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Buthmann JL, Miller JG, Uy JP, Coury SM, Jo B, Gotlib IH. Early life stress predicts trajectories of emotional problems and hippocampal volume in adolescence. Eur Child Adolesc Psychiatry 2024; 33:2331-2342. [PMID: 38135803 DOI: 10.1007/s00787-023-02331-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/28/2023] [Indexed: 12/24/2023]
Abstract
Exposure to early life stress (ELS) has been consistently associated with adverse emotional and neural consequences in youth. The development of brain structures such as the hippocampus, which plays a significant role in stress and emotion regulation, may be particularly salient in the development of psychopathology. Prior work has documented smaller hippocampal volume (HCV) in relation to both ELS exposure and risk for psychopathology. We used longitudinal k-means clustering to identify simultaneous trajectories of HCV and emotional problems in 155 youth across three assessments conducted approximately two years apart (mean baseline age = 11.33 years, 57% female). We also examined depressive symptoms and resilience approximately two years after the third timepoint. We identified three clusters of participants: a cluster with high HCV and low emotional problems; a cluster with low HCV and high emotional problems; and a cluster with low HCV and low emotional problems. Importantly, severity of ELS was associated with greater likelihood of belonging to the low HCV/high symptom cluster than to the low HCV/low symptom cluster. Further, low HCV/high symptom participants had more depressive symptoms and lower resilience scores than did participants in the low HCV/low symptom, but not than in the high HCV/low symptom cluster. Our findings suggest that smaller HCV indexes biological sensitivity to stress. This adds to our understanding of the ways in which ELS can affect hippocampal and emotional development in young people and points to hippocampal volume as a marker of susceptibility to context.
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Affiliation(s)
- Jessica L Buthmann
- Department of Psychology, Stanford University, 450 Jane Stanford Way, Stanford, CA, 94305, USA.
| | - Jonas G Miller
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Jessica P Uy
- Department of Psychology, Stanford University, 450 Jane Stanford Way, Stanford, CA, 94305, USA
| | - Saché M Coury
- Department of Psychology, Stanford University, 450 Jane Stanford Way, Stanford, CA, 94305, USA
| | - Booil Jo
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Ian H Gotlib
- Department of Psychology, Stanford University, 450 Jane Stanford Way, Stanford, CA, 94305, USA
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Amédée LM, Cyr C, Jean-Thorn A, Hébert M. Executive functioning in child victims of sexual abuse: A multi-informant comparative study. CHILD ABUSE & NEGLECT 2024; 152:106737. [PMID: 38564916 DOI: 10.1016/j.chiabu.2024.106737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 03/01/2024] [Accepted: 03/05/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Research examining the association between child sexual abuse and executive functions is limited. Yet, exposure to traumatic situations at a young age has been associated with changes in the prefrontal cortex, which hosts executive functions (Wesarg et al., 2020). These functions are crucial for social adaptation, as they make it possible to inhibit maladaptive behavior and respond flexibly to the demands of the environment. As middle childhood is a sensitive period for the development of self-regulatory abilities, exploring executive functioning in school-age children could provide potential intervention targets (Dajani & Uddin, 2015). OBJECTIVE Using multiple informants, this study compared executive functioning of sexually abused children to that of non-sexually victimized children and examined whether the differences were moderated by sex. METHODS The sample consisted of 225, 6-to-12 years old children with a history of child sexual abuse (CSA) and 97 children without a history of CSA. Children completed two executive functioning tasks measuring cognitive flexibility and inhibition. Parents and teachers completed questionnaires evaluating children's executive functioning. RESULTS In comparison to non-abused children, children with a history of CSA displayed greater executive functioning difficulties as assessed by both informant-reported questionnaires and self-completed tasks. Significant interaction effects were found, such as CSA predicting lower inhibition and executive functions at school in boys but not in girls. CONCLUSION This study is a first step in understanding the association between CSA and executive functioning and offers a clearer picture of the differential impact of sexual trauma according to children's sex.
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Alkema A, Marchi M, van der Zaag JAJ, van der Sluis D, Warrier V, Ophoff RA, Kahn RS, Cahn W, Hovens JGFM, Riese H, Scheepers F, Penninx BWJH, Cecil C, Oldehinkel AJ, Vinkers CH, Boks MPM. Childhood abuse v. neglect and risk for major psychiatric disorders. Psychol Med 2024; 54:1598-1609. [PMID: 38018135 DOI: 10.1017/s0033291723003471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
BACKGROUND Childhood maltreatment (CM) is a strong risk factor for psychiatric disorders but serves in its current definitions as an umbrella for various fundamentally different childhood experiences. As first step toward a more refined analysis of the impact of CM, our objective is to revisit the relation of abuse and neglect, major subtypes of CM, with symptoms across disorders. METHODS Three longitudinal studies of major depressive disorder (MDD, N = 1240), bipolar disorder (BD, N = 1339), and schizophrenia (SCZ, N = 577), each including controls (N = 881), were analyzed. Multivariate regression models were used to examine the relation between exposure to abuse, neglect, or their combination to the odds for MDD, BD, SCZ, and symptoms across disorders. Bidirectional Mendelian randomization (MR) was used to probe causality, using genetic instruments of abuse and neglect derived from UK Biobank data (N = 143 473). RESULTS Abuse was the stronger risk factor for SCZ (OR 3.51, 95% CI 2.17-5.67) and neglect for BD (OR 2.69, 95% CI 2.09-3.46). Combined CM was related to increased risk exceeding additive effects of abuse and neglect for MDD (RERI = 1.4) and BD (RERI = 1.1). Across disorders, abuse was associated with hallucinations (OR 2.16, 95% CI 1.55-3.01) and suicide attempts (OR 2.16, 95% CI 1.55-3.01) whereas neglect was associated with agitation (OR 1.24, 95% CI 1.02-1.51) and reduced need for sleep (OR 1.64, 95% CI 1.08-2.48). MR analyses were consistent with a bidirectional causal effect of abuse with SCZ (IVWforward = 0.13, 95% CI 0.01-0.24). CONCLUSIONS Childhood abuse and neglect are associated with different risks to psychiatric symptoms and disorders. Unraveling the origin of these differences may advance understanding of disease etiology and ultimately facilitate development of improved personalized treatment strategies.
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Affiliation(s)
- Anne Alkema
- Department of Psychiatry, Brain Center University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands
| | - Mattia Marchi
- Department of Psychiatry, Brain Center University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Jeroen A J van der Zaag
- Department of Psychiatry, Brain Center University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands
| | - Daniëlle van der Sluis
- Department of Psychiatry, Brain Center University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands
| | - Varun Warrier
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridgeshire, UK
| | - Roel A Ophoff
- Department of Psychiatry and Biobehavioral Science, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - René S Kahn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Wiepke Cahn
- Department of Psychiatry, Brain Center University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands
| | | | - Harriëtte Riese
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Floortje Scheepers
- Department of Psychiatry, Brain Center University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam Public Health and Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Charlotte Cecil
- Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Albertine J Oldehinkel
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Christiaan H Vinkers
- Department of Psychiatry and Anatomy & Neurosciences, Amsterdam University Medical Center location Vrije Universiteit Amsterdam, The Netherlands
- Amsterdam Public Health (Mental Health program) and Amsterdam Neuroscience (Mood, Anxiety, Psychosis, Stress & Sleep program) Research Institutes, Amsterdam, The Netherlands
- GGZ inGeest Mental Health Care, Amsterdam, The Netherlands
| | - Marco P M Boks
- Department of Psychiatry, Brain Center University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands
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Grauduszus Y, Sicorello M, Demirakca T, von Schröder C, Schmahl C, Ende G. New insights into the effects of type and timing of childhood maltreatment on brain morphometry. Sci Rep 2024; 14:11394. [PMID: 38762570 PMCID: PMC11102438 DOI: 10.1038/s41598-024-62051-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 05/10/2024] [Indexed: 05/20/2024] Open
Abstract
Childhood maltreatment (CM) is known to influence brain development. To obtain a better understanding of related brain alterations, recent research has focused on the influence of the type and timing of CM. We aimed to investigate the association between type and timing of CM and local brain volume. Anatomical magnetic resonance images were collected from 93 participants (79 female/14 male) with a history of CM. CM history was assessed with the German Interview Version of the "Maltreatment and Abuse Chronology of Exposure" scale, "KERF-40 + ". Random forest regressions were performed to assess the impact of CM characteristics on the volume of amygdala, hippocampus and anterior cingulate cortex (ACC). The volume of the left ACC was predicted by neglect at age 3 and 4 and abuse at age 16 in a model including both type and timing of CM. For the right ACC, overall CM severity and duration had the greatest impact on volumetric alterations. Our data point to an influence of CM timing on left ACC volume, which was most pronounced in early childhood and in adolescence. We were not able to replicate previously reported effects of maltreatment type and timing on amygdala and hippocampal volume.
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Affiliation(s)
- Yasmin Grauduszus
- Department of Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
| | - Maurizio Sicorello
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Traute Demirakca
- Department of Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Claudius von Schröder
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Gabriele Ende
- Department of Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Quidé Y, Watkeys OJ, Tonini E, Grotegerd D, Dannlowski U, Nenadić I, Kircher T, Krug A, Hahn T, Meinert S, Goltermann J, Gruber M, Stein F, Brosch K, Wroblewski A, Thomas-Odenthal F, Usemann P, Straube B, Alexander N, Leehr EJ, Bauer J, Winter NR, Fisch L, Dohm K, Rössler W, Smigielski L, DeRosse P, Moyett A, Houenou J, Leboyer M, Gilleen J, Thomopoulos SI, Thompson PM, Aleman A, Modinos G, Green MJ. Childhood trauma moderates schizotypy-related brain morphology: analyses of 1182 healthy individuals from the ENIGMA schizotypy working group. Psychol Med 2024; 54:1215-1227. [PMID: 37859592 DOI: 10.1017/s0033291723003045] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
BACKGROUND Schizotypy represents an index of psychosis-proneness in the general population, often associated with childhood trauma exposure. Both schizotypy and childhood trauma are linked to structural brain alterations, and it is possible that trauma exposure moderates the extent of brain morphological differences associated with schizotypy. METHODS We addressed this question using data from a total of 1182 healthy adults (age range: 18-65 years old, 647 females/535 males), pooled from nine sites worldwide, contributing to the Enhancing NeuroImaging Genetics through Meta-Analysis (ENIGMA) Schizotypy working group. All participants completed both the Schizotypal Personality Questionnaire Brief version (SPQ-B), and the Childhood Trauma Questionnaire (CTQ), and underwent a 3D T1-weighted brain MRI scan from which regional indices of subcortical gray matter volume and cortical thickness were determined. RESULTS A series of multiple linear regressions revealed that differences in cortical thickness in four regions-of-interest were significantly associated with interactions between schizotypy and trauma; subsequent moderation analyses indicated that increasing levels of schizotypy were associated with thicker left caudal anterior cingulate gyrus, right middle temporal gyrus and insula, and thinner left caudal middle frontal gyrus, in people exposed to higher (but not low or average) levels of childhood trauma. This was found in the context of morphological changes directly associated with increasing levels of schizotypy or increasing levels of childhood trauma exposure. CONCLUSIONS These results suggest that alterations in brain regions critical for higher cognitive and integrative processes that are associated with schizotypy may be enhanced in individuals exposed to high levels of trauma.
