Anatomical and Neurochemical Correlates of Parental Verbal Abuse: A Combined MRS-Diffusion MRI Study

Prolonged Disease Course Leads to Impaired Brain Function in Anxiety Disorder: A Resting State EEG Study

Objective

Anxiety disorder (AD) is a common disabling disease. The prolonged disease course may lead to impaired cognitive performance, brain function, and a bad prognosis. Few studies have examined the effect of disease course on brain function by electroencephalogram (EEG).

Methods

Resting-state EEG analysis was performed in 34 AD patients. The 34 patients with AD were divided into two groups according to the duration of their illness: anxious state (AS) and generalized anxiety disorder (GAD). Then, EEG features, including univariate power spectral density (PSD), fuzzy entropy (FE), and multivariable functional connectivity (FC), were extracted and compared between AS and GAD. These features were evaluated by three previously validated machine learning methods to test the accuracy of classification in AS and GAD.

Results

Significant decreased PSD and FE in GAD were detected compared with AS, especially in the Alpha 2 band. In addition, FC analysis indicated that GAD patients' connection between the left and right hemispheres decreased. Based on machine learning, AS and GAD are classified on a six-month criterion with the highest classification accuracy of up to 0.99 ± 0.0015.

Conclusion

The brain function of patients is more severely impaired in AD patients with longer illness duration. Resting-state EEG demonstrated to be a promising examination in the classification in GAD and AS using machine learning methods with better classification accuracy.

Atypical brain structural connectivity and social cognition in childhood maltreatment and peer victimisation

BACKGROUND

Childhood maltreatment (CM) is associated with neurobiological aberrations and atypical social cognition. Few studies have examined the neural effects of another common early-life interpersonal stressor, namely peer victimisation (PV). This study examines the associations between tract aberrations and childhood interpersonal stress from caregivers (CM) and peers (PV), and explores how the observed tract alterations are in turn related to affective theory of mind (ToM).

METHODS

Data from 107 age-and gender-matched youths (34 CM [age = 19.9 ± 1.68; 36%male], 35 PV [age = 19.9 ± 1.65; 43%male], 38 comparison subjects [age = 20.0 ± 1.66; 42%male] were analysed using tractography and whole-brain tract-based spatial statistics (TBSS).

RESULTS

At the whole-brain level using TBSS, the CM group had higher fractional anisotropy (FA) than the PV and comparison groups in a cluster of predominantly limbic and corpus callosal pathways. Segmented tractography indicated the CM group had higher FA in right uncinate fasciculus compared to both groups. They also had smaller right anterior thalamic radiation (ATR) tract volume than the comparison group and higher left ATR FA than the PV group, with these metrics associated with higher emotional abuse and enhanced affective ToM within the CM group, respectively. The PV group had lower inferior fronto-occipital fasciculus FA than the other two groups, which was related to lower affective ToM within the PV group.

CONCLUSION

Findings suggest that exposure to early-life stress from caregivers and peers are differentially associated with alterations of neural pathways connecting the frontal, temporal and occipital cortices involved in cognitive and affective control, with possible links to their atypical social cognition.

Childhood verbal abuse as a child maltreatment subtype: A systematic review of the current evidence

BACKGROUND

In recent years, the prevalence of childhood emotional abuse has surpassed other forms of maltreatment. Childhood verbal abuse (CVA) is a key attribute of emotional abuse, yet CVA is not recognized as its own form of maltreatment and thus, has not received adequate attention. Clear terminology, definitions, and measures are needed to aid in assessing the occurrence and impact of CVA for its recognition and prevention.

OBJECTIVE

We aim to synthesize the evidence on the terms, definitions, and measurements of CVA and identify outcomes associated with CVA.

PARTICIPANTS AND SETTING

A systematic review focused on adult perpetration of CVA among children and adolescents using clinical, community-based, and population-based samples.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed and four databases were utilized in May 2022: PsycINFO, MEDLINE, EMBASE, and ProQuest. A total of 149 quantitative and 17 qualitative studies were identified.

RESULTS

Across studies reviewed, the most common perpetrators of CVA were parents, mothers, and teachers. Definitional themes for CVA included negative speech volume, tone, and speech content, and their immediate impact. The most frequent measures cited were Adverse Childhood Experiences Study (ACE) Questionnaire and the Conflict Tactics Scale (CTS); 50 % used self-created measures. CVA was associated with a range of internalizing and externalizing outcomes across the lifespan.

