Transdiagnostic relationships between childhood adversity and cortical thickness of the rostral anterior cingulate...

Childhood adversity (CA) is the leading preventable risk factor for mental illness. While CA can exacerbate affective symptoms across various psychiatric disorders, its impact on brain morphology, particularly the rostral anterior cingulate cortex (rACC), has mainly been studied in specific stress-related psychiatric disorders, such as depression and anxiety disorders. Therefore, we set out to disentangle the relationships between CA, psychopathology and brain structure across a broader range of psychiatric disorders. We studied 227 patients with stress-related and/or neurodevelopmental disorders and 95 healthy controls. We focused on the rACC, as this region is highly impacted by CA and has a pivotal role in affective functions across psychiatric disorders. The presence of CA was associated with decreased left rACC thickness across the whole sample, independent of psychopathology. Additionally, the contralateral right rACC was associated with psychopathology, with psychiatric patients having a thinner rACC compared to healthy controls, which was most pronounced in the stress-related disorders group. While left rACC thickness negatively correlated with social anxiety-related concerns, right rACC thickness negatively correlated with various core symptoms of stress-related and neurodevelopmental disorders. Finally, our exploratory analyses across cortical regions did not reveal any robust effects that survived multiple comparison correction. Taken together, our results suggest that within the stress-related disorders group, the CA-related thinning of the left rACC may compound the effects of the affected right rACC. This 'double hit' in stress-related disorders may contribute to the well-established phenomenon that CA leads to a worse illness trajectory in these disorders.