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BACKGROUND: Childhood exposure to interpersonal violence (IPV) may be linked to distinct manifestations of mental illness, yet the nature of this change remains poorly understood. Network analysis can provide unique insights by contrasting the interrelatedness of symptoms underlying psychopathology across exposed and non-exposed youth, with potential clinical implications for a treatment-resistant population. We anticipated marked differences in symptom associations among IPV-exposed youth, particularly in terms of 'hub' symptoms holding outsized influence over the network, as well as formation and influence of communities of highly interconnected symptoms. METHODS: Participants from a population-representative sample of youth (n = 4433; ages 11-18 years) completed a comprehensive structured clinical interview assessing mental health symptoms, diagnostic status, and history of violence exposure. Network analytic methods were used to model the pattern of associations between symptoms, quantify differences across diagnosed youth with (IPV+) and without (IPV-) IPV exposure, and identify transdiagnostic 'bridge' symptoms linking multiple disorders. RESULTS: Symptoms organized into six 'disorder' communities (e.g. Intrusive Thoughts/Sensations, Depression, Anxiety), that exhibited considerably greater interconnectivity in IPV+ youth. Five symptoms emerged in IPV+ youth as highly trafficked 'bridges' between symptom communities (11 in IPV- youth). CONCLUSION: IPV exposure may alter mutually reinforcing symptom co-occurrence in youth, thus contributing to greater psychiatric comorbidity and treatment resistance. The presence of a condensed and unique set of bridge symptoms suggests trauma-enriched nodes which could be therapeutically targeted to improve outcomes in violence-exposed youth.
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Exposição à Violência , Transtornos Mentais , Adolescente , Criança , Humanos , Transtornos Mentais/psicologia , Violência , Saúde Mental , Transtornos de AnsiedadeRESUMO
BACKGROUND: Pediatric posttraumatic stress disorder (pPTSD) is more than three times as likely to develop in trauma-exposed female youth than males. Despite the staggering sex differences in the prevalence rates of pPTSD and symptom expression, relatively little is known about the underlying biomarkers of these sex-based variations in pPTSD as compared to typically development. METHODS: The Youth PTSD study recruited 97 youth, ages of 7 and 18, to undergo comprehensive clinical assessments and T1-weighted MRI to evaluate the extent to which sex can explain PTSD-related variations in brain structure. Whole-brain VBM as well as whole-brain estimates of cortical thickness and surface area were analyzed to identify group-by-sex interactions. Finally, we tested whether current or future symptom severity was predictive of regions exhibiting sex-based variations. RESULTS: Clinically, females with PTSD were significantly more likely to report exposure to and higher severity of interpersonal violence and symptoms of hyperarousal. Sex and PTSD status were predictive of gray matter across the lateral prefrontal cortex (PFC), including the ventrolateral PFC and frontal pole, where increased volume and surface area was found in PTSD females as compared to PTSD males. Interestingly, the ventrolateral prefrontal cortex and frontal pole were negatively predictive of symptoms 1 year later in only males with PTSD. CONCLUSIONS: Together, these results establish that youth with PTSD exhibit sex-based variations in clinical and trauma characteristics and prefrontal cortical structure relative to normative development. This work demonstrates the importance of examining the role that sex may play in the behavioral and neurobiological presentation of pPTSD.
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Transtornos de Estresse Pós-Traumáticos , Adolescente , Criança , Humanos , Feminino , Masculino , Transtornos de Estresse Pós-Traumáticos/diagnóstico por imagem , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Córtex Pré-Frontal/diagnóstico por imagem , Substância Cinzenta , Imageamento por Ressonância Magnética , EncéfaloRESUMO
This research investigated whether biases in processing threatening emotional cues operate as an indirect pathway through which parental harsh discipline is associated with adolescent socio-emotional functioning. Participants were 192 adolescents (M age = 12.4), and their parents assessed over two years. Findings revealed two significant indirect pathways involving fear processing. Greater parental harsh discipline was linked to more emotional response inhibition difficulty for fear, which was linked to more depressive symptoms in the following year. Greater parental harsh discipline was also associated with more emotional response inhibition difficulty for fear, and thereby, more peer problems later. Findings suggest that adolescent emotional processing operated as an indirect pathway linking parental harsh discipline and adolescent socio-emotional functioning within the broader social context.
