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Cited by 402Child Abuse and TraumaChild Welfare and AdoptionPsychopathy, Forensic Psychiatry, Sexual Offending

Annual Research Review: Childhood maltreatment, latent vulnerability and the shift to preventative psychiatry – the contribution of functional brain imaging

Open access
McCrory, Eamon J., Gerin, Mattia I., Viding, Essi·2017·Journal of Child Psychology and Psychiatry
DOI 10.1111/jcpp.12713PMC PMC6849838
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Abstract

Background: Childhood maltreatment is a potent predictor of poor mental health across the life span. We argue that there is a need to improve the understanding of the mechanisms that confer psychiatric vulnerability following maltreatment, if we are to progress from simply treating those with a manifest disorder, to developing effective preventative approaches that can help offset the likelihood that such disorders will emerge in the first place. Methods: We review extant functional neuroimaging studies of children and adolescents exposed to early neglect and/or maltreatment, including physical, sexual and emotional abuse across four neurocognitive domains: threat processing, reward processing, emotion regulation and executive control. Findings are discussed in the context of ‘latent vulnerability’, where alterations in neurocognitive function are considered to carry adaptive value in early adverse caregiving environments but confer long‐term risk. Results: Studies on threat processing indicate heightened as well as depressed neural responsiveness in maltreated samples, particularly in the amygdala, thought to reflect threat hypervigilance and avoidance respectively. Studies on reward processing generally report blunted neural response to anticipation and receipt of rewards, particularly in the striatum, patterns associated with depressive symptomatology. Studies on emotion regulation report increased activation of the anterior cingulate cortex (ACC) during active emotion regulation, possibly reflecting greater effortful processing. Finally, studies of executive control report increased dorsal ACC activity during error monitoring and inhibition. Conclusions: An emerging body of work indicates that altered neurocognitive functioning following maltreatment: (a) is evident even in the absence of overt psychopathology; (b) is consistent with perturbations seen in individuals presenting with psychiatric disorder; (c) can predict future psychiatric symptomatology. These findings suggest that maltreatment leads to neurocognitive alterations that embed latent vulnerability to psychiatric disorder, establishing a compelling case for identifying those children at most risk and developing mechanistically informed models of preventative intervention. Such interventions should aim to offset the likelihood of any future psychiatric disorder.

AI snapshot

Written from the paper’s full text.

TL;DR

This review argues that childhood maltreatment is associated with altered functioning across threat, reward, emotion regulation, and executive control systems, which may embed latent vulnerability to later psychiatric disorder. It synthesizes functional MRI studies in children and adolescents and calls for a shift toward preventative psychiatry targeting these neurocognitive mechanisms.

Key findings

  • Threat processing: maltreated or institutionalized children show altered amygdala responsiveness, including heightened activation to angry/fearful faces and, in one study, reduced amygdala/insula/vlPFC/OFC activity to rejection-related words; a meta-analysis of 20 child and adult studies found maltreatment reliably associated with increased bilateral amygdala activation to emotional faces plus hyperactivation of the parahippocampal gyrus and insula.
  • Reward processing: studies generally report blunted neural response to reward anticipation and receipt, particularly in the striatum; Hanson et al. (N = 106) found self-reported emotional neglect associated with blunted striatal response, which partially mediated the association with later depressive symptoms, while Dennison et al. (21 maltreated vs. 38 controls) found greater NAcc/putamen response to positive stimuli and that low left putamen activation predicted increased depression symptoms at 2-year follow-up.
  • Emotion regulation: studies report increased anterior cingulate cortex (ACC) activation during active emotion regulation, possibly reflecting greater effortful processing, alongside atypical fronto-limbic connectivity and activity whose direction varies by task and context.
  • Executive control: the two reviewed fMRI studies report increased dorsal ACC activity during error monitoring and inhibition; however, the authors caution that Danese et al. (2016) found cognitive deficits in victimized children were largely explained by pre-existing cognitive deficits and socioeconomic disadvantage.

Methods

  • Narrative review of extant functional neuroimaging (fMRI) studies of children and adolescents exposed to early neglect and/or maltreatment, including physical, sexual, and emotional abuse, across four neurocognitive domains: threat processing, reward processing, emotion regulation, and executive control.
  • The review summarizes studies listed in Table 1, including sample sizes, mean ages, tasks, maltreatment assessment methods, and maltreatment subtypes, and discusses findings in the context of the theory of latent vulnerability.
  • Main analysis is qualitative synthesis; no new primary data or author-conducted meta-analysis is reported.

