Reward Processing and High-Risk Behaviour in Adolescents with a History of Childhood Abuse

Funding for this study was provided by a Young Investigator Award from the Brain and Behaviour Research Foundation (NARSAD – Grant Number: 18774) awarded to Pia Pechtel. Pia Pechtel reports no biomedical financial interests or potential conflicts of interest.Systematic Literature Review: Abstract Objective: Childhood abuse (CA) is commonly associated with increased frequency of high-risk behaviours (HRB) in adolescence. Similarly, research has highlighted links between CA and blunted responses to reward. To date, little attention has been devoted to examine if altered reward processes may also be linked to increased engagement in HRB. To explore this hypothesis, this systematic review collated research that investigated the relationship among CA, reward processes and HRB. Specifically, the review addressed the question: Are HRB associated with altered reward processes in children and adults with a history of CA? Method: Behavioural and neurobiological studies on CA, reward processing and HRB in children and adults were selected from multidisciplinary and subject-specific databases published prior to the 1st of March 2016. The systematic literature search yielded 271 records with 198 non-duplicated results. Screening of 14 full-text publications led to five eligible studies synthesized in this review. Results: Results confirmed impaired reward learning and increased HRB in those with a history of CA. Associations of blunted anticipatory or consummatory reward processing and HRB in individuals with CA remained inconclusive. Conclusions: Reward learning appears to be associated with CA. Further research is required to explore the relationship between reward processes and HRB. Understanding CA from a neurodevelopment perspective is a critical step to developing effective intervention strategies to reduce HRB. Empirical Paper: Abstract Objective: Following childhood abuse (CA), adolescence often sees the onset of depression and high-risk behaviour (HRB). Despite the prevalence, little is known about underlying neurobiological factors linking CA and HRB. To address this gap, I examined if anticipatory and consummatory reward processing in adolescents with CA predict frequency of HRB, irrespective of depressive symptoms. Methods: Thirty-seven adolescents (M=17.08 years; SD = 1.86) participated in the study: 13 females with CA and current major depressive disorder (MDD), eight females with MDD and no CA, and 16 individuals with no CA and no MDD for comparison (control group). Adolescents completed the Card-Guessing paradigm to assess reward processing, while undergoing a magnetic resonance imaging scan. Neural region-of-interest responses in the striatum and pallidum were assessed during anticipatory and consummatory reward phases. Hierarchical regression models investigated if neural responses to reward were altered based on exposure to CA and if altered neural responses predicted higher use of HRB. Results: Data showed that (1) depressed adolescents engaged more frequently in HRB irrespective of history of CA, (2) anticipatory and consummatory reward processes were not altered based on a history of CA, and (3) blunted activation in right pallidum in anticipation of rewards predicted HRB irrespective of depressive symptoms. Conclusion: Although the current study did not confirm changes in reward processing following CA, blunted reward ‘wanting’ was linked to more frequent HRB. Findings are relevant to theories highlighting the critical role of the pallidum in perceiving cues as rewarding and in initiating goal-directed actions to obtain rewards.Young Investigator Award from the Brain and Behaviour Research Foundation (NARSAD

Demonstrating test‐retest reliability of electrophysiological measures for healthy adults in a multisite study of biomarkers of antidepressant treatment response

Growing evidence suggests that loudness dependency of auditory evoked potentials (LDAEP) and resting EEG alpha and theta may be biological markers for predicting response to antidepressants. In spite of this promise, little is known about the joint reliability of these markers, and thus their clinical applicability. New standardized procedures were developed to improve the compatibility of data acquired with different EEG platforms, and used to examine test‐retest reliability for the three electrophysiological measures selected for a multisite project—Establishing Moderators and Biosignatures of Antidepressant Response for Clinical Care (EMBARC). Thirty‐nine healthy controls across four clinical research sites were tested in two sessions separated by about 1 week. Resting EEG (eyes‐open and eyes‐closed conditions) was recorded and LDAEP measured using binaural tones (1000 Hz, 40 ms) at five intensities (60–100 dB SPL). Principal components analysis of current source density waveforms reduced volume conduction and provided reference‐free measures of resting EEG alpha and N1 dipole activity to tones from auditory cortex. Low‐resolution electromagnetic tomography (LORETA) extracted resting theta current density measures corresponding to rostral anterior cingulate (rACC), which has been implicated in treatment response. There were no significant differences in posterior alpha, N1 dipole, or rACC theta across sessions. Test‐retest reliability was .84 for alpha, .87 for N1 dipole, and .70 for theta rACC current density. The demonstration of good‐to‐excellent reliability for these measures provides a template for future EEG/ERP studies from multiple testing sites, and an important step for evaluating them as biomarkers for predicting treatment response.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135271/1/psyp12758_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/135271/2/psyp12758.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/135271/3/psyp12758-sup-0001-suppinfo1.pd

