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Abstract
BACKGROUND and Overview Dentists frequently treat patients who have a history of traumatic events. These traumatic events (including childhood sexual abuse, domestic violence, elder abuse and combat history) may influence how patients experience oral health care and may interfere with patients' engagement in preventive care. The purpose of this article is to provide a framework for how dentists can interact sensitively with patients who have survived traumatic events. CONCLUSIONS The authors propose the trauma-informed care pyramid to help engage traumatized patients in oral health care. Evidence indicates that all of the following play an important role in treating traumatized patients: demonstrating strong behavioral and communication skills, understanding the health effects of trauma, engaging in interprofessional collaboration, understanding the provider's own trauma-related experiences and understanding when trauma screening should be used in oral health practice. PRACTICAL IMPLICATIONS Dental patients with a history of traumatic experiences are more likely to engage in negative health habits and to display fear of routine dental care. Although not all patients disclose a trauma history to their dentists, some patients might. The trauma-informed care pyramid provides a framework to guide dental care providers in interactions with many types of traumatized patients, including those who choose not to disclose their trauma history in the context of oral health care.
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Zhang W, Ma Y, Chen J. Child Psychological Maltreatment and Its Correlated Factors in Chinese Families. SOCIAL WORK IN PUBLIC HEALTH 2016; 31:204-214. [PMID: 27030213 DOI: 10.1080/19371918.2015.1088813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The present study aimed to explore the prevalence and frequency of child psychological maltreatment and its correlated factors in Chinese families. A cross-sectional investigation was conducted among 1,002 parents of primary school students in Yuncheng City, China. Data were collected using the self-report questionnaire anonymously. Results showed that 696 (69.5%) surveyed parents had different extents of psychological maltreatment toward their children in the past 3 months. The high prevalence of parental psychology maltreatment was significantly associated with high scores on parental over-reactivity and low scores on recognition of child psychology maltreatment. These findings indicate that it is urgent to develop cultural interventions to raise parents' awareness of preventing child psychological maltreatment and to help parents use nonviolent child rearing in China.
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Affiliation(s)
- Wenjing Zhang
- a Beijing Academy of Educational Sciences , Beijing , China
- b Institute of Child and Adolescent Health, School of Public Health , Peking University , Beijing , China
| | - Yating Ma
- b Institute of Child and Adolescent Health, School of Public Health , Peking University , Beijing , China
| | - Jingqi Chen
- b Institute of Child and Adolescent Health, School of Public Health , Peking University , Beijing , China
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Roepke-Buehler SK, Dong X. Perceived Stress and Elder Abuse: A Population-Based Study of Adult Protective Services Cases in Chicago. J Am Geriatr Soc 2015; 63:1820-8. [PMID: 26280151 PMCID: PMC9943550 DOI: 10.1111/jgs.13613] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVES To characterize the relationship between perceived stress and Adult Protective Services (APS) elder abuse cases in a population-based sample. DESIGN Cross-sectional. SETTING Chicago. PARTICIPANTS community-dwelling, older adults (N = 8,558; mean age 74 ± 7, 62% female, 64% African American). MEASUREMENTS Perceived Stress Scale (PSS), APS database linkage. RESULTS Bivariate and adjusted analyses showed that perceived stress was significantly higher in APS clients than in participants without any APS interaction for various subtypes of abuse (e.g., abuse from a perpetrator and self-neglect). This relationship was strongest for those with a confirmed history of abuse from a perpetrator, with a medium-large effect size (t = -5.8, P < .001, Cohen D = -0.6). Those in the highest stress tertile had a likelihood of having confirmed history of abuse from a perpetrator that was nearly three times as great as that of those in lower stress tertiles (odds ratio = 2.7, 95% confidence interval = 1.2-6.2). Analyses of individual PSS items revealed a robust relationship between distress items and APS involvement. Items reflecting coping were inconsistently associated with elder abuse. CONCLUSION Clients of APS have higher levels of perceived stress, and abuse from a perpetrator strengthens this relationship. Therefore, victims of abuse from a perpetrator may be at the highest risk of stress-related consequences and should be targeted for intervention efforts that enhance empowerment and effective coping strategies.
