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Atalan Ergin D, Akgül G. School Belongingness as a Mediator in the Relationship Between Self-Reported PTSD and Cyber Victimization: Sex Differences. J Nerv Ment Dis 2023; 211:772-778. [PMID: 37549369 DOI: 10.1097/nmd.0000000000001699] [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] [Indexed: 08/09/2023]
Abstract
ABSTRACT The incidence of posttraumatic stress disorder (PTSD) has increased during the COVID-19 pandemic. Traumatized adolescents might cope with maladaptive strategies such as increased Internet usage, which might be a risk for cyber victimization. We investigated the relationship between self-reported PTSD and cyber victimization and the mediator role of school belongingness in this relationship. The sample consisted of 292 adolescents ages 11-14 years old (M = 12.53, SD = 0.71; nfemale = 165, 56.1%; nmale = 129, 43.9%). Results show that males are more likely to be cyber victims and have lower levels of school belongingness than females. In addition, results supported the association between higher levels of PTSD and higher levels of cyber victimization. Traumatized adolescents with high levels of school belongingness are less likely to be cyber victims. These findings highlight the importance of school-related personal and relational characteristics in promoting adolescent mental health.
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Affiliation(s)
| | - Gülendam Akgül
- Department of Educational Psychology, Ankara University, Ankara, Turkey
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52
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Russell JD, Heyn SA, Herringa RJ. Through a Developmental Lens: Emerging Insights to Understand and Treat Pediatric PTSD. Am J Psychiatry 2023; 180:636-644. [PMID: 37654114 PMCID: PMC10636806 DOI: 10.1176/appi.ajp.20230523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Affiliation(s)
- Justin D Russell
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison
| | - Sara A Heyn
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison
| | - Ryan J Herringa
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison
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53
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Baumann-Larsen M, Zwart JA, Dyb G, Wentzel-Larsen T, Stangeland H, Storheim K, Stensland SØ. Killing pain? A prospective population-based study on trauma exposure in childhood as predictor for frequent use of over-the-counter analgesics in young adulthood. The HUNT study. Psychiatry Res 2023; 327:115400. [PMID: 37574601 DOI: 10.1016/j.psychres.2023.115400] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 07/14/2023] [Accepted: 07/30/2023] [Indexed: 08/15/2023]
Abstract
Frequent and increasing use of over-the-counter analgesics (OTCA) is a public health concern. Pain conditions and psychological distress are related to frequent OTCA use, and as exposure to potentially traumatic events (PTE) in childhood appears to increase risk of experiencing such symptoms, we aimed to assess childhood PTEs and related symptoms in adolescence as predictors for frequent OTCA use in young adulthood. Prospective population survey data were used (n = 2947, 59.1% female, 10-13 years follow-up). Exposure to PTEs, symptoms of post-traumatic stress, anxiety and depression, musculoskeletal pain and headache were assessed in adolescence (13-19 years). Use of OTCA was assessed in young adulthood (22-32 years) and use of OTCA to treat musculoskeletal pain and headache served as separate outcomes in ordinal logistic regression analyses. Overall, exposure to childhood PTEs, particularly direct interpersonal violence, was significantly and consistently related to more frequent use of OTCA to treat musculoskeletal pain and headaches in young adulthood. Adjusting for psychological symptoms and pain attenuated associations, indicating that these symptoms are of importance for the relationship between traumatic events and OTCA use. These findings emphasize the need to address symptomatology and underlying causes at an early age.
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Affiliation(s)
- Monica Baumann-Larsen
- Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - John-Anker Zwart
- Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Grete Dyb
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Tore Wentzel-Larsen
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway; Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | - Helle Stangeland
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Kjersti Storheim
- Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway; Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
| | - Synne Øien Stensland
- Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway; Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
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54
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Efendi GY, Temeltürk RD, Çakmak IB, Dinçer M. Surviving the Immediate Aftermath of a Disaster: A Preliminary Investigation of Adolescents' Acute Stress Reactions and Mental Health Needs after the 2023 Turkey Earthquakes. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1485. [PMID: 37761446 PMCID: PMC10527644 DOI: 10.3390/children10091485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/23/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023]
Abstract
On 6 February, southeastern Turkey and parts of Syria were struck by two powerful earthquakes, one measuring a magnitude of 7.8 and the other, nine hours later, at a magnitude of 7.5. These earthquakes have been recorded as some of the deadliest natural disasters worldwide since the 2010 Haiti earthquake, impacting around 14 million people in Turkey. For trauma survivors, the stressors associated with an event can lead to the development of acute stress disorder (ASD) or other psychiatric disorders. Trauma experiences during adolescence can impact development and affect adolescents differently than adults. Although ASD in adults has been addressed in several studies, there is much less information available about how younger populations respond to acute stress. The aim of our study was to assess the occurrence of ASD among individuals seeking help at the Şanlıurfa Mehmet Akif İnan Research and Training Hospital Child and Adolescent Outpatient Clinic following the 2023 Turkey Earthquakes and the factors associated with acute stress reactions. A child and adolescent psychiatry specialist conducted psychiatric interviews with the adolescents, and the individuals were also asked to complete 'The National Stressful Events Survey Acute Stress Disorder Short Scale' (NSESSS) to evaluate acute stress symptoms. ASD diagnoses were established according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria. Results showed that 81.6% of the participants (n = 49) were diagnosed with ASD, and drug treatment was initiated in 61.7% of the cases (n = 37). It was determined that ASD rates did not differ according to gender, and patients without physical injury had higher acute stress symptom scores (p > 0.05). According to the logistic regression models, paternal educational levels and adolescents' own requests for psychiatric assistance were predictors of acute stress disorder (OR 10.1, β = 2.31, p = 0.006 and OR 16.9, 95 β = 2.83, p = 0.001, respectively). Our findings revealed striking results in demonstrating the need for careful evaluation of adolescents without physical injury in terms of acute stress disorder and the need to pay close attention to the psychiatric complaints of adolescents willing to seek mental health assistance. Moreover, our study suggests that the proportion of adolescents experiencing acute stress symptoms after earthquakes might be higher than previously reported. Estimation of the incidence rate and symptoms of psychiatric distress in the short-term period following a disaster is important for establishing disaster epidemiology and implementing efficient relief efforts in the early stages. The outcomes of this study have the potential to yield novel insights into the realms of disaster mental health and emergency response policies, as well as their pragmatic implementations.
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Affiliation(s)
- Gökçe Yağmur Efendi
- Department of Child and Adolescent Psychiatry, Şanlıurfa Mehmet Akif İnan Training and Research Hospital, Şanlıurfa 63500, Türkiye;
| | - Rahime Duygu Temeltürk
- Department of Child and Adolescent Psychiatry, Ankara University, Ankara 06590, Türkiye;
| | | | - Mustafa Dinçer
- Department of Child and Adolescent Psychiatry, Şanlıurfa Mehmet Akif İnan Training and Research Hospital, Şanlıurfa 63500, Türkiye;
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55
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Ely SL, Zundel CG, Gowatch LC, Evanski JM, Bhogal A, Carpenter C, Shampine M, Marusak H. Attention, attention! Posttraumatic stress disorder is associated with altered attention-related brain function. Front Behav Neurosci 2023; 17:1244685. [PMID: 37670803 PMCID: PMC10476007 DOI: 10.3389/fnbeh.2023.1244685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 08/01/2023] [Indexed: 09/07/2023] Open
Abstract
Posttraumatic stress disorder (PTSD) is a debilitating condition characterized by altered arousal, mood, and cognition. Studies report attentional alterations such as threat bias in individuals with PTSD, though this work has largely been conducted within emotionally-charged contexts (e.g., threatening stimuli). Emerging behavioral evidence suggests that PTSD-related attention deficits exist even in the absence of threatening cues or anxiety triggers. However, the role and functioning of attention brain circuits as they relate to PTSD remains underexplored. In this mini review, we highlight recent work using non-emotional stimuli to investigate the neurobiology of attention and disruptions to attention-related brain function among individuals with PTSD. We then discuss gaps in the current literature, including questions pertaining to the neural circuitry of attentional alterations in PTSD, as well as the contributions that trauma exposure, PTSD symptoms, comorbidities, and pre-existing vulnerabilities may have in this relationship. Finally, we suggest future directions for this emerging area of research, which may further inform knowledge surrounding the neurobiological underpinnings of PTSD and potential treatments.
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Affiliation(s)
- Samantha L. Ely
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
- Translational Neuroscience PhD Program, Wayne State University School of Medicine, Detroit, MI, United States
| | - Clara G. Zundel
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Leah C. Gowatch
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Julia M. Evanski
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
- Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI, United States
| | - Amanpreet Bhogal
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Carmen Carpenter
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - MacKenna Shampine
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Hilary Marusak
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
- Translational Neuroscience PhD Program, Wayne State University School of Medicine, Detroit, MI, United States
- Department of Pharmacology, Wayne State University School of Medicine, Detroit, MI, United States
- Merrill Palmer Skillman Institute, Wayne State University, Detroit, MI, United States
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56
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Švecová J, Furstova J, Kaščáková N, Hašto J, Tavel P. The effect of childhood trauma and resilience on psychopathology in adulthood: Does bullying moderate the associations? BMC Psychol 2023; 11:230. [PMID: 37568213 PMCID: PMC10422767 DOI: 10.1186/s40359-023-01270-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 08/03/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Exposure to traumatic events in childhood, including bullying, can negatively affect physical and mental health in adulthood. The aim of the present study was to determine the prevalence of bullying in different sociodemographic groups of the Slovak Republic and to assess the moderating effect of bullying on the associations between childhood trauma, resilience, and the later occurrence of psychopathology. METHODS For the analyses, a representative sample of the population of the Slovak Republic was used (N = 1018, mean age 46.24 years, 48.7% of men). Multivariate linear regression models were used to investigate the predictive ability of childhood trauma (The Childhood Trauma Questionnaire, CTQ) and resilience (The Brief Resilience Scale, BRS) to explain psychopathology (The Brief Symptom Inventory, BSI-53). Bullying (The Adverse Childhood Experiences - International Questionnaire, ACE-IQ) was used as a moderator. RESULTS In total, 13.5% of respondents have experienced bullying. The most common form of bullying was making fun of someone because of how their body or face looked (46.7%) and excluding someone from activities or ignoring them (36.5%). Higher scores in all types of psychopathology and the Global Severity Index (GSI) were significantly associated with higher scores of emotional and sexual abuse, and some of them with physical neglect. The protective effect of resilience was moderated by bullying in several types of psychopathology, specifically in somatization, obsessive-compulsive, interpersonal sensitivity, depression, psychoticism, and the GSI. CONCLUSION Understanding the links between childhood trauma, bullying, and later psychopathology can help professionals target policies, resources, and interventions to support children and families at risk. Every child should feel accepted and safe at home and school.
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Affiliation(s)
- Júlia Švecová
- Olomouc University Social Health Institute, Palacky University Olomouc, Univerzitni 22, Olomouc, 77111, Czech Republic.
| | - Jana Furstova
- Olomouc University Social Health Institute, Palacky University Olomouc, Univerzitni 22, Olomouc, 77111, Czech Republic
| | - Natália Kaščáková
- Olomouc University Social Health Institute, Palacky University Olomouc, Univerzitni 22, Olomouc, 77111, Czech Republic
- Psychiatric-Psychotherapeutic Outpatient Clinic, Heydukova 27, Bratislava, 81108, Slovakia
| | - Jozef Hašto
- Olomouc University Social Health Institute, Palacky University Olomouc, Univerzitni 22, Olomouc, 77111, Czech Republic
- Psychiatric-Psychotherapeutic Outpatient Clinic, Heydukova 27, Bratislava, 81108, Slovakia
| | - Peter Tavel
- Olomouc University Social Health Institute, Palacky University Olomouc, Univerzitni 22, Olomouc, 77111, Czech Republic
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57
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Becker TD, Castañeda Ramirez S, Bruges Boude A, Leong A, Ivanov I, Rice TR. Interventions for prevention and treatment of substance use in youth with traumatic childhood experiences: a systematic review and synthesis of the literature. Eur Child Adolesc Psychiatry 2023:10.1007/s00787-023-02265-x. [PMID: 37480386 DOI: 10.1007/s00787-023-02265-x] [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: 12/03/2022] [Accepted: 07/18/2023] [Indexed: 07/24/2023]
Abstract
Most substance use begins in adolescence. Both childhood trauma and associated post-traumatic stress disorder (PTSD) increase risk for early substance use, which is associated with greater eventual severity of substance use disorders (SUDs). When co-occurring, PTSD and SUD can reinforce and exacerbate each other, necessitating integrated treatment approaches. To systematically review existing literature on interventions for prevention or treatment of SUDs among adolescents (aged 10-24) with a history of trauma, with or without PTSD, we searched databases (PubMed, PsycInfo, CINAHL, Cochrane CENTRAL) using search terms related to substance use, trauma, adolescents, and interventions. Searches identified 8134 unique articles, 68 of which prompted full-text screening. Authors extracted data, applied the Effective Public Health Practice Project Quality Assessment Tool to evaluate the evidence, and synthesized findings. Thirty three articles met eligibility criteria, including 13 RCTs. Twenty studies (10 RCTs) evaluated interventions for substance use and co-occurring problems among youth with a history of trauma, predominantly via individual therapy based on cognitive-behavioral principles, although group therapy, case management, and other approaches have also been studied. Interventions with exposure-based components were infrequent but had robust results and minimal adverse outcomes. Thirteen studies examined differential response of youth with a history of trauma to standard SUD treatments, compared to youth without a history of trauma, with mixed findings. Youth with a history of trauma face elevated risk of SUDs and may respond differently to SUD treatments. Several promising interventions have been recently developed.