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Pais , Punição , Adolescente , Desenvolvimento do Adolescente , Criança , Emoções , HumanosRESUMO
BACKGROUND: Experiencing traumatic stress is common and may lead to posttraumatic stress disorder (PTSD) in a number of children and adolescents. Research using advanced imaging techniques is beginning to elucidate some of the neurobiological correlates of the traumatic stress response in youth. METHODS: This paper summarizes the emerging network perspective of PTSD symptoms and reviews brain imaging research emphasizing structural and functional connectivity studies that employ magnetic resonance imaging techniques in pediatric samples. RESULTS: Differences in structural connections and distributed functional networks such as the salience, default mode, and central executive networks are associated with traumatic and severe early life stress. The role of development has been relatively underappreciated in extant studies though there is evidence that critical brain regions as well as the structural and functional networks implicated undergo significant change in childhood and these typical developmental differences may be affected by traumatic stress. CONCLUSIONS: Future research will benefit from adopting a truly developmental approach that considers children's growth as a meaningful effect (rather than simply a covariate) interacting with traumatic stress to predict disruptions in the anatomical, functional, and connective aspects of brain systems thought to underlie the network of PTSD symptoms. Linking symptom networks with neurodevelopmental network models may be a promising avenue for future work.
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Encéfalo , Desenvolvimento Infantil , Imageamento por Ressonância Magnética , Rede Nervosa , Neuroimagem , Transtornos de Estresse Pós-Traumáticos , Estresse Psicológico , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Encéfalo/fisiopatologia , Criança , Desenvolvimento Infantil/fisiologia , Humanos , Rede Nervosa/diagnóstico por imagem , Rede Nervosa/patologia , Rede Nervosa/fisiopatologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico por imagem , Transtornos de Estresse Pós-Traumáticos/patologia , Transtornos de Estresse Pós-Traumáticos/fisiopatologia , Estresse Psicológico/diagnóstico por imagem , Estresse Psicológico/patologia , Estresse Psicológico/fisiopatologiaRESUMO
Sleep-related problems (SRPs) among adolescents are a growing concern. Theory and research suggest that emotional arousal may have cyclical relation with SRPs, but whether emotional dysregulation plays a role is not clear. We investigated associations between two physiological indices of emotion regulation (video baseline heart rate variability and change in heart rate variability to a stressor) and SRPs in a sample of 80 adolescents (ages 11-17 years; 51% female; 37.5% African American). The findings showed a negative relation between video baseline heart rate variability and SRPs, controlling for non-sleep-related anxiety disorder symptoms (ß = -0.29) and general manifest anxiety (ß = -0.25). We found no relation between change in heart rate variability to a stressor and SRPs when non-sleep-related anxious arousal was controlled. If replicated, findings illustrate the importance of physiological regulation of emotion influencing (or influenced by) SRPs during adolescence.
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Transtornos de Ansiedade/fisiopatologia , Ansiedade/fisiopatologia , Sistema Nervoso Autônomo/fisiologia , Regulação Emocional/fisiologia , Frequência Cardíaca/fisiologia , Estresse Psicológico/fisiopatologia , Adolescente , Sistema Nervoso Autônomo/fisiopatologia , Criança , Feminino , Humanos , Masculino , Transtornos do Sono-VigíliaRESUMO
Exposure to natural disasters can be highly traumatic and have a detrimental effect on youth mental health by threatening the satisfaction of basic human needs and goals. Recent research in adults suggests that exposure to disasters may exacerbate existential anxiety about the meaning of life. The current study expands this investigation to adolescents, who may be particularly vulnerable to the negative effects of disaster. Data came from 325 adolescents (mean age = 15.05 years, SD = 1.05) residing in the Greater New Orleans area who were exposed to Hurricanes Katrina and/or Gustav. Existential anxiety concerns were highly prevalent in the sample and were associated with elevated levels of posttraumatic stress disorder (R2 = .09) and depression symptoms (R2 = .13). Consistent with theoretical predictions, disaster exposure levels moderated the association between facets of existential anxiety and mental health symptoms. Findings highlight the salience of existential concerns in disaster exposed youth, and provide evidence that exposure to traumatic stress may strengthen their association with mental health problems.
