Childhood trauma and sensitivity to reward and

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Keywords: Childhood trauma. BAS. BIS. Sensitivity to reward. Sensitivity to punishment. Depressive symptoms ..... 7967(96)00068-X. Carver, C. S., & White, T. L. ...
Personality and Individual Differences 119 (2017) 134–140

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Childhood trauma and sensitivity to reward and punishment: Implications for depressive and anxiety symptoms Andrei C. Miu a, Mirela I. Bîlc a, Ioana Bunea a, Aurora Szentágotai-Tătar b,⁎ a b

Cognitive Neuroscience Laboratory, Department of Psychology, Babeș-Bolyai University, Cluj-Napoca, Cluj, Romania Department of Clinical Psychology and Psychotherapy, Babeș-Bolyai University, Cluj-Napoca, Cluj, Romania

a r t i c l e

i n f o

Article history: Received 1 March 2017 Received in revised form 24 June 2017 Accepted 14 July 2017 Available online xxxx Keywords: Childhood trauma BAS BIS Sensitivity to reward Sensitivity to punishment Depressive symptoms Anxiety symptoms

a b s t r a c t Extensive evidence indicates that early adversity is associated with a lifelong increased risk for psychopathology. One of the mechanisms underlying this effect may involve maladaptive personality traits. This study investigated whether childhood trauma is related to individual differences in sensitivity to reward and punishment, construed as the personality correlates of the behavioral activation system (BAS) and the behavioral inhibition system (BIS). The potential mediator role of these individual differences in the relation between childhood trauma and emotional symptoms was also examined. Healthy adult participants (N = 375), with a self-reported history of childhood interpersonal trauma, non-interpersonal trauma or no trauma, filled in questionnaires about the anticipation of, and emotional responsiveness to reward and punishment, as well as depressive and anxiety symptoms. Participants with a history of interpersonal trauma reported both reduced levels of motivation for reward and increased levels of sensitivity to punishment, compared to participants with non-interpersonal trauma and no trauma. Sensitivity to punishment carried the effect of interpersonal trauma on both depressive and anxiety symptoms, whereas motivation for reward played a mediator role only in the relation between trauma and depressive symptoms. © 2017 Published by Elsevier Ltd.

1. Introduction Childhood trauma is associated with a lifelong increased risk of psychopathology, including depression and anxiety (e.g., Lindert et al., 2014; Nanni, Uher, & Danese, 2012). The psychological mechanisms by which this effect persists into adulthood are not clear, but a wellknown hypothesis is that exposure to early trauma enhances the development of maladaptive traits, which in turn increase vulnerability to psychopathology (e.g., Barlow, Ellard, Sauer-Zavala, Bullis, & Carl, 2014; Rachman, 1980; Roy, 2002). For instance, a recent study (Spinhoven, Elzinga, Van Hemert, de Rooij, & Penninx, 2016) has found that a maladaptive personality pattern (i.e., high neuroticism and low extraversion, agreeableness and conscientiousness) may serve as mediator in the relation between child maltreatment (i.e., physical abuse, sexual abuse, and emotional abuse and neglect) and depressive and anxiety symptoms. The present study sought to test a similar mediation hypothesis, but in light of recent suggestions that altered responsiveness to reward may be involved in the link between childhood trauma and psychopathology (e.g., McLaughlin & Sheridan, 2016; Vujanovic, Wardle, Smith, & Berenz, 2017), it employed Gray's

⁎ Corresponding author at: 37 Republicii Street, 400015 Cluj-Napoca, Cluj, Romania. E-mail address: [email protected] (A. Szentágotai-Tătar).

http://dx.doi.org/10.1016/j.paid.2017.07.015 0191-8869/© 2017 Published by Elsevier Ltd.

