Childhood trauma and social support affect symptom profiles through cortical thickness abnormalities in major depressive disorder: A structural equation modeling analysis

Chenguang Jiang; Wenhao Jiang; Gang Chen; Wei Xu; Taipeng Sun; Linlin You; Suzhen Chen; Yingying Yin; Xiaoyun Liu; Zhenghua Hou; Zhao Qing; Chunming Xie; Zhijun Zhang; Jessica A Turner; Yonggui Yuan

doi:10.1016/j.ajp.2023.103744

Childhood trauma and social support affect symptom profiles through cortical thickness abnormalities in major depressive disorder: A structural equation modeling analysis

Asian J Psychiatr. 2023 Oct:88:103744. doi: 10.1016/j.ajp.2023.103744. Epub 2023 Aug 19.

Authors

Chenguang Jiang¹, Wenhao Jiang¹, Gang Chen², Wei Xu³, Taipeng Sun², Linlin You¹, Suzhen Chen¹, Yingying Yin¹, Xiaoyun Liu¹, Zhenghua Hou¹, Zhao Qing⁴, Chunming Xie⁵, Zhijun Zhang⁵, Jessica A Turner⁶, Yonggui Yuan⁷

Affiliations

¹ Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China.
² Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University; Department of Medical Psychology, Huai'an No.3 People's Hospital, Huaian, China.
³ Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University; Department of Clinical Psychology, Northern Jiangsu People's Hospital, Yangzhou, China.
⁴ Shing-Tung Yau Center; School of Biological Science and Medical Engineering, Southeast University, Nanjing, China.
⁵ Department of Neurology, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China.
⁶ Department of Psychiatry and Behavioral Health, Wexner Medical Center, Ohio State University, OH, United States. Electronic address: jessica.turner@osumc.edu.
⁷ Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China. Electronic address: yygylh2000@sina.com.

PMID: 37619416
DOI: 10.1016/j.ajp.2023.103744

Abstract

Background: Childhood trauma, low social support, and alexithymia are recognized as risk factors for major depressive disorder (MDD). However, the mechanisms of risk factors, symptoms, and corresponding structural brain abnormalities in MDD are not fully understood. Structural equation modeling (SEM) has advantages in studying multivariate interrelationships. We aim to illustrate their relationships using SEM.

Methods: 313 MDD patients (213 female; mean age 42.49 years) underwent magnetic resonance imaging and completed assessments. We integrated childhood trauma, alexithymia, social support, anhedonia, depression, anxiety, suicidal ideation and cortical thickness into a multivariate SEM.

Results: We first established the risk factors-clinical phenotype SEM with an adequate fit. Cortical thickness results show a negative correlation of childhood trauma with the left middle temporal gyrus (MTG) (p = 0.012), and social support was negatively correlated with the left posterior cingulate cortex (PCC) (p < 0.001). The final good fit SEM (χ2 = 32.92, df = 21, χ2/df = 1.57, CFI = 0.962, GFI = 0.978, RMSEA = 0.043) suggested two pathways, with left PCC thickness mediating the relationship between social support and suicidal ideation, and left MTG thickness mediating between childhood trauma and anhedonia/anxiety.

Conclusion: Our findings provide evidence for the impact of risk factor variables on the brain structure and clinical phenotype of MDD patients. Insufficient social support and childhood trauma might lead to corresponding cortical abnormalities in PCC and MTG, affecting the patient's mood and suicidal ideation. Future interventions should aim at these nodes.

Keywords: Alexithymia; Brain structure; Childhood trauma; Major depressive disorder (MDD); Social support; Structural equation modeling(SEM).