ABSTRACT
The aim of this study was to examine the relationship of maternal interpersonal violence-related posttraumatic stress disorder (IPV-PTSD), associated neural activity in response to mother-child relational stimuli, and child psychopathology indicators at child ages 12-42 months and one year later. The study tested the hypothesis that decreased maternal neural activity in regions that subserve emotion regulation would be associated with child symptoms associated with emotional dysregulation at both time points. Functional magnetic resonance imaging of 42 mothers with or without violence-exposure and associated IPV-PTSD were assessed. Their child's life-events and symptoms/behaviors indicative of high-risk subsequent PTSD diagnosis on a maternal-report questionnaire were measured one year later. Maternal IPV-PTSD severity was significantly associated with decreased ventromedial prefrontal cortex (vmPFC) activation in response to mother-child relational stimuli. Maternal IPV-PTSD severity and decreased vmPFC activation were then significantly associated with a child attachment disturbance at 12-42 months and symptoms/behaviors one year later, that were correlated with emotional dysregulation and risk for child PTSD. Maternal IPV-PTSD and child exposure to IPV were both predictive of child PTSD symptoms with maternal IPV-PTSD likely mediating the effects of child IPV exposure on child PTSD symptoms. These findings suggest that maternal IPV-PTSD severity and associated decreased vmPFC activity in response to mother-child relational stimuli are predictors of child psychopathology by age 12-42 months and one-year later. Significant findings in this paper may well be useful in understanding how maternal top-down cortico-limbic dysregulation promotes intergenerational transmission of IPV and related psychopathology and, thus should be targeted in treatment.
Subject(s)
Exposure to Violence/psychology , Mothers/psychology , Stress Disorders, Post-Traumatic/diagnosis , Adult , Brain/diagnostic imaging , Case-Control Studies , Child Behavior , Child, Preschool , Female , Humans , Infant , Interviews as Topic , Linear Models , Magnetic Resonance Imaging , Male , Mother-Child Relations , Phobic Disorders/diagnosis , Phobic Disorders/etiology , Prefrontal Cortex/diagnostic imaging , Severity of Illness Index , Stress Disorders, Post-Traumatic/pathology , Surveys and QuestionnairesABSTRACT
BACKGROUND: Methylation of the serotonin 3A receptor gene (HTR3A) has been linked to child maltreatment and adult psychopathology. The present study examined whether HTR3A methylation might be associated with mothers' lifetime exposure to interpersonal violence (IPV), IPV-related psychopathology, child disturbance of attachment, and maternal neural activity. METHODS: Number of maternal lifetime IPV exposures and measures of maternal psychopathology including posttraumatic stress disorder (PTSD), major depression and aggressive behavior (AgB), and a measure of child attachment disturbance known as "secure base distortion" (SBD) were assessed in a sample of 35 mothers and children aged 12-42 months. Brain fMRI activation was assessed in mothers using 30-s silent film excerpts depicting menacing adult male-female interactions versus prosocial and neutral interactions. Group and continuous analyses were performed to test for associations between clinical and fMRI variables with DNA methylation. RESULTS: Maternal IPV exposure-frequency was associated with maternal PTSD; and maternal IPV-PTSD was in turn associated with child SBD. Methylation status of several CpG sites in the HTR3A gene was associated with maternal IPV and IPV-PTSD severity, AgB and child SBD, in particular, self-endangering behavior. Methylation status at a specific CpG site (CpG2_III) was associated with decreased medial prefrontal cortical (mPFC) activity in response to film-stimuli of adult male-female interactions evocative of violence as compared to prosocial and neutral interactions. CONCLUSIONS: Methylation status of the HTR3A gene in mothers is linked to maternal IPV-related psychopathology, trauma-induced brain activation patterns, and child attachment disturbance in the form of SBD during a sensitive period in the development of self-regulation.
Subject(s)
Adult Survivors of Child Adverse Events/psychology , Aggression/physiology , Child Behavior/physiology , Exposure to Violence/psychology , Object Attachment , Prefrontal Cortex/physiopathology , Receptors, Serotonin, 5-HT3/metabolism , Self-Control , Stress Disorders, Post-Traumatic/physiopathology , Adult , Child, Preschool , DNA Methylation , Depressive Disorder, Major/physiopathology , Female , Humans , Infant , Magnetic Resonance Imaging , Male , Prefrontal Cortex/diagnostic imagingABSTRACT
The efficacy of the dyadic psychoanalytic method cannot be verified empirically, due to the impossibility of counterfactuals, controls, or double-blind experiments, although inventive psychoanalytic researchers have established validation methodologies for analyzing groups of case studies, outcomes, and even theoretical precepts. The unavailability of complete empirical validation for the most basic method of the discipline of psychoanalysis, or of its fundamental "report of findings"--the case study--means that the field's scientific rationale must be supplemented with public reasoning of another sort. Fortunately, the very conditions of uncertainty that make it impossible to falsify the findings of dyadic psychoanalysis lend it its ethical force by compelling its participants to confront the basic human dilemmas of freedom, meaning, and judgment, the ethical horizon of human affairs. One substantial value of psychoanalysis, then, is its capacity for generating "ethical knowledge" of the sort adumbrated by Aristotle's conception of practical knowledge (phronesis). Case studies written for a lay audience to highlight these basic dilemmas can demonstrate that psychoanalysis produces crucial knowledge, specific to individuals, for living a healthy and satisfying life.