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Affiliation(s)
- Yann Quidé
- NeuroRecovery Research Hub, School of Psychology, UNSW Sydney, Sydney, NSW, Australia
- Neuroscience Research Australia, Randwick, NSW, Australia
| | - Oliver J Watkeys
- Neuroscience Research Australia, Randwick, NSW, Australia
- School of Clinical Medicine, Discipline of Psychiatry and Mental Health, UNSW Sydney, Sydney, NSW, Australia
| | - Emiliana Tonini
- Neuroscience Research Australia, Randwick, NSW, Australia
- School of Clinical Medicine, Discipline of Psychiatry and Mental Health, UNSW Sydney, Sydney, NSW, Australia
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, Philipps Universität Marburg, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Philipps Universität Marburg, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
| | - Axel Krug
- Department of Psychiatry and Psychotherapy, Philipps Universität Marburg, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Tim Hahn
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Susanne Meinert
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Institute for Translational Neuroscience, University of Münster, Münster, Germany
| | - Janik Goltermann
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Marius Gruber
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Department for Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy, Philipps Universität Marburg, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, Philipps Universität Marburg, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
| | - Adrian Wroblewski
- Department of Psychiatry and Psychotherapy, Philipps Universität Marburg, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
| | - Florian Thomas-Odenthal
- Department of Psychiatry and Psychotherapy, Philipps Universität Marburg, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
| | - Paula Usemann
- Department of Psychiatry and Psychotherapy, Philipps Universität Marburg, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
| | - Benjamin Straube
- Department of Psychiatry and Psychotherapy, Philipps Universität Marburg, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
| | - Nina Alexander
- Department of Psychiatry and Psychotherapy, Philipps Universität Marburg, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
| | - Elisabeth J Leehr
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Jochen Bauer
- Clinic for Radiology, University Hospital Münster, Münster, Germany
| | - Nils R Winter
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Lukas Fisch
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Katharina Dohm
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Wulf Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
- Laboratory of Neuroscience (LIM 27), Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Lukasz Smigielski
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Child and Adolescent Psychiatry, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Pamela DeRosse
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Ashley Moyett
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
| | - Josselin Houenou
- Université Paris Est Créteil, Mondor University Hospitals, DMU IMPACT, APHP, INSERM U955 Team "Translational NeuroPsychiatry", Créteil, France
- Fondation FondaMental, Créteil, France
- NeuroSpin neuroimaging platform, UNIACT Lab, PsyBrain team, CEA Saclay, Gif-Sur-Yvette, France
| | - Marion Leboyer
- Université Paris Est Créteil, Mondor University Hospitals, DMU IMPACT, APHP, INSERM U955 Team "Translational NeuroPsychiatry", Créteil, France
- Fondation FondaMental, Créteil, France
| | - James Gilleen
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- School of Psychology, University of Roehampton, London, UK
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - André Aleman
- Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Gemma Modinos
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- MRC Centre for Neurodevelopmental Disorders, King's College London, London, UK
| | - Melissa J Green
- Neuroscience Research Australia, Randwick, NSW, Australia
- School of Clinical Medicine, Discipline of Psychiatry and Mental Health, UNSW Sydney, Sydney, NSW, Australia
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Seitz KI, Sicorello M, Schmitz M, Valencia N, Herpertz SC, Bertsch K, Neukel C. Childhood Maltreatment and Amygdala Response to Interpersonal Threat in a Transdiagnostic Adult Sample: The Role of Trait Dissociation. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024:S2451-9022(24)00016-8. [PMID: 38280631 DOI: 10.1016/j.bpsc.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 01/11/2024] [Accepted: 01/18/2024] [Indexed: 01/29/2024]
Abstract
BACKGROUND Childhood maltreatment (CM) confers risk for different mental disorders as well as transdiagnostic symptoms such as dissociation. Aberrant amygdala response to interpersonal threat may link CM to transdiagnostic psychopathology and has recently been shown to depend on type and developmental timing of CM experiences. Still, most studies on CM and threat-related amygdala response employ categorical disorder-specific perspectives and fail to consider type and timing of CM exposure. We aimed to investigate associations between CM, amygdala response to interpersonal threat, and dimensional psychopathological symptoms including trait dissociation in a transdiagnostic adult sample, specifically considering type, timing, and duration of CM. METHODS We conducted a cross-sectional neuroimaging study in 141 participants with varying levels of CM, including mostly female participants with major depressive disorder (n = 36), posttraumatic stress disorder (n = 34), and somatic symptom disorder (n = 35) and healthy volunteers (n = 36). Participants underwent functional magnetic resonance imaging during an emotional face-matching task, completed the brief German interview version of the Maltreatment and Abuse Chronology of Exposure scale, and answered self-report measures of transdiagnostic CM-related symptoms including trait dissociation. Data were analyzed using a machine learning-based model comparison procedure. RESULTS In our transdiagnostic sample, neither type nor timing or duration of CM predicted amygdala response to interpersonal threat. Instead, trait dissociation predicted blunted bilateral amygdala response and emerged as a possible mediator between CM and amygdala function. CONCLUSIONS Trait dissociation may be an important confounder in the widely documented association between CM and threat-related amygdala response, which should be considered in future longitudinal studies.
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Affiliation(s)
- Katja I Seitz
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Heidelberg, Germany; German Center for Mental Health (DZPG), partner site Mannheim, Heidelberg, Ulm, Germany.
| | - Maurizio Sicorello
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Marius Schmitz
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Noel Valencia
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Sabine C Herpertz
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Heidelberg, Germany; German Center for Mental Health (DZPG), partner site Mannheim, Heidelberg, Ulm, Germany
| | - Katja Bertsch
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Heidelberg, Germany; Department of Psychology, Ludwig-Maximilians-University Munich, Munich, Germany; Department of Psychology, Julius-Maximilians-University Wuerzburg, Wuerzburg, Germany
| | - Corinne Neukel
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Heidelberg, Germany; German Center for Mental Health (DZPG), partner site Mannheim, Heidelberg, Ulm, Germany
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Burback L, Brémault-Phillips S, Nijdam MJ, McFarlane A, Vermetten E. Treatment of Posttraumatic Stress Disorder: A State-of-the-art Review. Curr Neuropharmacol 2024; 22:557-635. [PMID: 37132142 PMCID: PMC10845104 DOI: 10.2174/1570159x21666230428091433] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/19/2023] [Accepted: 02/23/2023] [Indexed: 05/04/2023] Open
Abstract
This narrative state-of-the-art review paper describes the progress in the understanding and treatment of Posttraumatic Stress Disorder (PTSD). Over the last four decades, the scientific landscape has matured, with many interdisciplinary contributions to understanding its diagnosis, etiology, and epidemiology. Advances in genetics, neurobiology, stress pathophysiology, and brain imaging have made it apparent that chronic PTSD is a systemic disorder with high allostatic load. The current state of PTSD treatment includes a wide variety of pharmacological and psychotherapeutic approaches, of which many are evidence-based. However, the myriad challenges inherent in the disorder, such as individual and systemic barriers to good treatment outcome, comorbidity, emotional dysregulation, suicidality, dissociation, substance use, and trauma-related guilt and shame, often render treatment response suboptimal. These challenges are discussed as drivers for emerging novel treatment approaches, including early interventions in the Golden Hours, pharmacological and psychotherapeutic interventions, medication augmentation interventions, the use of psychedelics, as well as interventions targeting the brain and nervous system. All of this aims to improve symptom relief and clinical outcomes. Finally, a phase orientation to treatment is recognized as a tool to strategize treatment of the disorder, and position interventions in step with the progression of the pathophysiology. Revisions to guidelines and systems of care will be needed to incorporate innovative treatments as evidence emerges and they become mainstream. This generation is well-positioned to address the devastating and often chronic disabling impact of traumatic stress events through holistic, cutting-edge clinical efforts and interdisciplinary research.
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Affiliation(s)
- Lisa Burback
- Department of Psychiatry, University of Alberta, Edmonton, Canada
| | | | - Mirjam J. Nijdam
- ARQ National Psychotrauma Center, Diemen, The Netherlands
- Department of Psychiatry, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | | | - Eric Vermetten
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- Department of Psychiatry, New York University Grossman School of Medicine, New York, USA
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8
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Mazurka R, Cunningham S, Hassel S, Foster JA, Nogovitsyn N, Fiori LM, Strother SC, Arnott SR, Frey BN, Lam RW, MacQueen GM, Milev RV, Rotzinger S, Turecki G, Kennedy SH, Harkness KL. Relation of hippocampal volume and SGK1 gene expression to treatment remission in major depression is moderated by childhood maltreatment: A CAN-BIND-1 report. Eur Neuropsychopharmacol 2024; 78:71-80. [PMID: 38128154 DOI: 10.1016/j.euroneuro.2023.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 12/01/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023]
Abstract
Preclinical research implicates stress-induced upregulation of the enzyme, serum- and glucocorticoid-regulated kinase 1 (SGK1), in reduced hippocampal volume. In the current study, we tested the hypothesis that greater SGK1 mRNA expression in humans would be associated with lower hippocampal volume, but only among those with a history of prolonged stress exposure, operationalized as childhood maltreatment (physical, sexual, and/or emotional abuse). Further, we examined whether baseline levels of SGK1 and hippocampal volume, or changes in these markers over the course of antidepressant treatment, would predict treatment outcomes in adults with major depression [MDD]. We assessed SGK1 mRNA expression from peripheral blood, and left and right hippocampal volume at baseline, as well as change in these markers over the first 8 weeks of a 16-week open-label trial of escitalopram as part of the Canadian Biomarker Integration Network in Depression program (MDD [n = 161] and healthy comparison participants [n = 91]). Childhood maltreatment was assessed via contextual interview with standardized ratings. In the full sample at baseline, greater SGK1 expression was associated with lower hippocampal volume, but only among those with more severe childhood maltreatment. In individuals with MDD, decreases in SGK1 expression predicted lower remission rates at week 16, again only among those with more severe maltreatment. Decreases in hippocampal volume predicted lower week 16 remission for those with low childhood maltreatment. These results suggest that both glucocorticoid-related neurobiological mechanisms of the stress response and history of childhood stress exposure may be critical to understanding differential treatment outcomes in MDD. ClinicalTrials.gov: NCT01655706 Canadian Biomarker Integration Network for Depression Study.
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Affiliation(s)
- Raegan Mazurka
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada.
| | | | - Stefanie Hassel
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Jane A Foster
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Nikita Nogovitsyn
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Centre for Depression and Suicide Studies, St. Michael's Hospital, Toronto ON, Canada
| | - Laura M Fiori
- Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, Canada
| | - Stephen C Strother
- Rotman Research Institute, Baycrest, Toronto, ON, Canada; Department of Medical Biophysics, University of Toronto, Canada
| | | | - Benicio N Frey
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Mood Disorders Program, St. Joseph's Healthcare Hamilton, ON, Canada
| | - Raymond W Lam
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Glenda M MacQueen
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Roumen V Milev
- Departments of Psychiatry and Psychology, And Providence Care Hospital, Queen's University, Kingston, ON, Canada
| | - Susan Rotzinger
- Department of Psychiatry, University of Toronto, Canada; Centre for Depression and Suicide Studies, St. Michael's Hospital, Toronto ON, Canada
| | - Gustavo Turecki
- Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, Canada
| | - Sidney H Kennedy
- Department of Psychiatry, University of Toronto, Canada; Centre for Depression and Suicide Studies, St. Michael's Hospital, Toronto ON, Canada
| | - Kate L Harkness
- Department of Psychology, Queen's University, Kingston, ON, Canada
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9
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Rakesh D, Elzeiny R, Vijayakumar N, Whittle S. A longitudinal study of childhood maltreatment, subcortical development, and subcortico-cortical structural maturational coupling from early to late adolescence. Psychol Med 2023; 53:7525-7536. [PMID: 37203450 DOI: 10.1017/s0033291723001253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
BACKGROUND Examining neurobiological mechanisms that may transmit the effects of childhood maltreatment on mental health in youth is crucial for understanding vulnerability to psychopathology. This study investigated associations between childhood maltreatment, adolescent structural brain development, and mental health trajectories into young-adulthood. METHODS Structural magnetic resonance imaging data was acquired from 144 youth at three time points (age 12, 16, and 18 years). Childhood maltreatment was reported to occur prior to the first scan. Linear mixed models were utilized to examine the association between total childhood maltreatment, neglect, abuse and (i) amygdala and hippocampal volume development, and (ii) maturational coupling between amygdala/hippocampus volume and the thickness of prefrontal regions. We also examined whether brain development mediated the association between maltreatment and depressive and anxiety symptoms trajectories from age 12 to 28. RESULTS Total maltreatment, and neglect, were associated with positive maturational coupling between the amygdala and caudal anterior cingulate cortex (cACC), whereby at higher and lower levels of amygdala growth, maltreatment was associated with lower and higher PFC thinning, respectively. Neglect was also associated with maturational coupling of the hippocampus with prefrontal regions. While positive amygdala-cACC maturational coupling was associated with greater increases in anxiety symptoms, it did not significantly mediate the association between maltreatment and anxiety symptom trajectories. CONCLUSION We found maltreatment to be associated with altered patterns of coupling between subcortical and prefrontal regions during adolescence, suggesting that maltreatment is associated with the development of socio-emotional neural circuitry. The implications of these findings for mental health require further investigation.
