Self-reported neglect, amygdala volume, and symptoms of anxiety in adolescent boys

A Randomized Controlled Trial of a Parenting Intervention During Infancy Alters Amygdala-Prefrontal Circuitry in Middle Childhood

OBJECTIVE

Early adverse parenting predicts various negative outcomes, including psychopathology and altered development. Animal work suggests that adverse parenting might change amygdala-prefrontal cortex (PFC) circuitry, but work in humans remains correlational. The present study leveraged data from a randomized controlled trial examining the efficacy of an early parenting intervention targeting parental nurturance and sensitivity (Attachment and Biobehavioral Catch-up [ABC]) to test whether early parenting quality causally affects amygdala-PFC connectivity later in life.

METHOD

Participants (N = 60, mean age = 10.0 years) included 41 high-risk children whose parents were referred by Child Protective Services and randomly assigned to receive either ABC (n = 21) or a control intervention (n = 20) during the children's infancy and a comparison sample of low-risk children (n = 19). Amygdala-PFC connectivity was assessed via functional magnetic resonance imaging while children viewed fearful and neutral faces.

RESULTS

Across facial expressions, ABC produced different changes than the control intervention in amygdala-PFC connectivity in response to faces. The ABC group also exhibited greater responses than the control intervention group to faces in areas classically associated with emotion regulation, including the orbitofrontal cortex and right insula. Mediation analysis suggested that the effect of ABC on PFC activation was mediated by the intervention's effect on amygdala-PFC connectivity.

CONCLUSION

Results provide preliminary causal evidence for the effect of early parenting intervention on amygdala-PFC connectivity and on PFC responses to face viewing. Findings also highlight amygdala-PFC connectivity as a potential mediator of the effects of early parenting intervention on children's emotion regulation development.

CLINICAL TRIAL REGISTRATION INFORMATION

Intervening Early With Neglected Children; https://clinicaltrials.gov/; NCT02093052.

DIVERSITY & INCLUSION STATEMENT

We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. One or more of the authors of this paper received support from a program designed to increase minority representation in science. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list.

Maternal separation early in life induces excessive activity of the central amygdala related to abnormal aggression

Epidemiological studies have indicated that child maltreatment, such as neglect, is a risk factor of escalated aggression, potentially leading to delinquency and violent crime in the future. However, little is known about the mechanisms by which an early adverse environment may later cause violent behavior. In this study, we aimed to thoroughly examine the association between aggression against conspecific animals and the activity of amygdala subnuclei using the maternal separation (MS) model, which is a common model of early life stress. In the MS group, pups of Sprague-Dawley rats were separated from their dam during postnatal days 2-20 (twice a day, 3 h each). We only included 9-week-old male offspring for each analysis and compared the MS group with the mother-reared control group; both groups were raised by the same dam during postnatal days 2-20. The results revealed that the MS group exhibited higher aggression and excessive activity of only the central amygdala (CeA) among the amygdala subnuclei during the aggressive behavior test. Moreover, a significant positive correlation was observed between higher aggression and CeA activation. While CeA activity is known to be involved in hunting behavior for prey, some previous studies have also indicated a relationship between CeA and intraspecific aggression. It remains unclear, however, whether excessive CeA activity directly induces intraspecific aggression. Therefore, we stimulated the CeA using optogenetics with 8-week-old rats to clarify the relationship between intraspecific aggression and CeA activity. Notably, CeA activation resulted in higher aggression, even when the opponent was a conspecific animal. In particular, bilateral CeA activation resulted in more severe displays of aggressive behavior than necessary, such as biting a surrendered opponent. These findings suggest that an adverse environment during early development intensifies aggression through excessive CeA activation, which can increase the risk of escalating to violent behavior in the future.

Interpersonal early adversity demonstrates dissimilarity from early socioeconomic disadvantage in the course of human brain development: A meta-analysis

It has been established that early-life adversity impacts brain development, but the role of development itself has largely been ignored. We take a developmentally-sensitive approach to examine the neurodevelopmental sequelae of early adversity in a preregistered meta-analysis of 27,234 youth (birth to 18-years-old), providing the largest group of adversity-exposed youth to date. Findings demonstrate that early-life adversity does not have an ontogenetically uniform impact on brain volumes, but instead exhibits age-, experience-, and region-specific associations. Relative to non-exposed comparisons, interpersonal early adversity (e.g., family-based maltreatment) was associated with initially larger volumes in frontolimbic regions until ∼10-years-old, after which these exposures were linked to increasingly smaller volumes. By contrast, socioeconomic disadvantage (e.g., poverty) was associated with smaller volumes in temporal-limbic regions in childhood, which were attenuated at older ages. These findings advance ongoing debates regarding why, when, and how early-life adversity shapes later neural outcomes.

