[Emotional Abuse in Childhood and Adolescence: Biological Embedding and Clinical Implications]. / Emotionaler Missbrauch in Kindheit und Jugend ­ Biologische Einbettung und klinische Implikationen.

Emotional abuse, defined as degrading, manipulative, or neglectful behaviors by caregivers, represents a common adverse experience for children and adolescents, often co-occurring with other maltreatment types. Exposure to emotional abuse significantly affects mental health across the lifespan and is particularly associated with elevated depression risk.This review examinesmechanisms, by which emotional abuse influences brain development and the neuroendocrine stress response system and discusses the roles of genetic vulnerability and epigenetic processes in contributing to an elevated mental health risk. Emotional abuse has similar effects on brain networks responsible for emotion processing and regulation as other maltreatment types.Moreover, it uniquely affects networks related to self-relevant information and socio-cognitive processes. Furthermore, emotional abuse is associated with an impaired recovery of the neuroendocrine response to acute stress. Similar to other maltreatment types, emotional abuse is associated with epigenetic changes in genes regulating the neuroendocrine stress response system that are implicated in increased mental health risk.These findings suggest that emotional abuse has equally detrimental effects on children'smental health as physical or sexual abuse, warranting broader societal awareness and enhanced early detection efforts. Early interventions should prioritize emotion regulation, social cognition, self-esteemenhancement, and relationship- oriented approaches for victims of emotional abuse.

Children with maltreatment exposure exhibit rumination-like spontaneous thought patterns: association with symptoms of depression, subcallosal cingulate cortex thickness, and cortisol levels.

BACKGROUND: Childhood maltreatment is associated with pervasive risk for depression. However, the immediate cognitive and neural mechanisms that mediate this risk during development are unknown. We here studied the impact of maltreatment on self-generated thought (SGT) patterns and their association with depressive symptoms, subcallosal cingulate cortex (SCC) thickness, and cortisol levels in children. METHODS: We recruited 183 children aged 6-12 years, 96 of which were exposed to maltreatment. Children performed a mind wandering task to elicit SGTs. A subgroup of children underwent structural magnetic resonance imaging (N = 155) for SCC thickness analyses and saliva collection for quantification of free cortisol concentrations (N = 126) was collected. Using network analysis, we assessed thought networks and compared these networks between children with and without maltreatment exposure. Using multilevel analyses, we then tested the association between thought networks of children with maltreatment exposure with depressive symptoms, SCC thickness, and cortisol levels. RESULTS: Children exposed to maltreatment generated fewer positively valenced thoughts. Network analysis revealed rumination-like thought patterns in children with maltreatment exposure, which were associated with depressive symptoms, SCC thickness, and cortisol levels. Children with maltreatment exposure further exhibited decreased future-self thought coupling, which was associated with depressive symptoms, while other-related and past-oriented thoughts had the greatest importance within the network. CONCLUSIONS: Using a novel network analytic approach, we provide evidence that children exposed to maltreatment exhibit ruminative clustering of thoughts, which is associated with depressive symptoms and neurobiological correlates of depression. Our results provide a specific target for clinical translation to design early interventions for middle childhood. Targeting thought patterns in children with maltreatment exposure may be an effective strategy to effectively mitigate depression risk early in life.

Emotional maltreatment and neglect impact neural activation upon exclusion in early and mid-adolescence: An event-related fMRI study.

Child maltreatment gives rise to atypical patterns of social functioning with peers which might be particularly pronounced in early adolescence when peer influence typically peaks. Yet, few neuroimaging studies in adolescents use peer interaction paradigms to parse neural correlates of distinct maltreatment exposures. This fMRI study examines effects of abuse, neglect, and emotional maltreatment (EM) among 98 youth (n = 58 maltreated; n = 40 matched controls) using an event-related Cyberball paradigm affording assessment of both social exclusion and inclusion across early and mid-adolescence (≤13.5 years, n = 50; >13.5 years, n = 48). Younger adolescents showed increased activation to social exclusion versus inclusion in regions implicated in mentalizing (e.g., superior temporal gyrus). Individual exposure-specific analyses suggested that neglect and EM coincided with less reduction of activation to social exclusion relative to inclusion in the dorsal anterior cingulate cortex/pre-supplementary motor area (dACC/pre-SMA) among younger versus older adolescents. Integrative follow-up analyses showed that EM accounted for this dACC/pre-SMA activation pattern over and above other exposures. Moreover, age-independent results within respective exposure groups revealed that greater magnitude of neglect predicted blunted exclusion-related activity in the parahippocampal gyrus, while EM predicted increased activation to social exclusion in the precuneus/posterior cingulate cortex.