Multiplicity of perceptions on the sequelae of childhood sexual abuse : development of an empirical framework : a dissertation presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Psychology at Massey University, Palmerston North, New Zealand

After over 30 years of research, our knowledge of the consequences of childhood sexual abuse (CSA) is still marked by considerable disarray. A research programme of three studies was designed to improve our understanding of functioning in adulthood after CSA by considering perceptions of sexual abuse from three different viewpoints: Clients with a history of CSA, lay, non-abused adults, and sexual abuse practitioners. In the first study, Multidimensional scaling was employed to develop a reporting device summarising the wide range effects and coping efforts likely to following sexual abuse (RESA – Reporting Effects of Sexual Abuse). A two-fold mapping and profiling approach was then used to highlight consistency and specificity of sexual abuse sequelae by comparing effect-coping patterns of 113 adults with a history of CSA to profiles describing the functioning of nontraumatised adults. The second study then enquired about the stability of perceptions of CSA consequences carried by 149 lay, non-abused adults. An analogue priming study explored how the impact of emotional arousal and cognitive re-structuring intervention adjust participants’ understanding of CSA outcomes. As lay, non-abused adults were found to carry an oversimplified perception of CSA sequelae, Study Three therefore investigated if practitioners were exempt from such underlying biases. Signal detection analysis was used in the final third study to independently assess 85 practitioners’ judgment accuracy and bias when asked to identify sexual abuse effects among a set of supposedly unrelated behaviour, and to discriminate direct effects from secondary ways of coping with CSA. While practitioners were successful in detecting relevant CSA sequelae, they nonetheless demonstrated a highly overinclusive perception compared to the empirical reports by sexually abused clients and societal perceptions. Findings of the three studies were integrated to build an empirical framework on the multiplicity of perceptions on the sequelae of CSA. Overall, this research showed that all individuals, regardless of their association with CSA, carry perceptions about the consequences of CSA. These perceptions appeared to be universal, independent of emotional arousal or attempted cognitive restructuring. While CSA clients reported an array of effects and coping efforts, society only seemed to reflect basic elements of these as related to CSA. Professionals, on the other hand, indicated overinclusive perceptions in which most characteristics were identified as CSA sequelae, in particular as a mean of coping. Finally, no specific pathway was found to follow CSA. While there appeared to be an increased intensity of effects and a greater need for coping among adults with a history of CSA, the general pattern or type of sequelae was also reported by non-traumatised adults. Understanding the functional processes underlying these patterns of common sequelae can help to tailor treatment to the individual needs of clients who experienced CSA. Further implications of this empirical model for practice and research in the area of sexual abuse in Aotearoa/New Zealand are discussed

Early Maternal Withdrawal and Nonverbal Childhood IQ as Precursors for Substance Use Disorder in Young Adulthood: Results of a 20-Year Prospective Study

The relation between early mother–infant interaction and later socio-emotional development has been well established. The present study addresses the more recent interest in the impact of maternal caregiving on cognitive development and their role in decision-making in young adulthood. Using data from a prospective longitudinal study on attachment, prediction from early mother–infant interactions at age 18 months and from verbal and nonverbal cognitive skill at age 5 were examined as predictors of a substance use disorder (abuse/dependence) in young adulthood (age 20) on the Structured Clinical Interview for DSM-TV (SCID). Results reveal that the mother's withdrawal from interaction with the infant at age 18 months, coded using the AMBIANCE coding system (Atypical Maternal Behavior Instrument for Assessment and Classification), was associated with the child's lower nonverbal cognitive scores but not verbal cognitive scores at age 5. In addition, maternal withdrawal at 18 months predicted a clinical diagnosis of substance use disorder (alcohol/cannabis) at age 20. Finally, nonverbal reasoning at age 5 mediated the relationship between early maternal withdrawal and substance use disorder (alcohol/cannabis) in young adulthood. Findings indicate the need for further work examining how early maternal withdrawal affects nonverbal cognitive development by school entry, and how these nonverbal deficits further contribute to maladaptive coping strategies such as substance use by young adulthood

