The maternal brain in women with a history of early-life maltreatment: an imagination-based fMRI study of conflictual versus pleasant interactions with children

The maternal brain in women with a history of early-life maltreatment: an imagination-based fMRI study of conflictual versus pleasant interactions with children

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J Psychiatry Neurosci 2018;43(4):273-282

Corinne Neukel; Katja Bertsch, PhD; Anna Fuchs, PhD; Anna-Lena Zietlow, PhD; Corinna Reck, PhD; Eva Moehler, MD; Romuald Brunner, MD; Felix Bermpohl, MD; Sabine C. Herpertz, MD

Abstract

Background: Early-life maltreatment has severe consequences for the affected individual, and it has an impact on the next generation. To improve understanding of the intergenerational effects of abuse, we investigated the consequences of early-life maltreatment on maternal sensitivity and associated brain mechanisms during mother–child interactions.

Methods: In total, 47 mothers (22 with a history of physical and/or sexual childhood abuse and 25 without, all without current mental disorders) took part in a standardized real-life interaction with their 7- to 11-year-old child (not abused) and a subsequent functional imaging script-driven imagery task.

Results: Mothers with early-life maltreatment were less sensitive in real-life mother–child interactions, but while imagining conflictual interactions with their child, they showed increased activation in regions of the salience and emotion-processing network, such as the amygdala, insula and hippocampus. This activation pattern was
in contrast to that of mothers without early-life maltreatment, who showed higher activations in those regions in response to pleasant mother–child interactions. Mothers with early-life maltreatment also showed reduced functional connectivity between regions of the salience and the mentalizing networks.

Limitations: Region-of-interest analyses, which were performed in addition to whole-brain analyses, were exploratory in nature, because they were not further controlled for multiple comparisons.

Conclusion: Results suggest that for mothers with early-life maltreatment, conflictual interactions with their child may be more salient and behaviourally relevant than pleasant interactions, and that their salience network is poorly modulated by the brain regions involved in mentalizing processes. This activation pattern offers new insights into the mechanisms behind the intergenerational effects of maltreatment and into options for reducing these effects.


Submitted Jan. 30, 2017; Revised July 7, 2017; Revised Sept. 4, 2017; Revised Sept. 22, 2017; Accepted Oct. 7, 2017; Published online first May 16, 2018

Acknowledgments: The authors thank K. Ueltzhoeffer for his valuable input regarding the analysis, E. Mielke for her help with data collection, and I. Rek and K. Hillmann for participant recruitment and organization. The study was supported by a grant from the German Federal Ministry of Education and Research to SC.H. (BMBF; 01KR1207A; coordinator: RB). The BMBF had no influence on study design or manuscript.

Affiliations: From the Department of General Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Germany (Neukel, Zietlow, Reck, Herpertz); the Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Germany (Fuchs, Brunner); the Department of Psychology, Faculty of Psychology and Educational Science, Ludwig-Maximilian University of Munich, Germany (Reck); the Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatic Medicine, SHG Hospital, Kleinblittersdorf, Germany (Moehler); and the Department of Psychiatry and Psychotherapy, University Medicine Berlin, Charité Campus Mitte, Berlin, Germany (Bermpohl).

Competing interests: None declared.

Contributors: K. Bertsch, C. Reck, E. Moehler, R. Brunner, F. Bermpohl and S. Herpertz designed the study. C. Neukel, A. Fuchs, A.-L. Zietlow and E. Moehler acquired the data, which C. Neukel, K. Bertsch and S. Herpertz analyzed. C. Neukel wrote the article, which all authors reviewed. All authors approved the final version to be published and can certify that no other individuals not listed as authors have made substantial contributions to the paper.

DOI: 10.1503/jpn.170026

Correspondence to: C. Neukel, Department of General Psychiatry, University of Heidelberg, Voßstraße 4, 69115 Heidelberg, Germany; corinne.neukel@med.uni-heidelberg.de