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Affiliation(s)
- Timothy D Becker
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Psychiatry, NewYork-Presbyterian Hospital/Weill Cornell, 525 E. 68th Street, Box 140, New York, NY, 10065, USA.
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Vagelos College of Physicians & Surgeons, New York, USA.
| | | | - Adriana Bruges Boude
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alicia Leong
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Iliyan Ivanov
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Timothy R Rice
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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58
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Sierra RO, Pedraza LK, Barcsai L, Pejin A, Li Q, Kozák G, Takeuchi Y, Nagy AJ, Lőrincz ML, Devinsky O, Buzsáki G, Berényi A. Closed-loop brain stimulation augments fear extinction in male rats. Nat Commun 2023; 14:3972. [PMID: 37407557 DOI: 10.1038/s41467-023-39546-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 06/16/2023] [Indexed: 07/07/2023] Open
Abstract
Dysregulated fear reactions can result from maladaptive processing of trauma-related memories. In post-traumatic stress disorder (PTSD) and other psychiatric disorders, dysfunctional extinction learning prevents discretization of trauma-related memory engrams and generalizes fear responses. Although PTSD may be viewed as a memory-based disorder, no approved treatments target pathological fear memory processing. Hippocampal sharp wave-ripples (SWRs) and concurrent neocortical oscillations are scaffolds to consolidate contextual memory, but their role during fear processing remains poorly understood. Here, we show that closed-loop, SWR triggered neuromodulation of the medial forebrain bundle (MFB) can enhance fear extinction consolidation in male rats. The modified fear memories became resistant to induced recall (i.e., 'renewal' and 'reinstatement') and did not reemerge spontaneously. These effects were mediated by D2 receptor signaling-induced synaptic remodeling in the basolateral amygdala. Our results demonstrate that SWR-triggered closed-loop stimulation of the MFB reward system enhances extinction of fearful memories and reducing fear expression across different contexts and preventing excessive and persistent fear responses. These findings highlight the potential of neuromodulation to augment extinction learning and provide a new avenue to develop treatments for anxiety disorders.
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Affiliation(s)
- Rodrigo Ordoñez Sierra
- MTA-SZTE 'Momentum' Oscillatory Neuronal Networks Research Group, Department of Physiology, University of Szeged, Szeged, 6720, Hungary
| | - Lizeth Katherine Pedraza
- MTA-SZTE 'Momentum' Oscillatory Neuronal Networks Research Group, Department of Physiology, University of Szeged, Szeged, 6720, Hungary
| | - Lívia Barcsai
- MTA-SZTE 'Momentum' Oscillatory Neuronal Networks Research Group, Department of Physiology, University of Szeged, Szeged, 6720, Hungary
- HCEMM-SZTE Magnetotherapeutics Research Group, University of Szeged, Szeged, 6720, Hungary
- Neunos Inc, Boston, MA, 02108, USA
| | - Andrea Pejin
- MTA-SZTE 'Momentum' Oscillatory Neuronal Networks Research Group, Department of Physiology, University of Szeged, Szeged, 6720, Hungary
- HCEMM-SZTE Magnetotherapeutics Research Group, University of Szeged, Szeged, 6720, Hungary
- Neunos Inc, Boston, MA, 02108, USA
| | - Qun Li
- MTA-SZTE 'Momentum' Oscillatory Neuronal Networks Research Group, Department of Physiology, University of Szeged, Szeged, 6720, Hungary
| | - Gábor Kozák
- MTA-SZTE 'Momentum' Oscillatory Neuronal Networks Research Group, Department of Physiology, University of Szeged, Szeged, 6720, Hungary
| | - Yuichi Takeuchi
- MTA-SZTE 'Momentum' Oscillatory Neuronal Networks Research Group, Department of Physiology, University of Szeged, Szeged, 6720, Hungary
- Department of Biopharmaceutical Sciences and Pharmacy, Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, Japan
| | - Anett J Nagy
- MTA-SZTE 'Momentum' Oscillatory Neuronal Networks Research Group, Department of Physiology, University of Szeged, Szeged, 6720, Hungary
- HCEMM-SZTE Magnetotherapeutics Research Group, University of Szeged, Szeged, 6720, Hungary
- Neunos Inc, Boston, MA, 02108, USA
| | - Magor L Lőrincz
- MTA-SZTE 'Momentum' Oscillatory Neuronal Networks Research Group, Department of Physiology, University of Szeged, Szeged, 6720, Hungary
- Department of Physiology, Anatomy and Neuroscience, Faculty of Sciences University of Szeged, Szeged, 6726, Hungary
- Neuroscience Division, Cardiff University, Museum Avenue, Cardiff, CF10 3AX, UK
| | - Orrin Devinsky
- Department of Neurology, NYU Langone Comprehensive Epilepsy Center, NYU Grossman School of Medicine, New York, NY, 10016, USA
| | - György Buzsáki
- Neuroscience Institute, New York University, New York, NY, 10016, USA
- Center for Neural Science, New York University, New York, NY, 10016, USA
| | - Antal Berényi
- MTA-SZTE 'Momentum' Oscillatory Neuronal Networks Research Group, Department of Physiology, University of Szeged, Szeged, 6720, Hungary.
- HCEMM-SZTE Magnetotherapeutics Research Group, University of Szeged, Szeged, 6720, Hungary.
- Neunos Inc, Boston, MA, 02108, USA.
- Neuroscience Institute, New York University, New York, NY, 10016, USA.
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59
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Kasparek SW, Rosen ML, Lurie LA, Cikara M, Sambrook K, Cvencek D, Meltzoff AN, McLaughlin KA. Differentiating Between Us & Them: Reduced In-Group Bias as a Novel Mechanism Linking Childhood Violence Exposure with Internalizing Psychopathology. Res Child Adolesc Psychopathol 2023; 51:961-975. [PMID: 36862283 PMCID: PMC9979122 DOI: 10.1007/s10802-023-01035-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2023] [Indexed: 03/03/2023]
Abstract
Strong in-group bonds, facilitated by implicit favoritism for in-group members (i.e., in-group bias), promote mental health across development. Yet, we know little about how the development of in-group bias is shaped by early-life experiences. Childhood violence exposure is known to alter social information processing biases. Violence exposure may also influence social categorization processes, including in-group biases, in ways that influence risk for psychopathology. We examined associations of childhood violence exposure with psychopathology and behavioral and neural indices of implicit and explicit bias for novel groups in children followed longitudinally across three time points from age 5 to 10 years old (n = 101 at baseline; n = 58 at wave 3). To instantiate in-group and out-group affiliations, youths underwent a minimal group assignment induction procedure, in which they were randomly assigned to one of two groups. Youth were told that members of their assigned group shared common interests (in-group) and members of the other group did not (out-group). In pre-registered analyses, violence exposure was associated with lower implicit in-group bias, which in turn was associated prospectively with higher internalizing symptoms and mediated the longitudinal association between violence exposure and internalizing symptoms. During an fMRI task examining neural responses while classifying in-group and out-group members, violence-exposed children did not exhibit the negative functional coupling between vmPFC and amygdala to in-group vs. out-group members that was observed in children without violence exposure. Reduced implicit in-group bias may represent a novel mechanism linking violence exposure with the development of internalizing symptoms.
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Affiliation(s)
| | - Maya L Rosen
- Department of Psychology, Harvard University, Cambridge, MA, USA
- Program in Neuroscience, Smith College, Northampton, MA, USA
| | - Lucy A Lurie
- Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Mina Cikara
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Kelly Sambrook
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Dario Cvencek
- Institute for Learning & Brain Sciences, University of Washington, Seattle, WA, USA
| | - Andrew N Meltzoff
- Institute for Learning & Brain Sciences, University of Washington, Seattle, WA, USA
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60
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Yang R, Takarae Y, Adney H, Swineford C, Walker JC, Cheng P, Negash S, Wiggins JL. Neural correlates of irritability symptom relief in adolescents pre- and post-trauma-focused cognitive behavioral therapy: A pilot study on reward processing. Psychiatry Res Neuroimaging 2023; 332:111645. [PMID: 37087811 PMCID: PMC10901248 DOI: 10.1016/j.pscychresns.2023.111645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/23/2023] [Accepted: 04/13/2023] [Indexed: 04/25/2023]
Abstract
Despite that Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is a first-line, evidence-based treatment for youths experiencing trauma-related symptoms, treatment responses vary and it remains unclear for whom and how this treatment works. In this context, we examined pre-treatment neural reward processing and pre- vs. post-treatment changes in neural reward processing, in relation to irritability - a transdiagnostic and dimensional feature present in multiple trauma-related syndromes, following TF-CBT. Adolescents (N = 22) with childhood trauma history completed a child-friendly monetary incentive delay task during fMRI acquisition, prior to and after the treatment, and irritability symptoms were assessed at five time points over the course of the treatment. Individual irritability slopes (i.e., irritability change rate) and intercepts (i.e., initial irritability level), generated by linear growth curve modeling, were integrated with fMRI data. Repeated ANCOVAs demonstrated that both pre-treatment neural response to reward and pre- vs. post-treatment changes in neural reward processing correlated with irritability symptom relief, such that opposite baseline neural reward processing profiles and differential changing patterns were observed in individuals showing irritability symptom relief vs. not. Together, our findings provide proof of concept that integrating brain information with clinical information has the potential to identify predictors and mechanisms of symptom relief.
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Affiliation(s)
- Ruiyu Yang
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, United States; Department of Psychology, San Diego State University, United States.
| | - Yukari Takarae
- Department of Psychology, San Diego State University, United States
| | - Hailey Adney
- Department of Psychology, San Diego State University, United States
| | - Conner Swineford
- Department of Psychology, San Diego State University, United States
| | - Johanna C Walker
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, United States; Department of Psychology, San Diego State University, United States
| | - Philip Cheng
- Thomas Roth Sleep Disorders and Research Center, Henry Ford Hospital, United States
| | - Sesen Negash
- Department of Counseling & School Psychology, San Diego State University, United States
| | - Jillian Lee Wiggins
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, United States; Department of Psychology, San Diego State University, United States
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61
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Goodman G, Blum B, Rentrop C, Malberg N, Agrawal P. The Efficacy of Two Group Interventions on Mental Representations, Attachment Security, and Trauma Symptoms in Ethnically and Socioeconomically Minoritized Young Adolescents in an Urban Middle School. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105789. [PMID: 37239519 DOI: 10.3390/ijerph20105789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/17/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023]
Abstract
Symptoms resulting from childhood trauma can negatively impact socioemotional well-being and school performance during early adolescence unless positive changes in attachment security and mental representations of significant relationships occur. A sample of 109 eighth grade urban students were randomly assigned to one of two weekly, one-hour, school-based group interventions-Storytelling/Story-Acting for Adolescents (STSA-A) or Mentalization-Based Treatment Group Intervention (MBT-G). The Object Relations Inventory (ORI), Adolescent Attachment Questionnaire (AAQ) and Child PSTD Stress Scale (CPSS) were administered to students and their primary group leaders at the beginning (October) and end (May) of the intervention protocol as outcome variables. Participants in both the STSA-A and MBT-G intervention conditions experienced significant increases in attachment security and decreases in trauma symptoms. Over the course of eight months of group intervention, affective valence of paternal mental representations significantly decreased for boys and for participants in the STSA-A condition, while affective valence of primary group leader mental representations significantly decreased for participants in the MBT-G condition. STSA-A and MBT-G were found to be efficacious at improving attachment security and reducing trauma symptoms in young adolescents. The strengths of each group intervention for addressing interpersonal issues unique to specific types of adolescents are discussed.