approach to personality (Gray, 1987; Gray & McNaughton, 2000), which emphasizes individual differences in sensitivity to reward and punishment. The revised reinforcement sensitivity theory (Gray, 1987; Gray & McNaughton, 2000) argues that there are three emotional systems underlying motivated behavior: the fight-flight-freeze system, which is hypothesized to mediate fear and anger triggered by threat; the behavioral activation system (BAS), which is thought to support positive emotions induced by reward; and the behavioral inhibition system (BIS), which is involved in negative emotions induced by goal conflict. The personality correlates of these emotional systems have been widely investigated, with an increased focus on BAS and BIS (for review see Corr, 2016; Corr & McNaughton, 2008). Individual differences in the pursuit of appetitive goals and emotional responsiveness to reward are thought to reflect BAS sensitivity, whereas individual differences in the concern for potential punishment and emotional responsiveness to bad outcomes are thought to reflect BIS sensitivity. These individual differences have often been assessed using the BIS/BAS scales (Carver & White, 1994), a self-report measure which includes a BIS scale and three BAS subscales (i.e., Reward Drive, Fun Seeking and Reward Responsiveness) (for a review of other measures see Corr, 2016). Relative to extraversion and trait anxiety, BAS and BIS may be better able to predict happiness induced by cues of impending reward, and nervousness induced by cues of impending punishment, respectively (Carver & White, 1994).

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Moreover, clinical studies have confirmed the theoretical prediction (Fowles, 1993) that both anxiety disorders and depression are characterized by enhanced BIS (Johnson, Turner, & Iwata, 2003). In addition, depression may involve reduced BAS (Kasch, Rottenberg, Arnow, & Gotlib, 2002; but see Johnson et al., 2003). This hypothesis has been supported by behavioral evidence of reduced responsiveness to reward in depression (Henriques & Davidson, 2000). Furthermore, increased BAS scores, especially on the Reward Drive subscale, have been associated with long-term clinical improvements in depression (Kasch et al., 2002). Considering that childhood trauma has been linked with several personality differences that contribute to risk for psychopathology (e.g., Roy, 2002; Spinhoven et al., 2016; Szentagotai-Tatar & Miu, 2016), we were interested to examine its influence on BIS/BAS. These individual differences may carry the influence of childhood trauma on psychopathology, while also capturing specific aspects of the vulnerability to depression and anxiety. From this perspective, an outstanding question is whether childhood trauma is related to blunted BAS, which, in conjunction with enhanced BIS, may contribute more specifically to depression proneness. This issue is prominent given behavioral and neural evidence suggesting that childhood trauma may be indeed associated with dysfunctions in reward processing, and anhedonia (for a review see McLaughlin & Sheridan, 2016). For example, it has been recently reported that adults with a history of child maltreatment assess reward cues (i.e., potential financial gain) less positively and show reduced neural responses to reward in the basal ganglia (Dillon et al., 2009). To our knowledge, only one study has investigated the relation between childhood adversity and BIS/BAS (Rosenman & Rodgers, 2006), with some unexpected findings. Using a cumulative measure of childhood adversity, which included items about experiencing or witnessing physical and sexual abuse, emotional maltreatment, parental conflicts, parental depression, and financial hardships, this study (Rosenman & Rodgers, 2006) found a reduced probability of scoring in the top quartile of BIS for individuals with a history of childhood adversity. Separate analyses on each childhood adversity revealed both positive (e.g., parental depression, emotional abuse) and negative (e.g., parental separation, witnessing abuse) relations with BIS (Rosenman & Rodgers, 2006). Childhood adversity was not significantly related to BAS in this study. The negative association with BIS and the null results on BAS are difficult to reconcile with previous research considering that childhood adversity is a well-documented risk factor for psychopathology (e.g., Lindert et al., 2014; Nanni et al., 2012), and both self-report (Johnson et al., 2003; Kasch et al., 2002), and behavioral and neural evidence (Dillon et al., 2009; Henriques & Davidson, 2000) show that sensitivity to reward and punishment is altered in mental disorders such as depression. Therefore, we believe that further research is necessary in order to clarify the connections between early adversity and individual differences in sensitivity to reward and punishment. The present study investigated the relations between childhood trauma, BAS and BIS in adults. Childhood trauma can include a wide range of negative events, from physical and sexual abuse to chronic illness and loss of family or friends, and not all of these trauma types may increase vulnerability to psychopathology. Indeed, recent meta-analyses indicate that interpersonal trauma, which involves intentional harm inflicted by another person, is associated with depression and anxiety more often than non-interpersonal trauma (Alisic et al., 2014; Rytwinski, Scur, Feeny, & Youngstrom, 2013). Therefore, we examined BAS and BIS in individuals with a history of interpersonal or non-interpersonal trauma, in comparison to individuals with no reported history of childhood trauma. In addition, this study investigated the potential mediator role of BAS and BIS in the relations between childhood trauma and depressive and anxiety symptoms. In light of previous evidence on depression (e.g., Dillon et al., 2009; Henriques & Davidson, 2000; Kasch et al., 2002), we expected that low BAS and high BIS would carry the effects of childhood trauma on emotional symptoms, with the former being specifically involved in the path to depressive symptoms.

