Early childhood stress exposure, reward pathways, and adult decision making.

Individuals who have experienced chronic and high levels of stress during their childhoods are at increased risk for a wide range of behavioral problems, yet the neurobiological mechanisms underlying this association are poorly understood. We measured the life circumstances of a community sample of school-aged children and then followed these children for a decade. Those from the highest and lowest quintiles of childhood stress exposure were invited to return to our laboratory as young adults, at which time we reassessed their life circumstances, acquired fMRI data during a reward-processing task, and tested their judgment and decision making. Individuals who experienced high levels of early life stress showed lower levels of brain activation when processing cues signaling potential loss and increased responsivity when actually experiencing losses. Specifically, those with high childhood stress had reduced activation in the posterior cingulate/precuneus, middle temporal gyrus, and superior occipital cortex during the anticipation of potential rewards; reduced activation in putamen and insula during the anticipation of potential losses; and increased left inferior frontal gyrus activation when experiencing an actual loss. These patterns of brain activity were associated with both laboratory and real-world measures of individuals' risk taking in adulthood. Importantly, these effects were predicated only by childhood stress exposure and not by current levels of life stress.