Development of functional network architecture explains changes in children's altruistically motivated helping.

Childhood is marked by profound changes in prosocial behaviour. The underlying motivational mechanisms remain poorly understood. We investigated the development of altruistically motivated helping in middle childhood and the neurocognitive and -affective mechanisms driving this development. One-hundred and twenty seven 6-12 year-old children performed a novel gustatory costly helping task designed to measure altruistic motivations of helping behaviour. Neurocognitive and -affective mechanisms including emotion regulation, emotional clarity and attentional reorienting were assessed experimentally through an extensive task-battery while functional brain activity and connectivity were measured during an empathy for taste paradigm and during rest. Altruistically motivated helping increased with age. Out of all mechanisms probed for, only emotional clarity increased with age and accounted for altruistically motivated helping. This was associated with greater functional integration of the empathy-related network with fronto-parietal brain regions at rest. We isolate a highly specific neuroaffective mechanism as the crucial driver of altruistically motivated helping during child development.

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.

Interacting and dissociable effects of alexithymia and depression on empathy.

Major-depressive-disorder (MDD) and alexithymia have both been associated with empathy deficits. We examined whether depression and alexithymia show dissociable or interacting effects on cognitive and emotional trait and state empathy. Healthy controls with high and low alexithymia and MDD-patients with high and low alexithymia were assessed. We used the Interpersonal-Reactivity-Index-questionnaire (IRI) for trait cognitive and emotional empathy and the Multifaceted-Empathy-Test (MET) for state cognitive and emotional empathy. Firstly, we found a main effect of alexithymia, irrespective of depression, on trait and state cognitive empathy: High alexithymia subjects showed lower scores in perspective taking (IRI) and in the cognitive-empathy-component of the MET. Secondly, we found main effects of alexithymia and depression on trait emotional empathy (IRI-subscale personal distress). Moreover, we found a significant depression-by-alexithymia-interaction on trait emotional empathy: MDD-patients showed particularly high personal distress when affected by alexithymia (IRI). Thirdly, alexithymia and depression had no impact on state emotional empathy (MET). However, analyzing positive and negative trials separately, we found more emotional empathy in MDD-patients concerning negatively valenced stimuli. Our data suggest dissociable and interacting effects of MDD and alexithymia on empathy. Importantly, except for heightened personal distress, empathy deficits in MDD-patients were entirely due to concurrent alexithymia.

Evidence for Depressogenic Spontaneous Thoughts and Altered Resting-State Connectivity in Adolescents With a Maltreatment History.

OBJECTIVE: Childhood maltreatment has been associated with major depressive disorder (MDD). Atypical self-generated thoughts (SGT), lacking in positive and privileging negative content-a feature of ruminative thinking-might represent one vulnerability factor for developing depression. Rumination in MDD has been linked to alterations in resting-state functional connectivity (RSFC) of the subgenual anterior cingulate cortex (sgACC) to the default mode network and the fronto-parietal network (FPN). This study aimed to investigate online SGT content and its variability, as well as sgACC RSFC, as potential risk markers for depression in adolescents who experienced maltreatment. METHOD: Adolescents 12 to 16 years old (29 with maltreatment history [MT] and 39 with no maltreatment history [NMT]) performed an established mind-wandering task. Participants made nondemanding number discriminations during which intermittent questions probed their SGTs that were classified as off-task, positive, negative, self-related, other-related, past-oriented, or future-oriented. Resting-state data were acquired separately for 22 of 29 MT and 27 39 NMT adolescents, and seed-based functional connectivity analyses of the sgACC were performed. RESULTS: MT, relative to the NMT adolescents, generated significantly fewer positively valenced thoughts, and exhibited more extreme ratings for positively valenced thoughts. MT adolescents also showed significantly reduced RSFC between the sgACC and the FPN. Group differences in depressive symptoms between the MT and NMT adolescents were partly accounted by differences in sgACC-FPN RSFC. CONCLUSION: Adolescents who experienced maltreatment show a reduction in positively valenced spontaneous thoughts and reduced sgACC-FPN RSFC at the neural level. These may contribute to a ruminative thinking style, representing risk factors for developing depression later in life.

