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Cited by 1,473Child Abuse and TraumaChild Welfare and AdoptionPsychopathy, Forensic Psychiatry, Sexual Offending

Annual research review: enduring neurobiological effects of childhood abuse and neglect

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Teicher, Martin H., Samson, Jacqueline A.·2016·Journal of Child Psychology and Psychiatry
DOI 10.1111/jcpp.12507PMC PMC4760853
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Abstract

Background: Childhood maltreatment is the most important preventable cause of psychopathology accounting for about 45% of the population attributable risk for childhood onset psychiatric disorders. A key breakthrough has been the discovery that maltreatment alters trajectories of brain development. Methods: This review aims to synthesize neuroimaging findings in children who experienced caregiver neglect as well as from studies in children, adolescents and adults who experienced physical, sexual and emotional abuse. In doing so, we provide preliminary answers to questions regarding the importance of type and timing of exposure, gender differences, reversibility and the relationship between brain changes and psychopathology. We also discuss whether these changes represent adaptive modifications or stress‐induced damage. Results: Parental verbal abuse, witnessing domestic violence and sexual abuse appear to specifically target brain regions (auditory, visual and somatosensory cortex) and pathways that process and convey the aversive experience. Maltreatment is associated with reliable morphological alterations in anterior cingulate, dorsal lateral prefrontal and orbitofrontal cortex, corpus callosum and adult hippocampus, and with enhanced amygdala response to emotional faces and diminished striatal response to anticipated rewards. Evidence is emerging that these regions and interconnecting pathways have sensitive exposure periods when they are most vulnerable. Conclusions: Early deprivation and later abuse may have opposite effects on amygdala volume. Structural and functional abnormalities initially attributed to psychiatric illness may be a more direct consequence of abuse. Childhood maltreatment exerts a prepotent influence on brain development and has been an unrecognized confound in almost all psychiatric neuroimaging studies. These brain changes may be best understood as adaptive responses to facilitate survival and reproduction in the face of adversity. Their relationship to psychopathology is complex as they are discernible in both susceptible and resilient individuals with maltreatment histories. Mechanisms fostering resilience will need to be a primary focus of future studies.

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  • Biomedical evidence is increasing to support plausible causal relations between childhood trauma and poor health, with studies identifying neurological, hormonal, immunological, and epigenetic changes in those exposed to adverse childhood experiences.

    “biomedical evidence is increasing to support plausible causal relations between childhood trauma and poor health, with studies identifying neurological, hormonal, immunological, and epigenetic changes in those exposed to ACEs. 3,65,66”

    From The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. (2017) · cites this paper as [65]

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  • Emotional abuse and neglect often occur in combination with physical and sexual abuse but have been found to have adverse biopsychosocial effects that are distinct from those of physical or sexual abuse.

    “Emotional abuse and neglect often occur in combination with physical and sexual abuse but have been found to have adverse biopsychosocial effects that are distinct from those of physical or sexual abuse [159, 165].”

    From Complex PTSD and borderline personality disorder (2021) · cites this paper as [165]

    The Conclusions (page unavailable) report that maltreatment type matters and describe some different neurobiological findings for neglect and abuse. The Categories of Maltreatment section also reports brain associations with emotional abuse and emotional neglect. However, the review does not establish that emotional abuse and neglect often co-occur specifically with physical and sexual abuse, or that their broader biopsychosocial effects are distinct. (LLM, conf=0.84)

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  • Early adversity is a potent risk factor for physical and mental health problems in later life.

    “Such exposure is a potent risk factor for physical and mental health problems in later life [review in Ref. (34)].”

    From The Stress Acceleration Hypothesis of Nightmares (2017) · cites this paper as [34]

  • Early childhood trauma can disrupt the development of key brain regions, including the prefrontal cortex, amygdala, and hippocampus, which are critical for emotional regulation, memory processing, and cognitive functioning.

    “Trauma during the early years of life can disrupt the development of key brain regions, including the prefrontal cortex, amygdala, and hippocampus, which are critical for emotional regulation, memory processing, and cognitive functioning (Teicher & Samson, 2016).”

    From Trauma-Informed Research-Practice Partnership Building to Support Early Childhood Educators in an Appalachian Community (2023) · cites this paper as Teicher & Samson, 2016

  • Most existing models emphasize atypical limbic system development from prolonged early-life stress as a central mechanism for outcomes associated with caregiver deprivation.

    “Most existing models emphasize atypical limbic system development resulting from prolonged early-life stress as a central mechanism underlying developmental outcomes associated with caregiver deprivation.(25–31)”

    From Neglect as a violation of species-expectant experience: neurodevelopmental consequences (2017) · cites this paper as [31]

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Research works printed but not linked: 2

  1. De Bellis MD Keshavan MS Clark DB Casey BJ Giedd JN Boring AM 1999b A.E. Bennett Research Award. Developmental traumatology. Part II: Brain development Biol Psychiatry 45 10 1271 1284 10349033
  2. van der Kolk B Greenberg MS 1987 The psychobiology of the trauma response: Hyperarousal, constriction, and addiction to traumatic reexposure van der Kolk B Psychological Trauma 63 87 Washington DC American Psychiatric Press

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Authors
Teicher, M. H., & Samson, J. A.
Affiliations
Harvard University (US)
Corresponding author
Teicher, Martin H.
ORCID
Teicher, Martin H.
Venue
Journal of Child Psychology and Psychiatry
Publisher
Wiley
Published
2016-02
Volume
57
Issue
3
Pages
241-266
ISSN
  • 0021-9630 (ISSN-L)
  • 1469-7610
DOI
10.1111/jcpp.12507
PMC
PMC4760853
OpenAlex
W2266560836
Cited by
1,473
References
258
Citations by year
2026: 236 · 2025: 196 · 2024: 154 · 2023: 137 · 2022: 126 · 2021: 131 · 2020: 140 · 2019: 107 · 2018: 120 · 2017: 93 · 2016: 28 · 2013: 1
FWCI
17.21
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Journal of Child Psychology and Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute of Mental Health (5R01 MH091391)
  • National Institute on Drug Abuse (5RO1 DA017846)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
  • Social Sciences › Safety Research › Child Welfare and Adoption
  • Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
Keywords
child abuse, child neglect, brain development, neuroimaging, parental verbal abuse, witnessing domestic violence, sexual abuse, emotional abuse, amygdala, hippocampus, prefrontal cortex, corpus callosum, striatum, gender differences, exposure timing, resilience, psychopathology
MeSH terms
Adolescent, Brain, Child, Child Abuse, Child Abuse, Sexual, Child Development, Humans, Neuroimaging

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