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McCrory E, De Brito SA, Viding E. Research review: the neurobiology and genetics of maltreatment and adversity. J Child Psychol Psychiatry Allied Disciplines 51: 1079-1095
Abstract
The neurobiological mechanisms by which childhood maltreatment heightens vulnerability to psychopathology remain poorly understood. It is likely that a complex interaction between environmental experiences (including poor caregiving) and an individual's genetic make-up influence neurobiological development across infancy and childhood, which in turn sets the stage for a child's psychological and emotional development. This review provides a concise synopsis of those studies investigating the neurobiological and genetic factors associated with childhood maltreatment and adversity. We first provide an overview of the neuroendocrine findings, drawing from animal and human studies. These studies indicate an association between early adversity and atypical development of the hypothalamic-pituitary-adrenal (HPA) axis stress response, which can predispose to psychiatric vulnerability in adulthood. We then review the neuroimaging findings of structural and functional brain differences in children and adults who have experienced childhood maltreatment. These studies offer evidence of several structural differences associated with early stress, most notably in the corpus callosum in children and the hippocampus in adults; functional studies have reported atypical activation of several brain regions, including decreased activity of the prefrontal cortex. Next we consider studies that suggest that the effect of environmental adversity may be conditional on an individual's genotype. We also briefly consider the possible role that epigenetic mechanisms might play in mediating the impact of early adversity. Finally we consider several ways in which the neurobiological and genetic research may be relevant to clinical practice and intervention.
Introduction:
Attachment style has been associated with socio-emotional outcomes, however little evidence suggests a possible association with executive functioning. Few studies have demonstrated that attachment style mediates working memory and learning relationships. We hypothesized that attachment style affects performance and cortical activity patterns of working memory.
Methods:
We compared working memory performance and cortical activity in securely and insecurely attached first-year college students (N=49) using three n-back task conditions. Cortical activity was recorded by functional near-infrared spectroscopy during these three conditions of the n-back task. Attachment style was assessed using the Relationship Scale Questionnaire, categorized into four groups.
Results:
Both study groups showed similar working memory performance. The cortical representation of working memory was different between the two groups. The securely attached group demonstrated higher activity in the right superior frontal and superior-medial frontal areas across all n-back conditions as well as in the right superior frontal cortex during the two-back and three-back conditions. The insecurely attached group displayed higher activity in the bilateral supplementary motor area and the left premotor area only during the three-back condition.
Conclusion:
These findings emphasize the potential influence of attachment style on the cortical representation of working memory. Different activity maps between the two groups may reflect varying cognitive strategies employed to achieve a comparable working memory performance. Moreover, these results suggest that each style may have a distinct strategy to achieve attachment-relevant and irrelevant neurocognitive tasks.
A large body of evidence has demonstrated that exposure to childhood maltreatment at any stage of development can have long-lasting consequences. It is associated with a marked increase in risk for psychiatric and medical disorders. This review summarizes the literature investigating the effects of childhood maltreatment on disease vulnerability for mood disorders, specifically summarizing cross-sectional and more recent longitudinal studies demonstrating that childhood maltreatment is more prevalent and is associated with increased risk for first mood episode, episode recurrence, greater comorbidities, and increased risk for suicidal ideation and attempts in individuals with mood disorders. It summarizes the persistent alterations associated with childhood maltreatment, including alterations in the hypothalamic-pituitary-adrenal axis and inflammatory cytokines, which may contribute to disease vulnerability and a more pernicious disease course. The authors discuss several candidate genes and environmental factors (for example, substance use) that may alter disease vulnerability and illness course and neurobiological associations that may mediate these relationships following childhood maltreatment. Studies provide insight into modifiable mechanisms and provide direction to improve both treatment and prevention strategies.
Objective
Anxious behaviors often occur in individuals who have experienced early adversity. Anxious behaviors can bring many hazards, such as social withdrawal, eating disorders, negative self‐efficacy, self‐injurious thoughts and behaviors, anxiety disorders, and even depression. Abnormal behavior are is closely related to changes in corresponding circuit functions in the brain. This study investigated the relationship between brain circuits and anxious behaviors in maternal‐deprived rhesus monkey animal model, which mimic early adversity in human.
Methods
Twenty‐five rhesus monkeys (Macaca mulatta) were grouped by two different rearing conditions: 11 normal control and mother‐reared (MR) monkeys and 14 maternally deprived and peer‐reared (MD) monkeys. After obtaining images of the brain areas with significant differences in maternal separation and normal control macaque function, the relationship between functional junction intensity and stereotypical behaviors was determined by correlation analysis.
Results
The correlation analysis revealed that stereotypical behaviors were negatively correlated with the coupling between the left lateral amygdala subregion and the left inferior frontal gyrus in both MD and MR macaques.
Conclusion
This study suggests that early adversity‐induced anxious behaviors are associated with changes in the strength of the amygdala–prefrontal connection. The normalization of the regions involved in the functional connection might reverse the behavioral abnormality. It provides a solid foundation for effective intervention in human early adversity.
Significance Statement
This study suggests that early adversity‐induced anxious behaviors are associated with changes in the strength of the amygdala–prefrontal connection. The higher the amygdala–prefrontal connection strength, the less stereotyped behaviors exhibited by monkeys experiencing early adversity. Thus, in the future, changing the strength of the amygdala–prefrontal connection may reverse the behavioral abnormalities of individuals who experience early adversity. This study provides a solid foundation for effective intervention in humans' early adversity.
Stress-induced mental health disorders are aecting many people around the
world. However, eective drug therapy for curing psychiatric diseases does
not occur su�ciently. Many neurotransmitters, hormones, and mechanisms are
essential in regulating the body’s stress response. One of the most critical
components of the stress response system is the hypothalamus-pituitary-adrenal
(HPA) axis. The FKBP prolyl isomerase 51 (FKBP51) protein is one of the main
negative regulators of the HPA axis. FKBP51 negatively regulates the cortisol
eects (the end product of the HPA axis) by inhibiting the interaction between
glucocorticoid receptors (GRs) and cortisol, causing reduced transcription of
downstream cortisol molecules. By regulating cortisol eects, the FKBP51 protein
can indirectly regulate the sensitivity of the HPA axis to stressors. Previous studies
have indicated the influence of FKBP5 gene mutations and epigenetic changes in
dierent psychiatric diseases and drug responses and recommended the FKBP51
protein as a drug target and a biomarker for psychological disorders. In this review,
we attempted to discuss the eects of the FKBP5 gene, its mutations on dierent
psychiatric diseases, and drugs aecting the FKBP5 gene
Background
SARS-CoV-2 pandemic have posed great challenges for all families and children. Health risks and fears associated with SARS-CoV-2 negatively affect the parental mental health and perceived stress, which in turn influence parental coping and thereby impairs the mental health and well-being of their children. Additional risk factors within the parents, such as maternal childhood maltreatment (CM) experiences, may increase the risk of children to develop emotional problems during the pandemic.
Objective
The purpose of this longitudinal study is to determine whether preschool children of mothers with CM are at higher risk of developing emotional problems during the pandemic than preschool children of mothers without CM.
Method
74 mothers from a birth cohort examining pathways to resilience or vulnerability in the transgenerational transmission of CM, provided information on emotional problems of their children (aged 3–7 years) at two measurement time points (t1: May 2020, t2: March 2021) as part of an online “SARS-CoV-2 pandemic” survey. In addition, parents were asked for a retrospective assessment of their children's emotional problems before the pandemic at time t1. Children's emotional problems were assessed using the “emotional problems” scale of the German version of the Strengths and Difficulties Questionnaire (SDQ) and linked to previously collected data on mothers' childhood maltreatment experiences, which were collected using the German short version of the Trauma in Childhood Questionnaire (CTQ).
Results
Our analyses showed that children's emotional problems increased significantly over the SARS-CoV-2 pandemic [ F (1.86, 116.88) = 3.72, p = 0.030 η ² = 0.06] and were rated significantly higher in the group of children of mothers with CM, than in the group of mothers without CM [ F (1, 63) = 126.06, p < 0.001 η 2 = 0.67]. Furthermore children's emotional problems of mothers with CM increased significantly more and reached a clinically significant value during the pandemic than for children of mothers without CM [ F (1.86, 116.88) = 8.89, p < 0.001, η 2 = 0.12].
Conclusions
Children of mothers with CM appear to be at increased risk of developing emotional problems during the pandemic. CM therefore needs to be considered as an additional risk factor in the impact of the pandemic on children.
Little is known about the role of hypothalamic-pituitary-adrenal (HPA) axis functioning for children's cognitive development, especially among vulnerable groups. The current study explores the relationship between diurnal cortisol slope and cognitive outcomes among children at the ages of 5 and 6 who have been maltreated as infants and involved with child protective services, using data from the National Survey of Child and Adolescent Well-Being (NSCAW) I (N=158). Multiple regression analyses showed that a greater decline in salivary cortisol from morning to evening was positively associated with scores on applied problems and expressive communication, even after adjustment for confounding. It was also associated with lower odds of cognitive disability. There were null associations with letter-word identification, passage comprehension, auditory comprehension, matrices, and vocabulary. Results suggest that children involved with child protective services as infants, and thus exposed early to likely 'toxic' levels of stressors, may face dysregulation of the HPA axis and particular difficulties in some aspects of cognitive function. Potential explanations and implications for policy are discussed.
Children growing up in adversity are well known to be at risk of educational failure. Recent advances in neuroscience indicate that the nature of the caregiving environment in the first weeks and months of life influences the neural architecture of the developing brain, via epigenetic processes. Neglectful caregiving is hypothesised to contribute to later difficulties in self-regulation and an atypical stress response. Self-regulation is a key factor underpinning school readiness and the ability to engage successfully with learning experiences in a social classroom. This article describes research in school, which aimed to test this theory by exploring the self-regulation skills of six children known to have experienced neglect during their first year of life.