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Affiliation(s)
- Susan K. Roepke-Buehler
- Department of Behavioral Sciences, Rush University, Chicago, Illinois,Department of Medicine, Rush University, Chicago, Illinois
| | - XinQi Dong
- Department of Behavioral Sciences, Rush University, Chicago, Illinois,Department of Medicine, Rush University, Chicago, Illinois,Department of Nursing, Rush University, Chicago, Illinois
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Francis MM, Nikulina V, Widom CS. A Prospective Examination of the Mechanisms Linking Childhood Physical Abuse to Body Mass Index in Adulthood. CHILD MALTREATMENT 2015; 20:203-13. [PMID: 25648448 PMCID: PMC4824048 DOI: 10.1177/1077559514568892] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Previous research has reported associations between childhood physical abuse and body mass index (BMI) in adulthood. This article examined the role of four potential mediators (anxiety, depression, posttraumatic stress, and coping) hypothesized to explain this relationship. Using data from a prospective cohort design, court-substantiated cases of childhood physical abuse (N = 78) and nonmaltreated comparisons (N = 349) were followed up and assessed in adulthood at three time points (1989-1995, 2000-2002, and 2003-2005) when participants were of age 29.2, 39.5, and 41.2, respectively. At age 41, average BMI of the current sample was 29.97, falling between overweight and obese categories. Meditation analyses were conducted, controlling for age, sex, race, smoking, and self-reported weight. Childhood physical abuse was positively associated with subsequent generalized anxiety, major depression, and post-traumatic stress disorder symptoms at age 29.2 and higher levels of depression and posttraumatic stress predicted higher BMI at age 41.2. In contrast, higher levels of anxiety predicted lower BMI. Coping did not mediate between physical abuse and BMI. Anxiety symptoms mediated the relationship between physical abuse and BMI for women, but not for men. These findings illustrate the complexity of studying the consequences of physical abuse, particularly the relationship between psychiatric symptoms and adult health outcomes.
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Raja S, Hasnain M, Hoersch M, Gove-Yin S, Rajagopalan C. Trauma informed care in medicine: current knowledge and future research directions. FAMILY & COMMUNITY HEALTH 2015; 38:216-26. [PMID: 26017000 DOI: 10.1097/fch.0000000000000071] [Citation(s) in RCA: 209] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Traumatic events (including sexual abuse, domestic violence, elder abuse, and combat trauma) are associated with long-term physical and psychological effects. These events may influence patients' health care experiences and engagement in preventative care. Although the term trauma-informed care (TIC) is widely used, it is not well understood how to apply this concept in daily health care practice. On the basis of a synthesis of a review of the literature, the TIC pyramid is a conceptual and operational framework that can help physicians translate TIC principles into interactions with patients. Implications for clinical practice and future research are discussed in this article.
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Affiliation(s)
- Sheela Raja
- Department of Pediatric Dentistry, College of Dentistry (Dr Raja) and Department of Family Medicine (Dr Hasnain), University of Illinois at Chicago; US Department of Health and Human Services, Office on Women's Health, Region V, Chicago, Illinois (Ms Hoersch); Pritzker School of Medicine, Boston Medical Center, Boston, Massachusetts (Dr Gove-Yin); and Rutgers School of Dental Medicine, Newark, New Jersey (Ms Rajagopalan)
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Raja S, Hannan SM, Boykin D, Orcutt H, Hamad J, Hoersch M, Hasnain M. Self-reported physical health associations of traumatic events in medical and dental outpatients: a cross-sectional study. Medicine (Baltimore) 2015; 94:e734. [PMID: 25929906 PMCID: PMC4603029 DOI: 10.1097/md.0000000000000734] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The purpose of this cross-sectional study was to understand the prevalence and severity of health-related sequelae of traumatic exposure in a nonpsychiatric, outpatient sample.Self-report surveys were completed by patients seeking outpatient medical (n = 123) and dental care (n = 125) at a large, urban academic medical center.Results suggested that trauma exposure was associated with a decrease in perceptions of overall health and an increase in pain interference at work. Contrary to prediction, a history of interpersonal trauma was associated with less physical and emotional interference with social activities. A history of trauma exposure was associated with an increase in time elapsed since last medical visit. Depression and anxiety did not mediate the relationship between trauma history and medical care.Based on these results, clinical and research implications in relation to the health effects of trauma are discussed. The results suggest that routine screening for traumatic events may be important, particularly when providers have long-term relationships with patients.