Child maltreatment, social capital, maternal mental health and duration of program involvement: Assessment from a community-based empowerment program in Kenya

Multisystem, multi-level interventions are required to enable resilient, nurturing environments for children facing adversity. This study assesses parenting behavior associated with participation in a community-based, adapted microfinance program, and mediated by program-affiliated social capital, maternal depression and self-esteem among Kenyan women. Participants in the intervention, Kuja Pamoja kwa Jamii (KPJ, Swahili for "Come Together to Belong"), gather weekly to engage in trainings and group-based microfinance. Groups selected for the study had participated in the program for 0-15 months at the time of the first interview. Women (n = 400) completed surveys in June 2018 and June 2019. Measures included duration of program exposure, group-affiliated social capital (i.e. trust, belonging, cohesion, and expectation of mutual benefit), depression, self-esteem, and conflict tactics. We used regression analyses and generalized structural equation models to explore associations between program exposure, social capital, psychosocial variables and child maltreatment. Each standard deviation increase in duration of program exposure decreased odds of child physical abuse by 40% and child neglect by 35%. Each standard deviation in the social capital index predicted a significant reduction in odds of child physical abuse (aOR: 0.67), and child neglect (aOR: 0.71). Self-esteem and depression fully mediated observed associations between social capital and child maltreatment. Findings recommend further investigation of the potential for adapted microfinance programs to deliver parenting interventions, improve mental health and foster resilience-enabling social capital. A randomized control trial is required to validate the potential of the assessed intervention to improve parenting behaviors and supportive social conditions.

Interpersonal early adversity demonstrates dissimilarity from early socioeconomic disadvantage in the course of human brain development: A meta-analysis

It has been established that early-life adversity impacts brain development, but the role of development itself has largely been ignored. We take a developmentally-sensitive approach to examine the neurodevelopmental sequelae of early adversity in a preregistered meta-analysis of 27,234 youth (birth to 18-years-old), providing the largest group of adversity-exposed youth to date. Findings demonstrate that early-life adversity does not have an ontogenetically uniform impact on brain volumes, but instead exhibits age-, experience-, and region-specific associations. Relative to non-exposed comparisons, interpersonal early adversity (e.g., family-based maltreatment) was associated with initially larger volumes in frontolimbic regions until ~10-years-old, after which these exposures were linked to increasingly smaller volumes. By contrast, socioeconomic disadvantage (e.g., poverty) was associated with smaller volumes in temporal-limbic regions in childhood, which were attenuated at older ages. These findings advance ongoing debates regarding why, when, and how early-life adversity shapes later neural outcomes.

Overgrowth of the Amygdala in Children with Single Ventricle Congenital Heart Disease

Aim: Early life stress is associated with overgrowth of the amygdala, which plays a key role in the processing and memory of emotional responses. Herein, we aimed to explore the amygdala volume in children with single-ventricle congenital heart disease who experience repeated admissions during the neonatal period and infancy. Methods: We compared the amygdala volume measured using brain magnetic resonance imaging (MRI) between 40 patients after completion of the Fontan procedure and 40 age- and sex-matched control subjects Results: Age at the MRI study were 9.2 (8.5-11.1) and 10.2 (9.2-10.3) years in the Fontan and control groups, respectively. The maximum amygdala volume in the Fontan group was significantly larger than in the control group (1232 [983-1392] mm³/m² vs. 980 [728-1166] mm³/m², P < 0.001). The amygdala volume did not correlate to cardiac index (r  =  0.260) and central venous pressure (r = -0.107) in the Fontan group. Conclusions: Children with single-ventricle congenital heart disease exhibited amygdala overgrowth.

Early Life Adversity and Neuropsychiatric Disease: Differential Outcomes and Translational Relevance of Rodent Models

It is now well-established that early life adversity (ELA) predisposes individuals to develop several neuropsychiatric conditions, including anxiety disorders, and major depressive disorder. However, ELA is a very broad term, encompassing multiple types of negative childhood experiences, including physical, sexual and emotional abuse, physical and emotional neglect, as well as trauma associated with chronic illness, family separation, natural disasters, accidents, and witnessing a violent crime. Emerging literature suggests that in humans, different types of adverse experiences are more or less likely to produce susceptibilities to certain conditions that involve affective dysfunction. To investigate the driving mechanisms underlying the connection between experience and subsequent disease, neuroscientists have developed several rodent models of ELA, including pain exposure, maternal deprivation, and limited resources. These studies have also shown that different types of ELA paradigms produce different but somewhat overlapping behavioral phenotypes. In this review, we first investigate the types of ELA that may be driving different neuropsychiatric outcomes and brain changes in humans. We next evaluate whether rodent models of ELA can provide translationally relevant information regarding links between specific types of experience and changes in neural circuits underlying dysfunction.

Left amygdala structure mediates longitudinal associations between exposure to threat and long-term psychiatric symptomatology in youth

Traumatic experiences during childhood can have profound effects on stress sensitive brain structures (e.g., amygdala and hippocampus) and the emergence of psychiatric symptoms. Recent theoretical and empirical work has delineated dimensions of trauma (i.e., threat and deprivation) as having distinct neural and behavioral effects, although there are few longitudinal examinations. A sample of 243 children and adolescents were followed for three time points, with each assessment approximately 1 year apart (ages 9–15 years at Time 1; 120 males). Participants or their caregiver reported on youths' threat exposure, perceived stress (Time 1), underwent a T1‐weighted structural high‐resolution MRI scan (Time 2), and documented their subsequent psychiatric symptoms later in development (Time 3). The primary findings indicate that left amygdala volume, in particular, mediated the longitudinal association between threat exposure and subsequent internalizing and externalizing symptomatology. Greater threat exposure related to reduced left amygdala volume, which in turn differentially predicted internalizing and externalizing symptoms. Decreased bilateral hippocampal volume was related to subsequently elevated internalizing symptoms. These findings suggest that the left amygdala is highly threat‐sensitive and that stress‐related alterations may partially explain elevated psychopathology in stress‐exposed adolescents. Uncovering potential subclinical and/or preclinical predictive biomarkers is essential to understanding the emergence, progression, and eventual targeted treatment of psychopathology following trauma exposure.

