Background. Child maltreatment (CM) is defined as any act of commission or omission by a caregiver that results in harm, potential for harm, or threat of harm to a child. The impact of CM is intense and harmful, with neurobiological and neuroendocrine consequences, indeed CM affects child development in behavioral, emotional, social, physical, and cognitive areas. CM has shown to have common and powerful associations with the occurrence of various types of psychiatric disorders, and it comes to be a strong predictor of mental illness. Understanding how CM and, specifically the different types of CM, affect the development of psychopathologies in humans is still an open question. Furthermore, the neurobiological mechanisms that are elicited/activated by exposure to different types of CM and their impact on neurodevelopmental trajectories are not fully elucidated.
Objective. Here, we aim to investigate, thanks to a multidimensional approach, the impact of different types of CM on psycho-neuro-biological factors in adolescence.
Methodology. Adolescents who experienced different types of CM or normal environment will be exposed to a comprehensive screening aimed to evaluate psychological and behavioral parameters, brain functioning, and blood gene expression. To perform this evaluation a clinical and psychometric interview, a high-density EEG scanning (through the Geodesic Sensor Net system), and an RNA-Seq in blood cells will be performed. A picture of the complex effects of childhood abuse and neglect will be obtained by submitting all measured parameters to multivariate and exploratory analyses.
Expected Results. Through this examination, we intend to identify biological vulnerability factors responsible for deviating the normal developmental trajectories and causing psychopathological outcomes after a traumatic childhood
In the context of the study of the CM effects on neurodevelopment and on the susceptibility to psychopathologies there are several open questions. Some of which are: 1. Does CM affect brain structure and function? 2. Does the type of maltreatment matter or are they all stressors? 3. Does age at the time of abuse matter? 4. Are boys and girls affected in the same way? 5. What is the relationship between CM, brain changes, biological functional alterations, and psychiatric illness? 6. Are the neurobiological consequences of CM reversible? There is also a pressing mechanistic question how does CM "get under the skin" to produce these neurobiological effects? (Teicher and A. Samson, J Child Psychol Psychiatry, 2016)
With this project, we aim to answer, at least partially, some of these questions. The great novelty of this project lies in the combination of multiple strategies to assess the effects of different types of CM on psychopathological development from several angles. This analysis will use a top-down approach that will start from psychological measurements, to further move towards behavioral analysis (behavior that underlies emotional functions), to go through the investigation of brain functioning (in response to emotional stimuli), and to finally arrive to the analysis of the molecular pathways and the organic physiological functions that are differently modulated by CM subtypes. The last-mentioned analysis, which will be performed on a genome-wide scale, has never been conducted in this context and this is, now, possible thanks to the greater feasibility and cost reduction of this technique.
The psycho-neuro-biological view of the childhood abuse and neglect effects that we aim to obtain is more in line with a multidimensional idea of psychological alterations that is typical of the Research Domain Criteria (RDoC; NIH 2009) classification system. We indeed expect that the detected biological, neurophysiological and behavioral alterations may not be associated with specific psychopathologies, defined according to DSM5 criteria, but could instead be at the basis of specific functional alterations, such as for example anhedonia or antisocial behavior, common to different psychopathologies.
The identification of specific and new neuro-biological pathways altered by the various types of CM could help to develop new interventional pharmacological and psychological protocols. These treatment protocols, thanks to the creation of the complex individual's profile, could be personalized. This panel could be used longitudinally to both evaluate its utility as "predictor" of psychopathology and as a marker of an individual' s treatment response. Finally, the data obtained will also contribute to understanding the relevance and the contribution of the gender and timing on the outcomes of CM.
Overall this is a new approach for studying the effects of different types of CM, that lies on solid preclinical results, results that will guide us to dissect the complexity of this phenomenon in humans.