The impact of childhood abuse: what can we learn from neuroscience?

Professor Eamon McCrory shares the theory of latent vulnerability – and how a new clinical tool could help children’s mental health 

Children playing hula hoopIt’s widely acknowledged that child abuse and neglect can have a negative impact on mental health – even many years after the event.

How can we understand this better? Why do some children seem so resilient despite having experienced such adversity? How can we better help and support children before mental health problems emerge?

We’ve been using neurobiological research techniques such as functional magnetic imaging (fMRI) to shed some new light on these very old questions. This is helping us to understand how changes can occur in the brain activity of a child who has experienced abuse, even if they are not showing outward signs of a mental health disorder.


fMRI findings 

In recent years, researchers have focused on how experiences of abuse and neglect affect brain function. Functional magnetic imaging (fMRI) scanners help with this as they can be used to produce images of the brain, and indirectly measure neural activity.

The findings from our fMRI work are a far cry from the early research on maltreatment and neural structure, which often interpreted the experience of trauma as reflecting “damage” to the brain.

Children recruited for our fMRI studies had typically experienced maltreatment at home, but were not showing a mental health problem. In fact, most were doing pretty well.

Our researchers have started to look at how this group of children’s brains function. For example, we wanted to investigate how they respond to cues signaling threat. We chose to look at this response because we know that it is present in disorders commonly associated with maltreatment, such as anxiety, depression and conduct problems.

Findings to date have been relatively consistent.

They show that experience of maltreatment is associated with an increased neural response to threat, for example in the amygdala, which plays a primary role in processing significant aspects of our environment.

There are two important implications from such findings:

    • first, these neurobiological changes can be observed even in the absence of a mental health disorder.
    • second, these changes are strikingly consistent with the neural signature of people with common mental health problems.

Latent vulnerability 

On the basis of these findings, we’ve developed the theory of “latent vulnerability”.

This theory argues that children adapt to early neglectful, unpredictable or violent home or community settings in ways that help them cope and survive.

Because of this, their neurobiological systems change. Such alterations are thought (in many cases) to provide some advantage in the short term. For example, becoming highly vigilant to threat may help a child survive in a violent household. Indeed, very similar brain changes are seen in soldiers exposed to combat.

However, such adaptations may come at a high price: they may increase the long-term risk of mental health problems.

If children adapt to “fit” atypical and disturbed environments this may not be helpful to the way they cope with stable family environments, or at school. For example, being vigilant to threat may increase the risk of conflict with peers over time, making it more difficult for a child to develop strong social support networks. This in turn may make them more vulnerable to future stressors.

A preventative clinical approach

Overall, these findings are starting to provide a compelling case for a more preventative clinical approach.

The changes in neurocognitive functioning that have been shown in the fMRI studies have motivated us to want to develop an everyday clinical tool to identify those children who are at most risk of future mental health problems.

A clinical screening tool

The main aim of our new project, funded by the NSPCC and the Economic and Social Research Council (ESRC), is to lay the preliminary groundwork for developing an everyday clinical screening tool. This could help identify those children at most risk of future mental health problems. This is a long-term ambition and developing such a tool will take time.

The project will also allow us to investigate how the brains of children who have experienced maltreatment process reward cues (not just threat cues).

If we can identify those at most risk, as well as gain a better understanding of what contributes to their vulnerability, we’ll be in a good position to develop focused preventative interventions that can help to recalibrate the neurocognitive functioning of children who have experienced maltreatment. We believe that these are likely to involve promoting more effective support for children affected by abuse or neglect.

Achieving this longer-term goal could help us to reduce the likelihood that a mental health problem will emerge following childhood maltreatment.

For those interested in finding out more on this topic, I’ve recently published an overview of the current research.

Research to help children

Professor Eamon McCrory is leading one of 4 new research projects we are funding in partnership with the Economic and Social Research Council (ESRC) to find out what works to help children get back on track after abuse. Find out more about the £1.7 million to fund new research into what works for children after abuse.

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References

  1. McCrory, E. M.I. and Viding, E. (2017) Annual research review: childhood maltreatment, latent vulnerability and the shift to preventative psychiatry – the contribution of functional brain imaging. Journal of Child Psychology and Psychiatry, 58(4): 338–357.