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In Reply We agree with Begemann et al that psychiatric illness is often a confound in retrospective characterization of the potential neuroanatomical changes associated with childhood maltreatment (CM). One approach to address this confound is to conduct longitudinal studies. On the other hand, studies with large samples, such as those conducted by Dannlowski et al,1 show that CM alone, without any history of psychiatric illnesses, is associated with lower hippocampal volume. Dannlowski et al1 suggest that such brain limbic scars may mediate the relationship between CM, stressful life events, and psychiatric illnesses. Although this conclusion is somewhat tenuous without psychiatric illness present, these findings would seem to suggest a common theme related to CM and alterations to the hippocampal complex.
Van Dam NT, Sinha R. Childhood Trauma–Specific Reductions in Limbic Gray Matter Volume—Reply. JAMA Psychiatry. 2015;72(4):398-399. doi:10.1001/jamapsychiatry.2014.2682