Different types of childhood maltreatment appear to uniquely shape human brain development

A recent study published in Biological Psychiatry provides evidence that experiencing abuse or neglect during childhood is linked to specific physical changes in brain structure that vary based on a person’s age and sex. The research suggests these structural differences become most visible during young adulthood, with young women showing the most extensive brain alterations following early life adversity.

An extensive international team of researchers, representing dozens of institutions across eight countries, initiated this study to better understand the relationship between early life adversity and brain development. Many people who experience childhood maltreatment eventually develop stress-related mental health conditions, such as major depressive disorder and posttraumatic stress disorder.

Past studies often looked at the brains of people with these psychiatric conditions without separating the effects of the mental illness from the effects of the childhood trauma itself. The researchers wanted to isolate the physical impact of maltreatment across different stages of human life to see how the brain adapts to stress.

“Early life adversity, and particularly childhood maltreatment, remains one of the most potent risk factors for mental illness,” said study author Tiffany C. Ho, an associate professor at the University of California, Los Angeles and head of the Cognition, Affect, and Neurodevelopment in Youth Lab.

Prominent psychological theories distinguish between adversity characterized by active threat, such as physical abuse, and adversity characterized by deprivation, such as emotional neglect. Threat-related trauma tends to affect regions involved in fear learning and stress regulation. Deprivation-related neglect often influences circuits that handle reward processing and social functioning.

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To measure these subtle changes, the researchers used a technique called normative modeling. This approach tracks brain development similarly to how a pediatrician uses a growth chart for a child’s height and weight.

By creating a standard model of normal brain variation across different ages and sexes, they could pinpoint exactly where a trauma-exposed brain deviates from expected developmental patterns. This method helps separate true trauma responses from regular biological differences between individuals.

To conduct the study, the researchers analyzed data from 3,711 participants across 25 international sites in eight different countries. The sample included 1,389 patients diagnosed with either major depressive disorder or posttraumatic stress disorder, as well as 2,322 healthy participants. The combined group had an average age of 33.3 years, and 59.9 percent of the participants were female.

Participants completed a self-report survey called the Childhood Trauma Questionnaire-Short Form. This assessment measures the severity of emotional, physical, and sexual abuse, as well as physical and emotional neglect. The scientists separated general abuse and general neglect scores to see if different types of trauma produce different physical effects.

The scientists then used magnetic resonance imaging, commonly known as MRI, to take highly detailed pictures of the participants’ brains. They measured 14 subcortical volumes, which represent the sizes of deep internal brain structures.

They also collected 68 measures of cortical thickness and 68 measures of surface area. Cortical thickness refers to the depth of the brain’s wrinkled outer layer, while surface area refers to how much total space that folded outer layer covers.

The researchers divided the participants by sex and placed them into three distinct age groups. These groups included a pediatric cohort of individuals 18 years old and younger, young adults between 18 and 35 years old, and older adults aged 35 and older.

The data revealed that childhood maltreatment is associated with specific brain deviations that depend heavily on both biological sex and developmental stage. The strongest structural differences were observed in young adult females.

In this specific group, more severe abuse and neglect correlated with a smaller hippocampus and a smaller putamen. The hippocampus is a deep brain region heavily involved in memory and learning, while the putamen helps regulate movement and learning.

Young women who experienced trauma also showed a thinner entorhinal cortex, an area vital for navigating physical space and processing time. Additionally, they displayed increased surface area in the orbitofrontal cortex, a region at the very front of the brain that helps regulate emotions and complex decision-making.

For male participants, the structural changes varied greatly depending on the specific type of trauma. Young adult males with a history of abuse showed a wide range of differences, including a thicker medial orbitofrontal cortex.

These men also exhibited larger volumes in the thalamus and pallidum. The thalamus acts as a major relay station for sensory information, while the pallidum is involved in motivation and behavior. Neglect, by contrast, had very minimal associations with brain structure in males.

The researchers found no significant structural brain differences related to trauma in the pediatric group. They note that the physical effects of early life adversity might remain dormant during childhood before fully emerging in early adulthood.

Some brain regions in adults showed larger structures, while others were smaller than the standard growth charts predicted. This opposing pattern suggests the brain tends to actively reorganize its neural circuits to cope with the trauma over time.

“There is no single neuroanatomical scar of childhood maltreatment: the effects depend on the form of adversity experienced (e.g., abuse versus neglect), sex, and age,” Ho told PsyPost. “Overall, young adult females exhibit more widespread effects of abuse on brain structure, whereas the effects of neglect are far more circumscribed, with these patterns persisting at a reduced magnitude into older adulthood.”