Startle Latency as a Potential Marker for Amygdala-Mediated Hyperarousal

BACKGROUND

Fear-related disorders are characterized by hyperexcitability in reflexive circuits and maladaptive associative learning mechanisms. The startle reflex is suited to investigate both processes, either by probing it under baseline conditions or by deriving it in fear conditioning studies. In anxiety research, the amplitude of the fear-potentiated startle has been shown to be influenced by amygdalar circuits and has typically been the readout of interest. In schizophrenia research, prolonged startle peak latency under neutral conditions is an established readout, thought to reflect impaired processing speed. We therefore explored whether startle latency is an informative readout for human anxiety research.

METHODS

We investigated potential similarities and differences of startle peak latency and amplitude derived from a classical fear conditioning task in a sample of 206 participants with varying severity levels of anxiety disorders and healthy control subjects. We first reduced startle response to stable components and regressed individual amygdala gray matter volumes onto the resulting startle measures. We then probed time, stimulus, and group effects of startle latency.

RESULTS

We showed that startle latency and startle amplitude were 2 largely uncorrelated measures; startle latency, but not amplitude, showed a sex-specific association with gray matter volume of the amygdala; startle latencies showed a fear-dependent task modulation; and patients with fear-related disorders displayed shorter startle latencies throughout the fear learning task.

CONCLUSIONS

These data provide support for the notion that probing startle latencies under threat may engage amygdala-modulated threat processing, making them a complementary marker for human anxiety research.

Adverse Childhood Experiences Are Associated With Adult Dream Content: A Cross-Sectional Survey

Background

Dreams can be affected by recent life events and long-term life experiences. Previous evidence has shown that childhood adverse experiences are associated with sleep quality and dream experiences.

Objective

The aim of this study was to explore the relationship between childhood adverse experiences and dream content in adults.

Participants and Setting

A total of 163 participants without current or past physical or mental disorders aged between 18 and 35 were screened in the hospital. Among them, 120 subjects who completed a dream content record at home and whose anxiety and depression levels and sleep quality were within the normal range were included in the data analysis.

Methods

A cross-sectional survey was conducted from June 2017 to December 2019. Dream content for 10 consecutive days was recorded by the participants and coded by the Hall and Van de Castle coding system. Childhood adversity was assessed by the Childhood Trauma Questionnaire (CTQ). In the end, 719 dreams out of 626 nights for 120 participants (44 female) were included in the data analysis, gender differences between groups were analyzed using t-tests or U tests, and Spearman’s partial correlation and multiple linear regression were used to investigate the relationship between childhood trauma and dream content.

Results

Childhood adversity was associated with characters, friendly interactions, and objects in dream content. Regression models of childhood adversity predicting characters and objects in dream content were constructed. There were no gender differences in general demographic data, sleep quality, emotional state, childhood adversity, dream recall frequency, or dream content.

Conclusion

Childhood adversity is associated with adult dream content.

Mothers’ Attachment Representations and Children’s Brain Structure

Ample research demonstrates that parents’ experience-based mental representations of attachment—cognitive models of close relationships—relate to their children’s social-emotional development. However, no research to date has examined how parents’ attachment representations relate to another crucial domain of children’s development: brain development. The present study is the first to integrate the separate literatures on attachment and developmental social cognitive neuroscience to examine the link between mothers’ attachment representations and 3- to 8-year-old children’s brain structure. We hypothesized that mothers’ attachment representations would relate to individual differences in children’s brain structures involved in stress regulation—specifically, amygdala and hippocampal volumes—in part via mothers’ responses to children’s distress. We assessed 52 mothers’ attachment representations (secure base script knowledge on the Attachment Script Assessment and self-reported attachment avoidance and anxiety on the Experiences in Close Relationships scale) and children’s brain structure. Mothers’ secure base script knowledge was significantly related to children’s smaller left amygdala volume but was unrelated to hippocampal volume; we found no indirect links via maternal responses to children’s distress. Exploratory analyses showed associations between mothers’ attachment representations and white matter and thalamus volumes. Together, these preliminary results suggest that mothers’ attachment representations may be linked to the development of children’s neural circuitry related to stress regulation.

Peer Victimization Influences Attention Processing Beyond the Effects of Childhood Maltreatment by Caregivers

Background

Different types of maltreatment (emotional, physical, and sexual) lead to distortions in emotion and attention processing. The present study investigated whether the experience of peer victimization in childhood and adolescence has an additional influence on attention processing in adulthood.

