Abstract
Childhood maltreatment (CM) is one of the strongest predictors of adult mental illness,
although not all adults with CM develop psychopathology. Here, we describe the structure
and function of the emotional brain regions that may contribute to resilient functioning
after CM. We review studies that report medial prefrontal cortex, amygdala, and hippocampus
(limbic regions) structure, function, and/or connections in resilient adults (i.e.,
those reporting CM without psychopathology) versus vulnerable adults (i.e., those
reporting CM with psychopathology) or healthy adults (those without CM and with no
psychopathology). We find that resilient adults have larger hippocampal gray and white
matter volume and greater connectivity between the central executive network and the
limbic regions. In addition, resilient adults have improved ability to regulate emotions
through medial prefrontal cortex–limbic downregulation, lower hippocampal activation
to emotional faces, and increased amygdala habituation to stress. We highlight the
need for longitudinal designs that examine resilient functioning across domains and
consider gender, type, timing, and nature of CM assessments and further stressors
to further improve our understanding of the role of the emotional brain in resilient
functioning after CM.
Keywords
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Article info
Publication history
Published online: December 19, 2019
Accepted:
December 6,
2019
Received in revised form:
November 18,
2019
Received:
July 19,
2019
Identification
Copyright
© 2019 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
