Childhood abuse linked to thalamus size in violent mental health patients

By Mark Cowen, Senior medwireNews Reporter

Childhood psychosocial deprivation is associated with significantly reduced thalamic volume among violent individuals with antisocial personality disorder (ASPD) or schizophrenia, researchers report.

The team also found that higher levels of childhood psychosocial deprivation, particularly physical and sexual abuse, were associated greater reductions in thalamic volume among violent individuals with these mental health disorders.

"It is possible that a thalamic deficit leads to poor gating, which in turn makes it harder for these individuals to suppress intrusive memories and thoughts related to their abuse/maltreatment," comment Veena Kumari (King's College London, UK) and team.

The findings come from a study of 56 men with ASPD (n=13) or schizophrenia (n=28) and 15 mentally healthy controls. All patients with ASPD and 13 of those with schizophrenia had a history of serious violence.

Magnetic resonance imaging was used to compare brain volumes among the groups, and all participants were assessed for childhood physical abuse, sexual abuse, neglect, extreme poverty, foster home placement, having a criminal parent, severe family conflict, or a broken home on a psychosocial deprivation scale of 0 (none) to 4 (extreme).

The researchers found that psychosocially deprived violent individuals with ASPD or schizophrenia had significantly reduced mean thalamic volume compared with nondeprived violent patients with these disorders, at 9.58 and 10.01 cm3 versus 12.66 and 10.68 cm3, respectively, and controls, at 11.59 cm3.

In violent patients, thalamic volume was negatively associated with total psychosocial deprivation scores, and with physical and sexual abuse subscores.

In nonviolent participants, there was a trend toward reduced hippocampal and prefrontal volumes in psychosocially deprived individuals.

Voxel-based-morphometry analysis revealed that, among all participants, total psychosocial deprivation was significantly negatively associated with gray matter volume in the left prefrontal cortex.

In addition, total PSD score was significantly negatively associated with gray matter volume in the left precentral gyrus, and at a trend level in the left middle frontal gyrus, in nonviolent individuals.

Kumari and team conclude in European Psychiatry: "Violent mentally-disordered individuals with significant psychosocial deprivation, relative to those with no or minimal psychosocial deprivation, on average suffer from an additional brain deficit, ie, reduced thalamic volume."

They add: "This may have implications for management and treatment of violent mentally-disordered individuals with psychosocial deprivation."

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