But what if those kids could regulate their emotions? Could that better help them cope with difficult situations? Would it impact how effective therapy might be for them?

A 91±¬ĮĻ-led team of researchers sought to address those questions by studying what happens in the brains of maltreated adolescents when they viewed emotional images, and then tried to control their responses to them. The researchers found that with a little guidance, maltreated children have a surprising ability to regulate their emotions.

ā€œThey were just as able as other children to modulate their emotional responses when they were taught strategies for doing so,ā€ said , a 91±¬ĮĻ assistant professor of psychology and the studyā€™s lead author. ā€œThatā€™s very encouraging.ā€

Difficulties with regulating emotions are linked to the onset of mental disorders among maltreated children. Previous research has focused on how the brains of such children respond spontaneously to negative facial emotions, but the , published Aug. 20 in the Journal of the American Academy of Child and Adolescent Psychiatry, is thought to be the first looking at whether maltreatment impacts brain regions involved in emotion control.

The study involved 42 boys and girls age 13 to 19, half of whom had been physically and/or sexually abused. Using magnetic resonance imaging, the researchers tracked the teensā€™ brain activity as they were shown a series of photographs.

The teens were first shown neutral, positive and negative images and were told to let their emotions unfold naturally. The neutral images featured outdoor scenes or objects, such as a coffee cup or a pair of glasses, while the positive and negative images depicted scenarios showing people with different facial expressions ā€” a smiling family engaged in a fun activity, for example, or two people arguing. The exercise was intended to model real-world emotional situations, McLaughlin said.

ā€œHow much do you react when something emotional happens? Some people have really strong emotional reactions. Some people have much more muted responses,ā€ said McLaughlin, director of the 91±¬ĮĻā€™s .

ā€œThe question is, do we see differences in the brain in terms of how it responds to emotional information in kids who have been maltreated?ā€

The answer is yes, the researchers concluded. The positive images generated little difference in brain activity between the two groups. But when looking at negative images, the maltreated teens had more activity in brain regions involved in identifying potential threats ā€” including the amygdala, which plays a key role in processing emotions and learning about environmental threats ā€” than the control group. That makes sense, McLaughlin said, since in a chronically dangerous environment the brain is on heightened alert, constantly on the lookout for potential threats.

In a second exercise, participants were shown more photos and told to try to increase their emotional responses to the positive images and scale them back when viewing the negative images, using techniques they were taught beforehand. The children were shown how to use cognitive reappraisal, a strategy that involves thinking about a situation differently to alter the emotional response to it.

Participants thought about the negative images in ways that made them psychologically more distant ā€” for example, thinking that the people in the photos were strangers or that the scene was not really happening.

For the positive cues, they thought about the images in a way that made them more realistic, such as imagining that they were part of the happy scene or that it involved people they knew.

Again, the two groups were similar in their brain responses to the positive images. But the negative photos caused the maltreated teensā€™ brains to go into overdrive, drawing more heavily on regions in the prefrontal cortex to tamp down their feelings. The prefrontal cortex is involved in higher-order cognition and integrates information from other areas of the brain to effectively control emotions and behaviors and guide decision-making.

Though it was more difficult for them, the maltreated teens were able to modulate activity in the amygdala just as well as the participants with no history of maltreatment. That suggests that given the right tools, maltreated children may be able to control their emotional responses to real-world situations.

It also has promising implications for treatment, McLaughlin said, since the strategies participants used in the study are similar to those used in trauma therapy. Specifically, cognitive reappraisal, the strategy children used to regulate their emotions in the study, is a core technique used in trauma-focused treatments for children.

Thereā€™s a common assumption that children subjected to abuse or trauma will have problematic emotions across the board, McLaughlin said ā€” muted responses to positive situations and extreme reactions to negative ones. But the studyā€™s findings suggest that maltreated children are perhaps more resilient and adaptable than previously thought.