Primary and Secondary Variants of Psychopathy in a Volunteer Sample Are Associated With Different Neurocognitive Mechanisms.

BACKGROUND: Recent work has indicated that there at least two distinct subtypes of psychopathy. Primary psychopathy is characterized by low anxiety and thought to result from a genetic predisposition, whereas secondary psychopathy is characterized by high anxiety and thought to develop in response to environmental adversity. Primary psychopathy is robustly associated with reduced neural activation to others' emotions and, in particular, distress. However, it has been proposed that the secondary presentation has different neurocognitive correlates. METHODS: Primary (n = 50), secondary (n = 100), and comparison (n = 82) groups were drawn from a large volunteer sample (N = 1444) using a quartile-split approach across psychopathic trait (affective-interpersonal) and anxiety measures. Participants performed a widely utilized emotional face processing task during functional magnetic resonance imaging. RESULTS: The primary group showed reduced amygdala and insula activity in response to fear. The secondary group did not differ from the comparison group in these regions. Instead, the secondary group showed reduced activity compared with the comparison group in other areas, including the superior temporal sulcus/inferior parietal lobe, thalamus, pallidum, and substantia nigra. Both psychopathy groups also showed reduced activity in response to fear in the anterior cingulate cortex. During anger processing, the secondary group exhibited reduced activity in the anterior cingulate cortex compared with the primary group. CONCLUSIONS: Distinct neural correlates of fear processing characterize individuals with primary and secondary psychopathy. The reduced neural response to fear that characterizes individuals with the primary variant of psychopathic traits is not observed in individuals with the secondary presentation. The neurocognitive mechanisms underpinning secondary psychopathy warrant further systematic investigation.

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- to 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 and 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.

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.

Empathy in depression: Egocentric and altercentric biases and the role of alexithymia.

BACKGROUND: Major depressive disorder (MDD) has been associated with empathy deficits. The exact nature of these deficits and their relation to concurrent alexithymia remain unknown. Here we tested under which conditions MDD patients with high and low alexithymia show deficient empathy, particularly investigating empathic abilities when inhibition of self-related emotional states is needed and when it is not. METHODS: Healthy controls (low: n=28, high: n=14) and currently depressed MDD patients (low: n=11, high: n=18) with low or high alexithymia performed an emotional egocentricity paradigm based on tactile stimulation. This task measures empathic judgements, when emotional states of self and other differ and inhibition of self-related emotional states is needed, and when they do not and thus empathic judgments can be based on simple projection mechanisms. RESULTS: Only alexithymia but not depression decreased empathy, in situations when simple projection sufficed. However, when inhibition of self-related emotional states was needed, MDD patients showed an egocentric bias during empathic judgments and an altercentric bias during self emotion judgments, the latter suggesting heightened emotional contagion, both independent of alexithymia. Across the entire sample, alexithymia decreased the size of the egocentric bias. LIMITATIONS: This study was based on a relatively sample size. CONCLUSIONS: These results suggest that MDD patients show intact empathic judgments, when simple projection is required and no concurrent alexithymia is present. In situations when incongruent emotional states of self and other have to be resolved, MDD patients are prone to egocentric and altercentric biases.

Where the depressed mind wanders: Self-generated thought patterns as assessed through experience sampling as a state marker of depression.

