Abstract
BackgroundChildhood maltreatment is a strong risk factor for the development of depression in later life. However, the neurobiological mechanisms underlying this vulnerability are not well understood. As depression has been associated with dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis and increased responsiveness to psychosocial stressors, we speculated that childhood maltreatment may lead to lasting alteration of the stress response system, thereby increasing the risk of depression. This study investigated the effects of childhood maltreatment on the stress response in healthy subjects while controlling for psychiatric condition.MethodsForty-eight healthy young adults (24 females) with childhood maltreatment experience and 48 healthy controls (33 females) without such experience were administered the Montreal Imaging Stress Task during functional magnetic resonance imaging. Childhood maltreatment experience was assessed using the 28-item Childhood Trauma Questionnaire (CTQ). Between-group differences in subjective stress levels, whole brain activations and cortisol levels were assessed.ResultsRelative to healthy control subjects, individuals exposed to childhood maltreatment exhibited higher subjective stress and cortisol levels. Neurofunctionally, participants with histories of childhood maltreatment displayed significantly increased activation in the dorsolateral prefrontal cortex (dlPFC), insula and precuneus, and decreased activation in ventromedial prefrontal cortex (vmPFC) relative to healthy controls during the psychosocial stress task. Activations in dlPFC and insula correlated with CTQ scores in the childhood maltreatment group.ConclusionThe results of this study show that childhood maltreatment induces lasting changes in brain function and HPA-axis responsiveness to stress. The observed abnormal activation in the dlPFC, insula and vmPFC and enhanced cortisol response are similar to those seen in individuals with depression. This dysfunction might serve as a diathesis that embeds latent vulnerability to psychiatric disorders, and this mechanism provides evidence supporting the stress sensitization model.
Highlights
Childhood maltreatment, including physical abuse, emotional abuse, sexual abuse, physical neglect, and emotional neglect, is a potent predictor of poor mental health across the lifespan (McCrory et al, 2017)
Beck Depression Inventory-II (BDI) and Childhood Trauma Questionnaire (CTQ) subscale scores were significantly higher in the childhood maltreatment group than in the control group
Two-sample t tests showed that the childhood maltreatment group exhibited significantly increased activity in dorsolateral prefrontal cortex (dlPFC), insula, and precuneus, and decreased activity in ventromedial prefrontal cortex (vmPFC) compared with controls without childhood maltreatment experiences
Summary
Childhood maltreatment, including physical abuse, emotional abuse, sexual abuse, physical neglect, and emotional neglect, is a potent predictor of poor mental health across the lifespan (McCrory et al, 2017). Individuals who have experienced childhood trauma have been found to have a four-fold increased risk of depression compared with those who have not experienced such trauma (Young et al, 1997). Childhood adversity is clearly related to vulnerability to psychopathology, the specific mechanism underlying this relationship remains unclear. As a severe psychosocial stressor, childhood maltreatment may increase vulnerability to ongoing life stress and lower the threshold required to trigger affective episodes (Post et al, 2001). Hammen et al (2000) examined a number of childhood adversities and found a stress-sensitization effect in which women with higher levels of early adversity showed more depressive reactions to low levels of recent stressors compared with those with fewer adversities (Hammen et al, 2000). This study investigated the effects of childhood maltreatment on the stress response in healthy subjects while controlling for psychiatric condition
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