Disruptions in neural circuits underlying emotion regulation (ER) may be a mechanism linking child maltreatment with psychopathology. We examined the associations of maltreatment with neural responses during passive viewing of negative emotional stimuli and attempts to modulate emotional responses. We investigated whether the influence of maltreatment on neural activation during ER differed across development and whether alterations in brain function mediated the association between maltreatment and a latent general psychopathology (‘p’) factor.

Youth aged 8–16 years with (n = 79) and without (n = 72) exposure to maltreatment completed an ER task assessing neural responses during passive viewing of negative and neutral images and effortful attempts to regulate emotional responses to negative stimuli. P-factor scores were defined by a bi-factor model encompassing internalizing and externalizing psychopathology.

Maltreated youth had greater activation in left amygdala and salience processing regions and reduced activation in multiple regions involved in cognitive control (bilateral superior frontal gyrus, middle frontal gyrus, and dorsal anterior cingulate cortex) when viewing negative v. neutral images than youth without maltreatment exposure. Reduced neural recruitment in cognitive control regions mediated the association of maltreatment with p-factor in whole-brain analysis. Maltreated youth exhibited increasing recruitment with age in ventrolateral prefrontal cortex during reappraisal while control participants exhibited decreasing recruitment with age. Findings were similar after adjusting for co-occurring neglect.

Child maltreatment influences the development of regions associated with salience processing and cognitive control during ER in ways that contribute to psychopathology.

The Canterbury Primary Response Group (CPRG) was formed following the threats of severe acute respiratory syndrome (SARS) and avian influenza worldwide. The possible impact of these viruses alerted health care professionals that a community-wide approach was needed to manage and coordinate a response to any outbreak or potential outbreak. In Canterbury, New Zealand, the CPRG group took the responsibility to coordinate and manage the regional, out of hospital, planning and response coordination to annual influenza threats and the possible escalation to pandemic outbreaks.

To outline the formation of a primary health and community-wide planning group, bringing together not only a wide range of health providers, but also key community agencies to plan strategies and responses to seasonal influenza and possible pandemic outbreaks.

CPRG has developed a Pandemic Plan that focuses on the processes, structures, and roles to support and coordinate general practice, community pharmacies, community nursing, and other primary health care providers in the reduction of, readiness for, response to, and recovery from an influenza pandemic. The plan could reasonably apply to other respiratory-type pandemics such as SARS.

A comprehensive group of health professionals and supporting agencies meet monthly (more often if required) under the chair of CPRG to share information of the influenza-like illness (ILI) situation, virus types, and spread, as well as support strategies and response activities. Regular communication information updates are produced and circulated amongst members and primary health providers in the region.

Given that most ILI health consultations and treatments are self or primary health administered and take place outside of hospital services, it is essential for providers to be informed and consistent with their responses and knowledge of the extent and symptoms of ILI and any likelihood of a pandemic.

The Canterbury Primary Response Group (CPRG) was formed to provide a community-wide approach to manage, coordinate, plan for, and respond to health emergencies in the prehospital setting. Original communications within the CPRG group and to the primary sector were via email and the use of other organizations’ websites. These means were not easy to access and update content, and the group was depending on third parties.

To outline the development of a primary health interactive website, provide up-to-date planning and event information, and provide information and support in relation to emergency planning for major emergency and non-emergency health events.

The advancements of technology and planning practices have given CPRG the ability to develop information, planning, and operational reporting systems.

CPRG has developed a web-based portal that is available to primary health care (including community pharmacy) to provide planning assistance and templates as well as information on current events, such as the influenza season. It includes access to the CPRG suite of emergency plans and is a document repository for the Emergency Operations Centre (EOC). A further development has been a response management system for use in the CPRG EOC to assess any health situation and status of providers to enable a continually up-to-date dashboard and situational awareness reports to be visible to those coordinating the response.

Communication is a major factor, often the most criticized, when managing any response. The development of the CPRG website and system as described can alleviate this and provide accurate and consistent event and planning advice to those in the primary health sector.