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Presenter: Martin Teicher, MD, PhD
Childhood adversity is the most important preventable risk factor for mood, anxiety, personality, substance abuse and psychotic disorders. Recent studies suggest that clinical sequelae may stem, at least in part, from enduring effects on brain development. Research will be reviewed highlighting the effects of childhood abuse on EEG coherence, and the development of the hippocampus, white matter tracts, and cortical regions. Evidence will be presented identifying sensitive periods when specific brain regions are most vulnerable and unique effects of difference types of abuse on sensory systems and pathways that convey the adverse experience. These findings will be placed into context illustrating how exposure to abuse affects multiple components of the brain circuit responsible for threat detection and also affects the network architecture of the brain. Finally, the case will be made that maltreated and non-maltreated individuals with the same primary DSM diagnosis differ clinically, neurobiologically and genetically. We refer to the disorder in the maltreated cohort as an ‘ecophenotype’ and show that it is associated with earlier age of onset, more severe course, more comorbid diagnoses and poorer response to first-line treatments. Recognition of this distinction may be of paramount importance in effectively identifying appropriate interventions with neurofeedback emerging as a key modality for treating individuals with the ecophenotype.