BACKGROUND:Internalizing disorders (IDs) such as anxiety and depression show a peak onset during adolescence, a period characterized by maturation of the frontal lobe. Impaired emotion regulation and elevated reactivity are prominent transdiagnostic symptoms that are further impacted by childhood adversity. However, the mechanisms through which IDs and adversity alter neurodevelopmental trajectories of emotion processing during adolescence are poorly understood, particularly across implicit and explicit regulation strategies. METHODS:Utilizing an accelerated longitudinal design, youth (aged 10-17) with IDs (n = 65) and a typically-developing comparison group (CG; n = 74) completed an emotional N-Back (implicit) and cognitive reappraisal (explicit) task during fMRI at baseline and one-year follow-up. Linear mixed effects modeling was used to investigate group and age differences in regional frontal lobe activation, then explored how these effects were moderated by adversity. RESULTS:As compared to CG-youth, ID-youth showed developmental differences in the left ventral anterior insula during the implicit task, and the left dorsal anterior insula during the explicit task. Across both tasks, ID-youth lacked the increasing differential activation between negative and neutral stimuli across age that CG-youth exhibit. In ID-youth, adversity moderated neural activity during the explicit task, including the developmental trajectory of the dorsal anterior insula, but not the implicit task. CONCLUSIONS:The left anterior insula is a key developmental region with subregion-specificity. These findings highlight the importance of individual neural maturation and carry implications for emotion regulation-based pediatric clinical interventions. Further investigation is necessary to assess whether intervention effectiveness is dependent on adversity history.

Background: The use of social cues to attenuate prior learned fear associations is a critical skill for normative development. Impairments in extinction learning underlie emerging models of posttraumatic stress disorder (PTSD) in adults. However, few have investigated how trauma and/or related psychopathology may impact the unique neural and physiological processes of observed-parent vicarious safety learning during adolescence. Methods: This study enrolled typically developing (TD) (n = 42) and trauma-exposed (TE) (n = 45) parent-child dyads, where youths were classified as having low (TE+low) or high (TE+high) posttraumatic stress symptoms (PTSSs). Dyads completed acquisition (day 1), direct and vicarious extinction by watching a video of parent direct (day 2), and extinction recall (day 3). Youths completed all phases during functional magnetic resonance imaging. Analysis of behavioral outcomes, parent-child autonomic synchrony, and whole-brain voxelwise activation were used to characterize trauma- and PTSS-related correlates of vicarious extinction. Results: Autonomic synchrony analyses suggest that TE youths did not exhibit normative vicarious extinction transmission, where stronger autonomic synchrony with their parent did not result in lower arousal. Next, TE+high youths uniquely exhibited less successful behavioral learning and atypically high arousal in response to safety cues during vicarious extinction as compared with TE+low and TD youths. Brain activation analyses revealed that patterns of ventral and dorsolateral prefrontal cortex (PFC) recruitment differentiated PTSS load during vicarious extinction. Conclusions: This study identifies novel behavioral and neurobiological profiles of trauma and PTSD. Distinct behavioral impairments in vicarious learning may be related to disruptions in parent-child synchrony or altered recruitment of the lateral PFC during vicarious learning encoding.

Objective This multiple methods study examines the feasibility, acceptability, and preliminary outcomes associated with participation in the Mindfulness and Self-Compassion for Children and Caregivers course (MSC-CC).Background School-age youth are experiencing unprecedented levels of anxiety and depression. Self-compassion skills are accessible, evidence-based, transdiagnostic tools that can help children regulate difficult emotions. Learning self-compassion with a caregiver may improve child mental health and provide caregivers with resources to model and sustain skills.Methods We recruited two cohorts (23 dyads) comprising children (Mage = 8.4) and a caregiver to participate in live online group-based MSC-CC. Dyads completed pre- and post-course surveys and semistructured feedback interviews about their experience.Results Attendance and course satisfaction were high, and attrition was low. We detected significant improvements in caregiver-reported child mental health outcomes; child self-reports did not reach significance. We developed three themes from post-course interviews: (a) confidence in and application of emotional skills, (b) attunement and closeness, and (c) course engagement and relatability.Conclusions The MSC-CC program is feasible, acceptable, and associated with caregiver-reported improvement in child mental health and qualitative evidence of improved relational and family dynamics.Implications Despite inconsistent findings, dyadic self-compassion training is promising and should be examined compared to a control group.

