, et al
Childhood maltreatment and psychopathology affect brain development during adolescence
J Am Acad Child Adolesc Psychiatry
; doi:

To examine the effect of childhood maltreatment on brain development and evaluate whether psychopathology altered that effect, investigators from Australia used magnetic resonance imaging (MRI) to study development of the hippocampus and amygdala in adolescents. For the project, a cohort of adolescents were recruited from the Adolescent Development Study (a study of adolescent response to emotional and behavior problems in Melbourne, Australia). Participants were excluded if they had any preexisting psychopathology, substance use, eating disorder, learning disability, or chronic illness, or had used medications known to affect brain functioning. Participants completed the Childhood Trauma Questionnaire (CTQ) at baseline and follow-up. Higher CTQ scores were indicative of increased maltreatment. DSM-IV Axis 1 psychopathology was dichotomized as present or absent based on participants’ responses to the Schedule for Affective Disorders and Schizophrenia for School-Age Children – Present and Lifetime interview. The primary study outcomes were changes in growth of each hemisphere of the hippocampus and amygdala in each hemisphere from baseline to follow-up. After controlling for multiple confounding variables, the effect of maltreatment (as defined by CTQ scores) on development of these brain structures was assessed. In additional analyses the effects of psychopathology on changes in growth were assessed, after adjusting for CTQ scores.

Data were analyzed on a total of 117 adolescents with a mean baseline age of 12.62 years and mean follow-up of 3.78 years. Higher CTQ scores were significantly associated with a decrease in the expected development of the left amygdala (P = .014). There was no significant association between CTQ scores and change in the development of the right amygdala or the hippocampus. Axis I psychopathology, independent of CTQ scores, was associated with a significant decrease in left hippocampal development and an increase in left amygdala development (P = .017 and P = .006, respectively).

The authors conclude that childhood maltreatment was associated with slower development of the left amygdala and that Axis I psychopathology was associated with slower development of the left hippocampus, but surprisingly, more rapid growth of the left amygdala. They hypothesize that these effects may be related to the neurotoxic effects of stress (hypothalamic-pituitary-adrenal [HPA] axis dysfunction) leading to neural cell toxicity and deceleration of growth of the amygdala and hippocampus.

Dr Schreiber has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.

It is known that childhood stressors significantly correlate with risky adult behaviors. What hasn’t been understood is how the 2 are physiologically linked. Brain MRIs of adults who had high CTQ scores due to trauma as adolescents reveal decreased hippocampus volume and increased amygdala size, and suggest that structural changes in the hippocampus and amygdala in the adolescent may occur...

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