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Affiliation(s)
- Sheela Raja
- From the Department of Pediatric Dentistry, College of Dentistry, University of Illinois at Chicago (SR); Department of Psychology, Northern Illinois University (SMH, DB, HO); University of Illinois at Chicago (JH); Office on Women's Health, Region V, U.S. Department of Health and Human Services (MH); and Department of Family Medicine, University of Illinois at Chicago, Illinois, USA (MH)
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Mikula P, Nagyova I, Krokavcova M, Vitkova M, Rosenberger J, Szilasiova J, Gdovinova Z, Groothoff JW, van Dijk JP. The mediating effect of coping on the association between fatigue and quality of life in patients with multiple sclerosis. PSYCHOL HEALTH MED 2015; 20:653-61. [DOI: 10.1080/13548506.2015.1032310] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Franzese RJ, Covey HC, Tucker AS, McCoy L, Menard S. Adolescent exposure to violence and adult physical and mental health problems. CHILD ABUSE & NEGLECT 2014; 38:1955-1965. [PMID: 25466428 DOI: 10.1016/j.chiabu.2014.10.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 10/10/2014] [Accepted: 10/16/2014] [Indexed: 06/04/2023]
Abstract
Evidence on the relationship of adolescent exposure to violence (AEV) with adult physical and mental health problems is limited, with studies often focusing on earlier childhood rather than adolescence, and also on short term rather than long term outcomes. Information specifically on the relationship of AEV to seeking help for mental health problems in adulthood from either formal sources such as mental health professionals or informal sources such as friends and clergy is even more difficult to find. The present study investigates how adolescent exposure to violence (AEV), in the form of parental physical abuse, witnessing parental violence, and exposure to violence in the neighborhood, are related to self-reported adult physical problems and seeking formal or informal assistance with mental health, controlling for more general adolescent violent victimization and for self-reports and parent reports of mental health problems in adolescence. This study adds to the literature on AEV and adult physical problems, and provides a rare look at the relationship of AEV to adult help-seeking for mental health problems. The results suggest that AEV is associated with mental health problems in adolescence for both females and males, that for females AEV is related to physical problems and to seeking help for mental health problems in adulthood, but for males the only significant relationship involves inconsistent reports of witnessing parental violence and adult physical problems.
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Affiliation(s)
| | - Herbert C Covey
- Adams County Human Services Department, 1030 West 15th Avenue, Broomfield, CO 80020, USA
| | - Abigail S Tucker
- Community Reach Center, 8931 Huron Street, Thornton, CO 80260, USA
| | - Leah McCoy
- Department of Criminal Justice and Criminology, Sam Houston State University, Campus Box 2296, Huntsville, TX 77341, USA
| | - Scott Menard
- Department of Criminal Justice and Criminology, Sam Houston State University, Campus Box 2296, Huntsville, TX 77341, USA
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McPhie ML, Weiss JA, Wekerle C. Psychological distress as a mediator of the relationship between childhood maltreatment and sleep quality in adolescence: results from the Maltreatment and Adolescent Pathways (MAP) Longitudinal Study. CHILD ABUSE & NEGLECT 2014; 38:2044-52. [PMID: 25085207 DOI: 10.1016/j.chiabu.2014.07.009] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 07/08/2014] [Accepted: 07/10/2014] [Indexed: 05/14/2023]
Abstract
Childhood maltreatment represents an important public health concern, as it is often associated with a host of negative outcomes across development. In recent years, researchers have begun to examine the link between negative health-related behaviors and history of childhood maltreatment. The current study considers the relationship between history of childhood maltreatment and sleep disturbances in adolescence. Further, the role of psychological distress is considered as an explanatory link between childhood maltreatment and adolescent sleep disturbances. The current study is a secondary analysis using a subsample (N=73) of child welfare-involved youth who participated in the initial and 2-year time-point of the Maltreatment and Adolescent Pathways (MAP) Longitudinal Study on the variables of interest. Youth reported on lifetime maltreatment experiences, psychological distress, and sleep disturbances, in addition to the other measures administered as part of the larger MAP study protocol. More severe childhood maltreatment was related to increased sleep disturbances during adolescence, and psychological distress was a significant mediator of the childhood maltreatment-adolescent sleep disturbance association. The results demonstrate that a history of childhood maltreatment represents a risk factor for sleep disturbances in adolescence. The findings highlight the importance of inquiring about health-related behaviors in child welfare youth and the need to promote psychological well-being within this population.
