Exploring the Relationship Between Childhood Maltreatment and Addiction: A Review of the Neurocognitive Evidence

Childhood maltreatment has been shown to increase the risk of a range of psychiatric disorders including substance use disorders (SUDs) and is associated with the onset, course and severity of illness. We review the evidence for alterations in brain structure and neurocognitive processing in individuals who have experienced childhood maltreatment, focusing specifically on changes related to reward processing, executive functioning and affect processing. Changes in these neurocognitive systems have been documented in adults presenting with SUDs, who are typically characterized by heightened subcortico-striatal responses to salient stimuli and impairments in fronto-cingulate regulation. Maltreatment-specific effects in these processing domains may account for the particularly severe clinical presentation of SUDs in adults with histories of maltreatment in childhood. The findings are considered in relation to the theory of latent vulnerability, which contends that alterations in these neurocognitive systems may reflect calibration to early risk environments that in turn increases the risk of developing of SUDs later in life

Risk-taking, peer-influence and child maltreatment: A neurocognitive investigation

Maltreatment is associated with increased risk of a range of psychiatric disorders, many of which are characterized by altered risk-taking propensity. Currently, little is known about the neural correlates of risk-taking in children exposed to maltreatment, nor whether their risk-taking is atypically modulated by peer influence. Seventy-five 10-14 year-old children (maltreated (MT) group: N = 41; non-maltreated Group (NMT): N = 34) performed a Balloon Analogue Risk Task (BART), under three different peer influence conditions: while alone; while being observed by a peer; while being encouraged by a peer to take risks. The MT group engaged in less risk-taking irrespective of peer influence. There was no differential effect of peer influence on risk-taking behaviour across groups. At the neural level the right anterior insula (rAI) exhibited altered risk-sensitivity across conditions in the MT group. Across groups and conditions, rAI risk-sensitivity was negatively associated with risk-taking and within the MT group greater rAI risk-sensitivity was related to more anxiety symptoms. These findings suggest that children with a history of maltreatment show reduced risk-taking but typical responses to peer influence. Abnormal rAI functioning contributes to the pattern of reduced risk-taking and may predispose children exposed to maltreatment to develop future psychopathology

Autobiographical memory as a latent vulnerability mechanism following childhood maltreatment: Association with future depression symptoms and prosocial behavior

OBJECTIVES: Childhood maltreatment is associated with altered neural reactivity during autobiographical memory (ABM) recall and a pattern of overgeneral memory (OGM). Altered ABM and OGM have been linked with psychopathology and poorer social functioning. The present study investigated the association between altered ABM and subsequent socio-emotional functioning (measured two years later) in a sample of adolescents with (N = 20; maltreatment group, MT) and without (N = 17; non-MT group) documented childhood maltreatment histories. METHOD: At baseline, adolescents (aged 12.6 ± 1.45 years) were administered the Autobiographical Memory Test to measure OGM. Participants also recalled specific ABMs in response to emotionally valenced cue words during functional MRI. Adolescents in both groups underwent assessments measuring depressive symptoms and prosocial behavior at both timepoints. Regression analyses were carried out to predict outcome measures at follow-up controlling for baseline levels. RESULTS: In the MT group, greater OGM at baseline significantly predicted reduced prosocial behavior at follow-up and showed a trend level association with elevated depressive symptoms. Patterns of altered ABM-related brain activity did not significantly predict future psycho-social functioning. CONCLUSIONS: The current findings highlight the potential value of OGM as a cognitive mechanism that could be targeted to reduce risk of depression in adolescents with prior histories of maltreatment

Functional brain plasticity following childhood maltreatment: A longitudinal fMRI investigation of autobiographical memory processing

Altered autobiographical memory (ABM) processing characterizes some individuals with experiences of childhood maltreatment. This fMRI study of ABM processing evaluated potential developmental plasticity in neural functioning following maltreatment. Adolescents with (N = 19; MT group) and without (N = 18; Non-MT group) documented childhood maltreatment recalled specific ABMs in response to emotionally valenced cue words during fMRI at baseline (age 12.71 ± 1.48) and follow-up (14.88 ± 1.53 years). Psychological assessments were collected at both timepoints. Longitudinal analyses were carried out with BOLD signal changes during ABM recall and psychopathology to investigate change over time. In both groups there was relative stability of the ABM brain network, with some developmental maturational changes observed in cortical midline structures (ventromedial PFC (vmPFC), posterior cingulate cortex (pCC), and retrosplenial cortex (rSC). Significantly increased activation of the right rSC was observed only in the MT group, which was associated with improved psychological functioning. Baseline group differences in relation to hippocampal functioning, were not detected at follow-up. This study provides preliminary empirical evidence of functional developmental plasticity in children with documented maltreatment experience using fMRI. This suggests that altered patterns of brain function, associated with maltreatment experience, are not fixed and may reflect the potential to track a neural basis of resilience

