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Zhang Z, Meng P, Zhang H, Jia Y, Wen Y, Zhang J, Chen Y, Li C, Pan C, Cheng S, Yang X, Yao Y, Liu L, Zhang F. Brain Proteome-Wide Association Study Identifies Candidate Genes that Regulate Protein Abundance Associated with Post-Traumatic Stress Disorder. Genes (Basel) 2022; 13:genes13081341. [PMID: 35893077 PMCID: PMC9332745 DOI: 10.3390/genes13081341] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 07/16/2022] [Accepted: 07/20/2022] [Indexed: 02/06/2023] Open
Abstract
Although previous genome-wide association studies (GWASs) on post-traumatic stress disorder (PTSD) have identified multiple risk loci, how these loci confer risk of PTSD remains unclear. Through the FUSION pipeline, we integrated two human brain proteome reference datasets (ROS/MAP and Banner) with the PTSD GWAS dataset, respectively, to conduct a proteome-wide association study (PWAS) analysis. Then two transcriptome reference weights (Rnaseq and Splicing) were applied to a transcriptome-wide association study (TWAS) analysis. Finally, the PWAS and TWAS results were investigated through brain imaging analysis. In the PWAS analysis, 8 and 13 candidate genes were identified in the ROS/MAP and Banner reference weight groups, respectively. Examples included ADK (pPWAS-ROS/MAP = 3.00 × 10−5) and C3orf18 (pPWAS-Banner = 7.07 × 10−31). Moreover, the TWAS also detected multiple candidate genes associated with PTSD in two different reference weight groups, including RIMS2 (pTWAS-Splicing = 3.84 × 10−2), CHMP1A (pTWAS-Rnaseq = 5.09 × 10−4), and SIRT5 (pTWAS-Splicing = 4.81 × 10−3). Further comparison of the PWAS and TWAS results in different populations detected the overlapping genes: MADD (pPWAS-Banner = 4.90 × 10−2, pTWAS-Splicing = 1.23 × 10−2) in the total population and GLO1(pPWAS-Banner = 4.89 × 10−3, pTWAS-Rnaseq = 1.41 × 10−3) in females. Brain imaging analysis revealed several different brain imaging phenotypes associated with MADD and GLO1 genes. Our study identified multiple candidate genes associated with PTSD in the proteome and transcriptome levels, which may provide new clues to the pathogenesis of PTSD.
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Russell JD, Keding TJ, He Q, Li JJ, Herringa RJ. Childhood exposure to interpersonal violence is associated with greater transdiagnostic integration of psychiatric symptoms. Psychol Med 2022; 52:1883-1891. [PMID: 33161911 PMCID: PMC8106688 DOI: 10.1017/s0033291720003712] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Childhood exposure to interpersonal violence (IPV) may be linked to distinct manifestations of mental illness, yet the nature of this change remains poorly understood. Network analysis can provide unique insights by contrasting the interrelatedness of symptoms underlying psychopathology across exposed and non-exposed youth, with potential clinical implications for a treatment-resistant population. We anticipated marked differences in symptom associations among IPV-exposed youth, particularly in terms of 'hub' symptoms holding outsized influence over the network, as well as formation and influence of communities of highly interconnected symptoms. METHODS Participants from a population-representative sample of youth (n = 4433; ages 11-18 years) completed a comprehensive structured clinical interview assessing mental health symptoms, diagnostic status, and history of violence exposure. Network analytic methods were used to model the pattern of associations between symptoms, quantify differences across diagnosed youth with (IPV+) and without (IPV-) IPV exposure, and identify transdiagnostic 'bridge' symptoms linking multiple disorders. RESULTS Symptoms organized into six 'disorder' communities (e.g. Intrusive Thoughts/Sensations, Depression, Anxiety), that exhibited considerably greater interconnectivity in IPV+ youth. Five symptoms emerged in IPV+ youth as highly trafficked 'bridges' between symptom communities (11 in IPV- youth). CONCLUSION IPV exposure may alter mutually reinforcing symptom co-occurrence in youth, thus contributing to greater psychiatric comorbidity and treatment resistance. The presence of a condensed and unique set of bridge symptoms suggests trauma-enriched nodes which could be therapeutically targeted to improve outcomes in violence-exposed youth.
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Affiliation(s)
- Justin D. Russell
- Department of Psychiatry, University of Wisconsin School of Medicine & Public Health – Madison, WI
| | - Taylor J. Keding
- Department of Psychiatry, University of Wisconsin School of Medicine & Public Health – Madison, WI
- Neuroscience Training Program, University of Wisconsin – Madison, Madison, WI
| | - Quanfa He
- Department of Psychology, University of Wisconsin – Madison, Madison, WI
| | - James J. Li
- Department of Psychology, University of Wisconsin – Madison, Madison, WI
- Waisman Center, University of Wisconsin – Madison, Madison, WI
| | - Ryan J. Herringa
- Department of Psychiatry, University of Wisconsin School of Medicine & Public Health – Madison, WI
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Xian-Yu CY, Deng NJ, Zhang J, Li HY, Gao TY, Zhang C, Gong QQ. Cognitive behavioral therapy for children and adolescents with post-traumatic stress disorder: meta-analysis. J Affect Disord 2022; 308:502-511. [PMID: 35460743 DOI: 10.1016/j.jad.2022.04.111] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 03/27/2022] [Accepted: 04/15/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Children and adolescents who experience traumatic events may develop post-traumatic stress disorder (PTSD), which is often associated with other psychiatric disorders, including depression and anxiety. Cognitive behavioral therapy (CBT) is widely used in psychotherapy to treat PTSD in children and adolescents. This meta-analysis evaluated previous studies on the effectiveness of CBT in the treatment of PTSD in children and adolescents. METHODS Randomized controlled trials (RCTs) published before July 25, 2021, were retrieved from seven databases. All RCTs of CBT compared to control, including conventional treatment or other treatments, in children or adolescents with PTSD. Random effect models were employed for all outcomes. Risk of bias was performed by Cochrane Collaboration's tool. The publication bias was evaluated using the Egger's regression analysis. RESULTS Nineteen RCTs were included in the meta-analysis. Compared with control, CBT was effective in reducing the symptoms of PTSD in children and adolescents, with a variety of scales used to measure the overall PTSD symptoms: CAPS (SMD = -0.41, 95%CI [-0.71, -0.12]), CPSS (SMD = -0.88, 95%CI [-1.42, -0.34]) and UCLA-PTSD RI (SMD = -1.70, 95%CI [-2.98, -0.42]). Furthermore, CBT also improved the comorbidities of depression (SMD = -0.43, 95%CI [-0.70, -0.17]) and anxiety (SMD = -0.29, 95%CI [-0.56, -0.03]) associated with PTSD. However, CBT was not effective in reducing avoidance symptoms (SMD = 0.38, 95%CI [-0.55, 1.31]). CONCLUSION CBT can reduce the severity of PTSD in children and adolescents and improve the symptoms of depression and anxiety, as evident in the treatment of PTSD victims of sexual abuse and war and in patients aged more than 7 years.
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Affiliation(s)
- Chen-Yang Xian-Yu
- Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, Hubei, China
| | - Nian-Jia Deng
- Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, Hubei, China
| | - Jin Zhang
- Department of Information Resources, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China
| | - Hao-Yang Li
- Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, Hubei, China
| | - Teng-Yu Gao
- Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, Hubei, China
| | - Chao Zhang
- Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, Hubei, China.
| | - Qin-Qin Gong
- Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, Hubei, China; Center of Women's Health Sciences, Taihe Hospital, Hubei University of Medicine, Shiyan 420000, China.
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54
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Herridge MS, Azoulay É. The COVID-19 continuum of illness. THE LANCET RESPIRATORY MEDICINE 2022; 10:630-631. [PMID: 35716674 PMCID: PMC9212967 DOI: 10.1016/s2213-2600(22)00219-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 06/07/2022] [Indexed: 01/08/2023]
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Zhang Q, Li X, Liu X, Liu S, Zhang M, Liu Y, Zhu C, Wang K. The Effect of Non-Invasive Brain Stimulation on the Downregulation of Negative Emotions: A Meta-Analysis. Brain Sci 2022; 12:brainsci12060786. [PMID: 35741671 PMCID: PMC9221395 DOI: 10.3390/brainsci12060786] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 05/26/2022] [Accepted: 06/11/2022] [Indexed: 02/04/2023] Open
Abstract
(1) Background: Emotion regulation (ER) is regarded as a core treatment target for depression and other mental illnesses. In recent years, non-invasive brain stimulation (NIBS) has been extensively used as an intervention for mental illnesses, but there has been no systematic review conducted regarding its effect on emotion regulation. Therefore, we conducted a meta-analysis of the effectiveness of NIBS for emotion regulation; (2) Methods: Systematic searches were conducted in Embase, Web of Science, PubMed, and Cochrane Library. We analyzed the effects of NIBS on tasks assessing emotion regulation using a random-effects model, and further explored the moderating role of the following factors on transcranial direct current stimulation (tDCS) studies by conducting subgroup analyses and meta-regression: target electrode placement, return electrode placement, current intensity, target electrode size, and duration of intervention; (3) Results: A total of 17 studies were included. Our meta-analysis indicated a small but significant effect of NIBS on the downregulation of negative emotions. Separate analyses indicated that repetitive transcranial magnetic stimulation (rTMS) had a medium and significant effect on the downregulation of negative emotions, whereas tDCS had no significant effect. Subgroup analyses showed that the effect of tDCS was moderated by target and return electrode placemen; (4) Conclusions: These results indicate that NIBS had a positive effect on the downregulation of negative emotions. The stimulation protocols should be carefully considered and the underlying mechanisms should be further explored.
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Affiliation(s)
- Qingqing Zhang
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230032, China; (Q.Z.); (X.L.); (X.L.); (S.L.); (M.Z.); (Y.L.); (K.W.)
| | - Xiaoming Li
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230032, China; (Q.Z.); (X.L.); (X.L.); (S.L.); (M.Z.); (Y.L.); (K.W.)
| | - Xinying Liu
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230032, China; (Q.Z.); (X.L.); (X.L.); (S.L.); (M.Z.); (Y.L.); (K.W.)
| | - Shanshan Liu
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230032, China; (Q.Z.); (X.L.); (X.L.); (S.L.); (M.Z.); (Y.L.); (K.W.)
| | - Mengzhu Zhang
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230032, China; (Q.Z.); (X.L.); (X.L.); (S.L.); (M.Z.); (Y.L.); (K.W.)
| | - Yueling Liu
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230032, China; (Q.Z.); (X.L.); (X.L.); (S.L.); (M.Z.); (Y.L.); (K.W.)
| | - Chunyan Zhu
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230032, China; (Q.Z.); (X.L.); (X.L.); (S.L.); (M.Z.); (Y.L.); (K.W.)
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230032, China
- Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei 230032, China
- Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei 230011, China
- Correspondence:
| | - Kai Wang
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230032, China; (Q.Z.); (X.L.); (X.L.); (S.L.); (M.Z.); (Y.L.); (K.W.)
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230032, China
- Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei 230032, China
- Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei 230011, China
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
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Leite L, Esper NB, Junior JRML, Lara DR, Buchweitz A. An exploratory study of resting-state functional connectivity of amygdala subregions in posttraumatic stress disorder following trauma in adulthood. Sci Rep 2022; 12:9558. [PMID: 35688847 PMCID: PMC9187646 DOI: 10.1038/s41598-022-13395-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 05/03/2022] [Indexed: 11/09/2022] Open
Abstract
We carried out an exploratory study aimed at identifying differences in resting-state functional connectivity for the amygdala and its subregions, right and left basolateral, centromedial and superficial nuclei, in patients with Posttraumatic Stress Disorder (PTSD), relative to controls. The study included 10 participants with PTSD following trauma in adulthood (9 females), and 10 controls (9 females). The results suggest PTSD was associated with a decreased (negative) functional connectivity between the superficial amygdala and posterior brain regions relative to controls. The differences were observed between right superficial amygdala and right fusiform gyrus, and between left superficial amygdala and left lingual and left middle occipital gyri. The results suggest that among PTSD patients, the worse the PTSD symptoms, the lower the connectivity. The results corroborate the fMRI literature that shows PTSD is associated with weaker amygdala functional connectivity with areas of the brain involved in sensory and perceptual processes. The results also suggest that though the patients traumatic experience occured in adulthood, the presence of early traumatic experiences were associated with negative connectivity between the centromedial amygdala and sensory and perceptual regions. We argue that the understanding of the mechanisms of PTSD symptoms, its behaviors and the effects on quality of life of patients may benefit from the investigation of brain function that underpins sensory and perceptual symptoms associated with the disorder.
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Affiliation(s)
- Leticia Leite
- School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, 90619-900, Brazil.
| | - Nathalia Bianchini Esper
- School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, 90619-900, Brazil
- Brain Institute (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, 90610-000, Brazil
| | - José Roberto M Lopes Junior
- School of Psychology and Health, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, 90050-170, Brazil
| | | | - Augusto Buchweitz
- School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, 90619-900, Brazil.
- Brain Institute (BraIns), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, 90610-000, Brazil.
- Department of Psychology, University of Connecticut, Stamford, 06269-1020, United States of America.