Early experiences can have profound and lasting effects on mental health. Delineating neurodevelopmental pathways related to risk and resilience following adversity exposure is critical for promoting well-being and targeting interventions. A rapidly growing cross-species literature has facilitated advances in identifying neural and behavioral mechanisms linking early experiences with mental health, highlighting a central role of corticolimbic circuitry involved in learning and emotion regulation. Building upon knowledge of corticolimbic development related to stress and buffering factors, we describe the importance of the developmental timing and experiential elements of adversity in mental health outcomes. Finally, we discuss opportunities to translate knowledge of the developing brain and early experiences to optimize interventions for youth with psychopathology and to inform policy that promotes healthy development at the societal level. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
The impact of adverse childhood experiences (ACEs) differs between individuals and depends on the type and timing of the ACE. The aim of this study was to assess the relation between various recently occurred ACEs and morphology in the developing brain of children between 8 and 11 years of age. We measured subcortical volumes, cortical thickness, cortical surface area and fractional anisotropy in regions of interest in brain scans acquired in 1,184 children from the YOUth cohort. ACEs were based on parent-reports of recent experiences and included: financial problems; parental mental health problems; physical health problems in the family; substance abuse in the family; trouble with police, justice or child protective services; change in household composition; change in housing; bereavement; divorce or conflict in the family; exposure to violence in the family and bullying victimization. We ran separate linear models for each ACE and each brain measure. Results were adjusted for the false discovery rate across regions of interest. ACEs were reported for 83% of children in the past year. Children were on average exposed to two ACEs. Substance abuse in the household was associated with larger cortical surface area in the left superior frontal gyrus, t (781) = 3.724, p FDR = 0.0077, right superior frontal gyrus, t (781) = 3.409, p FDR = 0.0110, left pars triangularis, t (781) = 3.614, p FDR = 0.0077, left rostral middle frontal gyrus, t (781) = 3.163, p FDR = 0.0195 and right caudal anterior cingulate gyrus, t (781) = 2.918, p FDR = 0.0348. Household exposure to violence (was associated with lower fractional anisotropy in the left and right cingulum bundle hippocampus region t (697) = −3.154, p FDR = 0.0101 and t (697) = −3.401, p FDR = 0.0085, respectively. Lower household incomes were more prevalent when parents reported exposure to violence and the mean parental education in years was lower when parents reported substance abuse in the family. No other significant associations with brain structures were found. Longer intervals between adversity and brain measurements and longitudinal measurements may reveal whether more evidence for the impact of ACEs on brain development will emerge later in life.
This study tracked the longstanding effect of childhood adversities on health status over the course of a life. This study used the data from China Health and Retirement Longitudinal Study which was a nationally representative survey and documented the generation who had arrived in the middle- and old-age phase and experienced the difficult time in the early founding of PR China in their childhood. Results shown the significant associations between multiple forms of children adversities (economic distress, child neglect, child abuse, lack of friends, parental mental health problems) and health status in adolescence (from 0.068 to 0.102, p <0.01), and health status in mid and late adulthood, including self-rated general health problems (from 0.039 to 0.061, p <0.01), chronic conditions (from 0.014 to 0.120, p <0.01 except for lack of friends), body aches (from 0.016 to 0.062, p <0.01 except for child neglect), and depression (from 0.047 to 0.112, p <0.01). Meanwhile, results also shown an underlying pathway (i.e., health status in adolescence) linking childhood adversities and health status in mid and late adulthood. Results suggested that the experience of multiple forms of adversities in childhood represented a substantial source of health risk throughout life.
Background
A valid, quick and widely applicable retrospective screening tool for child maltreatment is of great importance to better adapt interventions and treatments. The Childhood Trauma Screener (CTS) , derived from the Childhood Trauma Questionnaire (CTQ), is one such instrument that aims to increase the likelihood of detecting mental and physical disorders that have manifested in adulthood as a result of traumatic experiences and maltreatment in childhood and adolescence. The present study aimed to investigate the psychometric properties of the CTS and generate normative data.
Methods
Data from two representative surveys were combined. Both surveys used identical methods. The CTS, consisting of five items, other self-report instruments, and demographic characteristics were used. Construct validity was examined using confirmatory factor analysis (CFA). A subsample was used to examine convergent validity with the Adverse Childhood Experiences Questionnaire (ACE). Normative data are reported for age groups and gender.
Results
A total of 5039 study participants provided valid responses to the 5-items questionnaire (54.3% female, response rate = 78.9%). CFA showed good fit indices for a 2-factor solution. Convergent validity was generally supported by moderate intercorrelations with the ACE.
Conclusions
The results confirm the solid psychometric properties of the CTS as an easy-to-use, ultra-short retrospective measure of child maltreatment. The data can be used to compare sample or individual results with reference data provided.
Background: Early childhood neglect can impact brain development across the lifespan. Using voxel-based approaches we recently reported that severe and time-limited institutional deprivation in early childhood was linked to substantial reductions in total brain volume in adulthood, more than twenty years later. Here we extend this analysis to explore deprivation-related regional white matter volume and microstructural organization using diffusion-based techniques.
Methods: A combination of tensor-based morphometry analysis and tractography was conducted on diffusion weighted imaging data from 59 young adults who spent between 3 and 41 months in the severely depriving Romanian institutions of the 1980’s before being adopted into UK families, and 20 non-deprived age-matched UK controls.
Results: Independent of total volume, institutional deprivation was associated with smaller volumes in localized regions across a range of white matter tracts including (1) long-ranging association fibers such as bilateral inferior longitudinal fasciculus, bilateral inferior fronto-occipital fasciculus, left superior longitudinal fasciculi, and left arcuate fasciculus; (2) tracts of the limbic circuitry including fornix and cingulum; and (3) projection fibers with the corticospinal tract particularly affected. Tractographic analysis found no evidence of altered microstructural organization of any tract in terms of hindrance modulated orientational anisotropy (HMOA), fractional anisotropy (FA) or mean diffusivity (MD).
Discussion: We provide further evidence for the effects of early neglect on brain development and their persistence in adulthood despite many years of environmental enrichment associated with successful adoption. Localized white matter effects appear limited to volumetric changes with microstructural organization unaffected.<br/
Psychopathology in children cannot be understood without considering developmental processes and transactional relationships, particularly the relationship with caregivers. Time-limited intersubjective child psychotherapy (TIC) is a developmental and transactional approach aimed at helping children and caregivers get back on healthier developmental trajectories. Core developmental processes, such as self-other-regulation and affect integration, are considered particularly important for healthy function and transactions with caregivers and contexts. Therefore, TIC seeks to strengthen core developmental processes in the child and the caregivers’ ability to scaffold the child’s development. This is achieved through parallel child therapy and parent sessions. The current study is a qualitative study of parents’ experiences of change after TIC. The study explores parents’ perception of change in their child, themselves, and their transactions, and what they experienced as helpful in therapy.
Materials and Methods
Nine semi-structured qualitative interviews were conducted with parents ( n = 13) of nine children aged 9–12 years with internalizing difficulties after completing TIC. The data were analyzed with thematic analysis.
Results
The parents described positive changes in the children’s ability to understand, regulate and express themselves. The parents also described positive changes in their parenting, and for all nine children the parents reported positive changes in the transactions between themselves and the child. Most parents saw the parallel child and parental sessions as particularly important, while several parents mentioned play and the therapeutic focus.
Discussion
Parents’ description of changes after TIC indicate that the parents perceived their children as strengthened in core developmental processes important for intersubjective exchanges such as self-regulation and affect integration. In addition, parents saw their children and their own contributions more clearly, and their transactions were described as more supportive and positive.
Conclusion
The results from this study give support to TIC as a developmentally supportive approach to therapy, with potential effects on children’s core developmental processes, their parents’ ability to both see and scaffold the child’s development and positive effects on the transactions between children and parents. The positive effects likely result from the integration of the different parts of TIC and the synergies taking place between them, rather than any one component by itself.
We examined whether childhood abuse is related to body mass index (BMI) in young adults and whether this relationship is mediated by depression and anxiety. Data are from the Dutch longitudinal cohort study TRAILS (n females = 836, n males = 719). At wave 4, childhood sexual, physical and verbal abuse, and lifetime major depressive disorder (MDD) and generalized anxiety disorder (GAD) were assessed. BMI was measured at wave 4 and 5 (mean age = 19.2/22.4 years). Sex-stratified structural equation models were estimated. Females who had experienced sexual abuse had a higher BMI at wave 4 (B = 0.97, 95%CI = [−0.01,1.96]) and a higher increase in BMI between wave 4 and 5 (B = 0.52, 95%CI = [0.04,1.01]) than females who had not experienced sexual abuse. Additionally, MDD and BMI at wave 4 were related in females (B = 1.35, 95%CI = [0.52,2.18]). MDD mediated the relationship between sexual abuse and BMI at wave 4 in females. In addition, sexual abuse moderated the relationship between MDD and BMI at wave 4. The relationship was stronger among females who had experienced sexual abuse than among females who had not. Prevention of BMI changes among females who experienced sexual abuse may thus be warranted, particularly when they developed MDD. MDD treatment, such as abuse-focused psychotherapy, may aid this prevention.
Sexual abuse is a serious social issue with adverse psychosocial consequences in the person who is victimized. High prevalence rate of abuse in both children and adults, no matter female or male, indicate that anyone can be a victim of this hazard. The manifestation of mental-health outcomes is diverse in nature and different across individuals and is determined by complex array of factors. This calls for the application of intervention techniques that are well-established by empirical research to be effective among victims of sexual abuse. This chapter is an attempt to discuss treatment methods established as effective and also other methods that are in use, though with limited research literature on its effectiveness or efficacy, for Posttraumatic Stress Disorder (PTSD) and other prominent and debilitating psychological and interpersonal effects of sexual abuse. Further, special issues concerning research and practice as well as future directions are outlined.
Childhood adversity has been suggested to affect the vulnerability for developmental psychopathology, including both exter-nalizing and internalizing symptoms. This study examines spontaneous attention biases for negative and positive emotional facial expressions as potential intermediate phenotypes. In detail, typically developing boys (6-13 years) underwent an eye-tracking paradigm displaying happy, angry, sad and fearful faces. An approach bias towards positive emotional facial expressions with increasing childhood adversity levels was found. In addition, an attention bias away from negative facial expressions was observed with increasing childhood adversity levels, especially for sad facial expressions. The results might be interpreted in terms of emotional regulation strategies in boys at risk for reactive aggression and depressive behaviour.
Caregiver history of childhood maltreatment can have pervasive effects on familial and household dynamics. Maternal history of child maltreatment (MCM) is linked to maternal depressive symptoms and offspring behavioural problems. Further, maternal and child mental health are associated with chaotic home environments. In this study, we examined the potential mediating roles of maternal depressive symptoms and child behavioural problems in the association between MCM and household chaos. A sample of 133 mother–child dyads participated in home visits during which mothers completed questionnaires measuring their history of child maltreatment, depressive symptoms, household chaos and child behaviour problems. Mothers also conducted videotaped home tours related to household chaos. Structural equation modelling results indicated that MCM was indirectly associated with higher household chaos via elevated maternal depressive symptoms and child externalizing, but not internalizing behaviour problems. Interventions aimed at mitigating the effects of MCM on maternal and child psychopathology may positively influence household dynamics.
The goals of the current study were to examine (i) differences in parenting between foster and biological parents, (ii) the longitudinal associations with children’s internalising and externalising problems and iii) the potential moderation of these by children’s callous-unemotional traits (CU traits). Data from 86 foster children (M = 4.44 years, male = 48%) and 148 biological children (M = 3.69 years, male = 49%) with their families were analysed in a longitudinal study with three measurement times. Parenting behaviour did not significantly differ between the foster and biological family groups. Significant longitudinal cross-lagged effects were found for parental warmth and support and children’s externalising problems. CU traits moderated the relationship between warmth and support and externalising problems of children. Findings suggest that parenting behaviours and child psychopathology do influence each other over time reciprocally and to a similar extent in both groups. However, there was also evidence for greater temporal stability of psychopathological symptoms and reduced responsivity to parental warmth in children with higher CU traits.
