Elsevier

NeuroImage

Volume 47, Supplement 2, August 2009, Pages T66-T71
NeuroImage

Reduced prefrontal cortical gray matter volume in young adults exposed to harsh corporal punishment

https://doi.org/10.1016/j.neuroimage.2009.03.005Get rights and content

Abstract

Objective

Harsh corporal punishment (HCP) during childhood is a chronic, developmental stressor associated with depression, aggression and addictive behaviors. Exposure to traumatic stressors, such as sexual abuse, is associated with alteration in brain structure, but nothing is known about the potential neurobiological consequences of HCP. The aim of this study was to investigate whether HCP was associated with discernible alterations in gray matter volume (GMV) using voxel-based morphometry (VBM).

Methods

1455 young adults (18–25 years) were screened to identify 23 with exposure to HCP (minimum 3 years duration, 12 episodes per year, frequently involving objects) and 22 healthy controls. High-resolution T1-weighted MRI datasets were obtained using Siemens 3 T trio scanner.

Results

GMV was reduced by 19.1% in the right medial frontal gyrus (medial prefrontal cortex; MPFC, BA10) (P = 0.037, corrected cluster level), by 14.5% in the left medial frontal gyrus (dorsolateral prefrontal cortex; DLPFC, BA9) (P = 0.015, uncorrected cluster level) and by 16.9% in the right anterior cingulate gyrus (BA24) (P < 0.001, uncorrected cluster level) of HCP subjects. There were significant correlations between GMV in these identified regions and performance IQ on the WAIS-III.

Conclusions

Exposing children to harsh HCP may have detrimental effects on trajectories of brain development. However, it is also conceivable that differences in prefrontal cortical development may increase risk of exposure to HCP.

Introduction

Corporal punishment (CP) has been defined as “the use of physical force with the intention of causing a child to experience pain but not injury for the purpose of correction or control of the child's behavior” (Straus et al., 1997). However, such discipline (or its excessive use) has been considered as a type of child maltreatment and has been identified as having various negative psychological and physiological consequences. A history of exposure to severe CP is reportedly associated with aggression, delinquency (Gershoff, 2002), antisocial and violent behaviors (Ambati et al., 1998, Ohene et al., 2006, Slade and Wissow, 2004, Straus et al., 1997), depression (Banks, 2002, Straus and Kantor, 1994), suicidal behavior (Straus and Kantor, 1994), and other psychiatric disorders such as PTSD (Medina et al., 2001) and substance abuse (Lau et al., 2005). Furthermore, CP is related to the intergenerational transmission of intimate partner and family violence (Deater-Deckard et al., 2003, Muller et al., 1995, Schwartz et al., 2006) and is associated with risk of being victim of physical abuse and risk of abusing one's own child or spouse (Gershoff, 2002).

Exposure to various forms of childhood abuse, including physical abuse, sexual abuse and neglect have been associated with alterations in brain structure (e.g., Andersen et al., 2008, Bremner et al., 1997, De Bellis et al., 1999De Bellis et al., 2002, De Bellis and Kuchibhatla, 2006, Richert et al., 2006, Teicher et al., 1997, 2004). Diffusion tensor differences have also been observed in young adults with high-level exposure to parental verbal abuse (Choi et al., 2008).

Is exposure to parental CP a sufficiently severe developmental stressor to be associated with discernible effects on brain morphometry? To address this question we chose to examine exposure to a form of CP that is widely considered to be excessive and unacceptable. The American Academy of Pediatrics (AAP) considers spanking with an open hand for the purpose of behavior modification to be an acceptable form of punishment. However, this form of punishment becomes unacceptable if it involves use of an object, extends to regions beyond buttocks and extremities, is conducted out of anger, or results in injury. We defined harsh CP (HCP) as a severe form of CP, in which an object (e.g., belt, paddle and hair brush) was used on occasion for the purpose of disciplining a child, provided it did not extend beyond the buttocks, was not conducted out of anger, and did not result in injury. We focused on HCP rather than ordinary CP, which is much more common, hypothesizing that HCP would be associated with a stronger signal and more discernible effects. If associations emerged between imaging findings and HCP it would justify studies in a larger group of subjects exposed to ordinary CP.

This study was designed to evaluate GMV using an unbiased, whole-brain, voxel-by-voxel approach in a non-clinical sample of late adolescents/young adults exposed to HCP during childhood. Our sample was screened to exclude extraneous factors (e.g., substance abuse, head injury, fetal drug exposure, exposure to physical, sexual or emotional abuse) that might have influenced brain development. We hypothesized that exposure to childhood HCP might alter the developmental trajectory of brain regions involved in regulating emotion, aggression, attention, and cognition.

Section snippets

Participants and procedure

The McLean Hospital Institutional Review Board approved all procedures. Participants in the study were recruited from the community through an advertisement entitled “Memories of Childhood”. Screenings were conducted on 1455 volunteers using a detailed online assessment instrument with 2342 entry fields that provided a vast array of information regarding childhood history, development, and symptomatology. The questionnaire also included demographic information, such as subjects' and parents'

Results

HCP subjects reported mean duration of exposure to CP of 8.5 ± 3.5 years. Thirty-six percent of controls had limited exposed to ordinary CP, with an average exposure duration of 1.8 ± 3.0 years. Average age of onset and offset of CP in the HCP group was 3.9 ± 2.3 and 11.4 ± 2.5 years, respectively. HCP began almost concurrently with CP (4.2 ± 2.3 years). Subjects in the HCP group were predominantly male (65%), whereas controls were predominantly female (73%; Table 1). Parents of HCP subjects had, on

Discussion

This study examined the association between exposure to HCP and brain structure. HCP includes occasional use of objects to induce pain, and is considered an unacceptable form of punishment by the AAP. Results from this study apply to HCP, they do not apply to exposure to ordinary forms of CP that the AAP considers acceptable (but less effective than alternative forms of discipline).

Chronic exposure to HCP was associated with a marked reduction in GMV in the right medial frontal gyrus (MPFC,

Conflict of interest

The authors declare that there is no conflict of interest.

Acknowledgments

This study was supported by RO1 awards from the U.S.A. National Institute of Mental Health (MH-53636, MH-66222) and National Institute of Drug Abuse (DA-016934, DA-017846) to MHT. We thank Dr. H. Tanabe, National Institute for Physiological Sciences, Aichi, Japan for his assistance with data analyses.

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