Objective: Studies investigating resting-state functional connectivity of the amygdala and hippocampus have produced inconsistent findings. The authors' objective was to conduct the largest systematic comparison of alterations in functional connectivity of the amygdala and hippocampus in individuals with posttraumatic stress disorder (PTSD) using a multicohort mega-analysis with uniform processing steps and parameters across all cohorts. Methods: Resting-state functional MRI data from 1,017 PTSD patients and 1,702 control participants from 32 international sites were centrally preprocessed with HALFpipe and analyzed using the Image-Based Meta- and Mega-Analysis (IBMMA) package for neuroimaging processing. Group-level seed-based whole-brain analyses were completed for the right and left amygdala and hippocampus. Additional correlation analyses were conducted between PTSD norm-severity scores and resting-state functional connectivity (rs-FC). Results: Compared to control participants, individuals with PTSD showed stronger rs-FC between the left amygdala seed and right hippocampus and amygdala and the left and right lingual gyri. Greater PTSD total norm-severity scores were significantly associated with rs-FC between the left amygdala and right hippocampus/amygdala and rs-FC between the right amygdala and left hippocampus/amygdala. Conclusions: Greater connectivity between subcortical threat centers involved in fear processing, memory, and extinction learning characterizes the resting state in PTSD. Future directions include investigating how different interventions, such as brain stimulation, neurofeedback, and psychotherapy, might modulate the aberrant neural networks in PTSD.

The increasing scale and complexity of neuroimaging datasets aggregated from multiple study sites present substantial analytic challenges, as existing statistical analysis tools struggle to handle missing voxel-data, suffer from limited computational speed and inefficient memory allocation, and are restricted in the types of statistical designs they are able to model. We introduce Image-Based Meta- & Mega-Analysis (IBMMA), a novel software package implemented in R and Python that provides a unified framework for analyzing diverse neuroimaging features, efficiently handles large-scale datasets through parallel processing, offers flexible statistical modeling options, and properly manages missing voxel-data commonly encountered in multi-site studies. IBMMA successfully analyzed a large-n dataset of several thousand participants and revealed findings in brain regions that some traditional software overlooked due to missing voxel-data resulting in gaps in brain coverage. IBMMA has the potential to accelerate discoveries in neuroscience and enhance the clinical utility of neuroimaging findings.

Childhood abuse represents one of the most potent risk factors for the development of psychopathology during childhood, accounting for 30-60% of the risk for onset. While previous studies have separately associated reductions in gray matter volume (GMV) with childhood abuse and internalizing psychopathology (IP), it is unclear whether abuse and IP differ in their structural abnormalities, and which GMV features are related to abuse and IP at the individual level. In a pooled multisite, multi-investigator sample, 246 child and adolescent females between the ages of 8-18 were recruited into studies of interpersonal violence (IPV) and/or IP (i.e. posttraumatic stress disorder (PTSD), depression, and/or anxiety). Youth completed assessments for IP, childhood abuse history, and underwent high resolution T1 structural MRI. First, we characterized how differences in GMV associated with childhood abuse exposure depend on the presence or absence of IP using voxel-based morphometry (VBM). Next, we trained convolutional neural networks to predict individual psychopathology and abuse experience and estimated the strength and direction of importance of each structural feature in making individual-level predictions using Shapley values. Shapley values were aggregated across the entire cohort, and the top 1% of feature clusters with the highest importance are reported. At a group-level, VBM analyses identified widespread decreases in GMV across the prefrontal cortex, insula, and hippocampus in youth with IP, while abuse experience was specifically associated with increased GMV in the cingulate cortex and supramarginal gyrus. Further, interactions between IP and severity of abuse were identified in the ventral and dorsal prefrontal cortex, anterior cingulate cortex, and thalamus. After extensive training, model tuning, and model evaluation, the neural networks performed above chance when predicting IP (63% accuracy) and abuse experiences (71% accuracy) at the level of the individual. Interestingly, structural regions with the highest importance in making individual IP predictions had a high degree of overlap with group-level patterns. We have identified unique structural correlates of childhood abuse and IP on both the group and individual level with a high degree of overlap, providing evidence that IP and trauma exposure may uniquely and jointly impact child and adolescent structural neurodevelopment. Feature learning may offer power and novelty above and beyond traditional group-level approaches to the identification of biomarkers and a movement towards individualized diagnosis and treatment.

