimed at exploring whether IS fosters coping with social exclusion and flexibility in emotion regulation. The first study investigated subjective feelings and behavioral affiliation tendencies in response to ostracism using a cyberball paradigm. Sixty-nine participants were assessed who differed with respect to IS. The second study examined habitual emotion regulation processes focusing on suppression and reappraisal as well as IS in 116 participants. Main results were that the effect of ostracism on distress and behavioral affiliation tendencies were qualified by IS-being ostracized had less impact on participants with stronger IS. Furthermore, Study 2 revealed that IS was associated with habitually stronger emotion regulation strategies. We conclude that having access to bodily signals helps (IS) reducing aversive states provoked by social exclusion, probably due to the fact that IS is associated with emotion regulation strategies.
The Determinants of young Adult Social well-being and Health longitudinal study draws on life-course models to understand ethnic differences in health. A key hypothesis relates to the role of psychosocial factors in nurturing the health and well-being of ethnic minorities growing up in the UK. We report the effects of culturally patterned exposures in childhood.
In 2002/2003, 6643 11-13 year olds in London, ~80 % ethnic minorities, participated in the baseline survey. In 2005/2006, 4782 were followed-up. In 2012-2014, 665 took part in a pilot follow-up aged 21-23 years, including 42 qualitative interviews. Measures of socioeconomic and psychosocial factors and health were collected.
Ethnic minority adolescents reported better mental health than White British, despite more adversity (e.g. economic disadvantage, racism). It is unclear what explains this resilience but findings support a role for cultural factors. Racism was an adverse influence on mental health, while family care and connectedness, religious involvement and ethnic diversity of friendships were protective. While mental health resilience was a feature throughout adolescence, a less positive picture emerged for cardio-respiratory health. Both, mental health and cultural factors played a role. These patterns largely endured in early 20s with family support reducing stressful transitions to adulthood. Education levels, however, signal potential for socio-economic parity across ethnic groups.
Adolescence is a period of life in which peer relationships become increasingly important. Adolescents have a greater likelihood of taking risks when they are with peers rather than alone. In this study, we investigated the development of social influence on risk perception from late childhood through adulthood. Five hundred and sixty-three participants rated the riskiness of everyday situations and were then informed about the ratings of a social-influence group (teenagers or adults) before rating each situation again. All age groups showed a significant social-influence effect, changing their risk ratings in the direction of the provided ratings; this social-influence effect decreased with age. Most age groups adjusted their ratings more to conform to the ratings of the adult social-influence group than to the ratings of the teenager social-influence group. Only young adolescents were more strongly influenced by the teenager social-influence group than they were by the adult social-influence group, which suggests that to early adolescents, the opinions of other teenagers about risk matter more than the opinions of adults.
© The Author(s) 2015.
Adverse childhood experiences (ACEs) have been associated with negative health outcomes, but the evidence has had limited application in primary care practice. The purpose of this study was to systematically review the research on associations between ACEs and adult health outcomes to inform nurse practitioners (NPs) in primary care practice.
The databases PubMed, CINAHL, PsycINFO, and Social Abstracts were searched for articles published in English between 2008 and 2013 using the search term "adverse childhood experiences." Forty-two research articles were included in the synthesis. The evidence was synthesized and is reported following the preferred reporting items for systematic reviews and meta-analysis procedure (PRISMA).
ACEs have been associated with health consequences including physical and psychological conditions, risk behaviors, developmental disruption, and increased healthcare utilization. Generalization of the results is limited by a majority of studies (41/42) measuring childhood adversity using self-report measures.
NPs are encouraged to incorporate assessment of patients' childhood history in routine primary care and to consider the evidence that supports a relationship between ACEs and health. Although difficult, talking about patient's childhood experiences may positively influence health outcomes.
©2015 American Association of Nurse Practitioners.
The adolescent brain is more “plastic” than it will ever be again, capable of remarkable adaptability in light of the many social, physical, sexual, and intellectual challenges that this developmental phase brings. This is also a peak time for clinical onset of most mental illnesses (see the chart) ( 1 ). One in five adolescents have a mental illness that will persist into adulthood ( 2 ). Mental illnesses that emerge before adulthood impose a 10-fold higher cost than those that emerge later in life ( 3 ). Mental health costs are the highest single source of global economic burden in the world ( 4 ).
