The protective effects of secure attachment despite childhood maltreatment on brain and behavior
Poster No:
476
Submission Type:
Abstract Submission
Authors:
Katharina Brosch1,2, Vincent Hammes2, Paula Usemann2, Elvisha Dhamala1, Frederike Stein2, Florian Thomas-Odenthal2, Lea Teutenberg2, Susanne Meinert3, Kira Flinkenflügel3, Katharina Thiel3, Alexandra Winter3, Janik Goltermann3, Tim Hahn3, Hamidreza Jamalabadi2, Benjamin Straube2, Andreas Jansen2, Udo Dannlowski3, Axel Krug2,4, Igor Nenadic2, Tilo Kircher2, Nina Alexander2
Institutions:
1Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, 2Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany, 3Institute for Translational Psychiatry, University of Münster, Münster, Germany, 4Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
First Author:
Katharina Brosch
Institute of Behavioral Science, Feinstein Institutes for Medical Research|Department of Psychiatry and Psychotherapy, University of Marburg
Manhasset, NY|Marburg, Germany
Institute of Behavioral Science, Feinstein Institutes for Medical Research|Department of Psychiatry and Psychotherapy, University of Marburg
Manhasset, NY|Marburg, Germany
Co-Author(s):
Elvisha Dhamala
Institute of Behavioral Science, Feinstein Institutes for Medical Research
Manhasset, NY
Institute of Behavioral Science, Feinstein Institutes for Medical Research
Manhasset, NY
Florian Thomas-Odenthal
Department of Psychiatry and Psychotherapy, University of Marburg
Marburg, Germany
Department of Psychiatry and Psychotherapy, University of Marburg
Marburg, Germany
Hamidreza Jamalabadi
Department of Psychiatry and Psychotherapy, University of Marburg
Marburg, Germany
Department of Psychiatry and Psychotherapy, University of Marburg
Marburg, Germany
Axel Krug
Department of Psychiatry and Psychotherapy, University of Marburg|Department of Psychiatry and Psychotherapy, University Hospital Bonn
Marburg, Germany|Bonn, Germany
Department of Psychiatry and Psychotherapy, University of Marburg|Department of Psychiatry and Psychotherapy, University Hospital Bonn
Marburg, Germany|Bonn, Germany
Introduction:
Childhood maltreatment (CM) is a traumatic interpersonal experience and survivors may struggle to form secure attachments even into adulthood. Individuals with a history of CM who are securely attached can therefore be described as interpersonally resilient. While CM constitutes a strong risk factor for major depressive disorder, secure attachment conversely has been associated with improved mental well-being and decreased depressive symptoms. CM and secure attachment have been independently associated with distinct alterations in brain structure. However, it is unclear how interpersonal resilience is associated with changes in behavior and brain structure. This study investigated the clinical outcomes and neural correlates of interpersonal resilience as defined by a secure attachment style in adulthood despite a history of CM.
Methods:
We investigated behavioral outcomes and gray matter volume (GMV) in a sample of N=1317 adults with and without a history of depression, aged 18–65. Participants were drawn from the FOR2107 study investigating the neurobiology of affective and psychotic disorders. On the behavioral level, we investigated perceived stress, self-reported depressive symptoms (Beck Depression inventory, BDI), rater-based depressive symptoms (Hamilton Depression Rating Scale, HAM-D), resilience (RS-25), global symptom severity (SCL-90) and global assessment of functioning (GAF). Brain structural data (3T magnetic resonance imaging) were analyzed using voxel-based morphometry. We applied a 2x2 factorial design (CM x attachment style) and investigated the main and interaction effects on behavior and brain. CM was assessed using the childhood trauma questionnaire (CTQ), and subjects were classified as maltreated or non-maltreated according to established cut-off scales. Accordingly, attachment style was assessed using the relationship scales questionnaire (RSQ), and participants were classified as securely or insecurely attached, resulting in four groups differing in experiences of maltreatment and attachment style. The group with CM and a secure attachment style was termed interpersonally resilient.
Results:
On a phenotypic level, both CM and secure attachment exerted opposing main effects on all behavioral outcomes, i.e., CM was associated with worse psychopathological outcomes (i.e., higher perceived stress, higher self-reported and rater based depressive scores, lower resilience, higher global symptom severity and lower global functioning), whereas the opposite was observed with secure attachment. Additionally, we detected interaction effects for BDI, GAF and SCL-90, such that interpersonally resilient individuals showed significantly lower self-reported depressive symptoms, higher global functioning scores, and lower global symptom severity (Figure 1). At the brain level, we detected a significant interaction effect of CM x attachment in a cluster comprising the left supramarginal gyrus: Interpersonally resilient individuals exhibited significantly larger GMV in this area (Figure 2).
·Figure 1
·Figure 2
Conclusions:
Our results shed light on the behavioral and neural correlates of interpersonal resilience. The supramarginal gyrus is part of the somatosensory association cortex and further considered to be part of the mirror neuron system. Increased volume in this area might constitute a neural compensatory mechanism to CM and aid interpersonally resilient individuals in more adaptively processing semantic information and tactile sensory integration. Our results further demonstrate that risk (i.e., CM) and protective factors (i.e., secure attachment) not only have independent but also interdependent influences. Interpersonally resilient individuals had better psychopathological outcomes, highlighting the importance of secure attachment as a resilience factor in mitigating the negative effects of CM. This suggests that treatment interventions targeted at developing and strengthening secure attachments may improve mental well-being.
Disorders of the Nervous System:
Psychiatric (eg. Depression, Anxiety, Schizophrenia) 1
Emotion, Motivation and Social Neuroscience:
Social Neuroscience Other 2
Keywords:
Psychiatric Disorders
Other - attachment, depression, childhood maltreatment
1|2Indicates the priority used for review
Provide references using author date format
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