51
|
Köhler-Forsberg O, Ge F, Hauksdóttir A, Thordardottir EB, Ásbjörnsdóttir K, Rúnarsdóttir H, Tómasson G, Jakobsdóttir J, Guðmundsdóttir B, Björnsson AS, Sigurðsson E, Aspelund T, Valdimarsdottir UA. Adverse childhood experiences and psychological functioning among women with schizophrenia or bipolar disorder: population-based study. Br J Psychiatry 2024; 224:6-12. [PMID: 37850429 PMCID: PMC10751941 DOI: 10.1192/bjp.2023.128] [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: 05/06/2023] [Revised: 07/07/2023] [Accepted: 08/30/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are well-known risk factors for schizophrenia and bipolar disorder. AIMS The aim was to study the associations between specific ACEs and psychological functioning in women with schizophrenia or bipolar disorder. METHOD Among 29 367 women (mean age 44 years) from the Icelandic Stress-And-Gene-Analysis (SAGA) study, 534 (1.8%, mean age 40) reported having been diagnosed with schizophrenia or bipolar disorder, which were combined to 'severe mental disorders'. Participants reported on 13 types of ACEs, childhood deprivation and psychological functioning (defined as coping ability and current symptoms of depression, anxiety and sleep disturbances). Adjusted Poisson regression calculated prevalence ratios (PRs) between ACEs and severe mental disorders. Linear regression assessed the association between ACEs and psychological functioning among women with a severe mental disorder. RESULTS Women with a severe mental disorder reported more ACEs (mean 4.57, s.d. = 2.82) than women without (mean 2.51, s.d. = 2.34) in a dose-dependent manner (fully-adjusted PR = 1.23 per ACE, 95% CI 1.20-1.27). After mutual adjustment for other ACEs, emotional abuse, sexual abuse, mental illness of a household member, emotional neglect, bullying and collective violence were associated with severe mental disorders. Among women with severe mental disorders, a higher number of ACEs was associated with increased symptom burden of depression (β = 2.79, 95% CI = 1.19-4.38) and anxiety (β = 2.04, 95% CI = 0.99-3.09) including poorer sleep quality (β = 0.83, 95% CI = 0.07-1.59). Findings were similar for schizophrenia and bipolar disorder separately. CONCLUSION Women with schizophrenia or bipolar disorder show a strong history of ACEs, which may interfere with their psychological functioning and, therefore, need to be addressed as part of their treatment, for example, with trauma-focused psychotherapy.
Collapse
Affiliation(s)
- Ole Köhler-Forsberg
- Psychosis Research Unit, Aarhus University Hospital – Psychiatry, Denmark; and Department of Clinical Medicine, Aarhus University, Denmark
| | - Fenfen Ge
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Iceland
| | - Arna Hauksdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Iceland
| | - Edda Bjork Thordardottir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Iceland; and Mental Health Services, Landspitali, The National University Hospital of Iceland, Iceland
| | | | - Harpa Rúnarsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Iceland
| | - Gunnar Tómasson
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Iceland
| | - Jóhanna Jakobsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Iceland
| | - Berglind Guðmundsdóttir
- Faculty of Medicine, University of Iceland, Iceland; and Mental Health Services, Landspitali, The National University Hospital of Iceland, Iceland
| | | | | | - Thor Aspelund
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Iceland
| | - Unnur A. Valdimarsdottir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Iceland; Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Sweden; and Harvard T.H. Chan School of Public Health, USA
| |
Collapse
|
52
|
Cuesta MJ, Gil-Berrozpe GJ, Sánchez-Torres AM, Moreno-Izco L, García de Jalón E, Peralta V. 20-Year trajectories of six psychopathological dimensions in patients with first-episode psychosis: Could they be predicted? Psychiatry Res 2024; 331:115614. [PMID: 38039651 DOI: 10.1016/j.psychres.2023.115614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/14/2023] [Accepted: 11/17/2023] [Indexed: 12/03/2023]
Abstract
Patients with first-episode psychoses (FEP) exhibit heterogeneity in clinical manifestations and outcomes. This study investigated the long-term trajectories of six key psychopathological dimensions (reality-distortion, negative, disorganization, catatonia, mania and depression) in patients diagnosed with FEP. A total of 243 patients were followed up for 20 years and the trajectories of the dimensions were analysed using growth mixture modelling. These dimensions showed varied course patterns, ranging from two to five trajectories. Additionally, the study examined the predictive value of different factors in differentiating between the long-term trajectories. The exposome risk score showed that familial load, distal and intermediate risk factors, acute psychosocial stressors and acute onset were significant predictors for differentiating between long-term psychopathological trajectories. In contrast, polygenic risk score, duration of untreated psychosis and duration of untreated illness demonstrated little or no predictive value. The findings highlight the importance of conducting a multidimensional assessment not only at FEP but also during follow-up to customize the effectiveness of interventions. Furthermore, the results emphasize the relevance of assessing premorbid predictors from the onset of illness. This may enable the identification of FEP patients at high-risk of poor long-term outcomes who would benefit from targeted prevention programs on specific psychopathological dimensions.
Collapse
Affiliation(s)
- Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra (Pamplona, Spain); Navarra Institute for Health Research (IdiSNA) (Pamplona, Spain).
| | - Gustavo J Gil-Berrozpe
- Department of Psychiatry, Complejo Hospitalario de Navarra (Pamplona, Spain); Navarra Institute for Health Research (IdiSNA) (Pamplona, Spain)
| | - Ana M Sánchez-Torres
- Navarra Institute for Health Research (IdiSNA) (Pamplona, Spain); Departament of Health Sciences, Universidad Pública de Navarra (UPNA), Pamplona, Spain
| | - Lucía Moreno-Izco
- Department of Psychiatry, Complejo Hospitalario de Navarra (Pamplona, Spain); Navarra Institute for Health Research (IdiSNA) (Pamplona, Spain)
| | - Elena García de Jalón
- Navarra Institute for Health Research (IdiSNA) (Pamplona, Spain); Mental Health Department, Servicio Navarro de Salud - Osasunbidea (Pamplona, Spain)
| | - Victor Peralta
- Navarra Institute for Health Research (IdiSNA) (Pamplona, Spain); Mental Health Department, Servicio Navarro de Salud - Osasunbidea (Pamplona, Spain)
| |
Collapse
|
53
|
Penner-Goeke S, Bothe M, Rek N, Kreitmaier P, Pöhlchen D, Kühnel A, Glaser LV, Kaya E, Krontira AC, Röh S, Czamara D, Ködel M, Monteserin-Garcia J, Diener L, Wölfel B, Sauer S, Rummel C, Riesenberg S, Arloth-Knauer J, Ziller M, Labeur M, Meijsing S, Binder EB. High-throughput screening of glucocorticoid-induced enhancer activity reveals mechanisms of stress-related psychiatric disorders. Proc Natl Acad Sci U S A 2023; 120:e2305773120. [PMID: 38011552 DOI: 10.1073/pnas.2305773120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 09/01/2023] [Indexed: 11/29/2023] Open
Abstract
Exposure to stressful life events increases the risk for psychiatric disorders. Mechanistic insight into the genetic factors moderating the impact of stress can increase our understanding of disease processes. Here, we test 3,662 single nucleotide polymorphisms (SNPs) from preselected expression quantitative trait loci in massively parallel reporter assays to identify genetic variants that modulate the activity of regulatory elements sensitive to glucocorticoids, important mediators of the stress response. Of the tested SNP sequences, 547 were located in glucocorticoid-responsive regulatory elements of which 233 showed allele-dependent activity. Transcripts regulated by these functional variants were enriched for those differentially expressed in psychiatric disorders in the postmortem brain. Phenome-wide Mendelian randomization analysis in 4,439 phenotypes revealed potentially causal associations specifically in neurobehavioral traits, including major depression and other psychiatric disorders. Finally, a functional gene score derived from these variants was significantly associated with differences in the physiological stress response, suggesting that these variants may alter disease risk by moderating the individual set point of the stress response.