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Affiliation(s)
- Divyangana Rakesh
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia
| | - Reham Elzeiny
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia
| | - Nandita Vijayakumar
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia
| | - Sarah Whittle
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia
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10
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Zhu J, Anderson CM, Ohashi K, Khan A, Teicher MH. Potential sensitive period effects of maltreatment on amygdala, hippocampal and cortical response to threat. Mol Psychiatry 2023; 28:5128-5139. [PMID: 36869224 PMCID: PMC10475146 DOI: 10.1038/s41380-023-02002-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 02/11/2023] [Accepted: 02/15/2023] [Indexed: 03/05/2023]
Abstract
Childhood maltreatment is a leading risk factor for psychopathology, though it is unclear why some develop risk averse disorders, such as anxiety and depression, and others risk-taking disorders including substance abuse. A critical question is whether the consequences of maltreatment depend on the number of different types of maltreatment experienced at any time during childhood or whether there are sensitive periods when exposure to particular types of maltreatment at specific ages exert maximal effects. Retrospective information on severity of exposure to ten types of maltreatment during each year of childhood was collected using the Maltreatment and Abuse Chronology of Exposure scale. Artificial Intelligence predictive analytics were used to delineate the most important type/time risk factors. BOLD activation fMRI response to threatening versus neutral facial images was assessed in key components of the threat detection system (i.e., amygdala, hippocampus, anterior cingulate, inferior frontal gyrus and ventromedial and dorsomedial prefrontal cortices) in 202 healthy, unmedicated, participants (84 M/118 F, 23.2 ± 1.7 years old). Emotional maltreatment during teenage years was associated with hyperactive response to threat whereas early childhood exposure, primarily to witnessing violence and peer physical bullying, was associated with an opposite pattern of greater activation to neutral than fearful faces in all regions. These findings strongly suggest that corticolimbic regions have two different sensitive period windows of enhanced plasticity when maltreatment can exert opposite effects on function. Maltreatment needs to be viewed from a developmental perspective in order to fully comprehend its enduring neurobiological and clinical consequences.
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Affiliation(s)
- Jianjun Zhu
- Department of Psychology, Guangzhou University, Guangzhou, 510000, China.
| | - Carl M Anderson
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
- Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, 02478, USA
| | - Kyoko Ohashi
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
- Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, 02478, USA
| | - Alaptagin Khan
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
- Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, 02478, USA
| | - Martin H Teicher
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA.
- Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, 02478, USA.
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11
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Cohodes EM, Mandell JD, Notti ME, Schroeder MM, Ababio R, McCauley S, Pierre JC, Hodges HR, Gee DG. Validation of an electronic self-administered version of the Dimensional Inventory of Stress and Trauma Across the Lifespan in a large sample of young adults. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2023:2024-24338-001. [PMID: 37956029 PMCID: PMC11089071 DOI: 10.1037/tra0001606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Recent advances in the dimensional assessment of traumatic stress have initiated research examining correlates of exposure to specific features of stress. However, existing tools require intensive, in-person, clinician administration to generate the rich phenotypic data required for such analyses. These approaches are time consuming, costly, and substantially restrict the degree to which assessment tools can be disseminated in large-scale studies, constraining the refinement of existing dimensional models of early adversity. Here, we present an electronic adaptation of the Dimensional Inventory of Stress and Trauma Across the Lifespan (DISTAL), called the DISTAL-Electronic (DISTAL-E), present descriptive statistics drawn from a large sample of N = 500 young adult participants who completed the novel measure, and provide information about its psychometric properties. Results suggest that the DISTAL-E adequately assesses the following dimensional indices of traumatic stress exposure: type, chronicity, age of onset, severity, proximity, caregiver involvement, controllability, predictability, betrayal, threat, and deprivation and that it has excellent content and convergent validity and good test-retest reliability over a 7-11 day period. Although the development of the DISTAL-E facilitates the broad assessment of dimensions of stress exposure in large-scale datasets and has the potential to increase access to stress-related research to a wider group of participants who may not be able to access clinical research in traditional, in-person, clinic-based settings, the generalizability of results of the present study may be constrained by the fact that study participants were primarily White, educated, and with middle-to-high income. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Emily M. Cohodes
- Department of Psychology, Yale University, 2 Hillhouse Avenue, New Haven, CT 06520
| | - Jeffrey D. Mandell
- Program in Computational Biology and Bioinformatics, Yale University, 135 College Street, New Haven, CT 06510
| | - Madeline E. Notti
- Department of Psychology, Yale University, 2 Hillhouse Avenue, New Haven, CT 06520
| | | | - Rachel Ababio
- Department of Psychology, Yale University, 2 Hillhouse Avenue, New Haven, CT 06520
| | - Sarah McCauley
- Department of Psychology, Yale University, 2 Hillhouse Avenue, New Haven, CT 06520
| | - Jasmyne C. Pierre
- Department of Psychology, Yale University, 2 Hillhouse Avenue, New Haven, CT 06520
| | - H. R. Hodges
- Department of Psychology, Yale University, 2 Hillhouse Avenue, New Haven, CT 06520
| | - Dylan G. Gee
- Department of Psychology, Yale University, 2 Hillhouse Avenue, New Haven, CT 06520
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12
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Orendain N, Anderson A, Galván A, Bookheimer S, Chung PJ. A data-driven approach to categorizing early life adversity exposure in the ABCD Study. BMC Med Res Methodol 2023; 23:164. [PMID: 37420169 PMCID: PMC10327383 DOI: 10.1186/s12874-023-01983-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 06/22/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND Adversity occurring during development is associated with detrimental health and quality of life outcomes, not just following exposure but throughout the lifespan. Despite increased research, there exists both overlapping and distinct definitions of early life adversity exposure captured by over 30 different empirically validated tools. A data-driven approach to defining and cataloging exposure is needed to better understand associated outcomes and advance the field. METHODS We utilized baseline data on 11,566 youth enrolled in the ABCD Study to catalog youth and caregiver-reported early life adversity exposure captured across 14 different measures. We employed an exploratory factor analysis to identify the factor domains of early life adversity exposure and conducted a series of regression analyses to examine its association with problematic behavioral outcomes. RESULTS The exploratory factor analysis yielded a 6-factor solution corresponding to the following distinct domains: 1) physical and sexual violence; 2) parental psychopathology; 3) neighborhood threat; 4) prenatal substance exposure; 5) scarcity; and 6) household dysfunction. The prevalence of exposure among 9-and 10-year-old youth was largely driven by the incidence of parental psychopathology. Sociodemographic characteristics significantly differed between youth with adversity exposure and controls, depicting a higher incidence of exposure among racial and ethnic minoritized youth, and among those identifying with low socioeconomic status. Adversity exposure was significantly associated with greater problematic behaviors and largely driven by the incidence of parental psychopathology, household dysfunction and neighborhood threat. Certain types of early life adversity exposure were more significantly associated with internalizing as opposed to externalizing problematic behaviors. CONCLUSIONS We recommend a data-driven approach to define and catalog early life adversity exposure and suggest the incorporation of more versus less data to capture the nuances of exposure, e.g., type, age of onset, frequency, duration. The broad categorizations of early life adversity exposure into two domains, such as abuse and neglect, or threat and deprivation, fail to account for the routine co-occurrence of exposures and the duality of some forms of adversity. The development and use of a data-driven definition of early life adversity exposure is a crucial step to lessening barriers to evidence-based treatments and interventions for youth.
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Affiliation(s)
- Natalia Orendain
- Center for Cognitive Neuroscience, University of California, Los Angeles, CA, USA.
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA.
- David Geffen School of Medicine, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA.
| | - Ariana Anderson
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
- David Geffen School of Medicine, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Adriana Galván
- David Geffen School of Medicine, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
- Department of Psychology, University of California, Los Angeles, CA, USA
| | - Susan Bookheimer
- Center for Cognitive Neuroscience, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
- David Geffen School of Medicine, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Paul J Chung
- Departments of Pediatrics and Health Policy & Management, University of California, Los Angeles, CA, USA
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
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13
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Goltermann J, Winter NR, Meinert S, Sindermann L, Lemke H, Leehr EJ, Grotegerd D, Winter A, Thiel K, Waltemate L, Breuer F, Repple J, Gruber M, Richter M, Teckentrup V, Kroemer NB, Brosch K, Meller T, Pfarr JK, Ringwald KG, Stein F, Heindel W, Jansen A, Kircher T, Nenadić I, Dannlowski U, Opel N, Hahn T. Resting-state functional connectivity patterns associated with childhood maltreatment in a large bicentric cohort of adults with and without major depression. Psychol Med 2023; 53:4720-4731. [PMID: 35754405 PMCID: PMC10388325 DOI: 10.1017/s0033291722001623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 03/11/2022] [Accepted: 05/13/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Childhood maltreatment (CM) represents a potent risk factor for major depressive disorder (MDD), including poorer treatment response. Altered resting-state connectivity in the fronto-limbic system has been reported in maltreated individuals. However, previous results in smaller samples differ largely regarding localization and direction of effects. METHODS We included healthy and depressed samples [n = 624 participants with MDD; n = 701 healthy control (HC) participants] that underwent resting-state functional MRI measurements and provided retrospective self-reports of maltreatment using the Childhood Trauma Questionnaire. A-priori defined regions of interest [ROI; amygdala, hippocampus, anterior cingulate cortex (ACC)] were used to calculate seed-to-voxel connectivities. RESULTS No significant associations between maltreatment and resting-state connectivity of any ROI were found across MDD and HC participants and no interaction effect with diagnosis became significant. Investigating MDD patients only yielded maltreatment-associated increased connectivity between the amygdala and dorsolateral frontal areas [pFDR < 0.001; η2partial = 0.050; 95%-CI (0.023-0.085)]. This effect was robust across various sensitivity analyses and was associated with concurrent and previous symptom severity. Particularly strong amygdala-frontal associations with maltreatment were observed in acutely depressed individuals [n = 264; pFDR < 0.001; η2partial = 0.091; 95%-CI (0.038-0.166)). Weaker evidence - not surviving correction for multiple ROI analyses - was found for altered supracallosal ACC connectivity in HC individuals associated with maltreatment. CONCLUSIONS The majority of previous resting-state connectivity correlates of CM could not be replicated in this large-scale study. The strongest evidence was found for clinically relevant maltreatment associations with altered adult amygdala-dorsolateral frontal connectivity in depression. Future studies should explore the relevance of this pathway for a maltreated subgroup of MDD patients.
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Affiliation(s)
- Janik Goltermann
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Nils Ralf Winter
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Susanne Meinert
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
- University of Münster, Institute for Translational Neuroscience, Münster, Germany
| | - Lisa Sindermann
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Hannah Lemke
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Elisabeth J. Leehr
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Dominik Grotegerd
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Alexandra Winter
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Katharina Thiel
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Lena Waltemate
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Fabian Breuer
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Jonathan Repple
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Marius Gruber
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Maike Richter
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Vanessa Teckentrup
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Nils B. Kroemer
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
- Department of Psychiatry & Psychotherapy, University of Bonn, Bonn, Germany
| | - Katharina Brosch
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Tina Meller
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | | | | | - Frederike Stein
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Walter Heindel
- University of Münster, Department of Clinical Radiology, Münster, Germany
| | - Andreas Jansen
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Tilo Kircher
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Igor Nenadić
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Udo Dannlowski
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Nils Opel
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
- University of Münster, Interdisciplinary Centre for Clinical Research (IZKF), Münster, Germany
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Tim Hahn
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
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14
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Streit F, Völker MP, Klinger-König J, Zillich L, Frank J, Reinhard I, Foo JC, Witt SH, Sirignano L, Becher H, Obi N, Riedel O, Do S, Castell S, Hassenstein MJ, Karch A, Stang A, Schmidt B, Schikowski T, Stahl-Pehe A, Brenner H, Perna L, Greiser KH, Kaaks R, Michels KB, Franzke CW, Peters A, Fischer B, Konzok J, Mikolajczyk R, Führer A, Keil T, Fricke J, Willich SN, Pischon T, Völzke H, Meinke-Franze C, Loeffler M, Wirkner K, Berger K, Grabe HJ, Rietschel M. The interplay of family history of depression and early trauma: associations with lifetime and current depression in the German national cohort (NAKO). FRONTIERS IN EPIDEMIOLOGY 2023; 3:1099235. [PMID: 38523800 PMCID: PMC10959537 DOI: 10.3389/fepid.2023.1099235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 04/28/2023] [Indexed: 03/26/2024]
Abstract
Introduction Family history of depression and childhood maltreatment are established risk factors for depression. However, how these factors are interrelated and jointly influence depression risk is not well understood. The present study investigated (i) if childhood maltreatment is associated with a family history of depression (ii) if family history and childhood maltreatment are associated with increased lifetime and current depression, and whether both factors interact beyond their main effects, and (iii) if family history affects lifetime and current depression via childhood maltreatment. Methods Analyses were based on a subgroup of the first 100,000 participants of the German National Cohort (NAKO), with complete information (58,703 participants, mean age = 51.2 years, 53% female). Parental family history of depression was assessed via self-report, childhood maltreatment with the Childhood Trauma Screener (CTS), lifetime depression with self-reported physician's diagnosis and the Mini-International Neuropsychiatric Interview (MINI), and current depressive symptoms with the depression scale of the Patient Health Questionnaire (PHQ-9). Generalized linear models were used to test main and interaction effects. Mediation was tested using causal mediation analyses. Results Higher frequencies of the childhood maltreatment measures were found in subjects reporting a positive family history of depression. Family history and childhood maltreatment were independently associated with increased depression. No statistical interactions of family history and childhood maltreatment were found for the lifetime depression measures. For current depressive symptoms (PHQ-9 sum score), an interaction was found, with stronger associations of childhood maltreatment and depression in subjects with a positive family history. Childhood maltreatment was estimated to mediate 7%-12% of the effect of family history on depression, with higher mediated proportions in subjects whose parents had a depression onset below 40 years. Abuse showed stronger associations with family history and depression, and higher mediated proportions of family history effects on depression than neglect. Discussion The present study confirms the association of childhood maltreatment and family history with depression in a large population-based cohort. While analyses provide little evidence for the joint effects of both risk factors on depression beyond their individual effects, results are consistent with family history affecting depression via childhood maltreatment to a small extent.
