Threat and deprivation are associated with distinct aspects of cognition, emotional processing, and psychopathology in children and adolescents

The relationship between childhood maltreatment subtypes and adolescent internalizing problems: The mediating role of maladaptive cognitive emotion regulation strategies

BACKGROUND

While childhood maltreatment is understood to be a significant risk factor for adolescent internalizing problems (depression and anxiety), underlying mechanisms linking each type of maltreatment to internalizing problems in adolescents remain unclear. Moreover, the current state of knowledge regarding the associations between maladaptive cognitive emotion regulation strategies and each type of maltreatment, as well as their impact on adolescent internalizing problems, is limited. Additionally, it remains unclear whether these maladaptive strategies mediate this relationship.

OBJECTIVE

This study sought to investigate the effects of childhood maltreatment types on adolescent internalizing problems and to explore whether the overall and specific types of maladaptive strategies mediate these associations.

METHODS

Using a cross-sectional design, adolescents (N = 7071, Mage = 14.05 years, SDage = 1.54) completed online questionnaires assessing childhood maltreatment, maladaptive cognitive emotion regulation strategies (including rumination, catastrophizing, self-blame, and other-blame), anxiety, and depression. The hypothesized mediating effects were tested using the Lavaan package in R software (4.1.2).

RESULTS

Different maltreatment types had varying effects on adolescent internalizing problems. Emotional neglect, emotional abuse, and sexual abuse significantly affected anxiety and depression, whereas physical neglect and physical abuse did not. Other than physical neglect and physical abuse, overall maladaptive strategies mediated the relationship between the other three types of maltreatment (emotional abuse, emotional neglect, and sexual abuse) and internalizing problems (anxiety and depression). For specific maladaptive strategies, rumination mediated the effects of physical abuse, emotional abuse, emotional neglect, and sexual abuse on internalizing problems (anxiety and depression). In contrast, catastrophizing mediated the relationship between physical neglect, emotional abuse, emotional neglect, sexual abuse and internalizing problems (anxiety and depression).

CONCLUSIONS

These results suggest that the effects of maltreatment types on internalizing problems are different and that maladaptive strategies, particularly rumination and catastrophizing, are important mechanisms through which childhood maltreatment affects internalizing problems. This is a reminder that mental health workers need to consider the different effects of maltreatment types when intervening and recognize the importance of prioritizing interventions for rumination and catastrophizing.

Belief Updating, Childhood Maltreatment, and Paranoia in Schizophrenia-Spectrum Disorders

BACKGROUND AND HYPOTHESIS

Exposure to childhood maltreatment-a risk factor for psychosis is associated with paranoia-may impact one's beliefs about the world and how beliefs are updated. We hypothesized that increased exposure to childhood maltreatment is related to volatility-related belief updating, specifically higher expectations of volatility, and that these relationships are strongest for threat-related maltreatment. Additionally, we tested whether belief updating mediates the relationship between maltreatment and paranoia.

STUDY DESIGN

Belief updating was measured in 75 patients with schizophrenia-spectrum disorders and 76 nonpsychiatric controls using a 3-option probabilistic reversal learning (3PRL) task. A Hierarchical Gaussian Filter (HGF) was used to estimate computational parameters of belief updating, including prior expectations of volatility (μ03). The Childhood Trauma Questionnaire (CTQ) was used to assess cumulative maltreatment, threat, and deprivation exposure. Paranoia was measured using the Positive and Negative Syndrome Scale (PANSS) and the revised Green et al. Paranoid Thoughts Scale (R-GPTS).

RESULTS

Greater exposure to childhood maltreatment is associated with higher prior expectations of volatility in the whole sample and in individuals with schizophrenia-spectrum disorders. This was specific to threat-related maltreatment, rather than deprivation, in schizophrenia-spectrum disorders. Paranoia was associated with both exposure to childhood maltreatment and volatility priors, but we did not observe a significant indirect effect of volatility priors on the relationship between maltreatment and paranoia.

CONCLUSIONS

Our study suggests that individuals with schizophrenia-spectrum disorders who were exposed to threatening experiences during childhood expect their environment to be more volatile, potentially facilitating aberrant belief updating and conferring risk for paranoia.