CONCLUSIONS

Recognizing CVA as a form of maltreatment will be a starting point for its identification and prevention. Primary prevention of CVA using trauma-informed approaches must include adult training on the importance of safety, support, and nurturance during verbal communication with children.

Effects of Parental Verbal Abuse Experience on the Glutamate Response to Swear Words in the Ventromedial Prefrontal Cortex: A Functional 1H-magnetic Resonance Spectroscopy Study

Objective

Several lines of evidence indicate verbal abuse (VA) critically impacts the developing brain; however, whether VA results in changes in brain neurochemistry has not been established. Here, we hypothesized that exposure to recurrent parental VA elicits heightened glutamate (Glu) responses during the presentation of swear words, which can be measured with functional magnetic resonance spectroscopy (fMRS).

Methods

During an emotional Stroop task consisting of blocks of color and swear words, metabolite concentration changes were measured in the ventromedial prefrontal cortex (vmPFC) and the left amygdalohippocampal region (AMHC) of healthy adults (14 F/27 M, 23 ± 4 years old) using fMRS. The dynamic changes in Glu and their associations with the emotional state of the participants were finally evaluated based on 36 datasets from the vmPFC and 30 from the AMHC.

Results

A repeated-measures analysis of covariance revealed a modest effect of parental VA severity on Glu changes in the vmPFC. The total score on the Verbal Abuse Questionnaire by parents (pVAQ) was associated with the Glu response to swear words (ΔGluSwe). The interaction term of ΔGluSwe and baseline N-acetyl aspartate (NAA) level in the vmPFC could be used to predict state-trait anxiety level and depressive mood. We could not find any significant associations between ΔGluSwe in the AMHC and either pVAQ or emotional states.

Conclusion

Parental VA exposure in individuals is associated with a greater Glu response towards VA-related stimuli in the vmPFC and that the accompanying low NAA level may be associated with anxiety level or depressive mood.

Cross-sectional study of retrospective self-reported childhood emotional neglect and inhibitory neurometabolite levels in the pregenual anterior cingulate cortex in adult humans

High childhood emotional maltreatment (CM-EMO) is reported in mood and anxiety disorders. The associations with an increased risk for psychopathology are not fully understood. One potential factor may be through alterations in gamma-Aminobutyric acid (GABA). The pregenual anterior cingulate cortex (pgACC) is an important brain region for emotion processing and its' GABA levels were previously implicated in mood and anxiety disorders pathophysiology. We examined the association between the self-reported CM-EMO in adulthood and GABA + levels in the pgACC and in a control region, anterior mid cingulate cortex. GABA+ and total creatine (tCr) were measured in the pgACC and aMCC voxels in seventy-four healthy volunteers (32 (43%) women, ages 19-54, age [standard deviation] = 27.1 [6.5]) using proton magnetic resonance spectroscopy at 7 T. Childhood Trauma Questionnaire was completed by adult participants to measure retrospective self-reported experience of emotional neglect (CM-EMO-NEG) and emotional abuse (CM-EMO-AB) during childhood. Linear mixed models tested the interaction between the region and the two subscales, and GABA+/tCr ratios, with an adjusted alpha = 0.025. Following, linear models, including with covariates were tested. There was an interaction effect between region and CM-EMO-NEG (B = -0.007, p = 0.009), driven by a negative relationship between CM-EMO-NEG and GABA+/tCr in the pgACC (B = -0.004, p = 0.013). Results for CM-EMO-NEG were robust to inclusion of different covariates (ps < 0.035). There was no interaction effect for the CM-EMO-AB (B = 0.007, p = 0.4). Limitations include cross-sectional measurement and retrospective nature of the CTQ. The findings indicate preliminary importance of inhibitory neurometabolite concentrations in the pgACC for retrospective reporting of CM-EMO-NEG.

