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PreprintCited by 7Child Abuse and TraumaMemory and Neural MechanismsStress Responses and Cortisol

How adverse childhood experiences get under the skin: A systematic review, integration and methodological discussion on threat and reward learning mechanisms

Open access
Ruge, Julia, Ehlers, Mana R, Kastrinogiannis, Alexandros, Klingelhöfer-Jens, Maren, Koppold, Alina, Abend, Rany, Lonsdorf, Tina B·2023
DOI 10.31234/osf.io/nfpbj

Preprint — published as 10.7554/elife.92700

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Abstract

Adverse childhood experiences (ACEs) are a major risk factor for the development of multiple psychopathological conditions, but the mechanisms underlying this link are poorly understood. Associative learning encompasses key mechanisms through which individuals learn to link important environmental inputs to emotional and behavioral responses. ACEs may impact the normative maturation of associative learning processes, resulting in their enduring maladaptive expression manifesting in psychopathology. In this review, we lay out a systematic and methodological overview and integration of the available evidence of the proposed association between ACEs and threat and reward learning processes. We summarize results from a systematic literature search (following PRISMA guidelines) which yielded a total of 81 articles (threat: n=38, reward: n=43). Across the threat and reward learning fields, behaviorally, we observed a converging pattern of aberrant learning in individuals with a history of ACEs, independent of other sample characteristics, specific ACE types, and outcome measures. Specifically, blunted threat learning was reflected in reduced discrimination between threat and safety cues, primarily driven by diminished responding to conditioned threat cues. Furthermore, attenuated reward learning manifested in reduced accuracy and learning rate in tasks involving acquisition of reward contingencies. Importantly, this pattern emerged despite substantial heterogeneity in ACE assessment and operationalization across both fields. We conclude that blunted threat and reward learning may represent a mechanistic route by which ACEs may become physiologically and neurobiologically embedded and ultimately confer greater risk for psychopathology. In closing, we discuss future directions for the research field, including methodological and ACE assessment considerations.

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Authors
Ruge, J., Ehlers, M. R., Kastrinogiannis, A., Klingelhöfer-Jens, M., Koppold, A., Abend, R., & Lonsdorf, T. B.
Affiliations
  • University Medical Center Hamburg-Eppendorf (DE)
  • Bielefeld University (DE)
  • Reichman University (IL)
Corresponding author
Ruge, Julia
ORCID
Publisher
Center for Open Science
Published
2023-05-17
DOI
10.31234/osf.io/nfpbj
OpenAlex
W4377024434
Cited by
7
References
39
Citations by year
2025: 1 · 2024: 3 · 2023: 3
Type
posted content
Language
en
Open access
Licence
Locations
  • PsyArXiv (OSF Preprints) (submittedVersion)
  • PsyArXiv (OSF Preprints) (submittedVersion, cc-by)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Memory and Neural Mechanisms
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
Keywords
adverse childhood experiences, threat learning, reward learning, associative learning, psychopathology, reward contingency

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