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. 2023;14(1):2181766.
doi: 10.1080/20008066.2023.2181766.

The long-term impact of early adverse experience on adaptive functioning: a pilot study integrating measures of mental status, nonverbal communication, and heart rate variability

Silvia Bussone  1 , Chiara Pesca  1 , Valentina Casetti  2 , Roberta Croce Nanni  3 , Cristina Ottaviani  4   5 , Alfonso Troisi  2 , Valeria Carola  1   5
Affiliations

The long-term impact of early adverse experience on adaptive functioning: a pilot study integrating measures of mental status, nonverbal communication, and heart rate variability

Silvia Bussone et al. Eur J Psychotraumatol. 2023.

Abstract
in English, Spanish, Chinese

Background: Childhood maltreatment (CM) can disrupt the development of behavioural and physiological systems, increasing the risk of physical and psychological adverse outcomes across the lifespan. CM may cause interpersonal dysfunctions that impair social communication and lead to dysfunctional activation of the autonomic nervous system. The present exploratory study analyzed the long-term impact of CM from an integrated perspective through the simultaneous assessment of psychological symptoms, social and behavioural communication, and physiological regulation.Methods: Participants were 55 healthy university students (9 males and 46 females; mean age ± SD = 25.26 ± 2.83 years), who filled out a battery of questionnaires to assess the presence of CM (Childhood Trauma Questionnaire) and psychopathological symptoms (Symptom Check-List-90 Item Revised). Participants were then subjected to a videotaped interview for the assessment of non-verbal behaviour (Ethological Coding System for Interviews) and measurement of tonic heart rate variability (HRV), a measure of physiological adaptability to the environment. We performed Pearson's correlation analysis to evaluate the associations between non-verbal behaviour, HRV, and CM variables. Multiple regression analysis was used to evaluate the independent associations between CM variables on HRV and nonverbal behaviour.Results: We found an association between more severe CM, increased symptoms-related distress (ps < .001), less submissive behaviour (ps < .018), and decreased tonic HRV (ps < .028). As a result of multiple regression analysis, participants with a history of emotional abuse (R² = .18, p = .002) and neglect (R² = .10, p = .03) were more likely to display decreased submissive behaviour during the dyadic interview. Moreover, early experience of emotional (R² = .21, p = .005) and sexual abuse (R² = .14, p = .04) was associated with decreased tonic HRV.Conclusion: Our preliminary findings show the utility of analyzing the long-term effects of adverse early experiences at different levels of 'adaptive functioning' (the capabilities needed to respond effectively to environmental demands).

Antecedentes: El maltrato infantil (MI) puede interrumpir el desarrollo de los sistemas fisiológicos y de comportamiento, lo que aumenta el riesgo de consecuencias adversas físicas y psicológicas a lo largo de la vida. A nivel conductual, el MI puede causar disfunciones interpersonales que perjudican la comunicación social y conducen a una activación disfuncional del sistema nervioso autónomo. El objetivo del presente estudio exploratorio es analizar el impacto a largo plazo del MI desde una perspectiva integrada a través de la evaluación simultánea de los síntomas psicológicos, la comunicación social y conductual, y la regulación fisiológica.

Métodos: Participaron 55 estudiantes universitarios sanos (9 hombres y 46 mujeres; edad media ± DE = 25,26 ± 2,83 años), que completaron una batería de cuestionarios para evaluar la presencia de MI (Cuestionario de Trauma Infantil – versión abreviada) y síntomas psicopatológicos (Lista de Verificación de Síntomas de 90 ítems Revisado). Luego, los participantes fueron sometidos a una entrevista grabada en video para la evaluación del comportamiento no verbal (Sistema de codificación etológica para entrevistas) y la medición de la variabilidad de la frecuencia cardíaca tónica (HRV, por sus siglas en inglés), una medida de adaptabilidad fisiológica al entorno. Realizamos el análisis de correlación de Pearson para evaluar las asociaciones entre las variables de comportamiento no verbal, HRV y MI. Luego, se utilizó un análisis de regresión múltiple para evaluar las asociaciones independientes entre las variables de MI en HRV y el comportamiento no verbal.

