Child maltreatment and the developing HPA axis

Emotional reactivity and past self-injurious behavior moderate the association between trauma exposure and fearlessness about death

INTRODUCTION

As suicide remains a global public health concern, recent work has sought to characterize mechanisms underlying the transition from suicidal ideation to action. Acquired capability for suicide, or fearlessness about death, has been identified as one key factor underlying this transition; however, understanding how this capability emerges remains limited. This study sought to extend previous work on the correlates of fearlessness about death by examining its relationship with painful and provocative events and emotional reactivity.

METHODS

We tested the extent to which trait emotional reactivity and past self-injurious behavior moderated the relationship between assaultive trauma exposure and fearlessness about death in a diverse sample of 273 community adults (aged 18-55, M/SD = 32.77/10.78).

RESULTS

A three-way interaction emerged, such that among individuals with heightened emotional reactivity and a history of self-injurious behavior (suicide attempt or non-suicidal self-injury), assaultive trauma was associated with increased fearlessness about death. In contrast, among adults with low emotional reactivity and a history of self-injurious behavior, assaultive trauma was associated with reduced fearlessness about death.

CONCLUSIONS

Results suggest that emotional reactivity may be a key dispositional factor that influences how trauma exposure and self-injurious behavior impact fearlessness about death.

The Impact of Adverse Childhood Experiences on Cognitive Control Across the Lifespan: A Systematic Review and Meta-analysis of Prospective Studies

Adverse childhood experiences (ACEs) are strongly associated with impaired cognitive control, yet research on ACEs' effects across cognitive control domains-working memory, cognitive flexibility, and inhibitory control-remains sparse. This systematic review and meta-analysis evaluated the overall impact of ACEs on each of these cognitive control domains and explored moderating factors such as age, gender, cognitive control paradigms, and ACEs subtypes based on the dimensional model of adversity and psychopathology. A database search was conducted in SCOPUS, MedLine, PsycINFO, and Web of Science. Only prospective studies were included to ensure temporal order inferences, with at least two data collection points, assessing ACEs at baseline (T1) and cognitive control during follow-up (T2). Thirty-two studies (N = 26,863) producing 124 effect sizes were analyzed. Three-level meta-analyses revealed small-to-medium negative associations between ACEs and overall cognitive control (g = -0.32), and in each domain: working memory (g = -0.28), cognitive flexibility (g = -0.28), and inhibitory control (g = -0.32). The negative associations between ACEs and cognitive control were consistent across age, gender, and cognitive control paradigms. ACEs subtypes moderated the association with cognitive flexibility (p = .04) but not working memory or inhibitory control. Specifically, the deprivation subtype exhibited a stronger negative association with cognitive flexibility compared to threat and threat-and-deprivation subtypes. These findings highlight the pervasive negative impact of ACEs on cognitive control across ages and emphasize the need for targeted interventions. Implications, current gaps, limitations in research, and future study recommendations are discussed.

Intergenerational effects of maternal childhood maltreatment on newborns' stress regulation: The role of maternal depressive symptoms

BACKGROUND

Maternal childhood maltreatment (CM) has been repeatedly associated with negative offspring's emotional outcomes. The dysregulation of the Hypothalamic-Pituitary-Adrenal (HPA) axis has emerged as the main underlying physiological mechanism.

OBJECTIVE

To explore the association between maternal CM and newborns' physiological and neurobehavioral stress responses, considering the role of perinatal maternal depression and bonding.

PARTICIPANTS AND SETTING

150 healthy women were followed throughout pregnancy. 79 mother-infant dyads were included in the final analyses. Maternal CM was evaluated using the Childhood Trauma Questionnaire and depressive symptoms by the Edinburgh Postnatal Depression Scale (EPDS) at each trimester. At 7 weeks postpartum, the EPDS and the Postpartum Bonding Questionnaire were administered. Newborns' behavioral responses were assessed using "States Organization" (SO) and "States Regulation" (SR) subdomains of the Neonatal Behavioral Assessment Scale (NBAS). Newborns' salivary samples were collected before and after the NBAS to study cortisol reactivity.

METHODS

A cross-lagged panel model was employed.

RESULTS

Infants born to mothers with higher CM presented more optimal scores on SO (β (0.635) = 0.216, p 〈001) and SR (ß (0.273) = 0.195, p = .006), and a higher cortisol reactivity after NBAS handling (β(0.019) = 0.217, p = .009). Moreover, newborns of mothers with higher CM and postpartum depressive symptoms exhibited a poorer performance on SR (ß (0.156 = -0.288,p = .002). Analyses revealed non-significant relationships between mother-infant bonding, newborns' cortisol reactivity and SO.

CONCLUSIONS

Newborns from mothers with greater CM present higher cortisol reactivity and more optimal behavioral responses, which may reflect a prenatal HPA axis sensitization. However, those exposed to maternal postnatal depressive symptoms present poorer stress recovery.

Predictors of the rate and course of reactive attachment disorder and disinhibited social engagement disorder symptoms in foster children during the first year of placement

BACKGROUND

Due to adverse care experiences, foster children are at risk for developing symptoms of reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED).

OBJECTIVE

This study investigated the factors influencing rate and course of RAD and DSED symptoms during the first year of placement in long-term foster care.

PARTICIPANTS AND SETTING

The sample consisted of 55 foster children aged 1 to 6 years. Measurements were taken at placement as well as 6 and 12 months after placement.

METHODS

RAD and DSED symptoms were assessed with the Disturbance of Attachment Interview (DAI). DSED symptoms were also assessed by observation with the Rating of Infant Stranger Engagement (RISE). Foster parents and caseworkers reported on children's preplacement experiences and placement characteristics.

RESULTS

RAD symptoms were rare at Wave 1 (5.5 %) and remitted in most children within the first six months of placement, t(54) = 3.06, p = .003. A total of 30.9 % of the foster children presented DSED symptoms according to the DAI, but only 5.5 % of the children according to the RISE. Foster parents reported symptom reduction, t(54) = 3.71, p = .003, while observational data indicated symptom stability. Prior placement in emergency foster care was associated with lower levels of RAD at Wave 1, F(1.62, 80.88) = 7.80, p = .002, while later placed children presented more RAD and DSED symptoms (RRAD2 = 0.07, RDSED2 = 0.08, RRISE2 = 0.12). Psychopathology of the biological parents (RRAD2 = 0.07, RDSED2 = 0.08) and visitation with the biological parents (RRISE2 = 0.14) predicted symptom stability.

CONCLUSION

A substantial number of foster children present persistent DSED symptoms indicating a need for evidenced based interventions.

The effect of stress on the antibody response after vaccination in children aged 0-18 years: A systematic review

Stress has been associated with less effective vaccine responses in adults. This review aims to investigate the evidence for a similar association in children. A systematic review search was conducted in January 2021 in three databases: Medline, Embase and PsycInfo. An updated search of the Medline database was systematically conducted until the most recent update on September 25th, 2023, to ensure the inclusion of the most current research available. Keywords related to stress, vaccines and children were used, and a total of 7263 (+1528) studies were screened by two independent investigators. Six studies met the inclusion criteria for data extraction and analysis. For quality assessment of the studies, the risk of bias in non-randomized studies-of interventions (ROBINS-I) tool was applied. Most of the studies suggest a negative role of stress on vaccine responses. However, the scarcity of studies, lack of confirmatory studies, risk of bias and heterogeneity according to age, type of vaccine, measures of stress and vaccine responses prevent a clear conclusion. Future studies should emphasize the use of as strict study designs as possible, including well-defined stress metrics and thorough examination of both pre- and post-vaccination responses. Systematic review registration: Prospero CRD42021230490.

Early Life Adversity, Microbiome, and Inflammatory Responses

Early life adversity has a profound impact on physical and mental health. Because the central nervous and immune systems are not fully mature at birth and continue to mature during the postnatal period, a bidirectional interaction between the central nervous system and the immune system has been hypothesized, with traumatic stressors during childhood being pivotal in priming individuals for later adult psychopathology. Similarly, the microbiome, which regulates both neurodevelopment and immune function, also matures during childhood, rendering this interaction between the brain and the immune system even more complex. In this review, we provide evidence for the role of the immune response and the microbiome in the deleterious effects of early life adversity, both in humans and rodent models.