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Affiliation(s)
- Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Maja P. Völker
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Johanna Klinger-König
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Lea Zillich
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Josef Frank
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Iris Reinhard
- Department of Biostatistics, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Jerome C. Foo
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Stephanie H. Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Lea Sirignano
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Heiko Becher
- Institute of Global Health, University Hospital Heidelberg, Heidelberg, Germany
| | - Nadia Obi
- Institute of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Oliver Riedel
- Leibniz-Institut für Präventionsforschung und Epidemiologie – BIPS, Bremen, Deutschland
| | - Stefanie Do
- Leibniz-Institut für Präventionsforschung und Epidemiologie – BIPS, Bremen, Deutschland
| | - Stefanie Castell
- Department for Epidemiology, Helmholtz Centre for Infection Research (HZI), Braunschweig, Germany
| | - Max J. Hassenstein
- Department for Epidemiology, Helmholtz Centre for Infection Research (HZI), Braunschweig, Germany
- PhD Programme “Epidemiology”, Braunschweig-Hannover, Germany
| | - André Karch
- Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany
| | - Andreas Stang
- Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany
| | - Börge Schmidt
- Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany
| | - Tamara Schikowski
- IUF—Leibniz Institute for Environmental Medicine, Düsseldorf, Germany
| | - Anna Stahl-Pehe
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research, University of Düsseldorf, Düsseldorf, Germany
| | - Hermann Brenner
- Network Ageing Research (NAR), Heidelberg University, Heidelberg, Germany
- Division of Clinical Epidemiology & Ageing Research, German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - Laura Perna
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Karin Halina Greiser
- German Cancer Research Centre (DKFZ) Heidelberg, Div. of Cancer Epidemiology, Heidelberg, Germany
| | - Rudolf Kaaks
- German Cancer Research Centre (DKFZ) Heidelberg, Div. of Cancer Epidemiology, Heidelberg, Germany
| | - Karin B. Michels
- Institute for Prevention and Cancer Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Claus-Werner Franzke
- Institute for Prevention and Cancer Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum Munchen, German Research Centre for Environmental Health, Neuherberg, Germany
- Chair of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Medical Faculty, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Beate Fischer
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Julian Konzok
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Rafael Mikolajczyk
- Institute for Medical Epidemiology, Biometrics and Informatics (IMEBI), Interdisciplinary Centre for Health Sciences, Medical School of the Martin Luther University Halle-Wittenberg, Halle, Germany
- German Center for Mental Health, Site Jena-Magdeburg-Halle, Jena, Germany
| | - Amand Führer
- Institute for Medical Epidemiology, Biometrics and Informatics (IMEBI), Interdisciplinary Centre for Health Sciences, Medical School of the Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Thomas Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Institute for Clinical Epidemiology and Biometry, University of Wuerzburg, Wuerzburg, Germany
- State Institute of Health, Bavarian Health and Food Safety Authority, Bad Kissingen, Germany
| | - Julia Fricke
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Stefan N. Willich
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Tobias Pischon
- Max-Delbrueck-Centre for Molecular Medicine in the Helmholtz Association (MDC), Molecular Epidemiology Research Group, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Max-Delbrueck-Centre for Molecular Medicine in the Helmholtz Association (MDC), Biobank Technology Platform, Berlin, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Claudia Meinke-Franze
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Markus Loeffler
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany
- Leipzig Research Center for Civilization Diseases (LIFE), University of Leipzig, Leipzig, Germany
| | - Kerstin Wirkner
- Leipzig Research Center for Civilization Diseases (LIFE), University of Leipzig, Leipzig, Germany
| | - Klaus Berger
- Institute of Epidemiology & Social Medicine, University of Muenster, Muenster, Germany
| | - Hans J. Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Cohodes EM, McCauley S, Pierre JC, Hodges HR, Haberman JT, Santiuste I, Rogers MK, Wang J, Mandell JD, Gee DG. Development and validation of the Dimensional Inventory of Stress and Trauma Across the Lifespan (DISTAL): A novel assessment tool to facilitate the dimensional study of psychobiological sequelae of exposure to adversity. Dev Psychobiol 2023; 65:e22372. [PMID: 37073593 DOI: 10.1002/dev.22372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/16/2022] [Accepted: 01/04/2023] [Indexed: 04/20/2023]
Abstract
Decades of research underscore the profound impact of adversity on brain and behavioral development. Recent theoretical models have highlighted the importance of considering specific features of adversity that may have dissociable effects at distinct developmental timepoints. However, existing measures do not query these dimensions in sufficient detail to support the proliferation of this approach. The Dimensional Inventory of Stress and Trauma Across the Lifespan (DISTAL) was developed with the aim to thoroughly and retrospectively assess the timing, severity (of exposure and reaction), type, persons involved, controllability, predictability, threat, deprivation, proximity, betrayal, and discrimination inherent in an individual's exposure to adversity. Here, we introduce this instrument, present descriptive statistics drawn from a sample of N = 187 adults who completed the DISTAL, and provide initial information about its psychometric properties. This novel measure facilitates the expansion of research focused on assessing the relative impact of exposure to key dimensions of adversity on the brain and behavior across development.
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Affiliation(s)
- Emily M Cohodes
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Sarah McCauley
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Jasmyne C Pierre
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - H R Hodges
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Jason T Haberman
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Isabel Santiuste
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Marisa K Rogers
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Jenny Wang
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Jeffrey D Mandell
- Program in Computational Biology and Bioinformatics, Yale University, New Haven, Connecticut, USA
| | - Dylan G Gee
- Department of Psychology, Yale University, New Haven, Connecticut, USA
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16
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The association between adverse childhood experiences and peripartal pain experience. Pain 2023:00006396-990000000-00255. [PMID: 36787580 DOI: 10.1097/j.pain.0000000000002870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 01/03/2023] [Indexed: 02/16/2023]
Abstract
ABSTRACT Adverse childhood experiences (ACEs) are associated with altered ongoing and evoked pain experiences, which have scarcely been studied for the peripartum period. We aimed to investigate how ACEs affect pain experience in pregnancy and labor. For this noninterventional trial with a short-term follow-up, pregnant women were divided into a trauma group (TG) with ACEs (n = 84) and a control group (CG) without ACEs (n = 107) according to the Childhood Trauma Questionnaire. Pain experience in pregnancy and labor was recorded by self-report and the German Pain Perception Scale. Pain sensitivity prepartum and postpartum was assessed by Quantitative Sensory Testing and a paradigm of conditioned pain modulation (CPM), using pressure pain thresholds (PPTs) and a cold pressor test. The TG showed higher affective and sensory scores for back pain and a more than doubled prevalence of preexisting back pain. Pelvic pain differences were nonsignificant. The TG also exhibited increased affective scores (1.71 ± 0.15 vs 1.33 ± 0.11), but not sensory scores for labor pain during spontaneous delivery. There were no group differences in prepartum pain sensitivity. While PPTs increased through delivery in the CG (clinical CPM), and this PPT change was positively correlated with the experimental CPM (r = 0.55), this was not the case in the TG. The association of ACEs with increased peripartal pain affect and heightened risk for preexisting back pain suggest that such women deserve special care. The dissociation of impaired clinical CPM in women with ACEs and normal prepartum experimental CPM implies at least partly different mechanisms of these 2 manifestations of endogenous pain controls.
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Begemann MJH, Schutte MJL, van Dellen E, Abramovic L, Boks MP, van Haren NEM, Mandl RCW, Vinkers CH, Bohlken MM, Sommer IEC. Childhood trauma is associated with reduced frontal gray matter volume: a large transdiagnostic structural MRI study. Psychol Med 2023; 53:741-749. [PMID: 34078485 PMCID: PMC9975993 DOI: 10.1017/s0033291721002087] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 04/27/2021] [Accepted: 05/04/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Childhood trauma increases risk for psychopathology and cognitive impairment. Prior research mainly focused on the hippocampus and amygdala in single diagnostic categories. However, other brain regions may be impacted by trauma as well, and effects may be independent of diagnosis. This cross-sectional study investigated cortical and subcortical gray matter volume in relation to childhood trauma severity. METHODS We included 554 participants: 250 bipolar-I patients, 84 schizophrenia-spectrum patients and 220 healthy individuals without a psychiatric history. Participants filled in the Childhood Trauma Questionnaire. Anatomical T1 MRI scans were acquired at 3T, regional brain morphology was assessed using Freesurfer. RESULTS In the total sample, trauma-related gray matter reductions were found in the frontal lobe (β = -0.049, p = 0.008; q = 0.048), this effect was driven by the right medial orbitofrontal, paracentral, superior frontal regions and the left precentral region. No trauma-related volume reductions were observed in any other (sub)cortical lobes nor the hippocampus or amygdala, trauma-by-group (i.e. both patient groups and healthy subjects) interaction effects were absent. A categorical approach confirmed a pattern of more pronounced frontal gray matter reductions in individuals reporting multiple forms of trauma and across quartiles of cumulative trauma scores. Similar dose-response patterns were revealed within the bipolar and healthy subgroups, but did not reach significance in schizophrenia-spectrum patients. CONCLUSIONS Findings show that childhood trauma is linked to frontal gray matter reductions, independent of psychiatric morbidity. Our results indicate that childhood trauma importantly contributes to the neurobiological changes commonly observed across psychiatric disorders. Frontal volume alterations may underpin affective and cognitive disturbances observed in trauma-exposed individuals.
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Affiliation(s)
- Marieke J. H. Begemann
- Department of Biomedical Sciences of Cells & Systems, Section Cognitive Neurosciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Maya J. L. Schutte
- Department of Biomedical Sciences of Cells & Systems, Section Cognitive Neurosciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Edwin van Dellen
- Department of Psychiatry, UMCU Brain Center, Utrecht University, Utrecht, the Netherlands
| | - Lucija Abramovic
- Department of Psychiatry, UMCU Brain Center, Utrecht University, Utrecht, the Netherlands
| | - Marco P. Boks
- Department of Psychiatry, UMCU Brain Center, Utrecht University, Utrecht, the Netherlands
| | - Neeltje E. M. van Haren
- Department of Psychiatry, UMCU Brain Center, Utrecht University, Utrecht, the Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Rene C. W. Mandl
- Department of Psychiatry, UMCU Brain Center, Utrecht University, Utrecht, the Netherlands
| | - Christiaan H. Vinkers
- Department of Psychiatry, Amsterdam UMC (location VUmc), Amsterdam, the Netherlands
- Department of Anatomy and Neurosciences, Amsterdam UMC (location VUmc), Amsterdam, the Netherlands
| | - Marc M. Bohlken
- Department of Psychiatry, UMCU Brain Center, Utrecht University, Utrecht, the Netherlands
| | - Iris E. C. Sommer
- Department of Biomedical Sciences of Cells & Systems, Section Cognitive Neurosciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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18
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Korgaonkar MS, Breukelaar IA, Felmingham K, Williams LM, Bryant RA. Association of Neural Connectome With Early Experiences of Abuse in Adults. JAMA Netw Open 2023; 6:e2253082. [PMID: 36701155 PMCID: PMC9880798 DOI: 10.1001/jamanetworkopen.2022.53082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
IMPORTANCE More than 10% of children experience sexual, physical, or emotional abuse, and abuse experienced during sensitive neurodevelopmental periods is associated with a greater risk of psychiatric disorders. OBJECTIVE To investigate the extent to which a history of abuse is associated with alterations in the intrinsic functional connectome of the adult brain independent from the restriction of associated psychiatric conditions. DESIGN, SETTING, AND PARTICIPANTS This cohort study assessed data from 768 adult participants from the greater Sydney, Australia, area who were included in the study without diagnostic restrictions and categorized based on a history of childhood sexual, physical, and/or emotional abuse. Data were collected from January 1, 2009, to December 31, 2015; data analysis was performed from October 1, 2020, to March 31, 2022. MAIN OUTCOMES AND MEASURES Outcomes were structured psychiatric interview responses, self-report of the frequency and extent of various types of negative experiences in childhood and adolescence, and intrinsic functional connectivity derived from 5 functional magnetic resonance imaging tasks and estimated among 436 brain regions, comprising intranetwork and internetwork connectivity of 8 large-scale brain networks. RESULTS Among the 647 individuals with usable data (330 female [51.0%]; mean [SD] age, 33.3 [12.0] years; age range, 18.2-69.2 years), history of abuse was associated with greater likelihood of a current psychiatric illness (odds ratio, 4.55; 95% CI, 3.07-6.72; P < .001) and with greater depressive, anxiety, and stress symptoms (mean difference, 20.4; 95% CI, 16.1-24.7; P < .001). An altered connectome signature of higher connectivity within somatomotor, dorsal, and ventral attention networks and between these networks and executive control and default mode networks was observed in individuals with a history of abuse experienced during childhood (n = 127) vs those without a history of abuse (n = 442; mean difference, 0.07; 95% CI, 0.05-0.08; familywise, Bonferroni-corrected P = .01; Cohen d = 0.82) and compared with those who experienced abuse in adolescence (n = 78; mean difference, 0.06; 95% CI, 0.04-0.08]; familywise, Bonferroni-corrected P < .001; Cohen d = 0.68). Connectome alterations were not observed for those who experienced abuse in adolescence. Connectivity of this signature was transdiagnostic and independent of the nature and frequency of abuse, sex, or current symptomatic state. CONCLUSIONS AND RELEVANCE Findings highlight the associations of exposure to abuse before and during adolescence with the whole-brain functional connectome. The experience of child abuse was found to be associated with physiologic changes in intrinsic connectivity, independent of psychopathology, in a way that may affect functioning of systems responsible for perceptual processing and attention.