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Xin N, Wang DT, Zhang L, Zhou Y, Cheng Y. Early developmental stage glucocorticoid exposure causes DNA methylation and behavioral defects in adult zebrafish. Comp Biochem Physiol C Toxicol Pharmacol 2022; 256:109301. [PMID: 35182718 DOI: 10.1016/j.cbpc.2022.109301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 01/21/2022] [Accepted: 02/12/2022] [Indexed: 11/20/2022]
Abstract
Post-traumatic stress disorder (PTSD) is a psychiatric disorder caused by genetic and environmental factors. It is closely related to a dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis, in which the epigenetic modification of the nr3c1 plays an important role. It is well known that nr3c1 methylation in offspring is reportedly related to early adverse life experiences, prenatal stress response, and early nursing conditions; however, the methylation location and extent of the nr3c1 are not sufficiently elucidated. In order to study the internal mechanism of PTSD caused by early adverse life experience, we used zebrafish to construct a psychopathological model. We found that early developmental stage prednisolone exposure caused HPA axis negative feedback dysfunction and hormone secretion disorder in adult male zebrafish. By analyzing nr3c1 promoter, we found that cytosine-guanine island (CpGI) 2 was highly methylated in adult male zebrafish, which affected the expression of glucocorticoid receptor, resulting in abnormal behavior and anxiety like phenotype of adult male zebrafish. Therefore, we believed that an early exposure of zebrafish larvae to prednisolone may be recorded through a change of CpGI 2 methylation in the nr3c1 promoter region, causing abnormal adult male zebrafish behavior. Moreover, the establishment of the zebrafish psychopathological model may facilitate the study of the clinical management of patients with PTSD.
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Affiliation(s)
- Ning Xin
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221000, China
| | - Da-Tong Wang
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221000, China
| | - Li Zhang
- Department of Geriatrics, Jinan Laigang Hospital, No.68 Xinxing Road, Jinan, Shandong 271100, China
| | - Yanlong Zhou
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221000, China
| | - Yanbo Cheng
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221000, China.
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Tanaka M, Spekker E, Szabó Á, Polyák H, Vécsei L. Modelling the neurodevelopmental pathogenesis in neuropsychiatric disorders. Bioactive kynurenines and their analogues as neuroprotective agents-in celebration of 80th birthday of Professor Peter Riederer. J Neural Transm (Vienna) 2022; 129:627-642. [PMID: 35624406 DOI: 10.1007/s00702-022-02513-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 05/05/2022] [Indexed: 02/06/2023]
Abstract
Following introduction of the monoamine oxidase type B inhibitor selegiline for the treatment of Parkinson's disease (PD), discovery of the action mechanism of Alzheimer's disease-modifying agent memantine, the role of iron in PD, and the loss of electron transport chain complex I in PD, and development of the concept of clinical neuroprotection, Peter Riederer launched one of the most challenging research project neurodevelopmental aspects of neuropsychiatric disorders. The neurodevelopmental theory holds that a disruption of normal brain development in utero or during early life underlies the subsequent emergence of neuropsychiatric symptoms during later life. Indeed, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and the International Classification of Diseases, 11th Revision categorize autism spectrum disorder and attention deficit hyperactivity disorder in neurodevelopmental disorders (NDDs). More and more evidence, especially from preclinical studies, is revealing that neurodevelopmental pathology is not limited to the diagnostic class above, but also contributes to the development of other psychiatric disorders such as schizophrenia, bipolar disorder, and obsessive-compulsive disorder as well as neurodegenerative diseases such as PD and Huntington's disease. Preclinical animal research is taking a lead in understanding the pathomechanisms of NDDs, searching for novel targets, and developing new neuroprotective agents against NDDs. This narrative review discusses emerging evidence of the neurodevelopmental etiology of neuropsychiatric disorders, recent advances in modelling neurodevelopmental pathogenesis, potential strategies of clinical neuroprotection using novel kynurenine metabolites and analogues, and future research direction for NDDs.
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Affiliation(s)
- Masaru Tanaka
- MTA-SZTE Neuroscience Research Group, Hungarian Academy of Sciences, University of Szeged (MTA-SZTE), Semmelweis u. 6, 6725, Szeged, Hungary
| | - Eleonóra Spekker
- MTA-SZTE Neuroscience Research Group, Hungarian Academy of Sciences, University of Szeged (MTA-SZTE), Semmelweis u. 6, 6725, Szeged, Hungary
| | - Ágnes Szabó
- Department of Neurology, Albert Szent-György Medical School, University of Szeged, Semmelweis u. 6, 6725, Szeged, Hungary
| | - Helga Polyák
- Department of Neurology, Albert Szent-György Medical School, University of Szeged, Semmelweis u. 6, 6725, Szeged, Hungary
| | - László Vécsei
- MTA-SZTE Neuroscience Research Group, Hungarian Academy of Sciences, University of Szeged (MTA-SZTE), Semmelweis u. 6, 6725, Szeged, Hungary. .,Department of Neurology, Albert Szent-György Medical School, University of Szeged, Semmelweis u. 6, 6725, Szeged, Hungary.
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Kiss L, Fotheringhame D, Kyegombe N, McAlpine A, Abilio L, Kyamulabi A, Walakira EJ, Devries K, Tanton C. Paper: violence, abuse and exploitation among trafficked women and girls: a mixed-methods study in Nigeria and Uganda. BMC Public Health 2022; 22:794. [PMID: 35448985 PMCID: PMC9022300 DOI: 10.1186/s12889-022-13021-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 03/08/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Africa is the global region where modern-slavery is most prevalent, especially among women and girls. Despite the severe health consequences of human trafficking, evidence on the risks and experiences of trafficked adolescents and young women is scarce for the region. This paper addresses this gap by exploring the intersections between violence, migration and exploitation among girls and young women identified as trafficking survivors in Nigeria and Uganda. METHODS We conducted secondary analysis of the largest routine dataset on human trafficking survivors. We used descriptive statistics to report the experiences of female survivors younger than 25 years-old from Nigeria and Uganda. We also conducted 16 semi-structured interviews with adolescents identified as trafficked in both countries. We used thematic analysis to explore participants' perceptions and experiences before, during and after the trafficking situation. RESULTS Young female survivors of human trafficking in Nigeria and Uganda are exposed to a range of experiences of violence before migration, during transit and at destination. The qualitative data revealed that children and adolescents migrated to escape family poverty, violence and neglect. They had very low levels of education and most had their studies interrupted before migrating. Family members and close social contacts were the most common intermediaries for their migration. During transit, sexual violence and hunger were common, especially among Nigerians. Participants in both the quantitative and qualitative studies reported high levels of violence, deception, coercion, withheld wages and poor working conditions at destination. The adolescents interviewed in the qualitative study reported severe mental suffering, including suicide attempts. Only one reported the prosecution of perpetrators. CONCLUSIONS Our findings suggest that interventions to prevent or mitigate the negative impact of adverse childhood experiences can contribute to preventing the trafficking of adolescents in Nigeria and Uganda. These interventions include social protection mechanisms, universal access to education, social service referrals and education of parents and carers. Importantly, effective prevention also needs to address the systemic conditions that makes trafficking of female adolescents invisible, profitable and inconsequential for perpetrators.
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Affiliation(s)
- Ligia Kiss
- Institute for Global Health, University College London, London, UK.
| | | | - Nambusi Kyegombe
- Global Health Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Alys McAlpine
- Institute for Global Health, University College London, London, UK
| | | | | | | | - Karen Devries
- Global Health Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Clare Tanton
- Global Health Department, London School of Hygiene and Tropical Medicine, London, UK
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Kim SY, Lee NE, Yoo DM, Kim JH, Kwon MJ, Kim JH, Bang WJ, Choi HG. Changes in the Mean of Medical Visits Due to Psychiatric Disease in Korean Children and Adolescents before and during the COVID-19 Pandemic. Life (Basel) 2022; 12:life12040600. [PMID: 35455091 PMCID: PMC9025358 DOI: 10.3390/life12040600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/13/2022] [Accepted: 04/15/2022] [Indexed: 12/16/2022] Open
Abstract
The COVID-19 pandemic has been suggested to have adverse impacts on psychiatric disorders. This study aimed to investigate the changes in medical visits due to a wide range of psychiatric disorders in children during the COVID-19 pandemic. The medical visits of all Korean children and adolescents (0−19 years old) due to the 12 following psychiatric disorders were investigated: autism; attention-deficit/hyperactivity disorder (ADHD); depressive disorder; bipolar disorder; primary insomnia; schizophrenia; panic disorder; hypochondriasis; posttraumatic stress disorder (PTSD); anxiety disorder; anorexia nervosa; and adephagia. The mean medical visits before and during the COVID-19 pandemic were compared. The mean number of clinical visits due to autism, ADHD, depressive disorder, bipolar disorder, panic disorder, hypochondriasis, PTSD, anxiety disorder, and anorexia nervosa was higher during the COVID-19 pandemic than before the COVID-19 pandemic (all p < 0.05). The higher mean number of medical visits due to psychiatric disorders was maintained in age and sex subgroups. The female and adolescent groups demonstrated a higher mean number of medical visits due to psychiatric disorders during the COVID-19 pandemic. The medical visits due to many psychiatric disorders were higher during the COVID-19 pandemic than before COVID-19 in children and adolescents in Korea. Women and adolescents were more susceptible to psychiatric disorders during the COVID-19 pandemic.
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Affiliation(s)
- So Young Kim
- Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam 13496, Korea;
| | - Na-Eun Lee
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang 14068, Korea; (N.-E.L.); (D.M.Y.)
| | - Dae Myoung Yoo
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang 14068, Korea; (N.-E.L.); (D.M.Y.)
| | - Ji Hee Kim
- Department of Neurosurgery, Hallym University College of Medicine, Anyang 14068, Korea;
| | - Mi Jung Kwon
- Department of Pathology, Hallym University College of Medicine, Anyang 14068, Korea;
| | - Joo-Hee Kim
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Hallym University College of Medicine, Anyang 14068, Korea;
| | - Woo Jin Bang
- Department of Urology, Hallym University College of Medicine, Anyang 14068, Korea;
| | - Hyo Geun Choi
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang 14068, Korea; (N.-E.L.); (D.M.Y.)
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang 14068, Korea
- Correspondence:
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61
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Bustamante D, Amstadter AB, Pritikin JN, Brick TR, Neale MC. Associations Between Traumatic Stress, Brain Volumes and Post-traumatic Stress Disorder Symptoms in Children: Data from the ABCD Study. Behav Genet 2022; 52:75-91. [PMID: 34860306 PMCID: PMC8860798 DOI: 10.1007/s10519-021-10092-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 11/07/2021] [Indexed: 11/26/2022]
Abstract
Reduced volumes in brain regions of interest (ROIs), primarily from adult samples, are associated with posttraumatic stress disorder (PTSD). We extended this work to children using data from the Adolescent Brain Cognitive Development (ABCD) Study® (N = 11,848; Mage = 9.92). Structural equation modeling and an elastic-net (EN) machine-learning approach were used to identify potential effects of traumatic events (TEs) on PTSD symptoms (PTSDsx) directly, and indirectly via the volumes 300 subcortical and cortical ROIs. We then estimated the genetic and environmental variation in the phenotypes. TEs were directly associated with PTSDsx (r = 0.92) in children, but their indirect effects (r < 0.0004)-via the volumes of EN-identified subcortical and cortical ROIs-were negligible at this age. Additive genetic factors explained a modest proportion of the variance in TEs (23.4%) and PTSDsx (21.3%), and accounted for most of the variance of EN-identified volumes of four of the five subcortical (52.4-61.8%) three of the nine cortical ROIs (46.4-53.3%) and cerebral white matter in the left hemisphere (57.4%). Environmental factors explained most of the variance in TEs (C = 61.6%, E = 15.1%), PTSDsx (residual-C = 18.4%, residual-E = 21.8%), right lateral ventricle (C = 15.2%, E = 43.1%) and six of the nine EN-identified cortical ROIs (C = 4.0-13.6%, E = 56.7-74.8%). There is negligible evidence that the volumes of brain ROIs are associated with the indirect effects of TEs on PTSDsx at this age. Overall, environmental factors accounted for more of the variation in TEs and PTSDsx. Whereas additive genetic factors accounted for most of the variability in the volumes of a minority of cortical and in most of subcortical ROIs.
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Affiliation(s)
- Daniel Bustamante
- Virginia Institute for Psychiatric and Behavioral Genetics, 800 E Leigh Street, Biotech One, Box 980126, Richmond, VA, 23298, USA.
- Integrative Life Sciences Doctoral Program, Virginia Commonwealth University, Richmond, VA, USA.
| | - Ananda B Amstadter
- Virginia Institute for Psychiatric and Behavioral Genetics, 800 E Leigh Street, Biotech One, Box 980126, Richmond, VA, 23298, USA
- Department of Psychiatry, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Joshua N Pritikin
- Virginia Institute for Psychiatric and Behavioral Genetics, 800 E Leigh Street, Biotech One, Box 980126, Richmond, VA, 23298, USA
- Department of Psychiatry, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Timothy R Brick
- Department of Human Development and Family Studies, and Institute for Computational and Data Sciences, The Pennsylvania State University, University Park, PA, USA
| | - Michael C Neale
- Virginia Institute for Psychiatric and Behavioral Genetics, 800 E Leigh Street, Biotech One, Box 980126, Richmond, VA, 23298, USA
- Department of Psychiatry, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
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62
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Speranza AM, Farina B, Bossa C, Fortunato A, Maggiora Vergano C, Palmiero L, Quintigliano M, Liotti M. The Role of Complex Trauma and Attachment Patterns in Intimate Partner Violence. Front Psychol 2022; 12:769584. [PMID: 35145451 PMCID: PMC8821899 DOI: 10.3389/fpsyg.2021.769584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 12/10/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Even if the relationship between adverse childhood experiences and intimate partner violence (IPV) has already been established, there are no sufficient studies examining the relationships between these factors and attachment representations, specifically attachment disorganization. Thus, this study aimed to explore, in a sample of women who experienced IPV (a) the presence of interpersonal adversities during childhood, and (b) attachment representations, with a particular focus on disorganization. METHODS Women's representations of attachment experiences were investigated through the Adult Attachment Interview, while the presence of various forms of interpersonal adversities during childhood was assessed using the Complex Trauma Questionnaire. The results of the IPV group (n = 98) were compared with those of women with no history of IPV (control group, n = 81). RESULTS Women in the IPV group showed higher values of multiple forms of adverse experiences within their caregiving system. They presented significantly higher rates of disorganized states of mind regarding attachment, indicative of a lack of resolution regarding traumatic experiences, and of disorganized working models resulting from complex trauma. Our results highlighted that, more than the presence of traumatic experiences, it is their irresolution - reflected in the disorganized states of mind regarding attachment at the Adult Attachment Interview - to be a significant predictor of IPV. CONCLUSION These results suggest underline the significance of offering a trauma- and attachment-informed therapy to those who experience IPV. Such results could help both clinicians and researchers in formulating clearer guidelines for IPV interventions.