Limitations

  • The paper states that reviewed studies often have small sample sizes, are cross-sectional and cannot establish causality, face difficulty defining and measuring maltreatment, and show heterogeneity in timing and type of exposure; many use self-report and normal-range adversity rather than clinically documented maltreatment, and the Childhood Trauma Questionnaire emotional abuse scale may conflate common experiences or depressive schemas with actual abuse.
  • The paper states that executive-control findings require caution because Danese et al. (2016) found cognitive deficits in victimized children were largely explained by pre-victimization deficits and socioeconomic disadvantage.
  • Evident from the text: as a narrative review, no systematic search strategy, inclusion criteria, or formal quality appraisal/meta-analytic synthesis is described, and most reviewed studies are cross-sectional with several small samples.

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Integrity signals

Registry

Crossref · 10.1111/jcpp.12713

Cites

147 of 147 references verified0 citation errors · 0 not checkable

Statistics

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Claims the paper makes

0 of 142 cited sources checked · 0 supported · 0 flagged

  • Findingcitation

    In McCrory et al. (2013), the group of children exposed to maltreatment (N = 18), compared to a matched sample of nonmaltreated children (N = 23), showed greater neural response in the amygdala to angry relative to neutral faces.

    “As hypothesized, the group of children exposed to maltreatment (N = 18), compared to a matched sample of nonmaltreated children (N = 23), showed greater neural response in the amygdala to angry relative to neutral faces.”
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    • cites McCrory et al., 2013

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  • Findingcitation

    A common epigenetic signature across maltreatment subtypes was observed, enriched for biological processes related to neural development and organismal growth.

    “In addition, a ‘common’ epigenetic signature across maltreatment subtypes was also observed, enriched for biological processes related to neural development and organismal growth (Cecil et al., 2016).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Cecil et al., 2016

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  • Findingcitation

    In McCrory et al. (2011), the group exposed to maltreatment (N = 20) showed increased activation in the amygdala and anterior insula when processing angry relative to neutral faces.

    “The group exposed to maltreatment (N = 20) showed increased activation in the amygdala and anterior insula when processing angry relative to neutral faces.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites McCrory et al., 2011

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  • Findingcitation

    Young adults self-reporting childhood experiences of maltreatment displayed altered patterns of epigenetic modulation in genes implicated in a range of physical and psychiatric disorders.

    “Recently, for example, we demonstrated that young adults self‐reporting childhood experiences of maltreatment displayed altered patterns of epigenetic modulation in genes implicated in a range of physical and psychiatric disorders (Cecil et al., 2016).”
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    • cites Cecil et al., 2016

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  • Findingcitation

    In White et al. (2012), emotional neglect was associated with higher amygdala reactivity, but only in those adolescents carrying the 'riskier' genetic polymorphisms.

    “As predicted, emotional neglect was associated with higher amygdala reactivity, but only in those adolescents carrying the ‘riskier’ genetic polymorphisms.”
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    • cites White et al., 2012

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    Findingcitation

    These changes are detectable as early as 15 months and include preferential attention to threatening information, heightened neural response to negative stimuli and enhanced perceptual ability for cues associated with danger, such as angry faces.

    “These changes are detectable as early as 15 months, and include preferential attention to threatening information, heightened neural response to negative stimuli and enhanced perceptual ability for cues associated with danger, such as angry faces (Curtis & Cicchetti, 2013; Pollak & Sinha, 2002; Pollak & Tolley‐Schell, 2003; Pollak, Vardi, Putzer Bechner, & Curtin, 2005).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Curtis & Cicchetti, 2013

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    • cites Pollak & Sinha, 2002

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    • cites Pollak et al., 2005

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    Findingcitation

    Amygdala response was negatively correlated with time spent in an adoptive family, suggesting that level of amygdala responsiveness to threat was calibrated in a dose-dependent manner tracking the level of adversity exposure.

    “Amygdala response was negatively correlated with time spent in an adoptive family, suggesting that level of amygdala responsiveness to threat was calibrated in a dose‐dependent manner tracking the level of adversity exposure.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Maheu et al., 2010

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    Findingcitation

    Maheu et al. (2010) found greater activation in subcortical regions including the amygdala and hippocampus in the deprived sample during threat processing in a paradigm using emotional faces, even when two participants who met criteria for a psychiatric diagnosis were removed.