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2. Method 2.1. Participants An initial sample of 679 volunteers (574 women) was recruited through campus and online advertisements, and screened with a childhood trauma questionnaire. Based on inclusion and exclusion criteria, a final sample of N = 375 participants (331 women), aged between 18 and 40 years (M = 21.33, SD = 4.40 years), was selected. An a priori sample size estimation indicated that a sample of minimum 159 participants was necessary to detect a medium size effect with a power over 0.80. Inclusion criteria were related to having a history of childhood interpersonal or non-interpersonal trauma, or no history of trauma. Considering that we were interested to investigate the specific effects of these types of trauma, exclusion criteria referred to a history of mixed trauma, that is, either both interpersonal and non-interpersonal trauma, or one of these types and another type of trauma (see below). In accordance with the Declaration of Helsinki guidelines, participants signed an informed consent and the procedure was approved by the university's Ethics Committee. 2.2. Measures The Childhood Traumatic Events Scale (CTES) (Pennebaker & Susman, 1988; see also Szentagotai-Tatar & Miu, 2016) was used to investigate the history of interpersonal (i.e., sexual abuse, such as rape or molestation; violent events, such as physical abuse, mugging or assault) and non-interpersonal trauma (i.e., death of a very close friend or family member; severe illness or injury) before age 17. Each type of trauma was assessed by a single item, asking participants to report whether the event had occurred and to rate its traumatic severity on a scale from 1 (not at all traumatic) to 7 (extremely traumatic). There was an additional item asking participants about any other unspecified traumatic event that may have affected their life and personality. Following Pennebaker and Susman (1988), only events rated as traumatic (≥ 6) were considered. Given that each type of trauma was assessed by a single item, internal consistency was not applicable. BIS and BAS were assessed using the BIS/BAS scales (Carver & White, 1994), which include a 7-item BIS scale (i.e., reactions to the anticipation of punishment) and three BAS subscales: 4 items for Reward Drive (i.e., persistent pursuit of desired goals), 4 items for Fun Seeking (i.e., desire for new rewards and willingness to approach potentially rewarding events on the spur of the moment) and 5 items for Reward Responsiveness (i.e., positive responses to the occurrence or anticipation of reward). In this sample, Cronbach's alphas were 0.72 for BIS, 0.68 for BAS Reward Drive, 0.64 for BAS Fun Seeking, and 0.63 for BAS Reward Responsiveness. Depressive symptoms (e.g., hopelessness, lack of interest) and anxiety symptoms (e.g., subjective apprehension, autonomic arousal) were assessed using the Depression Anxiety Stress Scales (DASS) (S. H. Lovibond & P. F. Lovibond, 1995). Each scale has 7 items and the Cronbach's alphas in this sample were 0.85 for the depressive symptom scale, and 0.78 for the anxiety symptoms scale. Notably, DASS has been shown to distinguish anxiety and mood disorders in clinical samples (e.g., Brown, Chorpita, Korotitsch, & Barlow, 1997) and its correlations with other clinical scales are high (e.g., P. F. Lovibond & S. H. Lovibond, 1995). 2.3. Procedure All questionnaires were filled in online. Based on answers to CTES, only participants who reported either childhood interpersonal trauma (sexual or physical abuse) or non-interpersonal trauma (severe illness or injury, loss of family or close friend), and participants who reported no trauma were included in the study. In order to compare groups with specific trauma, individuals (N = 288) who reported another

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unspecified major upheaval during childhood, which affected their life and personality, were excluded from the study. In addition, a small group (N = 16) who reported a mixed history of childhood trauma, both interpersonal and non-interpersonal, was also excluded. Participants in the selected sample filled in the BIS/BAS scales and DASS. In the instructions that preceded the CTES, participants were warned that items may evoke unpleasant memories.