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Affiliation(s)
- Anna Maria Speranza
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Benedetto Farina
- Department of Human Sciences, European University of Rome, Rome, Italy
| | - Caterina Bossa
- European Society for Trauma and Dissociation, Nijmegen, Netherlands
| | - Alexandro Fortunato
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Carola Maggiora Vergano
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Luigia Palmiero
- Department of Human Sciences, European University of Rome, Rome, Italy
| | - Maria Quintigliano
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Marianna Liotti
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
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63
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George GC, Keding TJ, Heyn SA, Herringa RJ. Longitudinal hippocampal circuit change differentiates persistence and remission of pediatric posttraumatic stress disorder. Depress Anxiety 2022; 39:8-18. [PMID: 34843625 PMCID: PMC8763137 DOI: 10.1002/da.23229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 11/03/2021] [Accepted: 11/16/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Previous studies have identified functional brain abnormalities in pediatric posttraumatic stress disorder (pPTSD) suggesting altered frontoparietal-subcortical function during emotion processing. However, little is known about how the brain functionally changes over time in recovery versus the persistence of pPTSD. METHODS This longitudinal study recruited 23 youth with PTSD and 28 typically developing (TD) youth (ages: 8.07-17.99). Within the PTSD group, nine remitted by the 1-year follow-up (Remit) while the remaining 14 persisted (PTSD). At each visit, youth completed an emotional processing task in which they viewed threat and neutral images during functional magnetic resonance imaging (fMRI). Voxelwise activation analyses using linear mixed-effects regression were conducted using a group (TD, Remit, PTSD) by time (baseline, follow-up) by valence (threat, neutral) design. Based on activation findings, a subsequent analysis of hippocampal functional connectivity was performed using a similar model. RESULTS PTSD youth showed significantly increasing hippocampal activation to threatening images compared to TD youth, while the Remit group showed more similar patterns to TD youth. Subsequent hippocampal functional connectivity analyses reveal the Remit group showed increasing functional connectivity between the hippocampus and visual cortex (V4) while viewing threat stimuli. CONCLUSIONS These findings represent one of the first preliminary reports of functional brain substrates of persistence and remission in pPTSD. Notably, increased hippocampal activation to threat and decreased connectivity in the hippocampal-V4 network over time may contribute to persistence in pPTSD. These findings suggest potential biomarkers that could be utilized to advance the treatment of pediatric PTSD.
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Affiliation(s)
- Grace C. George
- Neuroscience & Public Policy Program, University of Wisconsin-Madison, Madison, WI, USA,Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI, USA,Department of Psychiatry, BRAVE Youth Lab, 6001 Research Park Blvd., Madison, WI 53719, USA
| | - Taylor J. Keding
- Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI, USA,Department of Psychiatry, BRAVE Youth Lab, 6001 Research Park Blvd., Madison, WI 53719, USA
| | - Sara A. Heyn
- Department of Psychiatry, BRAVE Youth Lab, 6001 Research Park Blvd., Madison, WI 53719, USA
| | - Ryan J. Herringa
- Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI, USA,Department of Psychiatry, BRAVE Youth Lab, 6001 Research Park Blvd., Madison, WI 53719, USA
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A single case report of using Dummett’s systemic cognitive behavioural formulation to guide treatment of adolescent PTSD. COGNITIVE BEHAVIOUR THERAPIST 2022. [DOI: 10.1017/s1754470x2200054x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Abstract
Trauma-focused CBT (TF-CBT) is recommended by NICE for adolescents with post-traumatic stress disorder (PTSD). Whilst caregiver involvement is recommended, no specific guidance on the nature of involvement is provided although it is important that involvement takes account of the nature of the trauma. This case report details how Dummett’s systemic CBT formulation was used to plan an intervention such that systemic sessions were included in TF-CBT treatment of an adolescent female with PTSD which arose following interpersonal trauma. Trauma symptoms, trauma cognitions and depressive symptoms were measured throughout, with trauma symptoms showing clinically significant change over the course of therapy. Clinical implications are considered regarding the applicability of systemic CBT formulation and the inclusion of systemic sessions within TF-CBT for adolescents whose traumas arose interpersonally.
Key learning aims
(1)
To be able to incorporate systemic factors into a formulation of the maintenance of PTSD for adolescents using Dummett’s systemic cognitive behavioural formulation.
(2)
To identify systemic interventions that may facilitate change in interactions between adolescents and parental figures and change in trauma appraisals.
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65
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Jing C, Feng-Hong Z, Yi-Yan W. An investigation of the incidence of post-traumatic stress disorder, turnover intention and psychological resilience among medical staff in a public hospital in China during the outbreak of the omicron variant in the COVID-19 pandemic in 2022. Front Psychiatry 2022; 13:999870. [PMID: 36147988 PMCID: PMC9485436 DOI: 10.3389/fpsyt.2022.999870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 08/15/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To investigate the incidence of post-traumatic stress disorder (PTSD), turnover intention and psychological resilience of medical staff during the Outbreak of the Omicron Variant in the COVID-19 pandemic in 2022 and to provide a basis for adopting relevant psychological interventions to reduce medical staff turnover. METHODS Using the PTSD Checklist-Civilian Version (PCL-C) and a total score ranging from 17 to 85 points, a total score ≥ 38 indicates significant PTSD symptoms and a diagnosis of PTSD. The Chinese version of the Turnover Intention Scale (TIS) has a total score of 6 to 24 points; the higher the score, the stronger the turnover intention. The Chinese version of the Connor-Davidson Resilience Scale (CD-RISC) has a total score of 0 to 100 points, with higher scores indicating a better level of psychological resilience. A total of 443 front-line medical staff working in Chinese public hospitals and still treating all patients normally during COVID-19 were invited via the internet to complete a survey from 15 May to 30 May 2022 in China. RESULTS The incidence of PTSD was 14.4%, the total turnover intention score was 13.38 ± 4.08, and the total psychological resilience score was 87.16 ± 18.42. The prevalence of PTSD was higher among medical staff who were married, had children, and were worried about being infected; in addition, the PTSD group had a higher level of education, higher turnover intention, and lower psychological resilience than the non-PTSD group. The total scores for turnover intention and fear of being infected were risk factors for PTSD, while a high total psychological resilience score and high education level were protective factors for PTSD; the differences were statistically significant (all P < 0.05). CONCLUSION Post-traumatic stress disorder among Chinese medical personnel was associated with the marital status, childbirth, education level, turnover intention, and psychological resilience. Among these factors, psychological resilience might be exploited as a protective factor.
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Affiliation(s)
- Cui Jing
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhang Feng-Hong
- The Second People's Hospital of Gansu Province, Lanzhou, China
| | - Wang Yi-Yan
- West China Hospital of Sichuan University, Chengdu, China
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66
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Gindt M, Fernandez A, Zeghari R, Ménard ML, Nachon O, Richez A, Auby P, Battista M, Askenazy F. A 3-year retrospective study of 866 children and adolescent outpatients followed in the Nice Pediatric Psychotrauma Center created after the 2016 mass terror attack. Front Psychiatry 2022; 13:1010957. [PMID: 36569628 PMCID: PMC9772007 DOI: 10.3389/fpsyt.2022.1010957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The mass terrorist attack in Nice, France, in July 2016 caused deaths and injuries in a local population, including children and adolescents. The Nice Pediatric Psychotrauma Center (NPPC) was opened to provide mental health care to the pediatric population (0-18 years) who experienced traumatic events. OBJECTIVES This study describes the specificity of the care pathway for young trauma victims, with an explanation of how the NPPC works during the first three years. METHODS In this retrospective study, we conducted quantitative and qualitative data collection about new and follow-up consultations, primary and comorbid diagnoses, and the kind of trauma (terrorist attack versus other kinds of trauma). Ethics approval was obtained from the local Ethics committee. RESULTS 866 children and adolescents were followed in the NPPC. We found a high rate of Post-Traumatic Stress Disorder (PTSD; 71%) in this population with a high rate of comorbidities (67%), mainly sleep disorders (34.7%) and mood and anxiety disorders (16.2%). A high number of children and adolescents impacted by the terrorist attack required follow-up consultations after exposure to the mass terrorist attack, the first care-seeking requests continued to occur three years later, although at a slower rate than in the first and second years. New consultations for other kinds of trauma were observed over time. DISCUSSION This study supports previous findings on the significant impact of mass trauma in the pediatric population showing even a higher level of PTSD and a high rate of comorbidities. This may be explained by the brutality of the traumatic event, particularly for this age group. The findings of this study have implications for early interventions and long-term care for children and adolescents to prevent the development of chronic PTSD into adulthood.
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Affiliation(s)
- Morgane Gindt
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice Centre Hospitalier Universitaire-Lenval, Nice, France.,Université Côte d'Azur, CoBTek, Fédération de Recherche Interventions en Santé, Nice, France.,Centre Expert du Psychotrauma Provence Alpes Côte d'Azur Corse, Nice, France
| | - Arnaud Fernandez
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice Centre Hospitalier Universitaire-Lenval, Nice, France.,Université Côte d'Azur, CoBTek, Fédération de Recherche Interventions en Santé, Nice, France.,Centre Expert du Psychotrauma Provence Alpes Côte d'Azur Corse, Nice, France
| | - Radia Zeghari
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice Centre Hospitalier Universitaire-Lenval, Nice, France.,Université Côte d'Azur, CoBTek, Fédération de Recherche Interventions en Santé, Nice, France.,Centre Expert du Psychotrauma Provence Alpes Côte d'Azur Corse, Nice, France
| | - Marie-Line Ménard
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice Centre Hospitalier Universitaire-Lenval, Nice, France.,Université Côte d'Azur, CoBTek, Fédération de Recherche Interventions en Santé, Nice, France.,Centre Expert du Psychotrauma Provence Alpes Côte d'Azur Corse, Nice, France
| | - Ophelie Nachon
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice Centre Hospitalier Universitaire-Lenval, Nice, France.,Université Côte d'Azur, CoBTek, Fédération de Recherche Interventions en Santé, Nice, France.,Centre Expert du Psychotrauma Provence Alpes Côte d'Azur Corse, Nice, France
| | - Aurélien Richez
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice Centre Hospitalier Universitaire-Lenval, Nice, France.,Université Côte d'Azur, CoBTek, Fédération de Recherche Interventions en Santé, Nice, France.,Centre Expert du Psychotrauma Provence Alpes Côte d'Azur Corse, Nice, France
| | - Philippe Auby
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice Centre Hospitalier Universitaire-Lenval, Nice, France.,Université Côte d'Azur, CoBTek, Fédération de Recherche Interventions en Santé, Nice, France
| | - Michele Battista
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice Centre Hospitalier Universitaire-Lenval, Nice, France.,Université Côte d'Azur, CoBTek, Fédération de Recherche Interventions en Santé, Nice, France.,Centre Expert du Psychotrauma Provence Alpes Côte d'Azur Corse, Nice, France
| | - Florence Askenazy
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Pédiatriques de Nice Centre Hospitalier Universitaire-Lenval, Nice, France.,Université Côte d'Azur, CoBTek, Fédération de Recherche Interventions en Santé, Nice, France.,Centre Expert du Psychotrauma Provence Alpes Côte d'Azur Corse, Nice, France
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67
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Heikkilä AR, Lapinleimu H, Virtanen I, Rönnlund H, Raaska H, Elovainio M. Changes in objectively measured sleep among internationally adopted children in 1-year follow-up during the first years in new families. Front Pediatr 2022; 10:948010. [PMID: 36160771 PMCID: PMC9500395 DOI: 10.3389/fped.2022.948010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/18/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Psychosocial risks and environmental changes experienced by internationally adopted children may predict sleep problems, which are incidentally among the main concerns of adoptive parents. Several questionnaire studies have found sleep of internationally adopted children to be problematic, but none of those used an objective measure in a controlled study. OBJECTIVE To determine whether the objectively recorded sleep of internationally adopted children is worse than their controls who are living with their biological parents. METHODS To this case-control part of the Finnish Adoption Study, we recruited children who were adopted internationally to Finland between October 2012 and December 2016. Simultaneously, control children were recruited from 16 daycare centers. To assess sleep in children, actigraphy recordings were made twice, 1 year apart, between December 2013 and April 2018. In the adopted group, the first assessment took place 10 months after they had arrived in their families. The associations between adoption status and sleep parameters were analyzed using linear mixed modeling and adjusted for multiple potential confounders, including child age. RESULTS Seventy-eight internationally adopted children (boys 64%) aged 1-7 years and 99 controls (boys 53%) aged 2-6 years attended the first sleep recording. The recordings showed that the internationally adopted children slept longer (B = 0.48, 95% CI 0.23-0.73, P < 0.001) than the controls. There were no significant differences in sleep fragmentation or sleep efficiency between the groups. During the 1-year follow-up, the sleep patterns of the adopted children approached those of the controls. CONCLUSIONS The internationally adopted children spent more time in bed and slept more than their control children in both recordings. However, their sleep patterns were not very different from those of their peers and the differences appeared to vanish during the first years in their new family.