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Affiliation(s)
- Mayuresh S. Korgaonkar
- Brain Dynamics Centre, The Westmead Institute for Medical Research, University of Sydney, Westmead, New South Wales, Australia
- Discipline of Psychiatry, Sydney Medical School, Westmead, New South Wales, Australia
| | - Isabella A. Breukelaar
- Brain Dynamics Centre, The Westmead Institute for Medical Research, University of Sydney, Westmead, New South Wales, Australia
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Kim Felmingham
- Discipline of Psychological Science, University of Melbourne, Melbourne, Australia
| | - Leanne M. Williams
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
- Sierra-Pacific Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, California
| | - Richard A. Bryant
- Brain Dynamics Centre, The Westmead Institute for Medical Research, University of Sydney, Westmead, New South Wales, Australia
- School of Psychology, University of New South Wales, Sydney, Australia
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19
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Cooke EM, Connolly EJ, Boisvert DL, Hayes BE. A Systematic Review of the Biological Correlates and Consequences of Childhood Maltreatment and Adverse Childhood Experiences. TRAUMA, VIOLENCE & ABUSE 2023; 24:156-173. [PMID: 34105421 DOI: 10.1177/15248380211021613] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Childhood maltreatment (CM) and adverse childhood experiences (ACEs) are two primary forms of interpersonal victimization that have been associated with a host of deleterious health outcomes. Studies over the past decade have begun to use a range of biologically informed methods to better understand the role biology plays in the relationship between CM, ACEs, and later life outcomes. This line of research has shown that both forms of victimization occur at sensitive periods of development, which can increase the likelihood of "getting under the skin" and influence health and behavior across the life course. This review examines the current state of knowledge on this hypothesis. One hundred and ninety-nine studies are included in this systematic review based on criteria that they be written in English, use a biologically informed method, and be conducted on samples of humans. Results reveal that latent additive genetic influences, biological system functioning captured by biomarkers, polygenic risk scores, and neurobiological factors are commonly associated with exposure and response to CM and ACEs. The implication of these findings for the existing body of research on early life victimization and recommendations for future research and policy are discussed.
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Affiliation(s)
- Eric M Cooke
- Department of Criminal Justice and Criminology, 4038Sam Houston State University, Huntsville, TX, USA
| | - Eric J Connolly
- Department of Criminal Justice and Criminology, 4038Sam Houston State University, Huntsville, TX, USA
| | - Danielle L Boisvert
- Department of Criminal Justice and Criminology, 4038Sam Houston State University, Huntsville, TX, USA
| | - Brittany E Hayes
- School of Criminal Justice, 2514University of Cincinnati, OH, USA
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20
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Lakkireddy SP, Balachander S, Dayalamurthy P, Bhattacharya M, Joseph MS, Kumar P, Kannampuzha AJ, Mallappagari S, Narayana S, Alexander AC, Muthukumaran M, Sheth S, Puzhakkal JC, Ramesh V, Thatikonda NS, Selvaraj S, Ithal D, Sreeraj VS, Mahadevan J, Holla B, Venkatasubramanian G, John JP, Murthy P, Benegal V, Reddy YCJ, Jain S, Viswanath B. Neurocognition and its association with adverse childhood experiences and familial risk of mental illness. Prog Neuropsychopharmacol Biol Psychiatry 2022; 119:110620. [PMID: 35995305 PMCID: PMC7615105 DOI: 10.1016/j.pnpbp.2022.110620] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 08/14/2022] [Accepted: 08/16/2022] [Indexed: 11/30/2022]
Abstract
Environmental factors such as adverse childhood experiences (ACEs) may affect neurocognition, an endophenotype for several mental illnesses. This study examines the effect of ACEs on neurocognitive performance in first-degree relatives (FDRs) of patients with severe mental illness to determine whether familial risk has a moderating effect on the relationship between ACEs and neurocognition. Unaffected FDRs from multiplex families with severe mental illnesses (schizophrenia, bipolar disorder, obsessive-compulsive disorder, or alcohol use disorder) (n = 324) and healthy controls (with no familial risk) (n = 188) underwent neurocognitive tests for processing speed, new learning, working memory and Theory of Mind. ACEs were measured using the WHO ACE-International Questionnaire (ACE-IQ). Regression models were done to predict each neurocognitive domain by the effect of familial risk, ACE-IQ Score and their interaction (familial risk*ACE-IQ score). The main effect of familial risk predicted poor performance in all domains of neurocognition (p < 0.01), and the interaction had a negative association with global neurocognition (β = -0.093, p = 0.009), processing speed (β = -0.109, p = 0.003) and working memory (β = -0.092, p = 0.01). Among the ACEs sub-domains, only maltreatment (specifically the main effect of physical neglect and the interaction effect of sexual abuse with familial risk) predicted poorer neurocognition. In FDRs of schizophrenia and bipolar disorder, only the main effects of familial risk were significantly associated with poorer neurocognition. We conclude that there is a relationship between ACEs (especially maltreatment) and neurocognitive functioning, which is moderated by the familial risk of mental illnesses. Genetic/familial vulnerability may have a stronger association with neurocognition in schizophrenia and bipolar disorder.
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Affiliation(s)
- Sai Priya Lakkireddy
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Srinivas Balachander
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India.
| | - Pavithra Dayalamurthy
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Mahashweta Bhattacharya
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Mino Susan Joseph
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Pramod Kumar
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Anand Jose Kannampuzha
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Sreenivasulu Mallappagari
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Shruthi Narayana
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Alen Chandy Alexander
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Moorthy Muthukumaran
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Sweta Sheth
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Joan C Puzhakkal
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Vinutha Ramesh
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Navya Spurthi Thatikonda
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Sowmya Selvaraj
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Dhruva Ithal
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Vanteemar S Sreeraj
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Jayant Mahadevan
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Bharath Holla
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Ganesan Venkatasubramanian
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - John P John
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Pratima Murthy
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Vivek Benegal
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Y C Janardhan Reddy
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Sanjeev Jain
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Biju Viswanath
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India.
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21
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Siehl S, Sicorello M, Herzog J, Nees F, Kleindienst N, Bohus M, Müller-Engelmann M, Steil R, Priebe K, Schmahl C, Flor H. Neurostructural associations with traumatic experiences during child- and adulthood. Transl Psychiatry 2022; 12:515. [PMID: 36517466 PMCID: PMC9751132 DOI: 10.1038/s41398-022-02262-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 11/17/2022] [Accepted: 11/21/2022] [Indexed: 12/23/2022] Open
Abstract
Adverse experiences can lead to severe mental health problems, such as posttraumatic stress disorder (PTSD), throughout the lifespan. In individuals with PTSD, both global and local brain volume reductions have been reported-especially in the amygdala and hippocampus-while the literature on childhood maltreatment suggests a strong dependency on the timing of adverse events. In the present study, we pooled data from two studies to contrast the effects of reported trauma exposure during neurodevelopmentally sensitive periods in early life with trauma exposure during adulthood. A total of 155 women were allocated into one of six age-matched groups according to the timing of traumatization (childhood vs adulthood) and psychopathology (PTSD vs trauma-exposed healthy vs trauma-naïve healthy). Volumes of the amygdala and hippocampus were compared between these groups. Six additional exploratory regions of interest (ROI) were included based on a recent meta-analysis. Amygdala volume was strongly dependent on the timing of traumatization: Smaller amygdala volumes were observed in participants with childhood trauma and PTSD compared to the healthy control groups. In contrast, larger amygdala volumes were observed in both groups with trauma exposure during adulthood compared to the trauma-naïve control group. Hippocampal volume comparisons revealed no statistically significant differences, although the descriptive pattern was similar to that found for the amygdala. The remaining exploratory ROIs showed significant group effects, but no timing effects. The timing might be an important moderator for adversity effects on amygdala volume, potentially reflecting neurodevelopmental factors. Albeit confounded by characteristics like trauma type and multiplicity, these findings pertain to typical childhood and adulthood trauma as often observed in clinical practice and speak against a simple association between traumatic stress and amygdala volume.
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Affiliation(s)
- Sebastian Siehl
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany. .,Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany.
| | - Maurizio Sicorello
- grid.7700.00000 0001 2190 4373Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Julia Herzog
- grid.7700.00000 0001 2190 4373Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Frauke Nees
- grid.412468.d0000 0004 0646 2097Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
| | - Nikolaus Kleindienst
- grid.7700.00000 0001 2190 4373Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Martin Bohus
- grid.7700.00000 0001 2190 4373Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Meike Müller-Engelmann
- grid.7839.50000 0004 1936 9721Department of Clinical Psychology and Psychotherapy, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Regina Steil
- grid.7839.50000 0004 1936 9721Department of Clinical Psychology and Psychotherapy, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Kathlen Priebe
- grid.6363.00000 0001 2218 4662Department of Psychiatry and Psychotherapy, Charité–Universitätsmedizin, Berlin, Germany
| | - Christian Schmahl
- grid.7700.00000 0001 2190 4373Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Herta Flor
- grid.7700.00000 0001 2190 4373Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany
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22
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Schaefer JD, Cheng TW, Dunn EC. Sensitive periods in development and risk for psychiatric disorders and related endpoints: a systematic review of child maltreatment findings. Lancet Psychiatry 2022; 9:978-991. [PMID: 36403600 PMCID: PMC10443538 DOI: 10.1016/s2215-0366(22)00362-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/22/2022] [Accepted: 09/23/2022] [Indexed: 11/19/2022]
Abstract
Variation in the mental health of people who have experienced childhood maltreatment is substantial. One hypothesis is that this variation is attributable, in part, to the timing of maltreatment-specifically, whether maltreatment occurs during sensitive periods in development when the brain is maximally sensitive to particular types of environmental input. To determine whether there is scientific consensus around when periods of peak sensitivity occur, we did a systematic review of human observational studies. Although 89 (75%) of the 118 unique cross-sectional or longitudinal cohort studies we identified reported timing effects, no consistent sensitive periods were identified for any of the most studied outcomes. Thus, observational research on childhood maltreatment has yet to converge on a single period (or set of periods) of increased vulnerability. We identified study characteristics that might contribute to these between-study differences and used observations from our Review to suggest a comprehensive set of recommendations for future research.
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Affiliation(s)
| | - Theresa W. Cheng
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Erin C. Dunn
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Center on the Developing Child, Harvard University, Cambridge, MA, USA
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23
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Seitz KI, Gerhardt S, von Schroeder C, Panizza A, Thekkumthala D, Bertsch K, Herpertz SC, Schmahl C, Schalinski I. Measuring types and timing of childhood maltreatment: The psychometric properties of the KERF-40+. PLoS One 2022; 17:e0273931. [PMID: 36074774 PMCID: PMC9455860 DOI: 10.1371/journal.pone.0273931] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 08/17/2022] [Indexed: 12/03/2022] Open
Abstract
Childhood maltreatment, specifically during sensitive developmental periods, is a major risk factor for poor physical and mental health. Despite its enormous clinical relevance, there is still a lack of scales measuring different types, timing, and duration of childhood maltreatment. The current study sought to validate and determine the psychometric properties of the brief German version of the Maltreatment and Abuse Chronology of Exposure (MACE) scale, the KERF-40. The KERF-40 was administered as an interview (i.e., KERF-40-I) to 287 adult participants with and without mental disorders. Based on item response theory, items of the KERF-40-I were assigned to different types of maltreatment, resulting in a scaled version, the KERF-40+. Test-retest reliability was assessed in a small subsample (n = 14). Convergent and relative predictive validity were measured with correlations of the KERF-40+ and the Childhood Trauma Questionnaire (CTQ) as well as self-report measures of general and trauma-related psychopathology. Rasch analysis and fit statistics yielded a 49-item version, encompassing ten different types of maltreatment. The test-retest reliability of the KERF-40+ was shown to be acceptable to excellent for almost all global and subscale scores (.74 ≤ ρ ≤ 1.00), with the exception of the subscale emotional neglect (ρ = .55). Convergent validity with the CTQ was confirmed for both KERF-40+ global scores (.72 ≤ r ≤ .87) and corresponding subscale scores (.56 ≤ r ≤ .78). Relative predictive validity was reflected by significant small-to-moderate correlations between KERF-40+ global scores and indices of general and trauma-related psychopathology (.24 ≤ r ≤ .45). Taken together, the KERF-40+ appears to be suited for clinicians and researchers interested in retrospectively assessing different types, timing, and duration of childhood maltreatment experiences during sensitive periods in adults.