Unique and interactive effects of threat and deprivation on latent trait cortisol among emerging adults

Though considerable work supports the Dimensional Model of Adversity and Psychopathology, prior research has not tested whether the dimensions-threat (e.g., abuse) and deprivation (e.g., neglect)-are uniquely related to salivary trait indicators of hypothalamic pituitary adrenal (HPA) axis activity. We examined the unique and interactive effects of threat and deprivation on latent trait cortisol (LTC)-and whether these effects were modified by co-occurring adversities. Emerging adults (n = 90; Mage = 19.36 years; 99.88% cisgender women) provided salivary cortisol samples four times a day (waking, 30 min and 45 min postwaking, bedtime) over three 3-day measurement waves over 13 weeks. Contextual life stress interviews assessed early adversity. Though the effects varied according to the conceptualization of early adversity, overall, threat-but not deprivation, nor other co-occurring adversities-was uniquely associated with the across-wave LTC. Specifically, the incidence and frequency of threat were each negatively related to the across-wave LTC. Threat severity was also associated with the across-wave LTC, but only among those with no deprivation. Finally, the effects of threat were modified by other co-occurring adversities. Findings suggest that threat has unique implications for individual differences in HPA axis activity among emerging adults, and that co-occurring adversities modify such effects.

The cortisol/DHEA ratio mediates the association between early life stress and externalizing problems in adolescent boys

BACKGROUND

Despite evidence that early life stress (ELS) can influence the functioning of the hypothalamic-pituitary-adrenal (HPA) axis and increase maladaptive behaviors in adolescence, less attention has been paid to the role of the coordinated effects of the two primary adrenal hormones, cortisol and dehydroepiandrosterone (DHEA), in these associations.

METHODS

138 typically developing adolescents (76 females) reported the stressful events experienced during childhood and early adolescence across 30 domains. Two years later we assessed levels of externalizing problems and obtained salivary levels of cortisol and DHEA. Using causal moderated mediation analyses, we examined whether the ratio of cortisol to DHEA (CD ratio) mediates the association between ELS and subsequent externalizing problems.

RESULTS

We found that ELS is associated with both a lower CD ratio and more externalizing problems. Importantly, a lower CD ratio mediated the association between ELS and externalizing problems in boys.

CONCLUSIONS

An imbalance in adrenal hormones may be a mechanism through which ELS leads to an increase in externalizing problems in adolescent boys. These findings underscore the utility of using the CD ratio to index HPA-axis functioning.

Childhood maltreatment, genetic risk, and subsequent risk of arrhythmias: a prospective cohort study

Background: Emerging evidence has linked childhood maltreatment with cardiovascular disease risk; however, the association between childhood maltreatment and cardiac arrhythmias remains unclear. Moreover, any genetic predispositions to atrial fibrillation (AF), a common cardiac arrhythmia associated with an elevated risk of stroke, heart failure, and mortality, that modify such associations have been undocumented.Purpose: To examine the associations between childhood maltreatment and incident arrhythmias, and whether a genetic predisposition to arrhythmias modifies these associations.Methods: This prospective analysis included 151,741 participants from the UK Biobank (mean age 55.8 years, 43.4% male). Childhood maltreatment, including five types, was measured using the Childhood Trauma Screener (CTS). Incident arrhythmias (AF, ventricular arrhythmias [VA], and bradyarrhythmia [BA]) were documented through linked hospital admission and death registry. Weighted AF genetic risk score was calculated. Cox proportional hazard models were conducted to test for associations between childhood maltreatment and incident arrhythmias.Results: During a median follow-up of 12.21 years (interquartile range, 11.49-12.90 years), 6,588 AF, 2,093 BA, and 742 VA events occurred. Compared with the absence of childhood maltreatment, having 3-5 types of childhood maltreatment was associated with an increased risk of incident AF (HR, 1.23; 95%CI 1.09-1.37), VA (HR, 1.39; 95%CI 1.03-1.89), and BA (HR, 1.32; 95%CI 1.09-1.61) after adjusting demographic, socioeconomic and lifestyle factors. The associations between cumulative type of childhood maltreatment and the risk of AF (Poverall < .001; Pnonlinear = .674) and BA (Poverall = .007; Pnonlinear = .377) demonstrated a linear pattern. There was a gradient association between childhood maltreatment and AF risks across the intermediate and high genetic risk groups (both Ptrend < .05) but not within the low genetic risk group (Ptrend = .378), irrespective of non-significant interaction effect (Pinteraction = .204).Conclusion: Childhood maltreatment was associated with higher risks of incident arrhythmias, especially AF and BA. Genetic risk of AF did not modify these associations.

Emotional reactivity linking assaultive trauma and risky behavior: Evidence of differences between cisgender women and men

Accumulating evidence suggests that trauma exposure is positively associated with future engagement in risky behavior, such as substance misuse, aggression, risky sex, and self-harm. However, the psychological factors driving this association and their relevance across gender groups require further clarification. In a community sample of 375 adults with a high rate of trauma exposure (age range: 18-55 years, M = 32.98 years, SD = 10.64; 76.3% assaultive trauma exposure), we examined whether emotional reactivity linked lifetime assaultive trauma exposure with past-month risky behavior. We also explored whether this model differed for cisgender women (n = 178, 47.6%) and men (n = 197, 52.5%). As hypothesized, assaultive trauma was positively related to emotional reactivity, β = .20, SE = 0.03, t(369) = 3.65, p < .001, which, in turn, partially accounted for the association between assaultive trauma and past-month risky behavior, indirect effect: β = .03, SE = 0.01, 95% bootstrapped CI [0.01, 0.06]. Gender moderated this association such that assaultive trauma was indirectly associated with risky behavior via emotional reactivity for women but not for men, index moderation: B = -0.03, SE = 0.02, 95% bootstrapped CI [-0.07, -0.01]. Cross-sectional results suggest that emotional reactivity may be a proximal target for clinical intervention to aid in the reduction of risky behavior among women.

Childhood Maltreatment and Body Mass Index in Older Adults With Chronic Illness

Background

Childhood trauma has been associated with greater psychological and physical morbidity, including a greater risk of developing coronary artery disease (CAD). Emotional dysregulation and increased body mass index (BMI) may be involved. This study evaluated whether (1) childhood maltreatment is associated with a higher BMI at study onset and with greater increases in BMI 5 years later among older adults with CAD or other chronic illnesses; (2) sex and/or CAD status moderate these results; and (3) baseline symptoms of anxiety, depression, and perceived stress (emotional dysregulation) mediate the association between childhood maltreatment and BMI at follow-up.

Methods

A total of 1232 men and women (aged 60.86 [6.95] years) completed validated questionnaires on childhood maltreatment and symptoms of psychological distress. The weight and height of the participant were measured, and the BMI was calculated using the weight (kg)/height (m2) ratio.

Results

Childhood maltreatment was not significantly associated with BMI at study onset nor at follow-up. This relation did not differ as a function of sex nor CAD status. Although childhood maltreatment was associated with significantly greater psychological distress at study onset (all P < 0.001), there latter was not found to mediate the relation between maltreatment and change in BMI at follow-up.

Conclusions

In contrast to previous literature, childhood maltreatment was not associated with BMI nor with the change in BMI over 5 years in men and women with chronic disease. However, as psychological distress increases risk for morbidity and mortality, it may represent an important target for prevention and intervention in survivors of childhood maltreatment.

The neurobiological effects of childhood maltreatment on brain structure, function, and attachment

Childhood maltreatment is a risk factor for psychopathologies, and influences brain development at specific periods, particularly during early childhood and adolescence. This narrative review addresses phenotypic alterations in sensory systems associated with specific types of childhood maltreatment exposure, periods of vulnerability to the neurobiological effects of maltreatment, and the relationships between childhood maltreatment and brain structure, function, connectivity, and network architecture; psychopathology; and resilience. It also addresses neurobiological alterations associated with maternal communication and attachment disturbances, and uses laboratory-based measures during infancy and case-control studies to elucidate neurobiological alterations in reactive attachment disorders in children with maltreatment histories. Moreover, we review studies on the acute effects of oxytocin on reactive attachment disorder and maltreatment and methylation of oxytocin regulatory genes. Epigenetic changes may play a critical role in initiating or producing the atypical structural and functional brain alterations associated with childhood maltreatment. However, these changes could be reversed through psychological and pharmacological interventions, and by anticipating or preventing the emergence of brain alterations and subsequent psychopathological risks.