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Affiliation(s)
- Meghan L McPhie
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON M3J 1P3, Canada
| | - Jonathan A Weiss
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON M3J 1P3, Canada
| | - Christine Wekerle
- Department of Pediatrics, McMaster University, 1280 Main Street W., Hamilton, ON L8N 3Z5, Canada
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Wearick-Silva LE, Tractenberg SG, Levandowski ML, Viola TW, Pires JMA, Grassi-Oliveira R. Mothers who were sexually abused during childhood are more likely to have a child victim of sexual violence. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2014; 36:119-22. [PMID: 27000712 DOI: 10.1590/2237-6089-2013-0054] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Recurrent exposure to childhood sexual abuse (CSA) seems to be higher among victims of sexual abuse. In this sense, experiences related to sexual violence can perpetuate within the family context itself in various ways. Here, we investigate the association between being exposed to CSA and having a child victim of sexual abuse. METHOD We used a sample with 123 mothers, who were divided into 2 groups: one consisting of 41 mothers of sexually abused children and another consisting of 82 mothers of non-sexually abused children. History of exposure to CSA was evaluated by means of the Childhood Trauma Questionnaire - Short Form (CTQ) and we used a logistic regression model to estimate the prediction values regarding having or not a child exposed to sexual violence. RESULTS Mothers of sexually abused children had significantly higher scores on CTQ, especially on the sexual abuse subscale (SA). According to our logistic regression model, higher scores on the CTQ significantly predicted the status of being a mother of children exposed to sexual violence in our sample (Wald = 7.074; p = 0.008; Exp(B) = 1.681). Years of formal education reduced the likelihood of having a child victim of sexual violence (Wald = 18.994; p = 0.001; Exp(B) = 0.497). CONCLUSION Our findings highlight the importance of a possible intergenerational effect of sexual abuse. Family intervention and prevention against childhood maltreatment should take this issue in account.
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Affiliation(s)
| | - Saulo G Tractenberg
- Centre of Studies and Research in Traumatic Stress, PUCRS, Porto Alegre, RS, Brazil
| | - Mateus L Levandowski
- Centre of Studies and Research in Traumatic Stress, PUCRS, Porto Alegre, RS, Brazil
| | - Thiago W Viola
- Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Joelza M A Pires
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Miller AB, Esposito-Smythers C, Weismoore JT, Renshaw KD. The relation between child maltreatment and adolescent suicidal behavior: a systematic review and critical examination of the literature. Clin Child Fam Psychol Rev 2014; 16:146-72. [PMID: 23568617 DOI: 10.1007/s10567-013-0131-5] [Citation(s) in RCA: 205] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
A large body of research suggests that child maltreatment (CM) is associated with adolescent suicidal ideation and attempts. These studies, however, have not been critically examined and summarized in a manner that allows us to draw firm conclusions and make recommendations for future research and clinical work in this area. In this review, we evaluated all of the research literature to date examining the relationship between CM and adolescent suicidal ideation and attempts. Results generally suggest that childhood sexual abuse, physical abuse, emotional abuse, and neglect are associated with adolescent suicidal ideation and attempts across community, clinical, and high-risk samples, using cross-sectional and longitudinal research designs. In most studies, these associations remain significant when controlling for covariates such as youth demographics, mental health, family, and peer-related variables. When different forms of CM are examined in the same multivariate analysis, most research suggests that each form of CM maintains an independent association with adolescent suicidal ideation and suicide attempts. However, a subset of studies yielded evidence to suggest that sexual abuse and emotional abuse may be relatively more important in explaining suicidal behavior than physical abuse or neglect. Research also suggests an additive effect-each form of CM contributes unique variance to adolescent suicide attempts. We discuss the current limitations of this literature and offer recommendations for future research. We conclude with an overview of the clinical implications of this research, including careful, detailed screening of CM history, past suicidal behavior, and current suicidal ideation, as well as the need for integrated treatment approaches that effectively address both CM and adolescent suicidal ideation and suicide attempts.
