Seeing the positive in the face of adversity: neurocognitive markers of risk and resilience in emotional conflict processing in children with maltreatment exposure

Identifying cognitive-emotional mechanisms that distinguish risk from resilience for developing internalizing disorders after childhood maltreatment is essential for detecting early vulnerability and informing targeted interventions. We examined whether affective control and attentional biases contribute to internalizing symptoms versus resilience in children with maltreatment exposure during middle childhood. We recruited N = 208 children, aged 6-12 years, including N = 84 with maltreatment exposure from child welfare offices and clinics and N = 124 children without maltreatment exposure. An emotional flanker task was used to assess affective control and attentional biases. Associations between these cognitive-emotional mechanisms, internalizing symptoms, and trait resilience were examined. Children with maltreatment exposure showed reduced affective control and heightened attentional processing of distracting angry faces, indicating increased sensitivity to threat-related information. Among children exposed to maltreatment, greater avoidance of threat was associated with more internalizing symptoms. Notably, greater attentional processing of distracting happy faces was linked to higher trait resilience across both groups and moderated the association between maltreatment exposure and internalizing symptoms. These findings suggest that children with maltreatment exposure exhibit early difficulties in affective control and a bias toward negative information processing. Crucially, enhanced attentional engagement with positive stimuli may function as a protective factor, buffering against internalizing symptoms and fostering resilience. Early interventions targeting affective control and the processing of positive social cues may improve mental health outcomes in children exposed to maltreatment.