Collapse
Affiliation(s)
- Signe Penner-Goeke
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich 80804, Germany
- Graduate School of Systemic Neurosciences, Ludwig Maximilian University of Munich, Planegg 82152, Germany
| | - Melissa Bothe
- Department of Computational Molecular Biology, Max Planck Institute of Molecular Genetics, Berlin 14195, Germany
| | - Nils Rek
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich 80804, Germany
- International Max Planck Research School for Translational Psychiatry, Max Planck Institute of Psychiatry, Munich 80804, Germany
| | - Peter Kreitmaier
- Institute of Translational Genomics, Helmholtz Munich, Neuherberg 85764, Germany
| | - Dorothee Pöhlchen
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich 80804, Germany
- International Max Planck Research School for Translational Psychiatry, Max Planck Institute of Psychiatry, Munich 80804, Germany
| | - Anne Kühnel
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich 80804, Germany
- International Max Planck Research School for Translational Psychiatry, Max Planck Institute of Psychiatry, Munich 80804, Germany
| | - Laura V Glaser
- Department of Computational Molecular Biology, Max Planck Institute of Molecular Genetics, Berlin 14195, Germany
| | - Ezgi Kaya
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich 80804, Germany
- Graduate School of Systemic Neurosciences, Ludwig Maximilian University of Munich, Planegg 82152, Germany
| | - Anthi C Krontira
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich 80804, Germany
- International Max Planck Research School for Translational Psychiatry, Max Planck Institute of Psychiatry, Munich 80804, Germany
| | - Simone Röh
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich 80804, Germany
| | - Darina Czamara
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich 80804, Germany
| | - Maik Ködel
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich 80804, Germany
| | - Jose Monteserin-Garcia
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich 80804, Germany
| | - Laura Diener
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich 80804, Germany
| | - Barbara Wölfel
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich 80804, Germany
| | - Susann Sauer
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich 80804, Germany
| | - Christine Rummel
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich 80804, Germany
| | - Stephan Riesenberg
- Department of Evolutionary Genetics, Max-Planck-Institute for Evolutionary Anthropology, Leipzig 04103, Germany
| | - Janine Arloth-Knauer
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich 80804, Germany
| | - Michael Ziller
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich 80804, Germany
- Department of Psychiatry, University of Muenster, Muenster 48149, Germany
| | - Marta Labeur
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich 80804, Germany
| | - Sebastiaan Meijsing
- Department of Computational Molecular Biology, Max Planck Institute of Molecular Genetics, Berlin 14195, Germany
| | - Elisabeth B Binder
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich 80804, Germany
| |
Collapse
|
54
|
Tomás JM, Georgieva S, Navarro-Pérez JJ, Sancho P. Structural Validity and Internal Consistency of the Adolescents and Children Risk of Abuse and Maltreatment Parental Scale (ACRAM-PS). JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:11818-11841. [PMID: 37537893 DOI: 10.1177/08862605231189509] [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: 08/05/2023]
Abstract
There is a clear need for developing a comprehensive, unbiased, and psychometrically sound tool to assess child maltreatment. The aim of this study is to examine the structural validity, internal consistency, and convergent validity of a newly developed child maltreatment assessment instrument. A total of 286 professionals of the child protection system participated in the study, completing a total of 645 cases of children and adolescents. The Adolescents and Children Risk of Abuse and Maltreatment Parental Scale (ACRAM-PS), the Childhood Trauma Questionnaire Short Form (CTQ-SF) and other demographic variables were measured. Structural validity, internal consistency, and convergent validity of the ACRAM-PS were tested. This scale obtained good structural validity, internal consistency, and convergent validity as hypothesized patterns of correlations occurred as expected. This instrument implies a considerable improvement as it is comprehensive, psychometrically sound and, it has been articulated by its own users. It can significantly contribute to establish a common language among professionals, improve multidisciplinary communication, and optimize prevention, detection, and early intervention in child maltreatment.
Collapse
|
55
|
Ulvøy DE, Åvik Persson H, Kristensson Hallström I, Sollesnes R. Parents' experiences of their child's participation in divorce groups in Norway: A phenomenological study. Scand J Caring Sci 2023; 37:991-1000. [PMID: 37050849 DOI: 10.1111/scs.13173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 03/15/2023] [Accepted: 04/01/2023] [Indexed: 04/14/2023]
Abstract
BACKGROUND Children and youth who experience divorce are found to have increased risk of emotional and behavioural adjustment problems. Different prevention programmes have been developed to help and support children. Previous studies have focused on the child or the group leader's experience with divorce groups, but studies describing parent's experience are missing. The aim of this study was to explore parents' experiences of their child's participation in divorce groups. METHODS An inductive, qualitative and descriptive design was applied with philosophical orientation in naturalistic inquiry based on the outlines of a phenomenological perspective. Two fathers and three mothers from two different counties in Norway participated whereof four of them were interviewed twice. Systematic text condensation was used for the analysis. RESULTS Three themes emerged from the analysis: encouraging the child, missing communication and challenging situations. Parents described how they encouraged the child to attend divorce groups and hoped they would gain a deeper understanding of their parents' divorce and their own feelings. Missing communication relates to lack of information about the groups from the school, the group leader and from the child. Missing information was found to be a challenge for the parents and made them think that the divorce group was beneficial for the child but maybe not always for the family. Parents described challenging situations due to the divorce, and they struggled to understand their child and their own behaviour. CONCLUSIONS The opportunity for the child to talk to other children in the same situation in divorce groups was positive for the parents. To be beneficial for both children and their parents, structured information and cooperation among the school, the child and both parents are important. The knowledge from this study can support the development and use of intervention programmes in the future.