In this paper, we suggest ways to improve mediation analysis practice among consumer behavior researchers. We review the current methodology and demonstrate the superiority of structural equations modeling, both for assessing the classic mediation questions and for enabling researchers to extend beyond these basic inquiries. A series of simulations are presented to support the claim that the approach is superior. In addition to statistical demonstrations , logical arguments are presented, particularly regarding the introduction of a fourth construct into the mediation system. We close the paper with new prescriptive instructions for mediation analyses.
This study compares brain activation during causal attribution to three different loci, the self, another person and the situation; and further explores correlations with clinical scales (i.e. depression, anxiety and autism) in a typical population. While they underwent functional magnetic resonance imaging, 20 participants read short sentences about another person ('someone') who engaged in behaviors with the participant or made comments about the participant. The participants then attributed these behaviors to three attribution loci: themselves, the other person or the situation. The results revealed common activation across the three attribution loci in the bilateral temporo-parietal junction (TPJ), left posterior superior temporal sulcus, precuneus and right temporal pole (TP). Comparisons between the attribution loci revealed very little differences, except for increased activation of the right TP while making attributions to the situation compared with the self. In addition, when making attributions to the situation or other persons for negative events, there were reliable correlations between low activity in the left TPJ and high levels of anxiety and problematic social interaction in autism. The results indicate that attributions to different loci are based on the same underlying brain process, which might be atypical among persons with anxiety or autism symptoms.
Structural equation modeling (SEM) is a vast field and widely used by many applied researchers in the social and behavioral sciences. Over the years, many software pack-ages for structural equation modeling have been developed, both free and commercial. However, perhaps the best state-of-the-art software packages in this field are still closed-source and/or commercial. The R package lavaan has been developed to provide applied researchers, teachers, and statisticians, a free, fully open-source, but commercial-quality package for latent variable modeling. This paper explains the aims behind the develop-ment of the package, gives an overview of its most important features, and provides some examples to illustrate how lavaan works in practice.
Though only a decade has elapsed since the default network (DN) was first defined as a large-scale brain system, recent years have brought great insight into the network's adaptive functions. A growing theme highlights the DN as playing a key role in internally directed or self-generated thought. Here, we synthesize recent findings from cognitive science, neuroscience, and clinical psychology to focus attention on two emerging topics as current and future directions surrounding the DN. First, we present evidence that self-generated thought is a multifaceted construct whose component processes are supported by different subsystems within the network. Second, we highlight the dynamic nature of the DN, emphasizing its interaction with executive control systems when regulating aspects of internal thought. We conclude by discussing clinical implications of disruptions to the integrity of the network, and consider disorders when thought content becomes polarized or network interactions become disrupted or imbalanced.
Children who have experienced chronic parental rejection and exclusion during childhood, as is the case in childhood emotional maltreatment, may become especially sensitive to social exclusion. This study investigated the neural and emotional responses to social exclusion (with the Cyberball task) in young adults reporting childhood emotional maltreatment. Using functional magnetic resonance imaging, we investigated brain responses and self-reported distress to social exclusion in 46 young adult patients and healthy controls (mean age = 19.2±2.16) reporting low to extreme childhood emotional maltreatment. Consistent with prior studies, social exclusion was associated with activity in the ventral medial prefrontal cortex and posterior cingulate cortex. In addition, severity of childhood emotional maltreatment was positively associated with increased dorsal medial prefrontal cortex responsivity to social exclusion. The dorsal medial prefrontal cortex plays a crucial role in self-and other-referential processing, suggesting that the more individuals have been rejected and maltreated in childhood, the more self- and other- processing is elicited by social exclusion in adulthood. Negative self-referential thinking, in itself, enhances cognitive vulnerability for the development of psychiatric disorders. Therefore, our findings may underlie the emotional and behavioural difficulties that have been reported in adults reporting childhood emotional maltreatment.
Child sexual abuse is considered a modifiable risk factor for mental disorders across the life course. However the long-term consequences of other forms of child maltreatment have not yet been systematically examined. The aim of this study was to summarise the evidence relating to the possible relationship between child physical abuse, emotional abuse, and neglect, and subsequent mental and physical health outcomes.