“Young adult males exhibit some of the same brain structural alterations in relation to childhood abuse as do females, but, in contrast, experiences of childhood neglect among males appear to have minimal effects on the neuroanatomical features examined in this study.”

The study provides an extensive look at trauma and brain structure. But, like all research, there are some limitations. Because the research relied on cross-sectional data, meaning it captured a single snapshot in time for each person, it cannot definitively prove that childhood maltreatment directly caused these brain changes.

The self-report survey also relies on participants’ personal memories, which can sometimes be imprecise. The questionnaire misses other forms of early adversity as well, such as exposure to environmental toxins or severe housing instability.

The lack of findings in the pediatric group might simply be a result of the smaller sample size of 349 children. The scientists suggest that this specific group likely did not provide enough statistical power to detect subtle physical differences in the developing brain.

Future studies could follow the same individuals over several years to observe how trauma alters brain development in real time. Scientists also aim to investigate whether these distinct physical differences can predict how well a patient might respond to psychological or medical treatments.

Ultimately, understanding these unique brain patterns may help doctors design more personalized therapies for individuals with a history of early life adversity. Recognizing how trauma shapes the brain is a necessary step toward providing better care.

“My research focuses on the neuroscience of adversity, stress, and depression in humans,” Ho said. “One of the more surprising findings from my research is that the effects of depression and other similar conditions (e.g., PTSD) on the brain are rather small in magnitude and may even be partially explained by the effects of early life adversity on the brain.”

“At the same time, it is remarkable to see how common experiences of early life adversity and childhood maltreatment are, and that most exposed individuals do not necessarily go onto develop mental illness, which speaks to how adaptive and resilient the human brain is.”

The study, “Childhood Maltreatment and Deviations from Normative Brain Structure: A Mega-Analysis of 3,711 Individuals from the ENIGMA MDD and ENIGMA PTSD Working Groups,” was authored by Haley R. Wang, Zhen-Qi Liu, Elena Pozzi, Ahmed Hussain, Priyanka Sigar, Chadi Abdallah, Nina Alexander, Justin Baker, Jochen Bauer, Jennifer Urbano Blackford, Josh Cisler, Colm G. Connolly, Andrew Cotton, Judith Daniels, Udo Dannlowski, Maria Densmore, Terri deRoon-Cassini, Danai Dima, Stefan Du Plessis, Amit Etkin, Negar Fani, Lukas Fisch, Jacklynn Fitzgerald, Thomas Frodl, Cynthia H.Y. Fu, Ali Saffet Gonul, Evan M. Gordon, Ian Gotlib, Roberto Goya-Maldonado, Nynke A. Groenewold, Dominik Grotegerd, Tim Hahn, J. Paul Hamilton, Laura Han, Ilan Harpaz-Rotem, Courtney C. Haswell, Ryan Herringa, Julia Herzog, Jonathan Ipser, Neda Jahanshad, Tanja Jovanovic, Milissa Kaufman, Tilo Kircher, Maximilian Konowski, Sheri-Michelle Koopowitz, Axel Krug, John Krystal, Ruth Lanius, Christine Larson, Amit Lazarov, Lauren Lebois, Elisabeth Leehr, Ifat Levy, Meng Li, Antje Manthey, Adi Maron-Katz, Andrew McIntosh, Katie McLaughlin, Susanne Meinert, Benson Mwangi, Steven M. Nelson, Igor Nenadić, Yuval Neria, Richard Neufeld, Amar Ojha, Bunmi Olatunji, Elizabeth A. Olson, Nils Opel, Matthew Peverill, Kerry Ressler, Marisa Ross, Isabelle Rosso, Matthew Sacchet, Kelly Sambrook, Christian Schmahl, Soraya Seedat, Martha E. Shenton, Maurizio Sicorello, Anika Sierk, Jair C. Soares, Dan J. Stein, Frederike Stein, Murray B. Stein, Benjamin Suarez-Jimenez, Jean Théberge, Sophia I. Thomopoulos, Carissa Tomas, Paula Usemann, Leigh L. van den Heuvel, Sanne van Rooij, Henrik Walter, Martin Walter, Xin Wang, Heather Whalley, Nils R. Winter, Mon-Ju Wu, Hong Xie, Tony Yang, Xi Zhu, Sigal Zilcha-Mano, Giovana B. Zunta-Soares, Sophia Frangou, Paul M. Thompson, Lauren Salminen, Delin Sun, Rajendra Morey, Jennifer S. Stevens, Lianne Schmaal, and Tiffany C. Ho.