Methods

Two non-clinical samples consisting of individuals with different levels of experiences of maltreatment were recruited. In an evaluative conditioning task, images of faces with neutral emotional expression were either associated with short videos of intense negative statements, or associated with neutral videos. Subsequently, these faces were used as stimuli in an emotional Stroop task as well as a dot-probe task.

Results

In both tasks, hierarchical regression analyses revealed that retrospective reports of relational peer victimization made an incremental contribution to the prediction of attentional biases beyond child maltreatment. In the emotional Stroop task, emotional abuse was the strongest predictor for an attentional bias showing delayed responses to negatively associated faces, while peer victimization was associated with faster responses to negatively associated faces. In the dot-probe task, relational peer victimization was the strongest predictor for an attentional bias. When the attentional bias was examined in more detail, though, peer victimization did not show incremental contributions although emotional abuse remained the strongest predictor for facilitated attention toward negatively associated neutral faces.

Conclusion

Experiences of peer victimization leave additional cognitive scars beyond effects of childhood maltreatment by caregivers. It is likely that attentional biases in the aftermath of victimization put individuals at risk for the development of psychopathology.

Are Anxiety and Depression Taking Sides with Knee-Pain in Osteoarthritis?

Introduction: Total knee arthroplasty (TKA) bears a potential of rendering patients unsatisfied with the operation as a result of negative affectivity related to osteoarthritis and TKA. Not only is pain a lateralized experience, but negative affect and other psychosomatic correlates of pain might also be processed on grounds of lateralization. Lateralization in this context is likely linked to the amygdalae, which display differential left/right patterns of association with psychopathology. What is noteworthy is that osteoarthritis itself is linked not only to negative effects but also to childhood abuse. Method: The present study tests lateralization of psychosomatic correlates of knee-pain using the brief symptom inventory-18 (BSI-18), the dissociative experiences scale (FDS-20), the pain catastrophizing scale (PCS), the Tampa scale of kinesiophobia (TSK), the childhood trauma screener (CTS) and WOMAC. More precisely, we were interested in predicting the side of operations by means of the above-mentioned constructs using binary logistic regression, based on 150 participants (78 left knees) awaiting TKA for knee-osteoarthritis. Results: Somatization (p = 0.003), childhood abuse (p = 0.04) and pain-catastrophizing (p = 0.04) predicted operations on the right side. Anxiety (p = 0.001) and kinesiophobia (p = 0.002) predicted operations on the left side. Conclusions: Knee-pain may be differentially modulated by its psychosomatic correlates as a result of lateralization and corresponding patterns of psychosomatic reagibility.

Early Life Adversity and Males: Biology, Behavior, and Implications for Fathers' Parenting

Fathers have an important and unique influence on child development, but influences on fathers' parenting have been vastly understudied in the scientific literature. In particular, very little empirical research exists on the effects of early life adversity (ELA; e.g. childhood maltreatment, parental separation) on later parenting among fathers. In this review, we draw from both the human and non-human animal literature to examine the effects of ELA, specifically among males, in the following areas: 1) neurobiology and neurocognitive functioning, 2) hormones and hormone receptors, 3) gene-environment interactions and epigenetics, and 4) behavior and development. Based on these findings, we present a conceptual model to describe the biological and behavioral pathways through which exposure to ELA may influence parenting among males, with a goal of guiding future research and intervention development in this area. Empirical studies are needed to improve understanding of the relationship between ELA and father's parenting, inform the development of paternal and biparental interventions, and prevent intergenerational transmission of ELA.

Early Life Stress and Neurodevelopment in Adolescence: Implications for Risk and Adaptation

An alarming high proportion of youth experience at least one kind of stressor in childhood and/or adolescence. Exposure to early life stress is associated with increased risk for psychopathology, accelerated biological aging, and poor physical health; however, it is important to recognize that not all youth who experience such stress go on to develop difficulties. In fact, resilience, or positive adaptation in the face of adversity, is relatively common. Individual differences in vulnerability or resilience to the effects of early stress may be represented in the brain as specific patterns, profiles, or signatures of neural activation, structure, and connectivity (i.e., neurophenotypes). Whereas neurophenotypes of risk that reflect the deleterious effects of early stress on the developing brain are likely to exacerbate negative outcomes in youth, neurophenotypes of resilience may reduce the risk of experiencing these negative outcomes and instead promote positive functioning. In this chapter we describe our perspective concerning the neurobiological mechanisms and moderators of risk and resilience in adolescence following early life stress and integrate our own work into this framework. We present findings suggesting that exposure to stress in childhood and adolescence is associated with functional and structural alterations in neurobiological systems that are important for social-affective processing and for cognitive control. While some of these neurobiological alterations increase risk for psychopathology, they may also help to limit adolescents' sensitivity to subsequent negative experiences. We also discuss person-centered strategies that we believe can advance our understanding of risk and resilience to early stress in adolescents. Finally, we describe ways in which the field can broaden its focus to include a consideration of other types of environmental factors, such as environmental pollutants, in affecting both risk and resilience to stress-related health difficulties in youth.