Studies in the field of neuroscience and psychology have hypothesized that a causal association exists between atopic diseases and attention-deficit/hyperactivity disorder (ADHD). Previous systematic reviews and meta-analyses have reported a higher risk of ADHD in children with atopic diseases; however, the relationship between ADHD symptoms and atopic diseases remains unclear. We systematically reviewed observational cross-sectional and longitudinal studies to investigate the relationship between atopic diseases and ADHD symptom severity (hyperactivity/impulsivity and inattention). The majority of studies showed a statistically significant association between atopic diseases and both ADHD symptoms, with substantial heterogeneity in the outcome of hyperactivity/impulsivity. Remarkably decreased heterogeneity and statistical significance were observed in the second meta-analysis of ADHD-related behavior symptoms in atopic patients without ADHD. Our study indicated that atopic diseases not only associated with ADHD but also ADHD symptoms severity. This association was even observed in children with subthreshold ADHD, indicating that atopic diseases may play a role in the spectrum of ADHD symptom severity. Trial registration: This study was registered on PROSPERO (registration ID: CRD42020213219).
Purpose
Anorexia nervosa (AN) is a serious mental illness. It is frequently accompanied by a history of childhood maltreatment (CM) that may constitute a specific ecophenotype in patients with eating disorders necessitating special assessment and management. This retrospective study tested whether in patients with AN, CM-related chronic stress may manifest through low-grade inflammation reflected by an increase in white blood cell ratios (neutrophil-to-lymphocyte ratio, NLR, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio).
Methods
Participants (N = 206) were enrolled at an eating disorder daycare unit in Montpellier, France, from March 2013 and January 2020. CM was assessed using the childhood trauma questionnaire (CTQ). The Eating Disorder Examination Questionnaire (EDE-Q) and the MINI were used to assess AN severity and the other clinical characteristics, respectively.
Results
NLR was higher in patients with AN and history of CM (p = 0.029) and in patients with AN and history of emotional abuse (p = 0.021), compared with patients with AN without history of CM. In multivariate analysis, emotional abuse (β = 0.17; p = 0.027) contributed significantly to NLR variability.
Conclusion
In patients with AN, NLR is a low-grade inflammation marker that is influenced by various sociodemographic, clinical and biological factors. It is more directly affected by some CM types, especially emotional abuse, than by the presence/absence of CM history. Future studies should focus on mediators between CM and increased inflammation, such as interoceptive awareness, emotional dysregulation, food addiction, and stress sensitization.
Level of evidence
III. Evidence obtained from well-designed cohort or case–control analytic studies.
Social bonds enhance fitness in many group-living animals, generating interest in the processes that create individual variation in sociality. Previous work on female baboons shows that early life adversity and temperament both influence social connectedness in adulthood. Early life adversity might shape sociality by reducing ability to invest in social relationships or through effects on attractiveness as a social partner. We examine how females' early life adversity predicts sociality and temperament in wild olive baboons, and evaluate whether temperament mediates the relationship between early life adversity and sociality. We use behavioural data on 31 females to quantify sociality. We measure interaction style as the tendency to produce grunts (signals of benign intent) in contexts in which the vocalization does not produce immediate benefits to the actor. Early life adversity was negatively correlated with overall sociality, but was a stronger predictor of social behaviours received than behaviours initiated. Females who experienced less early life adversity had more benign interaction styles and benign interaction styles were associated with receiving more social behaviours. Interaction style may partially mediate the association between early life adversity and sociality. These analyses add to our growing understanding of the processes connecting early life experiences to adult sociality.
Interpersonal conflicts are inevitable, but the probability that conflicts involve aggressive behavior varies. Prior research that has tended to focus on victimization in intimate partnerships reported through retrospective designs. Addressing these limitations, the current study examines daily reports of behaving aggressively in any conflict across relationships in a sample of 512 young adults drawn from the nationally representative iCOR cohort. Respondent attitudes and affective measures were collected at the end of the daily data collection period. Regression methods were applied to examine the probability and frequency of aggression, investigating early and recent exposure to adversities, attitudes, self-control, affect and emotional states, and alcohol use behavior. Recent adversities and the propensity to endorse a defensive honor code attitude, consistent with theory and retrospective studies of aggression, predicted both prevalence and frequency of aggressive behavior. The associations of childhood maltreatment and self-control with the prevalence of behaving aggressively were as expected, but these constructs were significantly associated with the frequency of aggression with unexpected, inverse directionality. Moreover, respondents’ affect and other emotional states were only associated with the frequency, not the prevalence, of aggressive behavior. Overall, this daily data collection constructively distinguished risk and protective factors for behaving aggressively more often. Further research is needed to disentangle the extent to which affective states drive or is a consequence of frequent aggressive behavior.
Childhood maltreatment (CM) is associated with increased non-suicidal self-injury (NSSI) and suicidal behavior (SB), independently of demographic and mental health conditions. Self-Trauma Theory and Linehan’s Biopsychosocial Model might explain the emergence of Borderline Personality Disorder (BPD) symptoms as mediators of the association between CM and the risk of SB. However, little is known regarding such relationships when the exposure is recent for young persons. Here, we study 187 youths aged 7–17, with or without mental disorders. We explore CM experiences (considering the severity and frequency of different forms of neglect and abuse), recent stressful life events (SLEs), some BPD traits (emotion dysregulation, intense anger and impulsivity), and the risk of SB (including NSSI, suicide threat, suicide ideation, suicide plan and suicide attempt). We study the direct and mediating relationships between these variables via a structural equation analysis using the statistical software package EQS. Our findings suggest that youths exposed to more severe/frequent CM have more prominent BPD traits, and are more likely to have experienced recent SLEs. In turn, BPD traits increase the risk of SLEs. However, only emotion dysregulation and recent SLEs were found to be correlated with SB. Therefore, targeted interventions on emotion dysregulation are necessary to prevent NSSI or SB in children and adolescents exposed to CM, as is the minimization of further SLEs.
Despite growing attention to resilience following childhood maltreatment, it remains unclear how the development of resilience unfolds over time among child welfare-involved adolescents. Further, little is known about the immediate and enduring effects of two important attachments in children’s lives, namely caregiver–child relationship and deviant peer affiliation, on resilience development over time. This study sought to examine the ways in which caregiver–child relationships and deviant peer affiliation shape developmental trajectories of resilience among child welfare-involved youth. Data were drawn from the National Survey of Child and Adolescent Well-Being. Latent growth curve modeling was conducted on a sample of 711 adolescents. The results revealed that adolescents’ resilience increased across a 36-month period since initial contact with Child Protective Services. Better caregiver–child relationships were associated with a higher initial level of resilience among adolescents, whereas higher deviant peer affiliation was associated with a lower initial level of resilience. Significant lagged effects were also found; caregiver–child relationship quality and deviant peer affiliation at baseline were associated with resilience at 18 months after. The findings suggest that interventions that aim to promote positive caregiver–child relationships and prevent deviant peer relationships may help foster resilience among adolescents who have experienced child maltreatment.
Adversity early in life is common and is a major risk factor for the onset of psychopathology. Delineating the neurodevelopmental pathways by which early adversity affects mental health is critical for early risk identification and targeted treatment approaches. A rapidly growing cross-species literature has facilitated advances in identifying the mechanisms linking adversity with psychopathology, specific dimensions of adversity and timing-related factors that differentially relate to outcomes, and protective factors that buffer against the effects of adversity. Yet, vast complexity and heterogeneity in early environments and neurodevelopmental trajectories contribute to the challenges of understanding risk and resilience in the context of early adversity. In this overview, the author highlights progress in four major areas-mechanisms, heterogeneity, developmental timing, and protective factors; synthesizes key challenges; and provides recommendations for future research that can facilitate progress in the field. Translation across species and ongoing refinement of conceptual models have strong potential to inform prevention and intervention strategies that can reduce the immense burden of psychopathology associated with early adversity.
In this paper, I examine my work with Richard using neuro-psychoanalytic concepts to depict the recovery of a live object that had been buried with his mother, three years before. I ask whether encouraging alpha function in a traumatised child who might once have had access to a functioning thinking mind may be damaging to a core protective aspect of his personality: a ‘robot’ mechanism that switches on in his mind/body, to protect him from a tragic sequence of events. I suggest that psychotherapy with a child in a frozen state is a delicate process, involving the avoidance of triggering defensive aspects of the personality, while helping the child learn other, more protective aspects available to him. I show how incorporating the ‘music of silence’ and the spoken word can help a traumatised child recover emotional fluency. I draw on the neurobiological research of Bessel Van der Kolk and Stephen Porges to show how working in the bodily countertransference can be important in helping traumatised patients. The analysis extends to examining child psychotherapy literature around endings, with a focus on avoiding retraumatisation when finishing work with a bereaved child.
Background
There are currently 2.2 million people incarcerated in U.S. prisons and jails, representing a 500% increase over the past 40 years. An emerging literature suggests the impact of mass incarceration extends beyond the prison, jail, or detention center to the families of incarcerated individuals. Less scholarship has considered consequences of parental incarceration for their children's physical health.
Methods
We conduct a critical review of the literature investigating an association between parental incarceration and children's physical health outcomes from infancy to adulthood.
Results
Studies varied substantially in study design, sample composition, and methodological approach. Most studies suggest an association between parental incarceration and adverse physical health outcomes. Evidence is more consistent for outcomes such as infant and child mortality, lower healthcare access, and negative health behaviors and more mixed for measures such as self-reported/general health.
Conclusion
We propose a multilevel model of mechanistic pathways to stimulate future research on the potential pathways through which parental incarceration could influence children's physical health.
Background:
Early adversity is believed to alter the body's stress-response systems, putting children at increased risk for somatic and mental health problems. However, it remains unclear whether such alterations normalize under improved caregiving experiences. Thus, the goal of the present study was to investigate (a) whether children in foster care show endocrine and immunological alterations relative to children living with their biological families, (b) whether these alterations change over time spent with the foster family, and (c) whether the alterations are modulated by current caregiving experiences.
Methods:
A total of 94 children in foster care and 157 biological children, aged two to seven years, took part in a longitudinal study with three assessments conducted over a 12-month study period. At the initial assessment, children lived for an average of 18 months with their current foster families. Children's cortisol, dehydroepiandrosterone (DHEA) and progesterone concentrations and cortisol/DHEA ratios were measured in scalp hair and children's secretory immunoglobulin A (sIgA) levels in saliva. Caregiving quality was assessed based on caregiver-reports and observational measures of caregiver-child interactions.
Results:
Children in foster care had lower cortisol/DHEA ratios and higher progesterone concentrations than biological children, while no group differences were found for cortisol, DHEA or sIgA. Time spent with the current foster family did not significantly influence the child's endocrine or immunological markers. Importantly, caregiving quality modulated cortisol/DHEA ratios and sIgA concentrations: children in foster care of lower caregiving quality had lower cortisol/DHEA ratios than children in foster care of higher caregiving quality and showed decreasing, rather than increasing, sIgA concentrations across the study period.
