Childhood adversity timing associated with resilience to anxiety later in life

Research has shown that young people who face adversity such as traumatic or stressful events during brain development are 40% more likely to develop anxiety disorders by adulthood. But most people who endure these experiences during childhood and adolescence prove to be resilient to these mental health effects.

A new Yale study finds that when this adversity occurs during brain development may affect how susceptible people are to anxiety and other psychiatric problems as adults.

According to the study, published March 5 in the journal Communications Psychology, experiencing low-to-moderate levels of adversity during middle childhood (between the ages of 6 and 12) and adolescence may foster resilience to anxiety later in life.

The researchers found that those individuals who developed resilience to mental health challenges exhibited distinct patterns of brain activation when asked to differentiate between danger and safety, a process that is known to be disrupted in people with anxiety disorders.

Greater levels of childhood adversity are associated with higher risk of mental health problems in adulthood, but our findings suggest the story is more nuanced than that."

Lucinda Sisk, a Ph.D. candidate in Yale's Department of Psychology and lead author of the study

"Our findings suggest that a distinct pattern of discrimination between threat and safety cues - specifically, greater activation of the prefrontal cortex in response to safety - is linked with lower levels of anxiety, helping us better understand the heterogeneity we see in mental health among people who experienced adversity growing up."

For the study, the researchers assessed patterns of adversity exposure in 120 adults across four stages of development: early childhood, middle childhood, adolescence, and adulthood. Using neuroimaging technology, they examined participants' corticolimbic circuitry (a network of brain regions that integrates emotion, cognition, and memory), extracting measures of neural activation as participants viewed cues that signaled either threat or safety. This offered insights into how the process of discriminating between danger and safety is related to exposure to adversity, they said. 

The researchers then analyzed the data using a person-centered model which identified cohesive groups among the participants. Specifically, the model identified three latent profiles among the participants: those with lower lifetime adversity, higher neural activation to threat, and lower neural activation to safety; those who'd experienced low-to-moderate adversity during middle childhood and adolescence, had lower neural activation to threat, and higher neural activation to safety; and those with higher lifetime adversity exposure and minimal neural activation to both threat and safety. Individuals in the second profile had lower anxiety than those in the other two profiles, researchers found.

"The people who showed low or moderate levels of adversity exposure in middle childhood and adolescence had statistically lower levels of anxiety than either the first group, which had the lowest levels of adversity overall, or the third group, which had the highest levels of adversity exposure," Sisk said.

The study demonstrates that scientists can parse the variability of mental health outcomes in people who experience adversity while their brains are developing, said Dylan Gee, an associate professor of psychology (with tenure) in Yale's Faculty of Arts and Sciences (FAS) and co-senior author of the study.

It also provides novel insight that will help to identify people who may be at heightened risk for developing anxiety disorders and other psychiatric problems, Gee said.

"This is one of the first studies to show both that the timing of adversity exposure really matters and what underlying neural processes might contribute to risk or resilience to anxiety following adversity," she said. "If the same stressor occurs at age 5 versus age 15, it is affecting a brain that is at a very different point in its development.

"This study provides insight into the sensitive periods when the brain is especially plastic, and children's experiences are likely to have the most impact on their mental health later in life," she added. "It also indicates that the brain's ability to effectively distinguish between what is safe and what is dangerous helps to protect against the development of anxiety disorders following childhood adversity."

Arielle Baskin-Sommers, an associate professor of psychology (with tenure) in FAS is co-senior author on the study. Other study coauthors are Taylor J. Keding, Sonia Ruiz, Paola Odriozola, Sahana Kribakaran, Emily M. Cohodes, Sarah McCauley, Jason T. Haberman, and Camila Caballero, all of Yale; Sadie J. Zacharek of the Massachusetts Institute of Technology; Hopewell R. Hodges of the University of Minnesota; and Jasmyne C. Pierre of the City College of New York.