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Affiliation(s)
- Katja I. Seitz
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Heidelberg, Germany
- * E-mail:
| | - Sarah Gerhardt
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Claudius von Schroeder
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany
| | - Angelika Panizza
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany
| | | | - Katja Bertsch
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Heidelberg, Germany
- Department of Psychology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Sabine C. Herpertz
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany
| | - Inga Schalinski
- Department of Psychology, University of Konstanz, Konstanz, Germany
- Psychologische Hochschule Berlin, Berlin, Germany
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24
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Early life adversity shapes neural circuit function during sensitive postnatal developmental periods. Transl Psychiatry 2022; 12:306. [PMID: 35915071 PMCID: PMC9343623 DOI: 10.1038/s41398-022-02092-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 07/18/2022] [Accepted: 07/21/2022] [Indexed: 11/24/2022] Open
Abstract
Early life adversity (ELA) is a major risk factor for mental illness, but the neurobiological mechanisms by which ELA increases the risk for future psychopathology are still poorly understood. Brain development is particularly malleable during prenatal and early postnatal life, when complex neural circuits are being formed and refined through an interplay of excitatory and inhibitory neural input, synaptogenesis, synaptic pruning, myelination, and neurogenesis. Adversity that influences these processes during sensitive periods of development can thus have long-lasting and pervasive effects on neural circuit maturation. In this review, we will discuss clinical and preclinical evidence for the impact of ELA on neural circuit formation with a focus on the early postnatal period, and how long-lasting impairments in these circuits can affect future behavior. We provide converging evidence from human and animal studies on how ELA alters the functional development of brain regions, neural circuits, and neurotransmitter systems that are crucial for cognition and affective behavior, including the hippocampus, the hypothalamus-pituitary-adrenal (HPA) axis, neural networks of fear responses and cognition, and the serotonin (5-HT) system. We also discuss how gene-by-environment (GxE) interactions can determine individual differences in susceptibility and resilience to ELA, as well as molecular pathways by which ELA regulates neural circuit development, for which we emphasize epigenetic mechanisms. Understanding the molecular and neurobiological mechanisms underlying ELA effects on brain function and psychopathology during early postnatal sensitive periods may have great potential to advance strategies to better treat or prevent psychiatric disorders that have their origin early in life.
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25
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Maercker A, Cloitre M, Bachem R, Schlumpf YR, Khoury B, Hitchcock C, Bohus M. Complex post-traumatic stress disorder. Lancet 2022; 400:60-72. [PMID: 35780794 DOI: 10.1016/s0140-6736(22)00821-2] [Citation(s) in RCA: 71] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 04/19/2022] [Accepted: 04/27/2022] [Indexed: 12/21/2022]
Abstract
Complex post-traumatic stress disorder (complex PTSD) is a severe mental disorder that emerges in response to traumatic life events. Complex PTSD is characterised by three core post-traumatic symptom clusters, along with chronic and pervasive disturbances in emotion regulation, identity, and relationships. Complex PTSD has been adopted as a new diagnosis in the ICD-11. Individuals with complex PTSD typically have sustained or multiple exposures to trauma, such as childhood abuse and domestic or community violence. The disorder has a 1-8% population prevalence and up to 50% prevalence in mental health facilities. Progress in diagnostics, assessment, and differentiation from post-traumatic stress disorder and borderline personality disorder is reported, along with assessment and treatment of children and adolescents. Studies recommend multicomponent therapies starting with a focus on safety, psychoeducation, and patient-provider collaboration, and treatment components that include self-regulatory strategies and trauma-focused interventions.
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Affiliation(s)
- Andreas Maercker
- Division of Psychopathology and Clinical Intervention, University of Zurich, Zurich, Switzerland.
| | - Marylene Cloitre
- National Center for PTSD Division of Dissemination and Training and Department of Psychiatry and Behavioural Sciences, Stanford University, CA, USA
| | - Rahel Bachem
- Division of Psychopathology and Clinical Intervention, University of Zurich, Zurich, Switzerland
| | | | | | - Caitlin Hitchcock
- MRC Cognition and Brain Science Unit, University of Cambridge, Cambridge, UK; Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Martin Bohus
- Heidelberg University, Heidelberg Germany and Ruhr University, Bochum, Germany
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26
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Picci G, Taylor BK, Killanin AD, Eastman JA, Frenzel MR, Wang YP, Stephen JM, Calhoun VD, Wilson TW. Left amygdala structure mediates longitudinal associations between exposure to threat and long-term psychiatric symptomatology in youth. Hum Brain Mapp 2022; 43:4091-4102. [PMID: 35583310 PMCID: PMC9374891 DOI: 10.1002/hbm.25904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 04/14/2022] [Accepted: 04/17/2022] [Indexed: 12/04/2022] Open
Abstract
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.
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Affiliation(s)
- Giorgia Picci
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, Nebraska, USA
| | - Brittany K Taylor
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, Nebraska, USA.,Department of Pharmacology & Neuroscience, Creighton University, Omaha, Nebraska, USA
| | - Abraham D Killanin
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, Nebraska, USA.,College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Jacob A Eastman
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, Nebraska, USA
| | - Michaela R Frenzel
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, Nebraska, USA
| | - Yu-Ping Wang
- Department of Biomedical Engineering, Tulane University, New Orleans, Louisiana, USA
| | | | - Vince D Calhoun
- Mind Research Network, Albuquerque, New Mexico, USA.,Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, Georgia, USA
| | - Tony W Wilson
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, Nebraska, USA.,Department of Pharmacology & Neuroscience, Creighton University, Omaha, Nebraska, USA
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27
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Structural and Functional Deviations of the Hippocampus in Schizophrenia and Schizophrenia Animal Models. Int J Mol Sci 2022; 23:ijms23105482. [PMID: 35628292 PMCID: PMC9143100 DOI: 10.3390/ijms23105482] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/09/2022] [Accepted: 05/11/2022] [Indexed: 01/04/2023] Open
Abstract
Schizophrenia is a grave neuropsychiatric disease which frequently onsets between the end of adolescence and the beginning of adulthood. It is characterized by a variety of neuropsychiatric abnormalities which are categorized into positive, negative and cognitive symptoms. Most therapeutical strategies address the positive symptoms by antagonizing D2-dopamine-receptors (DR). However, negative and cognitive symptoms persist and highly impair the life quality of patients due to their disabling effects. Interestingly, hippocampal deviations are a hallmark of schizophrenia and can be observed in early as well as advanced phases of the disease progression. These alterations are commonly accompanied by a rise in neuronal activity. Therefore, hippocampal formation plays an important role in the manifestation of schizophrenia. Furthermore, studies with animal models revealed a link between environmental risk factors and morphological as well as electrophysiological abnormalities in the hippocampus. Here, we review recent findings on structural and functional hippocampal abnormalities in schizophrenic patients and in schizophrenia animal models, and we give an overview on current experimental approaches that especially target the hippocampus. A better understanding of hippocampal aberrations in schizophrenia might clarify their impact on the manifestation and on the outcome of this severe disease.
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28
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Heterogeneity in caregiving-related early adversity: Creating stable dimensions and subtypes. Dev Psychopathol 2022; 34:621-634. [PMID: 35314012 PMCID: PMC9492894 DOI: 10.1017/s0954579421001668] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Early psychosocial adversities exist at many levels, including caregiving-related, extrafamilial, and sociodemographic, which despite their high interrelatedness may have unique impacts on development. In this paper, we focus on caregiving-related early adversities (crEAs) and parse the heterogeneity of crEAs via data reduction techniques that identify experiential cooccurrences. Using network science, we characterized crEA cooccurrences to represent the comorbidity of crEA experiences across a sample of school-age children (n = 258; 6-12 years old) with a history of crEAs. crEA dimensions (variable level) and crEA subtypes (subject level) were identified using parallel factor analysis/principal component analysis and graph-based Louvain community detection. Bagging enhancement with cross-validation provided estimates of robustness. These data-driven dimensions/subtypes showed evidence of stability, transcended traditional sociolegally defined groups, were more homogenous than sociolegally defined groups, and reduced statistical correlations with sociodemographic factors. Finally, random forests showed both unique and common predictive importance of the crEA dimensions/subtypes for childhood mental health symptoms and academic skills. These data-driven outcomes provide additional tools and recommendations for crEA data reduction to inform precision medicine efforts in this area.
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29
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Stannard S, Berrington A, Alwan NA. The mediating pathways between parental separation in childhood and offspring hypertension at midlife. Sci Rep 2022; 12:7062. [PMID: 35488035 PMCID: PMC9054745 DOI: 10.1038/s41598-022-11007-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 04/15/2022] [Indexed: 11/12/2022] Open
Abstract
Social life course determinants of adult hypertension are relatively unknown. This paper examines how parental separation before age 10 relates to hypertension at age 46. Adjusting for parental confounders and considering the role of adult mediators, we aim to quantify unexplored mediating pathways in childhood using prospectively collected data. Data from the 1970 British Birth Cohort Study are utilised. Hypertension is measured by health care professionals at age 46. Potential mediating pathways in childhood include body mass index (BMI), systolic and diastolic blood pressure, illness, disability, family socioeconomic status (SES) and cognitive and developmental indicators at age 10. Additionally, we explore to what extent childhood mediators operate through adult mediators, including health behaviours, family SES, BMI and mental wellbeing. We also test for effect modification of the relationship between parental separation and hypertension by gender. Nested logistic regression models test the significance of potential mediating variables. Formal mediation analysis utilising Karlson Holm and Breen (KHB) method quantify the direct and indirect effect of parental separation on offspring hypertension at midlife. There was an association between parental separation and hypertension in mid-life in women but not men. For women, family SES and cognitive and behavioural development indicators at age 10 partly mediate the relationship between parental separation and hypertension at age 46. When adult mediators including, health behaviours, family SES, BMI and mental wellbeing are included, the associations between the childhood predictors and adult hypertension are attenuated, suggesting that these childhood mediators in turn may work through adult mediators to affect the risk of hypertension in midlife. We found family SES in childhood, cognitive and behaviour development indicators at age 10, including disruptive behaviour, coordination and locus of control in childhood, to be important mediators of the relationship between parental separation and midlife hypertension suggesting that intervening in childhood may modify adult hypertension risk.
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Affiliation(s)
- Sebastian Stannard
- Department of Social Statistics and Demography, University of Southampton, Building 58, University Road, Southampton, SO17 1BJ, UK. .,ESRC Centre for Population Change, University of Southampton, Southampton, UK.
| | - Ann Berrington
- Department of Social Statistics and Demography, University of Southampton, Building 58, University Road, Southampton, SO17 1BJ, UK.,ESRC Centre for Population Change, University of Southampton, Southampton, UK
| | - Nisreen A Alwan
- School of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.,NIHR Applied Research Collaboration Wessex, Southampton, UK
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30
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A Review of Family Environment and Neurobehavioral Outcomes Following Pediatric Traumatic Brain Injury: Implications of Early Adverse Experiences, Family Stress, and Limbic Development. Biol Psychiatry 2022; 91:488-497. [PMID: 34772505 DOI: 10.1016/j.biopsych.2021.08.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/21/2021] [Accepted: 08/11/2021] [Indexed: 12/30/2022]
Abstract
Pediatric traumatic brain injury (TBI) is a public health crisis, with neurobehavioral morbidity observed years after an injury associated with changes in related brain structures. A substantial literature base has established family environment as a significant predictor of neurobehavioral outcomes following pediatric TBI. The neural mechanisms linking family environment to neurobehavioral outcomes have, however, received less empiric study in this population. In contrast, limbic structural differences as well as challenges with emotional adjustment and behavioral regulation in non-TBI populations have been linked to a multitude of family environmental factors, including family stress, parenting style, and adverse childhood experiences. In this article, we systematically review the more comprehensive literature on family environment and neurobehavioral outcomes in pediatric TBI and leverage the work in both TBI and non-TBI populations to expand our understanding of the underlying neural mechanisms. Thus, we summarize the extant literature on the family environment's role in neurobehavioral sequelae in children with TBI and explore potential neural correlates by synthesizing the wealth of literature on family environment and limbic development, specifically related to the amygdala. This review underscores the critical role of environmental factors, especially those predating the injury, in modeling recovery outcomes post-TBI in childhood, and discusses clinical and research implications across pediatric populations. Given the public health crisis of pediatric TBI, along with the context of sparse available medical interventions, a broader understanding of factors contributing to outcomes is warranted to expand the range of intervention targets.