BACKGROUND:Previous investigations of whole thalamus and thalamic nuclei volumes in posttrauma psychopathology have been sparse and limited in scope and have yielded inconsistent results. To address this, volumetric estimates of whole thalamus and thalamic nuclei were obtained from structural brain magnetic resonance imaging scans from 2058 participants across 20 worldwide sites in the ENIGMA (Enhancing Neuro Imaging Genetics through Meta Analysis) Posttraumatic Stress Disorder (PTSD) working group. METHODS:Thalamic volumes were compared in trauma-exposed participants with PTSD (n = 238), major depressive disorder (MDD) (n = 184), and comorbid PTSD+MDD (n = 618) and in trauma-exposed control participants (n = 1018). PTSD and MDD symptom severity, PTSD symptom clusters, and childhood trauma were similarly examined for associations with thalamic volume. RESULTS:Participants with PTSD had smaller sensorimotor thalamic nuclei, while participants with MDD or comorbid PTSD+MDD had smaller mediodorsal (MD) thalamus volumes relative to control participants. Severity of PTSD and MDD symptoms negatively correlated with MD volume. A significant interaction between PTSD and MDD severity was found, such that MDD severity was positively associated with whole thalamus volume only among individuals with high PTSD severity. We observed both positive and negative volumetric associations for specific PTSD symptom clusters and childhood trauma subtypes. CONCLUSIONS:Whole thalamus volume and volumes of the sensorimotor and limbic thalamus may play an important role in the development of PTSD and MDD in the aftermath of trauma exposure. The interaction between PTSD and MDD symptoms and contrasting effects across PTSD symptom clusters and types of childhood adversity suggest that multiple neurobiological mechanisms are involved in shaping thalamic volume posttrauma.

Analysis of resting state fMRI (rs-fMRI) typically excludes images substantially degraded by subject motion. However, data quality, including degree of motion, relates to a broad set of participant characteristics, particularly in pediatric neuroimaging. Consequently, when planning quality control (QC) procedures researchers must balance data quality concerns against the possibility of biasing results by eliminating data. In order to explore how researcher QC decisions might bias rs-fMRI findings and inform future research design, we investigated how a broad spectrum of participant characteristics in the Adolescent Brain and Cognitive Development (ABCD) study were related to participant inclusion/exclusion across versions of the dataset (the ABCD Community Collection and ABCD Release 4) and QC choices (specifically, motion scrubbing thresholds). Across all these conditions, we found that the odds of a participant's exclusion related to a broad spectrum of behavioral, demographic, and health-related variables, with the consequence that rs-fMRI analyses using these variables are likely to produce biased results. Consequently, we recommend that missing data be formally accounted for when analyzing rs-fMRI data and interpreting results. Our findings demonstrate the urgent need for better data acquisition and analysis techniques which minimize the impact of motion on data quality. Additionally, we strongly recommend including detailed information about quality control in open datasets such as ABCD.