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Affiliation(s)
- Adam B Miller
- Department of Psychology, MS 3F5, George Mason University, Fairfax, VA 22030, USA.
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Tekoah SD, Harel-Shalev A. “Living in a movie” — Israeli women combatants in conflict zones. WOMENS STUDIES INTERNATIONAL FORUM 2014. [DOI: 10.1016/j.wsif.2014.03.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
BACKGROUND Psychological and educational correlates of bullying have been explored extensively. However, little information is available about the link between bullying and sexual risk-taking behaviors among adolescents, though for some youth it may be that sexual risk taking emerges in response to bullying involvement. Associations for both heterosexual youth and those who identify as gay, lesbian, bisexual, transgender, or questioning (GLBTQ) should be considered, as should the influence of victimization exposures in other domains. Accordingly, associations among bullying, other victimization forms, and sexual risk-taking behaviors were examined among adolescents with particular consideration to sexual orientation. METHODS A sample of 8687 high school students completed the Dane County Youth Survey, a countywide survey administered high school students from 24 schools. Participants were asked questions about their bullying involvement and sexual risk-taking behaviors (ie, engaging in casual sex and having sex while under the influence of alcohol or drugs). RESULTS Results indicated that bullies and bully-victims were more likely to engage in casual sex and sex under the influence. In multivariate analyses, these findings held even after controlling for demographic characteristics and victimization exposures in other domains, but primarily for heterosexual youth. CONCLUSIONS Bullies and bully-victims engaged in more sexual risk-taking behaviors, although patterns of association varied by sexual orientation. Bullying prevention programs and programs aimed at reducing unhealthy sexual practices should consider a broader stress and coping perspective and address the possible link between the stress of bullying involvement and maladaptive coping responses.
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Affiliation(s)
- Melissa K. Holt
- School of Education, Boston University, Boston, Massachusetts
| | - Jennifer L. Matjasko
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Dorothy Espelage
- College of Education, University of Illinois at Urbana-Champaign, Champaign, Illinois
| | - Gerald Reid
- School of Education, Boston University, Boston, Massachusetts
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Mostoufi S, Strachan E, Chopko L, Succop A, Martinez B, Ahumada SM, Afari N. Adverse childhood experiences, health perception, and the role of shared familial factors in adult twins. CHILD ABUSE & NEGLECT 2013; 37:910-916. [PMID: 23876862 PMCID: PMC4108345 DOI: 10.1016/j.chiabu.2013.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2012] [Revised: 06/07/2013] [Accepted: 06/16/2013] [Indexed: 06/02/2023]
Abstract
To examine the relationship between adverse childhood experiences (ACE) and health perception in adulthood, and to explore the contribution of shared familial factors to these associations. Data were collected from 180 female twins (90 pairs) from the community-based University of Washington Twin Registry. Participants completed questionnaires including the modified ACE Questionnaire, Traumatic Life Events Questionnaire, McGill Pain Questionnaire-Short Form, and the SF-36. Mixed effects linear regression modeling investigated the effects of ACE on indices of health perception controlling for correlated twin data. Additional models examined the associations while controlling for the experience of physical and/or sexual abuse in childhood; within-twin pair models that inherently adjust for familial factors explored shared familial influences. After controlling for relevant demographic variables, more ACE was associated with worse perceptions of general health (p=.01) and vitality (p=.05) on the SF-36. After controlling for childhood physical and/or sexual abuse, the relationship between ACE and general health remained significant (p=.01) while vitality was no longer significant. None of the associations remained significant after accounting for the influence of familial factors. These results support previous findings on the negative link between ACE and perceived health in adulthood. The detrimental effects of ACE on vitality may be accounted for by the experience of childhood physical and/or sexual abuse. Shared familial factors might play a partial role in the relationship between ACE and health perception. Future research should further investigate the genetic and environmental mechanisms that may explain this relationship.
