General psychopathology factor and unresolved-disorganized attachment uniquely correlated to white matter integrity using diffusion tensor imaging

Abstract

HIGHLIGHTS Recent research has identified a general psychopathology factor (GPF)  GPF and Unresolved trauma may be uniquely related to white matter integrity (WMI)  Unresolved trauma is uniquely associated with reduced WMI in the splenium  GPF is uniquely related to reduced WMI in the genu and body of the corpus callosum ABSTRACT Background: A dimensional approach of psychopathology focuses on features and risk factors that are shared across diagnoses. In support for this dimensional approach, studies point to a general psychopathology factor (GPF) associated with risk for multiple psychiatric disorders. It is, however, unknown how GPF relates to white matter integrity (WMI). In the current diffusion tensor imaging (DTI) study, we examined how GPF relates to abnormalities in a skeleton representation of white matter tracts, taking into account a trans-diagnostic risk factor:unresolved-disorganized attachment (Ud) resulting from loss or trauma.Methods: Unique associations between GPF, Ud, and WMI were examined in a combined sample of adolescents (N=63) with childhood sexual abuse-related posttraumatic stress disorder (N = 18), anxiety and depressive disorders (N=26) and without psychiatric disorder (N=19).WMI was measured using DTI. Ud was measured using the Adult Attachment Interview. We controlled for puberty stage, gender, age, and IQ.Results: Controlling for GPF, Ud was associated with reduced fractional anisotropy (FA) in the splenium and inferior fronto-occipital fasciculus (IFOF). Controlling for Ud, GPF was associated with reduced FA in the genu and body of the corpus callosum. Conclusions:Decreasing WMI in the genu and body with increasing psychopathology across diagnoses suggests demyelinization in these areas and may underlie comorbidity and presence of symptoms that transcend psychopathological diagnoses. In contrast, trauma-related WMI reductions in the splenium and IFOF may account for heterogeneity within diagnostic categories as a function of childhood trauma. These findings support the importance of a dimensional approach in addition to traditional diagnostic classifications in clinical research and practice.

Unresolved–disorganized attachment adjusted for a general psychopathology factor associated with atypical amygdala resting-state functional connectivity

“…Our findings are consistent with previous studies showing that unresolved loss or abuse is a transdiagnostic risk factor for increased vulnerability to psychopathology in general Riem et al, 2019). Moreover, these findings indicate that amygdala alterations previously found in patients with PTSD, depression, or anxiety disorders are not a specific biomarker for individual mental disorders, but instead may be common to several disorders with overlapping psychopathological symptoms.…”

“…Psychopathology and unresolved-disorganized attachment (Ud) (Bowlby, 1969(Bowlby, , 1980Hesse & Main, 2000) are different yet interrelated clinical constructs (Lyons-Ruth, Pechtel, Yoon, Anderson, & Teicher, 2016;Patalay et al, 2015;Riem et al, 2019) that can impair adolescent functioning. Ud is characterized by signs of disoriented and/or dissociated, disorganized narratives in cases of loss or abuse, which indicate simultaneous or sequential contradictory strategies to deal with the loss or other trauma, and often display a lack of reflective functioning (Fonagy, Steele, Moran, Steele, & Higgitt, 1991).…”

“…Ud is characterized by signs of disoriented and/or dissociated, disorganized narratives in cases of loss or abuse, which indicate simultaneous or sequential contradictory strategies to deal with the loss or other trauma, and often display a lack of reflective functioning (Fonagy, Steele, Moran, Steele, & Higgitt, 1991). Ud is thought to be a transdiagnostic risk factor that is relevant across psychopathologies (Lyons-Ruth & Jacobvitz, 2016;Riem et al, 2019) and accounts for patient characteristics not included in diagnostic categories. The general psychopathology factor (GPF), which represents lesser-to-greater severity of psychopathology across disorders, has also been identified as a transdiagnostic factor that represents clinical presentations on a continuum, contrary to diagnostic categorical classifications such as in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which are not optimal for research, partly because of the overlap between diagnostic categories and difficulty classifying individual patients (Caspi et al, 2014;Patalay et al, 2015;Tackett et al, 2013).…”

White matter tract myelin maturation and its association with general psychopathology in adolescence and early adulthood

“…Volumetric studies implicate grey matter reductions in prefrontal (Snyder, Hankin, Sandman, Head, & Davis, ), striatal (Gong et al, ), occipital and cerebellar regions (Moberget et al, ; Romer et al, ) in association with greater expression of p . In terms of white matter integrity, commonly indexed using diffusion imaging metrics, reduced integrity in callosal (Riem et al, ) and pontine‐cerebellar (Romer et al, ) pathways are also linked to the expression of a p ‐factor. However, positive associations with corpus callosum integrity have also been observed (Hinton et al, ), hinting that neurodiversity rather than a simple deficit accompanies variation in p .…”

Preserved cortical thickness, surface area and volume in adolescents with PTSD after childhood sexual abuse

“…The current study reports on cross-sectional baseline data from the adolescents with a history of sexual trauma and healthy non-traumatised controls. See also previous reports from neuroimaging research with the same population [19][20][21][22][23][24][25][26] . Inclusion criteria for the adolescents with a history of sexual trauma were: having experienced sexual abuse during their lifetime more than once by one or more perpetrators inside or outside the family, and being referred for treatment to the Psychotrauma Center of mental health institute GGZ Rivierduinen in Leiden or the child and adolescent psychotrauma center KJTC in Haarlem, both located in the Netherlands.…”