2 - (SYM 106) a Meta-analysis of Fear Conditioning in Children with Childhood Trauma or Maltreatment

Background: Childhood trauma and maltreatment have been identified as major risk factors for the development of fear-related disorders in adulthood. One hypothesis is that exposure to trauma or maltreatment impacts fear learning and extinction processes, which in turn may increase risk for these disorders. Some studies have shown differences in fear conditioning between trauma exposed and non-trauma exposed child populations, however, to date, a meta-analysis has not been conducted on this topic. Additionally, other research suggests that children exhibit different patterns of responses during fear conditioning compared to adults. In the current meta-analysis, we analyze the relationship between childhood trauma/maltreatment and responses to threat and safety cues in studies using classical fear conditioning paradigms conducted in children.

Methods: A PubMed, PsychInfo, and Web of Science search was conducted through February 1, 2023. We included studies that used classical fear conditioning paradigms, measured physiological or self-reported indicators of fear, examined childhood trauma or maltreatment (i.e., abuse, neglect, or violence exposure) with validated questionnaires, and recruited a population aged 18 or younger. Analysis outcomes will include response to threat cues, response to safety cues, and differential fear response.

Results: Of the 1,926 studies returned in our initial search, sixty-two were screened in full by two raters, and ultimately, ten studies met our criteria. The total sample size across studies is 783 and on average, samples were 50.9 percent female. The average age across participants was 10.56 years. The racial/ethnic breakdown was as follows: 52.3% White, 26.7% Black, 10.3% Hispanic/Latino, 6.4% Asian, and 9.3% Multiracial/other (4 studies did not report this demographic information). We hypothesize that children who have experienced trauma/maltreatment will demonstrate difficulty discriminating between threat and safety cues relative to children who have not experienced trauma/maltreatment. We will also examine potential moderators such as type of trauma/maltreatment, fear assessment method, and sample demographics such as sex and race.

Discussion: Results of this meta-analysis have important implications for understanding the impact of early life trauma and maltreatment on fear learning and potential development of fear-related disorders into adulthood. This meta-analysis can also inform future research on fear conditioning in children with and without trauma exposure.