The roles of early-life adversity and rumination in neural response to emotional faces amongst anxious and depressed adults

Abstract

Background: Early-life adversity (ELA) is a risk factor for internalizing psychopathology (IP). ELA is also linked to alterations in neural phenotypes of emotion processing and maladaptive emotion regulatory strategies, such as ruminative brooding, in adulthood. We therefore expected that ELA would predict cortical brain activation to emotional faces in transdiagnostic IP and in turn, mediate the extent of rumination amongst patients with IPs and ELA (IP + ELA).

Method: One hundred and thirty-two individuals, including 102 treatment-seeking adults with heterogeneous IPs and 30 healthy controls (HCs) performed an Emotional Face-Matching Task during functional magnetic resonance imaging. Whole-brain analyses compared HC (n = 30), IP (n = 52), and IP + ELA (n = 50) neural responses to emotional (angry, fearful, happy, and sad) faces v. shapes, controlling for depression and anxiety symptoms. Parameter estimates of activation were extracted for significant between-group differences and tested as a mediator of ruminative brooding in IP + ELA.

Results: IP + ELA demonstrated increased activation in the superior frontal gyrus and anterior cingulate cortex (fear), superior parietal lobule, precuneus, posterior cingulate, and inferior temporal gyrus (fear only), and cuneus (fear and angry). These regions were preferentially correlated with ruminative brooding in IP + ELA, many of which mediated the link between IP + ELA and ruminative brooding.

Conclusions: Results provide evidence that ELA history amongst IP patients augments engagement of brain regions involved in emotion processing, above and beyond what is accounted for by current symptoms. Though longitudinal designs are needed, alterations in the neural correlates of maladaptive processing of socio-emotional information may be a common pathway by which ELA poses risk for psychopathology.

Keywords: Anxiety; depression; early childhood adversity; emotion processing; functional neuroimaging; rumination.

Figure 1.

a) Foci of increased neural response for Fearful Faces > Shapes (cyan) and Angry Faces > Shapes (yellow). Areas of anatomical overlap between Fear > Shapes and Angry > Shapes (green). IP+ELA, IP, and HC extracted parameter estimates of activation (beta-weights) for b) Fearful > Shapes, c) Sad > Shapes, and d) Angry > Shapes. SFG = Superior Frontal Gyrus; ACC = Anterior Cingulate Cortex; PCC = Posterior Cingulate Cortex; Prec = Precuneus; SPL = Superior Parietal Lobule; ITG = Inferior Temporal Gyrus

Figure 2.

Scatterplot of association between fear-related brain activation in the right superior frontal gyrus and ruminative brooding (as unstandardized residuals after controlling for covariates). HC = Healthy Control; IP = Internalizing Psychopathology Patients; IP+ELA = Internalizing Psychopathology Patients with Early Life Adversity history.

Figure 3.

Conceptual mediation model evaluating enhanced brain activation to emotional faces as a mediator of increased ruminative brooding in IP+ELA. IP+ELA = Internalizing Psychopathology Patients with Early Life Adversity history.