Collapse
Affiliation(s)
- Dagny-Elise Ulvøy
- Department of Health and Caring Science, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Helene Åvik Persson
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | | | - Ragnhild Sollesnes
- Department of Health and Caring Science, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| |
Collapse
|
56
|
Zhang Y, Liu J, Chen L, Yang T, Luo X, Cui X, Wu S, He Y, Lu J. Prevalence of co-occurring severe depression and psychotic symptoms in college students and its relationship with childhood maltreatment. CHILD ABUSE & NEGLECT 2023; 146:106470. [PMID: 37748208 DOI: 10.1016/j.chiabu.2023.106470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 07/17/2023] [Accepted: 09/13/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND It has been demonstrated that childhood maltreatment (CM) is associated with an increased risk of depression and psychotic symptoms. However, there is still a lack of studies on the prevalence of co-occurring severe depression and psychotic symptoms (CSDPS) and the association between CM and CSDPS among college students. OBJECTIVE We aim to investigate the prevalence and demographic distribution of CSDPS among Chinese college students and to examine its relationship with CM. PARTICIPANTS AND SETTING A total of 7351 college students aged 18 and above completed the survey. Finally, 6854 valid questionnaires were included for further analysis. METHODS The Childhood Trauma Questionnaire and the item for witnessing domestic violence were used to assess the CM. The Prodromal Questionnaire-16 and the depression subscale of the Depression Anxiety and Stress-21 scale were used to assess psychotic symptoms and depressive symptoms. RESULTS The prevalence of CSDPS was 1.47 % among the college students. The multivariate logistic regression analysis showed that emotional abuse and emotional neglect were associated with an increased risk of CSDPS (all p < 0.05). The risk of CSDPS was dramatically increased for individuals who had experienced ≥3 types of CM (OR = 22.929, p < 0.001), as compared to those who had experienced 1-2 types of CM (OR = 4.452, p < 0.001) and those without the experience of CM. CONCLUSION CM was found to be associated with an increased risk of CSDPS among the college students. Notably, experiencing more types of CM was also associated with a higher risk of CSDPS.
Collapse
Affiliation(s)
- Yaru Zhang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Jianbo Liu
- Department of Child Psychiatry of Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen 518003, China
| | - Lin Chen
- The First Clinical College, Changsha Medical University, Changsha, Hunan, China
| | - Tingyu Yang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Xuerong Luo
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Xilong Cui
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Shuxian Wu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Yuqiong He
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
| | - Jianping Lu
- Department of Child Psychiatry of Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen 518003, China.
| |
Collapse
|
57
|
Bränn E, Vaina A, Daníelsdóttir HB, Thordardottir EB, Yang Q, Jakobsdóttir J, Aspelund T, Hauksdóttir A, Valdimarsdóttir UA, Lu D. Association between adverse childhood experiences and perinatal depressive symptoms: a cross-sectional analysis of 16,831 women in Iceland. Arch Womens Ment Health 2023; 26:839-849. [PMID: 37726573 PMCID: PMC10632282 DOI: 10.1007/s00737-023-01369-2] [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: 05/12/2023] [Accepted: 09/05/2023] [Indexed: 09/21/2023]
Abstract
Emerging data suggest that certain adverse childhood experiences (ACEs) are associated with perinatal depression (PND). However, few studies have comprehensively assessed the cumulative number and types of ACEs and their association to PND. We conducted a cross-sectional analysis among 16,831 female participants from the Stress-And-Gene-Analysis (SAGA) cohort in Iceland, 2018. ACEs were surveyed with the World Health Organization ACE-International questionnaire, while PND symptoms were assessed using the Edinburgh Postnatal Depression Scale (lifetime version). We, while adjusting for confounding factors, estimated the prevalence ratio (PR) of PND in relation to total number of ACEs using the Poisson quasi-likelihood model and further performed analyses for type-specific ACEs. At a mean age of 44 years (SD ± 11.1), 6,201 (36.8%) participants had experienced probable PND. Total number of ACEs was positively associated with PND (PR 1.11 per ACE, 95% CI: 1.10-1.11), also among women without any psychiatric comorbidities (PR 1.13, 95% CI: 1.11-1.14). PRs increased in a dose-response manner with the number of ACEs (P for trend < 0.001); women that endorsed 5 or more ACEs were twice as likely to have experienced PND (PR 2.24, 95% CI: 2.09-2.41). All ACE types (n = 13) were associated with PND, with most pronounced association for emotional neglect by a guardian (PR 1.53, 95% CI: 1.47-1.59). Our findings suggest a positive association between number of ACEs and PND symptoms. If our results are confirmed with prospective data, healthcare providers need to be alert of the risk of PND among expecting mothers with history of ACEs.
Collapse
Affiliation(s)
- Emma Bränn
- Institute of Environmental Medicine, Unit of Integrative Epidemiology, Karolinska Institutet, Stockholm, Sweden.
| | - Alexandra Vaina
- Institute of Environmental Medicine, Unit of Integrative Epidemiology, Karolinska Institutet, Stockholm, Sweden
| | | | - Edda Bjork Thordardottir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
- Mental Health Services, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
| | - Qian Yang
- Department of Medicine, Unit of Clinical Epidemiology, Karolinska Institutet, Stockholm, Sweden
| | - Jóhanna Jakobsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Thor Aspelund
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Arna Hauksdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Unnur A Valdimarsdóttir
- Institute of Environmental Medicine, Unit of Integrative Epidemiology, Karolinska Institutet, Stockholm, Sweden
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Donghao Lu
- Institute of Environmental Medicine, Unit of Integrative Epidemiology, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
58
|
Tumlin KI, Crowley A, Turner B, Riley E, Lyons J. Detection of traumatic stress in the presence of traumatic experiences: the role of resilience factors in foster care children five years or younger. Int J Ment Health Syst 2023; 17:39. [PMID: 37964314 PMCID: PMC10648362 DOI: 10.1186/s13033-023-00610-w] [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: 12/17/2022] [Accepted: 10/27/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Children less than five years of age comprised approximately 30% in 2020 of foster care entries in the United States, and they are consistently the largest foster care entry group. Very young children can respond differently to the same adverse life events. Detection of complex interpersonal traumas is core to providing appropriate interventions and prevention of reoccurring negative outcomes in these children. METHODS Children who (1) were identified as having experienced complex interpersonal trauma, but (2) who did not have traumatic stress symptoms were identified using Child and Adolescent Needs and Strengths data in a large midwestern state from 2010 to 2021. A logistic model was fit to determine the effect of cumulative traumatic exposures (e.g., adverse childhood experiences such that increased events were hypothesized to predict an increased likelihood of symptomatic detection. We conducted a latent class analysis to understand the relationship between traumatic experiences, asset-based factors, and the detection of traumatic stress in children aged five years and under who had exposure to traumatic events but did not have detectable traumatic stress symptoms. RESULTS We detected three classes within this population of very young children, who were described as "resilient" (demonstrating asset-based resilience when faced with traumatic experiences), "missed" (those who exhibit behavioral and mental health types like those with detected traumatic stress symptoms but who were not detected as such), and "unfolding". Very young children do demonstrate asset-based resilience when faced with traumatic experiences. CONCLUSIONS Detection of traumatic stress may be more difficult in young children. It is important to assess both traumatic stress and strengths to ensure that children who are resilient after exposure to traumatic experiences (i.e., do not demonstrate traumatic stress symptoms) are not referred to unnecessary interventions. Additional educational approaches are needed to help caseworkers identify symptoms of traumatic stress that mirror symptoms of other behavioral and emotional challenges. Precision medicine approaches are required to best match the interventions to specific needs of young children. Recognition of resilience in very young children is critical for designing systems that customize approaches of trauma-informed care.
