Childhood Maltreatment, Altered Limbic Neurobiology, and Substance Use Relapse Severity via Trauma-Specific Reductions in Limbic Gray Matter Volume

Dam, Nicholas T. Van; Rando, Kenneth; Potenza, Marc N.; Tuit, Ken I; Sinha, Rajita

doi:10.1001/jamapsychiatry.2014.680

Cited by 126 publications

(88 citation statements)

References 59 publications

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“…A large number of studies have established that many brain systems in humans and animal models are harmed by early adversity (57)(58)(59). A few recent neuroimaging studies, like the current one, have begun to search for specific brain mediators of the negative psychiatric effects produced by adversity.…”

Section: Discussionmentioning

confidence: 94%

Brain Regions Related to Impulsivity Mediate the Effects of Early Adversity on Antisocial Behavior

Mackey

Chaarani

Kan

et al. 2017

Biological Psychiatry

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BACKGROUND: Individual differences in impulsivity and early adversity are known to be strong predictors of adolescent antisocial behavior. However, the neurobiological bases of impulsivity and their relation to antisocial behavior and adversity are poorly understood. METHODS: Impulsivity was estimated with a temporal discounting task. Voxel-based morphometry was used to determine the brain structural correlates of temporal discounting in a large cohort (n 5 1830) of 14-to 15-year-old children. Mediation analysis was then used to determine whether the volumes of brain regions associated with temporal discounting mediate the relation between adverse life events (e.g., family conflict, serious accidents) and antisocial behaviors (e.g., precocious sexual activity, bullying, illicit substance use). RESULTS: Greater temporal discounting (more impulsivity) was associated with 1) lower volume in frontomedial cortex and bilateral insula and 2) greater volume in a subcortical region encompassing the ventral striatum, hypothalamus and anterior thalamus. The volume ratio between these cortical and subcortical regions was found to partially mediate the relation between adverse life events and antisocial behavior. CONCLUSIONS: Temporal discounting is related to regions of the brain involved in reward processing and interoception. The results support a developmental imbalance model of impulsivity and are consistent with the idea that negative environmental factors can alter the developing brain in ways that promote antisocial behavior.

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Section: Discussionmentioning

confidence: 94%

Brain Regions Related to Impulsivity Mediate the Effects of Early Adversity on Antisocial Behavior

Mackey

Chaarani

Kan

et al. 2017

Biological Psychiatry

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“…The effects of childhood abuse on the developing brain is well documented in the literature (D'Andrea, Ford, Stolbach, Spinazzola, & Van der Kolk, 2012;Ford et al, 2013;Van Der Kolk et al, 2005). A Level I controlled, randomized trial examined the effects of SUD and childhood maltreatment on altered limbic neurobiology, relapse severity in SUD, and reduced limbic gray matter volume using structured magnetic resonance (MRI) with the goal of finding neurobiological structural changes in the brain (Van Dam et al 2014). Clients presenting with a history of trauma had higher rates of relapse, in addition to having worse outcomes than those with SUD without a history of childhood maltreatment and PTSD (Choi et al, 2017;Edwards et al, 2017;Grupp, 2008;Hien et al, 2010;Hien, Cohen, Miele, Litt, & Capstick, 2004;Valerie, George, Vincent, & Robert, 2003).…”

Section: Resultsmentioning

confidence: 99%

Screening Adults With Substance Use Disorder for Adverse Childhood Experiences

Chandler

Kalmakis²,

Murtha³

2018

UJAN

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Objective: The purpose of this study was to assess the incidence of adverse childhood experiences (ACEs) and the efficacy and feasibility of a trauma-informed screening for ACEs among individuals in a substance use disorder recovery program. Method: Individual interviews, questionnaires, and postinterview survey and reflections were used in this cross-sectional clinical translation project. Descriptive statistics were used to analyze demographics, ACE scores, protective childhood experiences, self-reported diagnoses, and postintervention survey data. Postinterview reflections were reviewed and grouped into common ideas as shared by participants, as well as interesting impressions, insights, and responses to the interviews. Results: Thirty clients participated in the interview process. Among the 29 participants who completed the questionnaires, all reported at least one ACE, and 82.8% reported six or more ACEs. In addition, 96.6% reported experiencing more than four protective factors. Twelve (40%) clients were referred for further mental health counseling after the interviews. Notable findings from the interviews were the general lack of awareness of the relationship between ACEs and current substance use disorder among participants. Gaining knowledge about the impact of ACEs on their recovery seemed to provide a sense of relief and a feeling that they were “normal.” Conclusions: The trauma-informed care approach is intended to promote mindfulness regarding the effect of ACEs on substance abuse in this population. Screening for ACEs is necessary if effective interventions are to be provided, with the goal of improving client outcomes.

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“…Volumetric reductions in the amygdala (Soloff et al 2008;Aas et al 2012a;Hoy et al 2012), hippocampus (Hoy et al 2012), ventrolateral prefrontal cortex (Morandotti et al 2013) and in total grey matter (Sheffield et al 2013) have been reported among patients with psychotic disorders and borderline personality disorder with a history of childhood trauma compared with those without such a history. Structural brain changes as a result of childhood maltreatment have been associated with the severity of substance use relapse (Van Dam et al 2014), which may represent a significant problem given the high rates of such disorders reported among psychosis and borderline personality disorder cohorts (Regier et al 1990;Trull et al 2000). There is also evidence that childhood trauma may increase stress sensitivity among patients with psychosis, potentially through alterations in functioning of the hypothalamicpituitary-adrenal axis, the body's neurobiological stress response system (Neigh et al 2009;Lardinois et al 2011).…”

Section: Brain Developmentmentioning

confidence: 99%

Childhood trauma and functional disability in psychosis, bipolar disorder and borderline personality disorder: a review of the literature

Cotter

Kaess

Yung

2014

Ir. j. psychol. Med.

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Objectives. We aimed to examine the association between childhood trauma and functional impairment in psychotic disorders, bipolar disorder and borderline personality disorder, to speculate on possible mechanisms that underlie this association and discuss the implications for clinical work.Methods. Narrative review of the peer-reviewed English language literature in the area.Results. High rates of childhood trauma in psychotic disorders, bipolar disorder and borderline personality disorder were identified. This was associated with impaired social and occupational functioning in both the premorbid and established phases of each of these psychiatric disorders over and above the deficits typically observed in these populations. Possible mechanisms mediating this relationship include neurocognitive deficits, insecure attachment, higher rates of comorbidities and problems with adherence and response to treatment. Conclusions.Routine clinical inquiry about childhood maltreatment should be adopted within mental health settings. This has potentially important treatment implications for identifying those individuals at elevated risk of functional disability. While there is no clear guidance currently available on how to target childhood trauma in the treatment of psychotic disorders, bipolar disorder or borderline personality disorder, there are several promising lines of enquiry and further research is warranted.

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Childhood Maltreatment, Altered Limbic Neurobiology, and Substance Use Relapse Severity via Trauma-Specific Reductions in Limbic Gray Matter Volume

Cited by 126 publications

References 59 publications

Brain Regions Related to Impulsivity Mediate the Effects of Early Adversity on Antisocial Behavior

Brain Regions Related to Impulsivity Mediate the Effects of Early Adversity on Antisocial Behavior

Screening Adults With Substance Use Disorder for Adverse Childhood Experiences

Childhood trauma and functional disability in psychosis, bipolar disorder and borderline personality disorder: a review of the literature

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