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Ansiedade/psicologia , Tempestades Ciclônicas , Depressão/psicologia , Desastres , Transtornos de Estresse Pós-Traumáticos/psicologia , Adolescente , Vítimas de Desastres/estatística & dados numéricos , Medo/psicologia , Feminino , Humanos , Masculino , Nova Orleans/epidemiologia , Escalas de Graduação Psiquiátrica , Análise de Regressão , Índice de Gravidade de Doença , Inquéritos e QuestionáriosRESUMO
While conventional wisdom suggests that parents and their adolescent offspring will often disagree, the nature of discrepancies in informant reports of parenting behaviors is still unclear. This article suggests testing measurement invariance in an effort to clarify if discrepancies in informant scores reflect true differences in perspectives on the same construct, or if the instrument is simply not measuring the same construct across parents and youth. The study provides an example by examining invariance and discrepancy across child, adolescent, and parent reports on the Alabama Parenting Questionnaire. The sample for this study was 255 youth (51.4 % male) aged 6-17 years (M age = 12.3 years) and an accompanying parent. A five-factor model of the measure was found to provide approximately equivalent measurement across four participant groups (children under 12 years, adolescents aged 12-18 years, and parents of each group, respectively). Latent mean levels of reported parenting constructs varied greatly across informants. Age moderated the association between reports of two subscales, Parental Involvement and Positive Parenting, such that adolescents were more consistent with parents. The findings highlight the utility of testing measurement invariance across informants prior to evaluating differences in their reports, and demonstrate the benefits of considering invariance in the larger conversation over informant discrepancies.
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Atitude , Variações Dependentes do Observador , Relações Pais-Filho , Poder Familiar/psicologia , Psicologia do Adolescente , Psicometria/estatística & dados numéricos , Inquéritos e Questionários , Adolescente , Adulto , Alabama , Criança , Feminino , Humanos , MasculinoRESUMO
BACKGROUND: Anxiety control beliefs have emerged as a trans-diagnostic risk factor for anxiety disorders and a potential mechanism of change in cognitive and behavioral therapies. The purpose of this study was to examine the association between anxiety control beliefs and anxiety disorder symptoms following exposure to hurricanes in youth and test a developmental hypothesis about those associations. METHODS: A large school-based sample of (N = 1048) children and adolescents with a history of exposure to natural disaster were assessed with the short form of the Anxiety Control Questionnaire for Children (ACQ-C), symptom measures (PTSD and generalized anxiety disorder symptoms) and level of disaster exposure. Developmental differences in the association between ACQ-C scores and symptoms were tested, as well as the ACQ-C's ability to assess symptoms beyond level of exposure. RESULTS: ACQ-C scores were associated with symptoms beyond level of exposure, but age moderated the strength of the association. Modeling the interaction suggested that the ACQ-C short had incremental validity beyond hurricane exposure in youth over 12 years. CONCLUSIONS: Findings extend previous work to a novel population of youth and add to the developmental understanding of the role of anxiety control beliefs in anxiety regulation. Age differences in the linkages between anxiety control and symptoms is consistent with a developmental model where low perceived control exhibited by younger children may be less indicative of problems with anxiety but may instead be related to normal cognitive development.
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Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Desenvolvimento Infantil , Conhecimentos, Atitudes e Prática em Saúde , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Adolescente , Distribuição por Idade , Criança , Comorbidade , Tempestades Ciclônicas , Desastres , Feminino , Humanos , Masculino , Fatores de Risco , Distribuição por Sexo , Inquéritos e QuestionáriosRESUMO
Emotion-focused prevention and intervention efforts in schools have been promoted as a significant developmental and public health priority. This paper reports the results of a longitudinal study testing central premises of a school-based prevention model aimed at promoting positive emotional development through targeting test anxiety. Test anxiety interventions may be a practical strategy for conducting emotion-focused prevention and intervention efforts because of a natural fit within the ecology of the school setting. At-risk youth (n = 1,048) from urban public schools were screened and 325 with elevated test anxiety were offered the intervention in one of two waves (immediate intervention vs. waitlist). The intervention was associated with decreases in test anxiety, anxiety disorder, and depression symptoms. Critically, results suggest high participant satisfaction and growth curve analysis of follow-up assessments (end of the year, the next school year, and a subsequent school year) demonstrated positive developmental trajectories consistent with predictions (e.g., initial change in test anxiety predicted change in other symptoms). Findings provide evidence for the ecological validity of targeting test anxiety in school-based, emotion-focused prevention efforts.