BACKGROUND: Self-generated thoughts (SGTs), such as during mind wandering, occupy much of our waking life. Individuals with Major Depressive Disorder (MDD) are less in the "here and now" and prone to rumination. Few studies have looked at SGTs in depression using experience sampling methods and no study has so far investigated the specific contents of depressive SGTs and how they vary from one time point to another. METHODS: MDD patients (n=25) and matched healthy controls (n=26) performed an established mind wandering task, involving non-demanding number discriminations. Intermittent probe questions ask for participants' current SGTs, that is, how off-task the thoughts are, how positive or negative, self- or other-related, and past- or future-oriented. RESULTS: Multi-level modelling revealed that MDD patients engaged in more mind wandering than healthy controls. Their SGTs were predominantly negative and less positive, more self-related and past-oriented. Strongest predictor of depressive SGT was the decreased positive valence of thoughts. MDD patients' future and past-oriented thoughts were particularly more negative compared to healthy controls. Within MDD patients, the less positively valenced thoughts they had and the less variable these thoughts were, the more depressive symptoms they showed. LIMITATION: No other measures of rumination and worry were used. CONCLUSION: MDD patients show a very specific SGT pattern, possibly reflecting ruminative and anxious thoughts. This SGT pattern in depression might represent a useful state marker and even constitute an etiological factor of this debilitating disease, considering the importance of current SGT on and individual's cognitive processes and affective states.

Preserved Self-other Distinction During Empathy in Autism is Linked to Network Integrity of Right Supramarginal Gyrus.

Autism spectrum disorder (ASD) shows deficits in self-other distinction during theory of mind (ToM). Here we investigated whether ASD patients also show difficulties in self-other distinction during empathy and if potential deficits are linked to dysfunctional resting-state connectivity patterns. In a first study, ASD patients and controls performed an emotional egocentricity paradigm and a ToMtask. In the second study, resting-state connectivity of right temporo-parietal junction and right supramarginal gyrus(rSMG) were analysed using a large-scale fMRI data set. ASD patients exhibited deficient ToM but normal emotional egocentricity, which was paralleled by reduced connectivity of regions of the ToM network and unimpaired rSMG network connectivity. These results suggest spared self-other distinction during empathy and an intact rSMG network in ASD.

Children's Increased Emotional Egocentricity Compared to Adults Is Mediated by Age-Related Differences in Conflict Processing.

This study investigated the cognitive mechanisms underlying age-related differences in emotional egocentricity bias (EEB) between children (aged 7-12 years, n = 30) and adults (aged 20-30 years, n = 30) using a novel paradigm of visuogustatory stimulation to induce pleasant and unpleasant emotions. Both children and adults showed an EBB, but that of children was larger. The EEB did not correlate with other measures of egocentricity. Crucially, the developmental differences in EEB were mediated by age-related changes in conflict processing and not visual perspective taking, response inhibition, or processing speed. This indicates that different types of egocentricity develop independently of one another and that the increased ability to overcome EEB can be explained by age-related improvements in conflict processing.

Sex influence on face recognition memory moderated by presentation duration and reencoding.

OBJECTIVE: It has been suggested that women have a better face recognition memory than men. Here we analyzed whether this advantage depends on a better encoding or consolidation of information and if the advantage is visible during short-term memory (STM), only, or whether it also remains evident in long-term memory (LTM). METHOD: We tested short- and long-term face recognition memory in 36 nonclinical participants (19 women). We varied the duration of item presentation (1, 5, and 10 s), the time of testing (immediately after the study phase, 1 hr, and 24 hr later), and the possibility to reencode items (none, immediately after the study phase, after 1 hr). RESULTS: Women showed better overall face recognition memory than men (ηp² = .15, p < .05). We found this advantage, however, only with a longer duration of item presentation (interaction effect Sex × DURATION: ηp² = .16, p < .05). Women's advantage in face recognition was visible mainly if participants had the possibility to reencode faces during former test trials. CONCLUSIONS: Our results suggest women do not have a better face recognition memory than men per se, but may profit more than men from longer durations of presentation during encoding or the possibility for reencoding. Future research on sex differences in face recognition memory should explicate possible causes for the better encoding of face information in women.