Child Abuse and Neglect, Callous-Unemotional Traits, and Substance Use Problems: the Moderating Role of Stress Response Reactivity

Childhood maltreatment and substance use risk: A moderated mediation model of autonomic reactivity and distress tolerance

BACKGROUND/AIMS

The link between child maltreatment (CM) and substance use (SU) in young adulthood is established. The sympathetic nervous system (SNS) division of the autonomic nervous system may mediate this link. However, less is known on the indirect link between CM and SU via SNS functioning. Due to individual variability in the link between SNS functioning and SU risk, we aimed to examine the moderating role of distress tolerance (DT).

METHODS

A longitudinal sample of 118 young adults (YAs) from a low socioeconomic status background were assessed twice (between 9 and 12 months apart). CM, DT, and galvanic skin response (GSR) stress reactivity were measured during the initial study visit, while SU was assessed at both timepoints. Stress reactivity was assessed by measuring the GSR reactivity during a stress task. We tested the indirect associations between CM and changes in SU problems via GSR stress reactivity, and the moderation effects of DT on these indirect associations. A mediation model in the structural equation modeling (SEM) framework was then followed by a moderated mediation model to analyze these data.

RESULTS

YA's stress reactivity mediated the association between CM and alcohol use problems, and this indirect effect was weaker among YAs who had higher levels of DT. This pattern did not emerge with drug use problems.

CONCLUSIONS

Findings suggest that intervention and prevention efforts for SU outcomes should consider incorporating strategies that increase at-risk individuals' levels of DT. Providing strategies to help individuals stem their stress reactivity may reduce their risk for alcohol use.

Neural signatures of the development of antisocial behaviours and callous-unemotional traits among youth: The moderating role of parental support

Comorbidity of antisocial behaviours (AB) and callous-unemotional (CU) traits characterizes a subgroup of youth at risk for chronic and severe AB in adulthood. Although aberrant neural response to facial emotion confers heightened risk for AB and CU traits, the behavioural effect of this neural response varies by family context. The present study examines the effects of neural response to emotional faces, parental support and the interaction between the two as predictors of AB and CU traits in a longitudinal sample of preadolescents (Nbaseline  = 11,883; Mage  = 9.5; 47.8% female). Low CU youth who evinced attenuated response to fearful faces within the left superior temporal sulcus and fusiform gyrus showed smaller decreases of AB over time; these associations did not extend to high CU youth. Among high CU youth reporting low parental support, blunted response to fearful faces within the bilateral inferior parietal sulcus predicted smaller decreases of AB. Study findings highlight neurobehavioural differences between youth with high and low CU traits, as well as the interacting roles of negative face processing and parental support in the development of AB.

Physiological Stress Response Reactivity Mediates the Link Between Emotional Abuse and Youth Internalizing Problems

Youth who are raised in emotionally abusive families are more likely to have poor mental health outcomes such as depression and anxiety. However, the mechanisms of this association are unclear. The present study utilized a longitudinal sample of low-SES youth (N = 101, M_ageT1 = 10.24) to examine stress response reactivity (i.e. vagal withdrawal, sympathetic activation, and hypothalamic-pituitary-adrenal [HPA] axis activation) as mediators between emotional abuse and prospective youth internalizing symptoms. Results indicated that blunted HPA reactivity to a laboratory social stress task mediated the association between emotional abuse and youth internalizing symptoms. Emotional abuse was also associated with blunted parasympathetic nervous system activity (i.e. less vagal withdrawal than average). In sum, emotional abuse is a potent risk factor for youth internalizing symptoms, and this link may be mediated via dysregulation in physiological stress response systems. Primary prevention of childhood emotional abuse and secondary prevention programs that target self-regulation skills may reduce rates of youth internalizing symptoms and disorders.