Emotional scars: limbic brain processing alterations in adults with childhood abuse across mental health disorders

Abuse experienced during childhood and adolescence significantly influences brain development and increases the risk of psychiatric disorders later in life. However, its long-term impact on emotion processing across psychiatric conditions remains underexplored. In this functional MRI study, we examined a sample of 635 individuals with and without childhood abuse, including people with depression, anxiety disorders, PTSD, and healthy controls, to investigate differences in brain activation during conscious and non-conscious emotional face processing. Brain activation across regions involved in emotional regulation was compared in response to negative (anger, fear, disgust, sadness), happy and neutral facial expressions. Individuals exposed to abuse before age 13 showed heightened hippocampal activation during non-conscious negative emotion processing compared to non-abused individuals, an effect absent in those exposed to abuse between ages 13 and 18. Additionally, amygdala activation during conscious emotion processing was elevated across all emotions in individuals who experienced adolescent abuse (13-18 years), compared to both abuse-free individuals and those exposed to early childhood abuse. This transdiagnostic approach highlights distinct vulnerability windows in brain development, with differential effects on emotion processing depending on the timing of abuse. Our study provides novel insights into how early life adversities shapes emotional processing, advancing our understanding of its transdiagnostic impact on brain function.