Article summary with Pass it on? The neural responses to rejection in the context of a family study on maltreatment by van den Berg a.o. - 2018

Introduction

Child physical and emotional abuse and neglect are associated with increased risk for long-lasting behavioural, physical, and mental problems. Among the adverse consequences is the increased risk for maltreated individuals to maltreat their own children. to better identify risk factors for perpetrating abuse and neglect, it is crucial to examine factors that might play a role in the transmission of maltreatment. This multigenerational family study investigates the impact of experienced and perpetrated abuse and neglect on neural reactivity to social exclusion in 144 family members (90 parents and 54 offspring).

A core aspect of child abuse and neglect is parental rejection of needs for attention and nurturance, which can occur through parental aggression and hostility or via parental neglect and indifference. Chronic exposure to rejection during childhood is linked to emotional, cognitive, behavioural, and social deficits, like decreased self-esteem and hypersensitivity to signs of threat and rejection. Rejection sensitivity is associated with increased feelings of aggression and aggressive behaviour. Being rejected by your parents can enhance sensitivity for social rejection in many situations, including next-generation parent-child interactions.

Many studies show that the network of brain areas associated with social rejection and exclusion includes the insula, anterior cingulate cortex (ACC) and medial prefrontal cortex (mPFC). Altered neural responses to social exclusion have been observed in maltreated individuals. A history of maltreatment appears to affect neural networks that are also implicated in parenting behaviour. These networks enable parents to respond to infant pain and emotions, understand non-verbal signals, and infer intentions through empathy and mentalizing.

In sum this study examines the impact of experienced and perpetrated abuse and neglect on neural reactivity to social exclusion by strangers and family members using a multi-informant, multigenerational family design.

Materials & Methods

Participants

The sample was part of a larger sample from the 3G parenting study, a three-generation family study on the intergenerational transmission of parenting styles, stress, and emotion regulations. Ultimately 144 participants from two generations (parents and their offspring) of 54 families were included.

Procedure

Informed consent was obtained after describing the study to the participants. If eligible, participants did an fMRI session, performing three tasks in the scanner.

Measures

• Childhood maltreatment: adapted versions of the Conflict Tactics Scales (CTS) were administered in combination with the emotional neglect scale from the Childhood Trauma Questionnaire (CTQ-SF) to measure experienced childhood abuse and neglect by mother and/or father.
• Cyberball task: a commonly used paradigm to study the neural correlates of social exclusion. For his study an adapted version of the task was used where participants played two rounds of this with virtual ball-tossing game with two other players.
• Mood and need satisfaction: right before the cyberball game and right after each round of the game, participants completed four items from a mood questionnaire which measured feeling sad, happy, angry, and insecure. After each round additional items from the Need Threat Scale were completed to measure levels of need satisfaction, which measured belonging, control, self-esteem, and meaningful existence.
• Covariates: questionnaires were used to assess demographic information (age, gender, handedness, and household social economic status (SES)).

Results & conclusion

It was found that exclusion by strangers was especially associated with increased activity in the left insula while exclusion by a family member was mainly associated with higher activation in the ACC. Furthermore, altered neural activity to social exclusion by strangers in the insula, ACC, and dmPFC was associated with experienced maltreatment but not with parents’ own maltreating behaviour, indicating different neural correlates of experienced and perpetrated maltreatment. More specifically, hypersensitivity to social rejection in maltreated individuals was mainly driven by experienced neglect. Furthermore, exploratory analyses showed that abusive parents exhibited lower activation in the pre- and post-central gyrus during exclusion by strangers, possibly reflecting lower levels of perspective taking and empathic abilities. This study underscores the importance to distinguish between effects of abuse and neglect and suggests that the impact of experiencing rejection and maltreatment by your own parents goes beyond the family context.

What are the Strengths & limitations of this study?

This is the first multigenerational family study where differential neural effects of (experienced and perpetrated) abuse and neglect are examined, and the role of neural reactivity to social exclusion by strangers versus family is investigated. Research about the neural correlates of childhood maltreatment and maltreating parenting behaviour in particular is scarce, and our family study design enabled the investigation of intergenerational transmission of maltreatment directly. Another strength is that parent (both fathers and mothers) and child reports of maltreatment were combined to minimize the influence of individual reporter bias. Moreover, this study allowed to differentiate between a general sensitivity for exclusion versus rejection sensitivity in the family context.

A limitation is the use of retrospective reports to measure maltreatment, which can be subject to recall bias. However, parent and child reports in maltreatment scores were combined. Moreover, in this paradigm names of family members were used. For future research, pictures of own offspring and parents might be used, although this would decrease standardization of the task. Further, the sample to examine the effects of perpetrated maltreatment was smaller than the sample to assess effects of experienced maltreatment since only part of the sample were parents.