A Narrative Review of Methodological Considerations in Magnetic Resonance Imaging of Offspring Brain Development and the Influence of Parenting

Parenting has been robustly associated with offspring psychosocial development, and these effects are likely reflected in brain development. This hypothesis is being tested with increasingly rigorous methods and the use of magnetic resonance imaging, a powerful tool for characterizing human brain structure and function. The objective of this narrative review was to examine methodological issues in this field that impact the conclusions that can be drawn and to identify future directions in this field. Studies included were those that examined associations between parenting and offspring brain structure or function. Results show four thematic features in this literature that impact the hypotheses that can be tested, and the conclusions drawn. The first theme is a limited body of studies including repeated sampling of offspring brain structure and function, and therefore an over-reliance on cross-sectional or retrospective associations. The second involves a focus on extremes in early life caregiving, limiting generalizability. The third involves the nature of parenting assessment, predominantly parent- or child-report instead of observational measures which may be more ecologically valid measures of parenting. A closely related fourth consideration is the examination of detrimental versus positive parenting behaviors. While studies with one or more of these thematic limitations provide valuable information, future study design should consider addressing these limitations to determine how parenting shapes offspring brain development.

Effects of Early Life Stress on the Developing Basolateral Amygdala-Prefrontal Cortex Circuit: The Emerging Role of Local Inhibition and Perineuronal Nets

The links between early life stress (ELS) and the emergence of psychopathology such as increased anxiety and depression are now well established, although the specific neurobiological and developmental mechanisms that translate ELS into poor health outcomes are still unclear. The consequences of ELS are complex because they depend on the form and severity of early stress, duration, and age of exposure as well as co-occurrence with other forms of physical or psychological trauma. The long term effects of ELS on the corticolimbic circuit underlying emotional and social behavior are particularly salient because ELS occurs during critical developmental periods in the establishment of this circuit, its local balance of inhibition:excitation and its connections with other neuronal pathways. Using examples drawn from the human and rodent literature, we review some of the consequences of ELS on the development of the corticolimbic circuit and how it might impact fear regulation in a sex- and hemispheric-dependent manner in both humans and rodents. We explore the effects of ELS on local inhibitory neurons and the formation of perineuronal nets (PNNs) that terminate critical periods of plasticity and promote the formation of stable local networks. Overall, the bulk of ELS studies report transient and/or long lasting alterations in both glutamatergic circuits and local inhibitory interneurons (INs) and their associated PNNs. Since the activity of INs plays a key role in the maturation of cortical regions and the formation of local field potentials, alterations in these INs triggered by ELS might critically participate in the development of psychiatric disorders in adulthood, including impaired fear extinction and anxiety behavior.

Anxiety among Lebanese adolescents: scale validation and correlates

BACKGROUND

The Lebanese population has undergone several conflicts and were the most afflicted by shelling and chaos during the civil war from 1975 to 1990, or even by displacement, bereavement, emigration, family separations, not to mention the economic crises that have hit the country since 2019 under which young adults are still succumbing. Our study aims to validate the Lebanese Anxiety Scale and assess correlates of anxiety among Lebanese adolescents.

METHODS

A cross-sectional study was carried between January and May 2019, using a proportionate random sampling of schools from all five Lebanese governorates, among which 1810 adolescents aged 14 to 17 years.

RESULTS

All LAS items remained in the model and formed one factor solution that explained 61.38% of the total variance (KMO = 0.873; p_{Bartlett test} < 0.001), with an excellent Cronbach's alpha of 0.93. Higher neglect (B = 0.38), insomnia (B = 0.21) and child psychological abuse (B = 0.08) were significantly associated with more anxiety. Those results were considered adjusted overall sociodemographic variables since the latter had no statistically significant association with anxiety.

CONCLUSION

The study confirmed the association between anxiety and some variables such as psychological child abuse, neglect, and insomnia and emphasized the correlation between anxiety and these factors. Further, the LAS appears to be a short, valid and efficient tool for assessing anxiety among Lebanese adolescents. Further studies need to be carried to evaluate whether the LAS-10 gives a similar diagnosis to psychiatrists.

Childhood maltreatment predicts subsequent anxiety symptoms among Chinese adolescents: the role of the tendency of coping styles

Childhood maltreatment may have an influence on anxiety symptoms and coping styles. This longitudinal study aimed to estimate the prospective associations between different types of childhood maltreatment and anxiety symptoms among Chinese adolescents, with a particular focus on investigating whether these associations vary by the tendency of coping styles. Data were from the Longitudinal Study of Adolescents' Mental and Behavioral Well-being Research. The baseline sample included 1957 participants (response rate: 99.03%) and followed up at 1-year later (n = 1836, retention rate: 93.8%). Anxiety symptoms, childhood maltreatment, the tendency of coping styles, morning cortisol level, depressive symptoms, self-esteem, and other demographics were measured. Overall, the mean age of the baseline students was 13.6 (SD: 1.5) years. The final results showed that childhood emotional abuse (unstandardized β-estimate = 0.13, 95% CI = 0.07-0.18), physical abuse (unstandardized β-estimate = 0.08, 95% CI = 0.01-0.16), and sexual abuse (unstandardized β-estimate = 0.17, 95% CI = 0.04-0.29) were positively associated with anxiety symptoms at follow-up after adjusting for significant covariates at baseline. Additionally, the stratified analyses demonstrated that only among students with negative coping styles, childhood emotional abuse, physical abuse, and sexual abuse were associated with subsequent anxiety symptoms; the differences between the positive and negative coping style strata were significant (P < 0.05). Childhood maltreatment appears to be a predictor of anxiety symptoms among adolescents, and the tendency of coping styles may have a moderating role in these longitudinal associations. The efforts to prevent anxiety symptoms are recommended to be focused on adolescents with the experience of childhood maltreatment and negative coping styles.

