Massachusetts General Hospital, Department of Psychiatry, Boston, MA, USA.
Harvard Medical School, Department of Psychiatry, Boston, MA, USA.
Psychol Med. 2019 Oct;49(13):2267-2278. doi: 10.1017/S0033291718003203. Epub 2018 Nov 13.
Early-life adversity (ELA) is a risk factor for internalizing psychopathology (IP). ELA is also linked to alterations in neural phenotypes of emotion processing and maladaptive emotion regulatory strategies, such as ruminative brooding, in adulthood. We therefore expected that ELA would predict cortical brain activation to emotional faces in transdiagnostic IP and in turn, mediate the extent of rumination amongst patients with IPs and ELA (IP + ELA).
One hundred and thirty-two individuals, including 102 treatment-seeking adults with heterogeneous IPs and 30 healthy controls (HCs) performed an Emotional Face-Matching Task during functional magnetic resonance imaging. Whole-brain analyses compared HC (n = 30), IP (n = 52), and IP + ELA (n = 50) neural responses to emotional (angry, fearful, happy, and sad) faces v. shapes, controlling for depression and anxiety symptoms. Parameter estimates of activation were extracted for significant between-group differences and tested as a mediator of ruminative brooding in IP + ELA.
IP + ELA demonstrated increased activation in the superior frontal gyrus and anterior cingulate cortex (fear), superior parietal lobule, precuneus, posterior cingulate, and inferior temporal gyrus (fear only), and cuneus (fear and angry). These regions were preferentially correlated with ruminative brooding in IP + ELA, many of which mediated the link between IP + ELA and ruminative brooding.
Results provide evidence that ELA history amongst IP patients augments engagement of brain regions involved in emotion processing, above and beyond what is accounted for by current symptoms. Though longitudinal designs are needed, alterations in the neural correlates of maladaptive processing of socio-emotional information may be a common pathway by which ELA poses risk for psychopathology.
早期生活逆境(ELA)是内化精神病理学(IP)的风险因素。ELA 还与情绪处理的神经表型改变以及成年后适应性情绪调节策略(如沉思性沉思)有关。因此,我们预计 ELA 将预测跨诊断 IP 中情绪面孔的皮质脑激活,并反过来,在具有 IP 和 ELA(IP + ELA)的患者中,介导沉思的程度。
包括 102 名寻求治疗的具有不同 IP 的成年患者和 30 名健康对照组(HC)在内的 132 人在功能磁共振成像期间进行了情绪面孔匹配任务。全脑分析比较了 HC(n = 30)、IP(n = 52)和 IP + ELA(n = 50)对情绪(愤怒、恐惧、快乐和悲伤)面孔与形状的神经反应,同时控制抑郁和焦虑症状。提取了激活的参数估计值,以用于检验组间差异,并作为 IP + ELA 中沉思性沉思的中介进行测试。
IP + ELA 在额上回和前扣带回(恐惧)、顶叶上回、楔前叶、后扣带回和下颞回(仅恐惧)以及楔叶(恐惧和愤怒)中表现出增加的激活。这些区域与 IP + ELA 中的沉思性沉思呈优先相关,其中许多区域介导了 IP + ELA 和沉思性沉思之间的联系。
结果提供了证据,即在 IP 患者中,ELA 病史增强了参与情绪处理的大脑区域的参与,而不仅仅是由当前症状解释的。尽管需要进行纵向设计,但适应性处理社会情感信息的神经相关性的改变可能是 ELA 对精神病理学构成风险的共同途径。