Childhood maltreatment and amygdala-mediated anxiety and posttraumatic stress following adult trauma

Background Childhood abuse (physical, emotional, and sexual) is associated with aberrant connectivity of the amygdala, a key threat processing region. Heightened amygdala activity also predicts adult anxiety and posttraumatic stress disorder (PTSD) symptoms, as do experiences of childhood abuse. The current study explored whether amygdala resting-state functional connectivity (rsFC) may explain the relationship between childhood abuse and anxiety and PTSD symptoms following trauma exposure in adults. Methods Two-weeks post-trauma, adult trauma survivors (N=152, M age=32.61; SD=10.35; female=57.2%) completed the Childhood Trauma Questionnaire and underwent resting-state functional magnetic resonance imaging. PTSD and anxiety symptoms were assessed six-months post-trauma. Seed-to-voxel analyses evaluated the association between childhood abuse and amygdala rsFC. A mediation model evaluated the potential mediating role of amygdala connectivity on the relationship between childhood abuse and post-traumaanxiety and PTSD. Results Childhood abuse was associated with increased amygdala connectivity with the precuneus, covarying for age, gender, childhood neglect, and baseline PTSD symptoms. Amygdala-precuneus rsFC was a significant mediator of the effect of childhood abuse on anxiety symptoms six months post-trauma (B=0.065, CI [0.013, 0.130], SE=0.030), but not PTSD. A secondary mediation analysis investigating depression as an outcome was not significant. Discussion Amygdala-precuneus connectivity may be an underlying neural mechanism by which childhood abuse increases risk for anxiety following adult trauma. Specifically, this heightened connectivity may reflect attentional vigilance for threat or a tendency toward negative self-referential thoughts. Findings suggest that childhood abuse may contribute to longstanding upregulation of attentional vigilance circuits, which makes one vulnerable to anxiety-related symptoms in adulthood.