    “Greater activation in subcortical regions including the amygdala and hippocampus was observed in the deprived sample during threat processing in a paradigm using emotional faces, even when two participants who met criteria for a psychiatric diagnosis were removed.”
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    • cites Maheu et al., 2010

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    Findingcitation

    A modest dose-dependent neural response in the insula was found with the degree of violence exposure at home, pointing to neural calibration commensurate with level of exposure to early adversity.

    “In this study, we found a modest dose‐dependent neural response in the insula with the degree of violence exposure at home, again pointing to a pattern of neural calibration commensurate with the level of exposure to early adversity.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites McCrory et al., 2011

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  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Findingnone given

    Studies on emotion regulation report increased activation of the anterior cingulate cortex (ACC) during active emotion regulation, possibly reflecting greater effortful processing.

    “Studies on emotion regulation report increased activation of the anterior cingulate cortex (ACC) during active emotion regulation, possibly reflecting greater effortful processing.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingnone given

    Studies on threat processing indicate heightened as well as depressed neural responsiveness in maltreated samples, particularly in the amygdala, thought to reflect threat hypervigilance and avoidance respectively.

    “Studies on threat processing indicate heightened as well as depressed neural responsiveness in maltreated samples, particularly in the amygdala, thought to reflect threat hypervigilance and avoidance respectively.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Findingnone given

    Studies of executive control report increased dorsal ACC activity during error monitoring and inhibition.

    “Finally, studies of executive control report increased dorsal ACC activity during error monitoring and inhibition.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Findingcitation

    The CTQ emotional abuse items relate to common experiences for many children, such as being called lazy or stupid by family members or having family members say hurtful or insulting things.

    “Inspection of the items for emotional abuse in the CTQ reveal that they relate to common experiences for many children – being called ‘lazy’ or ‘stupid’ by people in one's family (including, for example, siblings) or having family members say ‘hurtful or insulting things to them’.”
    Quote in the paperSubstantial claim

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    Findingnone given

    Such changes are observable even in the absence of psychiatric disorder and in some cases predict future symptomatology.

    “Such changes are observable even in the absence of psychiatric disorder and in some cases, predict future symptomatology.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationnone given

    Indicators of latent vulnerability are not necessarily symptoms of any future disorder; they refer to cognitive processes or representations and associated patterns of neural activation implicated in the pathogenesis of a disorder.

    “First, these indicators are not necessarily symptoms of any future disorder. Rather, they refer to cognitive processes or representations and associated patterns of neural activation that are implicated in the pathogenesis of a disorder.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Individuals within a diagnostic category who have childhood histories of maltreatment may represent specific ecophenotypes.

    “Indeed, it has been suggested that individuals within a diagnostic category who have childhood histories of maltreatment may represent specific ecophenotypes (Teicher & Samson, 2013).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Teicher & Samson, 2013

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    Interpretationreasoning

    Latent vulnerability could be present for months or years, but clinical symptoms may only manifest under certain conditions characterized by stress or developmental challenge, or may never manifest given adequate protective factors and absence of future stressors.

    “Such vulnerability could theoretically be present for months or years, but clinical symptoms may only manifest under certain conditions characterized by stress or developmental challenge, or indeed may never manifest given adequate intrinsic and extrinsic protective factors (e.g. resilient genotypes, social support), and the absence of future stressors, despite the enduring presence of latent vul”
    Quote in the paperSubstantial claim

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    Interpretationcitation

    These neurobiological changes are often beneficial within the early maladaptive context (carry adaptive value) thus representing in part a functional response.

    “A general principle of the theory is that these changes are often beneficial within the early maladaptive context (i.e. carry adaptive value within that particular setting) thus representing in part a functional response.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites McCrory & Viding, 2015

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  • Classified as probably not a substantial claim.

    Interpretationreasoning

    Alterations in threat processing may place an individual at greater risk of developing maladaptive behaviours.

    “The successful navigation of an unpredictable environment depends on our ability to accurately and efficiently detect and respond to threat; as such, it is reasonable to assume that alterations in this system may potentially place an individual at a greater risk of developing maladaptive behaviours.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    Latent vulnerability is best indexed at a systems level and likely reflects a complex phenotype of maladaptive calibration in higher order systems important for socioemotional and cognitive functioning.

    “Second, these indicators are best indexed at a systems level. In other words, latent vulnerability likely reflects a complex phenotype that can be thought of as a ‘maladaptive calibration’ in higher order systems important for socioemotional and cognitive functioning.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Interpretationnone given

    Indicators of latent vulnerability should be present prior to onset of psychiatric disorder and help predict level of future risk.

