Annual Research Review
Annual Research Review: Enduring neurobiological effects of childhood abuse and neglect
Martin H. Teicher,
Jacqueline A. Samson,
Corresponding Author
Martin H. Teicher
Department of Psychiatry, Harvard Medical School, Boston, MA, USA
Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA
Correspondence
Martin H. Teicher, Developmental Biopsychiatry Research Program, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA; Email: [email protected]
Search for more papers by this authorJacqueline A. Samson
Department of Psychiatry, Harvard Medical School, Boston, MA, USA
Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA
Search for more papers by this authorMartin H. Teicher,
Jacqueline A. Samson,
Corresponding Author
Martin H. Teicher
Department of Psychiatry, Harvard Medical School, Boston, MA, USA
Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA
Correspondence
Martin H. Teicher, Developmental Biopsychiatry Research Program, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA; Email: [email protected]
Search for more papers by this authorJacqueline A. Samson
Department of Psychiatry, Harvard Medical School, Boston, MA, USA
Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA
Search for more papers by this authorConflict of interests statement: No conflicts declared.
Abstract
Background
Childhood maltreatment is the most important preventable cause of psychopathology accounting for about 45% of the population attributable risk for childhood onset psychiatric disorders. A key breakthrough has been the discovery that maltreatment alters trajectories of brain development.
Methods
This review aims to synthesize neuroimaging findings in children who experienced caregiver neglect as well as from studies in children, adolescents and adults who experienced physical, sexual and emotional abuse. In doing so, we provide preliminary answers to questions regarding the importance of type and timing of exposure, gender differences, reversibility and the relationship between brain changes and psychopathology. We also discuss whether these changes represent adaptive modifications or stress-induced damage.
Results
Parental verbal abuse, witnessing domestic violence and sexual abuse appear to specifically target brain regions (auditory, visual and somatosensory cortex) and pathways that process and convey the aversive experience. Maltreatment is associated with reliable morphological alterations in anterior cingulate, dorsal lateral prefrontal and orbitofrontal cortex, corpus callosum and adult hippocampus, and with enhanced amygdala response to emotional faces and diminished striatal response to anticipated rewards. Evidence is emerging that these regions and interconnecting pathways have sensitive exposure periods when they are most vulnerable.
Conclusions
Early deprivation and later abuse may have opposite effects on amygdala volume. Structural and functional abnormalities initially attributed to psychiatric illness may be a more direct consequence of abuse. Childhood maltreatment exerts a prepotent influence on brain development and has been an unrecognized confound in almost all psychiatric neuroimaging studies. These brain changes may be best understood as adaptive responses to facilitate survival and reproduction in the face of adversity. Their relationship to psychopathology is complex as they are discernible in both susceptible and resilient individuals with maltreatment histories. Mechanisms fostering resilience will need to be a primary focus of future studies.
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