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31
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Teicher MH, Gordon JB, Nemeroff CB. Recognizing the importance of childhood maltreatment as a critical factor in psychiatric diagnoses, treatment, research, prevention, and education. Mol Psychiatry 2022; 27:1331-1338. [PMID: 34737457 PMCID: PMC8567985 DOI: 10.1038/s41380-021-01367-9] [Citation(s) in RCA: 90] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/20/2021] [Accepted: 10/15/2021] [Indexed: 12/22/2022]
Abstract
Childhood maltreatment is the most important preventable risk factor for psychiatric disorders. Maltreated individuals typically develop psychiatric disorders at an earlier age, have a more pernicious course, more comorbidities, greater symptom severity, and respond less favorably to treatments than non-maltreated individuals with the same primary DSM-5 diagnosis. Furthermore, maltreated individuals have alterations in stress-susceptible brain regions, hypothalamic-pituitary-adrenal response, and inflammatory marker levels not discernible in their non-maltreated counterparts. Hence, maltreated and non-maltreated individuals with the same primary DSM-5 diagnoses appear to be clinically and neurobiologically distinct. The failure to embody this distinction in DSM-5 has interfered with our ability to discover novel treatments, to recommend currently available treatments most likely to be efficacious, and has been a largely unrecognized confound that has thwarted our ability to identify the biological basis for major psychiatric disorders. Incorporating this distinction into DSM will help transform this sign and symptom-based classification system to a more etiologically informed nosology. We discuss several diagnostic alternatives and recommend the inclusion of a Developmental Trauma Disorder diagnosis for severely dysregulated individuals, of all ages, with numerous comorbidities, who experienced interpersonal victimization and disruptions in attachment, such as emotional maltreatment or neglect. For less severely affected maltreated individuals, we suggest using conventional diagnostic categories, such as major depression, but with an essential modifier indicating a history of childhood maltreatment, or early life stress, to delineate the ecophenotypic variant. Implementing this strategy should improve our ability to effectively diagnose and treat individuals with psychiatric disorders and to accelerate discovery.
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Affiliation(s)
- Martin H Teicher
- Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, 02478, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
| | - Jeoffry B Gordon
- Citizens Review Panel-Critical Incidents, Office of Child Abuse Prevention, California Department of Social Services, Sacramento, CA, USA
| | - Charles B Nemeroff
- Institute of Early Life Adversity Research, The University of Texas at Austin, Austin, TX, 78712-1873, USA.
- Mulva Clinic for the Neurosciences, The University of Texas at Austin, Austin, TX, 78712-1873, USA.
- Department of Psychiatry and Behavioral Sciences, The University of Texas at Austin, Austin, TX, 78712-1873, USA.
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32
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Mathur A, Li JC, Lipitz SR, Graham-Engeland JE. Emotion Regulation as a Pathway Connecting Early Life Adversity and Inflammation in Adulthood: a Conceptual Framework. ADVERSITY AND RESILIENCE SCIENCE 2022; 3:1-19. [PMID: 35224511 PMCID: PMC8863511 DOI: 10.1007/s42844-022-00051-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/06/2022] [Indexed: 11/03/2022]
Abstract
Chronic inflammation is implicated in a variety of diseases (e.g., cardiovascular disease and cancer). Much evidence suggests that early life adversity (ELA), such as maltreatment or neglect, can increase risk for inflammation in adulthood. ELA may program proinflammatory activity via its effects on brain areas involved in emotion regulation. Of multiple emotion regulation strategies, some are considered maladaptive (e.g., expressive suppression), while others are generally adaptive (e.g., cognitive reappraisal). We propose a conceptual framework for how emotion regulation tendencies may affect vulnerability or resilience to inflammation in adults who experienced adversity in childhood and/or adolescence. In support of this framework, we summarize evidence for the relationships between emotion dysregulation and higher inflammation (i.e., vulnerability), as well as between cognitive reappraisal and lower inflammation (i.e., resilience), in healthy adults with a history of ELA. Plausible neurobiological, physiological, psychosocial, and ELA-specific factors, as well as interventions, contributing to these associations are discussed. Strengths and limitations of the extant research, in addition to ideas for future directions, are presented.
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33
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Deutschmann AU, Kirkland JM, Briand LA. Adolescent social isolation induced alterations in nucleus accumbens glutamate signalling. Addict Biol 2022; 27:e13077. [PMID: 34278652 PMCID: PMC9206853 DOI: 10.1111/adb.13077] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/20/2021] [Accepted: 06/28/2021] [Indexed: 01/03/2023]
Abstract
Exposure to adversity during early childhood and adolescence increases an individual's vulnerability to developing substance use disorder. Despite the knowledge of this vulnerability, the mechanisms underlying it are still poorly understood. Excitatory afferents to the nucleus accumbens (NAc) mediate responses to both stressful and rewarding stimuli. Understanding how adolescent social isolation alters these afferents could inform the development of targeted interventions both before and after drug use. Here, we used social isolation rearing as a model of early life adversity which we have previously demonstrated increases vulnerability to cocaine addiction-like behaviour. The current study examined the effect of social isolation rearing on presynaptic glutamatergic transmission in NAc medium spiny neurons in both male and female mice. We show that social isolation rearing alters presynaptic plasticity in the NAc by decreasing the paired-pulse ratio and the size of the readily releasable pool of glutamate. Optogenetically activating the glutamatergic input from the ventral hippocampus to the NAc is sufficient to recapitulate the decreases in paired-pulse ratio and readily releasable pool size seen following electrical stimulation of all NAc afferents. Further, optogenetically inhibiting the ventral hippocampal afferent during electrical stimulation eliminates the effect of early life adversity on the paired-pulse ratio or readily releasable pool size. In summary, we demonstrate that social isolation rearing leads to alterations in glutamate transmission driven by projections from the ventral hippocampus. These data suggest that targeting the circuit from the ventral hippocampus to the nucleus accumbens could provide a means to reverse stress-induced plasticity.
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Affiliation(s)
| | | | - Lisa A. Briand
- Department of Psychology, Temple University,Neuroscience Program, Temple University
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34
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Li S, Wang R, Thomas E, Jiang Z, Jin Z, Li R, Qian Y, Song X, Sun Y, Zhang S, Chen R, Wan Y. Patterns of adverse childhood experiences and depressive symptom trajectories in young adults: A longitudinal study of college students in China. Front Psychiatry 2022; 13:918092. [PMID: 35958653 PMCID: PMC9358020 DOI: 10.3389/fpsyt.2022.918092] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 06/30/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs) tend to cluster together in daily life, and most studies focus on the level of depression at certain points, but the dynamic process of depression is often neglected. Thus, research is urgently needed to explore the relationship between ACEs pattern and trajectory of depressive symptom levels at multiple time points in order to provides early targeted interventions to those who are most at risk. OBJECTIVE We aimed to explore patterns of ACEs, including types and timing, associated with depression trajectories in college students. METHODS A school-based health survey was used to collect data as part of a longitudinal study in two medical college in Anhui province, China. Questionnaires were issued to 3,662 participants aged 17-22 and recorded details of ACEs (types and timing) and depression. Latent class analysis (LCA) was used to identify "patterns" of ACEs type and timing. Depressive symptom trajectories employed latent class growth analysis (LCGA). Multiple logistic regressions were employed to evaluate the relationships between ACEs patterns and depressive symptom trajectories. RESULTS We identified five ACEs patterns: "High neglect/emotional abuse/community violence," "High neglect/emotional abuse," "High neglect/family dysfunction," "High neglect," "Low ACEs." We traced three depression trajectories: "High depressive symptom" "Moderate depressive symptom," "Low depressive symptom." "High neglect/emotional abuse/community violence," "High neglect/emotional abuse" and "High neglect/family dysfunction" demonstrated a high risk for "High depressive symptom" and "Moderate depressive symptom." "High neglect" showed a high risk for "Moderate depressive symptom" but not for "High depressive symptom" (P < 0.05). CONCLUSIONS The findings address the need for a comprehensive consideration of exposure to childhood adversity associated with the risk of depression in young adults through identifying more problematic ACEs patterns amongst exposed children.
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Affiliation(s)
- Shuqin Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui, China
| | - Rui Wang
- Teaching Affairs Office, Anqing Medical College, Anhui, China
| | - Erica Thomas
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
| | - Zhicheng Jiang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui, China
| | - Zhengge Jin
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui, China
| | - Ruoyu Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui, China
| | - Yan Qian
- Teaching Affairs Office, Anqing Medical College, Anhui, China
| | - Xianbing Song
- Department of Human Anatomy, Histology and Embryology, Anhui Medical College, Anhui, China
| | - Ying Sun
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui, China
| | - Shichen Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui, China
| | - Ruoling Chen
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
| | - Yuhui Wan
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui, China
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35
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Yang T, He Y, Wu S, Cui X, Luo X, Liu J. Association between schizoid tendencies and aggressive behaviors: mediating and moderating influences in childhood trauma and life events among Chinese adolescents. Ann Gen Psychiatry 2021; 20:51. [PMID: 34861879 PMCID: PMC8642850 DOI: 10.1186/s12991-021-00371-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 10/28/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND This study investigated an association between schizoid tendencies and aggressive behaviors in Chinese adolescents, and explored the underlying mechanism. METHODS The data of 3094 adolescents aged 12 to 16 years were collected from an epidemiological survey in China. All the subjects or their parents completed the Achenbach's Child Behavior Checklist, the Childhood Trauma Questionnaire-Short Form, and the Adolescent Self-rating Life Event Checklist (ASLEC). RESULTS Relative to the non-schizoid group, adolescents with schizoid tendencies (male or female) showed significantly higher scores for aggressive behaviors, emotional abuse, and ASLEC. Regarding females only, those with schizoid tendencies had significantly higher (lower) scores for physical abuse and emotional neglect (physical neglect). The aggressive behaviors score was predicted by scores for schizoid tendencies (βmale = 0.620, βfemale = 0.638, both P < 0.001) and ASLEC (βmale = 0.125, βfemale = 0.061, both P < 0.01), and by childhood trauma score (males: emotional neglect [β = 0.045, P = 0.021]; females: emotional abuse and sexual abuse [β = 0.118 and - 0.062, both P < 0.01]). The ASLEC and childhood trauma scores mediated the association between scores for schizoid tendencies and aggressive behaviors, specifically, emotional neglect (emotional abuse and sexual abuse) in males (females). In females, the interaction between scores for childhood trauma and ASLEC affected the aggressive behaviors score (P = 0.023). CONCLUSIONS Schizoid tendencies are associated with aggressive behaviors among Chinese adolescents. Recent life events and childhood trauma mediated an association between schizoid tendencies and aggressive behaviors. The interaction between childhood trauma and recent life events affected aggressive behaviors in females. Aggressive behaviors in adolescents may be ameliorated by reducing childhood trauma and life events.
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Affiliation(s)
- Tingyu Yang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Yuqiong He
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Shuxian Wu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Xilong Cui
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Xuerong Luo
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
| | - Jianbo Liu
- Department of Child Psychiatry of Shenzhen Kangning Hospital, Shenzhen Mental Health Center, School of Mental Health, Shenzhen University, Shenzhen, 518003, China.
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36
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Hanson JL, Nacewicz BM. Amygdala Allostasis and Early Life Adversity: Considering Excitotoxicity and Inescapability in the Sequelae of Stress. Front Hum Neurosci 2021; 15:624705. [PMID: 34140882 PMCID: PMC8203824 DOI: 10.3389/fnhum.2021.624705] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 04/23/2021] [Indexed: 12/19/2022] Open
Abstract
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.