Collapse
Affiliation(s)
- Kimberly I Tumlin
- Center for Innovation in Population Health, College of Public Health, Department of Athletic Training and Clinical Nutrition, College of Health Sciences, University of Kentucky, 720 Sports Center Drive, Lexington, KY, 40536, USA.
| | - Amanda Crowley
- College of Public Health, University of Kentucky, Lexington, KY, 40536, USA
| | | | - Elizabeth Riley
- Center for Innovation in Population Health, Department of Health Management & Policy, University of Kentucky, Lexington, KY, 40536, USA
| | - John Lyons
- Center for Innovation in Population Health, Department of Health Management & Policy, University of Kentucky, Lexington, KY, 40536, USA
| |
Collapse
|
59
|
McCarthy MJ, Brumback T, Thomas ML, Meruelo AD. The relations between chronotype, stressful life events, and impulsivity in the Adolescent Brain Cognitive Development (ABCD) study. J Psychiatr Res 2023; 167:119-124. [PMID: 37866325 DOI: 10.1016/j.jpsychires.2023.10.030] [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: 02/06/2023] [Revised: 10/04/2023] [Accepted: 10/14/2023] [Indexed: 10/24/2023]
Abstract
Circadian rhythm disturbances, especially circadian phase delays are associated with impulsive behaviors and have been implicated in psychiatric disorders. Chronotype is a developmentally regulated proxy measure of circadian phase. Past studies have investigated the relationship between chronotype and trauma and found that trauma is associated with evening chronotypes, suggesting the course of chronotype development may be affected by adverse childhood experiences (ACEs). However, the relationships among chronotype, impulsivity and ACEs have largely been studied in a pairwise manner using small, cross-sectional cohorts. We hypothesized that in a cohort of high-risk youth, childhood trauma would be associated with later chronotype, and later chronotype would be associated with higher rates of impulsivity. We analyzed a cross-sectional sample (n = 966) from Year 2 of adolescents at high risk for psychiatric disorders from the ABCD study who were characterized for chronotype, stressful life events, and impulsivity. We used a hierarchical regression model to examine the relationship between chronotype, stressful life events, and impulsivity using the Munich Chronotype Questionnaire (MCTQ), the Life Events Scale, Urgency, Premeditation, Perseverance and Sensation Seeking (UPPS) Impulsive Behavior scale. We found associations between eveningness, stressful life events, and all dimensions of impulsivity. Increased eveningness was associated with a higher number of stressful life events and increased impulsivity. Understanding the role of stressful life events and impulsivity in those predisposed towards eveningness is useful because it may improve our understanding of the biological mechanisms that contribute to psychiatric disorders, and lead to better prevention and treatment efforts using interventions such as increased lifestyle regularity and daytime light exposure.
Collapse
Affiliation(s)
- Michael J McCarthy
- University of California, San Diego, VA San Diego Healthcare System, 3350 La Jolla Village Dr, San Diego, CA, 92161, USA.
| | - Ty Brumback
- Northern Kentucky University, 1 Louie B Nunn Dr, Highland Heights, KY, 41099, USA.
| | - Michael L Thomas
- Colorado State University, 1876 Campus Delivery, Fort Collins, CO, 80523-1876, USA.
| | - Alejandro D Meruelo
- University of California, San Diego, 9500 Gilman Dr, La Jolla, CA, 92093, USA.
| |
Collapse
|
60
|
Agnafors S, Sydsjö G, Svedin CG, Bladh M. Symptoms of depression and internalizing problems in early adulthood - associated factors from birth to adolescence. Nord J Psychiatry 2023; 77:799-810. [PMID: 37688331 DOI: 10.1080/08039488.2023.2254281] [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: 11/04/2022] [Accepted: 08/29/2023] [Indexed: 09/10/2023]
Abstract
PURPOSE Even though the mechanisms behind the development of depression and internalizing problems remains unknown, many different factors have been shown to increase the risk. Longitudinal studies enable the investigation of exposure during different developmental periods during childhood. This study aims to examine factors associated with depressive and internalizing problems at age 20 in terms of sociodemographic factors, previous mental health problems and stressful life events during childhood, adolescence, and early adulthood. METHODS A birth cohort of 1723 children were followed to age 20. At the 20-year follow-up, n = 731 (44%) participated. Standardized instruments were filled out at baseline and the 3-,12- and 20-year follow-ups. RESULTS Depressive problems at age 20 were associated with female gender, experience of interpersonal life events reported at age 20, bullying victimization and reports on paternal mental health problems. Participants with depressive problems were also less likely to have experienced adolescence as happy and to report that their father had been a good father. Internalizing problems at age 20 were, in addition, associated with internalizing problems at age 12 and reports on maternal mental health problems. Internalizing problems were associated with a lower likelihood of experiencing adolescence as happy in the final model. CONCLUSION Recent events (i.e. interpersonal life events and bullying) seemed to be the most influential factors on the development of internalizing and depressive problems. Internalizing problems during childhood increased the risk for internalizing problems in early adulthood, emphasizing the importance of early intervention. Fewer factors were found to increase the risk for depressive problems compared to internalizing problems.
Collapse
Affiliation(s)
- Sara Agnafors
- Division of Children's and Women's health, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Research, Södra Älvsborgs Hospital, Borås, Sweden
| | - Gunilla Sydsjö
- Division of Children's and Women's health, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Carl Göran Svedin
- Department of Social Sciences, Marie Cederschiöld University, Sköndal, Sweden
| | - Marie Bladh
- Division of Children's and Women's health, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| |
Collapse
|
61
|
Baldini V, Stefano RD, Rindi LV, Ahmed AO, Koola MM, Solmi M, Papola D, De Ronchi D, Barbui C, Ostuzzi G. Association between adverse childhood experiences and suicidal behavior in schizophrenia spectrum disorders: A systematic review and meta-analysis. Psychiatry Res 2023; 329:115488. [PMID: 37769371 DOI: 10.1016/j.psychres.2023.115488] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/13/2023] [Accepted: 09/17/2023] [Indexed: 09/30/2023]
Abstract
Assessing and managing suicide behaviors is highly relevant to individuals with schizophrenia spectrum disorders. Our study aims to assess the association between adverse childhood experiences and suicidal behaviors in individuals with schizophrenia spectrum disorders. We included observational studies comparing the probability of suicide behaviors in adults with schizophrenia spectrum disorders exposed and unexposed to adverse childhood experiences. Odds ratio estimates were obtained by pooling data using a random-effects pairwise meta-analysis. Standardized criteria were used to assess the strength of the association of the pooled estimate. We found 21 eligible studies reporting outcomes for 6257 individuals from 11 countries. The primary outcome revealed an association between any suicidal behavior and adverse childhood experiences, which resulted "highly suggestive" according to validated Umbrella Criteria. Similarly, a positive association was confirmed for suicidal ideation and suicide attempt and for any subtype of adverse childhood experience. This meta-analysis showed that exposure to adverse childhood experiences strongly increases the probability of suicide behaviors in people with schizophrenia spectrum disorders.