2.4. Statistical analysis The main analyses focused on: (1) investigating potential BAS and BIS differences related to the history of childhood trauma; and (2) examining the potential mediator role of BAS and BIS in the relations between childhood trauma and depressive and anxiety symptoms. Given that the BAS and BIS scores were not normally distributed (p b 0.001 in all Kolmogorov-Smirnov tests), we used non-parametric KruskalWallis χ2 tests to compare these scores between the three trauma groups (interpersonal trauma vs. non-interpersonal trauma vs. no trauma). Non-parametric Mann-Whitney U tests were used for follow-up comparisons between each two groups, as well as for examining potential sex differences. In which the second aim was concerned, Pearson correlation was first used to describe the general relations between variables. Then, mediation analyses were run, using bias-corrected bootstrapping, with 5000 iterations (Shrout & Bolger, 2002). We report the effect of the predictor (i.e., childhood trauma) on potential mediators (i.e., BAS and BIS) (path a), and the effects of the latter on the outcomes (i.e., depressive and anxiety symptoms) (path b). Indirect effects are significant if the 95% bootstrapping confidence interval (CI) does not include zero (Shrout & Bolger, 2002). Although it is not a necessary condition of mediation (Shrout & Bolger, 2002), we report the total effect of childhood trauma on depressive and anxiety symptoms (path c) and use the ratio between paths a ∗ b/c as an approximation of the amount of mediation (Shrout & Bolger, 2002). All the statistical analyses were run in SPSS and the mediation analyses were done using the Process macro for SPSS (Hayes, 2013).

3. Results Interpersonal trauma was reported by 36 participants (29 women), whereas non-interpersonal trauma was reported by 127 participants (120 women). The rest of 212 participants (182 women) reported no trauma. The self-reported severity of interpersonal (M = 6.46; SD = 0.51) and non-interpersonal (M = 6.41; SD = 0.49) trauma was similar. The self-reported age of trauma was also similar for interpersonal (M = 12.06; SD = 4.02) and non-interpersonal (M = 11.86; SD = 3.83) events.

3.1. Childhood trauma and depressive and anxiety symptoms There were significant differences between groups in DASS depressive symptoms (Kruskal-Wallis χ2[2] = 19.80, p b 0.001). Follow-up Mann-Whitney tests indicated that participants with a history of interpersonal trauma reported significantly higher levels of depressive symptoms compared to both participants with no history of trauma (U = 2211, p b 0.001) and those with non-interpersonal trauma (U = 1596, p = 0.005) (Fig. 1A). However, participants with a history of non-interpersonal trauma also showed higher levels of depressive symptoms compared to those with no childhood trauma (U = 11,337, p = 0.014) (Fig. 1A). Trauma also had a significant effect on DASS anxiety symptoms (Kruskal-Wallis χ2[2] = 18.11, p b 0.001). The level of anxiety symptoms was significantly higher in participants with both interpersonal (U = 2538, p = 0.001) and non-interpersonal (U = 10,477.50, p = 0.001) trauma compared to those with no trauma (Fig. 1B). There was no significant difference in anxiety symptoms between participants with interpersonal and non-interpersonal trauma (U = 2008, p = 0.264) (Fig. 1B). 3.2. Sex differences in BIS/BAS Mann-Whitney tests indicated that women reported significantly higher BAS Reward Responsiveness (U = 4732.50, p b 0.001) and BIS scores (U = 3104, p b 0.001) compared to men. The BAS Fun Seeking and BAS Reward Responsiveness were not significantly different between women and men (p ≥ 0.790). Therefore, all subsequent analyses which focused on the BAS Reward Responsiveness and the BIS scores were separately followed up in women and men. 3.3. Childhood trauma and BIS/BAS Group had a significant effect on BAS Reward Drive scores (KruskalWallis χ2[2] = 10.01, p = 0.007) and Mann-Whitney follow-up tests indicated that the group with interpersonal trauma reported lower levels of BAS Drive compared to the groups without trauma (U = 2827.50, p = 0.012) and with non-interpersonal trauma, respectively (U = 1493, p = 0.001) (Fig. 2A). As shown in Fig. 2A, the difference between the latter two groups was not significant (p = 0.221). There were no significant group differences in BAS Fun Seeking (p = 0.259) and BAS Reward Responsiveness (p = 0.194). The effect of childhood trauma on BAS Reward Responsiveness remained non-significant when separately analyzed in women and men (p ≥ 0.198). A similar Kruskal-Wallis test indicated that there were significant group differences in BIS scores (χ2[2] = 7.95, p = 0.019). Considering the sex differences in BIS, we ran the Kruskal-Wallis test separately in women and men. The effect of childhood trauma was replicated in

Fig. 1. Comparison of depressive (A) and anxiety (B) symptoms between individuals with a history of childhood interpersonal trauma, non-interpersonal trauma, and no trauma. Abbreviations: DASS, Depression Anxiety Stress Scales. * p b 0.05; ** p b 0.01.