Effects of degraded speech processing and binaural unmasking investigated using functional near-infrared spectroscopy (fNIRS)

The present study aimed to investigate the effects of degraded speech perception and binaural unmasking using functional near-infrared spectroscopy (fNIRS). Normal hearing listeners were tested when attending to unprocessed or vocoded speech, presented to the left ear at two speech-to-noise ratios (SNRs). Additionally, by comparing monaural versus diotic masker noise, we measured binaural unmasking. Our primary research question was whether the prefrontal cortex and temporal cortex responded differently to varying listening configurations. Our a priori regions of interest (ROIs) were located at the left dorsolateral prefrontal cortex (DLPFC) and auditory cortex (AC). The left DLPFC has been reported to be involved in attentional processes when listening to degraded speech and in spatial hearing processing, while the AC has been reported to be sensitive to speech intelligibility. Comparisons of cortical activity between these two ROIs revealed significantly different fNIRS response patterns. Further, we showed a significant and positive correlation between self-reported task difficulty levels and fNIRS responses in the DLPFC, with a negative but non-significant correlation for the left AC, suggesting that the two ROIs played different roles in effortful speech perception. Our secondary question was whether activity within three sub-regions of the lateral PFC (LPFC) including the DLPFC was differentially affected by varying speech-noise configurations. We found significant effects of spectral degradation and SNR, and significant differences in fNIRS response amplitudes between the three regions, but no significant interaction between ROI and speech type, or between ROI and SNR. When attending to speech with monaural and diotic noises, participants reported the latter conditions being easier; however, no significant main effect of masker condition on cortical activity was observed. For cortical responses in the LPFC, a significant interaction between SNR and masker condition was observed. These findings suggest that binaural unmasking affects cortical activity through improving speech reception threshold in noise, rather than by reducing effort exerted.

White matter integrity moderates the relation between experienced childhood maltreatment and fathers' behavioral response to infant crying

The ability to provide appropriate responses to infant distress is vital to paternal care, but may be affected by fathers' experiences of childhood maltreatment. Detrimental effects of childhood maltreatment have been found in the adult brain's white matter fibers, accompanied with impaired emotional and cognitive functioning. In the current study (N = 121), we examined new and expectant fathers' childhood maltreatment experiences (i.e. emotional and physical abuse and neglect), current behavioral responses (i.e. handgrip force) to infant cry sounds, and white matter integrity using diffusion tensor imaging. First, more exposure to childhood maltreatment was associated with more use of excessive handgrip force in response to infant crying by fathers. Second, the association between experienced childhood maltreatment and white matter integrity was not significant in whole-brain analyses. Lastly, we found that the association between maltreatment exposure and excessive handgrip force during infant crying was absent in fathers with high tract integrity in the bilateral uncinate fasciculus. These findings possibly point to insufficient behavioral inhibition or emotional dysregulation in fathers who experienced childhood maltreatment, but buffering for this effect in those with larger integrity in brain fibers connecting the amygdala and prefrontal cortex.

Validation of the Traumatic Antecedents Questionnaire using item response theory

BACKGROUND

Traumatic Antecedents Questionnaire (TAQ) is a traumatic experience scale that measures exposure to traumatic events across four age periods. Although the TAQ has good convergent validity with other traumatic scales, the classification of the domains and the psychometric properties of the scale has not been verified.

METHODS

A total of 290 young adults completed the TAQ, and 156 participated in the retest. The number of trauma domains was determined using principal component analysis. Rasch model was used for verifying the items that each domain might represent in one common measurement.

RESULTS

When scores were transformed as binary a code 0 and 1 from the original 4 categories, 8 domains were established consisting of Domestic violence, Sexual/other rare trauma, Incompetence, Caring family, Accidents to close person, Unstable caring environment, Safe environment, and Lack of sexual/extreme trauma. Most domains had acceptable psychometric properties with a mean-square fit value within the range of 0.7-1.3. The Bland and Altman analysis suggest 98.7% of difference scores between test and retest were within ±2 standard deviations from the mean. TAQ severity showed a significant relationship with the multiplicity score of the Maltreatment and Abuse Chronology of Exposure scale (r = 0.677).

CONCLUSIONS

The newly proposed scoring system and 8 domains for the TAQ demonstrated excellent internal consistency, test-retest reliability, and validity. Further studies are needed to develop new items in domains with less than 5 items to improve the psychometric properties of the scale and to create a maltreatment domain that includes bullying items.