Identifying robust neural signatures of posttraumatic stress disorder (PTSD) symptoms is important to facilitate precision psychiatry and help in understanding and treatment of the disorder. Emergent research suggests structural covariance of early visual regions is associated with later PTSD development. However, large-scale analyses are needed – in heterogeneous samples of trauma-exposed and trauma naive individuals – to determine if such a neural signature is a robust – and potentially a pretrauma – marker of vulnerability. We analyzed data from the ENIGMA-PTSD dataset (n = 2,814) and the Human Connectome Project – Young Adult (HCP-YA) dataset (n = 890) to investigate whether structural covariance of early visual cortex is associated with either PTSD symptoms or perceived stress. Structural covariance was derived from a multimodal pattern previously identified in recent trauma survivors, and participant loadings on the profile were included in linear mixed effects models to evaluate associations with stress. Early visual cortex covariance loadings were negatively associated with PTSD symptoms in the ENIGMA-PTSD dataset. The relationship persisted when accounting for prior childhood maltreatment; supporting PTSD symptom specificity, no relationship was observed with depressive symptoms and no association was observed between loadings and perceived stress measures in the HCP-YA dataset. Structural covariance of early visual cortex was robustly associated with PTSD symptoms across an international, heterogeneous sample of trauma survivors. Future studies should aim to identify specific mechanisms that underlie structural alterations in the visual cortex to better understand posttrauma psychopathology.

BACKGROUND:Adolescence is a period that coincides with a peak in both the onset of psychopathology and a sensitive period for neural development. One transdiagnostic characteristic of psychopathology is impaired emotion regulation (ER), a process with both implicit (automatic) and explicit (voluntary) underpinnings. The current study aims to better understand the normative neurodevelopment of these two components of ER in adolescents. METHODS:139 youth (aged 10-20 years) completed ER assessment during fMRI at baseline and one-year follow-up. Implicit and explicit ER were examined using an emotional N-Back and a cognitive reappraisal task, respectively. Linear-mixed effects modeling was used to identify regions of the frontal cortex (Schaefer atlas) and the amygdala and hippocampus (Tian atlas) whose activity was predicted by ER- and age-related variables, covaried for sex, childhood adversity, and psychopathology symptoms. RESULTS:Regions that displayed change across age were localized to the salience/ventral attention network in the right hemisphere. For implicit ER, mid-insula activity showed changes during early adolescence (∼10 years old), such that activity to negative stimuli increased during this time before plateauing. For explicit ER, the posterior insula, Rolandic Operculum, and paracentral lobule showed linear decreases in activity across the entire age range, where the decrease occurred at a faster rate in response to neutral relative to negative stimuli. CONCLUSIONS:Functional changes in frontal circuits related to emotional attention may encode the development of ER during neurodevelopment. Maturation of these circuits seem to reach completion by mid-adolescence for implicit ER, but explicit ER continues developing across adolescence.

BACKGROUND:Identifying robust neural signatures of posttraumatic stress disorder (PTSD) symptoms is important to facilitate precision psychiatry and help in understanding and treatment of the disorder. Emergent research suggests that the structural covariance of early visual regions is associated with later PTSD development. However, large-scale analyses are needed in heterogeneous samples of trauma-exposed and trauma-naïve individuals to determine whether such a neural signature is a robust marker of vulnerability. METHODS:We analyzed data from the ENIGMA (Enhancing Neuro Imaging Genetics through Meta Analysis)-PTSD dataset (N = 2814) and the HCP-YA (Human Connectome Project-Young Adult) dataset (N = 890) to investigate whether the structural covariance of the early visual cortex is associated with either PTSD symptoms or perceived stress. Structural covariance was derived from a multimodal pattern previously identified in recent trauma survivors, and participant loadings on the profile were included in linear mixed effects models to evaluate associations with stress. RESULTS:Early visual cortex covariance loadings were negatively associated with PTSD symptoms in the ENIGMA-PTSD dataset. The relationship persisted when accounting for prior childhood maltreatment; supporting PTSD symptom specificity, no relationship was observed with depressive symptoms, and no association was observed between loadings and perceived stress measures in the HCP-YA dataset. CONCLUSIONS:The structural covariance of early visual cortex was robustly associated with PTSD symptoms across an international, heterogeneous sample of trauma survivors. Future studies should aim to identify specific mechanisms that underlie structural alterations in the visual cortex to better understand posttrauma psychopathology.