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Affiliation(s)
- Sheeva Mostoufi
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, 5500 Campanile Dr., San Diego, CA 92182-4611, USA
| | - Eric Strachan
- Department of Psychiatry & Behavioral Sciences, University of Washington, 1959 NE Pacific Street, Box 356560, Seattle, WA 98195-6560 , USA
| | - Laura Chopko
- Department of Psychiatry & Behavioral Sciences, University of Washington, 1959 NE Pacific Street, Box 356560, Seattle, WA 98195-6560 , USA
| | - Annemarie Succop
- Department of Psychiatry & Behavioral Sciences, University of Washington, 1959 NE Pacific Street, Box 356560, Seattle, WA 98195-6560 , USA
| | - Beatrice Martinez
- Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, 0737, La Jolla, CA 92093, USA
| | - Sandra M. Ahumada
- Institute of Child Development, University of Minnesota, Twin Cities, 75 East River Road, Minneapolis, MN 55455, USA
| | - Niloofar Afari
- Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, 0737, La Jolla, CA 92093, USA
- VA Center of Excellence for Stress and Mental Health and VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161, USA
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Samplin E, Ikuta T, Malhotra AK, Szeszko PR, DeRosse P. Sex differences in resilience to childhood maltreatment: effects of trauma history on hippocampal volume, general cognition and subclinical psychosis in healthy adults. J Psychiatr Res 2013; 47:1174-9. [PMID: 23726669 PMCID: PMC3727151 DOI: 10.1016/j.jpsychires.2013.05.008] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Revised: 04/10/2013] [Accepted: 05/09/2013] [Indexed: 01/25/2023]
Abstract
Recent data suggests that a history of childhood maltreatment is associated with reductions in hippocampal volume in healthy adults. Because this association is also evident in adults with psychiatric illness, it has been suggested that reductions in hippocampal volume associated with childhood maltreatment may be a risk factor for psychiatric illness. Such an interpretation suggests that healthy adults with a history of childhood maltreatment are more resilient to the effects of maltreatment. Current models of resilience suggest, however, that resiliency should be measured across multiple domains of functioning. The present study sought to investigate childhood maltreatment in relationship to hippocampal volumes in healthy adults and to address the question of whether the putative resiliency extends to other domains of functioning. Sixty-seven healthy Caucasian adults were assessed for a history of childhood emotional abuse, emotional neglect and physical abuse and received high resolution structural MR imaging scans. Participants with and without histories of abuse or neglect were compared on measures of total hippocampal volume, general cognitive ability and subclinical psychopathology. Our results suggest that childhood emotional abuse is associated with reduced hippocampus volume in males, but not in females. However, emotional abuse was associated with higher levels of subclinical psychopathology in both males and females. These data suggest that while females may be more resilient to the neurological effects of childhood maltreatment, they are not more resilient to the psychiatric symptoms associated with childhood maltreatment. Further research is needed to elucidate the mechanisms involved in these different levels of resilience.