Collapse
Affiliation(s)
- Valentina Baldini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy; Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy.
| | - Ramona Di Stefano
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy
| | - Lorenzo Vittorio Rindi
- Department of Systems Medicine, Infectious Disease Clinic, Tor Vergata University, Rome, Italy
| | - Anthony O Ahmed
- Department of Psychiatry, Weill Cornell Medicine, White Plains, NY, United States
| | - Maju Mathew Koola
- Department of Psychiatry and Behavioral Health, Cooper University Health Care, Cooper Medical School of Rowan University, Camden, NJ, United States
| | - Marco Solmi
- Department of Psychiatry, University of Ottawa, Ontario, Canada; The Champlain First Episode Psychosis Program, Department of Mental Health, The Ottawa Hospital, Ontario, Canada; Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program University of Ottawa Ontario; Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - Davide Papola
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, United States; WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, Verona, Italy
| | - Diana De Ronchi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
| | - Corrado Barbui
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, Verona, Italy
| | - Giovanni Ostuzzi
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, Verona, Italy
| |
Collapse
|
62
|
Liu Y, Hatch SL, Patalay P, Schott JM, Richards M. A lifecourse approach in examining the association between accumulation of adversity and mental health in older adulthood. J Affect Disord 2023; 339:211-218. [PMID: 37442442 DOI: 10.1016/j.jad.2023.07.001] [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: 02/28/2023] [Revised: 06/01/2023] [Accepted: 07/08/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND There is evidence for a cumulative effect of adversities on mental health, however, less is known on the accumulating duration of exposure to adversity across the lifecourse on mental health in older adults. METHODS Using data from the 1946 British birth cohort study (N = 2745), we examined associations between the accumulation of adversity (birth-63 years) and mental health (emotional symptom, life satisfaction, affective wellbeing) in older adults (63-69 years). Accumulation of adversity was assessed as the number of adversities and duration of exposure (number of lifecourse stages exposed to any, economic, psychosocial, or physical adversity). Linear regression tested their association with mental health, adjusted for sex, childhood cognition and emotional problems, and educational attainment. RESULTS Increased number of adversities was associated with increased emotional symptoms (β = 0.08 [0.06, 0.10]), decreased life satisfaction (β = -0.14 [-0.16, -0.12]) and decreased affective wellbeing (β = -0.08 [-0.10, -0.06]). Each additional duration of exposure was associated with a 0.38 [0.12, 0.65] standard deviation (SD) increase in emotional symptoms, and a - 0.68 [-0.96, -0.39] and -0.43 SD [-0.68, -0.18] decrease in life satisfaction and affective wellbeing, respectively. Life satisfaction showed stronger associations with economic and psychosocial compared to physical adversity. LIMITATIONS Some limitations include selective drop-out and lack of ethnic diversity. CONCLUSIONS Efforts to improve mental health in older adults should focus on reducing the number of adversities, as well as considering previous exposure across different lifecourse stages, to prevent adversities from becoming chronic. Future research should also consider the clustering and co-occurrence of different adversities across the lifecourse.
Collapse
Affiliation(s)
- Yiwen Liu
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK.
| | - Stephani L Hatch
- Department of Psychological Medicine, King's College London, London, UK; ESRC Centre for Society and Mental Health, King's College London, London, UK
| | - Praveetha Patalay
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK; Centre for Longitudinal Studies, Social Research Institute, University College London, London, UK
| | - Jonathan M Schott
- Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
| |
Collapse
|
63
|
Dube SR, Li ET, Fiorini G, Lin C, Singh N, Khamisa K, McGowan J, Fonagy P. Childhood verbal abuse as a child maltreatment subtype: A systematic review of the current evidence. CHILD ABUSE & NEGLECT 2023; 144:106394. [PMID: 37586139 DOI: 10.1016/j.chiabu.2023.106394] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 07/25/2023] [Accepted: 08/01/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND In recent years, the prevalence of childhood emotional abuse has surpassed other forms of maltreatment. Childhood verbal abuse (CVA) is a key attribute of emotional abuse, yet CVA is not recognized as its own form of maltreatment and thus, has not received adequate attention. Clear terminology, definitions, and measures are needed to aid in assessing the occurrence and impact of CVA for its recognition and prevention. OBJECTIVE We aim to synthesize the evidence on the terms, definitions, and measurements of CVA and identify outcomes associated with CVA. PARTICIPANTS AND SETTING A systematic review focused on adult perpetration of CVA among children and adolescents using clinical, community-based, and population-based samples. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed and four databases were utilized in May 2022: PsycINFO, MEDLINE, EMBASE, and ProQuest. A total of 149 quantitative and 17 qualitative studies were identified. RESULTS Across studies reviewed, the most common perpetrators of CVA were parents, mothers, and teachers. Definitional themes for CVA included negative speech volume, tone, and speech content, and their immediate impact. The most frequent measures cited were Adverse Childhood Experiences Study (ACE) Questionnaire and the Conflict Tactics Scale (CTS); 50 % used self-created measures. CVA was associated with a range of internalizing and externalizing outcomes across the lifespan. CONCLUSIONS Recognizing CVA as a form of maltreatment will be a starting point for its identification and prevention. Primary prevention of CVA using trauma-informed approaches must include adult training on the importance of safety, support, and nurturance during verbal communication with children.
Collapse
Affiliation(s)
- Shanta R Dube
- Director, Department of Public Health, Master of Public Health Program, Levine College of Health Sciences, Wingate University, Wingate, NC, United States of America.