Conclusions:
Our results indicate that caregiving quality in the foster family may have an important modulating effect on selected indicators of the child's stress response and could thereby mitigate the possible consequences of early childhood adversity.
Mentoring‐based interventions show promise among children in foster care, but previous research suggests that some benefit more than others. Because children in foster care experience relationship disruptions that could affect mentoring effectiveness, we examined whether children’s relational histories at baseline (i.e., relationship quality with birth parents, relationship quality with foster parents, caregiver instability, and previous mentoring experience) moderated the impact of a mentoring intervention on children’s mental health, trauma symptoms, and quality of life. Participants included 426 racially and ethnically diverse children (age: 9–11; 52% male) who participated in a randomized controlled trial of the Fostering Healthy Futures program (FHF), a 9‐month one‐to‐one mentoring and skills group intervention. Results showed that relationship quality with foster parents and prior mentoring experience did not moderate intervention impact. Relationship quality with birth parents and caregiver instability pre‐program, however, moderated the effect on some outcomes. The impact on quality of life was stronger for children with weaker birth parent relationships and fewer caregiver changes. Likewise, the impact on trauma symptoms was stronger for those with fewer caregiver changes. Overall, FHF seems to positively impact children with varied relational histories, yet some may derive more benefits – particularly those with fewer caregiver changes pre‐program. Children’s early relational histories may affect the impact of mentoring programs. Fostering Healthy Futures (FHF) improves mental health of children with varied relational histories. FHF’s impact on trauma symptoms was stronger for children with fewer caregiver changes pre‐program. FHF’s impact on quality of life was stronger for children with fewer caregiver changes pre‐program. FHF’s impact on quality of life was stronger for children with poorer birth parent relationships.
Background
There is a lack of studies examining psychosocial functioning in patients with non-suicidal self-injury (NSSI), especially in adolescents, and rates of impaired functioning in existing literature vary considerably. These variations may be attributable to further risk factors that influence psychosocial functioning. Thus, the aim of the study was to examine whether adolescent NSSI patients with childhood maltreatment (CM), a known risk factor for lower psychosocial functioning, may differ from adolescent NSSI patients without CM, and whether these differences may be explained by the severity of comorbid disorders. Specifically, we examined whether severity of borderline personality disorder (BPD), depression and posttraumatic stress disorder may explain differences in psychosocial functioning in NSSI patients with and without CM.
Methods
Data of 368 adolescents with NSSI disorder from an outpatient clinic were analyzed using structural equation modeling. Clinicans’ rating of the Global Assessment of Functioning Scale (GAF) was collected, in addition to clinical interviews.
Results
Results indicate that GAF scores were lower among NSSI patients with CM and that the difference in psychosocial functioning between these groups was explained by BPD and depression severity.
Conclusions
Psychosocial functioning in NSSI patients varies depending on whether they have experienced CM or not. Specifically, these differences seem to be attributable to higher BPD and depression severity in adolescent NSSI patients with CM. Clinicians should ensure to assess CM and focus on BPD and depression severity in this population. Treatment of BPD and depression may notably reduce psychosocial impairment in NSSI patients with CM.
Childhood maltreatment and adverse childhood experiences (ACEs) are two primary forms of interpersonal victimization that have been associated with a host of deleterious health outcomes. Studies over the past decade have begun to use a range of biologically informed methods to better understand the role that biology plays in the relationship between maltreatment, ACEs, and later life outcomes. This line of research has shown that both forms of victimization occur at sensitive periods of development, which can increase the likelihood of “getting under the skin” and influence health and behavior across the life course. This review examines the current state of knowledge on this hypothesis. One hundred and ninety-nine studies are included in this systematic review based on criteria that they be written in English, use a biologically informed method, and be conducted on samples of humans. Results reveal that latent additive genetic influences, endocrinological biomarkers, polygenic risk scores, and neurobiological features are commonly associated with exposure and response to childhood maltreatment and ACEs. The implication of these findings for the existing body of research on early life victimization and recommendations for future research are discussed.
Life stress increases risk for multiple forms of psychopathology, in part by altering neural processes involved in performance monitoring. However, the ways in which these stress-cognition effects are influenced by the specific timing and types of life stressors experienced remains poorly understood. To address this gap, we examined how different social-psychological characteristics and developmental timing of stressors are related to the error-related negativity (ERN), a negative-going deflection in the event-related potential (ERP) waveform that is observed from 0 to 100 ms following error commission. A sample of 203 emerging adults performed an ERN-eliciting arrow flanker task and completed an interview-based measure of lifetime stress exposure. Adjusting for stress severity during other developmental periods, there was a small-to-medium effect of stress on performance monitoring, such that more severe total stress exposure, as well as more severe social-evaluative stress in particular, experienced during early adolescence significantly predicted an enhanced ERN. These results suggest that early adolescence may be a sensitive developmental period during which stress exposure may result in lasting adaptations to neural networks implicated in performance monitoring.
Extensive research has demonstrated that rs1360780, a common single nucleotide polymorphism within the FKBP5 gene, interacts with early‐life stress in predicting psychopathology. Previous results suggest that carriers of the TT genotype of rs1360780 who were exposed to child abuse show differences in structure and functional activation of emotion‐processing brain areas belonging to the salience network. Extending these findings on intermediate phenotypes of psychopathology, we examined if the interaction between rs1360780 and child abuse predicts resting‐state functional connectivity (rsFC) between the amygdala and other areas of the salience network. We analyzed data of young European adults from the general population (N = 774; mean age = 18.76 years) who took part in the IMAGEN study. In the absence of main effects of genotype and abuse, a significant interaction effect was observed for rsFC between the right centromedial amygdala and right posterior insula (p < .025, FWE‐corrected), which was driven by stronger rsFC in TT allele carriers with a history of abuse. Our results suggest that the TT genotype of rs1360780 may render individuals with a history of abuse more vulnerable to functional changes in communication between brain areas processing emotions and bodily sensations, which could underlie or increase the risk for psychopathology. In 774 young European adults, we examined if child abuse and rs1360780 of the FKBP5 gene interact in predicting resting‐state functional connectivity (rsFC) between the amygdala and other areas of the salience network. An interaction was found in rsFC with the right posterior insula, driven by stronger rsFC in TT allele carriers with a history of abuse. After exposure to childhood abuse, individuals with the rs1360780 TT genotype may become more vulnerable to develop psychopathology due to altered amygdala functional connectivity.
Several decades of neuroimaging research in psychiatry have shed light on structural and functional neural abnormalities associated with individual psychiatric disorders. However, there is increasing evidence for substantial overlap in the patterns of neural dysfunction seen across disorders, suggesting that risk for psychiatric illness may be shared across diagnostic boundaries. Gaining insights on the existence of shared neural mechanisms which may transdiagnostically underlie psychopathology is important for psychiatric research in order to tease apart the unique and common aspects of different disorders, but also clinically, so as to help identify individuals early on who may be biologically vulnerable to psychiatric disorder in general. In this narrative review, we first evaluate recent studies investigating the functional and structural neural correlates of a general psychopathology factor, which is thought to reflect the shared variance across common mental health symptoms and therefore index psychiatric vulnerability. We then link insights from this research to existing meta-analytic evidence for shared patterns of neural dysfunction across categorical psychiatric disorders. We conclude by providing an integrative account of vulnerability to mental illness, whereby delayed or disrupted maturation of large-scale networks (particularly default-mode, executive, and sensorimotor networks), and more generally between-network connectivity, results in a compromised ability to integrate and switch between internally and externally focused tasks.
Background: Non-suicidal self-injury (NSSI) is defined as inflicting damage to one’s own body. It begins in adolescence and tends to become chronic. Objectives: Considering the high prevalence and chronicity of NSSI among girls, the present study aimed to investigate the factors affecting the prevalence of NSSI in female adolescents from their perspective. Methods: The participants consisted of 604 female high-school students in Saveh, aged 14 - 17 years (14.29 ± 1.11), who were selected via random cluster sampling from November 2018 to January 2019. They answered six questionnaires, including the Inventory of Statements About Self-injury (ISAS), Ways of Coping questionnaire (WCQ), Child Abuse Self-report scale (CASRS), Family Emotional Involvement and Criticism scale (FEICS), Emotion Reactivity scale (ERS), and Aggression questionnaire (AQ). Data were analyzed using logistic regression analysis. Results: The predictor variables of child abuse, emotion reactivity, perceived parental criticism, family emotional involvement, and problem- and emotion-focused coping styles could successfully distinguish NSSI individuals from those without NSSI (P < 0.05). There were no significant differences between minor and moderate groups. Conclusions: Family emotional support is a protective factor, while criticism, child abuse, and emotion-focused coping style are risk factors for NSSI.
As a founder of the field of applied developmental psychology, Dr Edward Zigler promoted public policy that translated scientific knowledge into real-world programs to improve the outcomes of high-risk children and families. Many researchers, practitioners, and public policy proponents have sought to carry on his legacy through integration of empirical research, evidence-based prevention and intervention, and advocacy to address a range of challenges facing families with young children. To advance the field of child maltreatment, a multidisciplinary team of investigators from the Universities of Rochester and Minnesota partnered with the Eunice Kennedy Shriver National Institute of Child Health and Human Development to create the T ranslational R esearch that A dapts N ew S cience FOR M altreatment Prevention Center (Transform). Building on state-of-the-art research methodologies and clinical practices, Transform leverages theoretically grounded research and evidence-based interventions to optimize outcomes for individuals across the life span who have experienced, or may be at risk for, maltreatment. Inspired by the work of Dr Zigler, Transform is committed to bridging science and real-world practice. Therefore, in addition to creating new science, Transform's Community Engagement Core provides translational science to a broad audience of investigators, child-serving professionals, and parental and governmental stakeholders. This article describes Transform's purpose, theoretical framework, current activities, and future directions.
Several studies have shown that child maltreatment is associated with both positive and negative effects on the recognition of facial emotions. Research has provided little evidence of a relation between maltreatment during childhood and young adults’ ability to recognize facial displays of emotion in children, an essential skill for a sensitive parental response. In this study, we examined the consequences of different forms of maltreatment experienced in childhood on emotion recognition during parenthood. Participants included sixty-three mothers of children aged 2 to 5 years. Retrospective self-reports of childhood maltreatment were assessed using the short form of the Childhood Trauma Questionnaire (CTQ). Emotion recognition was measured using a morphed facial emotion identification task of all six basic emotions (anger, disgust, fear, happiness, sadness, and surprise). A Path Analysis via Structural Equation Model revealed that a history of physical abuse is related to a decreased ability to recognize both fear and sadness in children, whereas emotional abuse and sexual abuse are related to a decreased ability to recognize anger in children. In addition, emotional neglect is associated with an increased ability to recognize anger, whereas physical neglect is associated with less accuracy in recognizing happiness in children’s facial emotional expressions. These findings have important clinical implications and expand current understanding of the consequences of childhood maltreatment on parents’ ability to detect children’s needs.