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Ansiedade/prevenção & controle , Emoções , Instituições Acadêmicas , Adolescente , Ansiedade/diagnóstico , Criança , Feminino , Humanos , Louisiana , Masculino , Estudos ProspectivosRESUMO
BACKGROUND: Violence exposure during childhood and adolescence is associated with increased prevalence and severity of psychopathology. Neurobiological correlates suggest that abnormal maturation of emotion-related brain circuitry, such as amygdala-prefrontal cortex (PFC), may underlie the development of psychiatric symptoms after exposure; however, it remains unclear how amygdala-PFC circuit maturation is related to psychiatric risk in the context of violence. METHODS: This study analyzed individual differences in amygdala-PFC circuit maturity using data collected from the Philadelphia Neurodevelopmental Cohort (PNC; N=1,133 youth). Neurodevelopment models of amygdala-PFC resting-state functional connectivity were built using deep learning, trained to predict chronological age in typically developing youth (neither violence exposed nor having a psychiatric diagnosis). Using the brain age gap estimate (BrainAGE), an index of relative circuit maturation, patterns of atypical neurodevelopment were interrogated. RESULTS: Violence exposure was associated with delayed maturation of basolateral amygdala (BLA) - PFC circuits, driven by increased BLA - medial orbitofrontal cortex functional connectivity. Increased psychiatric symptoms, on the other hand, was associated with advanced maturation of BLA - PFC functional connectivity, driven by decreased BLA - dorsolateral PFC functional connectivity. CONCLUSIONS: Delayed frontoamygdala maturation after exposure to violence suggests atypical, yet adaptive, development of threat appraisal processes, potentially reflecting greater threat generalization characteristic of younger children. Advanced circuit maturation with increasing symptoms suggests divergent neurodevelopmental mechanisms underlying illness after emotion-circuits have adapted to adversity, exacerbated by pre-existing vulnerabilities to early maturation. Disentangling the effects of adversity and psychopathology on neurodevelopment is crucial for helping youth recover from violence and preventing illness from continuing into adulthood.
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OBJECTIVE: Parents play a notable role in the development of child psychopathology. In this study, we investigated the role of parent psychopathology and behaviors on child brain-symptom networks to understand the role of intergenerational transmission of psychopathology. Few studies have documented the interaction of child psychopathology, parent psychopathology, and child neuroimaging. METHOD: We used the baseline cohort of the Adolescent Brain Cognitive Development Study (N = 7,151, female-at-birth = 3,619, aged 9-11 years) to derive brain-symptom networks using sparse canonical correlation analysis with the Child Behavior Checklist and resting-state functional magnetic resonance imaging. We then correlated parent psychopathology symptoms and parental behaviors with child brain-symptom networks. Finally, we used the significant correlations to understand, using the mediation R package, whether parent behaviors mediated the effect of parent psychopathology on child brain connectivity. RESULTS: We observed 3 brain-symptom networks correlated with externalizing (r = 0.19, internalizing (r = 0.17), and neurodevelopmental symptoms (r = 0.18). These corresponded to differences in connectivity between the default mode-default mode, default mode-control, and visual-visual canonical networks. We further detected aspects of parental psychopathology, including personal strength, thought problems, and rule-breaking symptoms to be associated with child brain connectivity. Finally, we found that parental behaviors and symptoms mediate each other's relationship to child brain connectivity. CONCLUSION: The current study suggests that positive parental behaviors can relieve potentially detrimental effects of parental psychopathology, and vice versa, on symptom-correlated child brain connectivity. Altogether, these results provide a framework for future research and potential targets for parents who experience mental health symptoms to help mitigate potential intergenerational transmission of mental illness.
