Cardiovascular reactivity as a mechanism linking child trauma to adolescent psychopathology

Abstract

Alterations in physiological reactivity to stress are argued to be central mechanisms linking adverse childhood environmental experiences to internalizing and externalizing psychopathology. Childhood trauma exposure may influence physiological reactivity to stress in distinct ways from other forms of childhood adversity. This study applied a novel theoretical model to investigate the impact of childhood trauma on cardiovascular stress reactivity – the biopsychosocial model of challenge and threat. This model suggests that inefficient cardiovascular responses to stress – a threat as opposed to challenge profile – are characterized by blunted cardiac output (CO) reactivity and increased vascular resistance. We examined whether childhood trauma exposure predicted an indicator of the threat profile of cardiovascular reactivity and whether such a pattern was associated with adolescent psychopathology in a population-representative sample of 488 adolescents (M = 16.17 years old, 49.2% boys) in the TRacking Adolescents’ Individual Lives Survey (TRAILS). Exposure to trauma was associated with both internalizing and externalizing symptoms and a pattern of cardiovascular reactivity consistent with the threat profile, including blunted CO reactivity during a social stress task. Blunted CO reactivity, in turn, was positively associated with externalizing, but not internalizing symptoms and mediated the link between trauma and externalizing psychopathology. None of these associations varied by gender. The biopsychosocial model of challenge and threat provides a novel theoretical framework for understanding disruptions in physiological reactivity to stress following childhood trauma exposure, revealing a potential pathway linking such exposure with externalizing problems in adolescents.

Cardiac reactions to emotional words in adolescents and young adults with PTSD after child abuse

“…Additional studies showed that this pattern of physiological reactivity in PTSD patients was associated with dissociative symptoms (Lanius et al, ; Sack, Cillien, & Hopper, ), multiple incident traumatization (Cuthbert et al, ; McTeague et al, ), and early developmental occurrence of traumatization (D'Andrea et al, ; Quevedo et al, ). Additionally, blunted reactivity has also been found in victims of child maltreatment (Heleniak, McLaughlin, Ormel, & Riese, ; MacMillan et al, ). Accordingly, cardiac reactions to physically threatening contrasted with neutral words were associated with physical types of childhood traumatization.…”

“…(Cuthbert et al, 2003;McTeague et al, 2010), and early developmental occurrence of traumatization (D'Andrea et al, 2013;Quevedo et al, 2010). Additionally, blunted reactivity has also been found in victims of child maltreatment (Heleniak, McLaughlin, Ormel, & Riese, 2016;MacMillan et al, 2009). Accordingly, cardiac reactions to physically threatening contrasted with neutral words were associated with physical types of childhood traumatization.…”

Child trauma exposure and psychopathology: mechanisms of risk and resilience

“…Here we focus on recent work examining physiological patterns based on a well-validated model of threat responding, where threat appraisals produce a pattern of autonomic nervous system (ANS) response characterized by increased sympathetic nervous system activation but constricted cardiac output (i.e., blood flow from the heart) due to peripheral vasoconstriction [24]. Two studies have documented this threat pattern of ANS reactivity to stress among adolescents with trauma histories [25,26]. …”

“…Magnified emotional reactivity to negative stimuli is associated with concurrent psychopathology [25,26] and mediates the association of child trauma with both internalizing and externalizing problems [18,27,28]. Heightened amygdala response to negative stimuli assessed prior to trauma exposure predicts the onset of PTSD symptoms following a traumatic stressor [29] and increases in internalizing symptoms following stressful life events [30].…”

Blunted cardiovascular responses to acute psychological stress predict low behavioral but not self‐reported perseverance

“…Although limited, there is preliminary evidence in support of this. Specifically, diminished reactivity is associated with high impulsivity/impaired response inhibition (Allen, Hogan, & Laird, ; Bennett, Blissett, Carroll, & Ginty, ; Bibbey, Ginty, Brindle, Phillips, & Carroll, ; Muñoz & Anastassiou‐Hadjicharalambous, ) and externalizing psychopathology (i.e., behavioral problems directed toward the external environment; Heleniak, McLaughlin, Ormel, & Riese, ). Finally, blunted reactivity also predicts poor performance during tasks that are motivation and effort contingent, such as lung function spirometry (Carroll et al, ; Carroll, Bibbey et al, ; Crim et al, ).…”