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Fig. 2. Comparison of BAS Reward Drive (A) and BIS (B) scores between individuals with a history of childhood interpersonal trauma, non-interpersonal trauma, and no trauma. Abbreviations: BAS, behavioral activation system; BIS, behavioral inhibition system. * p b 0.05; ** p b 0.01.

women (χ2[2] = 10.87, p = 0.004), and was marginally significant in men (χ2[2] = 5.87, p = 0.053). Follow-up Mann-Whitney tests in the whole sample showed that BIS scores were significantly higher in the group with interpersonal trauma compared to the group without trauma (U = 2727.50, p = 0.006), and marginally higher compared to the group with non-interpersonal trauma (U = 1800.50, p = 0.051) (Fig. 2B). There were no significant differences between the groups with non-interpersonal trauma and without trauma (p = 0.234).

3.4. BIS/BAS as mediator between interpersonal trauma and depressive and anxiety symptoms First, considering that the effect of trauma on BAS Drive and BIS scores was limited to the group with interpersonal trauma, trauma was dummy coded so as to compare the group with interpersonal trauma (coded with 1) with the other two groups (no trauma and non-interpersonal trauma, coded with 0). Next, the two-tailed correlations between the history of interpersonal trauma (dummy-coded), BAS and BIS, and DASS depressive and anxiety symptoms were examined. As shown in Table 1, interpersonal trauma correlated negatively with the BAS Reward Drive scores and positively with the BIS score. Interpersonal trauma also correlated positively with DASS depressive and anxiety symptoms. BAS Reward Drive correlated negatively with DASS depressive symptoms, and BIS correlated positively with both depressive and anxiety symptoms. In addition, BAS Reward Responsiveness correlated negatively with DASS depressive symptoms. As expected, there were positive correlations between all BAS scores, in the moderate range, and negative correlations between the BIS score and both BAS Reward Drive and BAS Fun Seeking.

There was a positive relation between BIS and BAS Reward Responsiveness. Finally, bias-corrected bootstrapping analysis with 5000 iterations was used to investigate whether these BIS/BAS scores were mediators in the relation between trauma and DASS depressive and anxiety symptoms. Two separate mediation models were tested, with interpersonal trauma as predictor, BAS Drive and BIS as mediators, and DASS depressive and anxiety symptoms as alternative outcomes (Fig. 3). The potential mediators were simultaneously tested in order to investigate whether their effects were independent. There was a significant total effect of interpersonal trauma on depressive symptoms (path c in Fig. 3A). Interpersonal trauma was a significant negative predictor of BAS Reward Drive (path a in Fig. 3A), and the latter was a significant negative predictor of DASS depressive symptoms (path b in Fig. 3A). Moreover, the bootstrapping CI of the indirect effect did not include zero [0.06; 0.83] and therefore, BAS Reward Drive was a significant mediator between interpersonal trauma and DASS depressive symptoms. The ratio a ∗ b/c suggested that about 10% of the total effect of childhood interpersonal trauma on depressive symptoms is mediated by BAS Reward Drive. Interpersonal trauma was also a significant positive predictor of BIS (path a in Fig. 3A), and the latter was a significant positive predictor of DASS depressive symptoms (path b in Fig. 3A). The bootstrapping CI of the indirect effect did not include zero [0.05; 0.62] and thus, supported the mediator role of BIS in the relation between interpersonal trauma and DASS depressive symptoms. About 7.8% of the total effect of childhood interpersonal trauma on depressive symptoms was mediated by BIS. A similar model focused on DASS anxiety symptoms and found a significant total effect of interpersonal trauma (path c in Fig. 3B). While

Table 1 Correlations between childhood interpersonal trauma, BAS and BIS, and depressive and anxiety symptoms. Variable

Childhood interpersonal trauma (dummy coded: 0 = yes; 1 = no) BIS/BAS BAS Reward Drive BAS Fun Seeking BAS Reward Responsiveness BIS DASS Depressive symptoms

BIS/BAS

DASS

BAS Reward Drive BAS Fun Seeking BAS Reward Responsiveness BIS

Depressive symptoms Anxiety symptoms

−0.16⁎⁎

0.23⁎⁎

−0.06

−0.07

0.14⁎⁎

0.36⁎⁎

0.46⁎⁎ 0.31⁎⁎

−0.16⁎⁎ −0.19⁎⁎ −0.13⁎⁎ −0.09 0.17⁎⁎ −0.23⁎⁎ 0.18⁎⁎

Note. Abbreviations: BAS, behavioral activation scale; BIS, behavioral inhibition scale; DASS, Depression Anxiety Stress Scales. ⁎ p b 0.05. ⁎⁎ p b 0.01.

