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A Randomized Controlled Trial of a Parenting Intervention During Infancy Alters Amygdala-Prefrontal Circuitry in Middle Childhood - 26/12/23

Doi : 10.1016/j.jaac.2023.06.015 
Emilio A. Valadez, PhD a, , Nim Tottenham, PhD b, Marta Korom, MA c, Alexandra R. Tabachnick, PhD d, Daniel S. Pine, MD e, Mary Dozier, PhD c
a University of Maryland, College Park, Maryland 
b Columbia University, New York 
c University of Delaware, Newark, Delaware 
d University of Illinois at Chicago 
e National Institute of Mental Health, Bethesda, Maryland 

Correspondence to Emilio A. Valadez, PhD, Department of Human Development and Quantitative Methodology, University of Maryland, 3942 Campus Drive, College Park, MD 20742Department of Human Development and Quantitative MethodologyUniversity of Maryland3942 Campus DriveCollege ParkMD20742

Abstract

Objective

Early adverse parenting predicts various negative outcomes, including psychopathology and altered development. Animal work suggests that adverse parenting might change amygdala–prefrontal cortex (PFC) circuitry, but work in humans remains correlational. The present study leveraged data from a randomized controlled trial examining the efficacy of an early parenting intervention targeting parental nurturance and sensitivity (Attachment and Biobehavioral Catch-up [ABC]) to test whether early parenting quality causally affects amygdala-PFC connectivity later in life.

Method

Participants (N = 60, mean age = 10.0 years) included 41 high-risk children whose parents were referred by Child Protective Services and randomly assigned to receive either ABC (n = 21) or a control intervention (n = 20) during the children’s infancy and a comparison sample of low-risk children (n = 19). Amygdala-PFC connectivity was assessed via functional magnetic resonance imaging while children viewed fearful and neutral faces.

Results

Across facial expressions, ABC produced different changes than the control intervention in amygdala-PFC connectivity in response to faces. The ABC group also exhibited greater responses than the control intervention group to faces in areas classically associated with emotion regulation, including the orbitofrontal cortex and right insula. Mediation analysis suggested that the effect of ABC on PFC activation was mediated by the intervention’s effect on amygdala-PFC connectivity.

Conclusion

Results provide preliminary causal evidence for the effect of early parenting intervention on amygdala-PFC connectivity and on PFC responses to face viewing. Findings also highlight amygdala-PFC connectivity as a potential mediator of the effects of early parenting intervention on children’s emotion regulation development.

Clinical trial registration information

Intervening Early With Neglected Children; clinicaltrials.gov/; NCT02093052.

Diversity & Inclusion Statement

We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. One or more of the authors of this paper received support from a program designed to increase minority representation in science. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list.

Le texte complet de cet article est disponible en PDF.

Key words : amygdala, early adversity, parenting, prefrontal cortex, randomized controlled trial


Plan


 This work was supported by the National Institute of Mental Health Award Numbers R01MH074374 (to M.D.) and R01MH091864 (to N.T.), and Intramural Research Program project ZIA MH002781 (to D.S.P.).
 The research was performed with permission from the University of Delaware Institutional Review Board.
 Author Contributions
Conceptualization: Valadez, Tottenham, Pine, Dozier
Data curation: Valadez, Korom, Tabachnick
Formal analysis: Valadez, Korom
Funding acquisition: Dozier
Investigation: Valadez, Tabachnick, Dozier
Methodology: Valadez, Korom
Software: Valadez, Tottenham, Korom
Supervision: Tottenham, Pine, Dozier
Visualization: Valadez
Writing – original draft: Valadez
Writing – review and editing: Valadez, Tottenham, Korom, Tabachnick, Pine, Dozier
 The authors would like to thank all the participants and families who have continued to dedicate their time to this research from infancy to adolescence. The authors also thank the many research assistants who helped with data collection over the years as part of this longitudinal study.
 Disclosure: Drs. Valadez, Tottenham, Tabachnick, Pine, and Dozier and Ms. Korom have reported no biomedical financial interests or potential conflicts of interest.


© 2023  American Academy of Child and Adolescent Psychiatry. Tous droits réservés.
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Vol 63 - N° 1

P. 29-38 - janvier 2024 Retour au numéro
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