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Affiliation(s)
- Geoff Goodman
- Emory School of Medicine, Emory University, Atlanta, GA 30322, USA
| | - Bryan Blum
- Clinical Psychology Doctoral Program, Long Island University, Brooklyn, NY 11201, USA
| | - Carla Rentrop
- Institute for Psychoanalytic Training and Research, New York, NY 10128, USA
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Steil R, Weiss J, Renneberg B, Gutermann J, Rosner R. Effect of therapeutic competence, adherence, and alliance on treatment outcome in youth with PTSD treated with developmentally adapted cognitive processing therapy. CHILD ABUSE & NEGLECT 2023; 141:106221. [PMID: 37178528 DOI: 10.1016/j.chiabu.2023.106221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 04/06/2023] [Accepted: 04/22/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Developmentally adapted cognitive processing therapy (D-CPT) is an effective treatment for posttraumatic stress disorder (PTSD) in adolescents and young adults. It is unclear if therapeutic adherence and competence in D-CPT are associated with higher PTSD treatment gains. OBJECTIVE To assess if higher therapeutic adherence and competence in D-CPT are associated with higher symptom reduction of PTSD in adolescents and young adults, while controlling for therapeutic alliance. PARTICIPANTS AND SETTING Participants were 38 patients (aged 14-21 years; M = 17.61 years, SD = 2.42 years) of a multicenter randomized controlled trial in which the efficacy of D-CPT was compared to a waitlist with treatment advice. METHODS Videotaped therapy sessions were rated using validated ratings scales to assess adherence and competence. Therapeutic alliance was assessed via weekly patient ratings. We used hierarchical linear modelling to assess the relationship of adherence and competence on PTSD symptoms being measured by both clinician and patient while controlling for alliance. RESULTS Neither adherence nor competence were related to treatment outcomes in clinician or patient rated PTSD symptom severity. Higher alliance was associated with a lower symptom severity at 12 months posttreatment in both clinician and patient rated PTSD symptoms. CONCLUSIONS In this study of young adults with PTSD, who were treated with D-CPT by well-trained therapists, therapeutic adherence and competence were not related to treatment outcome. This might be explained by a lack of range in therapist adherence and competence. Therapeutic alliance had a positive effect on PTSD symptom severity.
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Affiliation(s)
- Regina Steil
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe University Frankfurt, Frankfurt am Main, Germany.
| | - Judith Weiss
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Babette Renneberg
- Department of Clinical Psychology and Psychotherapy, Freie Universitaet Berlin, Berlin, Germany
| | - Jana Gutermann
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Rita Rosner
- Department of Psychology, Catholic University Eichstätt-Ingolstadt, Eichstätt, Germany
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Redican E, Vang ML, Shevlin M, Ghazali S, Elklit A. The co-occurrence of potentially traumatic events (PTEs) and their associations with posttraumatic stress disorder (PTSD) in Indian and Malaysian adolescents. Acta Psychol (Amst) 2023; 235:103896. [PMID: 36990035 DOI: 10.1016/j.actpsy.2023.103896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 03/06/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Although it is well-established that people can experience multiple traumatic events, there are few studies examining the co-occurrence of such experiences in non-Western nations. The current study sought to examine the occurrence of multiple potentially traumatic experiences (PTEs) and their associations with posttraumatic stress disorder (PTSD) among adolescents from two Asian nations. METHODS Latent class analysis (LCA) was employed to model the co-occurrence of PTEs in two school samples of adolescents from India (n = 411) and Malaysia (n = 469). Demographic correlates (i.e., sex, age, household composition, parent education) of the latent classes and the association between latent class membership and probable diagnosis of posttraumatic stress disorder (PTSD) were examined. RESULTS The LCA identified three latent classes for the Indian sample: 'Low Risk - moderate sexual trauma', 'Moderate Risk', and 'High Risk'. Similarly, three classes were also identified for the Malaysian sample: 'Low Risk', 'Moderate Risk', and 'High Risk'. Membership of 'Moderate Risk' was associated with male sex in both samples, and with older age and lower levels of parental education attainment in the Malaysian sample. No correlates of 'High Risk' class were identified in either sample. Membership of the 'High Risk' class was significantly associated with probable PTSD diagnosis in both samples, while membership of the 'Moderate Risk' class was associated with probable PTSD diagnosis in the Malaysian sample. CONCLUSION Findings from this study correspond with Western studies indicating co-occurrence of PTEs to be common and to represent a salient risk factor for the development of PTSD.
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Affiliation(s)
- Enya Redican
- Department of Psychology, Ulster University, United Kingdom.
| | - Maria Louison Vang
- Department of Psychology, The National Center of Psychotraumatology, Denmark.
| | - Mark Shevlin
- Department of Psychology, Ulster University, United Kingdom.
| | - Siti Ghazali
- Department of Psychological Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Malaysia.
| | - Ask Elklit
- Department of Psychology, The National Center of Psychotraumatology, Denmark.
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Andrews AR, Walker J, Bernard DL, Adams Z, de Arellano M, Danielson CK. Clinical diversity in a randomized trial that explicitly sought racial/ethnic diversity in its sample: Baseline comparisons in a treatment of youth substance use and posttraumatic stress. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2023; 15:S183-S191. [PMID: 36862478 PMCID: PMC10259880 DOI: 10.1037/tra0001444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
OBJECTIVE For more than two decades, federal agencies have sought to address a persistent lack of inclusion of Black, Latinx, Asian, and indigenous peoples in randomized controlled trials (RCTs), often with an underlying hypothesis that such efforts will increase diversity across clinically-relevant dimensions. We examined racial/ethnic and clinical diversity, including racial/ethnic differences in prior service access and symptom dimensions, in an RCT focusing on trauma-related mental health and substance use among adolescents. METHOD Participants were 140 adolescents in an RCT of Reducing Risk through Family Therapy. Recruitment followed several recommendations for enhancing diversity. Structured interviews examined trauma exposure, posttraumatic stress disorder (PTSD) and depression symptoms, substance use, service utilization, and demographics. RESULTS Non-Latinx (NL) Black youth were more likely to receive mental health services for the first time and have greater trauma exposure, but less likely to report symptoms of depression (ps < .05) relative to NL White youth. Relevant caregiver differences included that NL Black caregivers were more likely to be unemployed and looking for work (p < .05) despite having similar levels of education relative to NL White caregivers (p > .05). CONCLUSION Results suggest that efforts to expand racial/ethnic diversity in an RCT of combined substance use and trauma-focused mental health may also expand other clinical dimensions. Many of these differences reflect multiple dimensions of racism experienced by NL Black families that clinicians must attend to. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Arthur R Andrews
- Department of Psychology, Institute for Ethnic Studies, University of Nebraska-Lincoln
| | | | - Donte L Bernard
- Department of Psychological Sciences, University of Missouri
| | - Zachary Adams
- Department of Psychiatry, Indiana University School of Medicine
| | - Michael de Arellano
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina
| | - Carla Kmett Danielson
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina
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Liang Y, Wu R, Huang Q, Liu Z. Sex Differences in Patterns of Childhood Traumatic Experiences in Chinese Rural-To-Urban Migrant Children. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10040734. [PMID: 37189983 DOI: 10.3390/children10040734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/14/2023] [Accepted: 04/13/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Children and adolescents are likely to be exposed to various types of childhood traumatic experiences (CTEs) with gender-specific patterns. Rural-to-urban migrant children have been demonstrated a greater risk of CTE exposure than local children. However, no study has investigated sex differences in the patterns of CTEs and predictive factors among Chinese children. METHODS A large-scale questionnaire survey of rural-to-urban migrant children (N = 16,140) was conducted among primary and junior high schools in Beijing. Childhood trauma history, including interpersonal violence, vicarious trauma, accidents and injuries was measured. Demographic variables and social support were also examined. Latent class analysis (LCA) was utilized to examine patterns of childhood trauma, and logistic regression was used to examine predictors. RESULTS Four classes of CTEs were found among both boys and girls, labeled low trauma exposure, vicarious trauma exposure, domestic violence exposure, and multiple trauma exposure. The possibility of various CTEs in the four CTE patterns was higher among boys than girls. Sex differences also manifested in predictors of childhood trauma patterns. CONCLUSIONS Our findings shed light on sex differences in CTE patterns and predictive factors in Chinese rural-to-urban migrant children, suggesting that trauma history should be considered along with sex, and sex-specific prevention and treatment programs should be developed.
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Affiliation(s)
- Yiming Liang
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai 200062, China
| | - Ruiyao Wu
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai 200062, China
| | - Qi Huang
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai 200062, China
| | - Zhengkui Liu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
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66
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Martin AN, McLeigh JD, Lamminen LM. Examining the Feasibility of Telehealth Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) with Young People in Foster Care. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:1-9. [PMID: 37359463 PMCID: PMC10071250 DOI: 10.1007/s40653-023-00538-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/23/2023] [Indexed: 06/28/2023]
Abstract
Purpose: Despite the high rate of trauma exposure among young people with child welfare involvement, various systematic and patient barriers exist that inhibit utilization of evidence-based trauma treatments. One strategy for alleviating barriers to such treatments is using telehealth. A few studies have found that the clinical outcomes of telehealth TF-CBT are comparable to those found from clinic-based, in-person treatment administration. Studies have yet to examine the feasibility of telehealth TF-CBT with young people in care. The current study sought to address this gap by examining outcomes for patients who received telehealth TF-CBT, along with factors that may have impacted successful completion, at an integrated primary care clinic exclusively serving young people in care. Methods: Patient data were collected retrospectively from the electronic health records of 46 patients who received telehealth TF-CBT between March 2020 and April 2021, and feedback was sought via focus group from 7 of the clinic's mental health providers. A paired-sample t-test was conducted to evaluate the impact of the intervention for the 14 patients who completed treatment. Results: Responses from the Child and Adolescent Trauma Screen showed a significant decrease in posttraumatic stress symptoms when comparing pre-treatment scores (M = 25.64, SD = 7.85) to post-treatment scores (13.57, SD = 5.30), t(13) = 7.50, p < .001. The mean decrease in scores was 12.07 with a 95% confidence interval ranging from 8.60 to 15.55. Themes emerging from the focus group centered on home environment, caregiver participation, and systemic topics. Conclusions: Findings suggest that telehealth TF-CBT with young people in care is feasible but relatively low completion rates suggest that barriers to treatment completion remain.
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Affiliation(s)
- Adrianna N. Martin
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas USA
- Rees-Jones Center for Foster Care Excellence, Children’s Health, Dallas, Texas USA
| | - Jill D. McLeigh
- Rees-Jones Center for Foster Care Excellence, Children’s Health, Dallas, Texas USA
| | - Laura M. Lamminen
- Rees-Jones Center for Foster Care Excellence, Children’s Health, Dallas, Texas USA
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67
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Eslinger J, Sprang G, Jodts J. Keeping children and youth in trauma treatment: Examination of an alliance building dropout management program. Clin Child Psychol Psychiatry 2023; 28:721-733. [PMID: 35762135 DOI: 10.1177/13591045221111849] [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] [Indexed: 11/15/2022]
Abstract
Evidence-based treatments exist to address traumatic stress related symptoms for children, however dropout from trauma-focused treatment remains a concern. This study examined use of an alliance building dropout management program for a group of children ages 3-17 who received an evidence-based trauma-focused treatment. Logistic regression analysis was conducted to examine the relationships between child gender, race, ethnicity, age, guardianship, externalizing behaviors, participation in a dropout management program and the dose of treatment received. The final model was significant and participation in the dropout management program as well as a child's placement in foster care were significant individual correlates with full completion of treatment. Use of an Alliance Building Dropout Management program may help decrease overall dropout over and above the contribution of other variables known to impact treatment completion.
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Affiliation(s)
- Jessica Eslinger
- Department of Psychiatry, 12252University of Kentucky, Lexington, KY, USA.,Center on Trauma and Children, 4530University of Kentucky, Lexington, KY, USA
| | - Ginny Sprang
- Department of Psychiatry, 12252University of Kentucky, Lexington, KY, USA.,Center on Trauma and Children, 4530University of Kentucky, Lexington, KY, USA
| | - Jenna Jodts
- Center on Trauma and Children, 4530University of Kentucky, Lexington, KY, USA
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68
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Fagermoen EM, Jensen TK, Martinsen M, Ormhaug SM. Parent-Led Stepped Care Trauma Treatment: Parents' Experiences With Helping Their Child Recover. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:1-13. [PMID: 37359465 PMCID: PMC10064603 DOI: 10.1007/s40653-023-00537-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/22/2023] [Indexed: 06/28/2023]
Abstract
Purpose There is a need for interventions for traumatized children that are easily accessible and effective, and that involve parents directly in the recovery process. To meet this challenge, stepped care trauma-focused cognitive behavioral treatment (SC TF-CBT), which consists of a parent-led therapist-assisted intervention as the first step, was developed. Parent-led trauma-treatment is a promising, but novel approach. The aim of this study was therefore to gain knowledge on how parents experience the model. Methods Parents who participated in a SC TF-CBT feasibility study were consecutively recruited and interviewed with semi-structured interviews, which were then analysed using interpretative phenomenological analysis. Results The parents described that the intervention gave them insights that led to a sense of parental agency. Through the analysis we identified and labelled four themes: (i) understanding my child: how the trauma has affected my child and our relationship; (ii) understanding myself: how my reactions have stood in the way of helping my child; (iii) gaining competence: how to learn specific tasks that were not part of my normal parenting skills; and (iv) receiving support: how guidance, warmth and encouragement was necessary. Conclusions The results from this study show how the shifting of therapeutic tasks to parents may facilitate parental empowerment and improve the parent-child relationship. This knowledge may guide clinicians on how to provide support to parents so they can take a leading role in their child's recovery process after trauma. Trial registration ClinicalTrials.gov, NCT04073862. Retrospectively registered 03 June 2019 (first patient recruited May 2019), https://clinicaltrials.gov/ct2/show/NCT04073862.
