Adverse Childhood Experiences, Fear Learning, and the Moderating Role of Parenting: A Systematic Investigation of Functional Activity and Connectivity in Adolescence

Adverse childhood experiences (ACE) are well-established risk factors for psychopathology in adolescence, with symptoms frequently characterized by maladaptive fear learning behaviors. These behaviors are thought to underlie alterations in neurocognitive processing during fear conditioning and extinction. However, the core mechanisms driving these alterations remain underexplored, reflected in inconsistent reports of fear-related brain activation and connectivity in adolescents with ACE. Therefore, this study aims to advance our understanding of the neural correlates of fear learning following ACE in adolescents using fMRI. Specifically, we will (1) analyze both activation and seed-based functional connectivity; (2) include both ROI and whole-brain analyses; (3) examine additional key regions of the fear neurocircuitry (Hippocampus; Anterior Cingulate Cortex (ACC); Insula) beyond the amygdala and ventro-medial prefrontal cortex (vmPFC). Additionally, some mixed findings may stem from analyses that do not distinguish between different neurocognitive stages of fear learning, therefore we analyze three specific phases of fear learning separately: fear conditioning (FC), extinction learning (EL), and extinction recall (ER). Furthermore, literature on ACE and fear learning has overlooked the role of protective factors. Given the evidence that positive parenting promotes resilience following ACE, we test parenting as a moderator of the relationship between ACE and fear learning brain activity and connectivity.