| | - Elizabeth T Li
- Division of Psychology and Language Sciences, University College London, London, United Kingdom
| | - Guilherme Fiorini
- Division of Psychology and Language Sciences, University College London, London, United Kingdom
| | - Caleb Lin
- Division of Psychology and Language Sciences, University College London, London, United Kingdom
| | - Nikita Singh
- Division of Psychology and Language Sciences, University College London, London, United Kingdom
| | - Kumayl Khamisa
- Division of Psychology and Language Sciences, University College London, London, United Kingdom
| | - Jennifer McGowan
- Division of Psychology and Language Sciences, University College London, London, United Kingdom
| | - Peter Fonagy
- Division of Psychology and Language Sciences, University College London, London, United Kingdom
| |
Collapse
|
64
|
Cavanaugh C, Rucci S, Vasquez-Home O. Sex/gender differences in the associations between adverse childhood experiences and intimate partner violence with mental disorders. Psychiatry Res 2023; 328:115456. [PMID: 37688838 DOI: 10.1016/j.psychres.2023.115456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/27/2023] [Accepted: 08/28/2023] [Indexed: 09/11/2023]
Abstract
Sex and gender differences exist in mental and substance use disorders (MSUDs). Studies examining the moderating effects of sex/gender on MSUDs may help understand these differences. This national study explored whether sex/gender moderated (1) the associations between adverse childhood experience (ACEs; i.e., child abuse, child neglect, and child household dysfunction) and intimate partner violence (IPV) with MSUDs and (2) more associations with past year than lifetime MSUDs or mental (i.e., mood disorder, anxiety disorder, and posttraumatic stress disorder) than substance use disorders (i.e., alcohol use disorder and nicotine dependence). Data was used from participants in the National Epidemiologic Survey on Alcohol and Related Conditions. Logistic regression tested the main effects of ACEs, IPV, and sex/gender on five, past-year and lifetime MSUDs along with the ACE-sex/gender and IPV-sex/gender interactions. Sex/gender moderated 60% of the ACEs-MSUD and IPV-MSUD associations and more associations with lifetime (54%) than past year MSUDs (46%) and substance use (94%) than mental disorders (38%). For nearly half of the moderated associations, ACEs and IPV were associated with greater odds of MSUDs for males. Males who experienced IPV had greater odds of lifetime mood, anxiety, and alcohol use disorders than females. This study advances sex and gender informed research.
Collapse
Affiliation(s)
- Courtenay Cavanaugh
- Department of Psychology, Rutgers University, 311 North Fifth Street, Camden, NJ 08108, USA.
| | - Skylar Rucci
- Department of Psychology, Rutgers University, 311 North Fifth Street, Camden, NJ 08108, USA
| | - Orgelys Vasquez-Home
- Department of Psychology, Rutgers University, 311 North Fifth Street, Camden, NJ 08108, USA
| |
Collapse
|
65
|
Fan L, Chen Y, Zhu M, Mao Z, Li N. Correlation between childhood trauma experience and depressive symptoms among young adults: The potential mediating role of loneliness. CHILD ABUSE & NEGLECT 2023; 144:106358. [PMID: 37499308 DOI: 10.1016/j.chiabu.2023.106358] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/27/2023] [Accepted: 07/16/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND It is widely recognized that childhood trauma poses a significant risk of developing depressive symptoms. However, the underlying mediation mechanism between childhood trauma and depressive symptoms requires further exploration. OBJECTIVE This study focuses on exploring whether loneliness may act as a potential mediator between childhood trauma and depressive symptoms. PARTICIPANTS AND SETTING We analyzed a large sample of college students (N = 7293). Participants completed online questionnaires in the WeChat group. METHODS Childhood trauma, depressive symptoms, and loneliness were evaluated using the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Patient Health Questionnaire-9 (PHQ-9), and the University of California Los Angeles Loneliness Scale (UCLA-LS) respectively. The linear regression method was applied to explore the mediating role. RESULTS Gender, relationship with family, and left-behind experience are all substantial depressive symptoms risk factors. Childhood trauma was shown to be highly related to depressive symptoms, and this relationship was potentially mediated by loneliness. CONCLUSIONS Our research indicates that treating loneliness in those who have undergone childhood trauma may help prevent or treat depressive symptoms. Therefore, loneliness should be taken into consideration while treating and preventing depressive symptoms.
Collapse
Affiliation(s)
- Lurong Fan
- Business School, Sichuan University, Chengdu, Sichuan 610064, PR China.
| | - Yu Chen
- Business School, Sichuan University, Chengdu, Sichuan 610064, PR China.
| | - Mengyuan Zhu
- School of Economics and Management, Civil Aviation Flight University of China, PR China.
| | - Zhiqian Mao
- Business School, City University of Hong Kong, Hong Kong
| | - Na Li
- Mental Health Education Center, Chengdu Normal University, Chengdu 611130, PR China
| |
Collapse
|
66
|
Michopoulos V, Huibregtse ME, Chahine EB, Smith AK, Fonkoue IT, Maples-Keller J, Murphy A, Taylor L, Powers A, Stevens JS. Association between perimenopausal age and greater posttraumatic stress disorder and depression symptoms in trauma-exposed women. Menopause 2023; 30:1038-1044. [PMID: 37610715 PMCID: PMC10527101 DOI: 10.1097/gme.0000000000002235] [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] [Indexed: 08/24/2023]
Abstract
OBJECTIVE This study aimed to determine the relationship between stages of the menopause transition (premenopausal, perimenopausal, and postmenopausal) on symptoms of posttraumatic stress disorder (PTSD) and depression in trauma-exposed women. METHODS A cross-sectional study conducted between 2005 and 2017 recruited and enrolled an urban community sample (n = 6,093) from nonpsychiatric medical clinic waiting rooms of Grady Memorial Hospital, a public safety net hospital in Atlanta, Georgia. Participants were female, 18 to 65 years old, and predominantly Black/African American. RESULTS Of the 6,093 participants, 93.8% were Black/African American, 2.5% were White, and 3.8% were of all other races (Hispanic/Latino, Asian, multiracial). Participants younger than 40 years were categorized as premenopausal (n = 3,166), between 40 and 55 years of age were categorized as perimenopausal (n = 2,127), and older than 55 years were categorized as postmenopausal (n = 790). Menopause status was associated with total PTSD symptom severity ( F2,5416 = 9.61, P < 0.001), symptom severity within all three PTSD symptom clusters (avoidance/numbing symptoms: F2,5416 = 7.10, P < 0.001; intrusive symptoms: F2,5416 = 7.04, P < 0.001; hyperarousal symptoms: F2,5409 = 8.31, P < 0.001), and depression symptom severity ( F2,5148 = 11.4, P < 0.001). Compared with both premenopausal and postmenopausal women, perimenopausal women reported significantly worse total PTSD symptoms, symptoms in the hyperarousal cluster, and depressive symptoms. CONCLUSIONS The current cross-sectional data show that symptoms of PTSD and depression in women are associated with reproductive age, such that perimenopausal women show higher symptom severity than premenopausal and postmenopausal women. Future longitudinal studies can reveal how changes in hormones over the course of the menopause transition impact the symptoms, neurobiology, and psychophysiology of PTSD.
