Archival ReportNeurobiological Markers of Resilience to Depression Following Childhood Maltreatment: The Role of Neural Circuits Supporting the Cognitive Control of Emotion
Section snippets
Defining Resilience
Developmental and clinical psychologists have long been interested in resilience, and various definitions have been proposed. Some have conceived of resilience as a fixed trait or set of traits that are immutable 17, 18, 19 and may be present within an individual whether or not they have experienced adversity (20). Instead, we utilize the definition that resilience reflects an absence of negative outcomes despite exposure to adversity 15, 16, 21. To study this form of resilience from an
Cognitive Reappraisal
Cognitive reappraisal involves thinking about a stimulus in a way that changes the meaning to modify one’s emotional response (e.g., to reduce negative or enhance positive emotion) 31, 32, 33, 34, 35, 36. Cognitive reappraisal has been shown to modulate emotional responses in experimental settings 31, 32, 37, 38, 39, 40, real-world settings 38, 41, and clinical intervention studies, where training to enhance reappraisal is associated with reductions in symptoms of depression and anxiety in
Cognitive Reappraisal Neural Circuitry in Depression and Anxiety
Behaviorally, children and adults with depression and anxiety report similar reductions in negative emotion following reappraisal as those without psychopathology 31, 48, 73, 74, 75, 76, 77. However, those with depression and anxiety appear to use less-efficient reappraisal strategies 73, 74. Disruptions in neural activation of frontoparietal and limbic regions involved in cognitive reappraisal have also been associated with depression and anxiety. However, findings vary across age and
Cognitive Control Circuitry as a Mechanism of Resilience Following Childhood Adversity
The ability to effectively recruit frontoparietal circuitry in support of effortful emotion regulation strategies, such as cognitive reappraisal, could be a critical compensatory mechanism that may help to buffer against the heightened emotional and neurobiological reactivity commonly observed following childhood adversity. Prior work consistently demonstrates that children exposed to adversity, particularly experiences of threat, exhibit elevated emotional responses to negative stimuli
Evaluating a Neurobiological Mechanism of Resilience
Using preliminary data from our group, we completed a set of exploratory analyses to provide an empirical test of our proposed mechanism of resilience. Specifically, we assessed whether the ability to modulate amygdala reactivity using cognitive reappraisal is a potential neurobiological mechanism of resilience to depression and anxiety among children exposed to maltreatment, a form of adversity that has particularly strong associations with internalizing psychopathology. If the proposed
Methods and Materials
We examined these hypotheses in a longitudinal sample of 151 participants 8 to 17 years of age with (n = 79) and without (n = 72) history of childhood maltreatment (e.g., physical or sexual abuse) who completed an emotion regulation task while undergoing functional magnetic resonance imaging. This task assessed neural activation during passive viewing and effortful attempts to regulate emotional responses to negative stimuli using cognitive reappraisal (Figure 1). Participants also reported on
Preliminary Evidence
Across the entire sample, the use of cognitive reappraisal elicited the expected pattern of activation of frontoparietal regions and decreased activation of the amygdala (Supplemental Figure S1). Our primary hypothesis was that maltreated children who exhibited greater modulation of the amygdala during reappraisal (i.e., lower amygdala activity during reappraisal relative to passive viewing of negative stimuli) would be at lower risk for developing depression. To evaluate this hypothesis, we
Discussion
The ability to modulate negative emotion using cognitive control strategies may represent a resiliency marker, which protects against depression in children who have experienced adversity. The current report finds evidence of such a relationship. Specifically, greater capacity to modulate amygdala activation using cognitive reappraisal predicts decreasing levels of depressive symptoms across a 2-year follow-up period. Similarly, greater recruitment of prefrontal regions also predicts lower
Acknowledgments and Disclosures
This work was supported by National Institute of Mental Health (NIMH) Grant Nos. R01-MH103291 and R01-MH106482 (to KAM); NIMH Intramural Research Program Grant No. ZIAMH002782 (to DSP); and NIMH Grant No. K23MH112872 and Brain and Behavior Research Foundation National Alliance for Research on Schizophrenia and Depression Young Investigator Grant (to JLJ).
KAM, DSP, and AMR designed the research; AMR analyzed the data and drafted the manuscript; KAM, DSP, JLJ, and DGW provided critical comments
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