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Affiliation(s)
- Erin Samplin
- Center for Translational Psychiatry, The Feinstein Institute for Medical Research, Manhasset, NY, USA,Drexel University College of Medicine, Philadelphia, PA, USA
| | - Toshikazu Ikuta
- Center for Translational Psychiatry, The Feinstein Institute for Medical Research, Manhasset, NY, USA,Division of Psychiatry Research, The Zucker Hillside Hospital, Division of the North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
| | - Anil K. Malhotra
- Center for Translational Psychiatry, The Feinstein Institute for Medical Research, Manhasset, NY, USA,Division of Psychiatry Research, The Zucker Hillside Hospital, Division of the North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA,Department of Psychiatry and Behavioral Science, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA,Hofstra North Shore – LIJ School of Medicine, Departments of Psychiatry and Molecular Medicine, Hempstead, NY, USA
| | - Philip R. Szeszko
- Center for Translational Psychiatry, The Feinstein Institute for Medical Research, Manhasset, NY, USA,Division of Psychiatry Research, The Zucker Hillside Hospital, Division of the North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA,Hofstra North Shore – LIJ School of Medicine, Departments of Psychiatry and Molecular Medicine, Hempstead, NY, USA
| | - Pamela DeRosse
- Center for Translational Psychiatry, The Feinstein Institute for Medical Research, Manhasset, NY, USA,Division of Psychiatry Research, The Zucker Hillside Hospital, Division of the North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
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Lamela D, Figueiredo B. Parents' physical victimization in childhood and current risk of child maltreatment: the mediator role of psychosomatic symptoms. J Psychosom Res 2013; 75:178-83. [PMID: 23915776 DOI: 10.1016/j.jpsychores.2013.04.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Revised: 04/01/2013] [Accepted: 04/02/2013] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To test the potential mediation effect of psychosomatic symptoms on the relationship between parents' history of childhood physical victimization and current risk for child physical maltreatment. METHODS Data from the Portuguese National Representative Study of Psychosocial Context of Child Abuse and Neglect were used. Nine-hundred and twenty-four parents completed the Childhood History Questionnaire, the Psychosomatic Scale of the Brief Symptom Inventory, and the Child Abuse Potential Inventory. RESULTS Mediation analysis revealed that the total effect of the childhood physical victimization on child maltreatment risk was significant. The results showed that the direct effect from the parents' history of childhood physical victimization to their current maltreatment risk was still significant once parents' psychosomatic symptoms were added to the model, indicating that the increase in psychosomatic symptomatology mediated in part the increase of parents' current child maltreatment risk. DISCUSSION The mediation analysis showed parents' psychosomatic symptomatology as a causal pathway through which parents' childhood history of physical victimization exerts its effect on increased of child maltreatment risk. Somatization-related alterations in stress and emotional regulation are discussed as potential theoretical explanation of our findings. A cumulative risk perspective is also discussed in order to elucidate about the mechanisms that contribute for the intergenerational continuity of child physical maltreatment.
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Affiliation(s)
- Diogo Lamela
- School of Psychology, University of Minho, Portugal.
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Wise LA, Palmer JR, Rosenberg L. Lifetime abuse victimization and risk of uterine leiomyomata in black women. Am J Obstet Gynecol 2013; 208:272.e1-272.e13. [PMID: 23295977 DOI: 10.1016/j.ajog.2012.12.034] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Revised: 12/15/2012] [Accepted: 12/27/2012] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Uterine leiomyomata (UL) are a major contributor to gynecologic morbidity and medical costs, and black women are disproportionately affected by the condition. Previous studies have linked UL to psychosocial stress, including child abuse. We assessed the association between lifetime abuse victimization and UL among 9910 premenopausal women. STUDY DESIGN Data were derived from the Black Women's Health Study, a prospective cohort study. In 2005, participants reported their experiences of physical and sexual abuse within each life stage (childhood, adolescence, adulthood). Biennial follow-up questionnaires from 2005 through 2011 ascertained new UL diagnoses. Rate ratios (RRs) and 95% confidence intervals (CIs) were estimated using Cox regression. RESULTS There were 1506 incident UL cases diagnosed by ultrasound or surgery. UL incidence was higher among women who reported child abuse, particularly sexual abuse. Relative to no abuse across the life span, RRs were 1.16 (95% CI, 1.02-1.33) for physical abuse only, 1.34 (95% CI, 1.09-1.66) for sexual abuse only, and 1.17 (95% CI, 0.99-1.39) for both physical and sexual abuse in childhood. RRs for 1-3 and 4 or more incidents of child sexual abuse were 1.29 (95% CI, 1.04-1.61) and 1.41 (95% CI, 1.07-1.85), respectively, whereas the RRs for low, intermediate, and high frequencies of child physical abuse were 1.19, 1.04, and 1.23, respectively. The association was strongest for the highest category of child abuse severity (RR, 1.57; 95% CI, 1.19-2.07). No associations were found for teen or adult abuse. CONCLUSION In the present study, child sexual abuse was an independent risk factor for UL, supporting the hypothesis that childhood adversity increases UL risk.