Collapse
Affiliation(s)
- Vasiliki Michopoulos
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Megan E. Huibregtse
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States of America
| | - E. Britton Chahine
- Department of Gynecology and Obstetrics, Emory University School of Medicine Atlanta, GA, United States of America
| | - Alicia K. Smith
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States of America
- Department of Gynecology and Obstetrics, Emory University School of Medicine Atlanta, GA, United States of America
| | - Ida T. Fonkoue
- Divisions of Physical Therapy and Rehabilitation Science, Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, United States of America
| | - Jessica Maples-Keller
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Amy Murphy
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Linzie Taylor
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Abigail Powers
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Jennifer S. Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States of America
| |
Collapse
|
67
|
Thurston C, Murray AL, Franchino-Olsen H, Meinck F. Prospective longitudinal associations between adverse childhood experiences and adult mental health outcomes: a protocol for a systematic review and meta-analysis. Syst Rev 2023; 12:181. [PMID: 37777785 PMCID: PMC10541707 DOI: 10.1186/s13643-023-02330-1] [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: 02/03/2022] [Accepted: 08/18/2023] [Indexed: 10/02/2023] Open
Abstract
BACKGROUND Research cites a strong, dose-response relationship between adverse childhood experiences (ACEs) and poor adult mental health outcomes including anxiety, depression, post-traumatic stress disorder (PTSD), self-harm, suicidality, and psychotic-like experiences. AIM To systematically investigate the existence and strength of association between ACEs and adult mental health outcomes in prospective longitudinal studies. The review will focus on the outcomes: anxiety, depression, PTSD, self-harm, suicidal ideation, and psychotic-like experiences. METHODS Twelve electronic databases will be searched: Embase, PsycINFO, MEDLINE, and Global Health through the OVID interface. ProQuest will be used to search Public Affairs Information Service (PAIS), Dissertations and Theses, Sociology Database (including Sociological Abstracts and Social Services Abstracts), PTSDpubs (formerly The Published International Literature on Traumatic Stress (PILOTS) Database) and Applied Social Sciences Index and Abstracts (ASSIA). CINAHL, World Health Organisation (WHO) Global Index Medicus, and WHO Violence Info will also be searched. Eligible studies will be double screened, assessed, and their data will be extracted. Any disagreement throughout these processes will be settled by a third reviewer. If enough studies meet the criteria and the methodological quality of each study is sufficient, a meta-analysis will be conducted. ANALYSIS A narrative synthesis of included studies and the associations between ACEs and adult mental health will be completed. If the number of studies included per mental health outcome is two or more, a multi-level meta-analysis will be completed using odds ratio effect sizes as outcomes. DISCUSSION This review will contribute to the existing body of literature supporting the long-term effects of ACEs on adult mental health. This review adds to previous reviews that have either synthesised cross-sectional associations between ACEs and mental health outcomes, synthesised longitudinal studies exploring the effect of ACEs on different physical and mental health outcomes or synthesised longitudinal studies exploring the effect of ACEs on the same mental health outcomes using different methods. This review aims to identify methodological weaknesses and knowledge gaps in current literature that can be addressed in future primary studies. SYSTEMATIC REVIEW REGISTRATION This protocol has been registered in PROSPERO (CRD42021297882).
Collapse
Affiliation(s)
- Christina Thurston
- School of Social and Political Science, University of Edinburgh, Chrystal Macmillan Building, 15a George Square, Edinburgh, EH8 9LD, UK.
| | | | - Hannabeth Franchino-Olsen
- School of Social and Political Science, University of Edinburgh, Chrystal Macmillan Building, 15a George Square, Edinburgh, EH8 9LD, UK
| | - Franziska Meinck
- School of Social and Political Science, University of Edinburgh, Chrystal Macmillan Building, 15a George Square, Edinburgh, EH8 9LD, UK
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Faculty of Humanities, North-West University, Potchefstroom, South Africa
| |
Collapse
|
68
|
Karatzias T, Mc Glanaghy E, Cloitre M. Enhanced Skills Training in Affective and Interpersonal Regulation (ESTAIR): A New Modular Treatment for ICD-11 Complex Posttraumatic Stress Disorder (CPTSD). Brain Sci 2023; 13:1300. [PMID: 37759901 PMCID: PMC10527561 DOI: 10.3390/brainsci13091300] [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: 08/22/2023] [Revised: 08/31/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
ICD-11 Complex Posttraumatic Stress Disorder (CPTSD) is a relatively new condition; therefore, there is limited available evidence for its treatment. Prior to the recognition of CPTSD as a separate trauma condition, people who met criteria were often diagnosed with multiple co-morbid conditions such as PTSD, anxiety, depression, and emotional dysregulation difficulties. In the absence of a coherent evidence base, treatment tended to involve multiple treatments for these multiple conditions or lengthy phase-based interventions, often delivered in an integrative fashion, which was not standardized. In this paper, we present Enhanced Skills Training in Affective and Interpersonal Regulation (ESTAIR), a new flexible multi-modular approach for the treatment of CPTSD and its transdiagnostic symptoms. ESTAIR is consistent with trauma-informed and patient-centered care, which highlights the importance of patient choice in identification and sequencing in targeting CPTSD symptoms. Directions for future research are discussed.
Collapse
Affiliation(s)
- Thanos Karatzias
- School of Health & Social Care, Edinburgh Napier University, Edinburgh EH11 4BN, UK
- NHS Lothian Rivers Centre, EH11 1BG, Stanford University, 450 Jane Stanford Way, Stanford, CA 94305, USA
| | - Edel Mc Glanaghy
- NHS Forth Valley, Mayfield Building, Falkirk Community Hospital, Scotland FK1 5QE, UK;
| | - Marylene Cloitre
- National Centre for PTSD, Dissemination and Training Division, VA Palo Alto Health Care System, 795 Willow Road, Menlo Park, CA 94025, USA;
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA 94305, USA
| |
Collapse
|
69
|
Spitzer C, Lübke L, Müller S, Knorr S, Flemming E. [Comparison of Self-Reported Childhood Maltreatment Between East and West Germany]. PSYCHIATRISCHE PRAXIS 2023; 50:308-315. [PMID: 37146641 DOI: 10.1055/a-2042-2289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
OBJECTIVE The socioecological model emphasize the relevance of political, cultural and economic socialization effects for the prevalence of childhood maltreatment, which are analyzed by comparing child maltreatment between East and West German subjects who came of age before the fall of the Berlin Wall. METHODS Using an online survey, a representative general population sample with respect to age, gender distribution and income was assessed regarding child maltreatment and current psychological distress using standardized self-report instruments. RESULTS Of 507 study participants, 22,5% reported being born and socialized in East Germany. They reported significantly less emotional abuse than the 77,5% who grew up in the FRG. The East and West German subjects did not differ in any other form of abuse. CONCLUSION Our findings underline the importance of socialization and enculturation effects on memory, which should be considered when interpreting the results.