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Affiliation(s)
- Anna-Riitta Heikkilä
- Department of Pediatrics, University of Helsinki, Helsinki, Finland.,Department of Pediatrics, Helsinki University Hospital, Helsinki, Finland
| | - Helena Lapinleimu
- Department of Paediatrics and Adolescent Medicine, University of Turku, Turku, Finland.,Department of Paediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland
| | - Irina Virtanen
- Department of Clinical Neurophysiology, Turku University Hospital, Turku, Finland.,Department of Clinical Neurophysiology, University of Turku, Turku, Finland
| | - Hanni Rönnlund
- Department of Paediatrics and Adolescent Medicine, University of Turku, Turku, Finland.,Kaarina Health Center, Kaarina, Finland
| | - Hanna Raaska
- Department of Child Psychiatry, Helsinki University Hospital, Helsinki, Finland
| | - Marko Elovainio
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland.,Department of Health Services Research, National Institute for Health and Welfare, Helsinki, Finland
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68
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Sidamon‐Eristoff AE, Cohodes EM, Gee DG, Peña CJ. Trauma exposure and mental health outcomes among Central American and Mexican children held in immigration detention at the United States–Mexico border. Dev Psychobiol 2021; 64:e22227. [DOI: 10.1002/dev.22227] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/22/2021] [Accepted: 10/30/2021] [Indexed: 11/05/2022]
Affiliation(s)
| | - Emily M. Cohodes
- Department of Psychology Yale University New Haven Connecticut USA
| | - Dylan G. Gee
- Department of Psychology Yale University New Haven Connecticut USA
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69
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Balters S, Li R, Espil FM, Piccirilli A, Liu N, Gundran A, Carrion VG, Weems CF, Cohen JA, Reiss AL. Functional near-infrared spectroscopy brain imaging predicts symptom severity in youth exposed to traumatic stress. J Psychiatr Res 2021; 144:494-502. [PMID: 34768071 DOI: 10.1016/j.jpsychires.2021.10.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/11/2021] [Accepted: 10/18/2021] [Indexed: 10/19/2022]
Abstract
Functional near-infrared spectroscopy (fNIRS) is a non-invasive neuroimaging technique with the potential to enable the assessment of posttraumatic stress disorder (PTSD) brain biomarkers in an affordable and portable manner. Consistent with biological models of PTSD, functional magnetic resonance imaging (fMRI) and fNIRS studies of adults with trauma exposure and PTSD symptoms suggest increased activation in the dorsolateral prefrontal cortex (dlPFC) and ventrolateral PFC (vlPFC) in response to negative emotion stimuli. We tested this theory with fNIRS assessment among youth exposed to traumatic stress and experiencing PTSD symptoms (PTSS). A portable fNIRS system collected hemodynamic responses from (N = 57) youth with PTSS when engaging in a classic emotion expression task that included fearful and neutral faces stimuli. The General Linear Model was applied to identify cortical activations associated with the facial stimuli. Subsequently, a prediction model was established via a Support Vector Regression to determine whether PTSS severity could be predicted based on fNIRS-derived cortical response measures and individual demographic information. Results were consistent with findings from adult fMRI and fNIRS studies of PTSS showing increased activation in the dlPFC and vlPFC in response to negative emotion stimuli. Subsequent prediction analysis revealed ten features (i.e., cortical responses from eight frontocortical fNIRS channels, age and sex) strongly correlated with PTSS severity (r = 0.65, p < .001). Our findings suggest the potential utility of fNIRS as a portable tool for the detection of putative PTSS brain biomarkers.
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Affiliation(s)
- Stephanie Balters
- Department of Psychiatry and Behavioral Sciences, Stanford University, United States.
| | - Rihui Li
- Department of Psychiatry and Behavioral Sciences, Stanford University, United States.
| | - Flint M Espil
- Department of Psychiatry and Behavioral Sciences, Stanford University, United States
| | - Aaron Piccirilli
- Department of Psychiatry and Behavioral Sciences, Stanford University, United States
| | - Ning Liu
- Department of Psychiatry and Behavioral Sciences, Stanford University, United States
| | - Andrew Gundran
- Department of Psychiatry and Behavioral Sciences, Stanford University, United States
| | - Victor G Carrion
- Department of Psychiatry and Behavioral Sciences, Stanford University, United States
| | - Carl F Weems
- Department of Human Development and Family Studies, Iowa State University, United States
| | - Judith A Cohen
- Allegheny Health Network, Drexel University College of Medicine, United States
| | - Allan L Reiss
- Department of Psychiatry and Behavioral Sciences, Stanford University, United States; Department of Radiology, Stanford University, United States; Department of Pediatrics, Stanford University, United States
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Abstract
ABSTRACT Trauma exposure has been repeatedly linked to psychophysiological threat reactivity, although the directionality of this association has been inconsistent. Several factors likely contribute to inconsistent findings including type of trauma and threat paradigm. The present study therefore examined the impact of trauma type on psychophysiological reactivity to predictable (P-) and unpredictable (U-) threat in young adults (N = 112). Participants were classified into three groups: history of interpersonal or noninterpersonal trauma, or no history of trauma. Startle eyeblink potentiation was recorded during a well-validated threat-of-shock paradigm. Results indicated individuals with interpersonal trauma exposure displayed exaggerated startle reactivity to U-threat (only) compared with both other groups. In contrast, individuals with noninterpersonal trauma exhibited blunted startle reactivity to U-threat (only) compared with both other groups. Findings reveal that trauma and threat type influence threat reactivity and that those with a history of interpersonal trauma may uniquely display exaggerated sensitivity to stressors that are uncertain.
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Affiliation(s)
- Kayla A. Kreutzer
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio 43210
- Institute for Behavioral Medicine Research, The Ohio State University, Columbus, Ohio 43210
| | - Stephanie M. Gorka
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio 43210
- Institute for Behavioral Medicine Research, The Ohio State University, Columbus, Ohio 43210
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Sippel LM, Flanagan JC, Holtzheimer PE, Moran-Santa-Maria MM, Brady KT, Joseph JE. Effects of intranasal oxytocin on threat- and reward-related functional connectivity in men and women with and without childhood abuse-related PTSD. Psychiatry Res Neuroimaging 2021; 317:111368. [PMID: 34455213 PMCID: PMC8572525 DOI: 10.1016/j.pscychresns.2021.111368] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 08/10/2021] [Accepted: 08/18/2021] [Indexed: 01/01/2023]
Abstract
Novel treatments that target neurobiological alterations associated with childhood trauma, particularly among those with posttraumatic stress disorder (PTSD), could mitigate negative outcomes for these at-risk individuals. PTSD is characterized by abnormalities within the brain's salience network and reward circuitry, which are modulated by intranasal oxytocin. Using a double-blind, randomized, placebo-controlled crossover design, we tested whether intranasal oxytocin (24 international units) influenced functional coupling of the amygdala with the anterior insula (AI), dorsal anterior cingulate cortex, and nucleus accumbens in response to implicitly presented fearful, angry, and happy faces among childhood trauma-exposed individuals with (n = 16, 9 women) and without PTSD (n = 18, 12 women). Psychophysiological interaction analyses revealed that oxytocin effects were limited to amygdala-AI connectivity in the fear condition, distinct for men and women, and not impacted by PTSD diagnosis. In response to fear faces, oxytocin reduced left amygdala-left AI connectivity for women but not men; reduced left amygdala-right AI connectivity among women, but increased this connectivity in men; and reduced right amygdala-right anterior insula connectivity for men, but increased it for women. Results suggest that intranasal oxytocin modulates threat salience among childhood trauma-exposed individuals and that these effects vary as a function of gender and hemisphere.
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Affiliation(s)
- Lauren M Sippel
- National Center for PTSD, White River Junction, VT, USA; Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
| | - Julianne C Flanagan
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA; Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | - Paul E Holtzheimer
- National Center for PTSD, White River Junction, VT, USA; Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Megan M Moran-Santa-Maria
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Kathleen T Brady
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA; Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | - Jane E Joseph
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, USA
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72
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Sellnow K, Esbensen K, Cisler JM. Social Trust and Reciprocity Among Adolescent Girls Exposed to Interpersonal Violence. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:9977-9995. [PMID: 31608755 DOI: 10.1177/0886260519881522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Trauma research has traditionally focused on altered emotion regulation and its role in psychopathology, whereas mechanisms of social behavior remain comparatively unexplored, particularly among adolescents. It has been previously reported that adolescents with histories of interpersonal violence (IV) demonstrate disrupted social learning, and the degree to which they are impaired during social interactions requiring trustful behaviors may be associated with their levels of anxiety. In the present study, 52 adolescent females (n = 26 control; n = 26 IV-exposed) between ages of 11 and 17 completed a multi-round adaptation of the Trust Game in which they interacted with a confederate peer run by a computer program, alternating between the roles of investor and investee. The task was designed to operationalize the social behaviors of trust and trust reciprocity, where the magnitude of the participants' monetary investment in the confederate during the investor role represented trust while the proportion of investment returned to the confederate in the investee role represented trust reciprocity. IV-exposed and control participants did not differ in trust (i.e., as investors); however, IV-exposed participants without anxiety diagnoses demonstrated lower trust than those with anxiety diagnoses. For trust reciprocity (i.e., as investees), there were again no differences between IV-exposed participants and controls; however, IV-exposed participants with anxiety diagnoses had increased trust reciprocity compared with both other groups. Similarly, caregiver-reported anxiety symptoms were associated with trust reciprocity behaviors among the IV-exposed adolescents. Findings suggest that IV exposure and associated anxiety impacts adolescents' trust behaviors, demonstrating potential mechanisms for maladaptive social behavior among trauma-exposed youth.
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73
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Sawant NS, Umate MS. Dissociation, Stressors, and Coping in Patients of Psychogenic Nonepileptic Seizures. Indian J Psychol Med 2021; 43:479-484. [PMID: 35210675 PMCID: PMC8826194 DOI: 10.1177/0253717620956460] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 08/17/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Psychogenic nonepileptic seizures (PNES) commonly present both to neurologists and psychiatrists and include a wide range of psychopathology. In order to understand the demographics, dissociative experiences, stressful life events, abuse, and coping in these patients, this study was undertaken. METHODS This was a cross-sectional, observational study. A total of 71 patients of PNES, referred from neurology, were assessed on Dissociative Experience Scale (DES), Scale For Trauma and Abuse, Presumptive Stressful Life Events Scale (PSLES), and Ways of Coping Questionnaire to ascertain the dissociative experiences; the prevalence of trauma, abuse, and stressful life events, and the coping mechanisms. RESULTS Females predominated, with the duration of PNES up to 2 years. The mean ± SD total DES score was 38.14 ± 14.1, indicating high dissociation. On the PSLES, for the stressful life events in the last one year, the mean score was 98.28 ± 87.1. Marital and family conflicts and death were reported more. History of childhood or adult physical and sexual abuse was less reported. History of head trauma was present in 13 patients. Emotion-focused coping was used more than problem-solving strategies. CONCLUSIONS Very few Indian studies have looked into these nuances. This study has helped in improving the understanding of the various risk factors of PNES and the coping strategies, and in sensitizing psychiatrists and neurologists to enquire into trauma and abuse of these patients.
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Affiliation(s)
- Neena S Sawant
- Dept. of Psychiatry, Seth GSMC & KEM Hospital, Mumbai, Maharashtra, India
| | - Maithili S Umate
- Dept. of Psychiatry, Grant Govt Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India
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74
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Wamser-Nanney R. Child-reported posttraumatic stress symptoms and attrition from therapy. CHILD ABUSE & NEGLECT 2021; 121:105266. [PMID: 34479132 DOI: 10.1016/j.chiabu.2021.105266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 07/26/2021] [Accepted: 08/08/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND High rates of attrition from child trauma-focused treatment are a significant barrier to mitigating children's trauma-related difficulties. Nonetheless, to date, only one study has investigated child-reported posttraumatic stress symptoms (PTSS) in relation to dropout from trauma-focused therapy and the posttraumatic stress disorder (PTSD) symptom clusters remain unexamined. OBJECTIVE The present study sought to determine whether higher levels of child-reported PTSS, as well as the specific DSM-IV PTSD symptom clusters, predicted attrition from trauma-focused cognitive behavioral therapy (TF-CBT). PARTICIPANTS/SETTING/METHOD One hundred and seventy one children ages 7-18 (M = 11.76, SD = 2.71; 67.4% female; 55.8% Black) were included in the study from an archival database. Dropout was investigated by two operational definitions: 1) clinician-rated dropout, and 2) whether the child received an adequate dose of treatment (i.e., 12 or more sessions). RESULTS Sixty eight percent (68.4%) of the children prematurely terminated treatment per their clinician, yet 70.2% received an adequate treatment dose. Child's age and income were related to clinician-rated attrition, but PTSS did not correspond with either attrition definition. None of the PTSD symptom clusters were associated with clinician-rated dropout; however, higher levels of avoidance symptoms were tied to increased likelihood of the child receiving an adequate dose of treatment. CONCLUSION From a public health perspective, it is encouraging that children who are reporting higher levels of PTSS may not be at greater risk for attrition.
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Affiliation(s)
- Rachel Wamser-Nanney
- Psychological Sciences, University of Missouri, St. Louis, MO 63121, United States of America.
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75
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Douglas RD, Alvis LM, Rooney EE, Busby DR, Kaplow JB. Racial, ethnic, and neighborhood income disparities in childhood posttraumatic stress and grief: Exploring indirect effects through trauma exposure and bereavement. J Trauma Stress 2021; 34:929-942. [PMID: 34643296 DOI: 10.1002/jts.22732] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 06/28/2021] [Accepted: 07/01/2021] [Indexed: 11/09/2022]
Abstract
Previous findings suggest that experiences with systems of oppression that disproportionately affect individuals based on race and neighborhood residency (e.g., systemic racism, neighborhood income disadvantage [NID]) can be associated with higher odds of developing psychological problems following traumatic events. Although race/ethnicity and NID residency are often associated, they are separate concepts that play unique roles in mental health outcomes among youth. Residents of Black, Latinx, and income-disadvantaged communities also have an increased risk of exposure to polyvictimization and the loss of multiple loved ones. Studies have not carefully delineated the potential relations between race/ethnicity and NID residency, polyvictimization, accumulated losses, and trauma and grief outcomes in youth. We examined mediation models to investigate whether polyvictimization, the loss of multiple loved ones, and exposure to violent death were potential mechanisms through which race/ethnicity and NID would predict trauma and grief outcomes in youth. Participants (N = 429) included Black (19.9%), Latinx (36.0%), and White (27.3%) children and adolescents who were assessed through a routine baseline assessment at a trauma and grief outpatient clinic. Black youth reported significantly elevated posttraumatic stress and maladaptive grief symptoms through higher polyvictimization and violent death exposure relative to White youth, βs = .06-.12, ps <.001. Latinx identity and NID were positively and directly associated with specific domains of maladaptive grief reactions, βs = .10-.17, ps < .001. If replicated longitudinally, these findings suggest that polyvictimization and violent death exposure may be mechanisms through which Black youth develop more severe traumatic stress and grief reactions.
