Early life adversity, such as child maltreatment or child poverty, engenders problems with emotional and behavioral regulation. In the quest to understand the neurobiological sequelae and mechanisms of risk, the amygdala has been of major focus. While the basic functions of this region make it a strong candidate for understanding the multiple mental health issues common after ELA, extant literature is marked by profound inconsistencies, with reports of larger, smaller, and no differences in regional volumes of this area. We believe (...) integrative models of stress neurodevelopment, grounded in “allostatic load,” will help resolve inconsistencies in the impact of ELA on the amygdala. In this review, we attempt to connect past research studies to new findings with animal models of cellular and neurotransmitter mediators of stress buffering to extreme fear generalization onto testable research and clinical concepts. Drawing on the greater impact of inescapability over unpredictability in animal models, we propose a mechanism by which ELA aggravates an exhaustive cycle of amygdala expansion and subsequent toxic-metabolic damage. We connect this neurobiological sequela to psychosocial mal/adaptation after ELA, bridging to behavioral studies of attachment, emotion processing, and social functioning. Lastly, we conclude this review by proposing a multitude of future directions in preclinical work and studies of humans that suffered ELA. (shrink)

Introduction and ObjectiveThe early identification of depressive patients having a poor evolution, with frequent relapses and/or recurrences, is one of the priority challenges in this study of high prevalence mental disorders, and specifically in depression. So, this study aims to analyze the factors that may be associated with an increased risk of recurrence of major depression episodes in patients treated in primary care.MethodsA retrospective, descriptive study of cases-controls was proposed. The cases consisted of patients who had been diagnosed with major (...) depression and who had presented recurrences, in comparison with patients who had experienced a single major depression episode with no recurrence. The variables of the study are age at first episode; number of episodes; perception of severity of the depression episode suffered prior to recurrence; number of residual symptoms; physical and psychiatric comorbidity; history of anxiety disorders; family psychiatric history; high incidence of stressful life events ; and experiences of physical, psychological, or sexual abuse in childhood. The differences of the variables were compared between the case subjects and the control subjects, using the Mann–Whitney, chi-square, and Fisher’s U statistics. A multivariate analysis was performed.ResultsThe average age of those suffering more than one depressive episode is significantly older, and a higher percentage of subjects who have experienced more than one depressive episode have a history of anxiety disorders. In the multivariate analysis, the variables that obtained a significant value in the logistic regression analysis were age and having suffered sexual abuse during childhood.ConclusionThese indicators should be considered by primary care physicians when attending patients suffering from major depression. (shrink)

Why do people with psychopathology use less adaptive and more maladaptive strategies for negative emotions if such usage has self-destructive consequences? Although researchers have examined the reasons for people’s engagement in maladaptive “behaviors,” such as nonsuicidal self-injury, surprisingly little attention has been paid to the reasons why people might endorse maladaptive emotion regulation strategies. This article addresses this question, focusing on the case of depression, evaluating an array of 10 possible explanations. After considering the existing evidence, we provide a blueprint (...) to help the field reach stronger conclusions about depression and other forms of psychopathology. Better understanding of the origins of healthy/unhealthy ER has implications for clinical science, clinical practice, as well as their integration. (shrink)