Lecture 3: impact of early abuse and neglect on the brain

Question 1

How does the brain respond to threat?

Answer 1

1. First phase: autonomic nervous system (NA) releases adrenaline.
2. Second phase: the HPA axis is activated and cortisol is released (after 20 minutes).
3. Third phase: the acute phase is over and we go back to the less alert phase.

This can lead to 2 things:
- The receptors of stress become more sensitive and respond more quickly to stress.
- Too much cortisol changes the brain structures due to a lot of early life stress.

Question 2

Low and high road of stress

Answer 2

• Low road: super fast processing without conscious thought (jumping when you see a snake).
• High road: slower indirect path and more extensive processing (realising the snake was fake).

Maltreated people often have unconsious (low road) reaction to stress, which makes it very hard to change this response.

Question 3

The brain as an anticipation machine

Answer 3

The brain is constantly ‘making future’: the ability to use past experiences and information about our current state and environement to predict future actions. This braces us for future adversities. People who were maltreated often constantly brace themselves for the future (hyper-alter state).

Question 4

Study about childhood maltreatment and neurocognitive systems (McGrory et al., 2017)

Answer 4

Childhood maltreatment is associated with altered functioning in a range of neurocognitive systems:
- Threat processing
- Reward processing
- Emotion regulation
- Executive control
Such brain changes can predict symptomatology. These brain changes are strikingly consistent with brain changes in people with a psychiatric disorder, which suggests that childhood maltreatment causes a latent vulnerability for psychiatric disorders.

Question 5

Latent vulnerability

Answer 5

Vulnerability from latent experiences (like childhood maltreatment) to develop certain disorders.
Latent vulnerability refers to the way in which neurocognitive and biological systems adapt to early adverse environments (in this case: with brain changes). This may be functional in the short-term, but increase risk for psychiatric outcomes in the long-term.

Question 6

Maltreatment (and depression) often causes changes in these brain systems:

Answer 6

• Reward system
• Threat system
• Social/ self system

These changes can also be seen in people with depression.

Question 7

Study about maltreatment and the threat system (van Harmelen et al., 2013)

Answer 7

People with a history of maltreatment had a heightened amygdala sensitivity/activity while processing ALL emotional faces in adults. This sensitivity to ALL faces (and not only the angry ones) may be caused by an overall hypervigilance to facial expressions.

(This may be adaptive in the short term)

Question 8

Abuse and angry face identification

Answer 8

They showed people pictures (from vague to clear) of angry faces. People with a history of ABUSE were faster in indicating when they saw an angry face. They recognised the angry face earlier in the middle (medium-vague faces) but not at the beginning (extremely-vague faces) or end (clear faces).

Question 9

Cognitive vulnerability

Answer 9

People that were maltreated can develop cognitive vulnerability, which influences their self-image and social relations, and can result in:
- Negative self-inferences
- Dysfunctional attitudes
- Low self-worth
These cognitive vulnerabilities predispose people for disorder like depression and anxiety.

Question 10

Leiden Family Study (about inter-generational transmission of maltreatment)

Answer 10

• There was a strong association between someone’s own history of neglect and their neural (PFC) responses to social exclusion.
• There was no association between neural responses and maltreating behaviour as a parent.

OPNIEUW KIJKEN!

Question 11

maltreatment and mPFC

Answer 11

People with a history of maltreatment often show a decrease in volume of the mPFC. Dysfunctions in the mPFC are related to stress-related disorder (depression, PTSD), and can cause:
- Problems with reducing the fear response (less amygdala control).
- Problems with modulating neuroendocrine and autonomic stress responses (stress-hormone level).

Question 12

Reward processing and depression

Answer 12

The striatum is crucial for the processing of reward. Maltreatment diminished the sensitivity to rewards.

Question 13

How maltreatment can chronically increase stress-sensitiviy

Answer 13

• On a cognitive/ emotional level: negative schema’s about the self due to maltreatment can lead to negative self-image and strong cognitive sensitivity to new stressful situations.
  OPNIEUW KIJKEN!
• On a neurobiological level: by altering brain function in networks that are important for emotional reactivity, emotional memory and emotion regulation. And by chronically altering the sensitivy to stress in the HPA axis.

Question 14

Trier social stress test (TSST)

Answer 14

Provoking social stress (like a job interview) and measuring cortisol, heart rate and blood pressure. The stress levels during this test were much higher in people who experienced early life stress AND developed psychopathology.
–> The combination of these 2 factors is an indicator for a much higher stress response.