It's Not Nature versus Nurture; It's Neural Networks: Adverse Childhood Experiences and Attachment Disruption as Neurodevelopmental Causes of Adult Mental Illness and Addiction.

Neuroscience continues to uncover anatomical, mechanistic, and etiological linkages between mental illness and addiction. The neurodevelopmental pathogenesis of these often intertwined brain disorders is contributed to by both genetic and experiential-causal events. This article introduces the term ecocausatypes to describe traumatically adverse experiences and attachment disruptions that are biologically potent on par with genes, and highly interactive with genetics in causing psychiatric and addiction phenotypes. Neural network theory explains how genotypes and ecocausatypes are biologically integrated, leading to pathological patterns of social-emotional function and motivation in adulthood. At the heart of this pathogenesis, impulsivity is a behavioral feature of motivational neural network dysfunction that is associated with and interlinks disturbances in attachment, trauma-spectrum psychiatric disorders, and addiction vulnerability. On the neural network level, impulsivity is a product of neural wiring and information processing that involves connectivity between the prefrontal cortex, the amygdala, hippocampal formation, and the nucleus accumbens-the primary motivational neural network that is pathologically altered by addictive drugs. Recognizing the effects of ecocausatypes on the development of these frontal cortical-striatal-temporal limbic networks provides a clear understanding of how disordered attachment, trauma-spectrum mental illness, and addiction pathogenesis are biologically and clinically interlinked. This neuroscience has significant implications for training, clinical practice, and research in psychiatry, in which adverse childhood experiences and attachment disruptions are understood as being just as biologically important as genetics, and where medication management and attachment-based psychotherapies are routinely integrated.