Childhood trauma moderates inhibitory control and anterior cingulate cortex activation during stress

Objective: The anterior cingulate cortex (ACC) is critical for both stress and inhibitory control processes and has been implicated in childhood trauma. This prospective study tested the hypothesis that early trauma moderates the association between inhibitory control during late childhood and ACC stress reactivity during adolescence. Method: Sixty-four adolescents were stratified into higher- or lower-childhood-trauma groups. Inhibitory control was indicated by fewer errors on a Stroop Color-Word task. Personalized stress cues during functional magnetic resonance imaging assessed neural correlates of stress in adolescents. Results: Using a priori-defined anterior (rCZa) and posterior rostral cingulate zones of the ACC, associated with Stroop Color-Word task performance in prior meta-analyses, Stroop errors correlated inversely with activation in the rCZa during stress-cue exposure (r=-.23, p=.04). Childhood trauma moderated the association between Stroop errors and rCZa stress reactivity (interaction =-1.26, p=.02, 95% CI=-2.33,-0.20), where Stroop errors were inversely associated with brain activation among those with higher childhood trauma (simple slopes=-.83, p=.007, 95% CI=-1.40,-0.25). Low stress-related rCZa activation inversely (R-2=0.19, b=-0.43, p=.001, 95% CI=-4.11,-1.06) and Stroop errors directly (R-2=0.09, b=0.27, p=.048, 95%CI=0.02, 5.8) associated with baseline subjective anxiety while controlling for childhood trauma. Conclusions: This is the first study to demonstrate a moderating role of childhood trauma on the relationship between inhibitory control and stress-related ACC activation. Childhood trauma may portend neurodevelopmental changes that impede recruitment of control-associated ACC-functioning during distress, which may relate to dysregulation of stress-induced affective responses. Further work is needed to elucidate relationships between childhood trauma and addictive behaviors precipitated by stress.