Early adverse childhood experiences and preschoolers' attentional regulation: A latent class analysis

BACKGROUND

Adverse childhood experiences (ACEs) profoundly disrupt preschoolers' attentional regulation development. Different patterns of ACEs may be associated with different attentional regulation outcomes.

OBJECTIVE

Drawing from developmental systems theory and attachment theory, this study aimed to identify distinct patterns of early ACEs at age three and examined the associations of these patterns with preschoolers' attentional regulation at age five.

PARTICIPANTS AND SETTING

This study used the two waves of longitudinal data from the Future of Families and Child Wellbeing Study (N = 4457).

METHODS

First, this study applied latent class analysis (LCA) across nine indicators of ACEs at age three. Second, class membership was examined for associations with preschoolers' attentional regulation at age five.

RESULTS

LCA identified four latent classes of ACEs: separation (41.2 %), parental incarceration (33 %), family dysfunction (20.8 %), and child abuse (5 %). Children in the child abuse class exhibited lower levels of attentional regulation than those in the family dysfunction class (0.33 standard deviation difference, p < .01) or separation class (0.48 standard deviation difference, p < .001). Children in the parental incarceration class demonstrated lower levels of attentional regulation than those in the separation class (0.63 standard deviation difference, p < .001).

CONCLUSIONS

Findings provide implications for the need to prevent early child abuse and incorporate trauma-informed intervention programs to support preschoolers' attentional regulation during school-entry age.

Genetic and environmental influences on alpha amylase stress reactivity and shared genetic covariation with cortisol

Salivary alpha amylase (sAA) is a common measure of stress reactivity, primarily reflecting sympathetic nervous system activity. Salivary cortisol is also a reliable, frequently used biomarker of stress and reflects the hypothalamic-pituitary-adrenal (HPA) axis response. This study examined heritability across varying metrics of sAA in response to a social evaluative stressor, the Trier Social Stress Test (TSST). The goal of this study was to estimate genetic and environmental influences on measurements of sAA stress reactivity. Moreover, we evaluated the shared genetic covariation between sAA and cortisol. Participants included twins aged 15-20 years (54% female). We measured alpha amylase and cortisol reactivity to the TSST via serial salivary cortisol samples collected pre- and post-TSST. Modest to moderate heritability estimates (11-64%) were observed across measures purported to capture alpha amylase stress reactivity (peak, area under the curve, baseline-to-peak change). Findings also indicate that sAA baseline and peak are primarily influenced by a shared genetic factor. There was no evidence of shared genetic influences between sAA and cortisol. These findings suggest the genetic control of the HPA and Sympathetic Adreno-Medullar axis are genetically independent of one another despite both playing a role in response to stressors.

Cortisol's diurnal rhythm indexes the neurobiological impact of child adversity in adolescence

Adverse early life experiences, such as child maltreatment, shapes hypothalamic-pituitary-adrenal (HPA) activity. The impact of social context is often probed through laboratory stress reactivity, yet child maltreatment is a severe form of chronic stress that recalibrates even stable or relatively inflexible stress systems such as cortisol's diurnal rhythm. This study was designed to determine how different social contexts, which place divergent demands on children, shape cortisol's diurnal rhythm. Participants include 120 adolescents (9-14 years), including 42 youth with substantiated child physical abuse. Up to 32 saliva samples were obtained in the laboratory, on days youth stayed home, and on school days. A 3-level hierarchical linear model examined cortisol within each day and extracted the diurnal rhythm at level 1; across days at level 2; and between-individual differences in cortisol and its rhythm at level 3. While cortisol's diurnal rhythm was flattened when youth were in the novel laboratory context, the impact of maltreatment was observed within the home context such that maltreated children had persistently flattened diurnal rhythms. The effect of maltreatment overlapped with current chronic interpersonal family stress. Results are consistent with the idea that maltreatment exerts a robust, detrimental impact on the HPA axis and are interpreted in the context of less flexibility and rhythmicity. The HPA axis adapts by encoding signifiers of relevant harsh or unpredictable environments, and the extreme stress of physical abuse in the family setting may be one of these environments which calibrates the developing child's stress responsive system, even throughout a developmental stage in which the family takes on diminishing importance.

The cognitive tasks and event-related potentials associated childhood adversity: A systematic review

In this systematic review, 18 articles met inclusion criteria to be qualitatively analyzed for converging evidence of brain activity, measured using event-related potential (ERP), related to retrospectively reported childhood adversity/trauma. Using the PRISMA guidelines for systematic reviews, 917 articles were assessed for inclusion and were filtered using study parameters. The most common ERP components listed in the literature were P100, N170, N200, P200, P300, ERN, and LPP. We discuss levels of evidence for changed brain activity, each ERP component, and the tasks used to evoke them. The Childhood Trauma Questionnaire was found to be the most commonly cited measure. We note the need to assess the duration and intensity of childhood adversity/trauma measurements in the strengths and limitations of the reported childhood adversity/trauma measurements. No concrete converging evidence was found to support a relationship between ERP-measured brain activity and retrospectively reported childhood adversity/trauma. Thus, a discussion of limitations and future directions for this field of research is presented.

Associations Between Childhood Trauma and Tobacco Use Outcomes in Adults after Overnight Abstinence

INTRODUCTION

Childhood trauma is known to be associated with nicotine dependence, yet limited smoking outcomes have been examined and few studies have assessed associations between specific trauma subscales and smoking. Additionally, sex differences in trauma-smoking relations are understudied. This study examined associations between childhood trauma and several smoking-related outcomes in adults who smoke after overnight abstinence.

AIMS AND METHODS

People who smoke (N = 205) completed self-report and biochemical assessments evaluating childhood trauma, affect, nicotine dependence, smoking urges, withdrawal, and plasma cortisol and cotinine levels. Smoking outcomes were compared between those with and without a history of moderate to severe childhood trauma among the total sample and by sex.

RESULTS

Relative to those with no to minimal abuse, those with moderate to severe abuse had higher negative affect, withdrawal severity, and plasma cotinine levels. Exploratory analyses revealed that women were more likely than men to have urges to smoke for negative reinforcement and have higher withdrawal severity, but no interactions between abuse group and sex were observed. Examining specific trauma subscales, the moderate to severe emotional abuse group had more severe nicotine dependence, negative affect, and withdrawal compared to the no to minimal group. The moderate to severe sexual abuse group had more severe nicotine dependence and withdrawal compared to the no to minimal group.

CONCLUSIONS

Exposure to childhood trauma is associated with more severe nicotine dependence, negative affect, withdrawal, and higher plasma cotinine levels. Findings also indicate that different types of trauma may differentially affect smoking behaviors.

IMPLICATIONS

This study of adults who smoke finds that childhood trauma history may be a marker for smoking susceptibility and suggests that individuals with experiences of emotional and sexual abuse may require targeted forms of smoking cessation interventions. Moreover, findings suggest that smoking risks may differ for men and women. Findings inform public health interventions intended to reduce cigarette use in individuals with exposure to childhood trauma.

Methylation Patterns of the FKBP5 Gene in Association with Childhood Maltreatment and Depressive Disorders

Childhood maltreatment is an important risk factor for adult depression and has been associated with changes in the hypothalamic pituitary adrenal (HPA) axis, including cortisol secretion and methylation of the FKBP5 gene. Furthermore, associations between depression and HPA changes have been reported. This study investigated the associations of whole-blood FKBP5 mRNA levels, serum cortisol levels, childhood maltreatment, and depressive symptoms with the whole-blood methylation status (assessed via target bisulfite sequencing) of 105 CpGs at the FKBP5 locus using data from the general population-based Study of Health in Pomerania (SHIP) (N = 203). Both direct and interaction effects with the rs1360780 single-nucleotide polymorphism were investigated. Nominally significant associations of main effects on methylation of a single CpG site were observed at intron 3, intron 7, and the 3'-end of the gene. Additionally, methylation at two clusters at the 3'-end and intron 7 were nominally associated with childhood maltreatment × rs1360780 and depressive symptoms × rs1360780, respectively. The results add to the understanding of molecular mechanisms underlying the emergence of depression and could aid the development of personalised depression therapy and drug development.

