Practitioner Review: Neurobiological consequences of childhood maltreatment – clinical and therapeutic implications for practitioners

Abstract

BackgroundChildhood maltreatment is one of the most important preventable risk factors for a wide variety of psychiatric disorders. Further, when psychiatric disorders emerge in maltreated individuals they typically do so at younger ages, with greater severity, more psychiatric comorbid conditions, and poorer response to established treatments, resulting in a more pernicious course with an increased risk for suicide. Practitioners treating children, adolescents, and young adults with psychiatric disorders will likely encounter the highest prevalence of clients with early‐onset maltreatment‐associated psychiatric disorders. These may be some of their most challenging cases.MethodIn this report, we explore key validated alterations in brain structure, function, and connectivity associated with exposure to childhood maltreatment as potential mechanisms behind their patients' clinical presentations.ResultsWe then summarize key behavioral presentations likely associated with neurobiological alterations and propose a toolkit of established trauma and skills‐based strategies that may help diminish symptoms and foster recovery. We also discuss how some of these alterations may serve as latent vulnerability factors for the possible development of future psychopathology.ConclusionsResearch on the neurobiological consequences of childhood adversity provides a vastly enriched biopsychosocial understanding of the developmental origins of health and pathology that will hopefully lead to fundamental advances in clinical psychology and psychiatry.

Depressed patients with childhood maltreatment display altered intra- and inter-network resting state functional connectivity

“…A rapidly growing number of studies report that CM can alter trajectories of brain development and result in alterations in brain structure, function, connectivity, and network architecture of neural circuits critical for socio-cognitive functions, and by that, embed latent vulnerability to psychopathologies ( Lim et al, 2020 , Kraaijenvanger et al, 2020 , Pollok et al, 2022 , Li et al, 2023 , Oltean et al, 2023 , Yang et al, 2023 , Ireton et al, 2024 , Tomoda et al, 2024 ). Such developmental brain alterations contribute to the abnormal emotional regulation, reward processing, threat detection and response, interhemispheric integration, and sensory processing which are often present in maltreated individuals ( Samson et al, 2024 ). Most neuroimaging studies investigating the long-term impact of early life stress report on structural and functional alterations of brain areas involved in socio-affective functioning and stress regulation, whereas here we document that severely maltreated depressed patients display numerous alterations of intra- and inter-networks FC strengths, not only in their fronto-limbic circuits, but also in their sensory-motor, visual, auditory, and cerebellar networks.…”

“…Modern neuroimaging tools have been extensively utilized to understand the structural and functional alterations in the brains of depressed individuals ( Cattarinussi et al, 2021 , Yang et al, 2021 , Tse et al, 2023 ). Understanding the maltreatment-associated structural and functional brain differences may help us to develop preventive and therapeutic interventions for MDD ( Nemeroff, 2016 , Lippard and Nemeroff, 2020 , Samson et al, 2024 ).…”

Editorial: Thinking outside the box – enhancing causal models of neurodevelopmental disorders

“…Several articles in this issue aim to specify the pathways across explanatory levels (e.g. Cantave et al, 2024; the practitioner review by Samson, Newkirk, & Teicher, 2024, in which associations between brain alterations and exposure to childhood maltreatment are discussed; Madrid-Valero, Barclay, & Gregory, 2024). The paper by Madrid-Valero et al (2024) provides a good example of the complex interaction between genetic and environmental risk factors in the context of insomnia, a disorder with moderate heritability.…”

“…Several articles in this issue aim to specify the pathways across explanatory levels (e.g. Cantave et al., 2024; the practitioner review by Samson, Newkirk, & Teicher, 2024, in which associations between brain alterations and exposure to childhood maltreatment are discussed; Madrid‐Valero, Barclay, & Gregory, 2024). The paper by Madrid‐Valero et al.…”