Resultados: Encontramos una asociación entre MI más severa, mayor malestar relacionado con los síntomas (ps < .001), menos comportamiento sumiso (ps < .018) y disminución de la HRV tónica (ps < .028). Como resultado del análisis de regresión múltiple, los participantes con antecedentes de abuso emocional (R² = 0,18, p = 0,002) y negligencia (R² = 0,10, p = 0,03) tenían más probabilidades de mostrar un comportamiento de sumisión disminuido durante la entrevista diádica. Además, la experiencia temprana de abuso emocional (R² = 0,21, p = 0,005) y sexual (R² = 0,14, p = 0,04) se asoció con una disminución de la HRV tónica.

Conclusión: Nuestros hallazgos preliminares muestran la utilidad de analizar los efectos a largo plazo de las primeras experiencias adversas en diferentes niveles de "funcionamiento adaptativo" (las capacidades necesarias para responder de manera efectiva a las demandas ambientales). Se necesitan estudios futuros para replicar la validez del presente estudio piloto centrándose en poblaciones clínicas con tasas de prevalencia más altas de maltrato infantil.

背景：童年期虐待 (CM) 会破坏行为和生理系统的发育，增加一生中身体和心理不良后果的风险。 在行为层面，CM 可能会导致人际功能障碍，从而损害社会沟通并导致自主神经系统功能失调。 本探索性研究旨在通过同时评估心理症状、社会和行为交流以及生理调节，从综合角度分析 CM 的长期影响。

方法：参与者是 55名健康的大学生（9 名男性和 46 名女性；平均年龄 ± SD = 25.26 ± 2.83 岁），他们填写了一组问卷以评估 CM（简版童年期创伤问卷）和精神病症状的存在 （修订版90 条目症状检查表）。 然后对参与者进行录像访谈，以评估非语言行为（采访行为学编码系统）和强直心率变异性 (HRV) 测量，这是一种对环境的生理适应性的测量。 我们进行了皮尔逊相关性分析来评估非语言行为、HRV 和 CM 变量之间的关联。 然后，使用多元回归分析评估 CM 变量与 HRV 和非语言行为之间的独立关联。

结果：我们发现更严重的 CM、增加的症状相关痛苦(ps < .001)、降低的顺从行为 (ps < .018) 和减小的强直性 HRV (ps < .028) 之间存在关联。 作为多元回归分析的结果，有情感虐待史 (R² = .18, p = .002) 和忽视史 (R² = .10, p = .03) 的参与者更有可能在二元访谈期间表现出更少的顺从行为。 此外，早期的情绪经历 (R² = .21, p = .005) 和性虐待 (R² = .14, p = .04) 与强直 HRV 降低有关。

结论：我们的初步研究结果表现出在不同水平‘适应性功能’（有效响应环境需求所需的能力）下分析不良早期经历的长期影响的实用性。 未来的研究需要通过关注儿童虐待流行率较高的临床人群来重复本试点研究的有效性。

Keywords: Comunicación no verbal; Early-life stress; Estrés en la vida temprana; Variabilidad del ritmo cardíaco; heart rate variability; nonverbal communication; 心率变异性; 早年生活压力; 非口头交流.

Plain language summary

Substantial traumatic experiences during childhood, such as emotional abuse, emotional neglect, and sexual abuse were associated with lower heart rate variability levels in a sample of young adults.Young adults with a history of emotional abuse and neglect were more likely to display decreased submissive behaviour (ethological behaviour) during the dyadic interview.Severe childhood maltreatment was associated with increased symptoms-related distress, less submissive behaviour (ethological behaviour), and decreased tonic heart rate variability in young adults.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

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