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

Charlotte C. Schulz,Lars O. White,Margaret A. Sheridan,Arno Villringer,Kai von Klitzing,Margerete J. S. Schoett,Lorenz Deserno,Ferdinand Hoffmann,Pascal Vrtička,Michael J. Crowley

doi:10.1017/s0954579421001681

Abstract

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.

Highlights

Adversity and child maltreatment, in particular, confer risk for poor mental and physical health as well as relationship difficulties across the lifespan (Jaffee, 2017; Gunnar & Reid, 2019)
This study reported an association of emotional maltreatment (EM) with exclusion-related activation in the dorsomedial PFC (dmPFC), a brain region adjacent to the dorsal anterior cingulate cortex (dACC), forming part of a network thought to be involved in appraisal and expression of negative emotions (Etkin et al, 2011)
Our findings provide important new insights for the ongoing debate whether EM is best subsumed under the umbrella of threat/deprivation exposures or whether it is a qualitatively distinct experience, calling for an additional adversity dimension in its own right

Summary

Introduction

Adversity and child maltreatment, in particular, confer risk for poor mental and physical health as well as relationship difficulties across the lifespan (Jaffee, 2017; Gunnar & Reid, 2019). Besides abuse (∼threat) and neglect (∼deprivation), a subtype which may figure especially prominently in this case is emotional maltreatment (EM), inasmuch as it involves disruption of the species-expected caregiving relationship that carries forward to new social encounters (e.g., Tottenham, 2012; White et al, 2020). Aiming to fill this crucial gap, our study set out to examine neural activation during social inclusion and exclusion among youth exposed to abuse, neglect, and EM as compared to carefully matched unexposed controls

Objectives

Methods

Results

Discussion

Conclusion