Early Maternal Withdrawal and Nonverbal Childhood IQ as Precursors for Substance Use Disorder in Young Adulthood: Results of a 20-Year Prospective Study

The relation between early mother–infant interaction and later socio-emotional development has been well established. The present study addresses the more recent interest in the impact of maternal caregiving on cognitive development and their role in decision-making in young adulthood. Using data from a prospective longitudinal study on attachment, prediction from early mother–infant interactions at age 18 months and from verbal and nonverbal cognitive skill at age 5 were examined as predictors of a substance use disorder (abuse/dependence) in young adulthood (age 20) on the Structured Clinical Interview for DSM-IV (SCID). Results reveal that the mother’s withdrawal from interaction with the infant at age 18 months, coded using the AMBIANCE coding system (Atypical Maternal Behavior Instrument for Assessment and Classification), was associated with the child’s lower nonverbal cognitive scores but not verbal cognitive scores at age 5. In addition, maternal withdrawal at 18 months predicted a clinical diagnosis of substance use disorder (alcohol/cannabis) at age 20. Finally, nonverbal reasoning at age 5 mediated the relationship between early maternal withdrawal and substance use disorder (alcohol/cannabis) in young adulthood. Findings indicate the need for further work examining how early maternal withdrawal affects nonverbal cognitive development by school entry, and how these nonverbal deficits further contribute to maladaptive coping strategies such as substance use by young adulthood

Perceived parental protection and cortisol responses among young females with borderline personality disorder and controls

Borderline personality disorder (BPD) has been associated with deviations in cortisol in response to interpersonal stressors. Identifying mechanisms contributing to such deviations may help to address emotional dysregulation and the increased risk of self-destructive behavior. While dysfunctional relationships to caregivers have been widely reported among individuals with BPD, their contribution to cortisol hyperresponsiveness has yet to be investigated. Fifty-one females (aged 18–24years) participated to assess the impact of BPD and the quality of protective care in mother-daughter relationships on stress responsiveness. Seventeen females with BPD and twenty females without BPD participated with their mothers in a videotaped parent-young adult conflict discussion. Fourteen non-BPD females without their mothers were assessed for cortisol levels without stress exposure. Salivary cortisol samples were collected at lab entry and 20 and 40min after the onset of the discussion. Results revealed a higher overall cortisol response in the BPD group upon lab entry. BPD participants reported less experienced protection in the mother-daughter relationship which was associated with higher cortisol levels on lab entry and higher distress at study end. Results point to the perceived quality of parental protection as likely to modulate the activity of the stress response system among BPD patients

The Incremental Predictive Validity Of Rostral Anterior Cingulate Cortex Activity In Relation To Treatment Response In Depression: Evidence From The Embarc Study

Background: Postpartum depression (PPD) is the most common complication of childbearing with a 13% prevalence rate, but there are no widespread prevention strategies and no nutraceutical interventions have been developed. Postpartum blues (PPB) is often a prodromal state for PPD, since severe PPB strongly elevates risk for PPD. A dietary supplement kit consisting of monoamine precursor amino acids, tryptophan and tyrosine, and dietary antioxidants was created. The aim of this open-label study was to assess whether the dietary supplement reduces the vulnerability to depressed mood at day-5 postpartum, the typical peak of PPB. Methods: 41 healthy day-5 postpartum women were recruited into 2 groups. Supplemented group (n521) received the dietary supplement (2g tryptophan, 10g tyrosine, blueberry juice1extract), Control group (n520) not receiving supplements. PPB severity was quantitated by the elevation in depressed mood on the visual analogue scale (VAS) and the profile of mood state (POMS) following the sad mood induction procedure (MIP). Results: Univariate analysis of variance demonstrated a robust induction of depressed mood on the VAS in the controls but no effect in the supplement group following the sad MIP (F(1,39)5 88.33, p,0.001; effect size 2.9). A similarly effect of group on change in POMS depression scores was observed (F(1,39)5 19.81, p,0.001). Conclusions: The dietary supplement designed to counter functions of elevated MAO-A activity virtually eliminated the vulnerability to depressed mood during the peak of PPB. This suggests that this nutraceutical intervention is a highly promising approach to target this prodromal state of PPD