Prof. dr. Bernet M. ElzingaSection Clinical Psychology

Leiden University

Neurobiological Consequences of Childhood Abuse and Neglect

Long term psychological effects of childhood abuse and neglect

Spinhoven et al., 2010; Norman et al., 2012; Nanni et al., 2012

3x increased risk to develop depression, with early onset, chronic and severe trajectory, suicidality & poor treatment

response

Childhood < 18 jaar Adulthood

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• How does childhood abuse gets under the skin, to affect risk for later psychopathology?

• How does childhood stress incubates in the body, manifesting in psychopathology several decades later?

Child Abuse → Psychopathology

epigenetics brain functioning

Impact of childhood abuse and neglect on brain development

• Early childhood: Fear and Safety learning, -Limbic system• Puberty: Emotion Regulation, -Prefrontal brain regions

Two key developmental stages of neural plasticity:

Van Harmelen et al., 2013, SCAN

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I. Fear Learning

Amygdala response ↑ to faces in adults withreported history of emotional abuse and neglect

Van Harmelen et al., 2013, SCAN

► Pattern consistently observed in (male and female) with depression, anxiety, and healthy controls► Not explained by psychopathology, gender, nor neuroticism or recent life events

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Abused children earlier recognition angry faces

Pollak & Kistler, 2002

Amydala activation to faces associated with avoidance of eye contact in neglected children

Tottenham et al., 2011

Van Harmelen et al., 2013, SCAN

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in response to social exclusion

II. Emotion Regulation

Impact of Social Exclusion in individuals with history of childhood emotional abuse and neglect

Gunther Moor et al, 2011

Van Harmelen et al., 2014, PLoS ONE

II. Emotion Regulation

Self-referential processing (e.g., rumination)

Summary / Implications

• Childhood abuse, particular emotional abuse and neglect are most salient risk factors for emotional distress on long-term.

• Effects are transmitted not only on conscious level (‘you are a bad child!’), but also on implicit level by means of changes in neural reactivity

• In 30%, childhood abuse is transmitted to next generation: family studies and longitudinal studies needed to disentangle nature & nurture

• Family interventions (e.g., during early childhood, but also adolescents with depression) crucial to break vicious cycle

Thank you for your Attention

University of Leiden Prof. dr. Ph. Spinhoven Drs. A. van Harmelen (PhD) Prof. dr. E. Crone Prof. dr. N. van der Wee

Free University

Prof. Dr. B.W.J.H. Penninx

Prof. dr. D. Veltman

University of Groningen Prof. dr. A. Aleman