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Affiliation(s)
- Robyn D Douglas
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas
| | - Lauren M Alvis
- The Trauma and Grief Center at The Hackett Center for Mental Health, Meadows Mental Health Policy Institute, Houston, Texas
| | - Evan E Rooney
- Department of Psychology, University of Mississippi, Oxford, MS
| | - Danielle R Busby
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Julie B Kaplow
- The Trauma and Grief Center at The Hackett Center for Mental Health, Meadows Mental Health Policy Institute, Houston, Texas
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76
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Fan Y, Shi Y, Zhang J, Sun D, Wang X, Fu G, Mo D, Wen J, Xiao X, Kong L. The effects of narrative exposure therapy on COVID-19 patients with post-traumatic stress symptoms: A randomized controlled trial. J Affect Disord 2021; 293:141-147. [PMID: 34186232 PMCID: PMC8234566 DOI: 10.1016/j.jad.2021.06.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 05/11/2021] [Accepted: 06/13/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND With the global attack of Coronavirus Disease 2019 (COVID-19), cases with Post-traumatic Stress Disorder (PTSD) have been increasing steadily, which seriously affects the quality of life of patients and as such, seeking effective treatments is an urgent matter. Narrative Exposure Therapy (NET) is a typical cognitive behavioral therapy targeting trauma-related psychological disorders and may be an effective intervention. METHODS A total of 111 COVID-19 patients near the discharge stage with positive screening results for posttraumatic stress symptoms (PTSS) were randomly assigned (1:1) to either the study group or the control group. The study group received NET and personalized psychological intervention, while the control group only received personalized psychological intervention. PTSS, depression, anxiety and sleep quality were measured pre- and post-intervention to evaluate the effect of NET. This trial was registered with the International Standard Randomized Clinical Trial Registry (No. ChiCTR2000039369). RESULTS NET participants showed a significantly greater PTSS reduction in comparison with the control group after the intervention. Improvement in sleep quality, anxiety and depression after the intervention were pronounced but not significantly different between the two treatment groups. LIMITATIONS The assessors weren't blinded for the convenience of measurement and protection of participants' psychological security. CONCLUSIONS NET likely had a positive impact on PTSS of COVID-19 patients. Clinical staff should consider applying NET to improve the psychological well-being of patients who have experienced an epidemic such as COVID-19.
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Affiliation(s)
- Ying Fan
- Bachelor of Nursing, Wuhan University School of Health Sciences, Xiangzhou District People's Hospital in Hubei Province, China
| | - Yuxin Shi
- Bachelor of Nursing, Wuhan University School of Health Sciences, China
| | - Jun Zhang
- Associate Professor, Wuhan University School of Health Sciences, China.
| | - Dingwen Sun
- Associate chief physician, Vice President of Xiangzhou District People's Hospital, Xiangyang city, Hubei Province, China
| | - Xuefei Wang
- Bachelor of Nursing; Wuhan University School of Health Sciences, Xiangyang Central Hospital in Hubei Province, China
| | - Gaizhi Fu
- Associate professor of nursing, Director of psychological Outpatient Department, Xiangzhou District People's Hospital, Xiangyang city, Hubei Province, China
| | - Daorong Mo
- Associate professor of nursing; Xiangzhou District People's Hospital, Xiangyang city, Hubei Province, China
| | - Juan Wen
- Associate professor of nursing, Xiangzhou District People's Hospital, Xiangyang city, Hubei Province, China
| | - Xuexia Xiao
- Associate professor of nursing, Xiangyang Hospital of Traditional Chinese Medicine in Hubei Province, China
| | - Lingai Kong
- Bachelor of Public health, Wuhan University School of Health Sciences, China
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77
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Brewerton TD, Gavidia I, Suro G, Perlman MM, Genet J, Bunnell DW. Provisional posttraumatic stress disorder is associated with greater severity of eating disorder and comorbid symptoms in adolescents treated in residential care. EUROPEAN EATING DISORDERS REVIEW 2021; 29:910-923. [PMID: 34523192 DOI: 10.1002/erv.2864] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 08/21/2021] [Accepted: 09/02/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Past traumatic events, subsequent posttraumatic stress disorder (PTSD) and related psychiatric comorbidities are commonly associated with eating disorders (EDs) in adults but remain understudied in adolescents. METHODS Adolescent participants (mean [SD] age = 15.1 ± 1.5 years, 96.5% female) with EDs entering residential treatment (n = 647) at six sites in the United States completed validated self-report assessments of ED, PTSD, major depression, anxiety disorders and quality of life. Provisional DSM-5 PTSD diagnoses (PTSD+) were made via the Childhood Trauma Questionnaire, admission interviews and the PTSD Symptom Checklist for DSM-5. RESULTS PTSD+ occurred in 35.4% of participants, and those with ED-PTSD+ had significantly higher scores on all assessments (p ≤ 0.001), including measures of ED psychopathology, major depression, anxiety disorders and quality of life, as well as significantly higher rates of all forms of childhood trauma. Those with PTSD+ also exhibited a significantly higher percent median body mass index for age and sex and a lower propensity toward anorexia nervosa, restricting type. CONCLUSIONS Results confirm that adolescent patients in residential treatment with ED-PTSD+ are more symptomatic and have worse quality of life than their ED counterparts without PTSD. Integrated treatment approaches that effectively address ED-PTSD+ are greatly needed in ED programs that treat adolescents.
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Affiliation(s)
- Timothy D Brewerton
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA.,LLC, Mt. Pleasant, South Carolina, USA.,Monte Nido and Affiliates, Miami, Florida, USA
| | | | - Giulia Suro
- Monte Nido and Affiliates, Miami, Florida, USA
| | - Molly M Perlman
- Monte Nido and Affiliates, Miami, Florida, USA.,Department of Psychiatry and Behavioral Health, Florida International University Herbert Wertheim College of Medicine, Miami, Florida, USA
| | | | - Douglas W Bunnell
- Monte Nido and Affiliates, Miami, Florida, USA.,Private Practice, Westport, Connecticut, USA
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Giannopoulou I, Galinaki S, Kollintza E, Adamaki M, Kympouropoulos S, Alevyzakis E, Tsamakis K, Tsangaris I, Spandidos DA, Siafakas N, Zoumpourlis V, Rizos E. COVID-19 and post-traumatic stress disorder: The perfect 'storm' for mental health (Review). Exp Ther Med 2021; 22:1162. [PMID: 34504607 PMCID: PMC8392877 DOI: 10.3892/etm.2021.10596] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 08/10/2021] [Indexed: 12/28/2022] Open
Abstract
Since its outbreak, in December, 2019, in the Chinese city of Wuhan, coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has evolved into an ongoing global pandemic. Due to the novel antigenic properties of this virus, the world population could not develop immunity effectively and this led to the subsequent spread of COVID-19. This caused an unprecedented emergency situation with significant negative effects on health and well-being both on an individual and societal level. Apart from health, economic and social consequences, the impact of this pandemic on mental health is increasingly being reported in the scientific literature. The present review aimed to provide a comprehensive discussion of the possible neurological and neuropsychiatric manifestations of SARS-CoV-2, together with the related underlying molecular pathways. In addition, the present review focused on populations which are at a higher risk of developing psychiatric disturbances due to the COVID-19 pandemic and discussed possible routes of clinical management and therapeutics to minimize the burden associated with psychiatric disorders. Moreover, research findings exploring the prevalence of COVID-19-related post-traumatic stress disorder (PTSD) symptoms across vulnerable groups, including children, adolescents and COVID-19 survivors are presented, with particular emphasis on those with severe disease who required hospitalization and/or intensive care unit admission. Based on the available literature, the identification of potential determinants associated with PTSD across the different populations is underlined. Lessons learnt from the pandemics across the globe together with the ongoing research on COVID-19 and its impact on mental health, highlight the utmost importance for evidence-based, proactive and targeted interventions in high-risk groups aiming to mitigate the risks and manage vulnerabilities.
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Affiliation(s)
- Ioanna Giannopoulou
- Second Department of Psychiatry, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens 12462, Greece
| | - Sofia Galinaki
- Second Department of Psychiatry, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens 12462, Greece
| | - Evangelia Kollintza
- Second Department of Psychiatry, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens 12462, Greece
| | - Maria Adamaki
- Biomedical Applications Unit, Institute of Chemical Biology, National Hellenic Research Foundation (NHRF), Athens 11635, Greece
| | - Stylianos Kympouropoulos
- Second Department of Psychiatry, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens 12462, Greece
| | - Evangelos Alevyzakis
- Second Department of Psychiatry, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens 12462, Greece
| | - Konstantinos Tsamakis
- Second Department of Psychiatry, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens 12462, Greece
| | - Iraklis Tsangaris
- Second Department of Critical Care Medicine, Attikon University Hospital, Athens 12462, Greece
| | - Demetrios A Spandidos
- Laboratory of Clinical Virology, School of Medicine, University of Crete, Heraklion 71003, Greece
| | - Nikolaos Siafakas
- Clinical Microbiology Laboratory, School of Medicine, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens 12462, Greece
| | - Vassilios Zoumpourlis
- Biomedical Applications Unit, Institute of Chemical Biology, National Hellenic Research Foundation (NHRF), Athens 11635, Greece
| | - Emmanouil Rizos
- Second Department of Psychiatry, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens 12462, Greece
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79
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Hallam KT, Fernandes M, Pavlis A. Better off alone? Comparing the substance use, mental health and trauma risks of youth alcohol and other drug service users either living in out of home care, living with parents or experiencing homelessness. Drug Alcohol Rev 2021; 41:467-475. [PMID: 34499779 DOI: 10.1111/dar.13379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 06/22/2021] [Accepted: 07/23/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION All young people seeking assistance from youth alcohol and other drug services require support to help them minimise the harms from their substance use and continue to develop healthy and meaningful lives. A particular focus on young people in residential out of home care (OoHC) highlights the increased risks of substance use, mental health issues and continued vulnerabilities in this group. While in the past, research contrasted this group with young people living at home, this study contrasted young people in OoHC with homeless youths alongside those living with parents. METHODS The research contrasted these three groups of young people on substance use profiles, mental health and wellbeing and vulnerability to abuse (historic and current) in the Youth Needs Census conducted in Victoria and Queensland over 2013-2017. RESULTS The results demonstrate a clear risk of increased casual and daily methamphetamine use in the homeless youth group and occasional heroin use in the OoHC group. Mental health measures for both the OoHC and homeless youths were worse than the young people living at home. Trauma was similarly higher in these groups, with both historical and ongoing risks of violent crime for homeless youths. DISCUSSION AND CONCLUSIONS The results demonstrate the similar and serious health and wellbeing risks facing both youths in residential OoHC and homeless youths. These results are concerning as one of these groups is ostensibly in the care of the community and government, while the other group is experiencing unstable accommodation and associated physical risks.
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Affiliation(s)
- Karen T Hallam
- Institute for Innovation in Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia.,Centre for Youth AOD Research and Practice, Youth Support and Advocacy Service Pty Ltd, Melbourne, Australia
| | - Marilia Fernandes
- Institute for Health and Sport/Psychology, Victoria University, Melbourne, Australia
| | - Alexia Pavlis
- Institute for Health and Sport/Psychology, Victoria University, Melbourne, Australia.,Department of Psychology and Counselling, La Trobe University, Melbourne, Australia
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80
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Snigdha S, Ha K, Tsai P, Dinan TG, Bartos JD, Shahid M. Probiotics: Potential novel therapeutics for microbiota-gut-brain axis dysfunction across gender and lifespan. Pharmacol Ther 2021; 231:107978. [PMID: 34492236 DOI: 10.1016/j.pharmthera.2021.107978] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/21/2021] [Accepted: 08/17/2021] [Indexed: 12/12/2022]
Abstract
Probiotics are live microorganisms, which when administered in adequate amounts, present a health benefit for the host. While the beneficial effects of probiotics on gastrointestinal function are generally well recognized, new animal research and clinical studies have found that alterations in gut microbial communities can have a broad range of effects throughout the body. Non-intestinal sites impacted include the immune, endocrine, cardiovascular and the central nervous system (CNS). In particular, there has been a growing interest and appreciation about the role that gut microbiota may play in affecting CNS-related function through the 'microbiota-gut-brain axis'. Emerging evidence suggests potential therapeutic benefits of probiotics in several CNS conditions, such as anxiety, depression, autism spectrum disorders and Parkinson's disease. There may also be some gender-specific variances in terms of probiotic mediated effects, with the gut microbiota shaping and being concurrently molded by the hormonal environment governing differences between the sexes. Probiotics may influence the ability of the gut microbiome to affect a variety of biological processes in the host, including neurotransmitter activity, vagal neurotransmission, generation of neuroactive metabolites and inflammatory response mediators. Some of these may engage in cross talk with host sex hormones, such as estrogens, which could be of relevance in relation to their effects on stress response and cognitive health. This raises the possibility of gender-specific variation with regards to the biological action of probiotics, including that on the endocrine and central nervous systems. In this review we aim to describe the current understanding in relation to the role and use of probiotics in microbiota-gut-brain axis-related dysfunction. Furthermore, we will address the conceptualization and classification of probiotics in the context of gender and lifespan as well as how restoring gut microbiota composition by clinical or dietary intervention can help in supporting health outcomes other than those related to the gastrointestinal tract. We also evaluate how these new learnings may impact industrial effort in probiotic research and the discovery and development of novel and more personalized, condition-specific, beneficial probiotic therapeutic agents.