The mediation effect of glucocorticoid receptor gene (NR3C1) methylation between childhood maltreatment and depressive symptoms in Chinese adolescents: A 2-year longitudinal study

This three-wave longitudinal study examined whether methylation alterations in promoter exon 1F of a stress-related gene-NR3C1 (NR3C1-1F)-explained the longitudinal associations between childhood maltreatment and adolescent depressive symptoms. A total of 370 Han Chinese adolescents (Mage  = 16.31 ± 1.28 years; 51.4% girls) recruited from Shandong, China were tracked from 2018 to 2020. The results showed that the severity of childhood maltreatment, especially that of emotional abuse and physical neglect, conferred risk for adolescent depressive symptoms via reducing NR3C1-1F methylation levels. These mediation effects of NR3C1-1F methylation did not vary between adolescent sex or NR3C1 BclI and Tth111I polymorphisms. The findings highlight how childhood maltreatment contributes to psychopathology development at a biological level.

Does biological age mediate the relationship between childhood adversity and depression? Insights from the Detroit Neighborhood Health Study

The link between childhood adversity and adulthood depression is well-established; however, the underlying mechanisms are still being explored. Recent research suggests biological age may mediate the relationship between childhood adversity and depression in later life. This study examines if biological age mediates the relationship between childhood adversity and depression symptoms using an expanded set of biological age measures in an urban population-based cohort. Data from waves 1-3 of the Detroit Neighborhood Health Study (DNHS) were used in this analysis. Questions about abuse during childhood were coded to form a childhood adversity score similar to the Adverse Childhood Experience measure. Multiple dimensions of biological age, defined as latent variables, were considered, including systemic biological age (GrimAge, PhenoAge), epigenetic age (Horvath, SkinBlood), and immune age (cytomegalovirus, herpes simplex virus type 1, C-reactive protein, interleukin-6). Depression symptoms, modeled as a latent variable, were captured through the Patient Health Questionnaire-9 (PHQ-9). Models were adjusted for age, gender, race, parent education, and past depressive symptoms. Total and direct effects of childhood adversity on depression symptoms and indirect effects mediated by biological age were estimated. For total and direct effects, we observed a dose-dependent relationship between cumulative childhood adversity and depression symptoms, with emotional abuse being particularly influential. However, contrary to prior studies, in this sample, we found few direct effects of childhood adversity on biological age or biological age on depression symptoms and no evidence of mediation through the measures of biological age considered in this study. Further research is needed to understand how childhood maltreatment experiences are embodied to influence health and wellness.

Bridging Neuroscience and Clinical Assessment in a Patient with Alcohol Use Disorder, Anxiety, and Trauma

This article presents a unique framework that combines insights from neuroscience with clinical assessment to evaluate individuals who have co-occurring alcohol use disorder, anxiety, and trauma. Through the use of a case study, the authors demonstrate the practical application of this framework and contextualize the relevant neurocircuitry associated with alcohol withdrawal, maladaptive fear and anxiety, and chronic stress. By integrating these perspectives, they provide a comprehensive approach for assessing and treating patients with complex psychiatric histories, particularly those presenting with anxiety symptoms, offering valuable insights for practitioners.

Cognitive-Affective-Behavioral Pathways Linking Adversity and Discrimination to Daily Pain in African-American Adults

The tendency to ruminate, magnify, and experience helplessness in the face of pain - known as pain catastrophizing - is a strong predictor of pain outcomes and is associated with adversity. The ability to maintain functioning despite adversity - referred to as resilience - also influences pain outcomes. Understanding the extent to which pain catastrophizing and resilience influence relations between adversity and daily pain in healthy African-American adults could improve pain risk assessment and mitigate racial disparities in the transition from acute to chronic pain. This study included 160 African-American adults (98 women). Outcome measures included daily pain intensity (sensory, affective) and pain impact on daily function (pain interference). Adversity measures included childhood trauma exposure, family adversity, chronic burden from recent stressors, and ongoing perceived stress. A measure of lifetime racial discrimination was also included. Composite scores were created to capture early-life adversity (childhood trauma, family adversity) versus recent-life adversity (perceived stress, chronic burden). Increased pain catastrophizing was correlated with increased adversity (early and recent), racial discrimination, pain intensity, and pain interference. Decreased pain resilience was correlated with increased recent-life adversity (not early-life adversity or racial discrimination) and correlated with increased pain intensity (not pain-related interference). Bootstrapped multiple mediation models revealed that relationships between all adversity/discrimination and pain outcomes were mediated by pain catastrophizing. Pain resilience, however, was not a significant mediator in these models. These findings highlight opportunities for early interventions to reduce cognitive-affective-behavioral risk factors for persisting daily pain among African-American adults with greater adversity exposure by targeting pain catastrophizing.

Adversity type and timing predict temporal summation of pain in African-American adults

African Americans are disproportionately exposed to adversity across the lifespan, which includes both stressful and traumatic events. Adversity, in turn, is associated with alterations in pain responsiveness. Racial differences in pain responsiveness among healthy adults are well established. However, the extent to which adversity type and timing are associated with alterations in pain responsiveness among healthy African-American adults is not well understood. The present study included 160 healthy African-American adults (98 women), ages 18 to 45. Outcome measures included pain tolerance and temporal summation of pain to evoked thermal pain. Composite scores were created for early-life adversity (childhood trauma, family adversity) and recent adversity (perceived stress, chronic stress burden). A measure of lifetime racial discrimination was also included. Higher levels of recent adversity were associated with higher temporal summation of pain, controlling for gender, age, and education. Neither early-life adversity nor lifetime racial discrimination were associated with temporal summation of pain. The present findings suggest that heightened temporal summation of pain among healthy African-American adults is associated with exposure to recent adversity events. Improved understanding of how recent adversity contributes to heightened temporal summation of pain in African Americans could help to mitigate racial disparities in pain experiences by identifying at-risk individuals who could benefit from early interventions.

Prevalence of co-occurring severe depression and psychotic symptoms in college students and its relationship with childhood maltreatment

BACKGROUND

It has been demonstrated that childhood maltreatment (CM) is associated with an increased risk of depression and psychotic symptoms. However, there is still a lack of studies on the prevalence of co-occurring severe depression and psychotic symptoms (CSDPS) and the association between CM and CSDPS among college students.

OBJECTIVE

We aim to investigate the prevalence and demographic distribution of CSDPS among Chinese college students and to examine its relationship with CM.

PARTICIPANTS AND SETTING

A total of 7351 college students aged 18 and above completed the survey. Finally, 6854 valid questionnaires were included for further analysis.

METHODS

The Childhood Trauma Questionnaire and the item for witnessing domestic violence were used to assess the CM. The Prodromal Questionnaire-16 and the depression subscale of the Depression Anxiety and Stress-21 scale were used to assess psychotic symptoms and depressive symptoms.

RESULTS

The prevalence of CSDPS was 1.47 % among the college students. The multivariate logistic regression analysis showed that emotional abuse and emotional neglect were associated with an increased risk of CSDPS (all p < 0.05). The risk of CSDPS was dramatically increased for individuals who had experienced ≥3 types of CM (OR = 22.929, p < 0.001), as compared to those who had experienced 1-2 types of CM (OR = 4.452, p < 0.001) and those without the experience of CM.

CONCLUSION

CM was found to be associated with an increased risk of CSDPS among the college students. Notably, experiencing more types of CM was also associated with a higher risk of CSDPS.

Longitudinal trajectories of sleep quality in correlation with maltreatment in early childhood: A cohort of Chinese early adolescents

BACKGROUND

Child maltreatment may lead to sleep disturbance during the critical period of child development. Our study examined the effect of maltreatment in early childhood on trajectories of sleep quality among early adolescents.

METHODS

The study included 1611 participants (mean ± standard deviation age at baseline: 12.5 ± 0.5 years) from a middle school in southeastern China. Of these participants, 60.5 % were males. Information on early childhood maltreatment during pre-seventh grade was obtained through a self-report questionnaire at baseline, and sleep quality was collected at baseline and during follow-up. We used a group-based trajectory model to characterize trajectories of sleep quality.