Pediatric PTSD is a common and debilitating condition, affecting 5% of youth by the age of 18 years.1 Trauma-focused psychotherapies, particularly trauma-focused cognitive-behavioral therapy (TF-CBT) and eye movement desensitization and reprocessing (EMDR) have shown evidence of effectiveness in clinical trials and meta-analyses.2 Yet, it has been difficult to translate these studies into meaningful estimates of their effectiveness that can be communicated to providers and patients alike.

The dyadic relationship between a parent and child is a critical facilitator of social learning, particularly in the management of fear. Vicarious extinction, the process of learning by observing a parent extinguish learned threat responses, holds critical translational potential in understanding adolescent psychopathology involving aberrant threat responses. However, biological profiles of vicarious extinction irrespective of psychopathology have yet to be uncovered. Here, a community-representative sample of 97 parent-child dyads, enriched for trauma-exposure, completed a validated vicarious extinction paradigm. Youth completed all phases during functional magnetic resonance imaging, while caregivers simultaneously completed the behavioral task. Linear models interrogating behavioral, physiological, and neural correlates of acquisition and direct and vicarious extinction, controlled for trauma and symptom severity. The degree of parent-child autonomic synchrony was used to predict the strength of extinction learning. Youth behavioral and skin conductance response markers suggest successful threat acquisition and direct and vicarious extinction. Autonomic arousal during active vicarious extinction learning processes was significantly associated with the strength of parent-child synchrony. Neural activation analyses reveal patterns of early encoding of threat and safety discrimination that were reactivated during later threat reinstatement. Finally, results corroborate and expand known models of direct and vicarious extinction, respectively involving the ventromedial and ventrolateral prefrontal cortex. Altogether, this data confirms that youth can directly and vicariously modify learned threat associations with distinct neurobiological profiles. This delineation of vicarious extinction neural circuitry within a representative population is pivotal for understanding how these processes may be altered by the environment and/or psychopathology during adolescence.

Objective: Parents play a notable role in the development of child psychopathology. In this study, we investigated the role of parent psychopathology and behaviors on child brain-symptom networks to understand the role of intergenerational transmission of psychopathology. Few studies have documented the interaction of child psychopathology, parent psychopathology, and child neuroimaging. Method: We used the baseline cohort of the Adolescent Brain Cognitive Development Study (N = 7,151, female-at-birth = 3,619, aged 9-11 years) to derive brain-symptom networks using sparse canonical correlation analysis with the Child Behavior Checklist and resting-state functional magnetic resonance imaging. We then correlated parent psychopathology symptoms and parental behaviors with child brain-symptom networks. Finally, we used the significant correlations to understand, using the mediation R package, whether parent behaviors mediated the effect of parent psychopathology on child brain connectivity. Results: We observed 3 brain-symptom networks correlated with externalizing (r = 0.19, internalizing (r = 0.17), and neurodevelopmental symptoms (r = 0.18). These corresponded to differences in connectivity between the default mode-default mode, default mode-control, and visual- visual canonical networks. We further detected aspects of parental psychopathology, including personal strength, thought problems, and rule-breaking symptoms to be associated with child brain connectivity. Finally, we found that parental behaviors and symptoms mediate each other's relationship to child brain connectivity. Conclusion: The current study suggests that positive parental behaviors can relieve potentially detrimental effects of parental psychopathology, and vice versa, on symptom-correlated child brain connectivity. Altogether, these results provide a framework for future research and potential targets for parents who experience mental health symptoms to help mitigate potential intergenerational transmission of mental illness. Plain language summary: Utilizing data from 7,151 participants in the ABCD Study, the authors found that positive parental behaviors, like acceptance and appropriate parental monitoring may reduce the potentially detrimental effects of parental psychopathology on child brain connectivity. These results provide potential targets for parents that experience mental health symptoms, or clinicians who treat families, to help mitigate potential intergenerational transmission of mental illness.