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Affiliation(s)
- Else Merete Fagermoen
- Norwegian Centre for Violence and Traumatic Stress Studies, Pb 181 Nydalen, Oslo, 0409 Norway
| | - Tine K. Jensen
- Norwegian Centre for Violence and Traumatic Stress Studies, Pb 181 Nydalen, Oslo, 0409 Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Marianne Martinsen
- Faculty of Education, Inland Norway University of Applied Sciences, Hamar, Norway
| | - Silje M. Ormhaug
- Norwegian Centre for Violence and Traumatic Stress Studies, Pb 181 Nydalen, Oslo, 0409 Norway
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Haahr-Pedersen I, Vallières F, Hansen M, Aldamman K, Schmidt-Rasmussen V, Bramsen RH, Spitz P, Hyland P. Evidence of a traumatic stress dimension of psychopathology among at-risk children living in Denmark. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04381-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
AbstractThe Hierarchical Taxonomy of Psychopathology (HiTOP) is a quantitative model of psychopathology. HiTOP proposes that trauma-related distress is a facet of Internalizing psychopathology, but recent evidence with young people suggests that it may reflect a unique dimension of psychopathology. This study assessed the latent structure of child and adolescent psychopathology to determine whether there is evidence of a unique ‘Traumatic Stress’ dimension, and how dimensions of psychopathology are associated with specific types of childhood adversity and trauma, and suicidal ideation and self-injurious behavior. Participants were children and adolescents aged 1–17 years (N = 1,800) who were in contact with the Danish child protection system due to suspected child abuse. Confirmatory factor analysis was used to determine the optimal latent structure of psychopathology, and structural equation modelling was used to determine how the dimensions of psychopathology were associated with different forms of trauma and adversity and suicidality/self-harm. The best fitting model included three factors of Internalizing, Externalizing, and Traumatic Stress. The Traumatic Stress dimensions was associated with older age, living outside of the family home, parental mental illness, higher levels of parental conflict, and the presence of domestic violence in the child’s home. The Traumatic Stress dimension was not associated with suicidality/self-harm. This study provides additional evidence of a distinct dimension of Traumatic Stress among young people. Further studies are needed to determine if these findings are replicable, particularly in older participants.
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Baumann-Larsen M, Dyb G, Wentzel-Larsen T, Zwart JA, Storheim K, Stensland SØ. Exposure to traumatic events and use of over-the-counter analgesics in adolescents: cross-sectional findings from the Young-HUNT study. BMJ Open 2023; 13:e066058. [PMID: 36931675 PMCID: PMC10030485 DOI: 10.1136/bmjopen-2022-066058] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/19/2023] Open
Abstract
OBJECTIVE Frequent and increasing use of over-the-counter analgesics (OTCA) among adolescents is a public health concern. Prior research indicates that adolescents exposed to traumatic events may be at increased risk of suffering from headaches and musculoskeletal pain. In this study, we assessed the association between trauma exposure and use of OTCA for headaches and musculoskeletal pain. DESIGN A cross-sectional population study among adolescents, self-reported data on trauma exposure, pain and use of OTCA. SETTING AND PARTICIPANTS All 10 608 adolescents aged 13-19 years in a region of Norway were invited in this school-based survey, participation rate was 76%. OUTCOME MEASURE Frequency of OTCA use for headache and musculoskeletal pain served as separate outcomes in ordinal logistic regression analyses. RESULTS Trauma exposure was significantly and consistently related to higher frequency use of OTCA for headache and musculoskeletal pain, of which associations for bullying (OR 1.79, 95% CI 1.50 to 2.12, and OR 2.12, 95% CI 1.70 to 2.66), physical violence (OR 1.49, 95% CI 1.25 to 1.78 and OR 1.83, 95% CI 1.45 to 2.32) and sexual abuse (OR 1.83, 95% CI 1.55 to 2.18 and OR 1.53, 95% CI 1.18 to 1.90) were particularly strong. A dose-response relationship was found between interpersonal violence and OTCA use for headache (OR 1.46, 95% CI 1.29 to 1.66 for one type and OR 1.81, 95% CI 1.53 to 2.14 for two or more types) and musculoskeletal pain (OR 1.61, 95% CI 1.91 to 3.00 for one type and OR 2.39, 95% CI 1.91 to 3.00 for two or more types). The associations remained significant after adjustment for pain, although an attenuation in strength was observed. CONCLUSION Trauma exposed adolescents use OTCA for headaches and musculoskeletal pain more frequently than those not exposed. The higher frequency of pain conditions among trauma exposed only partially explained their more frequent OTCA use, indicating an increased risk relating to features beyond frequency of pain.
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Affiliation(s)
- Monica Baumann-Larsen
- Department of Research and Innovation, Oslo University Hospital Division of Clinical Neuroscience, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo Faculty of Medicine, Oslo, Norway
| | - Grete Dyb
- Institute of Clinical Medicine, University of Oslo Faculty of Medicine, Oslo, Norway
- Section for Trauma, catastrophes and forced migration - children and youths, Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Tore Wentzel-Larsen
- Section for Trauma, catastrophes and forced migration - children and youths, Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
- Regional Centre for Child and Adolescent Mental Health Eastern and Southern Norway, Oslo, Norway
| | - John-Anker Zwart
- Department of Research and Innovation, Oslo University Hospital Division of Clinical Neuroscience, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo Faculty of Medicine, Oslo, Norway
| | - Kjersti Storheim
- Department of Research and Innovation, Oslo University Hospital Division of Clinical Neuroscience, Oslo, Norway
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
| | - Synne Øien Stensland
- Department of Research and Innovation, Oslo University Hospital Division of Clinical Neuroscience, Oslo, Norway
- Section for Trauma, catastrophes and forced migration - children and youths, Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
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Lawrence TI, Mcfield AA, Byrne MM, S.Tarver S, Stewart TK. Depression and Substance Use as Consequences of Exposure to Family Violence: A Moderation Mediation and Self-Medication Hypothesis Study. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:69-79. [PMID: 36776628 PMCID: PMC9908810 DOI: 10.1007/s40653-022-00464-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/07/2022] [Indexed: 06/18/2023]
Abstract
Ample evidence exists suggesting that exposure to family violence leads to substance use and this relationship is moderated by gender; however, much is still unknown of the underlying mechanism of this relationship. Thus, the current study first examined whether exposure to family violence was associated with substance use. Then consistent with the self-medication hypothesis, we tested whether depressive symptoms mediated the relations between exposure to family violence and substance use. Finally, we examined the moderating effect of gender on the relationships among exposure to family violence and depressive symptoms/substance use (N = 1,850). Results suggest that exposure to family violence positively associated with substance use. Mediation results revealed that depressive symptoms explained the relationship between exposure to family violence and substance use. Moderation results indicated that males who were exposed to family violence were more likely to endorse depressive symptoms and more likely to use substances while controlling for sibling aggression victimization. This study provides new insight into the internalizing and externalizing symptoms of exposure to family violence, specifically for male adolescents. Implications are discussed.
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Affiliation(s)
| | - Ariel A. Mcfield
- University of Texas Permian Basin, 4901 East University, Odessa, TX 79762 USA
| | - Madeleine M. Byrne
- Dallas County Juvenile Department, Psychology Division, 2600 Lone Star Rd. Dallas, Dallas, TX 75212 USA
| | - Sheree S.Tarver
- Dallas County Juvenile Department, Psychology Division, 10503 Denton Dr, Dallas, TX 75220 USA
| | - Tiah K. Stewart
- Prairie View A&M University, P. O Box 519 MS, Prairie View, TX 2699 USA
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Traumatic stress load and stressor reactivity score associated with accelerated gray matter maturation in youths indexed by normative models. Mol Psychiatry 2023; 28:1137-1145. [PMID: 36575305 DOI: 10.1038/s41380-022-01908-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 12/01/2022] [Accepted: 12/02/2022] [Indexed: 12/28/2022]
Abstract
Understanding how traumatic stress affects typical brain development during adolescence is critical to elucidate underlying mechanisms related to both maladaptive functioning and resilience after traumatic exposures. The current study aimed to map deviations from normative ranges of brain gray matter for youths with traumatic exposures. For each cortical and subcortical gray matter region, normative percentiles of variations were established using structural MRI from typically developing youths without any traumatic exposure (n = 245; age range = 8-23) from the Philadelphia Neurodevelopmental Cohort (PNC). The remaining PNC participants with neuroimaging data (n = 1129) were classified as either within the normative range (5-95%), delayed (>95%) or accelerated (<5%) maturational ranges for each region using the normative model. An averaged quantile regression index was calculated across all regions. Mediation models revealed that high traumatic stress load was positively associated with poorer cognitive functioning and greater psychopathology, and these associations were mediated by accelerated gray matter maturation. Furthermore, higher stressor reactivity scores, which represent a less resilient response under traumatic stress, were positively correlated with greater acceleration of gray matter maturation (r = 0.224, 95% CI = [0.17, 0.28], p < 0.001), suggesting that more accelerated maturation was linked to greater stressor response regardless of traumatic stress load. We conclude that traumatic stress is a source of deviation from normative brain development associated with poorer cognitive functioning and more psychopathology in the long run.
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Wang J, Harrer S, Zwald ML, Leemis RW, Holland KM, Stone DM, McDavid Harrison K, Swedo EA. Association of Recent Violence Encounters With Suicidal Ideation Among Adolescents With Depression. JAMA Netw Open 2023; 6:e231190. [PMID: 36862413 PMCID: PMC9982692 DOI: 10.1001/jamanetworkopen.2023.1190] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
IMPORTANCE Suicide prevention is an important component of depression management. Knowledge about depressed adolescents with increased risk for suicide can inform suicide prevention efforts. OBJECTIVE To describe the risk of documented suicidal ideation within a year following a diagnosis of depression and to examine how the risk of documented suicidal ideation differed by recent violence encounter status among adolescents with new depression diagnoses. DESIGN, SETTING, AND PARTICIPANTS Retrospective cohort study in clinical settings including outpatient facilities, emergency departments, and hospitals. Using IBM's Explorys database containing electronic health records from 26 US health care networks, this study observed a cohort of adolescents with new depression diagnoses from 2017 to 2018 for up to 1 year. Data were analyzed from July 2020 to July 2021. EXPOSURES Recent violence encounter was defined by a diagnosis of child maltreatment (physical, sexual, or psychological abuse or neglect) or physical assault within 1 year before depression diagnosis. MAIN OUTCOMES AND MEASURES The main outcome was diagnosis of suicidal ideation within 1 year following depression diagnosis. Multivariable adjusted risk ratios of suicidal ideation were calculated for overall recent violence encounters and for individual forms of violence. RESULTS Among a total of 24 047 adolescents with depression, 16 106 (67.0%) were female and 13 437 (55.9%) were White. A total of 378 had experienceda violence (hereafter, encounter group) and 23 669 had not (hereafter, nonencounter group). Following the diagnosis of depression, 104 adolescents with any past-year violence encounter (27.5%) documented suicidal ideation within 1 year. In contrast, 3185 adolescents in the nonencounter group (13.5%) experienced thoughts of suicide following the diagnosis of depression. In multivariable analyses, those with any violence encounter had 1.7 times (95% CI 1.4-2.0) higher risk of documented suicidal ideation compared with those in the nonencounter group (P < .001). Among different forms of violence, sexual abuse (risk ratio, 2.1; 95% CI, 1.6-2.8) and physical assault (risk ratio, 1.7; 95% CI, 1.3-2.2) were associated with significantly increased risk of suicidal ideation. CONCLUSIONS AND RELEVANCE Among adolescents with depression, persons who experienced past-year violence encounters showed a higher rate of suicidal ideation than those who had not. These findings highlight the importance of identifying and accounting for past violence encounters when treating adolescents with depression to reduce risk of suicide. Public health approaches to prevent violence may help to avert morbidity associated with depression and suicidal ideation.