The cafeteria diet (CD), an experimental diet that mimics the obesogenic Western diet, can impair memory in adult rats. However, the suckling period is also particularly susceptible to diet‐induced behavioural modification. Here, following exposure to CD feeding during lactation, 24‐ to 26‐day‐old offspring were tested to determine maternal dietary effects on either open field habituation, object location (OL) learning or on recency learning. Whereas no impact on habituation learning could be demonstrated, both OL and recency memory were impaired. In controls (C), OL memory was shown both after a 5 min (p < .05) or 60 min (p < .001) inter‐trial interval (ITI). After the 60 min ITI, the difference between C and CD was significant (p < .05). Learning did not occur in the CD group at any time point and was not observed after the 24hr ITI in in either group. Whereas control rats demonstrated intact recency memory (p < .00001), no learning occurred in the CD group. Both groups differed significantly in their exploration ratios (p < .01). This study suggests a detrimental effect of exposure to an unhealthy Western diet during lactation, on cognitive functions in adolescent rats. These results could have implications for human cognition in the context of obesity epidemic.
The ability to provide appropriate responses to infant distress is vital to paternal care, but may be affected by fathers’ experiences of childhood maltreatment. Detrimental effects of childhood maltreatment have been found in the adult brain's white matter fibers, accompanied with impaired emotional and cognitive functioning. In the current study (N = 121), we examined new and expectant fathers’ childhood maltreatment experiences (i.e. emotional and physical abuse and neglect), current behavioral responses (i.e. handgrip force) to infant cry sounds, and white matter integrity using diffusion tensor imaging. First, more exposure to childhood maltreatment was associated with more use of excessive handgrip force in response to infant crying by fathers. Second, the association between experienced childhood maltreatment and white matter integrity was not significant in whole‐brain analyses. Lastly, we found that the association between maltreatment exposure and excessive handgrip force during infant crying was absent in fathers with high tract integrity in the bilateral uncinate fasciculus. These findings possibly point to insufficient behavioral inhibition or emotional dysregulation in fathers who experienced childhood maltreatment, but buffering for this effect in those with larger integrity in brain fibers connecting the amygdala and prefrontal cortex.
Social emotional learning (SEL) programs are increasingly being implemented in elementary schools to facilitate development of social competencies, decision-making skills, empathy, and emotion regulation and, in effect, prevent poor outcomes such as school failure, conduct problems, and eventual substance abuse. SEL programs are designed to foster these abilities in children with a wide range of behavioral, social, and learning needs in the classroom, including children who are economically disadvantaged. In a previous study of kindergartners residing in a high-poverty community (N = 327 at baseline), we observed significant behavioral improvements in children receiving an SEL program-The PATHS® curriculum (PATHS)-relative to an active control condition within one school year. The present investigation sought to determine whether these improvements were sustained over the course of two school years with intervention and an additional year when intervention was no longer provided. Further, using multilevel models, we examined whether baseline measures of neurocognition and stress physiology-known to be adversely impacted by poverty-moderated heterogeneous outcomes. Finally, a preliminary linear regression analysis explored whether neurocognition and physiological stress reactivity (heart rate variability, HRV) predict change in outcomes postintervention. Results confirmed that students who received PATHS sustained significant behavioral improvements over time. These effects occurred for the full sample, irrespective of putative baseline moderators, suggesting that children in high-risk environments may benefit from SEL interventions irrespective of baseline cognitive functioning as a function of overall substantial need. Of interest is that our exploratory analysis of change from waves three to four after the intervention concluded brought to light possible moderation by baseline physiology. Should subsequent studies confirm this finding, one plausible explanation may be that, when an intervention providing protective effects is withdrawn, children with higher HRV may not be able to regulate physiological stress responses to environmental challenges, leading to an uptick in maladaptive behaviors. In reverse, children with lower HRV-generally associated with poorer emotion regulation-may incur relatively greater gains in behavioral improvement due to lesser sensitivity to the environment, enabling them to continue to accrue benefits. Results are discussed in the context of possible pathways that may be relevant to understanding the special needs of children reared in very low-income, high-stress neighborhoods.
Sexual abuse is a serious social issue with adverse psychosocial consequences in the person who is victimized. High prevalence rate of abuse in both children and adults, no matter female or male, indicate that anyone can be a victim of this hazard. The manifestation of mental-health outcomes is diverse in nature and different across individuals and is determined by complex array of factors. This calls for the application of intervention techniques that are well-established by empirical research to be effective among victims of sexual abuse. This chapter is an attempt to discuss treatment methods established as effective and also other methods that are in use, though with limited research literature on its effectiveness or efficacy, for Posttraumatic Stress Disorder (PTSD) and other prominent and debilitating psychological and interpersonal effects of sexual abuse. Further, special issues concerning research and practice as well as future directions are outlined.
Young children's physiological and emotional regulation depend on supportive caregiving, especially in the context of stress and adversity. Experiences of child maltreatment become biologically embedded by shaping stress physiology. Maternal emotion socialization may have an important influence on children's limbic‐hypothalamic‐pituitary‐adrenal (LHPA) functioning. Grounded in theories of caregiver emotion socialization, a person‐centered latent profile analysis was utilized to identify profiles of maternal emotion socialization among a high risk, low income, and racially diverse group of 248 mothers and their young children (Mage = 4.39 years, SD = 1.10). The majority of the mothers (n = 165) had a history of involvement with the Department of Child Services for substantiated cases of child maltreatment. A latent profile analysis was conducted revealing three emotion socialization profiles: disengaged, engaged, and engaged + supportive. Emotion socialization profile differences in children's diurnal cortisol levels and slope (using area under the curve with respect to ground and increase, respectively) were examined. Children's diurnal cortisol levels were higher, and slopes were flatter, when mothers used more disengaged emotion socialization strategies. Mothers who neglected their children were more likely to fit the disengaged profile than the engaged profile. Implications for the socialization of regulation in children exposed to adversity are discussed.
Previous research has established associations between early life stress (ELS) and altered pituitary gland volume (PGV) growth during adolescence. The pituitary gland, however, is composed of an anterior and a posterior lobe with distinct histological and neuroendocrinological properties. While the anterior (but not posterior) pituitary gland is directly involved in the hypothalamic-pituitary-adrenal axis (HPAA) stress response, no studies have examined the effects of ELS on anterior PGV (aPGV). The present study investigated whether previously reported associations between ELS and PGV development during adolescence were driven by aPGV versus posterior PGV (pPGV). Ninety-one adolescents (49 males) were included from a longitudinal, community-based adolescent development study investigating risk for psychopathology. ELS (maternal affective behavior, childhood maltreatment, stressful life events) was assessed during early adolescence. Participants underwent two waves of structural magnetic resonance imaging during mid- and late-adolescence, and aPGV and pPGV were manually traced. Regression analyses showed that childhood maltreatment predicted greater aPGV growth in females. This finding was stronger than that previously reported for PGV. No associations were found between ELS and pPGV development. Neither aPGV nor pPGV changes mediated associations between ELS and psychopathology. Results suggest that ELS may accelerate aPGV (but not pPGV) growth throughout adolescence. Investigating the development of aPGV, rather than PGV, represents a novel approach to studying the effects of stress on HPAA functioning.
Background and purpose:
Becoming a parent can be an exciting and also challenging transition, particularly for parents who have experienced significant hurt in their own childhoods, and may be experiencing 'complex trauma.' Aboriginal and Torres Strait Islander (Aboriginal) people also experience historical trauma. While the parenting transition is an important time to offer support for parents, it is essential to ensure that the benefits of identifying parents experiencing complex trauma outweigh any risks (e.g., stigmatization). This paper describes views of predominantly Aboriginal stakeholders regarding (1) the relative importance of domains proposed for complex trauma assessment, and (2) how to conduct these sensitive discussions with Aboriginal parents.
Setting and methods:
A co-design workshop was held in Alice Springs (Central Australia) as part of an Aboriginal-led community-based participatory action research project. Workshop participants were 57 predominantly Aboriginal stakeholders with expertise in community, clinical, policy and academic settings. Twelve domains of complex trauma-related distress had been identified in existing assessment tools and through community consultation. Using story-telling and strategies to create safety for discussing complex and sensitive issues, and delphi-style methods, stakeholders rated the level of importance of the 12 domains; and discussed why, by whom, where and how experiences of complex trauma should be explored.
Main findings:
The majority of stakeholders supported the importance of assessing each of the proposed complex trauma domains with Aboriginal parents. However, strong concerns were expressed regarding where, by whom and how this should occur. There was greater emphasis and consistency regarding 'qualities' (e.g., caring), rather than specific 'attributes' (e.g., clinician). Six critical overarching themes emerged: ensuring emotional and cultural safety; establishing relationships and trust; having capacity to respond appropriately and access support; incorporating less direct cultural communication methods (e.g., yarning, dadirri); using strengths-based approaches and offering choices to empower parents; and showing respect, caring and compassion.
Conclusion:
Assessments to identify Aboriginal parents experiencing complex trauma should only be considered when the prerequisites of safety, trusting relationships, respect, compassion, adequate care, and capacity to respond are assured. Offering choices and cultural and strengths-based approaches are also critical. Without this assurance, there are serious concerns that harms may outweigh any benefits for Aboriginal parents.
This report describes the protocol for an ongoing project funded by the National Institutes of Health (R01MH108155) that is focused on effects of childhood maltreatment (MALTX) on neurocircuitry changes associated with adolescent major depressive disorder (MDD). Extant clinical and neuroimaging literature on MDD is reviewed, which has relied on heterogeneous samples that do not parse out the unique contribution of MALTX on neurobiological changes in MDD. Employing a 2 × 2 study design (controls with no MALTX or MDD, MALTX only, MDD only, and MDD + MALTX), and based on a cohesive theoretical model that incorporates behavioral, cognitive and neurobiological domains, we describe the multi-modal neuroimaging techniques used to test whether structural and functional alterations in the fronto-limbic and fronto-striatal circuits associated with adolescent MDD are moderated by MALTX. We hypothesize that MDD + MALTX youth will show alterations in the fronto-limbic circuit, with reduced connectivity between the amygdala (AMG) and the prefrontal cortex (PFC), as the AMG is sensitive to stress/threat during development. Participants with MDD will exhibit increased functional connectivity between the AMG and PFC due to self-referential negative emotions. Lastly, MDD + MALTX will only show changes in motivational/anticipatory aspects of the fronto-striatal circuit, and MDD will exhibit changes in motivational and consummatory/outcome aspects of reward-processing. Our goal is to identify distinct neural substrates associated with MDD due to MALTX compared to other causes, as these markers could be used to more effectively predict treatment outcome, index treatment response, and facilitate alternative treatments for adolescents who do not respond well to traditional approaches.