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Psychiatric problems in children (and adults) are reflected in brain networks. Remarkable advances in functional magnetic resonance imaging continue to evince a bidirectional relation between the functional flow of activation across the brain and the etiology of psychiatric disorders. This work is analogous to that of a city engineer surveying traffic to understand flow patterns, efficiency, congestion, and even the influence of city-wide conditions (eg, snowfall). Yet, the engineer further considers a factor long neglected in human neuroscience-the roads. Functional connectivity does not take place across the intercellular ether, but across a nexus of millions of interconnected axonal pathways or white matter (WM), so named for the color given by the fatty myelin surrounding the axons. Insight into the role of these tracts in the pathology of psychiatric illness continues to be limited, in contrast to the functional connectivity they support. WM tracts are among the last components of the brain to reach maturity, and their malleability in youth may play a key role in the manifestation of psychopathology in children. An emerging body of research suggests that pediatric psychopathology may be caused in part by WM alterations at both the global and the regional levels.1 Yet, these findings are almost exclusively derived from cross-sectional studies, which cannot model developmental course, and small sample sizes, which limit the ability to draw firm conclusions.
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Transtornos Mentais , Substância Branca , Adulto , Humanos , Adolescente , Criança , Substância Branca/diagnóstico por imagem , Substância Branca/patologia , Estudos Transversais , Encéfalo , Imageamento por Ressonância MagnéticaRESUMO
Resting-state functional connectivity (rsFC) has the potential to shed light on how childhood abuse and neglect relates to negative psychiatric outcomes. However, a comprehensive review of the impact of childhood maltreatment on the brain's resting state functional organization has not yet been undertaken. We systematically searched rsFC studies in children and youth exposed to maltreatment. Nineteen studies (total n = 3079) met our inclusion criteria. Two consistent findings were observed. Childhood maltreatment was linked to reduced connectivity between the anterior insula and dorsal anterior cingulate cortex, and with widespread heightened amygdala connectivity with key structures in the salience, default mode, and prefrontal regulatory networks. Other brain regions showing altered connectivity included the ventral anterior cingulate cortex, dorsolateral prefrontal cortex, and hippocampus. These patterns of altered functional connectivity associated with maltreatment exposure were independent of symptoms, yet comparable to those seen in individuals with overt clinical disorder. Summative findings indicate that rsFC alterations associated with maltreatment experience are related to poor cognitive and social functioning and are prognostic of future symptoms. In conclusion, maltreatment is associated with altered rsFC in emotional reactivity, regulation, learning, and salience detection brain circuits. This indicates patterns of recalibration of putative mechanisms implicated in maladaptive developmental outcomes.
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Encéfalo , Maus-Tratos Infantis , Adolescente , Humanos , Criança , Tonsila do Cerebelo , Mapeamento Encefálico , Giro do Cíngulo , Maus-Tratos Infantis/psicologia , Imageamento por Ressonância MagnéticaRESUMO
BACKGROUND: ADHD polygenic scores (PGSs) have been previously shown to predict ADHD outcomes in several studies. However, ADHD PGSs are typically correlated with ADHD but not necessarily reflective of causal mechanisms. More research is needed to elucidate the neurobiological mechanisms underlying ADHD. We leveraged functional annotation information into an ADHD PGS to (1) improve the prediction performance over a non-annotated ADHD PGS and (2) test whether volumetric variation in brain regions putatively associated with ADHD mediate the association between PGSs and ADHD outcomes. METHODS: Data were from the Philadelphia Neurodevelopmental Cohort (N = 555). Multiple mediation models were tested to examine the indirect effects of two ADHD PGSs-one using a traditional computation involving clumping and thresholding and another using a functionally annotated approach (i.e., AnnoPred)-on ADHD inattention (IA) and hyperactivity-impulsivity (HI) symptoms, via gray matter volumes in the cingulate gyrus, angular gyrus, caudate, dorsolateral prefrontal cortex (DLPFC), and inferior temporal lobe. RESULTS: A direct effect was detected between the AnnoPred ADHD PGS and IA symptoms in adolescents. No indirect effects via brain volumes were detected for either IA or HI symptoms. However, both ADHD PGSs were negatively associated with the DLPFC. CONCLUSIONS: The AnnoPred ADHD PGS was a more developmentally specific predictor of adolescent IA symptoms compared to the traditional ADHD PGS. However, brain volumes did not mediate the effects of either a traditional or AnnoPred ADHD PGS on ADHD symptoms, suggesting that we may still be underpowered in clarifying brain-based biomarkers for ADHD using genetic measures.