A systematic review was conducted using the Medline, EMBASE, and PsycINFO electronic databases up to 26 June 2012. Published cohort, cross-sectional, and case-control studies that examined non-sexual child maltreatment as a risk factor for loss of health were included. All meta-analyses were based on quality-effects models. Out of 285 articles assessed for eligibility, 124 studies satisfied the pre-determined inclusion criteria for meta-analysis. Statistically significant associations were observed between physical abuse, emotional abuse, and neglect and depressive disorders (physical abuse [odds ratio (OR) = 1.54; 95% CI 1.16-2.04], emotional abuse [OR = 3.06; 95% CI 2.43-3.85], and neglect [OR = 2.11; 95% CI 1.61-2.77]); drug use (physical abuse [OR = 1.92; 95% CI 1.67-2.20], emotional abuse [OR = 1.41; 95% CI 1.11-1.79], and neglect [OR = 1.36; 95% CI 1.21-1.54]); suicide attempts (physical abuse [OR = 3.40; 95% CI 2.17-5.32], emotional abuse [OR = 3.37; 95% CI 2.44-4.67], and neglect [OR = 1.95; 95% CI 1.13-3.37]); and sexually transmitted infections and risky sexual behaviour (physical abuse [OR = 1.78; 95% CI 1.50-2.10], emotional abuse [OR = 1.75; 95% CI 1.49-2.04], and neglect [OR = 1.57; 95% CI 1.39-1.78]). Evidence for causality was assessed using Bradford Hill criteria. While suggestive evidence exists for a relationship between maltreatment and chronic diseases and lifestyle risk factors, more research is required to confirm these relationships.
This overview of the evidence suggests a causal relationship between non-sexual child maltreatment and a range of mental disorders, drug use, suicide attempts, sexually transmitted infections, and risky sexual behaviour. All forms of child maltreatment should be considered important risks to health with a sizeable impact on major contributors to the burden of disease in all parts of the world. The awareness of the serious long-term consequences of child maltreatment should encourage better identification of those at risk and the development of effective interventions to protect children from violence. Please see later in the article for the Editors' Summary.
Adverse experiences during childhood can have long-lasting impacts on physical and mental health. At the heart of most theories of how these effects are transduced into health impacts is the activity of stress-mediating systems, most notably the hypothalamic-pituitary-adrenocortical (HPA) axis. Here we review the anatomy and physiology of the axis, models of stress and development, the development of the axis prenatally through adolescence, the role of experience and sensitive periods in shaping its regulation, the social regulation of the axis at different points in development, and finally conclude with suggestions for future research. We conclude that it is clear that early adversity sculpts the stress system, but we do not understand which dimensions have the most impact and at what points in early development. It is equally clear that secure attachment relationships buffer the developing stress system; however, the mechanisms of social buffering and how these may change with development are not yet clear. Another critical issue that is not understood is when and for whom adversity will result in hypo- vs hyperactivity of stress-mediating systems. These and other issues are important for advancing our understanding of how early adversity "gets under the skin" and shapes human physical and mental health.
Although exposure to adversity increases risk for poor mental health outcomes, many people exposed to adversity do not develop such outcomes. Psychological resilience, defined broadly as positive emotional and/or behavioral adaptation to adversity, may be influenced by genetic factors that have remained largely unexplored in the era of large-scale genome-wide studies. In this perspective, we provide an integrative framework for studying human genome-wide variation underlying resilience. We first outline three complementary working definitions of psychological resilience—as a capacity, process, and outcome. For each definition, we review emerging empirical evidence, including findings from positive psychology, to illustrate how a resilience-based framework can guide novel and fruitful directions for the field of psychiatric genomics, distinct from the ongoing study of psychiatric risk and related traits. Finally, we provide practical recommendations for future genomic research on resilience, highlighting a need to augment cross-sectional findings with prospective designs that include detailed measurement of adversities and outcomes. A research framework that explicitly addresses resilience could help us to probe biological mechanisms of stress adaptation, identify individuals who may benefit the most from prevention and early intervention, and ascertain modifiable protective factors that mitigate negative outcomes even for those at high genetic risk.
Research has demonstrated that adolescence is an important time for self- and other-oriented development that underlies many skills vital for becoming a contributing member of society with healthy intergroup relations. It is often assumed that these two processes, thinking about self and thinking about others, are pitted against each other when adolescents engage in social decision making such as giving or sharing. Recent evidence from social neuroscience, however, does not support this notion of conflicting motives, suggesting instead that thinking about self and others relies on a common network of social-affective brain regions, with the medial prefrontal cortex playing a central role in the integration of perspectives related to self and others. Here, we argue that self- and other-oriented thinking are intertwined processes that rely on an overlapping neural network. Adolescents’ motivation to contribute to society can be fostered most when self- and other-oriented motives align.
