Threat Sensitivity of Adolescents with Abuse Histories: The Impact of Residential Care

Childhood abuse is associated with neuro-developmental disruption, including heightened threat sensitivity. It is often assumed that this disruption is semi-permanent and resistant to change. Here we examine whether the exaggerated threat response seen in adolescents who have experienced past abuse was modified after a 7-month stay in a trauma-informed residential program. The sample included thirty-six adolescents who were placed into residential care and had either prior exposure to high levels of abuse (n = 36) or lower levels of abuse (n = 25). Groups (aged 12.7–18.9 years, 57 male) were matched on age, sex, IQ, and prescribed medications and were scanned twice (shortly after intake and after 7 months) on a looming threat task. Results indicated (i) trauma-informed residential care was associated with significant decline in depression, anxiety, aggression, and callous-unemotional trait symptoms irrespective of severity of prior abuse exposure; (ii) Participants who had been subjected to high levels of abuse showed heightened neural responsiveness to threats in both the posterior cingulate cortex/precuneus and the amygdala/hippocampus at intake that reduced after 7 months; (iii) Both groups showed declines in responsiveness within the rostromedial frontal cortex and the lingual gyrus and fusiform cortex after a 7-month treatment. These data demonstrate that intervention can ameliorate heightened neural threat responsiveness and symptom severity in adolescents who have been exposed to high levels of abuse.