Childhood Maltreatment and Neurobiology of Addiction: Important Predictors during Adolescent Years

Laura C. Hernandez Garcia, MD

McLean Hospital
Childhood Maltreatment and Neurobiology of Addiction: Important Predictors during Adolescent Years

Scientific Abstract

Background: We have previously reported the critical associations between degree of alcohol and drug use in maltreated (MAL) individuals and brain regions such as the lingula, anterior cingulate, orbitofrontal and dorsolateral prefrontal cortex (DLPFC). Lingula size was associated with increased frequency and quantity of alcohol use in 18-19-year-olds with history of MAL. Reduced cerebral blood flow in the inferior orbitofrontal cortex predicted an increase of cannabis use over the next 2-4 years in 18-19yo. The DLPFC predicted frequency of drug use, other than cannabis or alcohol. The aim was to assess the role of type and timing of MAL on neurobiological changes at 18-19 years and risk for high levels of drug and alcohol abuse by ages 20-21.

Methods: 148 (48M/100F) healthy, unmedicated young adults (18-19yo,19+/- 5.4) were recruited from the community. They were interviewed (SCID-IV-TR); severity and timing of exposure to ten forms of maltreatment were assessed using the Maltreatment and Abuse Chronology of Exposure (MACE) scale. Timeline Follow back assessment was used to measure substance use and neuroimaging data was collected. Random forest regression analysis was used to calculate the maximal importance of exposure to specific forms of MAL during specific ages.

Results: In 18-19-year-olds, peer emotional abuse and parental verbal abuse at age 17 were the biggest predictors of lingula size. Parental physical abuse at 5-6 years was the most important predictor of blood flow in the DLPFC of 18–19-year-olds. Regarding blood flow in the inferior orbitofrontal cortex, witnessing sibling abuse at 15, followed by parental physical abuse at age 15, were the biggest risk factors. In males, exposure to peer emotional abuse at 15, was the most critical for polysubstance use and lifetime use of stimulants, opioids and sedatives. In females, exposure to sexual abuse at 15yo, was critical for polysubstance use, lifetime use of stimulants, cocaine and hallucinogens.

Conclusions: This study provides further evidence for an association between childhood maltreatment during specific developmental sensitive periods, brain changes and substance abuse.

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Laura C. Hernandez Garcia, MD, Alaptagin Khanm MD, Martin H. Teicherm MD, PhD