Neural correlates of maternal empathy as a function of childhood emotional abuse history.

Childhood emotional abuse (CEA) has enduring effects on health and close relationships, including parenting. Mothers with maltreatment histories often experience parenting difficulties, yet research has primarily focused on physical and sexual abuse. Far less is known about how CEA influences maternal brain responses during parenting. Prior studies suggest atypical neural activity among at-risk mothers when viewing or hearing their own children. This study examined associations between maternal CEA and neural responses during a Child Face Mirroring Task (CFMT), an fMRI paradigm assessing maternal empathy toward child emotions, a key component of sensitive parenting. Fourteen low-income mothers (mean age = 32 years) with self-reported trauma exposures from a longitudinal parenting study completed CFMT scanning when their children were age 5. Mothers viewed images of their own and unknown children expressing neutral, ambiguous, distressful, or joyful emotions. Before each block, mothers were instructed to either "join" (empathize and imitate) or "observe" (remain neutral). The Join-Own-Child > Observe-Own-Child contrast was regressed against maternal CEA severity (Childhood Trauma Questionnaire). Whole-brain analyses were corrected for multiple comparisons. The Join-Own-Child > Observe-Own-Child contrast activated the supplementary motor area (SMA) and right pericentral gyrus (pCG). Higher CEA scores were associated with greater activation in SMA, dorsomedial prefrontal cortex (dmPFC), periaqueductal gray (PAG), middle cingulate cortex (MCC), left temporal pole, and right inferior temporal gyrus-but not pCG. Meta-analytic mapping indicated these regions support belief-based mentalization (i.e., the consideration of others' emotional or mental states), pain, and autobiographical memory processes. Maternal CEA was linked to heightened engagement of brain regions involved in top-down mentalization rather than sensorimotor imitation. Such over-mentalization (i.e., explaining away intentions and feelings of another person), and memory-linked processing may influence mothers' interpretations of their children's emotions, potentially impairing sensitivity. Understanding these neural mechanisms may inform therapeutic strategies to improve parenting among mothers with emotional abuse histories.