Do dimensions of childhood adversity differ in their direct associations with youth psychopathology? A meta-analysis

Growing evidence supports the unique pathways by which threat and deprivation, two core dimensions of adversity, confer risk for youth psychopathology. However, the extent to which these dimensions differ in their direct associations with youth psychopathology remains unclear. The primary aim of this preregistered meta-analysis was to synthesize the associations between threat, deprivation, internalizing, externalizing, and trauma-specific psychopathology. Because threat is proposed to be directly linked with socioemotional development, we hypothesized that the magnitude of associations between threat and psychopathology would be larger than those with deprivation. We conducted a search for peer-reviewed articles in English using PubMed and PsycINFO databases through August 2022. Studies that assessed both threat and deprivation and used previously validated measures of youth psychopathology were included. One hundred and twenty-seven articles were included in the synthesis (N = 163,767). Results of our three-level meta-analyses indicated that adversity dimension significantly moderated the associations between adversity and psychopathology, such that the magnitude of effects for threat (r's = .21-26) were consistently larger than those for deprivation (r's = .16-.19). These differences were more pronounced when accounting for the threat-deprivation correlation. Additional significant moderators included emotional abuse and youth self-report of adversity. Findings are consistent with the Dimensional Model of Adversity and Psychopathology, with clinical, research, and policy implications.

The impacts of early environmental adversity on cognitive functioning, body mass, and life-history behavioral profiles

Early adverse experiences or exposures have a profound impact on neurophysiological, cognitive, and somatic development. Evidence across disciplines uncovers adversity-induced alternations in cortical structures, cognitive functions, and related behavioral manifestations, as well as an energetic trade-off between the brain and body. Based on the life history (LH) framework, the present research aims to explore the adversity-adapted cognitive-behavioral mechanism and investigate the relation between cognitive functioning and somatic energy reserve (i.e., body mass index; BMI). A structural equation modeling (SEM) analysis was performed with longitudinal self-reported, anthropometric, and task-based data drawn from a cohort of 2,607 8- to 11-year-old youths and their primary caregivers recruited by the Adolescent Brain Cognitive Development (ABCDSM) study. The results showed that early environmental adversity was positively associated with fast LH behavioral profiles and negatively with cognitive functioning. Moreover, cognitive functioning mediated the relationship between adversity and fast LH behavioral profiles. Additionally, we found that early environmental adversity positively predicted BMI, which was inversely correlated with cognitive functioning. These results revealed an adversity-adapted cognitive-behavioral mechanism and energy-allocation pathways, and add to the existing knowledge of LH trade-off and developmental plasticity.

Intergenerational cascade processes from parental childhood adversity to child emotional and behavioral problems

BACKGROUND

Parental adverse childhood experiences (ACEs) may transmit to the next generation and influence children's emotional and behavioral problems. Relatively little evidence exists on the underlying pathways of this intergenerational transmission at the family- and individual-level.

OBJECTIVE

This study examined the intergenerational cascade processes of parental ACEs on children's emotional and behavioral problems via family cohesion, children's ACEs, and children's self-control.

PARTICIPANTS AND SETTING

283 children (52 % male, Mage = 10.47 years) and their parents (61.1 % mothers, Mage = 38.62 years) were recruited for a 2-month longitudinal study with surveys administered at three time points.

METHOD

Mediation models examined the intergenerational effects of parental ACEs (T1/T3) and family cohesion (T1) as reported by parents, and children's ACEs (T1) and children's self-control (T2) as reported by children, on children's internalizing and externalizing problems (T3) as reported by parents.

RESULTS

Family cohesion, children's ACEs, and children's self-control sequentially mediated the link between parental ACEs and children's externalizing problems (indirect effect = 0.004, 95 % CI [0.001, 0.014]). Parental ACEs were directly linked with children's internalizing problems (β = 0.191, SE = 0.075, p = .011).

CONCLUSIONS

Findings demonstrated intergenerational cascades of distal and proximal risk processes from parental ACEs to children's behavioral problems. These findings have implications for future interventions on children's externalizing problems that aim at improving family cohesion and children's self-control for families exposed to childhood adversity.

Cognitive deficits and enhancements in youth from adverse conditions: An integrative assessment using Drift Diffusion Modeling in the ABCD study

Childhood adversity can lead to cognitive deficits or enhancements, depending on many factors. Though progress has been made, two challenges prevent us from integrating and better understanding these patterns. First, studies commonly use and interpret raw performance differences, such as response times, which conflate different stages of cognitive processing. Second, most studies either isolate or aggregate abilities, obscuring the degree to which individual differences reflect task-general (shared) or task-specific (unique) processes. We addressed these challenges using Drift Diffusion Modeling (DDM) and structural equation modeling (SEM). Leveraging a large, representative sample of 9-10 year-olds from the Adolescent Brain Cognitive Development (ABCD) study, we examined how two forms of adversity-material deprivation and household threat-were associated with performance on tasks measuring processing speed, inhibition, attention shifting, and mental rotation. Using DDM, we decomposed performance on each task into three distinct stages of processing: speed of information uptake, response caution, and stimulus encoding/response execution. Using SEM, we isolated task-general and task-specific variances in each processing stage and estimated their associations with the two forms of adversity. Youth with more exposure to household threat (but not material deprivation) showed slower task-general processing speed, but showed intact task-specific abilities. In addition, youth with more exposure to household threat tended to respond more cautiously in general. These findings suggest that traditional assessments might overestimate the extent to which childhood adversity reduces specific abilities. By combining DDM and SEM approaches, we can develop a more nuanced understanding of how adversity affects different aspects of youth's cognitive performance. RESEARCH HIGHLIGHT: To understand how childhood adversity shapes cognitive abilities, the field needs analytical approaches that can jointly document and explain patterns of lowered and enhanced performance. Using Drift Diffusion Modeling and Structural Equation Modeling, we analyzed associations between adversity and processing speed, inhibition, attention shifting, and mental rotation. Household threat, but not material deprivation, was mostly associated with slower task-general processing speed and more response caution. In contrast, task-specific abilities were largely intact. Researchers might overestimate the impact of childhood adversity on specific abilities and underestimate the impact on general processing speed and response caution using traditional measures.

