Teicher, Martin H.


 speakers

 

Martin H. Teicher

 

Martin H. Teicher, MD, PhD, has been director of the Developmental Biopsychiatry Research Program at McLean Hospital since 1988. He was director of the former Developmental Psychopharmacology Laboratory (now the Laboratory of Developmental Neuropharmacology), and is currently an associate professor of psychiatry at Harvard Medical School.

Dr. Teicher is a member of the editorial board of the Journal of Child and Adolescent Psychopharmacology, Current Pediatric Reviews, and Current Psychosomatic Medicine. He is a member of the Scientific Advisory Council of the Juvenile Bipolar Research Foundation, and has been part of Harvard University's Brain Development Working Group. He has served on or chaired numerous review committees for the National Institute of Health, published more than 150 articles, and has received numerous honors.

 


 

  

 

Childhood Maltreatment: Sensitive Exposure Periods and the Importance of Type and Timing of Abuse

Martin H. Teicher

 

Exposure to childhood adversity markedly increases the risk of developing mood, anxiety, personality, substance abuse and psychotic disorders. Recent studies suggest that clinical sequelae may stem, at least in part, from enduring adverse effects on brain development. Generally, early onset and longer duration of abuse have been associated with greater brain changes, but this may be an oversimplification. An alternative hypothesis is that stress-susceptible brain regions have their own unique sensitive periods (or windows of vulnerability) to the effects of early stress. Further, some of the adverse consequences of exposure to early stress may remain hidden until they are unmasked by subsequent maturational events. Research will be reviewed highlighting the effects of childhood abuse on the development of the hippocampus, white matter tracts, and cortical regions. Evidence will be presented identifying sensitive periods when specific brain regions are most vulnerable to the effects of early stress. Further, findings will be presented showing that sensory systems and pathways that convey the adverse experience of the abuse are selective targeted by the type of abuse experienced. These findings will be placed into context illustrating how exposure to abuse affects multiple components of the brain circuit responsible for threat detection and response. Finally, the case will be made that individuals with histories of substantial childhood maltreatment with DSM psychiatric diagnoses differ clinically, neurobiogically and genetically from non-maltreated individuals with the same diagnosis. We refer to the disorder in the maltreated cohort as an ‘ecophenotype’ and show that it is associated with earlier age of onset, more severe course, more comorbid diagnoses and poorer response to first-line treatments. Recognition of this distinction may markedly enhance treatment algorithms and facilitate studies examining the biological bases of psychopathology.

 

 

Childhood Abuse, Brain Development and Psychopathology

Martin H. Teicher

 

Childhood maltreatment is the most important preventable risk factors for a vast array of psychiatric disorders. A critical question is how does maltreatment get ‘under the skin’ to enhance risk and how can this knowledge be used to preempt emergence of these disorders in maltreated children or to guide treatment. In this workshop we will explore in considerable depth the effects of childhood maltreatment on brain structure, function and connectivity. We will cover material in the keynote in greater depth and include effect of types of maltreatment and on brain regions not included in the keynote. A major emphasis will be on the relationship between brain changes and psychopathology. The ‘ecophenotype’ hypothesis that maltreated and non-maltreated individuals with the same DSM or ICD diagnosis are clinically, genetically and neurobiologically distinct will be explore in detail, as will be the surprising finding that certain maltreated individuals appear to be resilient to the psychiatric consequences of maltreatment but not to the neurobiological consequences. Emphasis will also be given to therapeutic strategies and mechanisms.

 

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