Childhood Neglect May Alter Pleasure Experience Later in Life

Young adults who experienced neglect as children may have more difficulty feeling pleasure than those who were abused, a study in Depression & Anxiety suggests.

“[Childhood trauma] exerts a lasting impact on cognition, emotion, and behavior in adulthood,” wrote Xiongzhao Zhu, Ph.D., of Central South University and colleagues. “Children who have experienced neglect may receive less attention and care from caregivers, resulting in less frequency of receiving feedback related to rewards and thus affecting reward learning.”

Anhedonia—the inability to feel pleasure or engage in enjoyable activities—is a common symptom in a variety of psychiatric illnesses, including major depressive disorder (MDD) and obsessive-compulsive disorder (OCD). Anhedonia may also point to those most likely to develop mental illness, the researchers noted.

To examine the relationship between anhedonia and childhood trauma, Zhu and colleagues recruited patients with MDD and OCD from a psychology clinic at a Second Xiangya Hospital in China as well as university students from four universities in China.

The participants completed the Childhood Trauma Questionnaire, which assesses neglect (emotional and physical) and abuse (emotional, physical, and sexual), as well as multiple assessments that measured various aspects of anhedonia. The final sample (average age 22 years) included 305 patients with MDD, 152 patients with OCD, and 2,110 university students.

Zhu and colleagues reported the following:

• Childhood trauma was reported by 69.8% of the MDD patients, 65.8% of the OCD patients, and 33.6% of the university students.
• Neglect was reported by 62.6% of the MDD patients, 55.3% of the OCD patients, and 30.0% of the university students; abuse was reported by 38.7% of the MDD group, 32.9% of the OCD group, and 9.00% of university students.
• Anhedonia subtypes, including physical anhedonia and social anhedonia, were reported by 72.5% to 82.5% of patients with MDD, 47.4% to 65.7% of patients with OCD, and 15.3% to 19.8% of the university students.
• Childhood neglect, not abuse, was associated with anticipatory and state anhedonia in OCD patients and anticipatory, consummatory, physical, and state anhedonia in MDD patients and university students.

“Regarding the more specific forms of [childhood trauma], emotional neglect had the strongest association with most aspects of anhedonia,” Zhu and colleagues wrote. “These findings highlight the role of neglect … in influencing anhedonia, which may provide insights into the mechanisms by which [childhood trauma] leads to psychopathology and suggest the importance of early interventions for families in such circumstances.”

(Image: iStock/KatarzynaBialasiewicz)

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Childhood Abuse May Impact Development of Close Social Bonds as Adults

Adults who experienced significant abuse or neglect during childhood may exhibit a preference for more “personal space” and discomfort with some types of social touching, reports a study in AJP in Advance.

“This sensory dysregulation may explain why individuals with severe childhood maltreatment often suffer from difficulties in establishing and maintaining close social bonds later in life,” wrote Ayline Maier, M.Sc., of the University of Bonn in Germany and colleagues. “Our results may have important implications for the understanding and effective treatment of childhood maltreatment and associated psychopathology.”

Maier and colleagues enrolled 92 adults who were not taking psychotropic medications and who had varying exposure to childhood maltreatment as assessed by the 25-item Childhood Trauma Questionnaire, which measures emotional, physical, and sexual abuse as well as emotional and physical neglect. The sample was divided into three groups: 33 adults with low childhood maltreatment (average score of 26), 30 adults with moderate maltreatment (average score of 36), and 29 with high maltreatment (average score of 63).

All participants completed an interpersonal distance assessment, whereby they slowly moved toward an unfamiliar person until they felt uncomfortable, and a social touch assessment, in which they received either slow or fast hand movements on their shins while undergoing MRI testing.

The data showed that adults in the high-maltreatment group reported a significantly greater amount of ideal personal space between them and another person than those with low maltreatment (about 35.5 inches versus 31.5 inches apart). The adults with high childhood maltreatment also reported more discomfort with fast shin touches compared with adults with low maltreatment. This increased discomfort correlated with greater activity in the sensory regions of the frontal cortex, suggesting that the brain is preparing a flight-or-fight decision in response to the touch, Maier and colleagues wrote.

Cognitive-behavioral therapy approaches do not directly address sensory-related discomfort that many of these individuals experience, the researchers noted. However, previous research has shown the effectiveness of massage for patients who have been sexually abused or have PTSD. The researchers concluded that the use of body-based interventions “could help individuals with a history of childhood maltreatment to facilitate their participation in social interactions by learning to tolerate and enjoy the comforts of social touch in a safe environment.”

To read more about this topic, see the Psychiatric News article “Prospective Study Delves Deeper Into Mental Health Effects of Childhood Trauma.”

(image: iStock/Cecilie_Arcurs)

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Meta-Analysis Finds Childhood Abuse, Neglect Associated With Self-Injurious Behavior

Understanding patients’ history of childhood abuse or neglect may help determine their risk of non-suicidal self-injury, according to a meta-analysis published in the January issue of Lancet Psychiatry.

Non-suicidal self-injury—defined as direct and deliberate destruction of one’s own bodily tissue without suicidal intent—is estimated to affect more than 5% of adults, 17% of adolescents, and 30% of adolescents with a mental disorder. Moreover, non-suicidal self-injury is known to be one of the strongest predictors for future suicide attempts, Richard T. Liu, Ph.D., of Brown University and colleagues wrote. While most patients who engage in repeated self-injurious behavior stop within a few years, about one-fifth of patients develop a chronic pattern of self-injury.

The meta-analysis by Liu and colleagues included 71 studies that evaluated the association between childhood maltreatment (including sexual abuse, physical abuse, physical neglect, emotional abuse, and emotional neglect) and non-suicidal self-injury. The researchers found that overall childhood maltreatment was positively associated with non-suicidal self-injury (odds ratio [OR] = 3.42). The association was strongest for emotional abuse (OR = 3.03) and weakest for emotional neglect (OR = 1.84), although the analysis for emotional neglect included the fewest studies.

The association of maltreatment with non-suicidal self-injury was found to be stronger in community samples than in clinical samples, suggesting that “screening for history of childhood maltreatment might be of most benefit in community settings,” they wrote.

In an accompanying commentary, Lianne Schmaal, Ph.D., and Sarah Bendall, Ph.D., of Orygen and the University of Melbourne wrote that “Disclosure of past childhood maltreatment to a health professional can be a distressing experience. Because non-suicidal self-injury might function to distract from distress in some people, disclosures of distressing maltreatment have the potential to raise the risk of non-suicidal self-injury afterwards.” Therefore, such assessments should be done in accordance with principles of trauma-informed care.

For related information, see the American Journal of Psychiatry article “Association of a History of Child Abuse With Impaired Myelination in the Anterior Cingulate Cortex: Convergent Epigenetic, Transcriptional, and Morphological Evidence.”

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