Childhood maltreatment and psychopathology: A case for ecophenotypic variants as clinically and neurobiologically distinct subtypes

By Martin H. Teicher, J. Samson. American Journal of Psychiatry, 2013

993 citations recorded by the source corpus.

Objective Childhood maltreatment increases risk for psychopathology. For some highly prevalent disorders (i.e., major depression, substance abuse, anxiety disorders and posttraumatic stress disorder) there is a substantial subset of individuals with maltreatment histories and a substantial subset without. Do those with maltreatment histories represent a clinically and biologically distinct subtype? Method The authors review literature on maltreatment as a risk factor for these disorders and on the clinical differences between individuals with and without maltreatment who share the same diagnoses. Neurobiological findings in maltreated individuals are reviewed and compared to findings reported for these disorders. Results Maltreated individuals with depressive, anxiety and substance use disorders show an earlier age of onset, greater symptom severity, more comorbidity, increased risk for suicide and poorer treatment response than non-maltreated individuals with the same diagnoses. Imaging findings associated with these disorders, such as reduced hippocampal volume and amygdala hyperreactivity are more consistently observed in maltreated individuals and may represent a maltreatment-related risk factor. Maltreated individuals also differ from others due to epigenetic modifications and genetic polymorphisms that interact with experience to increase risk for psychopathology. Conclusions Phenotypic expression of psychopathology may be strongly influenced by exposure to maltreatment leading to a constellation of ecophenotypes. While these ecophenotypes fit within conventional diagnostic boundaries, they likely represent distinct subtypes. Recognition of this distinction may be essential in determining the biological bases of these disorders. Further, treatment guidelines and algorithms may be enhanced if maltreated and non-maltreated individuals with the same diagnostic labels are differentiated.

Subfields: Clinical Psychology, Pediatrics, Perinatology and Child Health

View Paper: https://www.semanticscholar.org/paper/66cca725097b60e65775ba36d2afb0cdd7515ec8

How researchers see this paper

The researchers whose trusted networks rank it highest, strongest advocate first. Every researcher gets a different order.

In Clinical Psychology

1. J. Samson
2. C. Nemeroff
3. Martin H. Teicher
4. Gregory E. Miller
5. Robin Nusslock
6. Christine Marcelle Heim

In Pediatrics, Perinatology and Child Health

1. J. Samson
2. C. Nemeroff
3. Martin H. Teicher
4. Gregory E. Miller
5. Robin Nusslock

Citations in the corpus

• Paradise Lost: The Neurobiological and Clinical Consequences of Child Abuse and Neglect. (2016, background): “Teicher and Samson (2013) studied parental ‘‘verbal aggression’’ in 554 subjects 18–22 years of age.”
• Annual Research Review: Enduring neurobiological effects of childhood abuse and neglect (2016, positive): “Further, we proposed that the maltreated subgroup be considered a unique ecophenotype and so designated diagnostically (Teicher & Samson, 2013).”
• Early-Life Adversity and Physical and Emotional Health across the Lifespan: A Neuro-Immune Network Hypothesis (2015, background): “For example, children maltreated by their parents not only go on to develop psychiatric disorders like unipolar depression and substance abuse at higher than expected rates (2) but also show increased prevalence of metabolic syndrome, coronary heart disease, some cancers, and autoimmune conditions a”