Amygdala Allostasis and Early Life Adversity: Considering Excitotoxicity and Inescapability in the Sequelae of Stress

Early life adversity (ELA), such as child maltreatment or child poverty, engenders problems with emotional and behavioral regulation. In the quest to understand the neurobiological sequelae and mechanisms of risk, the amygdala has been of major focus. While the basic functions of this region make it a strong candidate for understanding the multiple mental health issues common after ELA, extant literature is marked by profound inconsistencies, with reports of larger, smaller, and no differences in regional volumes of this area. We believe integrative models of stress neurodevelopment, grounded in "allostatic load," will help resolve inconsistencies in the impact of ELA on the amygdala. In this review, we attempt to connect past research studies to new findings with animal models of cellular and neurotransmitter mediators of stress buffering to extreme fear generalization onto testable research and clinical concepts. Drawing on the greater impact of inescapability over unpredictability in animal models, we propose a mechanism by which ELA aggravates an exhaustive cycle of amygdala expansion and subsequent toxic-metabolic damage. We connect this neurobiological sequela to psychosocial mal/adaptation after ELA, bridging to behavioral studies of attachment, emotion processing, and social functioning. Lastly, we conclude this review by proposing a multitude of future directions in preclinical work and studies of humans that suffered ELA.

"She finds you abhorrent" - The impact of emotional context information on the cortical processing of neutral faces in depression

Depression is associated with abnormalities in patterns of information processing, particularly in the context of processing of interpersonal information. The present study was designed to investigate the differences in depressive individuals in cortical processing of facial stimuli when neutral faces were presented in a context that involved information about emotional valence as well as self-reference. In 21 depressive patients and 20 healthy controls, event-related potentials (ERPs) were recorded during the presentation of neutral facial expressions, which were accompanied by affective context information that was either self- or other-related. Across conditions, depressive patients showed larger mean P100 amplitudes than healthy controls. Furthermore, mean late positive potential (LPP) amplitudes of depressive patients were larger in response to faces in self-related than in other-related context. In addition, irrespective of self-reference, mean LPP responses of depressive patients to faces presented after socially threatening sentences were larger compared with faces presented after neutral sentences. Results regarding self-reference supported results of previous studies indicating larger mean amplitudes in self-related conditions. Findings suggest a general heightened initial responsiveness to emotional cues and a sustained emotion processing of socially threatening information in depressive patients.

Larger bilateral amygdalar volumes are associated with affective loss experiences

Affective loss (AL) (i.e., bereavement, relationship breakup) is a stressful life event leading to a heightened risk of developing a psychiatric disorder, for example, depression and anxiety disorder. These disorders have been associated with altered subcortical brain volumes. Little is known though, how AL in healthy subjects is linked to subcortical volumes. In a study with 196 healthy young adults, we probed the association between AL across the individual entire life span, assessed via the List of Threatening Experiences Questionnaire, and magnetic resonance imaging brain gray matter volumes (a priori selected: bilateral amygdalae, hippocampi, thalami; exploratory analyses: nuclei accumbens, caudate, putamina), segmented by use of volBrain. AL was defined as death of a first-degree relative/spouse, close relative/friend, and breakup of a marriage or steady relationship. AL was associated with larger bilateral amygdalar volumes and, after taking into account the total number of ALs, with smaller right hippocampal volumes, both irrespective of sex. Exploratory analyses of striatal volumes yielded an association of AL with larger right nucleus accumbens volumes in men, and increased caudate volumes after the loss of a first-degree relative irrespective of sex. Our data suggest that AL engenders alterations in limbic structures that likely involve processes of chronic stress and amygdala- and hippocampus-dependent fear conditioning, and resemble those observed in general anxiety disorder, childhood maltreatment, and major depressive disorder. Our exploratory findings of striatal volume alterations hint at a modulation of reward processing by AL.

Longitudinal changes in amygdala, hippocampus and cortisol development following early caregiving adversity

Although decades of research have shown associations between early caregiving adversity, stress physiology and limbic brain volume (e.g., amygdala, hippocampus), the developmental trajectories of these phenotypes are not well characterized. In the current study, we used an accelerated longitudinal design to assess the development of stress physiology, amygdala, and hippocampal volume following early institutional care. Previously Institutionalized (PI; N = 93) and comparison (COMP; N = 161) youth (ages 4–20 years old) completed 1–3 waves of data collection, each spaced approximately 2 years apart, for diurnal cortisol (N = 239) and structural MRI (N = 156). We observed a developmental shift in morning cortisol in the PI group, with blunted levels in childhood and heightened levels in late adolescence. PI history was associated with reduced hippocampal volume and reduced growth rate of the amygdala, resulting in smaller volumes by adolescence. Amygdala and hippocampal volumes were also prospectively associated with future morning cortisol in both groups. These results indicate that adversity-related physiological and neural phenotypes are not stationary during development but instead exhibit dynamic and interdependent changes from early childhood to early adulthood.