RESULTS

The study identified four trajectories of sleep quality, namely the low sleep score group (25.0 %), the moderate-low sleep score group (51.0 %), the moderate-increasing sleep score (17.0 %), and the high-decreasing sleep score (7.0 %) group. After adjusting for covariates, the findings revealed that emotional abuse and physical abuse were associated with an increased risk of developing new-onset sleep disturbances in early adolescents. Particularly, emotional abuse (incidence rate ratio = 1.71, 95 % confidence interval: 1.08-2.71) significantly increased the risk of belonging to the high-decreasing sleep score group. Moreover, there existed a dose-response relationship between early childhood maltreatment and sleep quality trajectories, with a higher number of maltreatment types in early childhood correlating with a greater risk of belonging to the high-decreasing sleep score group.

CONCLUSIONS

The findings of our study provide compelling evidence indicating that specific types and cumulative maltreatment during early childhood contribute to sleep disturbances among early adolescents. The study findings highlight the significance of preventing and reducing early childhood maltreatment to enhance sleep quality during early adolescence.

Child maltreatment and youth suicide risk: A developmental conceptual model and implications for suicide prevention

Experiences of child abuse and neglect are risk factors for youth suicidal thoughts and behaviors. Accordingly, suicide risk may emerge as a developmental process that is heavily influenced by the rearing environment. We argue that a developmental, theoretical framework is needed to guide future research on child maltreatment and youth (i.e., adolescent and emerging adult) suicide, and to subsequently inform suicide prevention efforts. We propose a developmental model that integrates principles of developmental psychopathology and current theories of suicide to explain the association between child maltreatment and youth suicide risk. This model bears significant implications for future research on child maltreatment and youth suicide risk, and for suicide prevention efforts that target youth with child maltreatment experiences.

Traumatic Stress and Resilience Among Transgender and Gender Diverse Youth

Traumatic stress increases the risk for mental health conditions and adversely impacts health, academic performance, and coping. Transgender and gender diverse (TGD) youth experience higher rates of abuse and maltreatment and interpersonal and community-embedded discrimination than their cisgender peers. Neurobiologic stress responses and social stress theory provide useful frameworks for understanding the effects of discrimination, stigma, and rejection. Despite facing higher rates of interpersonal trauma, TGD youth are quite resilient when able to access supports and affirming trauma-informed services. Clinicians play an important role in identifying and addressing traumatic stress impacting TGD youth and bolstering resilience.

The moderating role of adrenocortical reactivity in the associations between interparental conflict, emotional reactivity, and school adjustment

This study tested whether the associations between interparental conflict, children's emotional reactivity, and school adjustment were moderated by children's cortisol reactivity in a sample of young children (N = 243; mean age = 4.6 years at Wave 1; 56% female, 44% male) and their parents. Using a longitudinal, autoregressive design, observational assessments of children's emotional reactivity at Wave 2 mediated the relationship between an observational measure of Wave 1 conflict between parents and teacher's report of children's school adjustment at Wave 3. However, children's cortisol reactivity to parent conflict at Wave 1 moderated the first link, such that emotional reactivity operated as a mediator for children with heightened cortisol reactivity but not children with low cortisol reactivity. Moderation was expressed in a "for better" or "for worse" form hypothesized by biological sensitivity to context theory. Thus, children with high cortisol reactivity experienced greater emotional reactivity than their peers when faced with more destructive conflict but also lower emotional reactivity when exposed to more constructive interparental conflict. Results are discussed as to how they advance emotional security and biological sensitivity to context theories.

From childhood adversity to latent stress vulnerability in adulthood: the mediating roles of sleep disturbances and HPA axis dysfunction

Childhood adversity is a prominent predisposing risk factor for latent stress vulnerability, expressed as an elevated likelihood of developing stress-related psychopathology upon subsequent exposure to trauma in adulthood. Sleep disturbances have emerged as one of the most pronounced maladaptive behavioral outcomes of childhood adversity and are also a highly prevalent core feature of stress-related psychopathology, including post-traumatic stress disorder (PTSD). After reviewing the extensive literature supporting these claims, the current review addresses the notion that childhood adversity-induced sleep disturbances may play a causal role in elevating individuals' stress vulnerability in adulthood. Corroborating this, sleep disturbances that predate adult trauma exposure have been associated with an increased likelihood of developing stress-related psychopathology post-exposure. Furthermore, novel empirical evidence suggests that sleep disturbances, including irregularity of the sleep-wake cycle, mediate the link between childhood adversity and stress vulnerability in adulthood. We also discuss cognitive and behavioral mechanisms through which such a cascade may evolve, highlighting the putative role of impaired memory consolidation and fear extinction. Next, we present evidence to support the contribution of the hypothalamic-pituitary-adrenal (HPA) axis to these associations, stemming from its critical role in stress and sleep regulatory pathways. Childhood adversity may yield bi-directional effects within the HPA stress and sleep axes in which sleep disturbances and HPA axis dysfunction reinforce each other, leading to elevated stress vulnerability. To conclude, we postulate a conceptual path model from childhood adversity to latent stress vulnerability in adulthood and discuss the potential clinical implications of these notions, while highlighting directions for future research.

Association between Hpa Axis Functioning and Mental Health in Maltreated Children and Adolescents: A Systematic Literature Review

BACKGROUND

Previous studies have demonstrated that children who experience maltreatment show a more elevated risk of psychopathological disorders than children from the general population. The HPA (hypothalamic-pituitary-adrenal) axis is not mature at birth and undergoes strong social regulation during the first years of life. Consequently, early exposure to stress could modify the usual adaptative response to stress. In stressful situations, perturbations in both cortisol response and cortisol circadian rhythm have been observed. Nevertheless, studies that have evaluated the links between child abuse, dysregulation of the HPA axis, and mental disorders have shown diverse results. Because of the variety of methods employed in the different studies, no formal comparisons have been made. In this systematic review, we have brought together these results.

METHODS

We conducted a systematic review of studies analyzing the correlation between child abuse, mental disorders, and HPA axis activity in patients aged between 6 and 16 years. PubMed, Scopus, Cochrane, and Google Scholar were searched using relevant keywords and inclusion/exclusion criteria (from 2000 to 2020).

RESULTS

Fifteen studies from the 351 identified were included. Most patients were children in the child welfare system. Children who had experienced child abuse presented with more severe mental disorders (particularly in the dimensional measure) than children who had not been abused. HPA axis activity was assessed by measuring basal cortisol for some studies and cortisol reactivity for other studies. For children experiencing child abuse, there was a possible association between abuse and a decrease in the reactivity of the HPA axis. In addition, early life stress could be associated with lower matinal cortisol. However, the association between mental disorders and cortisol secretion in maltreated children did not seem obvious.

CONCLUSIONS

This systematic review demonstrates that mental disorders are more frequent and severe in cases where child abuse has occurred. Moreover, children who experienced child abuse seem to present changes in the reactivity of the HPA axis. Nevertheless, the potential correlation between these changes in the reactivity of the HPA axis and mental disorders in this population needs to be evaluated in further studies.

Investigating mitochondrial bioenergetics in peripheral blood mononuclear cells of women with childhood maltreatment from post-parturition period to one-year follow-up

BACKGROUND

Childhood maltreatment (CM) exerts various long-lasting psychological and biological changes in affected individuals, with inflammation being an interconnecting element. Besides chronic low-grade inflammation, CM might also affect the energy production of cells by altering the function and density of mitochondria, i.e. the body's main energy suppliers. Here, we compared mitochondrial respiration and density in intact peripheral blood mononuclear cells (PBMC), from women with and without CM between two time points, i.e. at the highly inflammatory phase within 1 week after parturition (t0) and again after 1 year (t2).

METHODS

CM exposure was assessed with the Childhood Trauma Questionnaire. Whole blood was collected from n = 52 healthy women within the study 'My Childhood - Your Childhood' at both time points to isolate and cryopreserve PBMC. Thawed PBMC were used to measure mitochondrial respiration and density by high-resolution respirometry followed by spectrophotometric analyses of citrate-synthase activity.