    “Third, these indicators should be present prior to onset of psychiatric disorder and help predict level of future risk.”
    Quote in the paperNot a substantial claim

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    Premisecitation

    The amygdala plays a critical role in the detection of salient stimuli, and in particular stimuli associated with danger.

    “Evidence from human and animal studies suggests that the amygdala, a subcortical medio‐temporal brain structure, plays a critical role in the detection of salient stimuli, and in particular stimuli associated with danger (Phelps & LeDoux, 2005).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Phelps & LeDoux, 2005

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    Premisecitation

    Psychiatric disorders in individuals who have experienced maltreatment are likely to develop earlier and with more severe symptomatology.

    “For example, psychiatric disorders in individuals who have experienced maltreatment are likely to develop earlier, with more severe symptomatology (Hovens et al., 2010)”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Hovens et al., 2010

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    Interpretationcitation

    Such adaptations incur a longer term cost as they may mean the individual is poorly optimized to negotiate the demands of other, more normative environments, thus increasing vulnerability to future stressors.

    “However, such adaptations are equally thought to incur a longer term cost as they may mean that the individual is poorly optimized to negotiate the demands of other, more normative environments, thus increasing vulnerability to future stressors (McCrory & Viding, 2015).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites McCrory & Viding, 2015

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  • May combine two claims.

    Interpretationreasoning

    Impaired processing in neurocognitive systems indexes latent vulnerability and sheds light on mechanisms implicated in the pathogenesis of psychiatric disorder.

    “Over recent years a series of functional imaging studies have begun to investigate the association between maltreatment and impairments in a number of neurocognitive systems; we suggest that impaired processing in these systems index latent vulnerability and shed light on the mechanisms implicated in the pathogenesis of psychiatric disorder.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationcitation

    Alterations in the reward network are not only implicated in the pathophysiology of depression but may also represent a marker of vulnerability.

    “These and related findings (Bress, Foti, Kotov, Klein, & Hajcak, 2013; Telzer, Fuligni, Lieberman, & Galván, 2014) suggest that alterations in the reward network are not only implicated in the pathophysiology of depression but may also represent a marker of vulnerability.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Bress, Foti, Kotov, Klein, & Hajcak, 2013

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    • cites Telzer, Fuligni, Lieberman, & Galván, 2014

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  • The quote only partly states this claim.

    Study design and conductreasoning

    It was not possible to conclude that the findings from the Hanson et al. study would be generalizable to definitions of maltreatment in a professional context because the sample had minimal to low range of maltreatment experience.

    “As such, it was not possible to conclude that the findings from this study would be generalizable to definitions of ‘maltreatment’ in a professional context.”
    Quote in the paperSubstantial claim

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    Study design and conductreasoning

    The Dennison et al. study benefits from a well-characterized group of adolescents who meet criteria for maltreatment and who are carefully matched with nonmaltreated peers.

    “This study benefits from a well‐characterized group of adolescents who meet criteria for maltreatment and who are carefully matched with nonmaltreated peers.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Decreases in reward-related ventral striatal activity were associated with greater depressive symptomatology and partially mediated the association between emotional neglect and subsequent depressive symptomatology.

    “In turn, decreases in reward‐related ventral striatal activity were associated with greater depressive symptomatology and partially mediated the association between emotional neglect and subsequent depressive symptomatology.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Altered responsiveness may confer increased risk of depression/anhedonia, anxiety and addiction.

    “However, they note that such altered responsiveness may confer increased risk of depression/anhedonia (Pizzagalli et al., 2009; Wacker, Dillon, & Pizzagalli, 2009), anxiety (Etkin et al., 2004; Redlich et al., 2015) and addiction (Balodis & Potenza, 2015; Corral‐Frías et al., 2015).”
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    • cites Pizzagalli et al., 2009

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    • cites Etkin et al., 2004

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    • cites Balodis & Potenza, 2015

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    Interpretationreasoning

    Although such changes may be adaptive in the short term, the theory of latent vulnerability contends that in the long term they contribute to an increased risk of psychopathology.

    “Although such changes may be adaptive in the short term, the theory of latent vulnerability contends that in the long term they contribute to an increased risk of psychopathology.”
    Quote in the paperSubstantial claim

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    Interpretationreasoning

    The blunting of anticipatory response would incur a cost, hampering exploratory behaviour in novel environments outside the home and reducing the likelihood of identifying sources of reward even when these are in fact available.