BACKGROUND:Violence exposure during childhood and adolescence is associated with increased prevalence and severity of psychopathology. Neurobiological correlates suggest that abnormal maturation of emotion-related brain circuitry, such as the amygdala-prefrontal cortex (PFC) circuit, may underlie the development of psychiatric symptoms after exposure. However, it remains unclear how amygdala-PFC circuit maturation is related to psychiatric risk in the context of violence. METHODS:In this study, we analyzed individual differences in amygdala-PFC circuit maturity using data collected from the PNC (Philadelphia Neurodevelopmental Cohort) (n = 1133 youths). Neurodevelopment models of amygdala-PFC resting-state functional connectivity were built using deep learning and trained to predict chronological age in typically developing youths (not violence exposed and without a psychiatric diagnosis). Using the brain age gap estimate, an index of relative circuit maturation, patterns of atypical neurodevelopment were investigated. RESULTS:Violence exposure was associated with delayed maturation of basolateral amygdala (BLA)-PFC circuits, driven by increased BLA-medial orbitofrontal cortex functional connectivity. In contrast, increased psychiatric symptoms were associated with advanced maturation of BLA-PFC functional connectivity, driven by decreased BLA-dorsolateral PFC functional connectivity. CONCLUSIONS:Delayed frontoamygdala maturation after exposure to violence suggests atypical, but adaptive, development of threat appraisal processes, potentially reflecting a greater threat generalization characteristic of younger children. Advanced circuit maturation with increasing symptoms suggests divergent neurodevelopmental mechanisms underlying illness after emotion circuits have adapted to adversity, exacerbated by preexisting vulnerabilities to early maturation. Disentangling the effects of adversity and psychopathology on neurodevelopment is crucial for helping youths recover from violence and preventing illness from continuing into adulthood.

Importance While adverse childhood experiences (ACEs) are known to impart significant risk for negative mental health and cognitive outcomes in youth, translation of ACE scores into clinical intervention is limited by poor specificity in predicting negative outcomes. This work expands on the ACE framework using a data-driven approach to identify 8 different forms of traumatic and adverse childhood experiences (TRACEs) and reveal their differential associations with psychiatric risk and cognition across development. Objective Building upon the traditional ACEs model, this study aimed to characterize unique components of commonly co-occurring TRACEs and to examine moderation of longitudinal change in mental health and cognitive development during adolescence. Design, Setting, and Participants This work draws from youth and their caregivers who completed up to 4 annual behavioral assessments from 2016 to 2021 as part of the ongoing Adolescent Brain Cognitive Development (ABCD) study. Data collection was performed at 21 regionally-distributed sites across the United States. Analyses for this work were conducted January 2023 through November 2023. Exposures Youth participants in the ABCD study's exposure to 268 different TRACEs, which were distilled into adversity components using nonlinear principal components analysis. Main Outcomes and Measures Mixed-effects and latent change score models considered TRACEs components as moderators of longitudinal change in internalizing and externalizing mental health problems, as well as longitudinal change in cognitive ability. Results Data were distilled from 11 876 youth participants, who were grouped into dyads with a caregiver. ABCD study youth participants were 9 to 10 years old at baseline assessment (year 0) and 12 to 13 years old at ABCD year 3. A total of 5679 participants (47.8%) were female. Analyses revealed that TRACEs organized into 8 thematic adversity components (e.g., family conflict, interpersonal violence). At baseline assessment (year 0), exposure to nearly every adversity component was associated with poorer mental health and diminished cognitive ability. Yet across time, it was observed that different forms of adversity were variably linked to both increases and decreases in internalizing and externalizing problems. For example, while peer aggression (t = 5.31) and family conflict (t = 5.67) were associated with increases in both internalizing and externalizing problems over early adolescence, community threat (t = 2.82) and poverty (t = 2.07) were linked to decreased problems, potentially representing adaptive suppression of symptoms. Finally, adversity types related to resource deprivation (eg, poverty, caregiver maladjustment) were associated with declines in cognitive ability over early adolescence. Conclusions and Relevance In this cohort study, distinct forms of TRACEs differentially moderated developmental changes in psychiatric risk and cognitive ability in different ways, offering the possibility for precision-based prediction of risk for youth. Such findings could be used in targeted early prevention and intervention strategies for at-risk youth.