0.12⁎ −0.01 −0.05 −0.03 0.33⁎⁎ 0.61⁎⁎

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Fig. 3. Models in which the BAS Reward Drive and BIS scores were tested as potential mediators between childhood interpersonal trauma and depressive (A) and anxiety symptoms (B).

interpersonal trauma was a significant positive predictor of BAS Reward Drive, the latter was not a significant predictor of DASS anxiety symptoms (path a in Fig. 3B). As expected, the bootstrapping CI of the indirect effect included zero [−0.54; 0.05] and did not support the mediator role of BAS Drive in the relation between interpersonal trauma and DASS anxiety symptoms. In contrast, interpersonal trauma was a significant positive predictor of BIS (path a in Fig. 3B), and the latter was a significant positive predictor of DASS anxiety symptoms (path b in Fig. 3B). BIS was a significant mediator in the relation between interpersonal trauma and DASS anxiety symptoms given that the bootstrapping CI of the indirect effect did not include zero [0.21; 1.23]. The ratio a ∗ b/c suggested that about 37% of the total effect of childhood interpersonal trauma on anxiety symptoms is mediated by BIS. 4. Discussion The results of this study indicate that, as expected, a childhood history of interpersonal trauma is associated with both low BAS and high BIS. We also found that the indirect effect of childhood interpersonal trauma on depressive symptoms is carried through both low BAS and high BIS, whereas the effect on anxiety symptoms involves only the latter. Therefore, in addition to elucidating the links between childhood trauma, BAS and BIS, these findings highlight the marked impact of interpersonal trauma and suggest that low BAS may specifically contribute to vulnerability to depression. The revised reinforcement sensitivity theory (Gray & McNaughton, 2000) has argued that enhanced sensitivity to punishment, as reflected through high BIS, contributes to proneness to anxiety and depression (see also Fowles, 1993). In addition, self-report (e.g., Kasch et al., 2002), behavioral (e.g., Henriques & Davidson, 2000) and neural (e.g., Dillon et al., 2009) evidence suggests that depression may also be characterized by reduced BAS. In contrast with these predictions, a previous study (Rosenman & Rodgers, 2006) reported that a cumulative score of early adversities was negatively associated with BIS and seemingly unrelated to BAS. Nonetheless, these results (Rosenman & Rodgers, 2006) suggested that certain forms of adversity, such as abuse, may be related to increased BIS. Prompted by this suggestion and previous meta-analytic results which indicated that interpersonal trauma is associated with depressive and anxiety symptoms more often than non-interpersonal trauma (Alisic et al., 2014; Rytwinski et al., 2013; this study), we found that, indeed, the former type of trauma was associated with both less persistent pursuit of desired goals, as reflected by reduced BAS Reward Drive scores, and higher anticipation of bad outcomes and responsiveness to punishment, as indicated by increased BIS scores. The predominant impact of interpersonal trauma may be explained by the fact that experiences of intentional harm, often from family or a trustworthy person, more readily prompt negative cognitive biases in beliefs about self and others (Alisic et al., 2014). Negatively biased beliefs about self and others may chronically enhance self-blaming and undermine social support (Alisic et al., 2014), and what the present study suggests is that the long-term detrimental consequences of childhood interpersonal trauma

