Curium-LUMC, Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Leiden, the Netherlands.
Leiden Institute for Brain and Cognition (LIBC), Leiden, the Netherlands.
J Trauma Stress. 2019 Oct;32(5):742-752. doi: 10.1002/jts.22432. Epub 2019 Jul 30.
Loss and abuse in children can lead to unresolved-disorganized (UD) attachment. How this condition relates to brain structure and functional connectivity (FC) is unknown. We therefore aimed to investigate gray matter volume (GMV) and resting state functional connectivity (RSFC) correlates of UD attachment in adolescents. Based on previous neuroimaging studies of trauma effects, we hypothesized that the structure of the amygdala and hippocampus and the FC of the latter would be linked to UD attachment. Anatomical and RSFC data were collected from a mixed group of adolescents (N = 74) with symptoms of posttraumatic stress disorder (PTSD) related to childhood sexual abuse (CSA), anxiety/depressive symptoms, and without psychiatric disorder as part of the Emotional Pathways' Imaging Study in Clinical Adolescents (EPISCA). Bilateral volumes of the amygdala and hippocampus were measured using the FMRIB Software Library, and RSFC of the hippocampus was assessed using seed-based correlation. UD attachment was measured using the Adult Attachment Interview. Hierarchical regression and correlation were used to assess the associations between UD status (continuous and categorical), brain structure, and FC, adjusting for a general psychopathology factor, puberty stage, gender, age, and IQ. UD attachment was associated with a smaller left hippocampal volume, R = .23, and a higher level of FC between the hippocampus and the middle temporal gyrus and lateral occipital cortex. The associations among UD attachment, specific brain structure, and FC across psychopathological classifications shows promise for dimensional complements to the dominant classificatory approach in clinical research and practice.
儿童的丧失和虐待会导致未解决的混乱（UD）依恋。这种情况与大脑结构和功能连接（FC）的关系尚不清楚。因此，我们旨在研究青少年 UD 依恋与灰质体积（GMV）和静息状态功能连接（RSFC）的关系。基于创伤效应的先前神经影像学研究，我们假设杏仁核和海马体的结构以及后者的 FC 与 UD 依恋有关。在情感途径的临床青少年影像学研究（EPISCA）中，我们从一组患有与儿童期性虐待（CSA）相关的创伤后应激障碍（PTSD）、焦虑/抑郁症状的混合青少年（N = 74）中收集了解剖学和 RSFC 数据，并且没有精神障碍。使用 FMRIB 软件库测量双侧杏仁核和海马体的体积，使用基于种子的相关性评估海马体的 RSFC。使用成人依恋访谈测量 UD 依恋。使用分层回归和相关性来评估 UD 状态（连续和分类）、大脑结构和 FC 之间的关联，同时调整一般心理病理学因素、青春期阶段、性别、年龄和智商。UD 依恋与左侧海马体体积较小有关，R =.23，以及海马体与颞中回和外侧枕叶皮质之间的 FC 水平较高。UD 依恋、特定大脑结构和跨精神病理学分类的 FC 之间的关联为临床研究和实践中占主导地位的分类方法提供了维度补充的希望。
