Adverse Life Experiences and Brain Function

Abstract

ImportanceAdverse life experiences have been proposed to contribute to diverse mental health problems through an association with corticolimbic functioning. Despite compelling evidence from animal models, findings from studies in humans have been mixed; activation likelihood estimation (ALE) meta-analyses have failed to identify a consistent association of adverse events with brain function.ObjectiveTo investigate the association of adversity exposure with altered brain reactivity using multilevel kernel density analyses (MKDA), a meta-analytic approach considered more robust than ALE to small sample sizes and methodological differences between studies.Data SourcesSearches were conducted using PsycInfo, Medline, EMBASE, and Web of Science from inception through May 4, 2022. The following search term combinations were used for each database: trauma, posttraumatic stress disorder (PTSD), abuse, maltreatment, poverty, adversity, or stress; and functional magnetic resonance imaging (fMRI) or neuroimaging; and emotion, emotion regulation, memory, memory processing, inhibitory control, executive functioning, reward, or reward processing.Study SelectionTask-based fMRI studies within 4 domains (emotion processing, memory processing, inhibitory control, and reward processing) that included a measure of adverse life experiences and whole-brain coordinate results reported in Talairach or Montreal Neurological Institute space were included. Conference abstracts, books, reviews, meta-analyses, opinions, animal studies, articles not in English, and studies with fewer than 5 participants were excluded.Data Extraction and SynthesisUsing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline, 2 independent reviewers assessed abstracts and full-text articles for entry criteria. A third reviewer resolved conflicts and errors in data extraction. Data were pooled using a random-effects model and data analysis occurred from August to November 2022.Main Outcomes and MeasuresPeak activation x-axis (left-right), y-axis (posterior-anterior), and z-axis (inferior-superior) coordinates were extracted from all studies and submitted to MKDA meta-analyses.ResultsA total of 83 fMRI studies were included in the meta-analysis, yielding a combined sample of 5242 participants and 801 coordinates. Adversity exposure was associated with higher amygdala reactivity (familywise error rate corrected at P < .001; x-axis = 22; y-axis = −4; z-axis = −17) and lower prefrontal cortical reactivity (familywise error rate corrected at P < .001; x-axis = 10; y-axis = 60; z-axis = 10) across a range of task domains. These altered responses were only observed in studies that used adult participants and were clearest among those who had been exposed to severe threat and trauma.Conclusions and RelevanceIn this meta-analysis of fMRI studies of adversity exposure and brain function, prior adversity exposure was associated with altered adult brain reactivity to diverse challenges. These results might better identify how adversity diminishes the ability to cope with later stressors and produces enduring susceptibility to mental health problems.

The AIP model as a theoretical framework for the treatment of personality disorders with EMDR therapy

“…These areas are crucial for memory formation, emotional regulation, decision-making, and social behavior. Results of a recent meta-analysis clearly show that a history of adverse childhood events is associated with long-lasting increases in amygdala responses in adults and reduced prefrontal cortex responses ( 19 ). Changes in these structures are likely to contribute to difficulties in processing and regulating emotions seen in some personality disorders.…”

Life-course neighbourhood deprivation and brain structure in older adults: the Lothian Birth Cohort 1936

“…It is critical to understand risk factors of structural brain differences, potential mechanisms, and biomarkers to inform rational bases for early interventions and to identify those at greatest risk of cognitive decline and dementia. Brain structure and functioning in later life has been linked to more proximal social determinants of health across the life course, including adversities [5,6] and individual socioeconomic position [7][8][9]; however, the long-term impact of distal factors in the life course, such as neighbourhood deprivation, are less understood. Neighbourhood disadvantage is an important modifiable predictor of old age health [10] and cognition [11] with effects distinct from individual socioeconomic factors.…”

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“…Another large-scale meta-analysis looked at brain function in response to repeated stressors over the lifetime. They found those exposed to repeated or ongoing stress showed heightened emotional reactivity and reduced ability to cope with new stressors (Hosseini-Kamkar et al, 2023). This dynamic of increased physical and emotional reactivity, combined with reduced ability to manage new situations, applies to all stress related factors identified in the triggering factors here and the reinforcing factors in the next section.…”