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Affiliation(s)
| | - Kevin Ha
- MeriCal, 233 E Bristol St., Orange, CA, USA
| | - Paul Tsai
- MeriCal, 233 E Bristol St., Orange, CA, USA
| | - Timothy G Dinan
- APC Microbiome Ireland, University College Cork, Cork, Ireland; Department of Psychiatry and Neurobehavioural Science, University College Cork, Cork, Ireland
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81
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Mottershead R, Ghisoni M. Horticultural therapy, nutrition and post-traumatic stress disorder in post-military veterans: developing non-pharmaceutical interventions to complement existing therapeutic approaches. F1000Res 2021; 10:885. [PMID: 34621518 PMCID: PMC8456374 DOI: 10.12688/f1000research.70643.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/25/2021] [Indexed: 12/12/2022] Open
Abstract
Non-pharmaceutical interventions for veterans living with post-traumatic stress disorder are becoming a more popular way to address some of the social and personal needs identified by this group. Horticultural therapy or growing and eating food together provides several ways to increase mood, improve nutritional status, reduce loneliness and reduce the physical health impacts of mental illnesses such as post-traumatic stress disorder. In this paper we will discuss some of the issues people living with post-traumatic stress disorder might face. We will also provide an overview of the therapeutic effects of these approaches and how they will be applied in a locally identified group.
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Affiliation(s)
- Richard Mottershead
- Ras Al Khaimah College of Nursing, RAK Medical and Health Sciences University, Ras Al Khaimah, P.O.Box 11172, United Arab Emirates
| | - Marjorie Ghisoni
- School of Medical and Health Sciences, Bangor University, Bangor, Wales, LL57 2DG, UK
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82
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Cohodes EM, Kribakaran S, Odriozola P, Bakirci S, McCauley S, Hodges HR, Sisk LM, Zacharek SJ, Gee DG. Migration-related trauma and mental health among migrant children emigrating from Mexico and Central America to the United States: Effects on developmental neurobiology and implications for policy. Dev Psychobiol 2021; 63:e22158. [PMID: 34292596 PMCID: PMC8410670 DOI: 10.1002/dev.22158] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 05/11/2021] [Accepted: 06/20/2021] [Indexed: 12/24/2022]
Abstract
Children make up over half of the world's migrants and refugees and face a multitude of traumatic experiences prior to, during, and following migration. Here, we focus on migrant children emigrating from Mexico and Central America to the United States and review trauma related to migration, as well as its implications for the mental health of migrant and refugee children. We then draw upon the early adversity literature to highlight potential behavioral and neurobiological sequalae of migration-related trauma exposure, focusing on attachment, emotion regulation, and fear learning and extinction as transdiagnostic mechanisms underlying the development of internalizing and externalizing symptomatology following early-life adversity. This review underscores the need for interdisciplinary efforts to both mitigate the effects of trauma faced by migrant and refugee youth emigrating from Mexico and Central America and, of primary importance, to prevent child exposure to trauma in the context of migration. Thus, we conclude by outlining policy recommendations aimed at improving the mental health of migrant and refugee youth.
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Affiliation(s)
- Emily M Cohodes
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Sahana Kribakaran
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Paola Odriozola
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Sarah Bakirci
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Sarah McCauley
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - H R Hodges
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Lucinda M Sisk
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Sadie J Zacharek
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Dylan G Gee
- Department of Psychology, Yale University, New Haven, Connecticut, USA
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83
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Wamser-Nanney R. Maternal Support and Attrition from Child Trauma-Focused Therapy. J Trauma Stress 2021; 34:840-850. [PMID: 34057745 DOI: 10.1002/jts.22698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 04/16/2021] [Accepted: 04/18/2021] [Indexed: 11/07/2022]
Abstract
Many children prematurely terminate from trauma-focused therapy (TFT), and attrition is a critical barrier in addressing the impacts of childhood sexual abuse (CSA). The field's knowledge of risk factors for dropout is growing; however, one aspect of the child's environment that remains unexamined is maternal support following the CSA disclosure/discovery. Maternal support has been theorized to play a valuable role in influencing children's outcomes after CSA and may be relevant in understanding attrition. The objective of the current study was to investigate the associations between children's symptoms, relationship to the perpetrator, and maternal support in relation to premature termination from TFT among 186 sexually abused children (Mage = 9.24 years, SD = 3.72, 67.3% female). Two operational definitions of attrition were used: (a) clinician-rated dropout (i.e., clinician's ratings of whether the child completed treatment) and (b) whether the child received an adequate treatment dose treatment (i.e., ≥12 sessions). Maternal marital status was the only factor associated with clinician-rated treatment dropout, OR = 2.35, whereas maternal support and blame/doubt were unrelated. Living farther from the clinic was tied to an increased risk of receiving an inadequate treatment dose, OR = 0.96. Replication of these findings is needed, particularly using a clinician-administered measure of caregiver support; yet, maternal emotional support and blame/doubt may not evince strong ties to dropout from TFT among sexually abused children. Additional work is needed to discern if there are key subgroups for whom support is more strongly related to the risk of premature termination following CSA.
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Affiliation(s)
- Rachel Wamser-Nanney
- Department of Psychological Sciences, University of Missouri St. Louis, St. Louis, Missouri, USA
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84
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Mohammadi-Farani A, Limoee M, Shirooie S. Sodium butyrate enhances fear extinction and rescues hippocampal acetylcholinesterase activity in a rat model of posttraumatic stress disorder. Behav Pharmacol 2021; 32:413-421. [PMID: 33883448 DOI: 10.1097/fbp.0000000000000633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
It is believed that impaired extinction of fear memories is an underlying cause for the development of posttraumatic stress disorder (PTSD). Histone deacetylases (HDAC) are enzymes that modulate extinction by changing the chromatin structure and altering protein synthesis in the brain. Studies show that stress modifies both HDAC activity and cerebral cholinergic neurotransmission. The present work aims to evaluate the effect of sodium butyrate (NaBu), an HDAC inhibitor, on behavioral markers of extinction and biochemical changes in HDAC and acetylcholinesterase activity in the hippocampus. NaBu was administered for 7 days in a group of rats that were exposed to single prolonged stress (SPS), as a model for PTSD. Contextual fear conditioning was performed on the 8th day, and fear extinction was measured in the next 4 consecutive days. Other behavioral tests to measure anxiety, locomotor activity and working memory were performed for further interpretation of the results. Hippocampal acetylcholinesterase and HDAC activity were also measured through biochemical tests. Behavioral results showed that treatment with NaBu can reverse the SPS-induced extinction deficits. Biochemical data indicated that while SPS induced overactivity in hippocampal HDAC, it decreased acetylcholinesterase activity in the region. Both effects were reversed after NaBu treatment. It seems that at least part of extinction deficiency in SPS exposed rats is related to hypoacetylation of acetylcholinesterase in the hippocampus. Preemptive therapy with an HDAC inhibitor reverses this process and is worth further evaluation as a possible therapeutic approach in PTSD.
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Affiliation(s)
- Ahmad Mohammadi-Farani
- Pharmaceutical Sciences Research Centre, Health Institute
- Department of Pharmacology and Toxicology, School of Pharmacy
| | - Mazdak Limoee
- Nano Drug Delivery Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
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85
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Wang P, Peng Z, Liu L, An L, Liu Y, Cao Q, Sun L, Ji N, Chen Y, Yang B, Wang Y. Neural response to trauma-related and trauma-unrelated negative stimuli in remitted and persistent pediatric post-traumatic stress disorder. Brain Behav 2021; 11:e02173. [PMID: 34076367 PMCID: PMC8323042 DOI: 10.1002/brb3.2173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 04/06/2021] [Accepted: 04/23/2021] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Most youths who suffer from post-traumatic stress disorder (PTSD) lose their diagnosis in the first 1-2 years. However, there are few studies on this brain mechanism, and the heterogeneity of the findings is partially due to the different stimuli applied and the mixed trauma history. Therefore, the use of trauma-related/unrelated stimuli to study the remittance mechanism of earthquake-induced PTSD could advance our knowledge of PTSD and inspire future treatment. METHODS Thirteen youths with PTSD, 18 remitted participants, and 18 control participants underwent functional magnetic resonance imaging (fMRI), while viewing trauma-related pictures, trauma-unrelated negative pictures, and scrambled pictures. RESULTS Under trauma-unrelated condition, the neural activity of the left hippocampus in the remitted group was between the two other groups. Under trauma-related condition, the PTSD and the remitted group exhibited higher neural activity in the right middle occipital gyrus than controls. The remitted group showed higher neural activity in the right parahippocampal gyrus and right lingual gyrus under trauma-related condition than trauma-unrelated condition, while no significant difference was found in PTSD group. CONCLUSION PTSD status-related group differences are mainly reflected in the left hippocampus under the trauma-unrelated condition, while the hyperactivity in the right middle occipital gyrus under trauma-related condition could be an endophenotype for PTSD.
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Affiliation(s)
- Peng Wang
- Sixth Hospital/Institute of Mental HealthPeking UniversityBeijingChina
- National Clinical Research Center for Mental Disorders & The Key Laboratory of Mental HealthMinistry of Health (Peking University)BeijingChina
- Shenzhen Children's HospitalShenzhenChina
- Cardiac Rehabilitation Center, Fuwai Hospital CAMS&PUMCBeijingChina
| | - Zu‐Lai Peng
- Sixth Hospital/Institute of Mental HealthPeking UniversityBeijingChina
- National Clinical Research Center for Mental Disorders & The Key Laboratory of Mental HealthMinistry of Health (Peking University)BeijingChina
| | - Lu Liu
- Sixth Hospital/Institute of Mental HealthPeking UniversityBeijingChina
- National Clinical Research Center for Mental Disorders & The Key Laboratory of Mental HealthMinistry of Health (Peking University)BeijingChina
| | - Li An
- Sixth Hospital/Institute of Mental HealthPeking UniversityBeijingChina
- National Clinical Research Center for Mental Disorders & The Key Laboratory of Mental HealthMinistry of Health (Peking University)BeijingChina
| | - Yu‐Xin Liu
- Sixth Hospital/Institute of Mental HealthPeking UniversityBeijingChina
- National Clinical Research Center for Mental Disorders & The Key Laboratory of Mental HealthMinistry of Health (Peking University)BeijingChina
| | - Qing‐Jiu Cao
- Sixth Hospital/Institute of Mental HealthPeking UniversityBeijingChina
- National Clinical Research Center for Mental Disorders & The Key Laboratory of Mental HealthMinistry of Health (Peking University)BeijingChina
| | - Li Sun
- Sixth Hospital/Institute of Mental HealthPeking UniversityBeijingChina
- National Clinical Research Center for Mental Disorders & The Key Laboratory of Mental HealthMinistry of Health (Peking University)BeijingChina
| | - Ning Ji
- Sixth Hospital/Institute of Mental HealthPeking UniversityBeijingChina
- National Clinical Research Center for Mental Disorders & The Key Laboratory of Mental HealthMinistry of Health (Peking University)BeijingChina
| | - Yun Chen
- Sixth Hospital/Institute of Mental HealthPeking UniversityBeijingChina
- National Clinical Research Center for Mental Disorders & The Key Laboratory of Mental HealthMinistry of Health (Peking University)BeijingChina
| | | | - Yu‐Feng Wang
- Sixth Hospital/Institute of Mental HealthPeking UniversityBeijingChina
- National Clinical Research Center for Mental Disorders & The Key Laboratory of Mental HealthMinistry of Health (Peking University)BeijingChina
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86
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Abstract
Abstract. Climate change is now widely recognized as the greatest threat faced by humanity for thousands of years and is known to affect the social and environmental determinants of health; including access to clean air, safe drinking water, sufficient food, and secure shelter ( WHO, 2018 ). Anthropogenic climate change has already resulted in warming and precipitation trends that claim 150,000 lives annually, and a recent report from the WHO forecasts that between 2030 and 2050 climate change will cause an additional 250,000 additional deaths per year ( WHO, 2018 ). The interaction between climate change, mental health, and physical health is not yet well understood. This review addresses the question of how climate change is affecting mental health and will demonstrate that climate psychopathologies really matter in the face of the climate emergency.
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Affiliation(s)
- Harriet E. Thompson
- The Centre for Climate Justice, Glasgow Caledonian University, United Kingdom
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87
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Orzechowski M, Wigand ME, Nowak M, Becker T, Steger F. Post-traumatic stress disorder, human rights and access to healthcare: an analysis of judgments of the European Court of Human Rights from an ethical perspective. Eur J Psychotraumatol 2021; 12:1930704. [PMID: 34211639 PMCID: PMC8221123 DOI: 10.1080/20008198.2021.1930704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Background: Human rights violations such as torture are associated with a high risk of post-traumatic stress disorder (PTSD). The judgements of the European Court of Human Rights (ECtHR) include a normative perspective on PTSD and address central ethical questions. Objective: To help bridge the gap between the psycho-medical and the legal discourse on human rights violations and to illustrate their medico-ethical implications by systematically assessing and categorizing all judgements by the ECtHR dealing with PTSD. Method: The ECtHR database was searched for 'post-traumatic stress disorder'. A descriptive statistic was performed on the Articles of the European Convention on Human Rights involved and violations to these articles. In a qualitative analysis, the judgements were thematically grouped. Results: The search yielded n = 103 judgements, of which n = 90 were included. There were mostly violations of Article 3 (prohibition of torture), Article 8 (Right to respect for private and family life) and Article 6 (Right to a fair trial). PTSD in these judgements is normatively discussed with regards to ethical, social and political themes such as inadequate access to healthcare, especially in prison, matters of asylum, expulsion and extradition, protection of minorities and minors, as well as rights and duties of traumatized witnesses. Conclusion: PTSD plays a central role in a large number of ECtHR judgements. Our results show that PTSD as a medical diagnosis also encompasses legal, ethical, social, and political dimensions. This knowledge is essential for healthcare professionals working with traumatized persons, but can also be relevant for political decision-makers.
