There is a well-established association between childhood maltreatment and later poor mental health and increasing recognition that we need to find ways to support children following such experiences to improve long-term outcomes. We suggest that the rationale for such a preventive approach is directly informed by the emerging findings from the field of functional neuroimaging. Here, we review the evidence from four neurocognitive systems: threat processing, reward processing, emotion regulation and executive control. We briefly summarise what is known about each system, review the evidence that altered functioning is implicated in common mental health problems and describe how the functioning of each system is altered following maltreatment. Across domains, these neurocognitive alterations following child maltreatment are in line with those seen in adults presenting with mental health problems yet most maltreated children studied do not have a presenting ‘disorder’. This suggests that these neurocognitive alterations may potentiate the risk of future psychopathology. We discuss this possibility in the context of the theory of latent vulnerability (McCrory and Viding, 2015). According to this model, children may respond to early adverse environments in ways that are potentially adaptive in the short term but which create vulnerability to future mental health problems in the long term. We also consider the clinical implications of the neuroimaging evidence ‒ in particular, the growing need for a more preventive clinical approach.

中文翻译：

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儿童虐待、潜在脆弱性和大脑的回顾：对临床实践和预防的影响

童年虐待与后来的心理健康状况不佳之间存在着公认的关联，而且人们越来越认识到，我们需要找到方法来支持经历此类经历的儿童，以改善长期结果。我们建议这种预防方法的基本原理直接来自功能性神经影像学领域的新发现。在这里，我们回顾了来自四个神经认知系统的证据：威胁处理、奖励处理、情绪调节和执行控制。我们简要总结了对每个系统的了解，回顾了功能改变与常见心理健康问题有关的证据，并描述了每个系统的功能在虐待后如何改变。跨域，虐待儿童后的这些神经认知改变与出现心理健康问题的成年人的情况一致，但大多数受虐待儿童的研究并没有表现出“障碍”。这表明这些神经认知改变可能会增加未来精神病理学的风险。我们在潜在脆弱性理论的背景下讨论这种可能性（McCrory 和 Viding，2015 年）。根据该模型，儿童可能会以短期内具有潜在适应性的方式对早期不利环境做出反应，但从长远来看，这会导致对未来心理健康问题的脆弱性。我们还考虑了神经影像学证据的临床意义——尤其是对更具预防性的临床方法的日益增长的需求。