Excessive guilt is a known symptom of adult depression, but a new study finds that such feelings in childhood can predict future mental illness, including depression, anxiety, obsessive-compulsive disorder and bipolar disorder.
The link seems to center around the anterior insula -- a brain region involved in the regulation of perception, emotion and self-awareness that has also been linked to mood disorders, anxiety disorders and schizophrenia. According to the researchers, children who displayed signs of pathological guilt had anterior insula with less volume, which is associated with depression, and were also more likely to become depressed.
The Washington University of St. Louis researchers conducted a 12-year longitudinal study of 145 preschool-age children. Between the ages of three and six, the children were assessed for depression and guilt. Between the ages of seven and 13, the children had fMRI brain scans every 18 months. The research team plans to continue studying the children for at least five more years.
More than half of the 47 preschoolers diagnosed with depression displayed pathological guilt, compared with 20 percent of the non-depressed preschoolers. The researchers found that the children with high levels of guilt, even if they weren't depressed, had smaller anterior insula volume -- which has been found to predict later occurrences of depression. Children with smaller insula volume in the right hemisphere, related to either depression or guilt, were more likely to have recurring episodes of clinical depression when they got older.
The finding, published last month in the journal JAMA Psychiatry, is the first to correlate childhood guilt with physical changes in the brain. Of course, the direction of causality is not yet known: While childhood guilt might give rise to these changes in the brain, it's also possible that children predisposed to depression are also more likely to experience excessive guilt.
In either case, the research highlights another potential tool for early detection of high-risk children, which can empower parents, educators and others to enact preventive measures.
"This research is really new and exciting because you can look at changes in the brain, and it shows that early intervention is really important," George Washington University psychologist Michelle New told The Atlantic. "Dismissing early symptomatology is dangerous."