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      Heightened neural reactivity to threat in child victims of family violence

      , , , , , ,
      Current Biology
      Elsevier BV

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          Burden and consequences of child maltreatment in high-income countries.

          Child maltreatment remains a major public-health and social-welfare problem in high-income countries. Every year, about 4-16% of children are physically abused and one in ten is neglected or psychologically abused. During childhood, between 5% and 10% of girls and up to 5% of boys are exposed to penetrative sexual abuse, and up to three times this number are exposed to any type of sexual abuse. However, official rates for substantiated child maltreatment indicate less than a tenth of this burden. Exposure to multiple types and repeated episodes of maltreatment is associated with increased risks of severe maltreatment and psychological consequences. Child maltreatment substantially contributes to child mortality and morbidity and has longlasting effects on mental health, drug and alcohol misuse (especially in girls), risky sexual behaviour, obesity, and criminal behaviour, which persist into adulthood. Neglect is at least as damaging as physical or sexual abuse in the long term but has received the least scientific and public attention. The high burden and serious and long-term consequences of child maltreatment warrant increased investment in preventive and therapeutic strategies from early childhood.
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            Functional neuroimaging of anxiety: a meta-analysis of emotional processing in PTSD, social anxiety disorder, and specific phobia.

            The study of human anxiety disorders has benefited greatly from functional neuroimaging approaches. Individual studies, however, vary greatly in their findings. The authors searched for common and disorder-specific functional neurobiological deficits in several anxiety disorders. The authors also compared these deficits to the neural systems engaged during anticipatory anxiety in healthy subjects. Functional magnetic resonance imaging and positron emission tomography studies of posttraumatic stress disorder (PTSD), social anxiety disorder, specific phobia, and fear conditioning in healthy individuals were compared by quantitative meta-analysis. Included studies compared negative emotional processing to baseline, neutral, or positive emotion conditions. Patients with any of the three disorders consistently showed greater activity than matched comparison subjects in the amygdala and insula, structures linked to negative emotional responses. A similar pattern was observed during fear conditioning in healthy subjects. Hyperactivation in the amygdala and insula were, of interest, more frequently observed in social anxiety disorder and specific phobia than in PTSD. By contrast, only patients with PTSD showed hypoactivation in the dorsal and rostral anterior cingulate cortices and the ventromedial prefrontal cortex-structures linked to the experience and regulation of emotion. This meta-analysis allowed us to synthesize often disparate findings from individual studies and thereby provide neuroimaging evidence for common brain mechanisms in anxiety disorders and normal fear. Effects unique to PTSD furthermore suggested a mechanism for the emotional dysregulation symptoms in PTSD that extend beyond an exaggerated fear response. Therefore, these findings help refine our understanding of anxiety disorders and their interrelationships.
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              A common role of insula in feelings, empathy and uncertainty.

              Although accumulating evidence highlights a crucial role of the insular cortex in feelings, empathy and processing uncertainty in the context of decision making, neuroscientific models of affective learning and decision making have mostly focused on structures such as the amygdala and the striatum. Here, we propose a unifying model in which insula cortex supports different levels of representation of current and predictive states allowing for error-based learning of both feeling states and uncertainty. This information is then integrated in a general subjective feeling state which is modulated by individual preferences such as risk aversion and contextual appraisal. Such mechanisms could facilitate affective learning and regulation of body homeostasis, and could also guide decision making in complex and uncertain environments.
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                Author and article information

                Journal
                Current Biology
                Current Biology
                Elsevier BV
                09609822
                December 2011
                December 2011
                : 21
                : 23
                : R947-R948
                Article
                10.1016/j.cub.2011.10.015
                22153160
                95de113e-b855-491d-9a99-5bbb21fce039
                © 2011

                https://www.elsevier.com/tdm/userlicense/1.0/

                http://www.elsevier.com/open-access/userlicense/1.0/

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