Mechanisms linking childhood adversity with psychopathology: Learning as an intervention target

• Type of Material: Article
• Authors: Katie A. McLaughlin, Harvard University; Stephanie N. DeCross, Harvard University; Tanja Jovanovic, Emory University; Nim Tottenham, Columbia University
• Language: English
• Date: 2019-07-01
• Publisher: Pergamon-Elsevier Science Ltd.
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2019 Elsevier Ltd. All rights reserved.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.brat.2019.04.008
• Title of Journal or Parent Work: Behavioral Research and Therapy
• Volume: 118
• Start Page: 101
• End Page: 109
• Grant/Funding Information: This work was supported by the National Institutes of Health (R01–MH103291 and R01- MH104682 to KM; R01MH091864 to NT; R01MH100122 to TJ; and R01MH111682 to TJ and NT); NARSAD Independent Investigator Award (#23419 to TJ), the National Science Foundation (Graduate Research Fellowship DGE1745303 to SD); Early Career Research Fellowship from the Jacobs Foundation (KM), and the One Mind Rising Star Award (KM).
• Keywords: Early-life stress; Fear extinction; Neural development deprivation; Social Sciences; Learning; Obsessive compulsive disorder; Adult psychiatric disorders; Psychopathology; Emotion regulation; Medial prefrontal cortex; Childhood adversity; Development; Psychology, Clinical; Anxiety disorders; Psychophysiological; Early intervention; Decision making; Early experience; Psychology
• Research Categories: Psychology, Developmental; Psychology, Psychobiology; Psychology, Behavioral; Health Sciences, Human Development

Abstract

Exposure to childhood adversity is common and a powerful risk factor for many forms of psychopathology. In this opinion piece, we argue for greater translation of knowledge about the developmental processes that are influenced by childhood adversity into targeted interventions to prevent the onset of psychopathology. Existing evidence has consistently identified several neurodevelopmental pathways that serve as mechanisms linking adversity with psychopathology. We highlight three domains in which these mechanisms are well-established and point to clear targets for intervention: 1) threat-related social information processing biases; 2) heightened emotional reactivity and difficulties with emotion regulation; and 3) disruptions in reward processing. In contrast to these established pathways, knowledge of how childhood adversity influences emotional learning mechanisms, including fear and reward learning, is remarkably limited. We see the investigation of these mechanisms as a critical next step for the field that will not only advance understanding of developmental pathways linking childhood adversity with psychopathology, but also provide clear targets for behavioral interventions. Knowledge of the mechanisms linking childhood adversity with psychopathology has advanced rapidly, and the time has come to translate that knowledge into clinical interventions to prevent the onset of mental health problems in children who have experienced adversity.