    “However, the blunting of anticipatory response would incur a cost, hampering exploratory behaviour in novel environments outside the home, reducing the likelihood of identifying sources of reward even when these are in fact available.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Premisenone given

    Hypoactivation of the amygdala to social threat cues (and associated regions) has also been observed in patients with PTSD.

    “This pattern of hypoactivation of the amygdala to social threat cues (and associated regions) has also been observed in patients with PTSD”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    White et al. (2012) note that in their sample it is emotional neglect that is primarily associated with elevated amygdala reactivity.

    “However, White et al. (2012) note that in their sample it is emotional neglect that is primarily associated with elevated amygdala reactivity.”
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    • cites White et al., 2012

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  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    Emotional neglect is a form of deprivation (an absence of expected social inputs) that requires vigilance as an adaptive response in order to maintain physical safety.

    “Arguably then, emotional neglect is a form of deprivation (an absence of expected social inputs) that requires vigilance as an adaptive response in order to maintain physical safety.”
    Quote in the paperNot a substantial claim

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    Study design and conductreasoning

    Dividing the 21 adolescents in the maltreatment sample into low and high reactivity to reward groups means that these findings are based on a relatively small sample size and require replication.

    “However, dividing the 21 adolescents in the maltreatment sample into ‘low’ and ‘high’ reactivity to reward groups means that these findings are based on a relatively small sample size and require replication.”
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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    This would set up a negative reinforcing cycle where a child is less expectant of rewards and less motivated to exert the effort required to attain them.

    “It is not difficult to imagine how this would set up a negative reinforcing cycle where a child is less expectant of rewards and less motivated to exert the effort required to attain them.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    This will have profound implications for how a child both experiences and shapes their environment, as well as how they develop an internalized sense of agency and mastery.

    “This will have profound implications for how a child both experiences and shapes their environment, as well as how they develop an internalized sense of agency and mastery.”
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    Study design and conductreasoning

    In both the Mehta and Goff studies, the institutionalized and comparison groups differed across one or more domains, including social, psychiatric and cognitive functioning, making it difficult to confidently attribute the observed differences in neural reactivity to early experience rather than concurrent difficulties.

    “However, in both studies the institutionalized and comparison groups differed across one or more domains, including social, psychiatric and cognitive functioning making it difficult to confidently attribute the observed differences in neural reactivity to early experience rather than concurrent difficulties.”
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    Interpretationreasoning

    Such calibration may reduce the likelihood of experiencing repeated episodes of disappointment, and as such would represent an adaptation that helps the child regulate their internal state within a deprived environment.

    “In addition, such calibration may reduce the likelihood of experiencing repeated episodes of disappointment, and as such would represent an adaptation that helps the child regulate their internal state within a deprived environment.”
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    Premisecitation

    A meta-analysis combining data from 20 child and adult studies found that maltreatment experience was reliably associated with increased bilateral amygdala activation to emotional faces, as well as hyperactivation of the parahippocampal gyrus and insula.

    “A recent meta‐analysis combining data from 20 child and adult studies, found that maltreatment experience was reliably associated with increased bilateral amygdala activation to emotional faces, as well as hyperactivation of the parahippocampal gyrus and insula (Hein & Monk, 2017).”
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    • cites Hein & Monk, 2017

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    Interpretationreasoning

    The discordance in direction of findings may be due to the range of participants recruited (previously institutionalized, typically developing, trauma exposed), the range in ages of participants, and the use of different types of tasks (simple affect processing versus more complex emotional conflict processing).

    “This is perhaps not surprising given the range of participants recruited (previously institutionalized, typically developing, trauma exposed), the range in ages of participants and the use of different types of tasks (simple affect processing tasks (Lee et al., 2015; Gee et al., 2013) versus more complex tasks of emotional conflict processing (Marusak et al., 2015).”
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    • cites Lee et al., 2015

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    • cites Gee et al., 2013

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    • cites Marusak et al., 2015

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    Premisereasoning

    The findings suggest atypical focal brain activity in regulatory regions such as the ventral ACC and the lPFC, as well as alterations in functional connectivity between frontal and subcortical brain regions, including the amygdala-vACC circuitry.