RESULTS

Over time, quantitative respiratory parameters increased, while qualitative flux control ratios decreased, independently of CM. Women with CM showed higher mitochondrial respiration and density at t0, but not at t2. We found significant CM group × time interaction effects for ATP-turnover-related respiration and mitochondrial density.

CONCLUSIONS

This is the first study to longitudinally investigate mitochondrial bioenergetics in postpartum women with and without CM. Our results indicate that CM-related mitochondrial alterations reflect allostatic load, probably due to higher inflammatory states during parturition, which normalize later. However, later inflammatory states might moderate the vulnerability for a second-hit on the level of mitochondrial bioenergetics, at least in immune cells.

Early life stress impairs brain and mental development during childhood increasing the risk of developing psychiatric disorders

In recent years, it has become known that stress in childhood, called early life stress (ELS), affects the mental health of children, adolescents, and adults. Child maltreatment (CM) is an inappropriate form of childcare that interferes with children's normal brain and mind development. Previous studies have reported that CM severely affects brain development and function. For example, ELS causes brain vulnerability and increases the risk of developing psychiatric disorders. In addition, it is known that the different types and timing of abuse have different effects on the brain. Epidemiological and clinical studies are being conducted to understand the mechanism underlying abuse on a child's mental health and appropriate brain development; however, they are not fully understood. Therefore, studies using animal models, as well as humans, have been conducted to better understand the effects of CM. In this review, we discuss the effects of comparing previous findings on different types of CM in human and animal models. However, it should be noted that there are differences between animal models and humans such as genetic polymorphism and susceptibility to stress. Our review provides the latest insights into the negative effects of CM on children's development and on psychiatric disorders in adulthood.

Prenatal stress modulates HPA axis homeostasis of offspring through dentate TERT independently of glucocorticoids receptor

In response to stressful events, the hypothalamic-pituitary-adrenal (HPA) axis is activated, and consequently glucocorticoids are released by the adrenal gland into the blood circulation. A large body of research has illustrated that excessive glucocorticoids in the hippocampus exerts negative feedback regulation of the HPA axis through glucocorticoid receptor (GR), which is critical for the homeostasis of the HPA axis. Maternal prenatal stress causes dysfunction of the HPA axis feedback mechanism in their offspring in adulthood. Here we report that telomerase reverse transcriptase (TERT) gene knockout causes hyperactivity of the HPA axis without hippocampal GR deficiency. We found that the level of TERT in the dentate gyrus (DG) of the hippocampus during the developmental stage determines the responses of the HPA axis to stressful events in adulthood through modulating the excitability of the dentate granular cells (DGCs) rather than the expression of GR. Our study also suggests that the prenatal high level of glucocorticoids exposure-induced hypomethylation at Chr13:73764526 in the first exon of mouse Tert gene accounted for TERT deficiency in the DG and HPA axis abnormality in the adult offspring. This study reveals a novel GR-independent mechanism underlying prenatal stress-associated HPA axis impairment, providing a new angle for understanding the mechanisms for maintaining HPA axis homeostasis.

Childhood maltreatment disrupts HPA-axis activity under basal and stress conditions in a dose-response relationship in children and adolescents

BACKGROUND

This study investigates the impact of childhood maltreatment (CM) on hypothalamic-pituitary-adrenal (HPA)-axis functioning and on anxiety perception. Moreover, the influence of CM severity and frequency was also explored.

METHODS

In total, 187 participants aged 7-17 were assessed for CM history using validated questionnaires and ad hoc interviews to be classified according to the criteria of the Tool for Assessing the Severity of Situations in which Children are Vulnerable (TASSCV). Psychopathology was ascertained using the K-SADS-PL5. To assess HPA-axis functioning, salivary cortisol samples were collected throughout a normal day and during an acute psychosocial stressor, the Trier Social Stress Test for children (TSST-C). Subjective anxiety was evaluated using STAI/-C.

RESULTS

Youth with a CM history had higher overall diurnal cortisol levels (p = 0.001), blunted cortisol response to acute psychosocial stress (p = 0.002) and greater perceived anxiety (p = 0.003), than those without CM. Specifically, participants exposed to moderate/severe or often/frequent CM showed the greater diurnal cortisol output (p_severity = 0.002; p_frequency = 0.003), and blunted cortisol response during the TSST-C (p_severity = 0.006; p_frequency = 0.008). Meanwhile, youth with low CM severity/frequency exhibited a similar cortisol response to those without CM. However, perceived anxiety was higher in those exposed to CM (p < 0.001), regardless of its severity/frequency.

CONCLUSIONS

Disturbances in HPA-axis functioning are already evident early after CM exposure, while psychological and physiological responses to an acute stressor are dissociated in youth exposed to CM. The dose-response relationship described in this paper highlights the need to comprehensively evaluate CM so that vulnerable children can be identified and assigned to proper interventions.

Associations between HPA axis reactivity and PTSD and depressive symptoms: Importance of maltreatment type and puberty

The functioning of the hypothalamic-pituitary-adrenal (HPA) axis is implicated in the etiology and maintenance of depressive and posttraumatic stress disorder (PTSD) symptoms. However, different maltreatment experiences as well as the increased sensitivity of the HPA axis during puberty may alter associations between the HPA axis and mental health. To address these gaps, the current study examined the potential bidirectional associations between cortisol reactivity to a stressor, PTSD symptoms, and depressive symptoms among early adolescents across two time points, 1 year apart (n = 454; Mage = 10.98 at Time 1 and Mage = 12.11 at Time 2). Multiple-group path models tested the pathways between cortiol reactivity and mental health prior to and during puberty, for different types of maltreatment . Overall, the results showed that associations between cortisol output and symptoms of PTSD and depression were driven by those in the midst of puberty. Specifically, higher cortisol output at Time 1 was linked with higher levels of subsequent PTSD and depressive symptoms for neglected youth who had reached puberty. However, depressive symptoms predicted subsequent lower cortisol output for the physical abuse and emotional abuse groups. These findings demonstrate longitudinal links between cortisol, depressive symptoms, and PTSD symptoms among youth with different types of maltreatment histories and highlight the need to consider the reorganization of the stress system during puberty in order to advance our understanding of the HPA axis and mental health.

The body keeps the score: The neurobiological profile of traumatized adolescents

Trauma-related disorders are debilitating psychiatric conditions that affect people who have directly or indirectly witnessed adversities. Experiencing multiple types of traumas appears to be common during childhood, and even more so during adolescence. Dramatic brain/body transformations occurring during adolescence may provide a highly responsive substrate to external stimuli and lead to trauma-related vulnerability conditions, such as internalizing (anxiety, depression, anhedonia, withdrawal) and externalizing (aggression, delinquency, conduct disorders) problems. Analyzing relations among neuronal, endocrine, immune, and biochemical signatures of trauma and internalizing and externalizing behaviors, including the role of personality traits in shaping these conducts, this review highlights that the marked effects of traumatic experience on the brain/body involve changes at nearly every level of analysis, from brain structure, function and connectivity to endocrine and immune systems, from gene expression (including in the gut) to the development of personality.

Juvenile social isolation affects the structure of the tanycyte-vascular interface in the hypophyseal portal system of the adult mice

Accumulating evidence indicates that social stress in the juvenile period affects hypothalamic-pituitary-adrenal (HPA) axis activity in adulthood. The biological mechanisms underlying this phenomenon remain unclear. We aimed to elucidate them by comparing adult mice that had experienced social isolation from postnatal day 21-35 (juvenile social isolation (JSI) group) with those reared normally (control group). JSI group mice showed an attenuated HPA response to acute swim stress, while the control group had a normal response to this stress. Activity levels of the paraventricular nucleus in both groups were comparable, as shown by c-Fos immunoreactivities and mRNA expression of c-Fos, Corticotropin-releasing factor (CRF), Glucocorticoid receptor, and Mineralocorticoid receptor. We found greater vascular coverage by tanycytic endfeet in the median eminence of the JSI group mice than in that of the control group mice under basal condition and after acute swim stress. Moreover, CRF content after acute swim stress was greater in the median eminence of the JSI group mice than in that of the control group mice. The attenuated HPA response to acute swim stress was specific to JSI group mice, but not to control group mice. Although a direct link awaits further experiments, tanycyte morphological changes in the median eminence could be related to the HPA response.

