Exposure to parental verbal abuse is associated with increased gray matter volume in superior temporal gyrus
Introduction
Brain development is largely guided by genetic factors, but the final form is sculpted by environmental factors and early experience. Exposure to traumatic events, such as childhood abuse and neglect, has been associated with alterations in the size or functional activity of a variety of brain regions (e.g., Andersen et al., 2008, Bremner et al., 1997, De Bellis et al., 1999, De Bellis et al., 2002b, De Bellis & Kuchibhatla, 2006, Richert et al., 2006, Teicher et al., 2004, Teicher et al., 1997, Tomoda et al., 2009a). We have recently conducted a voxel-based morphometry (VBM) study in young adults with histories of exposure to repeated episodes of childhood sexual abuse (CSA) and found that the most significant differences were bilateral reductions in gray matter volume (GMV) in the visual cortex (Tomoda et al., 2009a). Similarly, our laboratory conducted an analysis of fiber tract integrity in young adults exposed to parental verbal aggression (PVA) using diffusion tensor imaging (DTI) and tract based spatial statistics (TBSS), and observed a reduction in fractional anisotropy (FA) in three fiber tracts including the arcuate fasciculus that interconnects Wernicke's and frontal regions (Choi et al., 2009). These findings fit with an emerging hypothesis that exposure to early adversity may be associated with alterations in sensory systems that process and convey the adverse sensory experience (Teicher et al., 2006b).
PVA is a specific form of emotional abuse that some studies suggest may be associated with particularly severe psychiatric consequences (Johnson et al., 2001, Ney, 1987, Ney et al., 1994). However, unlike other forms of abuse, such as CSA, physical abuse (PA) and witnessing domestic violence (WDV), PVA is not considered a traumatic event by DSM-IV A1 and A2 criteria, and is often given little credence by mandated reporters (Manning & Cheers, 1995, Saulsbury & Campbell, 1985). We, however, have shown that exposure to PVA was associated in early adulthood with elevated symptoms of depression, anxiety, anger-hostility, dissociation, and ‘limbic irritability’ (Teicher et al., 2006a). Effect sizes for exposure to PVA were equivalent to those for WDV and non-familial CSA, and exceeded those for parental PA (Teicher et al., 2006a). Delineating the association between exposure to PVA and alterations in brain structure may help to increase awareness regarding the importance of this common but insidious form of childhood abuse.
Hence, the aim of this study was to investigate whether exposure to PVA exerts an enduring effect on GMV. VBM was used to provide an unbiased, even-handed, whole-brain, voxel-by-voxel assessment in a community sample of late adolescents/young adults exposed to PVA during childhood. Our sample was screened to exclude extraneous factors that might influence brain development. Further, we sought to assess whether alterations in regional GMV correlated with symptom ratings. We hypothesized that exposure to childhood PVA would be associated with alterations in the developmental trajectory of brain regions involved in processing verbally abusive stimuli, and would also affect brain regions regulating emotion, aggression, attention, and cognition.
Section snippets
Recruitment
The McLean Hospital Institutional Review Board approved all procedures. Participants for the study were recruited from the community through an advertisement entitled “Memories of Childhood.” Screenings were conducted on 1,455 volunteers using a detailed online assessment instrument with 2,342 entry fields that provided a vast array of information regarding developmental history and psychiatric symptoms. The questionnaire also included demographic information, such as subjects’ and parents’
Results
As seen in Table 1, the two groups were well-matched in age, parental education and degree of drug use. The most robust difference between groups, aside from their degree of exposure to PVA, was in their degree of perceived financial stress growing up (d’ = − 0.96). PVA subjects indicated that their family's financial resources were on average adequate, while controls indicated that they were more than adequate. There were slight differences between the groups in gender distribution, years of
Discussion
During the last few decades, researchers have made considerable progress in elucidating the neurobiological consequences of exposure to child abuse or maltreatment. Most studies have focused on individuals exposed to multiple forms of trauma (typically CSA and/or PA) who are highly symptomatic (Bremner et al., 1997, Carrion et al., 2007, De Bellis et al., 1999, De Bellis et al., 2002a, De Bellis et al., 2002b, Jackowski et al., 2008, Richert et al., 2006, Stein et al., 1997, Teicher et al., 2004
Financial disclosures and conflict of interest statement
The authors reported no biomedical financial interests or potential conflicts of interest.
Acknowledgments
This study was supported by RO1 awards from the U.S.A. National Institute of Mental Health (MH-53636, MH-66222) and National Institute of Drug Abuse (DA-016934, DA-017846) to M.H.T., and Grant-in-Aid for Scientific Research to A.T. from Japan–U.S. Brain Research Cooperation Program. We thank Ms. Cynthia E. McGreenery and Daniel Webster R.N., M.S., C.S., for recruitment and interviewing of subjects.
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Current address: Department of Psychology and Brain Science, The Johns Hopkins University, Baltimore, MD, USA.