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Affiliation(s)
- Jing Wang
- Division of Injury Prevention, National Center for Injury Prevention and Control, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Marissa L. Zwald
- Division of Violence Prevention, National Center for Injury Prevention and Control, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ruth W. Leemis
- Division of Violence Prevention, National Center for Injury Prevention and Control, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kristin M. Holland
- Division of Violence Prevention, National Center for Injury Prevention and Control, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Deborah M. Stone
- Division of Injury Prevention, National Center for Injury Prevention and Control, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kathleen McDavid Harrison
- Division of Violence Prevention, National Center for Injury Prevention and Control, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Elizabeth A. Swedo
- Division of Violence Prevention, National Center for Injury Prevention and Control, US Centers for Disease Control and Prevention, Atlanta, Georgia
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Chien WT, Lau CT. Traumatised Children's Perspectives on Their Lived Experience: A Review. Behav Sci (Basel) 2023; 13:bs13020170. [PMID: 36829399 PMCID: PMC9952495 DOI: 10.3390/bs13020170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/10/2023] [Accepted: 02/12/2023] [Indexed: 02/17/2023] Open
Abstract
Introduction: Most children have exposure of traumatic events during their life, such as natural disasters, accidents, and abuses. A review of traumatised children's perspective on traumatic events plays an important role in enhancing our understanding and promoting appropriate tailor-made intervention and support to these children. Methods: Four main health-related electronic databases were searched for all English full-text qualitative research articles over the past 11 years to uncover the recent best available perspective/evidence from traumatised children. The PRISMA checklist was adopted to guide the review process. Results: Five themes about children's experiences and perspectives towards the traumatic events encountered were summarised and integrated from 19 qualitative studies identified. They included daily life problems related to trauma, negative responses to trauma, perceived health needs, coping strategies related to trauma and stress, and growth from traumatic experience. Conclusions: This systematic review provides evidence about responses/impacts and perceived health needs of traumatised children and informs the direction caregivers' training can take, helping these children by early identification and timely intervention. More research is needed to examine/compare traumatised children's responses and coping between diverse traumatic experiences, time from exposure, and the sociodemographic characteristics of these children.
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Childhood adversity and co-occurring post-traumatic stress and externalizing symptoms among a predominantly low-income, African American sample of early adolescents. Dev Psychopathol 2023; 35:383-395. [PMID: 34924089 PMCID: PMC9207160 DOI: 10.1017/s0954579421001383] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Although there is strong evidence supporting the association between childhood adversity and symptomatology during adolescence, the extent to which adolescents present with distinct patterns of co-occurring post-traumatic stress (PTS) and externalizing symptoms remains unclear. Additionally, prior research suggests that experiencing nonviolent, negative life events may be more salient risk factors for developing some forms of psychopathology than exposure to violence. The current study used latent profile analysis to identify subgroups of early adolescents with distinct patterns of PTS, physical aggression, delinquency, and substance use, and examined subgroup differences in exposure to three forms of violent and nonviolent childhood adversity. Participants were a predominantly low-income, African American sample of 2,722 urban middle school students (M age = 12.9, 51% female). We identified four symptom profiles: low symptoms (83%), some externalizing (8%), high PTS (6%), and co-occurring PTS and externalizing symptoms (3%). A higher frequency of witnessing violence was associated with increased odds of membership in subgroups with externalizing symptoms, whereas a higher frequency of nonviolent, negative life events was associated with increased odds of membership in subgroups with PTS symptoms. Interventions aimed to address childhood adversity may be most effective when modules addressing both PTS and externalizing symptoms are incorporated.
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Abstract
Child abuse is associated with elevated risk for psychopathology. The current study examined the role of automatic emotion regulation as a potential mechanism linking child abuse with internalizing psychopathology. A sample of 237 youth aged 8-16 years and their caregivers participated. Child abuse severity was assessed by self-report questionnaires, and automatic emotion regulation was assessed using an emotional Stroop task designed to measure adaptation to emotional conflict. A similar task without emotional stimuli was also administered to evaluate whether abuse was uniquely associated with emotion regulation, but not cognitive control applied in a nonemotional context. Internalizing psychopathology was assessed concurrently and at a 2-year longitudinal follow-up. Child abuse severity was associated with lower emotional conflict adaptation but was unrelated to cognitive control. Specifically, the severity of emotional and physical abuse, but not sexual abuse, were associated with lower emotional conflict adaptation. Emotional conflict adaptation was not associated with internalizing psychopathology prospectively. These findings suggest that childhood emotional and physical abuse, in particular, may influence automatic forms of emotion regulation. Future work exploring the socioemotional consequences of altered automatic emotion regulation among youth exposed to child abuse is clearly needed.
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77
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Laricchiuta D, Panuccio A, Picerni E, Biondo D, Genovesi B, Petrosini L. The body keeps the score: The neurobiological profile of traumatized adolescents. Neurosci Biobehav Rev 2023; 145:105033. [PMID: 36610696 DOI: 10.1016/j.neubiorev.2023.105033] [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: 08/07/2022] [Revised: 12/13/2022] [Accepted: 01/02/2023] [Indexed: 01/05/2023]
Abstract
Trauma-related disorders are debilitating psychiatric conditions that affect people who have directly or indirectly witnessed adversities. Experiencing multiple types of traumas appears to be common during childhood, and even more so during adolescence. Dramatic brain/body transformations occurring during adolescence may provide a highly responsive substrate to external stimuli and lead to trauma-related vulnerability conditions, such as internalizing (anxiety, depression, anhedonia, withdrawal) and externalizing (aggression, delinquency, conduct disorders) problems. Analyzing relations among neuronal, endocrine, immune, and biochemical signatures of trauma and internalizing and externalizing behaviors, including the role of personality traits in shaping these conducts, this review highlights that the marked effects of traumatic experience on the brain/body involve changes at nearly every level of analysis, from brain structure, function and connectivity to endocrine and immune systems, from gene expression (including in the gut) to the development of personality.
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Affiliation(s)
- Daniela Laricchiuta
- Department of Philosophy, Social Sciences & Education, University of Perugia, Perugia, Italy.
| | - Anna Panuccio
- Laboratory of Experimental and Behavioral Neurophysiology, IRCCS Fondazione Santa Lucia, Rome, Italy; Department of Psychology, University Sapienza of Rome, Rome, Italy
| | - Eleonora Picerni
- Laboratory of Experimental and Behavioral Neurophysiology, IRCCS Fondazione Santa Lucia, Rome, Italy; Department of Neuroscience Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | | | | | - Laura Petrosini
- Laboratory of Experimental and Behavioral Neurophysiology, IRCCS Fondazione Santa Lucia, Rome, Italy
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Sharafeddin F, Ghaly M, Simon TB, Ontiveros-Ángel P, Figueroa JD. Prefrontal cortical protease TACE/ADAM17 is involved in neuroinflammation and stress-related eating alterations. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.01.23.525269. [PMID: 36747666 PMCID: PMC9900811 DOI: 10.1101/2023.01.23.525269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Childhood traumatic stress profoundly affects prefrontal cortical networks regulating top-down control of eating and body weight. However, the neurobiological mechanisms contributing to trauma-induced aberrant eating behaviors remain largely unknown. Traumatic stress influences brain immune responses, which may, in turn, disrupt prefrontal cortical networks and behaviors. The tumor necrosis factor alpha-converting enzyme / a disintegrin and metalloproteinase 17 (TACE/ADAM17) is a sheddase with essential functions in brain maturation, behavior, and neuroinflammation. This study aimed to determine the role of TACE/ADAM17 on traumatic stress-induced disruption of eating patterns. We demonstrate a novel mechanistic connection between prefrontal cortical TACE/ADAM17 and trauma-induced eating behaviors. Fifty-two (52) adolescent Lewis rats (postnatal day, PND, 15) were injected intracerebrally either with a novel Accell™ SMARTpool ADAM17 siRNA or a corresponding siRNA vehicle. The RNAscope Multiplex Fluorescent v2 Assay was used to visualize mRNA expression. Observation cages were used to monitor ethological behaviors in a more naturalistic environment over long periods. We found that traumatic stress blunts startle reactivity and alter eating behaviors (increased intake and disrupted eating patterns). We also found that the rats that received prefrontal cortical TACE/ADAM17 siRNA administration exhibited decreased eating and increased grooming behaviors compared to controls. These changes were associated with decreased AIF-1 expression (a typical marker of microglia and neuroinflammation). This study demonstrates that prefrontal cortical TACE/ADAM17 is involved in neuroinflammation and may play essential roles in regulating feeding patterns under stress conditions. TACE/ADAM17 represents a promising target to ameliorate inflammation-induced brain and behavior alterations.
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Affiliation(s)
- Fransua Sharafeddin
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, California, USA
| | - Mina Ghaly
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, California, USA
| | - Timothy B Simon
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, California, USA
| | - Perla Ontiveros-Ángel
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, California, USA
| | - Johnny D Figueroa
- Center for Health Disparities and Molecular Medicine, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, California, USA
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Abstract
Purpose of Review The goal of this review is to describe how socioeconomic status (SES) is evaluated in the pediatric trauma literature and further consider how differences in SES can lead to inequities in pediatric injury. Recent Findings Insurance status, area-level income, and indices of socioeconomic deprivation are the most common assessments of socioeconomic status. Children from socioeconomically disadvantaged backgrounds experience higher rates of firearm-related injuries, motor vehicle-related injuries, and violence-related injuries, contributing to inequities in morbidity and mortality after pediatric injury. Differences in SES may also lead to inequities in post-injury care and recovery, with higher rates of readmission, recidivism, and PTSD for children from socioeconomically disadvantaged backgrounds. Summary Additional research looking at family-level measures of SES and more granular measures of neighborhood deprivation are needed. SES can serve as an upstream target for interventions to reduce pediatric injury and narrow the equity gap.
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Affiliation(s)
- Stephen Trinidad
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH MLC 2023 USA
| | - Meera Kotagal
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH MLC 2023 USA
- Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH USA
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80
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Mullins JL, Zhou E, Michalska KJ. How Parental Support Affects Latina Girls During the COVID-19 Pandemic. SOCIAL PSYCHOLOGY 2023. [DOI: 10.1027/1864-9335/a000476] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Abstract. The current study focuses on a sample of low- to middle-income school-age Latina girls and their parents and examines how children’s distress proneness interacts with parental empathic accuracy and posttraumatic growth in the wake of the COVID-19 pandemic to predict children’s empathy and prosocial behavior toward unknown others. Approximately 2–3 months into state-mandated stay-at-home orders, 55 parent–daughter dyads were recruited to participate in this four-session longitudinal study. To assess distress proneness, daughters (ages 8–13 years, 100% Latina) identified their degree of distress in response to pandemic-related stressors. Concurrently, their parents reported how they thought their children would respond to these same pandemic-related stressors, which assessed parental empathic accuracy. Parents also completed an adapted version of the Posttraumatic Growth Inventory, which assessed perceived positive outcomes of the COVID-19 pandemic. Upon study completion, a behavioral measure of children’s empathic and prosocial behaviors was collected. Parental empathic accuracy interacted with children’s distress proneness to positively predict children’s affective empathy, such that children’s distress proneness predicted affective empathy at high and mean, but not low, levels of parental empathic accuracy. In a separate analysis, parental posttraumatic growth interacted with children’s distress proneness to positively predict children’s altruistic sharing behavior, such that children’s distress proneness predicted altruistic sharing behavior only at high, but not mean or low, levels of parental posttraumatic growth. The results of this study highlight how positive parental socialization and understanding of children’s tendencies toward distress are associated with children’s empathic and prosocial behaviors, particularly during major global crises.
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Affiliation(s)
- Jordan L. Mullins
- Department of Psychology, University of California, Riverside, CA, USA
| | - Elayne Zhou
- Department of Psychology, University of California, Riverside, CA, USA
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81
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Zaverdinou E, Katimertzi M, Chrousos GP, Darviri C, Vlachakis D, Kanaka-Gantenbein C, Bacopoulou F. Post-traumatic Stress Disorder as a Risk Factor for the Development of Risky Behavior Among Adolescent Offenders: A Systematic Review. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1425:119-129. [PMID: 37581786 DOI: 10.1007/978-3-031-31986-0_11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
The purpose of this research study was to obtain greater insight into the associations of post-traumatic stress disorder (PTSD) and trauma-exposed experiences with the development of offending behavior in adolescents. Using the PubMed and Scopus databases, we performed a systematic review of recent cross-sectional studies between 2016 and 2022, investigating the associations of PTSD and trauma with the social and mental behavior of adolescents. Fifty-three articles were initially identified. Due to duplication, eight articles were excluded, leaving 45 remaining articles. In addition, 34 articles were excluded due to year of publication, review, abstract, or irrelevant title. Seven articles were included in this systematic review after excluding the remaining due to different study types or samples. Included studies primarily examined the associations of PTSD symptomatology and expression of externalizing symptoms with risky behavior and the commission of a crime. The strongest outcomes were increased levels of violent behavior, violent delinquency, and total risk in correlation with PTSD symptoms, emotional numbing, use of drugs, and in some cases maltreatment. The results of the systematic review suggest that PTSD symptoms and risky behavior, which can be also fueled by maltreatment activities in the family circle, are associated with criminal behavior. Future research is needed to confirm these findings.