Expected final online publication date for the Annual Review of Psychology Volume 71 is January 4, 2020. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
This review provides a broad overview of my research group’s work on social buffering in human development in the context of the field. Much of the focus is on social buffering of the hypothalamic-pituitary-adrenocortical (HPA) system, one of the two major arms of the mammalian stress system. This focus reflects the centrality of the HPA system in research on social buffering in the fields of developmental psychobiology and developmental science. However, buffering of the cardiovascular and autonomic nervous system is also discussed. The central developmental question in this area derives from attachment theory, which argues that the infant’s experience of stress and arousal regulation in the context of her early attachment relationships is not an immature form of social buffering experienced in adulthood but rather the foundation out of which individual differences in the capacity to gain stress relief from social partners emerges. The emergence of social buffering in infancy, changes in social buffering throughout childhood and adolescence, the influence of early experience on later individual differences in social buffering, and critical gaps in our knowledge are described.
Recalling happy memories elicits positive feelings and enhances one’s wellbeing, suggesting a potential adaptive function in using this strategy for coping with stress. In two studies, we explored whether recalling autobiographical memories that have a positive content—that is, remembering the good times—can dampen the hypothalamic–pituitary–adrenal axis stress response. Participants underwent an acute stressor or control task followed by autobiographical memory recollection (of only positive or neutral valence). Across both studies, recalling positive, but not neutral, memories resulted in a dampened cortisol rise and reduced negative affect. Further, individuals with greater self-reported resiliency showed enhanced mood, despite stress exposure. During positive reminiscence, we observed engagement of corticostriatal circuits previously implicated in reward processing and emotion regulation, and stronger connectivity between ventrolateral and dorsolateral prefrontal cortices as a function of positivity. These findings highlight the restorative and protective function of self-generated positive emotions via memory recall in the face of stress.
Poverty and exposure to adversity have been linked with decreased educational success. Various environmental and neurobiological pathways have been proposed for these associations, however, existing models have several clear drawbacks. Here we outline existing models, and propose an alternate model linking exposure to adverse experiences in childhood to education success. Specifically, we propose that measured dimensions of experience (e.g. decreased cognitive enrichment or increased exposure to violence), instead of named exposures (e.g. poverty) impact neurobiology through neurodevelopmental processes of neuroplasticity. Our model results in testable hypotheses and clear intervention strategies. We predict that exposure to trauma will have a distinct neurobiological impact from exposure to a lack of cognitive stimulation and that these distinct exposures will benefit from different interventions. Specificity in this arena is thus likely to better support educational achievement for disadvantaged children.
Promoting mental health and emotional wellbeing (EWB) in children and young people (YP) is vitally important for their psycho-social development. Critical review of the literature reveals a dearth of research that has explored the perspective of the child, adolescent or adult in this concept, with much research being intervention focused and promoted at crisis level. The current study aims to address this gap in understanding of young persons' and parents' perspectives.
A small-scale, exploratory qualitative study was conducted with YP, and parents of YP aimed at exploring the meaning of EWB and how it could be promoted. Data were collected via focus groups with 15 YP (aged 18-24 years) and 15 interviews with parents of a different group of YP.
Study participants identified key constructs for good EWB as stability, coping ability, happiness, confidence, balance, empathy and being grounded. Feeling comfortable with self, managing and controlling emotions and having the confidence to persevere with challenges were all felt to contribute to a positive sense of EWB. Sources of support were overwhelmingly cited as family and friends, with schools identified as a potentially good environment for supporting and promoting the EWB of pupils. Participants stressed the need for a positive attitude change towards YP, advocating this as promoting a sense of belonging and community citizenship. A lay-informed 'recipe' for successful EWB promotion is drawn out, centred on the core goal of raising awareness and understanding of YP's EWB, in the YP themselves, their parents, schools and the wider community.
This research provides key messages for society, policy makers, education and public health and healthcare practitioners for integration into the delivery of services for YP and families that include education on supporting EWB, activities for YP and a multi-agency approach to supporting families within the community.
© Royal Society for Public Health 2014.