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Affiliation(s)
- Marcin Orzechowski
- Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany
| | - Moritz E Wigand
- Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany.,Department of Psychiatry II, Ulm University and BKH Günzburg, Günzburg, Germany
| | - Marianne Nowak
- Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany
| | - Thomas Becker
- Department of Psychiatry II, Ulm University and BKH Günzburg, Günzburg, Germany
| | - Florian Steger
- Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany
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88
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Stupar D, Stevanovic D, Vostanis P, Atilola O, Moreira P, Dodig-Curkovic K, Franic T, Doric A, Davidovic N, Avicenna M, Multazam IN, Nussbaum L, Thabet AA, Ubalde D, Petrov P, Deljkovic A, Monteiro AL, Ribas A, Jovanovic M, Joana O, Knez R. Posttraumatic stress disorder symptoms among trauma-exposed adolescents from low- and middle-income countries. Child Adolesc Psychiatry Ment Health 2021; 15:26. [PMID: 34090487 PMCID: PMC8180049 DOI: 10.1186/s13034-021-00378-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 05/27/2021] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Exposure to traumatic events in childhood is associated with the development and maintenance of various psychiatric disorders, but most frequently with posttraumatic stress disorder (PTSD). The aim of this study was to evaluate the types of traumatic events experienced and the presence and predictors of PTSD symptoms among adolescents from the general population from ten low- and middle-income countries (LMICs). METHODS Data were simultaneously collected from 3370 trauma-exposed adolescents (mean age = 15.41 [SD = 1.65] years, range 12-18; 1465 (43.5%) males and 1905 (56.5%) females) in Brazil, Bulgaria, Croatia, Indonesia, Montenegro, Nigeria, the Palestinian Territories, the Philippines, Romania, and Serbia, with Portugal, a high-income country, as a reference point. The UCLA PTSD Reaction Index for the DSM-5 (PTSD-RI-5) was used for the assessment of traumatic events and PTSD symptoms. RESULTS The most frequently reported traumatic events were death of a close person (69.7%), witnessing violence other than domestic (40.5%), being in a natural disaster (34.4%) and witnessing violent death or serious injury of a close person (33.9%). In total, 28.5% adolescents endorsed two to three DSM-5 PTSD criteria symptoms. The rates of adolescents with symptoms from all four DSM-5 criteria for PTSD were 6.2-8.1% in Indonesia, Serbia, Bulgaria, and Montenegro, and 9.2-10.5% in Philippines, Croatia and Brazil. From Portugal, 10.7% adolescents fall into this category, while 13.2% and 15.3% for the Palestinian Territories and Nigeria, respectively. A logistic regression model showed that younger age, experiencing war, being forced to have sex, and greater severity of symptoms (persistent avoidance, negative alterations in cognitions and mood, and alterations in arousal and reactivity) were significant predictors of fulfilling full PTSD criteria. CONCLUSIONS Nearly every third adolescent living in LMICs might have some PTSD symptoms after experiencing a traumatic event, while nearly one in ten might have sufficient symptoms for full DSM-5 PTSD diagnosis. The findings can inform the generation of PTSD burden estimates, allocation of health resources, and designing and implementing psychosocial interventions for PTSD in LMICs.
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Affiliation(s)
- Dusko Stupar
- Clinic for Neurology and Psychiatry for Children and Youth, Belgrade, Serbia
| | - Dejan Stevanovic
- Clinic for Neurology and Psychiatry for Children and Youth, Belgrade, Serbia
| | - Panos Vostanis
- School of Psychology, Leicester University, Leicester, UK
| | - Olayinka Atilola
- Department of Behavioural Medicine, Lagos State University College of Medicine Ikeja, Lagos, Nigeria
| | - Paulo Moreira
- Lusíada University, Porto, Portugal
- CIPD, Porto, Portugal
| | | | - Tomislav Franic
- Child and Adolescent Psychiatry, School of Medicine, University of Split, Split, Croatia
| | - Ana Doric
- Department of Psychology, Faculty of Humanities and Social Sciences, Rijeka, Croatia
| | - Nikolina Davidovic
- Child and Adolescent Psychiatry, School of Medicine, University of Split, Split, Croatia
| | - Mohamad Avicenna
- Faculty of Psychology, State Islamic University Syarif Hidayatullah, Jakarta, Indonesia
| | | | - Laura Nussbaum
- Department of Child and Adolescent Psychiatry, University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania
| | - Abdul Aziz Thabet
- School of Public Health, Gaza Branch, Al Quds University, Jerusalem, Palestinian Territories, Israel
| | - Dino Ubalde
- Department of Psychology, St. Dominic College of Asia, City of Bacoor, Bacoor, Philippines
| | - Petar Petrov
- Department of Child and Adolescent Psychiatry, University Hospital St. Marina, Varna, Bulgaria
| | | | | | - Adriana Ribas
- Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | - Rajna Knez
- Department of Pediatrics, Skaraborgs Hospital Skövde, Skövde, Sweden.
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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89
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Lenart EK, Bee TK, Seger CP, Lewis RH, Filiberto DM, Huang DD, Fischer PE, Croce MA, Fabian TC, Magnotti LJ. Youth, poverty, and interpersonal violence: a recipe for PTSD. Trauma Surg Acute Care Open 2021; 6:e000710. [PMID: 33907715 PMCID: PMC8051402 DOI: 10.1136/tsaco-2021-000710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Emily K Lenart
- Department of Surgery, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Tiffany K Bee
- Department of Surgery, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Catherine P Seger
- Department of Surgery, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Richard H Lewis
- Department of Surgery, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Dina M Filiberto
- Department of Surgery, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Dih-Dih Huang
- Department of Surgery, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Peter E Fischer
- Department of Surgery, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Martin A Croce
- Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Timothy C Fabian
- Surgery, University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee, USA
| | - Louis J Magnotti
- Surgery, University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee, USA
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90
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Damian AJ, Boyd R. Advancing the Role of School-Based Health Centers in Driving Health Justice. THE JOURNAL OF SCHOOL HEALTH 2021; 91:274-276. [PMID: 33655508 DOI: 10.1111/josh.12999] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 11/27/2020] [Accepted: 12/29/2020] [Indexed: 06/12/2023]
Affiliation(s)
- April Joy Damian
- Weitzman Institute, Community Health Center, Inc, 19 Grand Street, Middletown, CT, 06457
| | - Robert Boyd
- School-Based Health Alliance, 1010 Vermont Ave NW, Suite 600, Washington, DC, 20005
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91
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Hilberdink CE, van Zuiden M, Schrantee A, Korosi A, Kaiser A, Zhutovsky P, Ginty AT, Ensink JBM, Lindauer RJL, Vrijkotte TGM, de Rooij SR. Dysregulated functional brain connectivity in response to acute social-evaluative stress in adolescents with PTSD symptoms. Eur J Psychotraumatol 2021; 12:1880727. [PMID: 33968316 PMCID: PMC8075091 DOI: 10.1080/20008198.2021.1880727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Posttraumatic stress disorder (PTSD) is associated with dysregulated neural, cortisol, and cardiac stress reactivity and recovery. This understanding is predominantly based on studies in adults applying emotional-cognitive and trauma-related stimuli inducing negative emotions or perceived threat. Despite large numbers of adolescents with PTSD, few studies are available on neurobiological stress reactivity in this population. Moreover, no previous studies investigated neural reactivity to social-evaluative stress. Objective: To investigate functional brain connectivity, cortisol and cardiac reactivity to acute social-evaluative stress, and additional cortisol measures in trauma-exposed adolescents with and without high PTSD symptoms. Method: A speech preparation task to induce acute social-evaluative stress elicited by anticipatory threat, was used in a subsample of the Amsterdam Born Child and their Development (ABCD) birth cohort, consisting of trauma-exposed adolescents with (n = 20) and without (n = 29) high PTSD symptoms. Psychophysiological interaction analyses were performed to assess group differences in functional connectivity of the hippocampus, mPFC and amygdala during social-evaluative stress and recovery, measured by fMRI. Additionally, perceived stress, heart rate and cortisol stress reactivity and recovery, cortisol awakening response and day curve were compared. Results: The stressor evoked significant changes in heart rate and perceived stress, but not cortisol. The PTSD symptom and control groups differed in functional connectivity between the hippocampus and cerebellum, middle and inferior frontal gyrus, and the mPFC and inferior frontal gyrus during social-evaluative stress versus baseline. Mostly, the same patterns were found during recovery versus baseline. We observed no significant group differences in amygdala connectivity, and cortisol and cardiac measures. Conclusions: Our findings suggest threat processing in response to social-evaluative stress is disrupted in adolescents with PTSD symptoms. Our findings are mainly but not entirely in line with findings in adults with PTSD, which denotes the importance to investigate adolescents with PTSD as a separate population.
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Affiliation(s)
- Charlotte E Hilberdink
- Department of Psychiatry, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Mirjam van Zuiden
- Department of Psychiatry, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Anouk Schrantee
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Aniko Korosi
- Swammerdam Institute for Life Sciences, Centre for Neuroscience, University of Amsterdam, Amsterdam, The Netherlands
| | - Antonia Kaiser
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Paul Zhutovsky
- Department of Psychiatry, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Annie T Ginty
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA
| | - Judith B M Ensink
- Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands.,Department of Child and Adolescent Psychiatry (JBME, RJLL), Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Ramon J L Lindauer
- Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands.,Department of Child and Adolescent Psychiatry (JBME, RJLL), Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Tanja G M Vrijkotte
- Department of Epidemiology and Data Science, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Susanne R de Rooij
- Department of Epidemiology and Data Science, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Department of Public Health and Occupational Health, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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92
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Michalek JE, Lisi M, Awad D, Hadfield K, Mareschal I, Dajani R. The Effects of a Reading-Based Intervention on Emotion Processing in Children Who Have Suffered Early Adversity and War Related Trauma. Front Psychol 2021; 12:613754. [PMID: 33841247 PMCID: PMC8024483 DOI: 10.3389/fpsyg.2021.613754] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 03/02/2021] [Indexed: 12/31/2022] Open
Abstract
Early adversity and trauma can have profound effects on children's affective development and mental health outcomes. Interventions that improve mental health and socioemotional development are essential to mitigate these effects. We conducted a pilot study examining whether a reading-based program (We Love Reading) improves emotion recognition and mental health through socialization in Syrian refugee (n = 49) and Jordanian non-refugee children (n = 45) aged 7-12 years old (M = 8.9, 57% girls) living in Jordan. To measure emotion recognition, children classified the expression in faces morphed between two emotions (happy-sad and fear-anger), while mental health was assessed using survey measures of optimism, depression, anxiety, distress, and insecurity. Prior to the intervention, both groups of children were significantly biased to interpret ambiguous facial expressions as sad, while there was no clear bias on the fear-anger spectrum. Following the intervention, we found changes in Syrian refugee children's bias in emotion recognition away from sad facial expressions, although this returned to pre-intervention levels 2 months after the end of the program. This shift in the bias away from sad facial expressions was not associated with changes in self-reported mental health symptoms. These results suggest a potential positive role of the reading intervention on affective development, but further research is required to determine the longer-term impacts of the program.
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Affiliation(s)
- Julia E. Michalek
- Department of Biological and Experimental Psychology, Queen Mary University of London, London, United Kingdom
| | - Matteo Lisi
- Department of Psychology, University of Essex, Colchester, United Kingdom
| | - Deema Awad
- Department of Biological and Experimental Psychology, Queen Mary University of London, London, United Kingdom
| | | | - Isabelle Mareschal
- Department of Biological and Experimental Psychology, Queen Mary University of London, London, United Kingdom
| | - Rana Dajani
- Biology and Biotechnology Department, Hashemite University, Zarqa, Jordan
- Jepson School of Leadership Studies, University of Richmond, Richmond, VA, United States
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93
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Mapping Sex-Specific Neurodevelopmental Alterations in Neurite Density and Morphology in a Rat Genetic Model of Psychiatric Illness. eNeuro 2021; 8:ENEURO.0426-20.2020. [PMID: 33441401 PMCID: PMC7986540 DOI: 10.1523/eneuro.0426-20.2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/19/2020] [Accepted: 12/28/2020] [Indexed: 11/21/2022] Open
Abstract
Neurite orientation dispersion and density imaging (NODDI) is an emerging magnetic resonance (MR) diffusion-weighted imaging (DWI) technique that permits non-invasive quantitative assessment of neurite density and morphology. NODDI has improved our ability to image neuronal microstructure over conventional techniques such as diffusion tensor imaging (DTI) and is particularly suited for studies of the developing brain as it can measure and characterize the dynamic changes occurring in dendrite cytoarchitecture that are critical to early brain development. Neurodevelopmental alterations to the diffusion tensor have been reported in psychiatric illness, but it remains unknown whether advanced DWI techniques such as NODDI are able to sensitively and specifically detect neurodevelopmental changes in brain microstructure beyond those provided by DTI. We show, in an extension of our previous work with a Disc1 svΔ2 rat genetic model of psychiatric illness, the enhanced sensitivity and specificity of NODDI to identify neurodevelopmental and sex-specific changes in brain microstructure that are otherwise difficult to observe with DTI and further corroborate observed changes in brain microstructure to differences in sex-specific systems-level animal behavior. Together, these findings inform the potential application and clinical translational utility of NODDI in studies of brain microstructure in psychiatric illness throughout neurodevelopment and further, the ability of advanced DWI methods such as NODDI to examine the role of biological sex and its influence on brain microstructure in psychiatric illness.