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Affiliation(s)
- Lauren A Wise
- Slone Epidemiology Center at Boston University, Boston, MA 02215, USA.
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Psychosocial issues in rehabilitation: bringing the unconscious to consciousness. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2013; 33:2-3. [PMID: 24651555 DOI: 10.3928/15394492-20121105-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Cour F, Robain G, Claudon B, Chartier-Kästler E. [Childhood sexual abuse: how important is the diagnosis to understand and manage sexual, anorectal and lower urinary tract symptoms]. Prog Urol 2012; 23:780-92. [PMID: 23830273 DOI: 10.1016/j.purol.2012.10.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2012] [Accepted: 10/15/2012] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To understand and manage the sequels of childhood sexual abuse on sexual, anorectal and lower urinary tract functions. MATERIAL AND METHODS Review of articles published in the Medline database, selected according to their scientific relevance and published guidelines on this subject together with our own experience. RESULTS A history of sexual abuse is frequently found when assessing dysfunction or symptoms of the lower urinary tract. In this context, urinary stress incontinence is rarely involved but it can be linked by epidemiological factors. Dysuria with urgency is the most frequent expressed symptom. When associated with anorectal disorders and pelvic pain or a sexual disorder in particular dyspareunia, a sexual abuse should be evoked and specific questions asked to the patient. Although these symptoms are frequently encountered in 12 to 33% of women, and 8 to 16% of men, few practitioners, whatever their speciality ask about them as routine. It is important that the physician diagnose the existence of sexual abuse, in particular when the symptoms mentioned by the patient are not conclusive, in spite of thorough urological assessment. Patients finding the initial examination difficult and painful and the failure of the initial treatment should lead to questions concerning abuse, if neglected by the initial medical inquiry. CONCLUSIONS Clinicians involved in perineal functional pathology are able to acquire standardized modalities of inquiry about child sexual abuse for a better time management and efficacy in the therapeutic approach. The interest of a multidisciplinary diagnostic and therapeutic approach is primordial, associating psychological therapy and if necessary perineal re-education. This can avoid unnecessary tests and out-patient visits. Directing patients towards a multidisciplinary approach is highly advisable.
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Affiliation(s)
- F Cour
- Service d'urologie, université de Versailles-Saint-Quentin-en-Yvelines, hôpital Foch, 40, rue Worth, 92150 Suresnes, France.
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Grasso DJ, Ford JD, Briggs-Gowan MJ. Early life trauma exposure and stress sensitivity in young children. J Pediatr Psychol 2012; 38:94-103. [PMID: 23008502 DOI: 10.1093/jpepsy/jss101] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The current study replicates and extends work with adults that highlights the relationship between trauma exposure and distress in response to subsequent, nontraumatic life stressors. METHODS The sample included 213 2-4-year-old children in which 64.3% had a history of potential trauma exposure. Children were categorized into 4 groups based on trauma history and current life stress. RESULTS In a multivariate analysis of variance, trauma-exposed children with current life stressors had elevated internalizing and externalizing problems compared with trauma-exposed children without current stress and nontrauma-exposed children with and without current stressors. The trauma-exposed groups with or without current stressors did not differ on posttraumatic stress disorder symptom severity. Accounting for number of traumatic events did not change these results. CONCLUSIONS These findings suggest that early life trauma exposure may sensitize young children and place them at risk for internalizing or externalizing problems when exposed to subsequent, nontraumatic life stressors.
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Affiliation(s)
- Damion J Grasso
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT 06030, USA.
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