Examining the relationship between psychosocial adversity and inhibitory control: an fMRI study of children growing up in extreme poverty

Exposure to psychosocial adversity (PA) is associated with poor behavioral, physical, and mental health outcomes in adulthood. Growing evidence suggests that deficits in executive functions may in part moderate these outcomes, with inhibitory control as an example of such a putative moderator. However, much of the literature examining the development of inhibitory control has been based on children in higher resource environments, and little is known how growing up in a low resource setting might exacerbate the link between inhibitory control and health outcomes. In this context we collected fMRI data during a Go/No-Go inhibitory control task and PA variables for 68 children 5 to 7 years of age living in Dhaka, Bangladesh, an area with a high prevalence of PA. The children's mothers completed behavioral questionnaires to assess the child's PA and their own PA. Whole-brain activation underlying inhibitory control was examined using the No-Go versus Go contrast, and associations with PA variables were assessed using whole-brain regressions. Childhood neglect was associated with weaker activation in the right posterior cingulate, whereas greater family conflict, economic stress, and maternal PA factors were associated with greater activation in the left medial frontal gyrus, right superior and middle frontal gyrus, and left cingulate gyrus. These data suggest that neural networks supporting inhibitory control processes may vary as a function of exposure to different types of PA, particularly between those related to threat and deprivation. Furthermore, increased activation in children with greater PA may serve as a compensatory mechanism, allowing them to maintain similar behavioral task performance.

COVID-19-related stress exacerbates the effect of child maltreatment on negative affect via increased identity confusion during adolescence

INTRODUCTION

Exposure to childhood maltreatment may undermine the crucial developmental task of identity formation in adolescence, placing them at risk for developing negative affect. The current study investigated whether COVID-19-related stress intensified the indirect link between child maltreatment and adolescents' negative affect through identity confusion.

METHOD

Using multidimensional assessments of child maltreatment (threat vs. deprivation), the study included a sample of 124 adolescents (Mage  = 12.89, SD = 0.79; 52% female) assessed before (January 2018 to March 2020) and during the pandemic (May to October 2020) in Georgia, United States. The majority of the participants were European American (78.8%), followed by African American (11.5%), Hispanic (3.8%), Asian/Pacific Islander (1.0%), and other (4.8%). We used structural equation modeling to test (a) the mediating role of identity confusion in the link between childhood maltreatment and negative affect and (b) whether COVID-19-related stress moderated these indirect effects. Simple slopes and Johnson-Neyman plots were generated to probe regions of significant interaction effects.

RESULTS

Threat and deprivation predicted an increase in adolescent identity confusion. Additionally, childhood threat and deprivation were indirectly linked to adolescents' negative affect through increased levels of identity confusion. COVID-19-related stress significantly exacerbated the link between identity confusion and negative affect.

CONCLUSION

Identity confusion is a mechanism underlying the link between child maltreatment and the development of negative affect in adolescence. Our results inform prevention and intervention programs that aim to reduce negative affect among adolescents who experience threatening and depriving rearing environments.

Maternal Childhood Abuse Versus Neglect Associated with Differential Patterns of Infant Brain Development

Severity of maternal childhood maltreatment has been associated with lower infant grey matter volume and amygdala volume during the first two years of life. A developing literature argues that effects of threat (abuse) and of deprivation (neglect) should be assessed separately because these distinct aspects of adversity may have different impacts on developmental outcomes. However, distinct effects of threat versus deprivation have not been assessed in relation to intergenerational effects of child maltreatment. The objective of this study was to separately assess the links of maternal childhood abuse and neglect with infant grey matter volume (GMV), white matter volume (WMV), amygdala and hippocampal volume. Participants included 57 mother-infant dyads. Mothers were assessed for childhood abuse and neglect using the Adverse Childhood Experiences (ACE) questionnaire in a sample enriched for childhood maltreatment. Between 4 and 24 months (M age = 12.28 months, SD = 5.99), under natural sleep, infants completed an MRI using a 3.0 T Siemens scanner. GMV, WMV, amygdala and hippocampal volumes were extracted via automated segmentation. Maternal history of neglect, but not abuse, was associated with lower infant GMV. Maternal history of abuse, but not neglect, interacted with age such that abuse was associated with smaller infant amygdala volume at older ages. Results are consistent with a threat versus deprivation framework, in which threat impacts limbic regions central to the stress response, whereas deprivation impacts areas more central to cognitive function. Further studies are needed to identify mechanisms contributing to these differential intergenerational associations of threat versus deprivation.