In this review, we summarize current evidence for compassion-based approaches for PTSD and the potential for their application to the adolescent PTSD population. Exposure to traumatic events is common in adolescence and PTSD remains a public health crisis. Accessibility, willingness, and engagement are significant barriers to established treatments for PTSD, with attrition rates as high as 50 %. Compassion-based therapies provide potential solutions to treatment obstacles by providing a non-threatening, transdiagnostic option unburdened by aspects of current trauma treatment which may be associated with treatment resistance (e.g., exposure, trauma narrative, induction of fear). Compassion-based approaches are intuitive for trauma treatment, as compassion activates the self-soothing system, thereby disarming the fear system and promoting affect regulation. Compassion-based treatments demonstrate reductions across a substantial range of PTSD symptoms in adults, however, in adolescents extant literature is sparse, with cross-sectional studies suggesting self-compassion is inversely associated with trauma-related psychopathology. Understanding the impact of compassion-based approaches on adolescent PTSD is warranted as the adolescent developmental period may be a particularly opportune time for this approach. Evaluation of the impact of compassion-based treatment on adolescent PTSD in clinical populations via randomized-controlled studies and comparison of its relative efficacy to current evidence-based practices is warranted.

OBJECTIVE:Maltreatment is a significant contributor of emotion dysregulation. Self-compassion could be an effective novel emotion regulation strategy for maltreatment. We compare self-compassion and other strategies with and without the context of maltreatment. METHODS:We recruited a cross-sectional sample of 188 adult participants using Mechanical Turk (21-69 years), with and without childhood maltreatment exposure, to complete an emotion regulation task comparing reappraisal, self-compassion, and a non-instruction condition for positive and negative emotions. We examined the impact of valence and strategy on self-reported emotional intensity in response to each image, and analyzed the interaction of maltreatment exposure and severity with valence and regulation strategy. FINDINGS:Without factoring in maltreatment, we observed significant differences between reappraisal and self-compassion (F(1,14,117.1) = 5.716, p < 0.001) in response to emotional images. When using self-compassion, negative images evoked less intense negative emotions, and more extreme positive emotions compared to reappraisal. We also detected a significant interaction of valence, strategy, and maltreatment severity (F(2,16,818.2) = 4.24, p = 0.014). We observed differences in emotional responses for those with high levels and low levels of maltreatment severity between strategies. Self-compassion use resulted in the most consistent emotional ratings across all severity levels for negative image trials, while reappraisal and non-instructed trials minimized emotional responses as severity increased. In response to positive images, reappraisal was most effective at minimizing emotions at low levels of maltreatment severity and performed similarly to self-compassion at higher levels of severity. CONCLUSION:The current study provides early evidence that self-compassion performs effectively as an emotion regulation strategy. It performed similarly, or superior, to reappraisal in the context of maltreatment and was consistently effective across both maltreatment and abuse severity in a cross-sectional sample. We observed more extreme positive affect in those who experienced maltreatment. However, these strategies performed similarly when we did not include maltreatment, indicating similar general effectiveness. These findings have potential implications for further research regarding emotion regulation strategies and for clinical interventions as a function of maltreatment.