Emerging evidence suggests that alterations in the development of the gastrointestinal (GI) tract during the early postnatal period can influence brain development and vice-versa. It is increasingly recognized that communication between the GI tract and brain is mainly driven by neural, endocrine, immune, and metabolic mediators, collectively called the gut-brain axis (GBA). Changes in the GBA mediators occur in response to the developmental changes in the body during this period. This review provides an overview of major developmental events in the GI tract and brain in the early postnatal period and their parallel developmental trajectories under physiological conditions. Current knowledge of GBA mediators in context to brain function and behavioral outcomes and their synthesis and metabolism (site, timing, etc.) is discussed. This review also presents hypotheses on the role of the GBA mediators in response to the parallel development of the GI tract and brain in infants.
Discovering the processes through which early adverse experiences affect children’s nervous-system development, health, and behavior is critically important for developing effective interventions. However, advances in our understanding of these processes have been constrained by conceptualizations that rely on categories of adversity that are overlapping, have vague boundaries, and lack consistent biological evidence. Here, we discuss central problems in understanding the link between early-life adversity and children’s brain development. We conclude by suggesting alternative formulations that hold promise for advancing knowledge about the neurobiological mechanisms through which adversity affects human development.
The notion of psychological trauma has been liberally used both in clinical literature and general discourse. However, no consensus exists on its exact meaning and definition. Whereas traditionally trauma has been mostly associated with criterion A of acute and posttraumatic stress disorders (PTSDs) as defined in the Diagnostic and Statistical Manual of Mental Disorders, many researchers find this definition too constraining and not accounting for the complexity and many aspects of trauma. This touched off a quest for a broader more accommodating trauma concept, and a dimensional view of trauma with PTSD as its extreme manifestation has been suggested. The dimensional view also has its detractors arguing that “conceptual bracket creep” may undermine the category’s utility. Both categorical and dimensional views mostly rely on trauma’s clinical phenomenology and lack a unified theoretical basis. In an attempt to reconcile this contradiction, a hybrid categorical–dimensional model of trauma based on the general theory of stress has been recently proposed (Krupnik, 2019). Herein, I explore the categorical boundary of the trauma concept, as posited by the model, within the predictive processing framework (PPF). I integrate the PPF view with the theory of stress. In conclusion, I briefly discuss how the proposed model of trauma may guide clinical practice.
Objective: Smaller hippocampal volume has been reported in several stress-related psychiatric disorders, including posttraumatic stress disorder (PTSD), borderline personality disorder with early abuse, and depression with early abuse. Patients with borderline personality disorder and early abuse have also been found to have smaller amygdalar volume. The authors examined hippocampal and amygdalar volumes in patients with dissociative identity disorder, a disorder that has been associated with a history of severe childhood trauma. Method: The authors used magnetic resonance imaging to measure the volumes of the hippocampus and amygdala in 15 female patients with dissociative identity disorder and 23 female subjects without dissociative identity disorder or any other psychiatric disorder. The volumetric measurements for the two groups were compared. Results: Hippocampal volume was 19.2% smaller and amygdalar volume was 31.6% smaller in the patients with dissociative identity disorder, compared to the healthy subjects. The ratio of hippocampal volume to amygdalar volume was significantly different between groups. Conclusions: The findings are consistent with the presence of smaller hippocampal and amygdalar volumes in patients with dissociative identity disorder, compared with healthy subjects.
In the laboratory rat and guinea pig, glucocorticoids (GCs), the adrenal steroids that are secreted during stress, can damage the hippocampus and exacerbate the hippocampal damage induced by various neurological insults. An open question is whether GCs have similar deleterious effects in the primate hippocampus. In fact, we showed that sustained and fatal stress was associated with preferential hippocampal damage in the vervet monkey; however, it was not possible to determine whether the excessive GC secretion that accompanied such stress was the damaging agent. The present study examines this possibility. Pellets of cortisol (the principal GC of primates) were stereotaxically implanted into hippocampi of 4 vervet monkeys; contralateral hippocampi were implanted with cholesterol pellets as a control. One year later at postmortem, preferential damage occurred in the cortisol-implanted side. In the cholesterol side, mild cell layer irregularity was noted in 2 of 4 cases. By contrast in the cortisol-exposed hippocampi, all cases had at least 2 of the following neuropathologic markers: cell layer irregularity, dendritic atrophy, soma shrinkage and condensation, or nuclear pyknosis. Damage was severe in some cases, and was restricted to the CA3/CA2 cellfield. This anatomical distribution of damage, and the cellular features of the damage agree with that observed in instances of GC-induced toxicity in the rodent hippocampus, and of stress-induced toxicity in the primate hippocampus. These observations suggest that sustained GC exposure (whether due to stress, Cushings syndrome or exogenous administration) might damage the human hippocampus.
Neurobiological factors contributing to violence in humans remain poorly understood. One approach to this question is examining allelic variation in the X-linked monoamine oxidase A (MAOA) gene, previously associated with impulsive aggression in animals and humans. Here, we have studied the impact of a common functional polymorphism in MAOA on brain structure and function assessed with MRI in a large sample of healthy human volunteers. We show that the low expression variant, associated with increased risk of violent behavior, predicted pronounced limbic volume reductions and hyperresponsive amygdala during emotional arousal, with diminished reactivity of regulatory prefrontal regions, compared with the high expression allele. In men, the low expression allele is also associated with changes in orbitofrontal volume, amygdala and hippocampus hyperreactivity during aversive recall, and impaired cingulate activation during cognitive inhibition. Our data identify differences in limbic circuitry for emotion regulation and cognitive control that may be involved in the association of MAOA with impulsive aggression, suggest neural systems-level effects of X-inactivation in human brain, and point toward potential targets for a biological approach toward violence.
Neurobiological factors contributing to violence in humans remain poorly understood. One approach to this question is examining allelic variation in the X-linked monoamine oxidase A (MAOA) gene, previously associated with impulsive aggression in animals and humans. Here, we have studied the impact of a common functional polymorphism in MAOA on brain structure and function assessed with MRI in a large sample of healthy human volunteers. We show that the low expression variant, associated with increased risk of violent behavior, predicted pronounced limbic volume reductions and hyperresponsive amygdala during emotional arousal, with diminished reactivity of regulatory prefrontal regions, compared with the high expression allele. In men, the low expression allele is also associated with changes in orbitofrontal volume, amygdala and hippocampus hyperreactivity during aversive recall, and impaired cingulate activation during cognitive inhibition. Our data identify differences in limbic circuitry for emotion regulation and cognitive control that may be involved in the association of MAOA with impulsive aggression, suggest neural systems-level effects of X-inactivation in human brain, and point toward potential targets for a biological approach toward violence.
Variations in maternal care affect the development of individual differences in neuroendocrine responses to stress in rats.
As adults, the offspring of mothers that exhibited more licking and grooming of pups during the first 10 days of life showed
reduced plasma adrenocorticotropic hormone and corticosterone responses to acute stress, increased hippocampal glucocorticoid
receptor messenger RNA expression, enhanced glucocorticoid feedback sensitivity, and decreased levels of hypothalamic corticotropin-releasing
hormone messenger RNA. Each measure was significantly correlated with the frequency of maternal licking and grooming (all
r's > −0.6). These findings suggest that maternal behavior serves to “program” hypothalamic-pituitary-adrenal responses to
stress in the offspring.
Cognitive event-related potentials (ERPs) were recorded from 23 maltreated and 21 nonmaltreated children. Children were presented with slides of Ekman photographs of asingle model posing an angry (25%), a happy (25%), or a neutral (50%) facial expression. In 1 of 2 counterbalanced target conditions, children were asked to press a button in response to the angry face; in the other target condition, they responded to the happy face. Both samples, as expected, exhibited the largest amplitude of the P300 component of the ERP to target stimuli and the smallest amplitude to nontargets. For nonmaltreated children, the average amplitude of P300 across slides was comparable for the 2 target conditions. In contrast, maltreated children displaed larger P300 ampltude to stimuli when they were directed to attend to angry, as opposd children displayed larger p300 amplitude to stimuli whe they were directed to attend to angry, as opposed to happy, targets. These reaults suggest different cognitive processing for positive versus negative affective expressions by children with histories of atypical emotiaonal exotional experiences.
In this study, the authors examined time-varying associations between schizotypal (STPD), borderline (BPD), avoidant (AVPD), or obsessive-compulsive (OCPD) personality disorders and co-occurring Axis I disorders in 544 adult participants from the Collaborative Longitudinal Personality Disorders Study. The authors tested predictions of specific longitudinal associations derived from a model of crosscutting psychobiological dimensions (L. J. Siever & K. L. Davis, 1991) with participants with the relevant Axis I disorders. The authors assessed participants at baseline and at 6-, 12-, and 24-month follow-up evaluations. BPD showed significant longitudinal associations with major depressive disorder and posttraumatic stress disorder. AVPD was significantly associated with anxiety disorders (specifically social phobia and obsessive-compulsive disorder). Two of the four personality disorders under examination (STPD and OCPD) showed little or no association with Axis I disorders.
Available research indicates that maltreated children frequently experience multiple types of maltreatment, although relatively
few studies examine this issue directly. Review of existing studies also shows that, when investigated, maltreatment types
are often correlated. However, from study to study the strength of associations among maltreatment types varies considerably,
apparently due to methodological differences, such as differences in operational definitions of the maltreatment types, composition
of samples and/or method of scaling used. Failure to account for overlap among maltreatment types can result in a misleading
picture of a child’s trauma history. This in turn can lead to an inaccurate evaluation of the relationship between a child’s
victimization experiences and later developmental outcomes. The wide variation in correlations among the maltreatment types
from study to study raises questions about the validity of the different operational definitions used. Improving the construct
validity of the maltreatment type measures is proposed as the means to obtaining more consistent results. Steps by which to
achieve this objective are outlined.
The cerebellum is a brain region recognized primarily in the coordination of movement and related accessory motor functions. In addition, emerging evidence implicates the cerebellum in cognitive processes and suggests that this brain region might be subject to experience-dependent changes in structure. Therefore, the aim of this study was to evaluate the role of early environmental deprivation in the maturation of the cerebellum and aspects of cognitive development.
Structural magnetic resonance imaging volumes of 12 cerebellar sub-regions from 31 previously neglected and 30 typically developing children were compared with subjects' corresponding neuropsychological test scores.
Neglected children had smaller volume of the superior-posterior cerebellar lobes. Moreover, superior-posterior lobe volume was found to mediate neuropsychological test performance differences between groups, with larger volumes yielding better outcomes on tests of memory and planning.
These data support the importance of experience-dependent changes in cerebellar structure and highlight the role of the cerebellum in higher cognitive functions.
