Individuals with a history of child abuse are at high risk for a broad range of psychiatric and substance use disorders. This chapter reviews key findings from research on the genetics of child abuse-related psychiatric disorders, neuroimaging investigations with maltreated youth, and resiliency studies. Relevant empirical work in the field was reviewed, with an emphasis on prior reviews, meta-analytic studies, and recent publications. Genetic factors are not associated with distinct psychiatric disorders but rather diverse clinical phenotypes, and a history of abuse is frequently associated with alterations in structural and functional brain changes across multiple brain regions and circuits that mediate a wide variety of emotional and cognitive processes. Heterogeneity in clinical outcome and brain measures varies as a function of a wide range of factors, and emerging findings on genetic and neural plasticity offers significant promise in understanding risk and resilience in maltreated youth. Child maltreatment is a strong predictor of early onset of psychiatric illness, increased comorbidity, and poor treatment response; however, a history of abuse need not lead to the development of psychiatric problems. Risk is altered by genetic factors, and can be ameliorated by positive factors in the environment—including the availability of positive support, enrichment experiences, and the delivery of evidence-based psychotherapeutic clinical interventions. Future multidisciplinary and translational studies will help to further delineate the mechanisms by which experiences of maltreatment confers risk for psychopathology, as well as help to further delineate factors associated with resiliency.
Sudden Loss and Psychiatric Disorders Across the Life Course: Toward a Developmental Lifespan Theory of Bereavement-Related Risk and Resilience