Varying Cognitive Scars - Differential Associations Between Types of Childhood Maltreatment and Facial Emotion Processing

Background

Distorted cognitive processing has been found among survivors of child maltreatment. However, different types of abuse and neglect may bring about differences in emotion and attention processing. The present study aimed to detect differential associations between various types of childhood maltreatment and attentional biases in facial emotion processing.

Methods

A non-clinical sample was recruited on University campus and consisted of 67 individuals with varying degrees of maltreatment. In an evaluative conditioning task, images of faces with neutral emotional expressions were either associated with short videos of intense negative statements, or associated with neutral videos. Subsequently, these faces were used as stimuli in a face in the crowd recognition task in which the familiar faces had to be recognized within a crowd of unfamiliar neutral faces.

Results

In multiple linear regression analyses controlling for the intercorrelatedness of types of maltreatment, differential relationships between types of maltreatment and attentional bias were found. While emotional abuse was associated with faster detection of negatively associated faces, emotional neglect was associated with an impaired recognition of familiar stimuli regardless of the emotional content.

Conclusion

Results indicated that interindividual differences in cognitive biases may be due to the activation of diverse cognitive schemas based on differential experiences of maltreatment.

Early Adversity and the Neotenous Human Brain

Human brain development is optimized to learn from environmental cues. The protracted development of the cortex and its connections with subcortical targets has been argued to permit more opportunity for acquiring complex behaviors. This review uses the example of amygdala-medial prefrontal cortex circuitry development to illustrate a principle of human development-namely, that the extension of the brain's developmental timeline allows for the (species-expected) collaboration between child and parent in co-construction of the human brain. The neurobiology underlying affective learning capitalizes on this protracted timeline to develop a rich affective repertoire in adulthood. Humans are afforded this luxuriously slow development in part by the extended period of caregiving provided by parents, and parents aid in scaffolding the process of maturation during childhood. Just as adequate caregiving is a potent effector of brain development, so is adverse caregiving, which is the largest environmental risk factor for adult mental illness. There are large individual differences in neurobiological outcomes following caregiving adversity, indicating that these pathways are probabilistic, rather than deterministic, and prolonged plasticity in human brain development may also allow for subsequent amelioration by positive experiences. The extant research indicates that the development of mental health cannot be considered without consideration of children in the context of their families.

Childhood Trauma, Cognitive Emotion Regulation and Motivation for Behavior Change Among Clients of Opioid Substitution Treatment With and Without Past Year Synthetic Cathinone Use During Therapy

Background

With a decrease in heroin's purity and availability in the European drug market, Hungarian opioid dependent patients started to substitute heroin with novel psychoactive substances (NPS) and especially with synthetic cathinones.

Goal

This study aims to assess whether clients of opioid substitution treatment (OST) with and without a history of synthetic cathinone use during therapy differ in (1) the rate and type of experienced childhood trauma, (2) the way they cope with negative life events, (3) their motivation to change substance use behavior, (4) the rate of treatment retention.

Methods

A total of 198 clients of an outpatient centers (Nyírõ Gyula National Institute of Psychiatry and Addictions, Budapest) OST were asked to provide information about their general substance use experiences, including the consumption of NPS during treatment, their childhood traumatic experiences (Childhood Trauma Questionnaire), cognitive emotion regulation strategies (Cognitive Emotion Regulation Questionnaire), their motivation to change substance use behavior (University of Rhode Island Change Assessment Scale) and current psychiatric symptoms (Brief Symptom Inventory). Baseline data was collected in the summer of 2015, while 4 years follow-up data on treatment retention was obtained in the summer of 2019.

Results

The majority of the clients were male (N = 141, 71.2%), receiving methadone as a substitute for opioids (N = 178, 89.9%), while mean age of the full sample was 39.7 (SD = 6.8). Based on a logistic regression model, the odds for past year synthetic cathinone use was higher among clients with more severe psychiatric symptoms (B = 0.8, OR = 2.2, p < 0.01) and among clients who were in treatment for a shorter period of time (B = 0.1, OR = 0.9, p < 0.05). Synthetic cathinone use during treatment was further associated with less adaptive strategies to cope with negative life events. Synthetic cathinone use was also a risk factor for reduced treatment retention (B = -0.8, OR = 0.4, p < 0.05) and was associated with lower odds of being member of a latent class with less severe psychopathological profile (B = -0.9, OR = 0.4, p < 0.05).

Conclusion

Synthetic cathinone use during treatment is associated with poorer treatment outcomes and might be characterized by more severe psychiatric symptoms and amotivation to change substance use among opioid dependent clients.