In summary, the technique of VBM if implemented correctly is an incredibly powerful and useful tool in the study of neurological disease. It can increase understanding of disease processes, which can be useful both from a scientific point of view and also by providing anatomical information that can be helpful for differential diagnosis of disease. Similar voxel-level statistical techniques can also be applied to other imaging modalities, such as functional MRI and positron emission tomography. It should be stressed, however, that because of the statistical nature of the technique, the power of VBM lies in group analyses. Although it has been applied to single subjects, it has not been optimized or validated for such use. Hence it can provide very important information about regions of atrophy across groups but cannot provide reliable information for single-subject diagnosis. Nevertheless, it is likely to be an important biomarker in future drug trials to assess treatment effects at the group level.
Chronic exposure to stress hormones, whether it occurs during the prenatal period, infancy, childhood, adolescence, adulthood or aging, has an impact on brain structures involved in cognition and mental health. However, the specific effects on the brain, behaviour and cognition emerge as a function of the timing and the duration of the exposure, and some also depend on the interaction between gene effects and previous exposure to environmental adversity. Advances in animal and human studies have made it possible to synthesize these findings, and in this Review a model is developed to explain why different disorders emerge in individuals exposed to stress at different times in their lives.
Objective: The purpose of this study was to determine whether anterior limbic and paralimbic regions of the brain are differentially activated during the recollection and imagery of traumatic events in trauma-exposed individuals with and without posttraumatic stress disorder (PTSD). Method: Positron emission tomography (PET) was used to measure normalized regional cerebral blood flow (CBF) in 16 women with histories of childhood sexual abuse: eight with current PTSD and eight without current PTSD. In separate script-driven imagery conditions, participants recalled and imagined traumatic and neutral autobiographical events. Psychophysiologic responses and subjective ratings of emotional state were measured for each condition. Results: In the traumatic condition versus the neutral control conditions, both groups exhibited regional CBF increases in orbitofrontal cortex and anterior temporal poles; however, these increases were greater in the PTSD group than in the comparison group. The comparison group exhibited regional CBF increases in insular cortex and anterior cingulate gyrus; increases in anterior cingulate gyrus were greater in the comparison group than in the PTSD group. Regional CBF decreases in bilateral anterior frontal regions were greater in the PTSD group than in the comparison group, and only the PTSD group exhibited regional CBF decreases in left inferior frontal gyrus. Conclusions: The recollection and imagery of traumatic events versus neutral events was accompanied by regional CBF increases in anterior paralimbic regions of the brain in trauma-exposed individuals with and without PTSD. However, the PTSD group had greater increases in orbitofrontal cortex and anterior temporal pole, whereas the comparison group had greater increases in anterior cingulate gyrus.
The effects of maternal proximity on the behavioral and physiological responses of infant rhesus macaques during 4 days of total or adjacent separations from the mother were studied. The 6 infants tested showed behavioral responses that differentiated the two separation conditions. Major differences were found in the quantity and quality of vocalizations, the occurrence of cage-biting and cage-shaking behavior, object exploration, and hunched and freezing postures. In particular, the structure of coo vocalizations clearly discriminated between the presence or the absence of the mother during separation. Cerebrospinal fluid (CSF) concentrations of dopamine and serotonin metabolites did not discriminate between the two separation conditions but showed a transient elevation at 24 hr after separation and were not different from baseline by 96 hr after separation. In contrast, both the plasma cortisol and the CSF norepinephrine metabolite responses tended to be greater and to persist for a longer period of time when infants were totally isolated. The results are discussed within the context of attachment and coping theories. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This chapter focuses on the role of the hippocampus in learning and memory processes. The study was initiated in 1957, after a report showed remarkably severe amnesia in a patient resulting from the surgical removal of the hippocampal formation and a large amount of the adjacent tissue in the medial temporal lobes. This led to the universal consensus that the hippocampus is involved in learning and memory. The unique contribution of hippocampus in learning includes its role in spatial processing, working memory, relational learning, episodic memory, context processing, declarative memory, and the encoding of experiences in general. This chapter evaluates the potential relationship between neural representation by individual hippocampal neurons and learning and memory. The most commonly reported behavioral correlate of hippocampal output neurons (pyramidal cells) is location-selective firing, referred to as place fields. The chapter provides evidence that demonstrates the sensory and movement responsiveness of place fields. It also presents a context discrimination hypothesis to evaluate the role that place fields may play in hippocampal-dependent mnemonic functions.
Objectives.
—To determine the prevalence of childhood physical or sexual abuse in women seen in primary care practices; to identify physical and psychologic problems associated with that abuse; and to compare the effects of childhood physical vs sexual abuse and childhood vs adult abuse.
concerned with the normal and abnormal development of the mechanisms and processes involved in emotion activation, emotion expressions and emotion–related behavior, the feeling/experiential component of emotions, and emotion-cognition relations / when is the influence of emotion adaptive and when maladaptive, and under what circumstances is it one or the other / what sorts of emotion-related biological, sociocultural, and cognitive processes lead to developmental psychopathology / can phenomena as seemingly disparate as genetic anomalies and inappropriate belief systems be implicated / present a few general remarks on the neural basis of emotions and . . . focus on those aspects that have clear implications for developmental psychopathology (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This study examined the effects of stressful environments on physiological and affective functioning among 131 maltreated school-aged children attending a summer day camp. Sixty-six nonmaltreated children also attending the camp served as a comparison group. Salivary Cortisol measures were obtained daily at 10:00 a.m. and at 4:00 p.m. Depression was measured using the Child Depression Inventory. Children with scores of 19 or higher were classified as depressed. Internalizing and externalizing behavior problems were determined from the Teacher Report Form of the Child Behavior Checklist. Children with t scores of 70 or higher were classified as having clinical levels of these problems. Maltreated children had slightly elevated afternoon Cortisol concentrations, but their morning concentrations did not differ significantly from those of nonmaltreated children. Neither clinical levels of depression, internalizing, or externalizing problems were predictive of the elevated afternoon values. Depression among maltreated children was, however, associated with altered activity of the hypothalamic-pituitary-adrenocortical (HPA) axis. Depressed maltreated children had lower morning Cortisol concentrations compared to nondepressed maltreated children and were more likely to show a rise rather than the expected decrease in Cortisol from morning to afternoon. These data replicated earlier findings. There was no evidence that depressed, nonmaltreated children exhibited this change in diurnal Cortisol activity.
Salivary cortisol concentrations (10:30–11:30 a.m.) and social behavior (observations and teacher reports) were examined in 33 maltreated (26 boys) and 16 comparison (8 boys) children. The maltreated children were studied for 31 days while they attended a therapeutic preschool for abused and neglected children. Children in the comparison sample were studied while attending a preschool serving economically disadvantaged families. Each child's cortisol values over days were used to compute measures of basal activity (median cortisol) and reactivity (ratio of quartile ranges). Median cortisol was not significantly correlated with social behavior measures. Cortisol reactivity was positively correlated with social competence and negatively correlated with shy/internalizing behavior. Maltreated children exhibited less cortisol reactivity then did comparison children. Maltreated children also scored lower in social competence and higher in shy/internalizing and acting out/externalizing behaviors. In additional analyses, maltreated children failed to show elevations in cortisol on days of high versus low social conflict in the classroom. Social competence was also found to correlate positively with cortisol levels on high-conflict days. In all, the results suggest a reduction in cortisol reactivity in maltreated children related to the impairment in social competence frequently noted among these children.
The role of the mother-toddler attachment relationship in moderating the relations between behavioral inhibition and changes in salivary cortisol levels in response to novel events was examined in 77 18-month-olds. Behavioral inhibition was determined by observing toddler inhibition of approach to several novel events. Attachment security to mother was assessed using the Ainsworth Strange Situation. Changes in salivary cortisol were used to index activity of the stress-sensitive hypothalamic-pituitary-adrenocortical (HPA) system. In addition, toddler coping behaviors and the behaviors used by mothers to help toddlers manage novel events were examined. Elevations in cortisol were found only for inhibited toddlers in insecure attachment relationships. Mothers in these relationships appeared to interfere with their toddlers' coping efforts. These results are discussed in the context of a coping model of the relations between temperament and stress reactivity.
Animal studies have shown that mother–infant interactions can have long-term impacts on areas of the brain that regulate fearful behavior and the physiology of stress. Here, the research on human infants and children is reviewed with an eye to whether early experiences have similar effects in our species. Research shows that during the first year, sensitive and responsive caregiving becomes a powerful regulator of emotional behavior and neuroendocrine stress hormone activity in young children. Indeed, quality-of-care effects can be detected for children throughout the preschool years. Reviewed research suggests that temperament affects the likelihood that children will show increases in stress hormones as the quality of their care decreases. Finally, we review the literature on stress hormone activity in children who have been maltreated early in life, and explore the critical question of whether enhancing care later in development can reverse the effects on behavior and neurobiology of early adverse experiences. ©2003 Michigan Association for Infant Mental Health.
Sensitization of stress-responsive neurobiological systems as a possible consequence of early adverse experience has been implicated in the pathophysiology of mood and anxiety disorders. In addition to early adversities, adulthood stressors are also known to precipitate the manifestation of these disorders. The present study sought to evaluate the relative role of early adverse experience vs. stress experiences in adulthood in the prediction of neuroendocrine stress reactivity in women. A total of 49 women (normal volunteers, depressed patients, and women with a history of early abuse) underwent a battery of interviews and completed dimensional rating scales on stress experiences and psychopathology, and were subsequently exposed to a standardized psychosocial laboratory stressor. Outcome measures were plasma adrenocorticotropin (ACTH) and cortisol responses to the stress test. Multiple linear regression analyses were performed to identify the impact of demographic variables, childhood abuse, adulthood trauma, major life events in the past year, and daily hassles in the past month, as well as psychopathology on hormonal stress responsiveness. Peak ACTH responses to psychosocial stress were predicted by a history of childhood abuse, the number of separate abuse events, the number of adulthood traumas, and the severity of depression. Similar predictors were identified for peak cortisol responses. Although abused women reported more severe negative life events in adulthood than controls, life events did not affect neuroendocrine reactivity. The regression model explained 35% of the variance of ACTH responses. The interaction of childhood abuse and adulthood trauma was the most powerful predictor of ACTH responsiveness. Our findings suggest that a history of childhood abuse per se is related to increased neuroendocrine stress reactivity, which is further enhanced when additional trauma is experienced in adulthood. Depression and Anxiety 15:117–125, 2002.
Children who enter foster care have usually experienced maltreatment as well as disruptions in relationships with primary caregivers. These children are at risk for a host of problematic outcomes. However, there are few evidence-based interventions that target foster children. This article presents preliminary data testing the effectiveness of an intervention, Attachment and Biobehavioral Catch-up, to target relationship formation in young children in the foster care system. Children were randomly assigned to the experimental intervention that was designed to enhance regulatory capabilities or to a control intervention. In both conditions, the foster parents received in-home training for 10 weekly sessions. Post-intervention measures were collected 1 month following the completion of the training. Outcome measures included children's diurnal production of cortisol (a stress hormone), and parent report of children's problem behaviors. Children in the experimental intervention group had lower cortisol values than children in the control intervention. Also, the experimental intervention parents reported fewer behavior problems for older versus younger foster children. Results provide preliminary evidence of the effectiveness of an intervention that targets children's regulatory capabilities and serve as an example of how interventions can effectively target foster children in the child welfare system.
