Previous Institutionalization is Associated with Elevated Functional Connectivity between the Nucleus Accumbens and Amygdala during Safety Learning

BACKGROUND: Previous institutionalization (PI) is a unique form of early life adversity that is associated with increased risk for psychopathology, especially internalizing disorders. Onset of internalizing disorders is most common during adolescence. Developmental models emphasize differences in childhood learning, and corresponding avoidance behaviors, as a core pathway linking adversity to internalizing disorders yet little empirical research has tested this theory. METHODS: During functional magnetic resonance imaging, 43 PI (12.1 to 22.8 years) and 47 comparison (9.9 to 22.9 years) youth completed an aversive learning task. The task involved an escapable stimulus reinforced with an aversive sound (CS+r), the same escapable stimulus without reinforcement (CS+nr), or an escapable stimulus that was never reinforced (CS-). Internalizing symptoms were measured using the parent-report Revised Child Anxiety and Depression Scales.RESULTS: Functional connectivity between the nucleus accumbens (NAcc) and amygdala was elevated among the PI versus comparison youth, specifically for the CS- (p=.035). PI youth showed elevated connectivity for the CS- regardless of symptoms, whereas comparison youth showed elevated connectivity at higher but not lower levels of symptoms (p=.027). Elevated connectivity for the CS- was more evident among the PI group during early adolescence relative to late adolescence (p=.007).CONCLUSIONS: NAcc-amygdala functional connectivity, a circuit which has previously been implicated in escape from threat, is elevated during safety learning among PI adolescents. Differences in NAcc-amygdala functional connectivity may attenuate with age following adoption. Institutionalization may impact neurodevelopment in ways that increase generalization of threat appraisals to safe stimuli, thereby increasing risk for developing psychopathology.