Negative versus withdrawn maternal behavior: Differential associations with infant gray and white matter during the first 2 years of life

Distinct neural effects of threat versus deprivation emerge by childhood, but little data are available in infancy. Withdrawn versus negative parenting may represent dimensionalized indices of early deprivation versus early threat, but no studies have assessed neural correlates of withdrawn versus negative parenting in infancy. The objective of this study was to separately assess the links of maternal withdrawal and maternal negative/inappropriate interaction with infant gray matter volume (GMV), white matter volume (WMV), amygdala, and hippocampal volume. Participants included 57 mother-infant dyads. Withdrawn and negative/inappropriate aspects of maternal behavior were coded from the Still-Face Paradigm at four months infant age. Between 4 and 24 months (M age = 12.28 months, SD = 5.99), during natural sleep, infants completed an MRI using a 3.0 T Siemens scanner. GMV, WMV, amygdala, and hippocampal volumes were extracted via automated segmentation. Diffusion weighted imaging volumetric data were also generated for major white matter tracts. Maternal withdrawal was associated with lower infant GMV. Negative/inappropriate interaction was associated with lower overall WMV. Age did not moderate these effects. Maternal withdrawal was further associated with reduced right hippocampal volume at older ages. Exploratory analyses of white matter tracts found that negative/inappropriate maternal behavior was specifically associated with reduced volume in the ventral language network. Results suggest that quality of day-to-day parenting is related to infant brain volumes during the first two years of life, with distinct aspects of interaction associated with distinct neural effects.

Empirically-derived dimensions of childhood adversity and cumulative risk: associations with measures of depression, anxiety, and psychosis-spectrum psychopathology

Background: Investigating different approaches to operationalizing childhood adversity and how they relate to transdiagnostic psychopathology is relevant to advance research on mechanistic processes and to inform intervention efforts. To our knowledge, previous studies have not used questionnaire and interview measures of childhood adversity to examine factor-analytic and cumulative-risk approaches in a complementary manner.Objective: The first aim of this study was to identify the dimensions underlying multiple subscales from three well-established childhood adversity measures (the Childhood Trauma Questionnaire, the Childhood Experience of Care and Abuse Interview, and the Interview for Traumatic Events in Childhood) and to create a cumulative risk index based on the resulting dimensions. The second aim of the study was to examine the childhood adversity dimensions and the cumulative risk index as predictors of measures of depression, anxiety, and psychosis-spectrum psychopathology.Method: Participants were 214 nonclinically ascertained young adults who were administered questionnaire and interview measures of depression, anxiety, psychosis-spectrum phenomena, and childhood adversity.Results: Four childhood adversity dimensions were identified that captured experiences in the domains of Intrafamilial Adversity, Deprivation, Threat, and Sexual Abuse. As hypothesized, the adversity dimensions demonstrated some specificity in their associations with psychopathology symptoms. Deprivation was uniquely associated with the negative symptom dimension of psychosis (negative schizotypy and schizoid symptoms), Intrafamilial Adversity with schizotypal symptoms, and Threat with depression, anxiety, and psychosis-spectrum symptoms. No associations were found with the Sexual Abuse dimension. Finally, the cumulative risk index was associated with all the outcome measures.Conclusions: The findings support the use of both the empirically-derived adversity dimensions and the cumulative risk index and suggest that these approaches may facilitate different research objectives. This study contributes to our understanding of the complexity of childhood adversity and its links to different expressions of psychopathology.

A Dutch Perspective on Two Health Related Issues Regarding Children and Adolescents with Intellectual Disabilities

In this opinion article, we want to inspire readers by highlighting recent Dutch developments about two important health related issues regarding the quality of life of children and adolescents with intellectual disabilities. Firstly we focus on the prevention, treatment and reduction of (disability-related) somatic and psychological problems by specialized physicians for people with intellectual disabilities. Secondly, we emphasize the importance of the prevention of adverse childhood experiences and the promotion of protective and compensatory experiences. Subsequently, we stress the need for trauma informed care to support children and adolescents with intellectual disabilities who encounter adverse events. A specialized and multidisciplinary approach is advised as is the need for promoting healthy (family) relations with a focus on (co)regulation and connection as a basis for recovery.