Home visiting is an important mechanism for minimizing the lifelong effects of early childhood adversity. To do so, it must be informed by the biology of early brain and child development. Advances in neuroscience, epigenetics, and the physiology of stress are revealing the biological mechanisms underlying well-established associations between early childhood adversity and suboptimal life-course trajectories. Left unchecked, mediators of physiologic stress become toxic, alter both genome and brain, and lead to a vicious cycle of chronic stress. This so-called "toxic stress" results a wide array of behavioral attempts to blunt the stress response, a process known as "behavioral allostasis." Although behaviors like smoking, overeating, promiscuity, and substance abuse decrease stress transiently, over time they become maladaptive and result in the unhealthy lifestyles and noncommunicable diseases that are the leading causes of morbidity and mortality. The biology of toxic stress and the concept of behavioral allostasis shed new light on the developmental origins of lifelong disease and highlight opportunities for early intervention and prevention. Future efforts to minimize the effects of childhood adversity should focus on expanding the capacity of caregivers and communities to promote (1) the safe, stable, and nurturing relationships that buffer toxic stress, and (2) the rudimentary but foundational social-emotional, language, and cognitive skills needed to develop healthy, adaptive coping skills. Building these critical caregiver and community capacities will require a public health approach with unprecedented levels of collaboration and coordination between the healthcare, childcare, early education, early intervention, and home visiting sectors.
Decades of research have demonstrated strong links between social ties and health. Although considerable evidence has shown that social support can attenuate downstream physiological stress responses that are relevant to health, the neurocognitive mechanisms that translate perceptions of social ties into altered physiological responses are still not fully understood. This review integrates research from social and affective neuroscience to illuminate some of the neural mechanisms involved in social support processes, which may further our understanding of the ways in which social support influences health. Two types of social support that have been shown to relate to health are receiving and giving social support. As the neural basis of giving support, neural regions involved in maternal caregiving behavior may be critical for the health benefits of support giving through the inhibition of threat-related neural and physiological responding. This article will then review neuroimaging studies in which participants were primed with or received support during a negative experience as well as studies in which self-reports of perceived support were correlated with neural responses to a negative experience. As the neural basis of receiving support, this article reviews the hypothesis that receiving support may benefit health through the activation of neural regions that respond to safety and inhibit threat-related neural and physiological responding. Neuroimaging studies in which participants provided support to others or engaged in other related forms of prosocial behavior will then be reviewed. Implications of these findings for furthering our understanding of the relationships between social support and health are discussed.
There is extensive clinical literature reporting traumatic childhood experiences in patients with psychosis. A quantitative meta-analysis addressing the prevalence of self-reported childhood sexual (CSA), physical (CPA) and emotional abuse (CEA) in psychotic patients has yet to be done. We conducted, a systematic literature search to identify retrospective studies addressing self-reported childhood abuse in patients with DSM/ICD psychosis. Demographic, clinical, and methodological variables were extracted from each publication, or obtained directly from its authors. Quantitative meta-analysis of CSA, CPA, CEA in the sample of patients was performed. Statistical heterogeneity and publication bias were assessed and meta-regressions performed to control for different moderators. Twenty-three studies were retrieved and included a total of 2017 psychotic patients. The prevalence of self-reported CSA, CPA, CEA were respectively of 26%, 39% and 34%. Age, publication year, gender and substance abuse moderated CSA, while age, clinical setting and substance abuse moderated CPA. Results indicated that CEA was moderated by gender and publication year of the study. According to our meta-analysis, psychotic patients have a consistently high self-report of childhood traumatic events which are sexual, physical and emotional in nature. It is our opinion that clinicians should be trained and skilled to carefully investigate childhood abuse in psychosis.
Multi-center studies using magnetic resonance imaging facilitate studying small effect sizes, global population variance and rare diseases. The reliability and sensitivity of these multi-center studies crucially depend on the comparability of the data generated at different sites and time points. The level of inter-site comparability is still controversial for conventional anatomical T1-weighted MRI data. Quantitative multi-parameter mapping (MPM) was designed to provide MR parameter measures that are comparable across sites and time points, i.e., 1 mm high-resolution maps of the longitudinal relaxation rate (R1 = 1/T1), effective proton density (PD(*)), magnetization transfer saturation (MT) and effective transverse relaxation rate (R2(*) = 1/T2(*)). MPM was validated at 3T for use in multi-center studies by scanning five volunteers at three different sites. We determined the inter-site bias, inter-site and intra-site coefficient of variation (CoV) for typical morphometric measures [i.e., gray matter (GM) probability maps used in voxel-based morphometry] and the four quantitative parameters. The inter-site bias and CoV were smaller than 3.1 and 8%, respectively, except for the inter-site CoV of R2(*) (<20%). The GM probability maps based on the MT parameter maps had a 14% higher inter-site reproducibility than maps based on conventional T1-weighted images. The low inter-site bias and variance in the parameters and derived GM probability maps confirm the high comparability of the quantitative maps across sites and time points. The reliability, short acquisition time, high resolution and the detailed insights into the brain microstructure provided by MPM makes it an efficient tool for multi-center imaging studies.