    “Specifically, the findings suggest atypical focal brain activity in regulatory regions such as the ventral ACC (vACC) and the lPFC as well as alterations in functional connectivity between frontal and subcortical brain regions, including the amygdala–vACC circuitry.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Interpretationreasoning

    Differences in the direction of effects across the focal activation studies may relate to the paradigm used, task context and the scope within any given paradigm for participants to simply engage in avoidance of negative stimuli; such avoidance may reduce the processing of aversive stimuli in the short term at the expense of the development of effective emotion regulation skills.

    “Differences in the direction of effects across the focal activation studies, in contrast, may relate to the paradigm used, task context and the scope within any given paradigm for participants to simply engage in avoidance of negative stimuli; such avoidance may reduce the processing of aversive stimuli in the short term at the expense of the development of effective emotion regulation skills.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    A complex pattern of altered connectivity characterizes individuals exposed to early adversity that is related to developmental stage, the nature of adversity experienced, and the specific computational demands of any given emotional processing task.

    “It is likely that a complex pattern of altered connectivity characterizes individuals exposed to early adversity that is related to developmental stage, the nature of adversity experienced and the specific computational demands of any given emotional processing task.”
    Quote in the paperSubstantial claim

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    Premisecitation

    Findings from the two fMRI studies indicate increased activity during error monitoring and inhibition in medial and lateral frontal regions, such as the dACC and frontal motor regions, consistent with altered executive control following maltreatment experience.

    “Findings from these studies indicate increased activity during error monitoring and inhibition in medial and lateral frontal regions, such as the dACC and frontal motor regions consistent with altered executive control following maltreatment experience, which may in turn increase risk of future psychopathology.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Mueller et al., 2010

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    • cites Lim et al., 2015

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    Premisecitation

    In a longitudinal study of 171 maltreated children and 151 control children, maltreatment experience was associated with high emotion lability/negativity at age 7 that contributed to poor emotion regulation at age 8, which in turn was predictive of increases in internalizing symptomatology a year later.

    “For example, in a longitudinal study of 171 children who had experienced maltreatment and 151 control children, maltreatment experience was associated with high emotion lability/negativity at an age of 7 years that contributed to poor emotion regulation (age 8), which in turn was predictive of increases in internalizing symptomatology a year later (Kim‐Spoon, Cicchetti, & Rogosch, 2013).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Kim‐Spoon, Cicchetti, & Rogosch, 2013

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    Premisecitation

    Impaired executive control is associated with emotion regulation difficulties, rumination and reduced social skills, which are all predictors of psychopathology.

    “Impaired executive control is associated with emotion regulation difficulties, rumination and reduced social skills, which are all predictors of psychopathology (Snyder, Kaiser, Warren, & Heller, 2015; Snyder, Miyake et al., 2015).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Snyder, Kaiser, Warren, & Heller, 2015

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    • cites Snyder, Miyake et al., 2015

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    Premisenone given

    Atypical connectivity and focal activity has been found in fronto-limbic neural circuits, including the ventral ACC and the amygdala, and also in lateral frontal regions.

    “Specifically, atypical connectivity and focal activity has been found in fronto‐limbic neural circuits, including the ventral ACC (vACC) and the amygdala, and also in lateral frontal regions.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisereasoning

    The findings of seven studies with children and adolescents with histories of maltreatment largely converge, indicating functional alteration in a group of brain regions implicated in emotion regulation.

    “The findings of these studies largely converge, indicating functional alteration in a group of brain regions implicated in emotion regulation.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    There are many differences across the paradigms used in these studies that make interpretation of such contrasting findings challenging.

    “There are many differences across the paradigms used in these studies that make interpretation of such contrasting findings challenging.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    The increased activity in maltreated adolescents was observed in the dorsal dACC, the middle cingulate cortex (MCC) and in lateral frontal regions, including the supplementary motor area.

    “In particular, increased activity was observed in the dorsal dACC, the middle cingulate cortex (MCC) and in lateral frontal regions, including the supplementary motor area.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Lim et al., 2015

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  • May combine two claims.

    Interpretationreasoning

    Atypical emotion regulatory responses characterize children exposed to maltreatment, and the direction of the response may partly depend on the degree to which the processing of any aversive stimuli is mandated by the context or avoidable by some form of distraction.

    “However, it is arguable that while atypical emotion regulatory responses characterize children exposed to maltreatment the direction of the response may partly depend on the degree to which the processing of any aversive stimuli is mandated by the context or avoidable by some form of distraction.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationreasoning

    Differences in the direction of effects across the functional connectivity studies may in part relate to variation in the ages and forms of adverse experiences characterizing each sample.