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Transtorno do Deficit de Atenção com Hiperatividade , Neurociências , Adolescente , Humanos , Transtorno do Deficit de Atenção com Hiperatividade/genética , Encéfalo/diagnóstico por imagem , Córtex Cerebral , Substância Cinzenta/diagnóstico por imagemRESUMO
There is broad consensus that children's ability to regulate emotion, particularly negative affect, can have enormous implications for the cascading processes underlying social and emotional development. With the burgeoning autonomy of toddlerhood comes a rudimentary understanding of the varieties of emotional experience, and initial awareness that a child's actions can augment or attenuate the intensity of those experiences. Successful forays into emotion regulation are crucial for healthy psychological development, allowing children to accommodate life's difficulties by purposefully altering their emotional state (ie, coping) when necessary. By contrast, persistent negative affect in childhood is known to increase the risk for depression by late adolescence.1 Neuroimaging studies in youth and adults have implicated a key circuit in the generation and regulation of negative affect including the amygdala, a subcortical structure that detects emotionally salient information, and the medial prefrontal cortex (mPFC), a cortical region known to exert regulatory influence on the amygdala. Synchronous activation of these regions, reflecting functional transmission of information between them, is conceptually and empirically linked to individual differences in the intensity and purposeful modulation of emotion.2 Furthermore, amygdala reactivity is associated with negative affect in preschoolers,3 whereas emotion-related amygdala-mPFC connectivity may shape the subsequent development of resting (intrinsic) amygdala-mPFC connectivity, particularly in childhood.4.
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Regulação Emocional , Adolescente , Adulto , Tonsila do Cerebelo , Encéfalo/diagnóstico por imagem , Criança , Pré-Escolar , Emoções , Humanos , Imageamento por Ressonância Magnética , Vias Neurais , Córtex Pré-FrontalRESUMO
BACKGROUND: There is evidence that the amygdala undergoes extensive development. The exact nature of this change remains less clear, with evidence suggesting linear, curvilinear, and null effects. The aim of this study was the identification of a normative reference of left and right amygdala development by parceling variance into separate effects of age and longitudinal growth. METHODS: Data came from the National Institutes of Health MRI Study of Normal Brain Development. Participants in this sample were 54% female and ranged in age from 5 to 18 years (mean = 11.37 years) at study entry. RESULTS: As predicted, the age at initial scan moderated the slope of both left and right amygdala volumes, demonstrating that the nature of longitudinal growth varies across age (i.e., steeper slopes observed among those first scanned at an early age). Follow-up analysis showed that the positive longitudinal growth slope becomes nonsignificant at 13.1 years of age for the left amygdala and at 14.5 years for the right amygdala, suggesting that growth of the left amygdala peaks earlier than growth of the right amygdala. CONCLUSIONS: Findings suggest that rapid increases in volumes at early ages decline as youths enter adolescence and may turn to minor declines in volume during late adolescence or early adulthood.
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Tonsila do Cerebelo , Imageamento por Ressonância Magnética , Adolescente , Adulto , Encéfalo , Criança , Pré-Escolar , Feminino , Humanos , Estudos Longitudinais , Masculino , Puberdade , Estados UnidosRESUMO
Pediatric post-traumatic stress disorder (pPTSD) is a prevalent and pervasive form of mental illness comprising a disparate constellation of psychiatric symptoms. Emerging evidence suggests that pPTSD may be characterized by alterations in functional networks traversing the brain. Yet, little is known about pathological changes in the structural tracts underlying functional connectivity. In adults, PTSD is linked to widespread change in white matter integrity throughout the brain, yet similar studies with youth populations have yet to be conducted. Current understanding of the nature and treatment of pPTSD may be enhanced by examining alterations in white matter, while further untangling effects of age and sex. Here, we assess the microstructure of 12 major white matter tracts in a sample of well-phenotyped youth with PTSD. Measures of fractional anisotropy were derived from diffusion tensor images acquired from 82 unmediated youth (ages 8-18), of whom 39 met criteria for pPTSD. Diagnosis of pPTSD was linked to remarkable age- and sex-linked differences in the microstructure of major white matter tracts including the uncinate fasciculus, cingulum bundle, and inferior longitudinal fasciculus. In each case, youth with PTSD show an absence of increased white matter integrity with age, suggesting an altered pattern of neurodevelopment that may contribute to persistence or worsening of illness. Broadly, our results suggest abnormal white matter development in pediatric PTSD, a finding which may contribute to illness persistence, comorbidity with other disorders, and poorer prognosis across time. Critically, these findings further speak to the nature of pPTSD as a 'whole-brain' disorder.
