Department of Psychology, Harvard University, Cambridge, Massachusetts.
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington.
Biol Psychiatry. 2019 Sep 15;86(6):464-473. doi: 10.1016/j.biopsych.2019.04.033. Epub 2019 May 10.
Childhood adversity is strongly linked to negative mental health outcomes, including depression and anxiety. Leveraging cognitive neuroscience to identify mechanisms that contribute to resilience in children with a history of maltreatment may provide viable intervention targets for the treatment or prevention of psychopathology. We present a conceptual model of a potential neurobiological mechanism of resilience to depression and anxiety following childhood adversity. Specifically, we argue that neural circuits underlying the cognitive control of emotion may promote resilience, wherein a child's ability to recruit the frontoparietal control network to modulate amygdala reactivity to negative emotional cues-such as during cognitive reappraisal-buffers risk for internalizing symptoms following exposure to adversity.
We provide preliminary support for this model of resilience in a longitudinal sample of 151 participants 8 to 17 years of age with (n = 79) and without (n = 72) a history of childhood maltreatment who completed a cognitive reappraisal task while undergoing functional magnetic resonance imaging.
Among maltreated youths, those who were better able to recruit prefrontal control regions and modulate amygdala reactivity during reappraisal exhibited lower risk for depression over time. By contrast, no association was observed between neural functioning during reappraisal and depression among youths without a history of maltreatment.
These preliminary findings support the hypothesis that children who are better able to regulate emotion through recruitment of the frontoparietal network exhibit greater resilience to depression following childhood maltreatment. Interventions targeting cognitive reappraisal and other cognitive emotion regulation strategies may have potential for reducing vulnerability to depression among children exposed to adversity.
童年逆境与负面心理健康结果密切相关,包括抑郁和焦虑。利用认知神经科学来确定有助于有虐待史的儿童恢复力的机制,可能为治疗或预防精神病理学提供可行的干预目标。我们提出了一个关于童年逆境后抑郁和焦虑恢复力的潜在神经生物学机制的概念模型。具体来说,我们认为,情绪认知控制的神经回路可能会促进恢复力,即在孩子能够招募额顶控制网络来调节杏仁核对负面情绪线索的反应的情况下——例如在认知重评期间——可以缓冲在逆境暴露后出现内化症状的风险。
我们在一个 151 名 8 至 17 岁参与者的纵向样本中为该恢复力模型提供了初步支持,其中有(n=79)和没有(n=72)童年虐待史,他们在进行功能磁共振成像的同时完成了认知重评任务。
在受虐待的青少年中,那些在重评期间更能够招募前额叶控制区域并调节杏仁核反应的人,随着时间的推移,抑郁风险较低。相比之下,在没有虐待史的青少年中,重评期间的神经功能与抑郁之间没有关联。
这些初步发现支持了这样的假设,即那些通过招募额顶网络来调节情绪的孩子在童年虐待后表现出更大的抗抑郁能力。针对认知重评和其他认知情绪调节策略的干预措施可能具有降低儿童暴露于逆境后易患抑郁症的潜力。