    “Differences in the direction of effects across the functional connectivity studies may in part relate to variation in the ages and forms of adverse experiences characterizing each sample.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    In Gee et al. (2013), differences only emerged in the subset of younger children (not the adolescents) within the institutionalized sample: they showed a pattern of more negative connectivity similar to that seen in the older adolescents across both groups.

    “Differences only emerged in the subset of younger children (not the adolescents) within the institutionalized sample: they showed a pattern of more negative connectivity similar to that seen in the older adolescents across both groups.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Gee et al., 2013

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    Differences in the supplementary motor area between maltreated adolescents and a psychiatric comparison group suggest that alterations in the brain network involved in executive control are related to maltreatment exposure and are not just an epiphenomenon of concurrent psychopathology.

    “Differences in the supplementary motor area were evident in comparison with the psychiatric comparison group, suggesting that alterations in the brain network involved in executive control are related to maltreatment exposure and are not just an epiphenomenon of concurrent psychopathology.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Lim et al., 2015

      Not checked in the free run.

  • May combine two claims.

    Study design and conductreasoning

    Selecting participants on the basis of only one subtype of maltreatment means that the complete maltreatment history in experimental and comparison groups is not fully captured, and unmeasured adversity may be driving observed effects rather than the maltreatment subtype.

    “To select participants on the basis of only one subtype of maltreatment (and disregard or simply ignore the others) means that the complete maltreatment history in the experimental and comparison groups is not fully captured. This unmeasured adversity may be what is in fact driving any observed effects rather that the maltreatment subtype on which the researchers have chosen to focus.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    Matching groups on chronological age, IQ, sex, SES, and puberty in younger adolescents ensures that observed differences can be more confidently attributed to maltreatment experience rather than to poorer cognitive functioning or general deprivation.

    “Such matching ensures that any observed differences can be more confidently attributed to the maltreatment experience (rather than, say, poorer cognitive functioning or general deprivation).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Recent findings from two large longitudinal cohorts show that although individuals with a history of childhood victimization had deficits in general intelligence and executive control, such deficits were largely explained by cognitive deficits present prior to victimization and by nonspecific effects of childhood socioeconomic disadvantage.

    “Rather strikingly, the data demonstrated that although individuals with a history of childhood victimization were characterized by deficits in general intelligence and executive control (in line with the extant literature), such deficits were largely explained by cognitive deficits present prior to the experience of childhood victimization and by nonspecific effects of childhood socioeconomic dis”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Danese et al., 2016

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The Childhood Trauma Questionnaire (CTQ) is a self-report measure commonly used to index levels of physical, sexual and emotional abuse, as well as physical and emotional neglect.

    “The Childhood Trauma Questionnaire (CTQ) is a self‐report measure commonly used to index levels of physical, sexual and emotional abuse, as well as physical and emotional neglect (Bernstein & Fink, 1998).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Bernstein & Fink, 1998

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    These changes are strikingly consistent with those seen in individuals presenting with psychiatric disorder, suggesting such neurocognitive adaptations embed latent vulnerability to future psychiatric disorder.

    “These changes are strikingly consistent with those seen in individuals presenting with psychiatric disorder suggesting such neurocognitive ‘adaptations’ embed latent vulnerability to future psychiatric disorder.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    In one study of over 2000 male adolescents aged 12-14 years using the CTQ, over half met threshold for severe or extreme emotional abuse, while rates of other forms of maltreatment were in line with clinical expectations.

    “In one study of over 2000 male adolescents aged 12–14 years using the CTQ, it was found that over half met threshold for ‘severe’ or ‘extreme’ emotional abuse, while the rates of other forms of maltreatment were in line with what might be expected based on clinical experience (Mikaeili, Barahmand, & Abdi, 2013).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Mikaeili, Barahmand, & Abdi, 2013

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    There is almost no provision for children who have experienced maltreatment but do not present with a manifest psychiatric disorder, and such children have generally not been viewed as the concern of mental health professionals, despite evidence of elevated risk of future disorder.

    “There is almost no provision for those children who have experienced maltreatment but who do not present with a manifest psychiatric disorder; indeed, such children have generally not been viewed as the concern of mental health professionals at all despite a compelling evidence documenting the significantly elevated risk of future disorder that characterize these children (Vachon et al., 2015).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Vachon et al., 2015

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    Neurocognitive alterations may hold functional value for the child in the context of an early neglectful or abusive home environment, but may also contribute to the pathogenesis of future poor mental health problems, ceasing to be adaptive during later stages or in more normative environments.