Early-life stress and current stress predict BMI and height growth trajectories in puberty

In cross-sectional analyses, early institutional care is associated with shorter stature but not obesity during puberty in children adopted into US families. We examined whether shorter stature and leaner body composition in youth adopted internationally from institutions would continue as puberty progressed. We also examined whether current psychosocial stress would moderate the association between early institutional deprivation and growth during adolescence. Using an accelerated longitudinal design and linear mixed-effects models, we examined the height and body mass index (BMI) of 132 previously institutionalized (PI) and 176 nonadopted (NA) youth. We examined youth aged 7-15 at the beginning of the study three times across 2 years. Nurses assessed anthropometrics and pubertal status. Current psychosocial stress was measured using the Youth Life Stress Interview. Our results indicated that PI youth remained shorter and leaner across three assessments than NA youth. However, age-and-sex-adjusted BMI increased faster in PI youth. Psychosocial stress during puberty predicted greater age-and-sex-adjusted BMI, but this effect did not differ by group. The gap in BMI but not height appears to close between PI and NA youth. Higher psychosocial stress was associated with higher BMI during puberty.

The impact of childhood trauma and daily life experiences on emotional and psychotic symptom intensity in psychosis: An experience sampling study

Adverse childhood experiences create vulnerability to psychosis through biological and cognitive changes, and that may be observed as an increased emotional and psychotic response to daily life experiences in adulthood. This study aims to examine the effects of childhood maltreatment on psychotic patients' daily stress and emotional and psychotic intensity related to various experiences throughout the day. Daily activities and events, and emotional and psychotic intensity of forty-one psychotic patients were assessed with the Experience Sampling Method. The Childhood Trauma Questionnaire (CTQ) was used to evaluate childhood adversities. Multilevel regression analyses showed that all trauma subtypes, except for sexual abuse, were associated with increased psychosis and event-stress. Emotional maltreatment was the most associated trauma type with high negative and low positive affect and increased daily stress. Patients reported the highest stress and negative affect related to internal experiences but the lowest stress related to recreational actions. Social activities were also associated with higher positive affect and lower stress and psychosis, with the high CTQ group having greater stress in those activities. Our study demonstrates the negative impact of childhood trauma, especially emotional maltreatment, on daily stress and emotional and psychotic intensity in psychotic patients via different daily experiences.

Stress and reward: A multimodal assessment of childhood sexual abuse

Background

Childhood adversity has been found to impact stress and brain reward systems but it is unclear whether interactions between these systems might explain resilient vs. non-resilient trajectories following childhood sexual abuse (CSA). To address this gap, we adopted a multimodal approach in which cortisol reactivity to an acute stressor was assessed in conjunction with behavioral and neural measures of reward responsiveness in females with major depressive disorder (MDD) or no psychiatric disorders (i.e., resilient) who experienced CSA compared to females with and without MDD who did not experience abuse.

Methods

Latent Class Mixed Modelling (LCMM) identified classes of adults (n = 62; MAge = 26.48, SD = 5.68) characterized by distinct cortisol trajectories in response to a combined social evaluative cold pressor task. Classes were examined for their history of CSA and resilience as well as behavioral and neural measures of reward responsiveness using 128-channel electroencephalography (event-related potentials and source localization analysis).

Results

LCMM analysis identified two distinct classes of individuals with increased (Responders) or blunted (Non-Responders) cortisol reactivity to an acute stressor. Unlike Responders, Non-Responders did not modulate reward responses throughout the stress manipulation. No differences emerged between Responders and Non-Responders in terms of CSA or resilience. However, exploratory results showed that blunted cortisol response and non-modulation of reward responses emerged for those who experienced CSA at a younger age.

Conclusions

Co-occurring blunted stress and reward reactivity emerged irrespective of adults' experience of CSA or resilience. However, preliminary findings showed that CSA ending during peripubertal development was associated with blunted cortisol and reward responsiveness. Future research needs to replicate findings in larger samples and could investigate if increasing reward responsiveness during critical times of neurodevelopment could normalize stress reactivity to future stressors and thus promote resilience.

Sex-specific behavioral outcomes of early-life adversity and emerging microglia-dependent mechanisms

Early-life adversity (ELA) is known to alter brain circuit maturation as well as increase vulnerability to cognitive and emotional disorders. However, the importance of examining sex as a biological variable when researching the effects of ELA has not been considered until recently. This perspective discusses the sex-specific behavioral outcomes of ELA in both humans and animal models, then proposes microglia-mediated mechanisms as a potential underlying cause. Recent work in rodent models suggests that ELA provokes cognitive deficits, anhedonia, and alcohol abuse primarily in males, whereas females exhibit greater risk-taking and opioid addiction-related behaviors. In addition, emerging evidence identifies microglia as a key target of ELA. For example, we have recently shown that ELA inhibits microglial synapse engulfment and process dynamics in male mice, leading to an increase in excitatory synapse number onto corticotrophin-releasing hormone (CRH)-expressing neurons in the paraventricular nucleus of the hypothalamus (PVN) and aberrant stress responses later in life. However, ELA-induced synaptic rewiring of neural circuits differs in females during development, resulting in divergent behavioral outcomes. Thus, examining the role of microglia in the sex-specific mechanisms underlying ELA-induced neuropsychiatric disorders is an important topic for future research.

Childhood trauma moderates morphometric associations between orbitofrontal cortex and amygdala: implications for pathological personality traits

BACKGROUND

Research has demonstrated that chronic stress exposure early in development can lead to detrimental alterations in the orbitofrontal cortex (OFC)-amygdala circuit. However, the majority of this research uses functional neuroimaging methods, and thus the extent to which childhood trauma corresponds to morphometric alterations in this limbic-cortical network has not yet been investigated. This study had two primary objectives: (i) to test whether anatomical associations between OFC-amygdala differed between adults as a function of exposure to chronic childhood assaultive trauma and (ii) to test how these environment-by-neurobiological effects relate to pathological personality traits.

METHODS

Participants were 137 ethnically diverse adults (48.1% female) recruited from the community who completed a clinical diagnostic interview, a self-report measure of pathological personality traits, and anatomical MRI scans.

RESULTS

Findings revealed that childhood trauma moderated bilateral OFC-amygdala volumetric associations. Specifically, adults with childhood trauma exposure showed a positive association between medial OFC volume and amygdalar volume, whereas adults with no childhood exposure showed the negative OFC-amygdala structural association observed in prior research with healthy samples. Examination of the translational relevance of trauma-related alterations in OFC-amygdala volumetric associations for disordered personality traits revealed that trauma exposure moderated the association of OFC volume with antagonistic and disinhibited phenotypes, traits characteristic of Cluster B personality disorders.

CONCLUSIONS

The OFC-amygdala circuit is a potential anatomical pathway through which early traumatic experiences perpetuate emotional dysregulation into adulthood and confer risk for personality pathology. Results provide novel evidence of divergent neuroanatomical pathways to similar personality phenotypes depending on early trauma exposure.

Perinatal and early childhood biomarkers of psychosocial stress and adverse experiences

The human brain develops through a complex interplay of genetic and environmental influences. During critical periods of development, experiences shape brain architecture, often with long-lasting effects. If experiences are adverse, the effects may include the risk of mental and physical disease, whereas positive environments may increase the likelihood of healthy outcomes. Understanding how psychosocial stress and adverse experiences are embedded in biological systems and how we can identify markers of risk may lead to discovering new approaches to improve patient care and outcomes. Biomarkers can be used to identify specific intervention targets and at-risk children early when physiological system malleability increases the likelihood of intervention success. However, identifying reliable biomarkers has been challenging, particularly in the perinatal period and the first years of life, including in preterm infants. This review explores the landscape of psychosocial stress and adverse experience biomarkers. We highlight potential benefits and challenges of identifying risk clinically and different sub-signatures of stress, and in their ability to inform targeted interventions. Finally, we propose that the combination of preterm birth and adversity amplifies the risk for abnormal development and calls for a focus on this group of infants within the field of psychosocial stress and adverse experience biomarkers. IMPACT: Reviews the landscape of biomarkers of psychosocial stress and adverse experiences in the perinatal period and early childhood and highlights the potential benefits and challenges of their clinical utility in identifying risk status in children, and in developing targeted interventions. Explores associations between psychosocial stress and adverse experiences in childhood with prematurity and identifies potential areas of assessment and intervention to improve outcomes in this at-risk group.