ā€œIt seems that they are able to cope effectively, even in very stimulating emotional situations, if theyā€™re taught strategies for doing so,ā€ she said. ā€œWe think the findings are really promising.ā€

The research was funded by the National Institutes of Health and the Charles H. Hood Foundation. Co-authors are 91±¬ĮĻ psychology graduate student Matthew Peverill, Andrea Gold of the National Institute of Mental Health, Sonia Alves of Harvard University and Boston Childrenā€™s Hospital, and Margaret Sheridan of Harvard University.

New 91±¬ĮĻ research finds that children’s early environments have a lasting impact on their responses to stress later in life, and that the negative effects of deprived early environments can be mitigatedĀ ā€” but only if that happens before age 2.

April 20 in the Proceedings of the National Academy of Sciences, the research is believed to be the first to identify a sensitive period during early life when children’s stress response systems are particularly likely to be influenced by their caregiving environments.

“The early environment has a very strong impact on how the stress response system in the body develops,” said lead author , a 91±¬ĮĻ assistant professor of psychology.

“But even kids exposed to a very extreme negative environment who are placed into a supportive family can overcome those effects in the long term.”

The study focuses on children who spent the first years of their lives in Romanian orphanages and others who were removed from orphanages and placed in foster care. It finds that the institutionalized children had blunted stress system responses ā€” for example, less heart rate acceleration and blood pressure increases during stressful tasks and lower production of cortisol, the primary hormone responsible for stress response.

By comparison, children who were removed from the Romanian institutions and placed with foster parents before the age of 24 months had stress system responses similar to those of children being raised by families in the community.

The results suggest that children’s early experiences can impact the development of the stress response system, and that removing them from adverse environments can mitigate such damaging effects.

“Institutionalization is an extreme form of early neglect,” McLaughlin said. “Placing kids into a supportive environment where they have sensitive, responsive parents, even if they were neglected for a period of time early in life, has a lasting, meaningful effect.”

TheĀ researchĀ is part of the , launched in 2000 to study the effects of institutionalization on brain and behavior development among some of the thousands of Romanian children placed in orphanages during dictator Nicolae Ceausescu’s reign.

Researchers tested 138 children at about age 12 from three groups: those who had spent several years in institutions, others who were removed from institutions and placed into high-quality foster care, and children raised in families living in areas near the institutions.

The children placed into foster care were moved at between six months and 3 years of age. Those left in institutions remained there for varying amounts of time before eventually being adopted, reunited with their biological parents or placed in government foster care after policies around institutionalization changed in Romania.

During the tests, children were asked to perform potentially stressful tasks including delivering a speech before teachers, receiving social feedback from other children and playing a game that broke partway through. Researchers measured the children’s heart rate, blood pressure and several other markers including cortisol.

The children raised in institutions showed blunted responses in the sympathetic nervous system, associated with the flight or fight response, and in the , which regulates cortisol. A dulled stress response system is linked to health problems including chronic fatigue, pain syndrome and autoimmune conditions, as well as aggression and behavioral problems.

“Together, the patterns of blunted stress reactivity among children who remained in institutional care might lead to heightened risk for multiple physical and mental health problems,” the researchers write.

McLaughlin said it’s difficult to say for certain why the children’s stress response systems were blunted. It’s possible that since they endured such extreme stress early in life, the tasks the researchers put them through were relatively benignĀ in comparison and thusĀ did not evoke a strong response.

More significantly, McLaughlin said, their stress response systems might have been initially hyperactive at earlier points in development, then adapted to high levels of stress hormones by reducing the number of receptors in the brain that stress hormones bind to.

“If we’d been able to measure their stress systems early in life, we would expect to find very high levels of stress hormones and stress reactivity,” she said.

Related research from the study found that children raised in the orphanages had in areas linked to impulse control and attention, and overall.

The children involved in the study are now about 16 years old, and researchers next plan to investigate whether puberty has an impact on their stress responses. It could have a positive effect, McLaughlin said, since puberty might represent another sensitive period when stress response systems are particularly tuned to environmental inputs.

