Early life trauma and social processing in HIV: the role of neuroendocrine factors and inflammation

Abstract

Objective: Early life trauma (ELT) and HIV are associated with social processing deficits. In people with HIV (PWH), we examined whether facial emotion identification accuracy differs by ELT and whether neuroendocrine factors including cortisol, oxytocin (OT), and arginine vasopressin, and/or immune system measures play a role in the ELT-performance association. Methods: We used secondary data from the placebo condition of a pharmacologic challenge study in PWH. Presence of ELT was measured with the Childhood Trauma Questionnaire (at least moderate experiences of sexual, physical, and/or emotional abuse). Social processing was measured with the Facial Emotion Perception Test (FEPT). Salivary immune system measures and cortisol were sampled across a 5-hour study session. Blood was collected at study session start (12 PM) to measure OT and arginine vasopressin. We examined the association of ELT with FEPT and five biological moderators (from principal components analysis of 12 biomarkers) of ELT-FEPT associations. Results: Of 58 PWH (42 men; mean [standard deviation] age = 33.7 [8.9] years), 50% endorsed ELT. ELT-exposed PWH demonstrated lower identification accuracy across all emotional expressions (unstandardized β [B] = 0.13; standard error [SE] = 0.05; p = .021, d = 0.63) and had higher OT levels compared with ELT-unexposed PWH (t (1,56) = 2.12, p = .039; d = 0.57). For total accuracy, an OT/C-reactive protein factor moderated the ELT-FEPT association (B = 0.14; SE = 0.05; p = .014); accuracy was lower in ELT-exposed PWH versus ELT-unexposed PWH when the factor was low but not when high. Similar results were obtained for fearful, neutral, and happy faces ( p values < .05). Regardless of ELT, a myeloid migration (MCP-1/MMP-9) factor was associated with reduced accuracy ( p values < .05). Conclusions: Our pilot findings suggest that ELT may alter social processing in PWH, and OT and C-reactive protein may be a target for improving social processing in ELT-exposed PWH, and myeloid migration markers may be a target in PWH more generally.

Through the Looking-Glass: Psychoneuroimmunology and the Microbiome-Gut-Brain Axis in the Modern Antiretroviral Therapy Era

“…Many PWH experience early life stress that serves as a risk factor for developmental trajectories that increase vulnerability to HIV and could create fundamentally different set points in neuroendocrine signaling ( 127 ). Developmental vulnerabilities ( 128 ) as well as intersectional stigma and discrimination related to HIV and other minoritized identities (e.g., racial/ethnic minority, sexual minority, or gender minority) may have important health consequences ( 129 , 130 ).…”

The Interaction of HIV With Mental Health in the Modern Antiretroviral Therapy Era

“…Greater activity in the anterior insula (potentially reflecting higher interoceptive awareness) during a heartbeat detection task was found to be associated with more severe depressive symptoms regardless of HIV status. The neuroendocrine and immune sequelae of childhood abuse were examined in relation to social processing by Rubin et al ( 19 ). This cross-sectional study documented that PWH who experienced early life stress had higher levels of oxytocin and inflammation that paralleled greater difficulties with facial emotion recognition, one important aspect of social processing.…”

“…Shortell and colleagues ( 20 ) also report an association of higher oxytocin with greater depressive symptoms in a sample of predominantly Black/African American PWH. In another study in this issue, Rubin and colleagues ( 21 ) examined whether alterations in glucocorticoid receptor gene expression were associated with cognitive function in PWH. Upregulation of a gene relevant to glucocorticoid receptor expression ( FKBP5 ) was associated with poorer attention and working memory in older women with HIV.…”