Ventral striatum dysfunction in children and adolescents with reactive attachment disorder: functional MRI study

Abstract

BackgroundChild maltreatment is a major risk factor for psychopathology, including reactive attachment disorder (RAD).AimsTo examine whether neural activity during reward processing was altered in children and adolescents with RAD.MethodSixteen children and adolescents with RAD and 20 typically developing (TD) individuals performed tasks with high and low monetary rewards while undergoing functional magnetic resonance imaging.ResultsSignificantly reduced activity in the caudate and nucleus accumbens was observed during the high monetary reward condition in the RAD group compared with the TD group (P=0.015, family-wise error-corrected cluster level). Significant negative correlations between bilateral striatal activity and avoidant attachment were observed in the RAD and TD groups.ConclusionsStriatal neural reward activity in the RAD group was markedly decreased. The present results suggest that dopaminergic dysfunction occurs in the striatum of children and adolescents with RAD, leading towards potential future risks for psychopathology.Declaration of interestNone.Copyright and usage© The Royal College of Psychiatrists 2015. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.

Annual Research Review: Enduring neurobiological effects of childhood abuse and neglect

“…Another consistent functional imaging finding reported in six studies is diminished BOLD response in the striatal regions of maltreated individuals to anticipated reward in the monetary incentive delay task. This finding has been observed in both children and adults and includes orphans experiencing early deprivation (Mehta et al., ); children with reactive attachment disorder (Takiguchi et al., ); maltreated children at high risk for depression (Hanson et al., ); a birth cohort studied as adults who experienced early family adversity (Boecker et al., ); and adults reporting exposure to physical, sexual or emotional abuse (Dillon et al., ).…”

Practice Parameter for the Assessment and Treatment of Children and Adolescents With Reactive Attachment Disorder and Disinhibited Social Engagement Disorder

“…78 In the other, a larger group of children with RAD were compared to nonaffected controls. 87,88 In both studies, significantly reduced activity in the striatum (caudate and nucleus accumbens) was observed during the high monetary reward condition in the children with RAD compared with other groups of children. The problem is that diminished reward sensitivity has been shown to be reduced in children who have experienced adversity, 89,90 so whether the findings are specific to RAD is unclear.…”

Is There an Ace Up Our Sleeve? A Review of Interventions and Strategies for Addressing Behavioral and Neurobiological Effects of Adverse Childhood Experiences in Youth

“…Maltreated youth show further evidence of impaired cognitive control with longer response times and elevated responses in the dorsal ACC, inferior PFC, and striatum when switching from prepotent to alternative responses (Mueller, Maheu, Dozier, Peloso, Mandell, & Leibenluft, 2010). Children with attachment disorder, orphaned children experiencing early deprivation, and maltreated children at high risk for depression show diminished responses in striatal regions during anticipation of rewards during the monetary incentive delay task (Hanson, Hariri, & Williamson, 2015;Mehta, Gore-Langton, Golembo, Colvert, Williams, & Sonuga-Barke, 2010;Takiguchi, Fujisawa, Mizushima, Saito, Okamoto, & Shimada, 2015). Further, even in a stage of health, youth offspring of parents with bipolar disorder have reduced pregenual ACC activation and connectivity during the anticipation of loss and reward compared with healthy youth without any psychopathology, providing additional evidence that parental psychopathology has an early and significant impact on neural responses to reward in youth (Singh, Kelley, Howe, Reiss, Gotlib, & Chang, 2014).…”