Citation

Teicher MH. Am. J. Psychiatry 2020; 177(1): 4-6.

Affiliation

Department of Psychiatry, Harvard Medical School, Boston; and Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, Mass.

Copyright

(Copyright © 2020, American Psychiatric Association)

DOI

10.1176/appi.ajp.2019.19111159

PMID

31892302

Abstract

In this issue, Maier et al. present results from a fascinating study that is a pleasure to read. Unlike the vast majority of studies on the clinical and neurobiological consequences of maltreatment, the authors did not focus on the usual, albeit important, array of symptoms or diagnoses, such as depression, anxiety, and substance use. Rather, they took a deeper dive to ascertain how maltreatment may modify some key individual differences that may underlie psychiatric vulnerabilities. Briefly, they found that relatively severe exposure to childhood maltreatment was associated with preference for increased interpersonal distance and less pleasurable responses to touch, particularly moderately fast touch that is involved in tactile discrimination. Further, they found that moderately fast touch was associated with exaggerated brain activation in the right superior temporal gyrus and right posterior insula, which correlated with lower comfort ratings. In addition, they report that slow, generally comforting touch, was associated, in the severely maltreated, with a blunted right hippocampal response.

As this study suggests, we as a profession may be paying insufficient attention to the role that sensory processing problems play in our patients and how they may contribute to life difficulties or underlie their more overt clinical symptoms. There are, however, a few disorders in which sensory processing problems are quite apparent. In autism spectrum disorder, problems with hyperresponsiveness, hyporesponsiveness, or sensory preoccupation are often overt and clearly interfere with daily life. Problems with tactile sensitivity or defensiveness also often come to light clinically in individuals with attention deficit hyperactivity disorder or developmental disabilities ...

Language: en