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Affiliation(s)
- Jamie L. Hanson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Brendon M. Nacewicz
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, United States
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37
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Kirsch DE, Tretyak V, Radpour S, Weber WA, Nemeroff CB, Fromme K, Strakowski SM, Lippard ETC. Childhood maltreatment, prefrontal-paralimbic gray matter volume, and substance use in young adults and interactions with risk for bipolar disorder. Sci Rep 2021; 11:123. [PMID: 33420255 PMCID: PMC7794246 DOI: 10.1038/s41598-020-80407-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 12/21/2020] [Indexed: 12/13/2022] Open
Abstract
Childhood maltreatment is associated with adverse effects on the brain, and an increased risk for psychopathology, including mood and substance use disorders. Individuals vary on the degree to which they exhibit neurobiological and clinical differences following maltreatment. Individuals with bipolar disorder exhibit greater magnitude of maltreatment-related prefrontal-paralimbic gray matter volume (GMV) deficits compared to typically developing individuals. It is unclear if greater structural differences stem from greater neural vulnerability to maltreatment in bipolar disorder, or if they relate to presence of other clinical features associated with childhood maltreatment, e.g., elevated prevalence of comorbid substance use disorders. To investigate this, we compared young adults with a family history of bipolar disorder (n = 21), but who did not fulfill diagnostic criteria for bipolar disorder, with typically developing young adults without a family history of bipolar disorder (n = 26). Participants completed structural neuroimaging, clinical and family history interviews, and assessment of childhood maltreatment and recent alcohol and cannabis use patterns. We examined relations between childhood maltreatment and prefrontal-paralimbic GMV by modeling main effects of maltreatment and family history group by maltreatment interactions on prefrontal-paralimbic GMV. We also examined relations between maltreatment and associated GMV changes with recent alcohol and cannabis use. Childhood maltreatment correlated with lower ventral, rostral and dorsolateral prefrontal and insular cortical GMV across all participants regardless of the presence or absence of familial history of bipolar disorder. However, exploratory analyses did reveal greater maltreatment-related GMV differences in individuals with prodromal symptoms of depression. Lower insula GMV was associated with greater frequency of cannabis use across all participants and greater quantity of alcohol use only in those with familial risk for bipolar disorder. Results suggest familial risk for bipolar disorder, and presumably genetic risk, may relate to outcomes following childhood maltreatment and should be considered in prevention/early intervention strategies.
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Affiliation(s)
- Dylan E Kirsch
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, 1601 Trinity Street, Stop Z0600, Health Discovery Building, Austin, TX, 78712, USA.,Waggoner Center for Alcohol and Addiction Research, University of Texas, Austin, TX, USA.,Institute for Neuroscience, University of Texas, Austin, TX, USA
| | - Valeria Tretyak
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, 1601 Trinity Street, Stop Z0600, Health Discovery Building, Austin, TX, 78712, USA.,Waggoner Center for Alcohol and Addiction Research, University of Texas, Austin, TX, USA.,Department of Psychology, University of Texas, Austin, TX, USA
| | - Sepeadeh Radpour
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, 1601 Trinity Street, Stop Z0600, Health Discovery Building, Austin, TX, 78712, USA
| | - Wade A Weber
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, 1601 Trinity Street, Stop Z0600, Health Discovery Building, Austin, TX, 78712, USA
| | - Charles B Nemeroff
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, 1601 Trinity Street, Stop Z0600, Health Discovery Building, Austin, TX, 78712, USA.,Waggoner Center for Alcohol and Addiction Research, University of Texas, Austin, TX, USA.,Institute of Early Life Adversity Research, University of Texas, Austin, TX, USA
| | - Kim Fromme
- Waggoner Center for Alcohol and Addiction Research, University of Texas, Austin, TX, USA.,Department of Psychology, University of Texas, Austin, TX, USA
| | - Stephen M Strakowski
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, 1601 Trinity Street, Stop Z0600, Health Discovery Building, Austin, TX, 78712, USA.,Waggoner Center for Alcohol and Addiction Research, University of Texas, Austin, TX, USA.,Institute for Neuroscience, University of Texas, Austin, TX, USA.,Department of Psychology, University of Texas, Austin, TX, USA
| | - Elizabeth T C Lippard
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, 1601 Trinity Street, Stop Z0600, Health Discovery Building, Austin, TX, 78712, USA. .,Waggoner Center for Alcohol and Addiction Research, University of Texas, Austin, TX, USA. .,Institute for Neuroscience, University of Texas, Austin, TX, USA. .,Department of Psychology, University of Texas, Austin, TX, USA. .,Institute of Early Life Adversity Research, University of Texas, Austin, TX, USA.
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Bohus M, Kleindienst N, Hahn C, Müller-Engelmann M, Ludäscher P, Steil R, Fydrich T, Kuehner C, Resick PA, Stiglmayr C, Schmahl C, Priebe K. Dialectical Behavior Therapy for Posttraumatic Stress Disorder (DBT-PTSD) Compared With Cognitive Processing Therapy (CPT) in Complex Presentations of PTSD in Women Survivors of Childhood Abuse: A Randomized Clinical Trial. JAMA Psychiatry 2020; 77:1235-1245. [PMID: 32697288 PMCID: PMC7376475 DOI: 10.1001/jamapsychiatry.2020.2148] [Citation(s) in RCA: 87] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Childhood abuse significantly increases the risk of developing posttraumatic stress disorder (PTSD), often accompanied by symptoms of borderline personality disorder (BPD) and other co-occurring mental disorders. Despite the high prevalence, systematic evaluations of evidence-based treatments for PTSD after childhood abuse are sparse. OBJECTIVE To compare the efficacy of dialectical behavior therapy for PTSD (DBT-PTSD), a new, specifically designed, phase-based treatment program, against that of cognitive processing therapy (CPT), one of the best empirically supported treatments for PTSD. DESIGN, SETTING, AND PARTICIPANTS From January 2014 to October 2016, women who sought treatment were included in a multicenter randomized clinical trial with blinded outcome assessments at 3 German university outpatient clinics. The participants were prospectively observed for 15 months. Women with childhood abuse-associated PTSD who additionally met 3 or more DSM-5 criteria for BPD, including affective instability, were included. Data analysis took place from October 2018 to December 2019. INTERVENTIONS Participants received equal dosages and frequencies of DBT-PTSD or CPT, up to 45 individual sessions within 1 year and 3 additional sessions during the following 3 months. MAIN OUTCOMES AND MEASURES The predefined primary outcome was the course of the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) score from randomization to month 15. Intent-to-treat analyses based on dimensional CAPS-5 scores were complemented by categorical outcome measures assessing symptomatic remission, reliable improvement, and reliable recovery. RESULTS Of 955 consecutive individuals assessed for eligibility, 193 were randomized (DBT-PTSD, 98; CPT, 95; mean [SD] age, 36.3 [11.1] years) and included in the intent-to-treat analyses. Analysis revealed significantly improved CAPS-5 scores in both groups (effect sizes: DBT-PTSD: d, 1.35; CPT: d, 0.98) and a small but statistically significant superiority of DBT-PTSD (group difference: 4.82 [95% CI, 0.67-8.96]; P = .02; d, 0.33). Compared with the CPT group, participants in the DBT-PTSD group were less likely to drop out early (37 [39.0%] vs 25 [25.5%]; P = .046) and had higher rates of symptomatic remission (35 [40.7%] vs 52 [58.4%]; P = .02), reliable improvement (53 [55.8%] vs 73 [74.5%]; P = .006), and reliable recovery (34 [38.6%] vs 52 [57.1%]; P = .01). CONCLUSIONS AND RELEVANCE These findings support the efficacy of DBT-PTSD and CPT in the treatment of women with childhood abuse-associated complex PTSD. Results pertaining to the primary outcomes favored DBT-PTSD. The study shows that even severe childhood abuse-associated PTSD with emotion dysregulation can be treated efficaciously. TRIAL REGISTRATION German Clinical Trials Register: DRKS00005578.
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Affiliation(s)
- Martin Bohus
- Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany,McLean Hospital, Harvard Medical School, Boston, Massachusetts
| | - Nikolaus Kleindienst
- Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Christopher Hahn
- Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | | | - Petra Ludäscher
- Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Regina Steil
- Institute of Psychology, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Thomas Fydrich
- Department of Psychology, Faculty of Life Sciences, Humboldt University, Berlin, Germany
| | - Christine Kuehner
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Patricia A. Resick
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina
| | | | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Kathlen Priebe
- Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany,Department of Psychology, Faculty of Life Sciences, Humboldt University, Berlin, Germany,Department of Psychiatry and Psychotherapy, Charité–Universitätsmedizin Berlin, Berlin, Germany
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39
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Sicorello M, Thome J, Herzog J, Schmahl C. Differential Effects of Early Adversity and Posttraumatic Stress Disorder on Amygdala Reactivity: The Role of Developmental Timing. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 6:1044-1051. [PMID: 33359153 DOI: 10.1016/j.bpsc.2020.10.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/28/2020] [Accepted: 10/13/2020] [Indexed: 01/23/2023]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is associated with altered processing of threat-related stimuli. Neurobiological models implicate right amygdala hyperreactivity in these alterations, but this potential biomarker also has been observed in individuals exposed to adverse childhood experiences (ACEs) (i.e., abuse and neglect) without psychopathology. Separation of the differential contributions of PTSD and ACEs to amygdala reactivity might benefit from incorporating the developmental timing of the events. METHODS We conducted comprehensive retrospective interviews assessing ACEs for each life year between the ages of 1 and 17 years in a sample of 60 women exposed to trauma (including 34 participants with PTSD and 26 healthy participants). Functional magnetic resonance imaging was used to extract amygdala reactivity to threatening versus neutral scenes. Amygdala reactivity was predicted from PTSD diagnosis, total ACE severity, and ACE severity by life year using random forest regression. RESULTS PTSD and ACEs significantly predicted reactivity in the right amygdala (R2 = 7%) but did not explain variance in the left amygdala. ACEs during both a prepubertal (ages 3 and 4) and a postpubertal (ages 16 and 17) period emerged as particularly predictive, while total ACE severity did not contribute to prediction. Follow-up analyses revealed a positive relationship between amygdala activity and PTSD and a negative relationship between amygdala activity and ACEs during predictive life years. CONCLUSIONS The opposing effects of PTSD and ACEs caution against simplistic etiological and diagnostic interpretations of amygdala function. The identification of potentially sensitive periods for the effects of ACEs on amygdala reactivity to threat may help to uncover interactions between traumatization and development of PTSD.
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Affiliation(s)
- Maurizio Sicorello
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany.
| | - Janine Thome
- Department of Theoretical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Julia Herzog
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
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40
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Yuan M, Rubin-Falcone H, Lin X, Rizk MM, Miller JM, Sublette ME, Oquendo MA, Burke A, Ogden RT, Mann JJ. Smaller left hippocampal subfield CA1 volume is associated with reported childhood physical and/or sexual abuse in major depression: A pilot study. J Affect Disord 2020; 272:348-354. [PMID: 32553377 DOI: 10.1016/j.jad.2020.03.169] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 02/22/2020] [Accepted: 03/29/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Smaller hippocampal volumes are reported in adults with major depressive disorder (MDD) and in reported childhood abuse. The hippocampus is a complex structure with distinct functional subfields. We sought to examine the effect of MDD diagnosis and childhood abuse on hippocampal subfields. METHODS Forty-one MDD participants (17 reported abuse and 24 did not) and 46 healthy volunteers (HV) (2 reported abuse) underwent T1- weighted structural magnetic resonance imaging (MRI) and clinical characterization in a retrospective design. A subfield segmentation program was used to measure the whole and subfield hippocampal volumes. Linear mixed-effects models were fitted for group comparisons. RESULTS No main effect of diagnosis interaction effect between diagnosis and subfield region was observed. However, a comparison of abused MDD vs. HVs showed a group by region interaction. A significant interaction between childhood abuse and region was observed. Effects were confined to the left side of the brain, and post hoc, exploratory region-specific tests indicated smaller left CA1 volume in abused MDD compared with non-abused MDD. In addition, smaller amygdala volume was found in all MDD compared with HVs. LIMITATIONS We did not have a sample of healthy volunteers with reported childhood abuse. CONCLUSIONS The diagnosis of pure MDD may not be sufficient to exert effects on hippocampal volumes, indicating the importance of taking into account childhood trauma in studies on psychopathological mechanisms. Left CA1 might be the hippocampal subfield most relevant to reported childhood abuse. Smaller amygdala volume may be related to MDD diagnosis independent of childhood abuse.
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Affiliation(s)
- Minlan Yuan
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China; Department of Psychiatry, Columbia University, New York, NY, United States; Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States.
| | - Harry Rubin-Falcone
- Department of Psychiatry, Columbia University, New York, NY, United States; Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States
| | - Xuejing Lin
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Mina M Rizk
- Department of Psychiatry, Columbia University, New York, NY, United States; Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States; Department of Psychiatry, Faculty of Medicine, Minia University, Egypt
| | - Jeffrey M Miller
- Department of Psychiatry, Columbia University, New York, NY, United States; Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States
| | - M Elizabeth Sublette
- Department of Psychiatry, Columbia University, New York, NY, United States; Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States
| | - Maria A Oquendo
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Ainsley Burke
- Department of Psychiatry, Columbia University, New York, NY, United States; Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States
| | - R Todd Ogden
- Department of Psychiatry, Columbia University, New York, NY, United States; Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States; Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - J John Mann
- Department of Psychiatry, Columbia University, New York, NY, United States; Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States; Department of Radiology, Columbia University College of Physicians and Surgeons, New York, NY, United States.
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