In this issue of the Journal, Heim et al. (14) make use of the burgeoning structural MRI technique of measuring cortical brain thickness to understand neuroplastic responses to childhood trauma. The authors studied 51 medically healthy women, of whom 55% (N=28) reported moderate-to-severe maltreatment, 18% (N=9) had PTSD, and 24% (N=12) had major depression. Cortical thinning was found to be present in the brain areas involved in the perception or processing of behaviors that are specific to the type of abuse experienced. For example, childhood sexual abuse was associated with cortical thinning in the genital representation field of the primary somatosensory cortex, whereas emotional abuse was associated with cortical thinning in regions linked to self-awareness and self-evaluation (15). The authors conclude that cortical adaptation to traumatic events may lead to decreases in the density of dendritic spines, leading to cortical thinning. They suggest that such changes relate to the child’s sensory processing of the abusive experience, which alters cortical representation fields in a regionally specific fashion, based on the nature of the abuse itself. This finding comports with another recent work in which young adults, compared with an unexposed group, who witnessed domestic violence as children had decreased visual cortex gray matter (15), in terms of both volume and cortical thickness, regardless of whether or not they developed psychopathology. In addition, Heim et al. noted that age at onset, although not severity of childhood sexual abuse, was related to cortical thinning in the left temporal pole, the left parietal lobe, the left frontal pole, and the right frontal pole, areas associated with autobiographical memory among other functions. This, they postulate, may serve as the neuroanatomical basis for the observation that victims of childhood sexual abuse often have poor, if any, recollection of the experience and report overgeneralized memories. A question that arises from this finding is whether individuals who experience trauma at a later age, outside the window of peak vulnerability for cortical thinning, develop psychopathology through a mechanism that is distinct from the one responsible for consequences in those who experience trauma during an earlier, critical period.