Alterations in Reward and Emotional Processing Differentiate Among Adults With a History of Childhood Maltreatment: Implications for Substance Use Behaviors

Although childhood maltreatment is a well-established risk factor for a multitude of poor psychosocial outcomes, considerably less is known about mechanisms driving this risk transmission. Recent theoretical models posit that types of childhood maltreatment (deprivation vs. threat) may lead to alterations in reward and emotional processing that confer risk for later psychosocial problems. However, empirical examination of these theories is currently limited. We used a person-centered approach to identify profiles of reward and emotional processing in a sample of 758 adults reporting elevated childhood maltreatment. Latent profile analysis indicated a 3-class solution best fit the data: a blunted reward class (n = 220; 29.0%) characterized by low reward processing and average emotional processing; a disrupted emotional processing class (n = 242; 31.9%) marked by normative levels of reward processing but high emotional pain and experiential avoidance and low distress tolerance; and an emotional resilience class (n = 296; 39.1%) characterized by normative reward and emotional processing. Consistent with theoretical models, the specificity of disruption was differentially associated with dimensions of childhood maltreatment, with individuals in the blunted reward class reporting more childhood neglect and individuals in the disrupted emotional processing class reporting more childhood physical/sexual abuse. These profiles of disrupted reward and emotional processing also showed differential relations with the frequency and affective motivations for lifetime substance use. Findings provide empirical support for novel conceptual models of childhood maltreatment that focus on the consequences that may represent mechanisms for problematic behaviors like substance use.