Unresolved–Disorganized Attachment is Associated With Smaller Hippocampus and Increased Functional Connectivity Beyond Psychopathology

Abstract

Loss and abuse in children can lead to unresolved–disorganized (UD) attachment. How this condition relates to brain structure and functional connectivity (FC) is unknown. We therefore aimed to investigate gray matter volume (GMV) and resting state functional connectivity (RSFC) correlates of UD attachment in adolescents. Based on previous neuroimaging studies of trauma effects, we hypothesized that the structure of the amygdala and hippocampus and the FC of the latter would be linked to UD attachment. Anatomical and RSFC data were collected from a mixed group of adolescents (N = 74) with symptoms of posttraumatic stress disorder (PTSD) related to childhood sexual abuse (CSA), anxiety/depressive symptoms, and without psychiatric disorder as part of the Emotional Pathways’ Imaging Study in Clinical Adolescents (EPISCA). Bilateral volumes of the amygdala and hippocampus were measured using the FMRIB Software Library, and RSFC of the hippocampus was assessed using seed‐based correlation. UD attachment was measured using the Adult Attachment Interview. Hierarchical regression and correlation were used to assess the associations between UD status (continuous and categorical), brain structure, and FC, adjusting for a general psychopathology factor, puberty stage, gender, age, and IQ. UD attachment was associated with a smaller left hippocampal volume, R 2 = .23, and a higher level of FC between the hippocampus and the middle temporal gyrus and lateral occipital cortex. The associations among UD attachment, specific brain structure, and FC across psychopathological classifications shows promise for dimensional complements to the dominant classificatory approach in clinical research and practice.

Conceptual Analysis: A Social Neuroscience Approach to Interpersonal Interaction in the Context of Disruption and Disorganization of Attachment (NAMDA)

“…Moreover, in a small study of 18 infants from low-income families followed through adulthood, Lyons-Ruth et al ( 9 ) found that disorganized attachment classified using the SSP in infancy was associated with a larger amygdala volume in adulthood, while a recent study on adults ( N = 74) showed unresolved attachment to be associated with reduced hippocampal volume ( 12 ). Similar morphological changes have again surfaced in human and non-human primate studies showing increased amygdala volume following exposure to physical abuse ( 119 ), chronic maternal depression ( 120 ), as well as institutional rearing and international adoption ( 121 , 122 ).…”

Preserved cortical thickness, surface area and volume in adolescents with PTSD after childhood sexual abuse

“…The current study reports on cross-sectional baseline data from the adolescents with a history of sexual trauma and healthy non-traumatised controls. See also previous reports from neuroimaging research with the same population [19][20][21][22][23][24][25][26] . Inclusion criteria for the adolescents with a history of sexual trauma were: having experienced sexual abuse during their lifetime more than once by one or more perpetrators inside or outside the family, and being referred for treatment to the Psychotrauma Center of mental health institute GGZ Rivierduinen in Leiden or the child and adolescent psychotrauma center KJTC in Haarlem, both located in the Netherlands.…”

Attachment security and striatal functional connectivity in typically developing children

“…Hippocampal growth is closely linked to environmental factors, such as caregiving experiences, and abusive parenting in childhood or early life adversity causes significant reduction in hippocampal volumes ( Opendak et al, 2017 ; Teicher et al, 2012 ; van Hoof et al, 2019 ). A recent longitudinal study demonstrated that early support enhances hippocampal development and early childhood maternal support predicted a steeper hippocampal growth trajectory ( Luby et al, 2016 ).…”

“…The hippocampal function is also implicated in modulating individual predisposition to react to dismissing attachment-related narratives ( Krause et al, 2016 ), as well as in mentalizing one’s attachment figures ( Laurita et al, 2019 ). In adolescents, a higher level of functional connectivity between the hippocampi, the middle temporal gyri and the lateral occipital cortex was associated with unresolved-disorganized attachment ( van Hoof et al, 2019 ). These findings provide clear evidence that the individual differences in attachment types are captured by distinguishing features of the neural activation in socio-emotional processing with an engagement of temporo-limbic regions from childhood to adulthood.…”