Conséquences développementales de la maltraitance infantile : de la résilience à la psychopathologie. Exemple du trouble de personnalité borderline à l'adolescence

Childhood maltreatment (CM) has many lasting consequences for the development of children and adolescents. The aim of this work was to study different hypotheses that may underlie these consequences ranging from resilience to psychopathology during adolescence. This period is indeed a period characterized by major hormonal and neurobiological changes and by the onset of numerous mental disorders. Furthermore, puberty timing is directly impacted by CM. We hypothesized and explored reward system and stress responsiveness impairments in a large multicentric cohort of community adolescents (IMAGEN) and in adolescents with a psychiatric disorder associated with CM : Borderline Personality Disorder (BPD) ('suicide attempters' cohort and ADOLIMIS). Neuroimaging analyzes of the reward sytem found that lower regional volumes and blunted reactivity correlated with an earlier puberty timing in adolescents with lower motivational behaviors and higher emotional problems. Affective computing analyzes reported that BPD adolescents showed a higher response to stress but a lack of self-perception. We propose an integrative model of the developmental consequences of CM during adolescence ranging from resilience to psychopathology, highlitghing an association of putative risk factors requiring increased monitoring such as earlier timing of puberty and precocity of suicidal behavior and anxiety disorders. These results open up prospects for targeted therapies such as neurofeedback and for new hypotheses that will be explored in the neuroimaging part of the ADOLIMIS study.