Childhood maltreatment impacts the activity of the neural empathy but not theory of mind network: findings from a transdiagnostic sample.

backgroundChildhood maltreatment (CM) is a risk factor for psychopathology, including posttraumatic stress disorder (PTSD), major depressive disorder (MDD) and somatic symptom disorder (SSD). One possible mechanism linking CM with psychopathology is social cognition, comprising empathy and theory of mind (ToM). While prior research has focused on the association of CM with behavioral empathy and ToM capacities, not much is known about its association with functional neural correlates.

methodsThe sample included N = 101 adults with PTSD, MDD, and SSD, as well as healthy volunteers (HV) with varying CM experiences. We assessed social cognition and its neural correlates by applying the EmpaToM task and CM using a validated interview covering ten CM types. We analyzed neural activations related to empathy and ToM and calculated correlations between neural activations in regions-of-interest and CM severity. Finally, applying multiple linear regression analysis we investigated whether the association between neural activations and CM severity was moderated by primary diagnosis.

resultsWe found significant activation in the neural empathy and ToM networks. Exploratory analyses indicated activation related to empathy in the dorsomedial prefrontal cortex (dmPFC) to be negatively associated with CM severity. This association was not moderated by primary diagnosis. Activation in the neural ToM network was not associated with CM severity.

conclusionsResults highlight an association of CM severity with activation of the neural empathy but not the ToM network. Especially empathy-related dmPFC activity might be a transdiagnostic mechanism through which CM contributes to the risk for psychopathology. This result should be replicated in an independent sample but represents a promising starting point for the development of transdiagnostic therapeutic approaches.