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Transtornos de Estresse Pós-Traumáticos , Substância Branca , Adolescente , Adulto , Anisotropia , Encéfalo/diagnóstico por imagem , Criança , Imagem de Tensor de Difusão , Humanos , Transtornos de Estresse Pós-Traumáticos/diagnóstico por imagem , Substância Branca/diagnóstico por imagemRESUMO
Imaging methods have elucidated several neurobiological correlates of traumatic and adverse experiences in childhood. This knowledge base may foster the development of programs and policies that aim to build resilience and adaptation in children and youth facing adversity. Translation of this research requires both effective and accurate communication of the science. This review begins with a discussion of integrating the language used to describe and identify childhood adversity and their outcomes to clarify the translation of neurodevelopmental findings. An integrative term, Traumatic and Adverse Childhood Experiences (TRACEs+) is proposed, alongside a revised adverse childhood experiences (ACEs) pyramid that emphasizes that a diversity of adverse experiences may lead to a common outcome and that a diversity of outcomes may result from a common adverse experience. This term facilitates linkages between the ACEs literature and the emerging neurodevelopmental knowledge surrounding the effect of traumatic adverse childhood experiences on youth in terms of the knowns and unknowns about neural connectivity in youth samples. How neuroscience findings may lead directly or indirectly to specific techniques or targets for intervention and the reciprocal nature of these relationships is addressed. Potential implications of the neuroscience for policy and intervention at multiple levels are illustrated using existing policy programs that may be informed by (and inform) neuroscience. The need for transdisciplinary models to continue to move the science to action closes the article. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Experiências Adversas da Infância/psicologia , Política de Saúde , Resiliência Psicológica , Criança , HumanosRESUMO
OBJECTIVE: Childhood abuse represents one of the most potent risk factors for developing psychopathology, especially in females. Evidence suggests that exposure to early-life adversity may be related to advanced maturation of emotion processing neural circuits. However, it remains unknown whether abuse is related to early circuit maturation and whether maturation patterns depend on the presence of psychopathology. METHODS: A multisite sample of 234 girls (ages 8-18 years) completed clinical assessment, maltreatment histories, and high-resolution T1-weighted structural MRI. Girls were stratified by abuse history and internalizing disorder diagnosis into typically developing (no abuse/no diagnosis), resilient (abuse/no diagnosis), and susceptible (abuse/current diagnosis) groups. Machine learning models of normative brain development were aggregated in a stacked generalization framework trained to predict chronological age using gray matter volume in whole-brain, emotion, and language circuit parcellations. Brain age gap estimations (BrainAGEs; predicted age minus true chronological age) were calculated as indices of relative circuit maturation. RESULTS: Childhood abuse was related to reduced BrainAGE (delayed maturation) specific to emotion circuits. Delayed emotion circuit BrainAGE was further related to increased hyperarousal symptoms. Childhood physical neglect was associated with increased whole-brain BrainAGE (advanced maturation). Neural contributors to emotion circuit BrainAGE differed in girls with and without an internalizing diagnosis, especially in the lateral prefrontal, parietal, and insular cortices and the hippocampus. CONCLUSIONS: Abuse exposure in girls is associated with a delayed structural maturation pattern specific to emotion circuitry, a potentially adaptive mechanism enhancing threat generalization. Physical neglect, on the other hand, is associated with a broader brain-wide pattern of advanced structural maturation. The differential influence of fronto-parietal cortices and the hippocampus on emotion circuit maturity in resilient girls may represent neurodevelopmental markers of reduced psychiatric risk following abuse.