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Affiliation(s)
- Eleni Zaverdinou
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Katimertzi
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - George P Chrousos
- University Research Institute of Maternal and Child Health & Precision Medicine, and UNESCO Chair in Adolescent Health Care, Aghia Sophia Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Christina Darviri
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Vlachakis
- Laboratory of Genetics, Department of Biotechnology, School of Applied Biology and Biotechnology, Agricultural University of Athens, Athens, Greece
| | - Christina Kanaka-Gantenbein
- First Department of Pediatrics, School of Medicine, Aghia Sophia Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Flora Bacopoulou
- Center for Adolescent Medicine and UNESCO Chair in Adolescent Health Care, First Department of Pediatrics, School of Medicine, Aghia Sophia Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece.
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82
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Last BS, Johnson C, Dallard N, Fernandez-Marcote S, Zinny A, Jackson K, Cliggitt L, Rudd BN, Mills C, Beidas RS. Implementing trauma-focused cognitive behavioral therapy in Philadelphia: A 10-year evaluation. IMPLEMENTATION RESEARCH AND PRACTICE 2023; 4:26334895231199467. [PMID: 37790185 PMCID: PMC10496473 DOI: 10.1177/26334895231199467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023] Open
Abstract
Background: In 2012, Philadelphia's Department of Behavioral Health and Intellectual disAbility Services (DBHIDS) developed an initiative to implement an evidence-based treatment for posttraumatic stress disorder (PTSD), trauma-focused cognitive behavioral therapy (TF-CBT), across the city's behavioral health system. This report evaluates the initiative's 10-year implementation and effectiveness outcomes. Method: The Exploration, Preparation, Implementation, and Sustainment framework guided our implementation evaluation. The implementation outcomes include adoption, reach, and sustainment; these were obtained during regular evaluation data collection from publicly funded behavioral health agencies participating in the TF-CBT initiative. We analyze effectiveness outcomes (i.e., changes in PTSD symptoms) from a subset of patients receiving TF-CBT, which were collected in 6-month intervals by our research team between 2013 and 2021. Results: From 2012 to 2021, DBHIDS trained 478 clinicians in TF-CBT across 20 behavioral health agencies. During this time, 23,401 youths were screened for potentially traumatic events and PTSD symptoms, and 7,550 youths received TF-CBT. Through the TF-CBT initiative, the city expanded the network of TF-CBT providers from 3 to 20 agencies. DBHIDS sustained this network by maintaining the participation of 16 behavioral health agencies over the course of a decade. The subset of 202 youths who were evaluated to assess TF-CBT effectiveness was drawn from 94 therapists and 20 agencies across Philadelphia. All participating youths completed a baseline assessment, and 151 (75%) completed at least one follow-up assessment. Linear mixed-effects models accounting for observations nested within participants and nested within clinicians found that treatment significantly reduced PTSD symptoms. Conclusion: Between 2012 and 2021, DBHIDS successfully implemented and sustained TF-CBT across the city's behavioral health system. Adoption, reach, and sustainment of TF-CBT were high. Despite the considerable adverse experiences faced by youths seeking treatment in Philadelphia's behavioral health system, TF-CBT was effective. Future directions to improve TF-CBT implementation in the next iteration of the initiative are described.
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Affiliation(s)
- Briana S. Last
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - Christina Johnson
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Natalie Dallard
- Community Behavioral Health, Philadelphia Department of Behavioral Health and Intellectual disAbility Services, Philadelphia, PA, USA
| | - Sara Fernandez-Marcote
- Community Behavioral Health, Philadelphia Department of Behavioral Health and Intellectual disAbility Services, Philadelphia, PA, USA
| | - Arturo Zinny
- Community Behavioral Health, Philadelphia Department of Behavioral Health and Intellectual disAbility Services, Philadelphia, PA, USA
- Center for Nonviolence and Social Justice, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Kamilah Jackson
- Community Behavioral Health, Philadelphia Department of Behavioral Health and Intellectual disAbility Services, Philadelphia, PA, USA
- Talawa International Consultants, Philadelphia, PA, USA
| | - Lauren Cliggitt
- Hall-Mercer Community Mental Health Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Brittany N. Rudd
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - Chynna Mills
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Rinad S. Beidas
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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Ouhmad N, Deperrois R, Combalbert N, El Hage W. The Role of Anxiety and Depression in the Emotion Regulation Strategies of People Suffering from Post-Traumatic Stress Disorder. THE JOURNAL OF PSYCHOLOGY 2023; 157:143-159. [PMID: 36796009 DOI: 10.1080/00223980.2022.2134279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
Researchers have explored the links between cognitive emotion regulation, impaired cognitive functioning, and anxiety-depression, including the link to anxiety and depression levels. However, very few studies have examined these dimensions in clinical populations with post-traumatic stress disorder (PTSD). A sample of 183 participants was divided into three groups: 59 trauma-exposed with PTSD, 61 trauma-exposed without PTSD, and 63 non-trauma-exposed non-PTSD (controls). All participants were assessed on the following dimensions: PTSD (PCL-5), cognitive emotion regulation (CERQ), anxiety and depression (HADS). Results indicate a specific profile of emotion regulation associated with PTSD. Compared to other groups, participants with PTSD showed more difficulty managing their emotions, with more rumination, self-blame, and catastrophizing. Moreover, these difficulties were also correlated with levels of anxiety and depression, that is, participants with PTSD who had higher anxiety and depression scores used more maladaptive strategies. The PTSD group used significantly more maladaptive cognitive emotion regulation strategies than the other groups, with distinct profiles related to anxiety and depressive symptomatology.
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84
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Redican E, Murphy J, McBride O, Bunting L, Shevlin M. The Prevalence, Patterns and Correlates of Childhood Trauma Exposure in a Nationally Representative Sample of Young People in Northern Ireland. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:963-976. [PMID: 35571535 PMCID: PMC9077031 DOI: 10.1007/s40653-022-00449-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/28/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE Childhood trauma (CT) exposure is common, with many young people affected by multiple co-occurring traumas. METHODS Participants were a representative sample of 11-19-year-olds (n = 1293), who participated in the largest ever representative survey of youth mental health in Northern Ireland (NI) - the NI Youth Wellbeing Prevalence Survey 2020. This study used latent class analysis (LCA) to identify typologies that were most representative of trauma experience and co-occurrence among young people living in NI. Demographic, parental and deprivation variables were then used within a multinomial logistic regression analysis to describe trauma class membership. RESULTS Over 35% (n = 478) of participants reported exposure to at least one CT, with over 50% (n = 259) of trauma-exposed young people reporting multiple trauma exposure. LCA results provided support for a three-class model; 'low-exposure', 'moderate-exposure: community-victimization' and 'high-exposure: sexual-trauma'. While none of the child, parental or familial covariates differentiated members of the 'moderate-exposure: community-victimization' from 'low-exposure', those in 'high-exposure: sexual-trauma' were over four and a half times more likely to belong to a family in receipt of income benefits and over ten times more likely to have experienced some form of out-of-home care. CONCLUSIONS This study highlights the presence of three distinct trauma classes in the NI adolescent population. In particular, this study identifies a small minority of young people who have experienced multiple CT's, including sexually based traumas, with these traumas most likely to have occurred in the context of out-of-home care and familial poverty.
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Affiliation(s)
- Enya Redican
- School of Psychology, Ulster University, Coleraine, UK
| | - Jamie Murphy
- School of Psychology, Ulster University, Coleraine, UK
| | - Orla McBride
- School of Psychology, Ulster University, Coleraine, UK
| | | | - Mark Shevlin
- School of Psychology, Ulster University, Coleraine, UK
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85
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Heyn SA, Bailowitz S, Russell JD, Herringa RJ. Sex-based variations of prefrontal structure and longitudinal symptoms in pediatric posttraumatic stress disorder. Depress Anxiety 2022; 39:902-912. [PMID: 36349877 PMCID: PMC9762118 DOI: 10.1002/da.23296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 10/25/2022] [Accepted: 10/30/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Pediatric posttraumatic stress disorder (pPTSD) is more than three times as likely to develop in trauma-exposed female youth than males. Despite the staggering sex differences in the prevalence rates of pPTSD and symptom expression, relatively little is known about the underlying biomarkers of these sex-based variations in pPTSD as compared to typically development. METHODS The Youth PTSD study recruited 97 youth, ages of 7 and 18, to undergo comprehensive clinical assessments and T1-weighted MRI to evaluate the extent to which sex can explain PTSD-related variations in brain structure. Whole-brain VBM as well as whole-brain estimates of cortical thickness and surface area were analyzed to identify group-by-sex interactions. Finally, we tested whether current or future symptom severity was predictive of regions exhibiting sex-based variations. RESULTS Clinically, females with PTSD were significantly more likely to report exposure to and higher severity of interpersonal violence and symptoms of hyperarousal. Sex and PTSD status were predictive of gray matter across the lateral prefrontal cortex (PFC), including the ventrolateral PFC and frontal pole, where increased volume and surface area was found in PTSD females as compared to PTSD males. Interestingly, the ventrolateral prefrontal cortex and frontal pole were negatively predictive of symptoms 1 year later in only males with PTSD. CONCLUSIONS Together, these results establish that youth with PTSD exhibit sex-based variations in clinical and trauma characteristics and prefrontal cortical structure relative to normative development. This work demonstrates the importance of examining the role that sex may play in the behavioral and neurobiological presentation of pPTSD.
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Affiliation(s)
- Sara A. Heyn
- Department of Psychiatry, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Sophie Bailowitz
- Department of Psychiatry, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Justin D. Russell
- Department of Psychiatry, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Ryan J. Herringa
- Department of Psychiatry, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
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Bauer A, Fairchild G, Hammerton G, Murray J, Santos IS, Tovo Rodrigues L, Munhoz TN, Barros AJD, Matijasevich A, Halligan SL. Associations between childhood trauma and childhood psychiatric disorders in Brazil: a population-based, prospective birth cohort study. Lancet Psychiatry 2022; 9:969-977. [PMID: 36328032 DOI: 10.1016/s2215-0366(22)00337-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/08/2022] [Accepted: 09/14/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Childhood trauma is a proposed transdiagnostic risk factor for psychopathology, but epidemiological evidence from low-income and middle-income countries (LMICs) is scarce. We investigated associations between trauma and child psychiatric disorders in a birth cohort in Brazil. METHODS The 2004 Pelotas Birth Cohort is an ongoing, population-based, prospective birth cohort, including all hospital births occurring between Jan 1 and Dec 31, 2004, in the city of Pelotas, Brazil. When the children were aged 6 and 11 years, trained psychologists administered the Development and Well-Being Assessment clinical interview to caregivers to assess current child psychiatric disorders (anxiety disorders, mood disorders, ADHD and hyperactivity disorders, and conduct and oppositional disorders), and lifetime trauma exposure (ie, experiencing or witnessing life-threatening events) including interpersonal and non-interpersonal events. Analyses used multiple imputation and logistic regression models. OUTCOMES Of 4263 live births, 4231 children were included in the study sample, and 4229 (2195 [51·9%] boys and 2034 [48·1%] girls; 2581 [61·7%] with White mothers and 1600 [38·3%] with Black or mixed race mothers) were included in the imputed analyses. 1154 (34·3%) of 3367 children with complete data at age 11 years had been exposed to trauma by that age. After adjusting for confounders, at age 6 years, trauma was associated with increased odds of anxiety disorders (adjusted odds ratio 1·79 [95% CI 1·33-2·42]) and any psychiatric disorder (1·59 [1·22-2·06]), and at age 11 years, with any psychiatric disorder (1·45 [1·17-1·79]) and all four specific diagnostic classes of anxiety disorders (1·47 [1·04-2·09]), mood disorders (1·66 [1·08-2·55]), ADHD and hyperactivity disorders (1·47 [1·01-2·13]), and conduct and oppositional disorders (1·76 [1·19-2·61]). Interpersonal trauma and non-interpersonal trauma were each associated with increased odds of multiple psychiatric disorders, even when adjusting for their co-occurrence. INTERPRETATION A considerable mental health burden associated with childhood trauma is already evident by middle childhood in this sample from Brazil. Evidence-based efforts to reduce the incidence of childhood trauma in Brazil and address its consequences are urgently needed. FUNDING Children's Pastorate, WHO, National Support Program for Centres of Excellence, Brazilian National Research Council, Brazilian Ministry of Health, São Paulo Research Foundation, University of Bath, Wellcome Trust. TRANSLATION For the Portuguese translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Andreas Bauer
- Department of Psychology, University of Bath, Bath, UK; Centre for Epidemiological Research, Federal University of Pelotas, Pelotas, Brazil; Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil.
| | | | - Gemma Hammerton
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Joseph Murray
- Centre for Epidemiological Research, Federal University of Pelotas, Pelotas, Brazil; Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil
| | - Ina S Santos
- Centre for Epidemiological Research, Federal University of Pelotas, Pelotas, Brazil
| | | | - Tiago N Munhoz
- Centre for Epidemiological Research, Federal University of Pelotas, Pelotas, Brazil; Faculty of Psychology, Federal University of Pelotas, Pelotas, Brazil
| | - Aluísio J D Barros
- Centre for Epidemiological Research, Federal University of Pelotas, Pelotas, Brazil
| | - Alicia Matijasevich
- Centre for Epidemiological Research, Federal University of Pelotas, Pelotas, Brazil; Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Sarah L Halligan
- Department of Psychology, University of Bath, Bath, UK; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
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87
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Stover CS, Hahn H, Maciejewski KR, Epstein C, Marans S. The child and family traumatic stress intervention: Factors associated with symptom reduction for children receiving treatment. CHILD ABUSE & NEGLECT 2022; 134:105886. [PMID: 36152531 DOI: 10.1016/j.chiabu.2022.105886] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 09/08/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE We examine factors associated with changes in posttraumatic stress symptoms for children following completion of an early and brief, trauma-focused mental health treatment that engages children together with their caregivers, with the child as the identified patient. METHOD The Child and Family Traumatic Stress Intervention (CFTSI), a brief (5-8 session) trauma-focused mental health treatment designed to reduce trauma symptoms in the aftermath of traumatic experiences in children aged 7 years and older. CFTSI has been widely disseminated in Child Advocacy Centers (CAC) and community treatment clinics nationally. We report on results of a naturalistic treatment study of CFTSI implementation without a comparison group that includes 1190 child caregiver dyads from 13 community-based clinical settings. RESULTS Mixed modeling revealed a significant reduction in child reported posttraumatic stress scores from pre to post-CFTSI. Scores on the Child Posttraumatic Checklist (CPSS) declined an average of 8.74 points from pre to post-CFTSI (p < .0001). There were no statistically significant differences in CPSS score changes based on age, gender, ethnicity, race, number of prior trauma types the child had experienced, caregiver posttraumatic stress symptoms, child relationship to the perpetrator, nature of event or length of time to begin treatment. CONCLUSION This study provides further evidence that CFTSI can reduce child posttraumatic stress symptoms when implemented by community-based providers.