    “Neurocognitive alterations may hold functional value for the child in the context of an early neglectful or abusive home environment. But they may also serve to contribute to the pathogenesis of future poor mental health problems, ceasing to be adaptive or beneficial during later stages of development or in more normative environments (McCrory & Viding, 2015).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites McCrory & Viding, 2015

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    The neuroimaging findings provide both the motivation and the rationale to pursue a much more explicitly preventative psychiatry approach for children exposed to maltreatment before they present with a frank psychiatric disorder.

    “Arguably the most important implication of these neuroimaging findings is that they provide both the motivation and the rationale to pursue a much more explicitly preventative psychiatry approach in helping those children exposed to maltreatment before they present with a frank psychiatric disorder.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Current models of social care and mental health provision discourage innovation in indicated prevention, with social care prioritizing child protection and mental health services prioritizing treatment of children meeting criteria for a psychiatric disorder.

  • May combine two claims.

    Premisecitation

    In maltreatment, where the caregiver shows an absence of mentalizing and contingent and marked mirroring, the development of epistemic trust is compromised, leading to mistrust of information from others and limits on learning and mentalization.

    “In the case of maltreatment, where the caregiver shows an absence of mentalizing and contingent and marked mirroring, the development of epistemic trust is compromised. This leads to a child mistrusting the information conveyed by others, limits their ability to learn about the cultural and interpersonal world, and developing effective mentalization skills themselves (Bo, Sharp, Fonagy, & Kongers”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Bo, Sharp, Fonagy, & Kongerslev, 2015

      Not checked in the free run.

    • cites Fonagy & Allison, 2014

      Not checked in the free run.

61 of 61

  • The paper relies on this without support.

    Current models of social care and mental health provision discourage innovation in indicated prevention, with social care prioritizing child protection and mental health services prioritizing treatment of children meeting criteria for a psychiatric disorder.

    “Current models of social care and mental health provision are typically organized in such a way that discourages innovation in the field of indicated prevention – where those children presenting with the greatest latent vulnerability might be identified and offered a form of intervention to offset the likelihood of a future mental health problem emerging. At the level of social care the priority”
1 of 1

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Much of the ELS work on automatic emotional processing examines threat and the amygdala, not reward.

    “While there is a literature on automatic emotional processing in ELS, many of these studies focus on threat processing and amygdala activity rather than reward (McCrory et al., 2017).”

    From The effects of early life stress on reward processing (2018) · cites this paper as McCrory et al., 2017

Cites

Flagged first, then by citations

3 of the 150 references couldn’t be matched to a known paper.

Research works printed but not linked: 2

  1. Bernstein D.P., 1998, Childhood Trauma Questionnaire: A retrospective self‐report ‐ manual
  2. Gerin M.I., A neuro‐computational investigation of maltreatment and reinforcement‐based decision making: A candidate mechanism contributing to latent vulnerability, Development and Psychopathology

Cited by

Sorted by citations

Related

Authors
McCrory, E. J., Gerin, M. I., & Viding, E.
Affiliations
  • Anna Freud Centre (GB)
  • University College London (GB)
Corresponding author
McCrory, Eamon J.
ORCID
Venue
Journal of Child Psychology and Psychiatry
Publisher
Wiley
Published
2017-03-13
Volume
58
Issue
4
Pages
338-357
ISSN
  • 0021-9630 (ISSN-L)
  • 1469-7610
DOI
10.1111/jcpp.12713
PMC
PMC6849838
OpenAlex
W2598533315
Semantic Scholar
22aff47026943f37eb6f20cf5ce956236417cc0d
Cited by
402
References
150
Citations by year
2026: 57 · 2025: 45 · 2024: 45 · 2023: 54 · 2022: 35 · 2021: 40 · 2020: 52 · 2019: 40 · 2018: 21 · 2017: 11 · 2016: 1
FWCI
5.13
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Child Psychology and Psychiatry (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
Funders
Economic and Social Research Council (ES/K005723/1)
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, physical abuse, sexual abuse, emotional abuse, threat processing, reward processing, emotion regulation, executive function, amygdala, striatum, anterior cingulate cortex, depressive symptoms, risk prediction
MeSH terms
Adolescent, Adolescent Psychiatry, Mental Disorders, Child, Child Abuse, Child Psychiatry, Humans, Neurocognitive Disorders, Functional Neuroimaging

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-07.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-07.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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