Ghosts in the nursery: An experimental investigation of a parent's own maltreatment experience, attention to infant faces, and dyadic reciprocity

Previous studies have shown that the experience of childhood maltreatment can influence recognition and processing of emotional cues and that these effects can extend into adulthood. Such alterations in cognitive processing may have important implications for processing of infant affect and parenting behavior. This study investigated whether the experience of childhood maltreatment altered attentional processing of infant faces in a community sample of mothers, using an established visual search task. Increased scores on a measure of childhood maltreatment were associated with decreased preferential bias toward infant faces (indexed by slower reaction times to infant compared to adult faces). Exploratory analysis of the relationship between attentional processing and actual "own child" parenting behavior (as measured by a video-recorded mother-child interaction) found that lower attentional bias to infant faces mediated the relationship between higher levels of childhood maltreatment and lower levels of mother-infant Dyadic Reciprocity. This suggests that childhood maltreatment may have enduring effects on the preferential processing of infant cues as well as parenting behavior

A neurocomputational investigation of reinforcement-based decision making as a candidate latent vulnerability mechanism in maltreated children

Alterations in reinforcement-based decision making may be associated with increased psychiatric vulnerability in children who have experienced maltreatment. A probabilistic passive avoidance task and a model-based functional magnetic resonance imaging analytic approach were implemented to assess the neurocomputational components underlying decision making: (a) reinforcement expectancies (the representation of the outcomes associated with a stimulus) and (b) prediction error signaling (the ability to detect the differences between expected and actual outcomes). There were three main findings. First, the maltreated group (n = 18; mean age = 13), relative to nonmaltreated peers (n = 19; mean age = 13), showed decreased activity during expected value processing in a widespread network commonly associated with reinforcement expectancies representation, including the striatum (especially the caudate), the orbitofrontal cortex, and medial temporal structures including the hippocampus and insula. Second, consistent with previously reported hyperresponsiveness to negative cues in the context of childhood abuse, the maltreated group showed increased prediction error signaling in the middle cingulate gyrus, somatosensory cortex, superior temporal gyrus, and thalamus. Third, the maltreated group showed increased activity in frontodorsal regions and in the putamen during expected value representation. These findings suggest that early adverse environments disrupt the development of decision-making processes, which in turn may compromise psychosocial functioning in ways that increase latent vulnerability to psychiatric disorder

Investigating patterns of neural response associated with childhood abuse v. childhood neglect

BACKGROUND: Childhood maltreatment is robustly associated with increased risk of poor mental health outcome and changes in brain function. The authors investigated whether childhood experience of abuse (e.g. physical, emotional and sexual abuse) and neglect (physical and emotional deprivation) was differentially associated with neural reactivity to threat. METHODS: Participants were drawn from an existing study and allocated to one of four groups based on self-report of childhood maltreatment experience: individuals with childhood abuse experiences (n = 70); individuals with childhood neglect experiences (n = 87); individuals with combined experience of childhood abuse and neglect (n = 50); and non-maltreated individuals (n = 207) propensity score matched (PSM) on gender, age, IQ, psychopathology and SES. Neural reactivity to facial cues signalling threat was compared across groups, allowing the differential effects associated with particular forms of maltreatment experience to be isolated. RESULTS: Brain imaging analyses indicated that while childhood abuse was associated with heightened localised threat reactivity in ventral amygdala, experiences of neglect were associated with heightened reactivity in a distributed cortical fronto-parietal network supporting complex social and cognitive processing as well as in the dorsal amygdala. Unexpectedly, combined experiences of abuse and neglect were associated with hypo-activation in several higher-order cortical regions as well as the amygdala. CONCLUSIONS: Different forms of childhood maltreatment exert differential effects in neural threat reactivity: while the effects of abuse are more focal, the effects of neglect and combined experiences of abuse are more distributed. These findings are relevant for understanding the range of psychiatric outcomes following childhood maltreatment and have implications for intervention