Morphometric Biomarkers of Adolescents With Familial Risk for Alcohol Use Disorder

BACKGROUND

While many adolescents exhibit risky behavior, teenagers with a family history (FH+) of an alcohol use disorder (AUD) are at a heightened risk for earlier initiation of alcohol use, a more rapid escalation in frequency and quantity of alcohol consumption and developing a subsequent AUD in comparison with youth without such family history (FH-). Neuroanatomically, developmentally normative risk-taking behavior parallels an imbalance between more protracted development of the prefrontal cortex (PFC) and earlier development of limbic regions. Magnetic resonance imaging (MRI)-derived volumetric properties were obtained for these structures in FH+ and FH- adolescents.

METHODS

Forty-two substance-naïve adolescents (13- to 14-year-olds), stratified into FH+ (N = 19, 13 girls) and FH- (N = 23, 11 girls) age/handedness-matched groups, completed MRI scanning at 3.0T, as well as cognitive and clinical testing. T1 images were processed using FreeSurfer to measure PFC and hippocampi/amygdalae subfields/nuclei volumes.

RESULTS

FH+ status was associated with larger hippocampal/amygdala volumes (p < 0.05), relative to FH- adolescents, with right amygdala results appearing to be driven by FH+ boys. Volumetric differences also were positively associated with family history density (p < 0.05) of having an AUD. Larger subfields/nuclei volumes were associated with higher anxiety levels and worse auditory verbal learning performance (p < 0.05).

CONCLUSIONS

FH+ risk for AUD is detectable via neuromorphometric characteristics, which precede alcohol use onset and the potential onset of a later AUD, that are associated with emotional and cognitive measures. It is plausible that the development of limbic regions might be altered in FH+ youth, even prior to the onset of alcohol use, which could increase later risk. Thus, targeted preventative measures are warranted that serve to delay the onset of alcohol use in youth, particularly in those who are FH+ for an AUD.

Longitudinal pathways linking family risk, neural risk processing, delay discounting, and adolescent substance use

BACKGROUND

Current theories in neuroscience emphasize the crucial role of individual differences in the brain contributing to the development of risk taking during adolescence. Yet, little is known about developmental pathways through which family risk factors are related to neural processing of risk during decision making, ultimately contributing to health risk behaviors. Using a longitudinal design, we tested whether neural risk processing, as affected by family multi-risk index, predicted delay discounting and substance use.

METHOD

One hundred and fifty-seven adolescents (aged 13-14 years at Time 1, 52% male) were assessed annually three times. Family multi-risk index was measured by socioeconomic adversity, household chaos, and family risk-taking behaviors. Delay discounting was assessed by a computerized task, substance use by questionnaire data, and risk-related neural processing by blood-oxygen-level-dependent (BOLD) responses in the amygdala during a lottery choice task.

RESULTS

Family multi-risk index at Time 1 was related to adolescent substance use at Time 3 (after controlling for baseline substance use) indirectly through heightened amygdala sensitivity to risks and greater delay discounting.

CONCLUSIONS

Our results elucidate the crucial role of neural risk processing in the processes linking family multi-risk index and the development of substance use. Furthermore, risk-related amygdala activation and delay discounting are important targets in the prevention and treatment of substance use among adolescents growing up in high-risk family environments.

Concordance of genetic variation that increases risk for anxiety disorders and posttraumatic stress disorders and that influences their underlying neurocircuitry

BACKGROUND

There have been considerable recent advances in understanding the genetic architecture of anxiety disorders and posttraumatic stress disorder (PTSD), as well as the underlying neurocircuitry of these disorders. However, there is little work on the concordance of genetic variations that increase risk for these conditions, and that influence subcortical brain structures. We undertook a genome-wide investigation of the overlap between the genetic influences from single nucleotide polymorphisms (SNPs) on volumes of subcortical brain structures and genetic risk for anxiety disorders and PTSD.

METHOD

We obtained summary statistics of genome-wide association studies (GWAS) of anxiety disorders (N_cases= 7016, N_controls= 14,745), PTSD (European sample; N_cases= 2424, N_controls= 7113) and of subcortical brain structures (N = 13,171). SNP Effect Concordance Analysis (SECA) and Linkage Disequilibrium (LD) Score Regression were used to examine genetic pleiotropy, concordance, and genome-wide correlations respectively. SECAs conditional false discovery was used to identify specific risk variants associated with anxiety disorders or PTSD when conditioning on brain related traits.

RESULTS

For anxiety disorders, we found evidence of significant concordance between increased anxiety risk variants and variants associated with smaller amygdala volume. Further, by conditioning on brain volume GWAS, we identified novel variants that associate with smaller brain volumes and increase risk for disorders: rs56242606 was found to increase risk for anxiety disorders, while two variants (rs6470292 and rs683250) increase risk for PTSD, when conditioning on the GWAS of putamen volume.

LIMITATIONS

Despite using the largest available GWAS summary statistics, the analyses were limited by sample size.

CONCLUSIONS

These preliminary data indicate that there is genome wide concordance between genetic risk factors for anxiety disorders and those for smaller amygdala volume, which is consistent with research that supports the involvement of the amygdala in anxiety disorders. It is notable that a genetic variant that contributes to both reduced putamen volume and PTSD plays a key role in the glutamatergic system. Further work with GWAS summary statistics from larger samples, and a more extensive look at the genetics underlying brain circuits, is needed to fully delineate the genetic architecture of these disorders and their underlying neurocircuitry.