Is Childhood Maltreatment Associated with Body Image Disturbances in Adulthood? A Systematic Review and Meta-Analysis

PURPOSE

We aimed to synthesize the evidence for an association between childhood maltreatment and body image disturbances in adulthood. Information on maltreatment subtypes and mediator variables was included to gain further insights into the mechanisms of the association. In addition, we aimed to examine the role of body image disturbances in the development of negative mental health outcomes associated with childhood maltreatment.

METHODS

Based on a comprehensive search strategy, eligible studies were identified in PubMed, Scopus, and Web of Science. The eligibility assessment was performed by two reviewers, and 132 articles were studied full-text. To reduce heterogeneity, only non-clinical samples were included in the meta-analysis. A meta-regression was computed to examine the influence of maltreatment subtype on body image disturbances.

RESULTS

Our results provide evidence for a robust association between childhood maltreatment and cognitive-affective body image, both in clinical and community samples. Included studies (N = 40) indicate that body image disturbances are especially pronounced in individuals suffering from Posttraumatic Stress Disorder (PTSD) after childhood maltreatment. The meta-analysis included 12 studies with a total of 15.481 participants, and indicates a small overall effect size (r = 0.21, 95% CI = [0.16, 0.26], p < .001). Meta-regression revealed no significant impact of maltreatment subtype in non-clinical samples.

CONCLUSION

Childhood maltreatment should be considered as a distal risk factor for the development of a negative cognitive-affective body image. We argue for future longitudinal studies which allow a better understanding of the pathways linking childhood maltreatment, body image disturbances and associated psychopathology.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40653-021-00379-5.

Nature-Based Relaxation Videos and Their Effect on Heart Rate Variability

Growing evidence suggests that natural environments – whether in outdoor or indoor settings – foster psychological health and physiological relaxation, indicated by increased wellbeing, reduced stress levels, and increased parasympathetic activity. Greater insight into differential psychological aspects modulating psychophysiological responses to nature-based relaxation videos could help understand modes of action and develop personalized relaxation interventions. We investigated heart rate variability (HRV) as an indicator of autonomic regulation, specifically parasympathetic activity, in response to a 10-min video intervention in two consecutive studies as well as heart rate (HR). We hypothesized that a nature-based relaxation video elicits HRV increase and HR decrease, with response magnitude being affected by aspects of early life adversity (conceptualized as low parental care and high overprotection/constraint) and trait mindfulness. In Study 1, N = 60 participants (52% female, age_mean = 23.92 ± 3.13 years, age_range = 18–34 years) watched a relaxation video intervention depicting different natural scenery. We analyzed changes in HR and respiratory sinus arrhythmia (RSA) as a standard HRV measure, both based on 3-min segments from the experimental session, in multiple growth curve models. We found a decrease in HR and increase of RSA during the video intervention. Higher paternal care and lower trait mindfulness observing skills (assessed via questionnaires) were associated with higher RSA values before but not during video exposure. In Study 2, N = 90 participants (50% female, age_mean = 22.63 ± 4.57 years, age_range = 18–49 years) were assigned to three video conditions: natural scenery from Study 1, meditation video, or short clip from “The Lord of the Rings.” Again, HR decreased, and RSA increased during video segments, yet without expected group differences across different video types. We found higher parental care and lower parental overprotection to predict higher RSA at different times during the experiment. Interestingly, lower paternal overprotection predicted overall higher RSA. These results suggest a generic relaxation effect of video interventions on autonomic regulation that we discuss in light of different theories mapping restorative effects of natural environments. Further, psychological characteristics like aspects of early life adversity and trait mindfulness could contribute to individual differences in autonomic regulation. This study contributes to a better understanding of autonomic and psychological responses to relaxation videos.

Early Adversity and Changes in Cortisol and Negative Affect in Response to Interpersonal Threats in the Laboratory

Adverse childhood experiences, such as abuse and neglect, are associated with poor health outcomes. This association may be partially explained by differences in stress physiology. Though most early adverse experiences occur within the context of interpersonal relationships, stress exposures manipulated in the laboratory rarely involve interpersonal interactions beyond the mere presence of others. This study examines whether adverse childhood experiences are associated with differences in affective and cortisol reactivity to two stressors which may more closely resemble the powerlessness and the lack of control characteristic of many adverse childhood experiences: a dominant (vs. submissive) interaction partner and lower (vs. higher) social status. We also manipulate social-evaluative threat as a test of whether these interpersonal stressors are more germane to stress reactivity associated with early adversity than the performance anxiety evoked by more traditional laboratory stressors, such as the Trier Social Stress Test. The results partially support the hypothesis that participants with greater early adversity may be more reactive to interpersonal stressors reminiscent of early adverse experience. Given the interpersonal nature of most adverse childhood experiences, conceptualizing and measuring associations with stress physiology in an interpersonal context may more closely capture the psychological and biological embedding of these early experiences.

In vivo social regulation of high-risk parenting: A conceptual model of Parent-Child Interaction Therapy for child maltreatment prevention

Meta-analyses show that Parent-Child Interaction Therapy (PCIT) significantly reduces child abuse and neglect in families where maltreatment has already occurred; however, research into the underlying mechanisms of change (i.e., how PCIT effects positive changes in parenting) remains limited. In this article, we discuss a new conceptual model of PCIT's active ingredients that is informed by biobehavioral research documenting the physiological underpinnings of problematic parenting. We describe deficits in self-regulation observed in child maltreating parents and PCIT's unique live coaching approach and associated techniques that may form the basis for in-vivo social regulation in the act of parenting that supports more effective, positive parenting behavior, strengthens parents' self-regulation skills, and reduces child maltreatment.

Adverse childhood experiences and late-life diurnal HPA axis activity: Associations of different childhood adversity types and interaction with timing in a sample of older East Prussian World War II refugees

Adverse childhood experiences (ACEs) have been associated with unfavorable health outcomes throughout the life up to old age. Mechanisms through which ACEs impact later life health are still not entirely clear. There is growing evidence for the idea that alterations in the hypothalamic pituitary adrenal (HPA) axis might cause the effects of ACEs on later health consequences. Only few studies have investigated associations between ACEs and diurnal HPA axis functioning in older adults. Therefore, we investigated the impact of type and timing of ACEs linked to flight of war on diurnal HPA axis activity in a sample of East Prussian World War II refugees aged 74-91 years. We calculated a dichotomous variable according to the (minimum) age at trauma: early ACE (eACE; 0-5 years) and late ACE (lACE; 6-17 years). Multiple linear regression analysis using different ACEs linked to flight of war (war-related trauma, individual experience of violence, neglect) as well as age at trauma and the interactions of ACEs and age at trauma as predictors and three cortisol outcomes (AUC_G (area under the curve with respect to the ground), decline (morning to night) and CAR (cortisol awakening response)) was performed. For AUC_G, we found a negative association of individual experience of violence only in lACE participants. For decline, a positive association with neglect was observed for the whole study sample. The overall model for CAR was not statistically significant. Our findings support the hypothesis that type as well as timing of ACEs might influence diurnal HPA axis functioning into old age. These findings may contribute to a better understanding of the lifelong influence of ACEs.

Suicide: Allostatic regulation and resilience

Suicide is a complex public health problem that is the result of a number of intertwined biopsychosocial factors. The diathesis-stress model suggests that suicide is the result of an interaction between genetic vulnerability and environmental stressors. Chronic stress and trauma contribute to biologic adaptations, including hypothalamus-pituitary-adrenal axis dysregulation, that contribute to the degradation of regulatory mechanisms and promote wear and tear the body, represented by allostatic load (AL). AL has been associated with a number of negative outcomes, including mental health problems and suicide. Fortunately, there are pharmacological and non-pharmacological interventions that are effective at reducing AL and reversing its effects. Thus, AL may provide a construct for supporting early risk identification, prevention, and treatment of suicide. AL biomarkers that are amenable to measurable change, effective treatments to reduce AL and perhaps help prevent suicide, and how to best tailor them to the individual and societal levels are important avenues of therapeutic inquiry.