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94
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La Buissonniere-Ariza V, Fitzgerald K, Meoded A, Williams LL, Liu G, Goodman WK, Storch EA. Neural correlates of cognitive behavioral therapy response in youth with negative valence disorders: A systematic review of the literature. J Affect Disord 2021; 282:1288-1307. [PMID: 33601708 DOI: 10.1016/j.jad.2020.12.182] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 11/25/2020] [Accepted: 12/24/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Cognitive-behavioral therapy (CBT) is the gold-standard psychotherapeutic treatment for pediatric negative valence disorders. However, some youths do not respond optimally to treatment, which may be due to variations in neural functioning. METHODS We systematically reviewed functional magnetic resonance imaging studies in youths with negative valence disorders to identify pre- and post-treatment neural correlates of CBT response. RESULTS A total of 21 studies were identified, of overall weak to moderate quality. The most consistent findings across negative valence disorders consisted of associations of treatment response with pre- and post-treatment task-based activation and/or functional connectivity within and between the prefrontal cortex, the medial temporal lobe, and other limbic regions. Associations of CBT response with baseline and/or post-treatment activity in the striatum, precentral and postcentral gyri, medial and posterior cingulate cortices, and parietal cortex, connectivity within and between the default-mode, cognitive control, salience, and frontoparietal networks, and metrics of large-scale brain network organization, were also reported, although less consistently. LIMITATIONS The poor quality and limited number of studies and the important heterogeneity of study designs and results considerably limit the conclusions that can be drawn from this literature. CONCLUSIONS Despite these limitations, these findings provide preliminary evidence suggesting youths presenting certain patterns of brain function may respond better to CBT, whereas others may benefit from alternative or augmented forms of treatment.
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Affiliation(s)
- Valerie La Buissonniere-Ariza
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, One Baylor Plaza - BCM350, Houston, TX, 77030, USA.
| | - Kate Fitzgerald
- Department of Psychiatry, University of Michigan, Rachel Upjohn Building, 4250 Plymouth Road, Ann Arbor, MI, 48109, USA
| | - Avner Meoded
- Edward B. Singleton Department of Radiology, Texas Children's Hospital and Baylor College of Medicine, Houston, TX, USA
| | - Laurel L Williams
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, One Baylor Plaza - BCM350, Houston, TX, 77030, USA
| | - Gary Liu
- Department of Neuroscience, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA
| | - Wayne K Goodman
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, One Baylor Plaza - BCM350, Houston, TX, 77030, USA
| | - Eric A Storch
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, One Baylor Plaza - BCM350, Houston, TX, 77030, USA
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95
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Karadag M, Topal Z, Ezer RN, Gokcen C. Use of EMDR-Derived Self-Help Intervention in Children in the Period of COVID-19: A Randomized-Controlled Study. JOURNAL OF EMDR PRACTICE AND RESEARCH 2021. [DOI: 10.1891/emdr-d-20-00054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Self-help treatments are an important intervention tool, with high accessibility and ease of application. To our knowledge, no research has previously been conducted on any self-help intervention derived from eye movement desensitization and reprocessing (EMDR) therapy. In this study, we evaluated the mental health status of children not directly affected by the pandemic and investigated the effects of using an EMDR-derived self-help intervention in children as a low-intensity treatment. The mental health status of 178 children was evaluated online via the State-Trait Anxiety Inventory for Children (STAIC) and Childhood Posttraumatic Stress Reaction Index (CPTS-RI). Then, children were randomly assigned to intervention and waitlist. A booklet containing EMDR-derived techniques was sent via the school online portal and the intervention was conducted. Posttests were administered 4 weeks later. The attrition rate was 45.5%, with 97 children completing the trial (intervention: 52; waitlist: 45). At baseline, 76.4% of children showed posttraumatic stress symptoms (PTSS) above threshold. Results showed a statistically significant decrease in the posttest PTSS scores for the intervention group compared to waitlist. The intervention group had significant pre–post improvement on all but one subscale, while the waitlist group showed a significant increase in state anxiety on the STAIC. In conclusion, posttraumatic stress was found to be high in children during the COVID-19 outbreak period, and EMDR-derived self-help intervention appeared to be an effective psychosocial intervention tool.
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96
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Weems CF, Russell JD, Herringa RJ, Carrion VG. Translating the neuroscience of adverse childhood experiences to inform policy and foster population-level resilience. ACTA ACUST UNITED AC 2021; 76:188-202. [PMID: 33734788 DOI: 10.1037/amp0000780] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Imaging methods have elucidated several neurobiological correlates of traumatic and adverse experiences in childhood. This knowledge base may foster the development of programs and policies that aim to build resilience and adaptation in children and youth facing adversity. Translation of this research requires both effective and accurate communication of the science. This review begins with a discussion of integrating the language used to describe and identify childhood adversity and their outcomes to clarify the translation of neurodevelopmental findings. An integrative term, Traumatic and Adverse Childhood Experiences (TRACEs+) is proposed, alongside a revised adverse childhood experiences (ACEs) pyramid that emphasizes that a diversity of adverse experiences may lead to a common outcome and that a diversity of outcomes may result from a common adverse experience. This term facilitates linkages between the ACEs literature and the emerging neurodevelopmental knowledge surrounding the effect of traumatic adverse childhood experiences on youth in terms of the knowns and unknowns about neural connectivity in youth samples. How neuroscience findings may lead directly or indirectly to specific techniques or targets for intervention and the reciprocal nature of these relationships is addressed. Potential implications of the neuroscience for policy and intervention at multiple levels are illustrated using existing policy programs that may be informed by (and inform) neuroscience. The need for transdisciplinary models to continue to move the science to action closes the article. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Carl F Weems
- Department of Human Development and Family Studies, Iowa State University
| | - Justin D Russell
- Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin-Madison
| | - Ryan J Herringa
- Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin-Madison
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97
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Cisler JM, Herringa RJ. Posttraumatic Stress Disorder and the Developing Adolescent Brain. Biol Psychiatry 2021; 89:144-151. [PMID: 32709416 PMCID: PMC7725977 DOI: 10.1016/j.biopsych.2020.06.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 05/30/2020] [Accepted: 06/01/2020] [Indexed: 02/07/2023]
Abstract
Posttraumatic stress disorder (PTSD) in adolescents is common and debilitating. In contrast to adult PTSD, relatively little is known about the neurobiology of adolescent PTSD, nor about how current treatments may alter adolescent neurodevelopment to allow recovery from PTSD. Improving our understanding of biological mechanisms of adolescent PTSD, taken in the context of neurodevelopment, is crucial for developing novel and personalized treatment approaches. In this review, we highlight prevailing constructs of PTSD and current findings on these domains in adolescent PTSD. Notably, little data exist in adolescent PTSD for prominent adult PTSD constructs, including threat learning and attentional threat bias. Most work to date has examined general threat processing, emotion regulation, and their neural substrates. These studies suggest that adolescent PTSD, while phenomenologically similar to adult PTSD, shows unique neurodevelopmental substrates that may impair recovery but could also be targeted in the context of adolescent neuroplasticity to improve outcomes. Both cross-sectional and longitudinal data suggest abnormal frontolimbic development compared with typically developing youths, a pattern that may differ from resilient youths. Whether current treatments such as trauma-focused psychotherapy engage these targets and restore healthy neurodevelopment remains an open question. We end our review by highlighting emerging areas and knowledge gaps that could be addressed to better characterize the biology underlying adolescent PTSD. Emerging studies in computational modeling of decision making, caregiver-related transmission of traumatic stress, and other areas may offer new targets that could harness adolescent neurobehavioral plasticity to improve resilience and recovery for some of our most vulnerable youths.
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98
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Jones S, Castelnovo A, Riedner B, Flaherty B, Prehn-Kristensen A, Benca R, Tononi G, Herringa R. Sleep and emotion processing in paediatric posttraumatic stress disorder: A pilot investigation. J Sleep Res 2021; 30:e13261. [PMID: 33442931 PMCID: PMC8365752 DOI: 10.1111/jsr.13261] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/29/2020] [Accepted: 11/23/2020] [Indexed: 11/28/2022]
Abstract
Emotion processing abnormalities and sleep pathology are central to the phenomenology of paediatric posttraumatic stress disorder, and sleep disturbance has been linked to the development, maintenance and severity of the disorder. Given emerging evidence indicating a role for sleep in emotional brain function, it has been proposed that dysfunctional processing of emotional experiences during sleep may play a significant role in affective disorders, including posttraumatic stress disorder. Here we sought to examine the relationship between sleep and emotion processing in typically developing youth, and youth with a diagnosis of posttraumatic stress disorder . We use high-density electroencephalogram to compare baseline sleep with sleep following performance on a task designed to assess both memory for and reactivity to negative and neutral imagery in 10 youths with posttraumatic stress disorder, and 10 age- and sex-matched non-traumatized typically developing youths. Subjective ratings of arousal to negative imagery (ΔArousal = post-sleep minus pre-sleep arousal ratings) remain unchanged in youth with posttraumatic stress disorder following sleep (mean increase 0.15, CI -0.28 to +0.58), but decreased in TD youth (mean decrease -1.0, 95% CI -1.44 to -0.58). ΔArousal, or affective habituation, was negatively correlated with global change in slow-wave activity power (ρ = -0.58, p = .008). When considered topographically, the correlation between Δslow-wave activity power and affective habituation was most significant in a frontal cluster of 27 electrodes (Spearman, ρ = -0.51, p = .021). Our results highlight the importance of slow-wave sleep for adaptive emotional processing in youth, and have implications for symptom persistence in paediatric posttraumatic stress disorder. Impairments in slow-wave activity may represent a modifiable risk factor in paediatric posttraumatic stress disorder.
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Affiliation(s)
- Stephanie Jones
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA.,Wisconsin Institute for Sleep and Consciousness, University of Wisconsin-Madison, Madison, WI, USA
| | - Anna Castelnovo
- Sleep and Epilepsy Center, Neurocenter of the Southern Switzerland, Regional Hospital (EOC) of Lugano, Lugano, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Brady Riedner
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA.,Wisconsin Institute for Sleep and Consciousness, University of Wisconsin-Madison, Madison, WI, USA
| | - Bethany Flaherty
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA.,Wisconsin Institute for Sleep and Consciousness, University of Wisconsin-Madison, Madison, WI, USA
| | - Alexander Prehn-Kristensen
- Department of Child and Adolescent Psychiatry and Psychotherapy, Centre for Integrative Psychiatry, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Ruth Benca
- Department of Psychiatry & Human Behavior, School of Medicine, University of California-Irvine, Irvine, CA, USA
| | - Giulio Tononi
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA.,Wisconsin Institute for Sleep and Consciousness, University of Wisconsin-Madison, Madison, WI, USA
| | - Ryan Herringa
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
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99
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Asanjarani F, Szczygieł M, Arif A. The Persian Language Version of the Obsession With the COVID-19 Scale for Adolescents. Front Psychiatry 2021; 12:800982. [PMID: 35002815 PMCID: PMC8739484 DOI: 10.3389/fpsyt.2021.800982] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 12/07/2021] [Indexed: 01/08/2023] Open
Abstract
Objective: The worldwide pandemic of coronavirus disease (COVID-19) has caused significant public health burdens and psychological dysfunctions. In this challenging time, adolescents require special care. The Persian version of the Obsession with COVID-19 Scale (OCS) for adolescents was developed to screen for dysfunctional obsession associated with the coronavirus during the global pandemic. The structure and internal consistency of the OCS were established. Design and Measures: Although there are different language versions of the OCS, this is the first study to validate the psychometric properties of the OCS in Iranian adolescents. Seven hundred and nine students (369 girls) participated in the study. Demographic questions and the OCS were administered. Results: The findings provided support for the existence of a unidimensional structure that met the criteria for configural, metric, and full scalar invariance across gender (girls and boys), inhabitancy (urban and rural), and infection experience (infected and non-infected). The OCS is short and highly reliable measurement. However, further research is necessary to establish the validity of the scale in Iranian population. Conclusions: The development of such valid scales is an essential part of both research and practice during times of crisis, like a global pandemic. Diagnosis of pandemic related to obsessive thoughts in adolescents is needed as the COVID-19 pandemic is still ongoing and as experts point out, it can be expected that the effects of the pandemic will be observed in the coming years. The Persian version makes it possible to conduct international comparative research on the anxiety related to the COVID-19 pandemic.
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Affiliation(s)
- Faramarz Asanjarani
- Department of Counseling, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran
| | - Monika Szczygieł
- Department of Neurocognitive Psychology, Faculty of Pedagogy and Psychology, Institute of Psychology, Pedagogical University, Kraków, Poland
| | - Amna Arif
- Department of Education, Social Sciences and Humanities, University of Management and Technology, Lahore, Pakistan
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100
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White JD, Arefin TM, Pugliese A, Lee CH, Gassen J, Zhang J, Kaffman A. Early life stress causes sex-specific changes in adult fronto-limbic connectivity that differentially drive learning. eLife 2020; 9:58301. [PMID: 33259286 PMCID: PMC7725504 DOI: 10.7554/elife.58301] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 11/30/2020] [Indexed: 12/26/2022] Open
Abstract
It is currently unclear whether early life stress (ELS) affects males and females differently. However, a growing body of work has shown that sex moderates responses to stress and injury, with important insights into sex-specific mechanisms provided by work in rodents. Unfortunately, most of the ELS studies in rodents were conducted only in males, a bias that is particularly notable in translational work that has used human imaging. Here we examine the effects of unpredictable postnatal stress (UPS), a mouse model of complex ELS, using high resolution diffusion magnetic resonance imaging. We show that UPS induces several neuroanatomical alterations that were seen in both sexes and resemble those reported in humans. In contrast, exposure to UPS induced fronto-limbic hyper-connectivity in males, but either no change or hypoconnectivity in females. Moderated-mediation analysis found that these sex-specific changes are likely to alter contextual freezing behavior in males but not in females.
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Affiliation(s)
- Jordon D White
- Department of Psychiatry, Yale University School of Medicine, New Haven, United States
| | - Tanzil M Arefin
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, United States
| | - Alexa Pugliese
- Department of Psychiatry, Yale University School of Medicine, New Haven, United States
| | - Choong H Lee
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, United States
| | - Jeff Gassen
- Department of Psychology, Texas Christian University, Fort Worth, United States
| | - Jiangyang Zhang
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, United States
| | - Arie Kaffman
- Department of Psychiatry, Yale University School of Medicine, New Haven, United States
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