New research suggests that exposure to childhood adversity is associated with reduced cognitive control and alterations in key brain networks. The findings, which appear in the journal Social Cognitive and Affective Neuroscience, could help explain the link between childhood adversity and depression.
“My work focuses on how we can use objective biomarkers to aid in clinical decision making,” said study author Scott A. Langenecker of the University of Utah.
“One challenging clinical decision point is what to do when individuals have recovered from a depressive episode. Do we continue treatment? Do we exercise regular check-ins? Or do we just wait and see?”
“As depressive episodes can sneak up on people and as they may interfere with help-seeking, it may be better to have objective tools to predict risk for recurrence of depression, so that we can provide a higher level of follow-up care and preventative treatments (or maintenance therapy) for these individuals. As about half of those with remitted depression will have recurrence in a year or two, this could be a very useful clinical decision tool,” Langenecker explained.
The researchers were particularly interested in a component of cognitive control known as inhibitory control — meaning the ability to stop a hasty reflexive response. “Cognitive control impairment is associated with depression and has been observed in the remitted phase of illness,” the researchers wrote.
In the study, 53 individuals with remitted major depressive disorder and 40 healthy controls completed a Go/No-Go task measuring inhibitory control. The participants also completed a survey on childhood adversity and current life stress, and underwent a fMRI scanning session to assess gray matter volume and resting state connectivity in the brain.
The researchers found that participants who reported higher level of childhood adversity tended to exhibit poorer inhibitory control. This was true in both groups even after controlling for depression symptoms and current stressors.
Langenecker and his colleagues also found that childhood adversity was associated with alterations in three important brain networks: the cognitive control network, the salience and emotion network, and the default mode network.
“We know that depression is different for each person, and for some it is a recurrent, chronic illness somewhat like diabetes. We should be asking critical questions of our health care systems, insurance companies and providers about how we can better maintain wellness and prevent recurrence,” Langenecker told PsyPost.
“Treatment can be preventative and does not need to be reactive. Higher levels of care and proactive prevention can reduce bad outcomes (like relationship problems and divorce, education difficulties, low work productivity and quality (presenteeism), and risk for suicide).”
The study — like all research — has some limitations.
“The main caveat is that the study has not yet been replicated, and in a larger sample. Many interesting leads like this do not replicate because of subtle differences in the samples used and analysis techniques,” Langenecker explained.
“I’d like to encourage individuals who struggle with depression to demand better preventative treatment options and better insurance coverage for these types of biometric tools,” he added. “Ask your care provider what steps they take for evidence-based practice. Ask them to use objective measures of treatment change and empirically based treatments.”
The study, “Cognitive control and network disruption in remitted depression: a correlate of childhood adversity“, was authored by Meghan E. Quinn, Jonathan P. Stange, Lisanne M. Jenkins, Samantha Corwin, Sophie R. DelDonno, Katie L. Bessette, Robert C. Welsh, and Scott A. Langenecker.
