Lim Lena, Rubia Katya, Lukito Steve
Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore; and Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.
Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.
BJPsych Open. 2024 Oct 28;10(6):e185. doi: 10.1192/bjo.2024.767.
Childhood maltreatment and peer victimisation are common sources of early-life interpersonal stress. Childhood maltreatment is associated with atypical frontolimbic emotion processing and regulation, and increased vulnerability for self-harm/suicide. However, few studies have compared the neurofunctional correlates between caregiver- versus peer-inflicted mistreatment.
We compared the alterations of neurofunctional correlates of facial emotion processing in youths exposed to childhood maltreatment or peer victimisation, and explored their associations with self-harm.
Functional magnetic resonance imaging data were collected from 114 age- and gender-matched youths (39 childhood maltreatment, 37 peer victimisation and 38 controls) during an emotion discrimination task. Region-of-interest (amygdala, insula) and whole-brain analyses were conducted.
Groups differed significantly during disgust processing only. Both groups had lower activation in the right amygdala and bilateral posterior insula than controls; left insular underactivation was furthermore related to increased self-harm in maltreated youths. Compared with controls, at the whole-brain level, both groups also had underactivation in a cluster of bilateral limbic-thalamic-striatal, precuneus/posterior cingulate, temporal, fusiform/lingual and cerebellar regions, which was negatively associated with emotional problems in controls, as well as a cluster of somatosensory regions associated with increased self-harm in maltreated youths.
Early-life interpersonal stress from caregivers or peers is associated with common underactivation of limbic-thalamic-striatal, precuneus/posterior cingulate and somatosensory regions during disgust processing. The hypoactivation of key emotion and sensory processing and self-referential brain regions could be a potential suppressive mechanism to cope with the aversive emotion; however, it may also entail increased risk of affective psychopathology in seemingly healthy youths.
儿童期虐待和同伴欺凌是早期人际压力的常见来源。儿童期虐待与额颞叶非典型情绪处理和调节有关，且自我伤害/自杀的易感性增加。然而，很少有研究比较照顾者造成的虐待与同伴造成的虐待之间的神经功能相关性。
我们比较了遭受儿童期虐待或同伴欺凌的青少年面部情绪处理的神经功能相关性变化，并探讨了它们与自我伤害的关联。
在一项情绪辨别任务中，收集了114名年龄和性别匹配的青少年（39名遭受儿童期虐待、37名遭受同伴欺凌和38名对照）的功能磁共振成像数据。进行了感兴趣区域（杏仁核、脑岛）和全脑分析。
仅在厌恶处理过程中，各组之间存在显著差异。两组在右侧杏仁核和双侧后岛叶的激活均低于对照组；此外，受虐待青少年的左侧岛叶激活不足与自我伤害增加有关。与对照组相比，在全脑水平上，两组在双侧边缘 - 丘脑 - 纹状体、楔前叶/后扣带回、颞叶、梭状回/舌回和小脑区域的一组簇中也存在激活不足，这与对照组的情绪问题呈负相关，以及与受虐待青少年自我伤害增加相关的一组体感区域。
来自照顾者或同伴的早期人际压力与厌恶处理过程中边缘 - 丘脑 - 纹状体、楔前叶/后扣带回和体感区域的共同激活不足有关。关键情绪和感觉处理以及自我参照脑区的低激活可能是应对厌恶情绪的一种潜在抑制机制；然而，这也可能增加看似健康的青少年发生情感精神病理学的风险。