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Affiliation(s)
- Carla Smith Stover
- Yale School of Medicine Child Study Center, 230 South Frontage Road, New Haven, CT 06520, United States of America.
| | - Hilary Hahn
- Yale School of Medicine Child Study Center, 230 South Frontage Road, New Haven, CT 06520, United States of America; Yale School of Public Health, 350 George Street, New Haven, CT 06520, United States of America
| | - Kaitlin R Maciejewski
- Yale Center for Analytical Science, 300 George Street, New Haven, CT 06520, United States of America
| | - Carrie Epstein
- Yale School of Medicine Child Study Center, 230 South Frontage Road, New Haven, CT 06520, United States of America
| | - Steven Marans
- Yale School of Medicine Child Study Center, 230 South Frontage Road, New Haven, CT 06520, United States of America
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88
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Sprang G, Garcia A. An Investigation of Secondary Traumatic Stress and Trauma-informed Care Utilization in School Personnel. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:1095-1103. [PMID: 36439655 PMCID: PMC9684366 DOI: 10.1007/s40653-022-00465-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/07/2022] [Indexed: 06/16/2023]
Abstract
Trauma-informed practices in schools are designed to address the impacts of trauma on students and increase supports for school personnel who are delivering this care The impact of a trauma-informed school-based intervention. Journal of Adolescence, 43, 142-147, Mendelsonet al., 2015. Research has established that professionals trained to implement the approach may have secondary traumatic stress (STS) reactions that could interfere with successful implementation (Stevens al., 2020). In this study it was hypothesized that increased use of trauma-informed care strategies would be associated with decreases in total STS scores, as well as all STS subscale scores at the end of a system's transformation initiative, controlling for sex, age, education, years worked in schools, and exposure to student trauma awareness at baseline. The Trauma Sensitive Schools Checklist (TSSC) and the Secondary Traumatic Stress Scale (STSS) were used to measure study outcomes in a sample of 205 school personnel at baseline and follow up. Statistically significant improvement in STSS scores and TSSC score were noted from Time 1 to Time 2. As hypothesized, improvements in TSSC scores were associated with decreased levels of STS over time, controlling for the covariates. However, the symptom domains of intrusion and arousal impacted this relationship in a differential manner than avoidance and alterations in cognitions and mood. This study provides evidence that increased use of trauma-informed care practices can positively impact the STS levels of school personnel, though special attention should be paid to those with high levels of intrusion or arousal.
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Affiliation(s)
- Ginny Sprang
- College of Medicine/Department of Psychiatry, University of Kentucky, Lexington, KY USA
- Center On Trauma and Children, 3470 Blazer Parkway Suite 100, Lexington, KY 40515 USA
| | - Antonio Garcia
- University of Kentucky College of Social Work, 655 Patterson Office Tower, Lexington, KY 40506 USA
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89
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Copeland WE, Shanahan L, McGinnis EW, Aberg KA, van den Oord EJ. Early adversities accelerate epigenetic aging into adulthood: a 10-year, within-subject analysis. J Child Psychol Psychiatry 2022; 63:1308-1315. [PMID: 35137412 PMCID: PMC9842095 DOI: 10.1111/jcpp.13575] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/14/2021] [Indexed: 01/19/2023]
Abstract
BACKGROUND Longitudinal studies are needed to clarify whether early adversities are associated with advanced methylation age or if they actually accelerate methylation aging. This study test whether different dimensions of childhood adversity accelerate biological aging from childhood to adulthood, and, if so, via which mechanisms. METHODS 381 participants provided one blood sample in childhood (average age 15.0; SD = 2.3) and another in young adulthood (average age 23.1; SD = 2.8). Participants and their parents provided a median of 6 childhood assessments (total = 1,950 childhood observations), reporting exposures to different types of adversity dimensions (i.e. threat, material deprivation, loss, unpredictability). The blood samples were assayed to estimate DNA methylation age in both childhood and adulthood and also change in methylation age across this period. RESULTS Cross-sectional associations between the childhood adversity dimensions and childhood measures of methylation age were non-significant. In contrast, multiple adversity dimensions were associated with accelerated within-person change in methylation age from adolescence to young adulthood. These associations attenuated in model testing all dimensions at the same time. Accelerated aging increased with increasing number of childhood adversities: Individuals with highest number of adversities experienced 2+ additional years of methylation aging compared to those with no exposure to childhood adversities. The association between total childhood adversity exposure and accelerated aging was partially explained by childhood depressive symptoms, but not anxiety or behavioral symptoms. CONCLUSIONS Early adversities accelerate epigenetic aging long after they occur, in proportion to the total number of such experiences, and in a manner consistent with a shared effect that crosses multiple early dimensions of risk.
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Affiliation(s)
| | - Lilly Shanahan
- Jacobs Center for Productive Youth Development & Department of Psychology, University of Zurich
| | | | - Karolina A. Aberg
- Center for Biomarker Research and Precision Medicine, Virginia Commonwealth University
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90
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Sinko L, Beck D, Seng J. Developing the TIC Grade: A Youth Self-Report Measure of Perceptions of Trauma-Informed Care. J Am Psychiatr Nurses Assoc 2022; 28:455-463. [PMID: 33167772 DOI: 10.1177/1078390320970652] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Service delivery organizations are advancing the provision of trauma-informed care (TIC) for youth to improve outcomes. However, currently there are no validated, reliable evaluation measures to capture the voices of adolescent clients and how well they perceive TIC implementation. AIMS The purpose of this project was to create an evaluation measure with strong content validity for adolescent health and service users to give feedback to organizations about their implementation of TIC. This article outlines Step 1 of our instrument development, by discussing our process creating the measure and affirming content validity. Psychometric testing of this measure (Step 2) is described in a companion paper. METHODS We combined deductive theory substruction with an inductive participatory process to create, revise, and finalize the measure. The National Center for Trauma-Informed Care's framework of four practices and six principles was substructed into an 18-item draft measure. A four-member community youth advisory board (CYAB) then worked to inductively modify our draft to provide age-appropriate clarity and ensure a nontriggering respondent experience. Finally, the CYAB members conducted cognitive interviews with 10 other adolescents in local evening data collection events, refining the measure for future psychometric testing. RESULTS The process resulted in a 20-item form based on CYAB feedback. Refinements included providing an accessible definition of trauma, asking questions about trauma history, and asking whether trauma affected the client's visit on the day of service use. CONCLUSIONS The CYAB involvement enhanced content validity and ensured a trauma-informed instrument development approach.
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Affiliation(s)
- Laura Sinko
- Laura Sinko, PhD, RN, Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA, USA
| | - Dana Beck
- Dana Beck, BA, BSN, RN, FNP-BC, University of Michigan School of Nursing, Ann Arbor, MI, USA
| | - Julia Seng
- Julia Seng, PhD, CNM, FAAN, University of Michigan School of Nursing, Ann Arbor, MI, USA
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91
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Boodoo R, Lagman JG, Jairath B, Baweja R. A Review of ADHD and Childhood Trauma: Treatment Challenges and Clinical Guidance. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2022. [DOI: 10.1007/s40474-022-00256-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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92
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Wa Mwenda Jonas KA, Kisungu Basile K, Jean Baptiste KN, Alyousef HA, Meng H. Associations between posttraumatic stress symptoms and abuse experiences in child and adolescent girls from a Central African country. J Trauma Stress 2022; 35:1432-1444. [PMID: 35642389 DOI: 10.1002/jts.22843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 03/18/2022] [Accepted: 03/19/2022] [Indexed: 11/11/2022]
Abstract
Posttraumatic stress disorder (PTSD) is frequently reported among survivors of abuse. However, there is a paucity of research examining the association between PTSD and abuse, including polyvictimization, in nonconflict areas of the Democratic Republic of Congo (DRC). We aimed to investigate the prevalence and correlates of PTSD among girls in nonconflict zones who experienced at least one type of abuse. Participants in this cross-sectional study were 3,011 middle-school girls, aged 11-18 years, who attended randomly selected schools and completed questionnaires. The probable PTSD prevalence was 67.5%. The rate of probable PTSD increased with the number of experienced abuse types over a 12-month period. The findings demonstrated associations between probable PTSD and exposure to five (86.9%), four (63.9%), and three types of abuse (60.1%). The strongest association was observed between probable PTSD and experiencing five types of abuse, OR = 26.806, 95% CI [19.303, 37.225]; associations were also found between PTSD and abuse with a weapon, OR = 4.341, 95% CI [3.519, 5.354]; rape with penetration, OR = 4.728, 95% CI [3.447, 6.484]; and experiencing three, OR = 6.625, 95% CI [4.325, 10.148], or four types of abuse, OR = 7.114, 95% CI [5.025,10.070]. The findings of this study underscore the importance of the need for psychological and physical health care for girls who have been exposed to abuse, regardless of the number of abuse experiences or abuse types she has experienced.
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Affiliation(s)
| | - Kalema Kisungu Basile
- Department of School and Professional Orientation, National Pedagogical University, Kinshasa, Congo
| | | | - Hala Ayaman Alyousef
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Heng Meng
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
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93
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Lowe SR, James P, Arcaya MC, Vale MD, Rhodes JE, Rich-Edwards J, Roberts AL, Koenen KC. Do levels of posttraumatic growth vary by type of traumatic event experienced? An analysis of the Nurses' Health Study II. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2022; 14:1221-1229. [PMID: 32212776 PMCID: PMC7529660 DOI: 10.1037/tra0000554] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Posttraumatic growth (PTG) has been documented in the aftermath of a range of traumatic events, including bereavement, physical assault, and rape. However, only a handful of studies have examined whether levels of total PTG, as well as the 5 domains of PTG (Appreciation of Life, New Possibilities, Relating to Others, Personal Strength, and Spiritual Change), vary by the type of potentially traumatic event. The current study examined variation in total PTG and PTG domains, as well as posttraumatic stress (PTS), by event type using data from a large epidemiological study. METHOD Participants were from a substudy of the Nurses' Health Study 2, an epidemiologic study of female nurses in the United States (N = 1,574). RESULTS Controlling for demographic covariates, we found that rape was consistently associated with lower PTG, both total PTG and all five PTG domains, relative to other event types. Other findings were limited to specific PTG domains; for example, intimate partner violence (IPV) was associated with higher Personal Strength and New Possibilities. In contrast, rape and IPV were associated with higher PTS, and the serious illness or injury of someone close with lower PTS, relative to other event types. CONCLUSION These results add to the growing literature exploring variation in PTG by event type and suggest that different events could yield markedly different patterns of PTG domains and PTS. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Sarah R. Lowe
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT
| | - Peter James
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA
| | - Mariana C. Arcaya
- Department of Urban Studies and Planning, Massachusetts Institute of Technology, Boston, MA
| | - Mira D. Vale
- Department of Sociology, University of Michigan, Ann Arbor, MI
| | - Jean E. Rhodes
- Department of Psychology, University of Massachusetts Boston, Boston, MA
| | - Janet Rich-Edwards
- Division of Women’s Health, Department of Medicine, Brigham and Women’s Hospital, Boston, MA
- Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital, Boston, MA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Andrea L. Roberts
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA
| | - Karestan C. Koenen
- Department of Social Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA
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94
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Tang Y, Ma Y, Zhang J, Wang H. The relationship between negative life events and quality of life in adolescents: Mediated by resilience and social support. Front Public Health 2022; 10:980104. [PMID: 36211680 PMCID: PMC9538389 DOI: 10.3389/fpubh.2022.980104] [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: 06/28/2022] [Accepted: 09/05/2022] [Indexed: 01/25/2023] Open
Abstract
Background Quality of life has become an important indicator for assessing the health care of adolescents. This study aimed to explore the relationship between negative life events and quality of life in adolescents and the potential mediating roles of resilience and social support. Methods A stratified cluster sampling technique was used to select 3,860 adolescents as study participants. The Adolescent Self-Rating Life Events Checklist, the Resilience Scale for Chinese Adolescents, the Social Support Rating Scale, and the Adolescent Quality of Life Scale were used by participants to rate their negative life events, resilience, social support, quality of life, respectively. The correlations between study variables were analyzed by the Pearson correlation analyses. The AMOS 26.0 software was used to explore the mediating roles of resilience and social support in negative life events and quality of life. Results There was a negative correlation between negative life events and quality of life (β=-0.745, P < 0.05); resilience and social support played an important mediating role in the relationship between negative life events and quality of life (βResilience = -0.287, P < 0.05; βSocial support = -0.124, P < 0.05). The emotional adjustment dimension of resilience (β = -0.285, P < 0.05) and the subjective support dimension of social support (β = -0.100, P < 0.05) played the largest mediating roles, respectively. Conclusion Negative life events were negatively correlated with adolescents' quality of life. Strengthening resilience and social support is expected to weaken and reduce the adverse effects of negative life events on adolescents and further maintain and improve their quality of life.