“It’s possible that the environment during that period could reverse the impacts of early adversity on the system,” she said.

are Charles Nelson at Harvard Medical School, Nathan Fox at the University of Maryland and Charles Zeanah at Tulane University, who led the Bucharest early intervention study; Margaret Sheridan at Harvard Medical School; and Florin Tibu at the Institute for Child Development in Bucharest.

91±¬ĮĻ research on children who began life in these institutions shows that early childhood neglect is associated with changes in brain structure. A published this month in shows that children who spent their early years in these institutions have thinner brain tissue in cortical areas that correspond to impulse control and attention.

“These differences suggest a way that the early care environment has dramatic and lasting effects for children’s functioning,” said lead author , a 91±¬ĮĻ assistant professor of psychology.

Since 2000, the has worked to document and treat the children’s health. McLaughlin joined the team about six years ago to focus on brain development.

This study is among the first in any setting to document how social deprivation in early life affects the thickness of the , the thin folded layer of gray matter that forms the outer layer of the brain.

“We find a pervasive pattern of differences [among institutionalized children] in areas of the brain related to attention, working memory and social cognition,” McLaughlin said.

It’s known that children raised in institutions tend to have attention deficit hyperactivity disorder, or ADHD, about four or five times more often than other children, McLaughlin said. The new work suggests how this happens.

The study provides “very strong support” for a link between the early environment and ADHD, McLaughlin said.

Researchers compared brain scans from 58 children who spent at least some time in institutions and 22 non-institutionalized children from nearby communities, all between the ages of 8 and 10. This was the first time in the ongoing study that the children underwent an MRI scan, which creates a 3-D map of the brain.

Related last year found children raised in the orphanages had less gray matter overall, while this study pinpoints the location of those differences. The most significant changes were in areas of the brain related to working memory and attention.

The brain scan images can explain more than 75 percent of the difference in symptoms of ADHD between kids who did and did not spend time in institutions. Thinning was seen in children who left the institution as early as 8 months of age. Researchers also found that the thinner the brain tissue, the more symptoms of inattention and impulsivity the children displayed.

Researchers did not find differences in the volume of sub-cortical structures. No significant difference was seen between girls and boys, who were about equally represented.

When the study began in 2000, some of the young children remained in institutions, while others were adopted by foster families selected and trained by the research team to try to reverse the effects of early neglect. Of the children in the study who spent time in an institution, the new study finds little differences in brain structure between the 31 who remained for a longer time and the 27 who went into high-quality foster care before their third birthday.

“It’s surprising, and a little disappointing,” McLaughlin said. Most characteristics measured by the study were dramatically improved among the children moved to foster care.

“It’s one of the few areas [of behavior] where you don’t see improvements,” McLaughlin said.

The researchers can’t pinpoint exactly which conditions acted to alter brain development. Babies in the institutions had their physical needs met but they lacked socialization, language exposure, human touch and emotional attachment with their caregiver. Future research will try to tease out which stimuli are most important for brain development and at what ages.

ADHD has many different causes and can often be treated, McLaughlin said. This study only looked at the link to childhood deprivation.

The results are meaningful for other countries, such as those in Africa, where orphanages and institutions are becoming more common. The findings may also be relevant for less-extreme situations of neglect.

“Paying attention to very early care environments should be an important public health priority, especially for abandoned or orphaned children,” McLaughlin said.

She will soon participate in a follow-up study in Bucharest. The children, now teenagers around 16 years old, will participate in physical and mental health checkups and can opt to participate in more detailed tests such as the brain scans.

The three researchers who lead the Bucharest early intervention study ā€“ at Harvard Medical School, at the University of Maryland and at Tulane University ā€“ are co-authors on the paper. Other co-authors are and Warren Winter at Harvard Medical School.

The research was funded by the John D. and Catherine T. MacArthur Foundation and the National Institutes of Health.

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Ā For more information, contact McLaughlin at mclaughk@uw.edu or 206-616-7863.