Sex-specific associations between childhood maltreatment and adolescent brain structure and function: insights from the ABCD study

Childhood Maltreatment (CM) is an established risk factor for negative health outcomes, yet its associations with pediatric brain development and potential sex-specific effects remain underexplored. Most prior studies have treated CM as a unitary construct, overlooking the distinct effects of different subtypes. Using data from the Adolescent Brain Cognitive Development (ABCD) Study ( N = 11,866; ages 9–10), we examined associations between emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect, and total CM scores with brain structure and function in the hippocampus, amygdala, lateral orbitofrontal cortex (lOFC), medial orbitofrontal cortex (mOFC), and rostral anterior cingulate cortex (rACC). Mixed-effects models tested CM subtype, sex, and their interaction effects, with multiple comparisons corrected using the Benjamini–Hochberg false discovery rate (FDR) method. Boys reported higher exposure to emotional abuse ( p = .010), emotional neglect ( p = .037), and physical neglect ( p < .001), while girls had greater sexual abuse ( p < .001). Sexual abuse was associated with smaller hippocampal volume in boys ( p = .003) but not in girls ( p = .449). Emotional abuse was related to lower lOFC volume in boys ( p = .026) and marginally larger volume in girls ( p = .050). Total CM scores were related to smaller hippocampus ( p FDR = 0.015), amygdala ( p FDR = 0.022), and lOFC volumes ( p FDR = 0.022) across sexes, and these total-CM main effects were attenuated after socioeconomic adjustment. Sexual and/or emotional abuse in boys was associated with differences in hippocampal and lOFC volumes. Total CM scores were associated with smaller hippocampal, amygdala, and lOFC volumes across sexes. These patterns highlight sex-specific associations between CM subtypes and brain structure during late childhood/early adolescence.