also include low motivation for reward and increased sensitivity to punishment. As suggested by one of the reviewers, other mechanisms may underlie the long-term negative consequences of early interpersonal trauma, such as attachment insecurity and alteration of brain development. Insecure child-parent attachment may have long-term effects by serving as an internal working model for future relationships (e.g., Bowlby, 1969). Indeed, there is evidence that this mechanism is involved in the link between early interpersonal trauma and adult depression (e.g., Fowler, Allen, Oldham, & Frueh, 2013). Also, by negatively interfering with the development of brain structures such as the amygdala, which undergo sensitive maturation periods during childhood, early interpersonal trauma may induce long-term emotional dysfunctions and contribute to risk for psychopathology (Lupien, McEwen, Gunnar, & Heim, 2009). Non-interpersonal trauma may not have as much capacity to alter these mechanisms. In this study, childhood trauma was not related to the other two BAS dimensions, that is, impulsive approach of reward (i.e., BAS Fun Seeking) and emotional responsiveness to reward (i.e., BAS Reward Responsiveness). Importantly, the present results parallel previous findings of blunted motivation for reward and enhanced sensitivity to punishment in depression (e.g., Kasch et al., 2002). The divergence between our findings and those reported by Rosenman and Rodgers (2006) may be due to methodological differences such as the separation of interpersonal and non-interpersonal trauma and the focus on childhood negative events that were perceived as traumatic (i.e., severity rating ≥ 6) in the present study. Furthermore, the present mediation analyses showed differences in the involvement of BAS and BIS in the paths from childhood trauma to depressive and anxiety symptoms. Namely, the effect of interpersonal trauma on depressive symptoms was carried by both blunted motivation for reward and enhanced sensitivity to punishment, whereas that on anxiety symptoms was only carried by the latter. The common involvement of increased BIS in the relation between childhood trauma and both depressive and anxiety symptoms is in line with previous theoretical predictions (e.g., Fowles, 1993). In addition, the specific mediator role played by reduced BAS Reward Drive in the relation between childhood trauma and depressive symptoms corroborates and extends previous reports of blunted sensitivity to reward in depression (Dillon et al., 2009; Henriques & Davidson, 2000; Kasch et al., 2002). Based on the size of the a and b paths and the sample size estimations reported by Fritz and MacKinnon (2007), we had sufficient power to detect the mediator role of BIS in the relations between childhood trauma and both depressive and anxiety symptoms. For BAS as mediator between childhood trauma and depressive symptoms, we would have needed a slightly larger sample (i.e., 396 participants) (Fritz & MacKinnon, 2007). The main limitation of this study is related to its correlational and cross-sectional design. The present mediation analyses suggest a direction of the effect, with childhood trauma influencing the development of individual differences in sensitivity to reward and punishment, which in turn may contribute to depressive and anxiety symptoms. The first part of this path is in line with the temporal sequence of the variables considering that the predictor is related to events that occurred in childhood and the mediators are individual differences that

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may peak in late adolescence (e.g., Braams, van Duijvenvoorde, Peper, & Crone, 2015; Urosevic, Collins, Muetzel, Lim, & Luciana, 2012). However, it is not possible to argue for the temporal precedence of BAS and BIS relative to depressive and anxiety symptoms, given that their development may indeed be simultaneous. Nevertheless, this part of the mediation path is informed by theory, which argues that BAS and BIS contribute to proneness to depression and anxiety and not the other way around (e.g., Fowles, 1993; Gray & McNaughton, 2000). Another potential limitation of the present study is related to its exclusive reliance on self-report measures, which may be prone to subjective biases. Indeed, childhood trauma may be underreported in questionnaires (for review see Thabrew, de Sylva, & Romans, 2012) and self-reported depressive and anxiety symptoms may not easily discriminate clinical problems. In addition, it would be ideal to parallel the self-reported BAS and BIS with behavioral and neural measures (e.g., Simon et al., 2010). Finally, the present sample was not randomly selected and therefore, it may not be representative for the general population. Particularly, the small number of men, which reflected the asymmetric sex distribution in the initial pool of volunteers, may have limited the capacity of identifying sex-related effects. These results add to a growing literature showing that individual differences in sensitivity to reward and punishment may carry the longterm negative effects of childhood trauma (McLaughlin & Sheridan, 2016; Vujanovic et al., 2017). The main implication of this line of research is related to the possibility of using these individual differences as markers of vulnerability to psychopathology. In light of the present results, future prospective studies could investigate whether the development of blunted sensitivity to reward and enhanced sensitivity to punishment precede the onset of anxiety and depression in individuals with a history of childhood trauma. Should this hypothesis be supported, sensitivity to reward and punishment could be used to identify individuals that were exposed to early trauma and may have an increased risk for psychopathology. In conclusion, the present study has shown that a history of childhood interpersonal trauma is associated with reduced motivation for reward and increased sensitivity to punishment in adults. These results suggest that enhanced BIS contributes to long-term vulnerability to both depression and anxiety following childhood trauma, whereas blunted BAS may tip the scale toward depression. Overall, the present findings extend the evidence on the mediator role of maladaptive dispositional traits such as altered BAS and BIS in the long-term pathogenetic influence of childhood trauma.

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