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Affiliation(s)
- Yinshuang Tang
- Department of Maternal and Child Health and Adolescent Health, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Yingjie Ma
- Department of Epidemiology and Health Statistics, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Jinglin Zhang
- Department of Maternal and Child Health and Adolescent Health, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Hong Wang
- Department of Maternal and Child Health and Adolescent Health, School of Public Health, Chongqing Medical University, Chongqing, China
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The Lasting Effects of Early Adversity and Updating Ability on the Tendency to Develop PTSD Symptoms Following Exposure to Trauma in Adulthood. COGNITIVE THERAPY AND RESEARCH 2022. [DOI: 10.1007/s10608-022-10328-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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96
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Spiegel JA, Graziano PA, Arcia E, Cox SK, Ayala M, Carnero NA, O’Mara NL. Addressing Mental Health and Trauma-Related Needs of Sheltered Children and Families with Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT). ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2022; 49:881-898. [PMID: 35867261 PMCID: PMC9393136 DOI: 10.1007/s10488-022-01207-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2022] [Indexed: 10/26/2022]
Abstract
Children and adolescents ("youth") experiencing homelessness are at a disproportionately high risk of exposure to potentially traumatic events (PTE). However, limited evidence exists as to what interventions are effective when implemented with this high-risk population. The purpose of this study was to (1) document the mental health and trauma-related needs of sheltered youth and their mothers, and (2) examine the feasibility/effectiveness of Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) administered within the context of a homeless shelter. Three hundred and twenty-one youth (Mage = 10.06 years, SD = 3.24 years, 56.4% male, 70.1% Black/African American, 34.6% Hispanic/Latinx) and their mothers were recruited from a homeless shelter and provided 10 weeks of TF-CBT, with the option for up to eight additional weeks of therapy based on clinical need. Families completed pre- and post-intervention assessments. Results demonstrated clinically elevated pre-intervention PTSD symptoms and rates of exposure to PTE in sheltered youth well above those previously reported in the general population. TF-CBT resulted in substantial reductions in both maternal and self-reported severity of youth PTSD symptomology, which were largely attributable to reductions in re-experiencing and arousal. Effectiveness of TF-CBT varied by age and the number of exposures to PTE. Overall, these findings illustrate the importance of assessing and addressing the mental health and trauma-related needs of sheltered youth and the feasibility and efficacy of embedding an evidence-based trauma-focused treatment protocol within a shelter environment. Additional implications of these findings are discussed.
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Affiliation(s)
- Jamie A. Spiegel
- Florida International University - Center for Children and Families and Department of Psychology, 11200 SW 8th Street, Miami, FL 33199 USA
| | - Paulo A. Graziano
- Florida International University - Center for Children and Families and Department of Psychology, 11200 SW 8th Street, Miami, FL 33199 USA
| | | | - Shana K. Cox
- Sundari Foundation, Inc. dba Lotus House Women’s Shelter (Lotus House), 217 NW 15th Street, Miami, FL 33136 USA
| | - Muriel Ayala
- Sundari Foundation, Inc. dba Lotus House Women’s Shelter (Lotus House), 217 NW 15th Street, Miami, FL 33136 USA
| | - Nicole A. Carnero
- Sundari Foundation, Inc. dba Lotus House Women’s Shelter (Lotus House), 217 NW 15th Street, Miami, FL 33136 USA
| | - Noelle L. O’Mara
- Sundari Foundation, Inc. dba Lotus House Women’s Shelter (Lotus House), 217 NW 15th Street, Miami, FL 33136 USA
| | - Sundari Foundation
- Sundari Foundation, Inc. dba Lotus House Women’s Shelter (Lotus House), 217 NW 15th Street, Miami, FL 33136 USA
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Avery J, Morris H, Jones A, Skouteris H, Deppeler J. Australian Educators' Perceptions and Attitudes Towards a Trauma-Responsive School-Wide Approach. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:771-785. [PMID: 35958717 PMCID: PMC9360270 DOI: 10.1007/s40653-021-00394-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/29/2021] [Indexed: 06/15/2023]
Abstract
Staff perceptions and attitudes regarding the introduction of the Reframing Learning and Teaching Environments (ReLATE) trauma-responsive school-wide approach were investigated in three Catholic primary schools in Victoria, Australia. School leaders, teachers, and support staff were interviewed regarding their experiences of the approach either individually or in focus groups. Educator attitudes towards trauma-responsive education was evaluated using the ARTIC-ED Scale, prior to and after participating in the six-month intervention. Qualitative data were interpreted using ecological analysis of the themes arising guided by the trauma informed principles and frameworks of the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Trauma Learning Policy Initiative (TLPI). Findings indicated significant shifts towards trauma-responsive practice following the introduction of ReLATE. Strong themes emerged relating to the influence of improved trauma knowledge on perceptions of student behavior, consequent reported adaptations to behavior management practices, strengthened sense of trust and respect in the school climate, the centrality of leadership to effect change, and importance of school-fit to program uptake. Strengths and limitations of ReLATE are considered, along with implications for teacher professional learning, the role of leadership in effecting change and significance of perceived school-fit and collaboration. Supplementary Information The online version contains supplementary material available at 10.1007/s40653-021-00394-6.
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Affiliation(s)
- Julie Avery
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic Australia
| | - Heather Morris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic Australia
| | | | - Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic Australia
- School of Business, Warwick University, Coventry, UK
| | - Joanne Deppeler
- School of Education, Monash University, Melbourne, Vic Australia
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98
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Ramos C, Cabral E, Serrão V, Figueira P, Santos PV, Baptista J. Psychometric Properties of the Parent-Report Version of the UCLA PTSD Reaction Index for DSM-5. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:627-637. [PMID: 35958709 PMCID: PMC9360296 DOI: 10.1007/s40653-021-00406-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/13/2021] [Indexed: 06/15/2023]
Abstract
The UCLA PTSD Reaction Index for DSM-5 (RI-5) is a developmentally appropriate and well recognized screening tool for the assessment of Post-Traumatic Stress Disorder (PTSD) in children and adolescents. The children/adolescent self-report version of the RI-5 has been thoroughly studied in very recent years, showing adequate psychometric properties. Despite such results, the utility of the parent/caregiver-report version, which also integrates the RI-5 system, remains to be explored. As such, the present study aimed to test the general psychometric properties of the parent/caregiver-report version of RI-5, based on a sample of 457 children and adolescents, aged between 7 and 17 years, exposed to at least one potentially traumatic experience, and their respective primary caregivers. The RI-5 total score and categories revealed good internal consistency reliability. The total number of traumas reported emerged as a significant predictor of the RI-5 total score. The RI-5 total score proved to be significantly correlated with more internalizing and externalizing problems, but correlation coefficients were below .70, serving as an indicator of discriminant validity. The four-factor structure of the RI-5 was supported through confirmatory factor analysis. In conclusion, the present study provided preliminary evidence supporting the utility of the parent/caregiver-report version of the RI-5 for research purposes and for clinical assessment and treatment, anchored on a multiple informant perspective of child psychopathology.
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Affiliation(s)
- Cláudia Ramos
- Centro de Investigação e de Intervenção Social (CIS-IUL), Instituto Universitário de Lisboa (Iscte-IUL), Lisbon, Portugal
| | - Eva Cabral
- Centro de Investigação e de Intervenção Social (CIS-IUL), Instituto Universitário de Lisboa (Iscte-IUL), Lisbon, Portugal
| | - Vítor Serrão
- Centro de Investigação e de Intervenção Social (CIS-IUL), Instituto Universitário de Lisboa (Iscte-IUL), Lisbon, Portugal
| | | | | | - Joana Baptista
- Centro de Investigação e de Intervenção Social (CIS-IUL), Instituto Universitário de Lisboa (Iscte-IUL), Lisbon, Portugal
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99
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Shenk CE, O'Donnell KJ, Pokhvisneva I, Kobor MS, Meaney MJ, Bensman HE, Allen EK, Olson AE. Epigenetic Age Acceleration and Risk for Posttraumatic Stress Disorder following Exposure to Substantiated Child Maltreatment. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2022; 51:651-661. [PMID: 33471576 PMCID: PMC8289945 DOI: 10.1080/15374416.2020.1864738] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Child maltreatment is among the strongest predictors of posttraumatic stress disorder (PTSD). However, less than 40% of children who have been maltreated are ever diagnosed with PTSD, suggesting that exposure to child maltreatment alone is insufficient to explain this risk. This study examined whether epigenetic age acceleration, a stress-sensitive biomarker derived from DNA methylation, explains variation in PTSD diagnostic status subsequent to child maltreatment. METHOD Children and adolescents (N = 70; 65.7% female), 8-15 years of age (M = 12.00, SD = 2.37) and exposed to substantiated child maltreatment within the 12 months prior to study entry, were enrolled. Participants provided epithelial cheek cells via buccal swab for genotyping and quantification of epigenetic age acceleration within a case-control design. PTSD diagnostic status was determined using the Child PTSD Symptoms Scale according to the DSM-IV-TR algorithm. RESULTS Epigenetic age acceleration predicted current PTSD status, revealing an effect size magnitude in the moderate range, OR = 2.35, 95% CI: 1.22- 4.51, after adjusting for sample demographics, polygenic risk for PTSD, and lifetime exposure to other childhood adversities. Supplemental analyses demonstrated that epigenetic age acceleration was related to a greater severity of PTSD arousal symptoms (r =.29, p =.015). There were no differential effects for child maltreatment subtype on epigenetic age acceleration or PTSD status. CONCLUSIONS The biological embedding of child maltreatment may explain variation in PTSD diagnostic status and serve as a novel approach for informing selective prevention or precision-based therapeutics for those at risk for PTSD.
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Affiliation(s)
- Chad E Shenk
- Department of Human Development and Family Studies, The Pennsylvania State University
- Department of Pediatrics, The Pennsylvania State University College of Medicine
| | - Kieran J O'Donnell
- The Douglas Hospital Research Centre, Department of Psychiatry, McGill University
- Child and Brain Developmental Program, Canadian Institute for Advanced Research
| | - Irina Pokhvisneva
- The Douglas Hospital Research Centre, Department of Psychiatry, McGill University
| | - Michael S Kobor
- Child and Brain Developmental Program, Canadian Institute for Advanced Research
- Centre for Molecular Medicine and Therapeutics, Department of Medical Genetics, University of British Columbia
| | - Michael J Meaney
- The Douglas Hospital Research Centre, Department of Psychiatry, McGill University
- Child and Brain Developmental Program, Canadian Institute for Advanced Research
- Agency for Science, Technology and Research, Singapore Institute of Clinical Sciences
| | - Heather E Bensman
- Department of Pediatrics, The University of Cincinnati College of Medicine
| | - Elizabeth K Allen
- Department of Human Development and Family Studies, The Pennsylvania State University
| | - Anneke E Olson
- Department of Human Development and Family Studies, The Pennsylvania State University
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100
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Cultural and Telehealth Considerations for Trauma-Focused Treatment Among Latinx Youth: Case Reports and Clinical Recommendations to Enhance Treatment Engagement. COGNITIVE AND BEHAVIORAL PRACTICE 2022. [DOI: 10.1016/j.cbpra.2022.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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