Processing of emotion information by maltreated and control children was assessed with event-related brain potentials (ERPs). Maltreated children, for whom negative facial displays may be especially salient, and demographically comparable peers were tested to increase knowledge of differential processing of emotion information. ERPs were measured while children responded to pictures depicting facial displays of anger, fear, and happiness. Maltreated children showed larger P3b amplitude when angry faces appeared as targets than did control children; the two groups did not differ when targets were either happy or fearful facial expressions or for nontargets of any emotional content. These results indicate that aberrant emotional experiences associated with maltreatment may alter the allocation of attention and sensitivity that children develop to process specific emotion information.
Early-life stimulation (e.g. brief handling) attenuates the behavioral and neuroendocrine responses to stressors encountered in adulthood, particularly with respect to activation of hypothalamic-pituitary-adrenal (HPA) activity. In contrast, if neonates were subjected to a more severe stressor, such as protracted separation from the dam or exposure to an endotoxin, then the adult response to a stressor was exaggerated. These early-life experiences program HPA functioning, including negative feedback derived from stimulation of hippocampal glucocorticoid receptors, and corticotropin-releasing hormone (CRH) and arginine vasopressin (AVP) coexpression in PVN neurons, to modify the response to subsequent stressor experiences. The persistent variations of HPA activity observed in handled/stimulated animals may stem from alterations in dam–pup interactions (e.g. increased arched-back feeding, licking, grooming). In addition genetic makeup is critical in determining stress reactivity. For instance, BALB/cByJ mice are more reactive to stressors than C57BL/6ByJ mice, exhibiting greater HPA hormonal alterations and behavioral disturbances. BALB/cByJ also fail to acquire a spatial learning response in a Morris water-maze paradigm, which has been shown to be correlated with hippocampal cell loss associated with aging. Early-life handling of BALB/cByJ mice prevented these performance deficits and attenuated the hypersecretion of ACTH and corticosterone elicited by stressors. The stressor reactivity may have been related to maternal and genetic factors. When BALB/cByJ mice were raised by a C57BL/6ByJ dam, the excessive stress-elicited HPA activity was reduced, as were the behavioral impairments. However, cross-fostering the more resilient C57BL/6ByJ mice to a BALB/cByJ dam failed to elicit the behavioral disturbances. It is suggested that genetic factors may influence dam–pup interactive styles and may thus proactively influence the response to subsequent stressors among vulnerable animals. In contrast, in relatively hardy animals the early-life manipulations may have less obvious effects.
Total midsagittal area and seven subdivisions of the corpus callosum were measured on magnetic resonance images of 114 healthy boys and girls, aged 4 to 18. Striking variability of size was noted for all measures. Total midsagittal corpus callosum area increased in a robust and linear fashion from ages 4 to 18 (slope = 13.1 mm2/year, P = 0.0001 and slope = 11.1 mm2/year, P = 0.0001 for females and males, respectively). Posterior and mid regions demonstrated greater age-related changes than anterior regions with the rostrum and genu (anterior regions) having reached adult sizes in the youngest of our subjects. There were no significant effects of sex for any measures. These findings support anatomical studies indicating ongoing myelination of higher association areas throughout adolescence, but raise intriguing questions about anterior-posterior gradients of interhemispheric myelination.
Background:
The authors previously reported elevated cerebrospinal fluid (CSF) corticotropin-releasing factor (CRF) concentrations in juvenile primates nursed by mothers undergoing experimentally imposed unpredictable foraging conditions in comparison to normally reared controls. The purpose of the present study was to determine if these changes would endure into young adulthood.
Methods:
Cisternal CSF samples were obtained from those unpredictably reared young adult primates who had been previously studied as juveniles and age-matched ad libitum normally reared controls. Samples were assayed for CSF CRF.
Results:
Concentrations of CSF CRF were significantly elevated in the unpredictably reared sample in comparison to the ad libitum-reared control group. A significant positive correlation was noted between juvenile and young adult CSF CRF values within the unpredictably reared cohort.
Conclusions:
Disturbances of maternal-infant attachment processes have an enduring impact on primate CRF function into young adulthood. The CRF elevations following unpredictable maternal foraging conditions appear traitlike in nature.
At its simplest, voxel-based morphometry (VBM) involves a voxel-wise comparison of the local concentration of gray matter between two groups of subjects. The procedure is relatively straightforward and involves spatially normalizing high-resolution images from all the subjects in the study into the same stereotactic space. This is followed by segmenting the gray matter from the spatially normalized images and smoothing the gray-matter segments. Voxel-wise parametric statistical tests which compare the smoothed gray-matter images from the two groups are performed. Corrections for multiple comparisons are made using the theory of Gaussian random fields. This paper describes the steps involved in VBM, with particular emphasis on segmenting gray matter from MR images with nonuniformity artifact. We provide evaluations of the assumptions that underpin the method, including the accuracy of the segmentation and the assumptions made about the statistical distribution of the data.
Background: Previous investigations suggest that maltreated children with a diagnosis of posttraumatic stress disorder (PTSD) evidence alterations of biological stress systems. Increased levels of catecholaminergic neurotransmitters and steroid hormones during traumatic experiences in childhood could conceivably adversely affect brain development.Methods: In this study, 44 maltreated children and adolescents with PTSD and 61 matched controls underwent comprehensive psychiatric and neuropsychological assessments and an anatomical magnetic resonance imaging (MRI) brain scan.Results: PTSD subjects had smaller intracranial and cerebral volumes than matched controls. The total midsagittal area of corpus callosum and middle and posterior regions remained smaller; while right, left, and total lateral ventricles were proportionally larger than controls, after adjustment for intracranial volume. Brain volume robustly and positively correlated with age of onset of PTSD trauma and negatively correlated with duration of abuse. Symptoms of intrusive thoughts, avoidance, hyperarousal or dissociation correlated positively with ventricular volume, and negatively with brain volume and total corpus callosum and regional measures. Significant gender by diagnosis effect revealed greater corpus callosum area reduction in maltreated males with PTSD and a trend for greater cerebral volume reduction than maltreated females with PTSD. The predicted decrease in hippocampal volume seen in adult PTSD was not seen in these subjects.Conclusions: These data suggest that the overwhelming stress of maltreatment experiences in childhood is associated with adverse brain development.
The hippocampus is vulnerable to the damaging actions of insults such as transient ischemia and repetitive stimulation, as well as repeated exposure to exogenous glucocorticoids. This study investigated effects of a repeated psychological stressor, restraint, on the CA3 pyramidal neurons which are vulnerable to damage by repetitive stimulation. Repeated daily restraint stress for 21 days caused apical dendrites of CA3 pyramidal neurons to atrophy, while basal CA3 dendrites did not change. Rats undergoing this treatment were healthy and showed some adaptation of the glucocorticoid stress response over 21 days; however, stress reduced body weight gain by 14% and increased adrenal weight relative to body weight by 20%. Results are discussed in relation to the possible role of adrenal steroids and excitatory amino acids.
An investigation of the association between diurnal changes in cortisol and DHEA levels, or in the cortisol/DHEA ratio at five different time points at presentation, and the occurrence of undesirable life events (losses, dangers to self and others, disappointments) during follow-up, and the outcome of major depression at 36 weeks were investigated.
Psychosocial and endocrine assessment of a consecutive cohort (N = 68) of 8- to 16-year-old subjects with first episode major depression reassessed 12 months after presentation using a repeat measures design.
Higher cortisol/DHEA ratios at 20.00 or 24.00 h predicted persistent major depression. Basal levels of either hormone alone or cortisol/DHEA ratios at the other three time points (08.00, 12.00 or 16.00 h) did not. High cortisol/DHEA ratios (i.e. values greater than the 60th percentile) at both evening points (20.00 and 24.00 h) also predicted the occurrence of subsequent disappointing life events but no other category of undesirable event. Both high evening cortisol/DHEA ratio at 20.00 h and one or more severely disappointing life events between presentation and follow-up predicted persistent major depression: 86% of subjects with both of these factors were still depressed at 36 weeks whereas 81% with neither factor were not.
The finding that it is depressed subjects with high cortisol/DHEA ratios at presentation who are specifically at risk for subsequent disappointing life events suggests a putative role for these adrenal steroids in abnormal cognitive or emotional processes associated with disturbed interpersonal behaviour.
Arousal-regulating mechanisms are important in explaining individual differences in antisocial behavior.
Alterations in salivary cortisol concentration and cardiovascular activity were studied in 21 boys with oppositional defiant disorder (ODD) and 31 normal controls (NC) during a 2-hour stressful procedure involving frustration and provocation.
Baseline levels of heart rate (HR) were significantly lower in the ODD group, but their HR levels were higher during provocation and frustration. Cortisol levels in the ODD group were overall lower than those of the NC group, and the effect of stress seemed to be minimal and similar for both groups; however, individual differences were large. Since anxiety plays an important mediating role in cortisol response, subjects were divided into one of four groups based on the intensity of their externalizing behavior and anxiousness. Cortisol increase due to stress exposure was strongest in highly externalizing and highly anxious subjects; cortisol decrease was strongest in those subjects who were high in externalizing behavior and low in anxiousness.
The results of the study support an important role for hypothalamic-pituitary-adrenal axis sympathetic autonomic functioning in persistent antisocial behavior in young boys.
Background: Childhood sexual abuse (CSA) has been associated with alterations in brain morphology using region of interest analyses that have focused on stress-sensitive target regions. This study was designed to ascertain the effects on gray matter volume (GMV) of exposure to CSA in healthy young adult college students selected based on exposure history regardless of psychiatric outcome. Voxel-based morphometry (VBM) provided unbiased delineation of the most significantly affected brain regions. Methods: High-resolution T1-weighted magnetic resonance imaging (MRI) datasets were obtained for 23 unmedicated female subjects with CSA and 14 healthy female control subjects of equivalent age and socioeconomic status with no history of trauma. Cortical surface-based analysis (FreeSurfer) was performed to verify VBM results. Results: Gray matter volume was reduced by 12.6% and 18.1% in right and left primary visual (V1) and visual association cortices of abused subjects. This reduction was directly related to duration of CSA before age 12. Gray matter volume of left and right V1 correlated with measure of visual memory (r = .353, p = .032 and r = .448, p = .005). Cortical surface-based analysis indicated that GMV of abused subjects was reduced in the left fusiform (p = .004), left middle occipital (p = .04), and right lingual (p = .002) gyri. Conclusions: Early visual experience exerts a strong influence on the developing mammalian visual cortex. Present findings indicate that exposure to CSA may also affect the development of this region and are apparent even in a population of subjects who are sufficiently healthy to matriculate.