Collapse
Affiliation(s)
- Carsten Spitzer
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Rostock
| | - Laura Lübke
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Rostock
| | - Sascha Müller
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Rostock
- Institut für Psychologie, Universität Kassel
| | - Stefanie Knorr
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Rostock
| | - Eva Flemming
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Rostock
| |
Collapse
|
70
|
de Bles NJ, Pütz LEH, Rius Ottenheim N, van Hemert AM, Elzinga BM, Penninx BWJH, Giltay EJ. Childhood trauma and anger in adults with and without depressive and anxiety disorders. Acta Psychiatr Scand 2023; 148:288-301. [PMID: 37430486 DOI: 10.1111/acps.13589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 05/17/2023] [Accepted: 06/10/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND Childhood trauma (CT) is associated with severe sequelae, including stress-related mental health disorders that can perpetuate long into adulthood. A key mechanism in this relationship seems to be emotion regulation. We aimed to investigate (1) whether childhood trauma is associated with anger in adulthood, and, if so, (2) to explore which types of childhood trauma predominate in the prediction of anger in a cohort that included participants with and without current affective disorders. METHODS In the Netherlands Study of Depression and Anxiety (NESDA), childhood trauma was assessed with a semi-structured Childhood Trauma Interview (CTI) at baseline, and analyzed in relation to anger as measured at a 4-year follow-up with the Spielberger Trait Anger Subscale (STAS), the Anger Attacks Questionnaire, and cluster B personality traits (i.e., borderline, antisocial) of the Personality Disorder Questionnaire 4 (PDQ-4), using analysis of covariance (ANCOVA) and multivariable logistic regression analyses. Post hoc analyses comprised cross-sectional regression analyses, using the Childhood Trauma Questionnaire-Short Form (CTQ-SF) also obtained at a 4-year follow-up. RESULTS Participants (n = 2271) were on average 42.1 years (SD = 13.1), and 66.2% were female. Childhood trauma showed a dose-response association with all anger constructs. All types of childhood trauma were significantly associated with borderline personality traits, independently of depression and anxiety. Additionally, all types of childhood trauma except for sexual abuse were associated with higher levels of trait anger, and a higher prevalence of anger attacks and antisocial personality traits in adulthood. Cross-sectionally, the effect sizes were larger compared with the analyses with the childhood trauma measured 4 years prior to the anger measures. CONCLUSIONS Childhood trauma is linked with anger in adulthood, which could be of particular interest in the context of psychopathology. Focus on childhood traumatic experiences and adulthood anger may help to enhance the effectiveness of treatment for patients with depressive and anxiety disorders. Trauma-focused interventions should be implemented when appropriate.
Collapse
Affiliation(s)
- N J de Bles
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - L E H Pütz
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - N Rius Ottenheim
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - A M van Hemert
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - B M Elzinga
- Department of Clinical Psychology, Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - B W J H Penninx
- Department of Psychiatry, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - E J Giltay
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- Health Campus, The Hague, Leiden University, Leiden, The Netherlands
| |
Collapse
|
71
|
Yuan M, Yang B, Rothschild G, Mann JJ, Sanford LD, Tang X, Huang C, Wang C, Zhang W. Epigenetic regulation in major depression and other stress-related disorders: molecular mechanisms, clinical relevance and therapeutic potential. Signal Transduct Target Ther 2023; 8:309. [PMID: 37644009 PMCID: PMC10465587 DOI: 10.1038/s41392-023-01519-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 05/14/2023] [Accepted: 05/31/2023] [Indexed: 08/31/2023] Open
Abstract
Major depressive disorder (MDD) is a chronic, generally episodic and debilitating disease that affects an estimated 300 million people worldwide, but its pathogenesis is poorly understood. The heritability estimate of MDD is 30-40%, suggesting that genetics alone do not account for most of the risk of major depression. Another factor known to associate with MDD involves environmental stressors such as childhood adversity and recent life stress. Recent studies have emerged to show that the biological impact of environmental factors in MDD and other stress-related disorders is mediated by a variety of epigenetic modifications. These epigenetic modification alterations contribute to abnormal neuroendocrine responses, neuroplasticity impairment, neurotransmission and neuroglia dysfunction, which are involved in the pathophysiology of MDD. Furthermore, epigenetic marks have been associated with the diagnosis and treatment of MDD. The evaluation of epigenetic modifications holds promise for further understanding of the heterogeneous etiology and complex phenotypes of MDD, and may identify new therapeutic targets. Here, we review preclinical and clinical epigenetic findings, including DNA methylation, histone modification, noncoding RNA, RNA modification, and chromatin remodeling factor in MDD. In addition, we elaborate on the contribution of these epigenetic mechanisms to the pathological trait variability in depression and discuss how such mechanisms can be exploited for therapeutic purposes.
Collapse
Affiliation(s)
- Minlan Yuan
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Biao Yang
- Department of Abdominal Oncology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Gerson Rothschild
- Department of Microbiology and Immunology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, 10032, USA
| | - J John Mann
- Department of Psychiatry, Columbia University, New York, NY, 10032, USA
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, 10032, USA
- Department of Radiology, Columbia University, New York, NY, 10032, USA
| | - Larry D Sanford
- Sleep Research Laboratory, Center for Integrative Neuroscience and Inflammatory Diseases, Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Xiangdong Tang
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Mental Health Center, Translational Neuroscience Center, and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Canhua Huang
- Department of Biotherapy, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Chuang Wang
- Department of Pharmacology, and Provincial Key Laboratory of Pathophysiology in School of Medicine, Ningbo University, Ningbo, Zhejiang, 315211, China.
| | - Wei Zhang
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, China.
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, 610041, China.
- Medical Big Data Center, Sichuan University, Chengdu, 610041, China.
| |
Collapse
|
72
|
Xia Y, Wang G, Xiao L, Du Y, Lin S, Nan C, Weng S. Effects of Early Adverse Life Events on Depression and Cognitive Performance from the Perspective of the Heart-Brain Axis. Brain Sci 2023; 13:1174. [PMID: 37626530 PMCID: PMC10452582 DOI: 10.3390/brainsci13081174] [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: 06/29/2023] [Revised: 07/30/2023] [Accepted: 08/04/2023] [Indexed: 08/27/2023] Open
Abstract
Early adverse life events (EALs) increase susceptibility to depression and impair cognitive performance, but the physiological mechanisms are still unclear. The target of this article is to clarify the impact of adverse childhood experiences on emotional and cognitive performance from the perspective of the heart-brain axis. We used the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) to test cognitive function and the Childhood Trauma Questionnaire (CTQ) to assess adverse childhood experiences. Heart rate variability (HRV) and electroencephalograms (EEG) were acquired at rest. We observed that subjects with depression had experienced more traumatic events during their childhood. Furthermore, they exhibited lower heart rate variability and higher power in the delta, theta, and alpha frequency bands. Moreover, heart rate variability partially mediated the association between childhood trauma exposure and depressive symptoms. Our findings suggested that adverse life events in childhood could influence the development of depression in adulthood, which might be linked to cardiac autonomic dysfunction and altered brain function.
Collapse
Affiliation(s)
- Yujie Xia
- Department of Psychiatry, Renmin Hospital of Wuhan University, 238 Jiefang Rd., Wuhan 430060, China; (Y.X.)
| | - Gaohua Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, 238 Jiefang Rd., Wuhan 430060, China; (Y.X.)
- Institute of Neuropsychiatry, Renmin Hospital of Wuhan University, 238 Jiefang Rd., Wuhan 430060, China
- Taikang Center for Life and Medical Sciences, Wuhan University, China Donghu Road No. 115, Wuhan 430071, China
| | - Ling Xiao
- Department of Psychiatry, Renmin Hospital of Wuhan University, 238 Jiefang Rd., Wuhan 430060, China; (Y.X.)
- Institute of Neuropsychiatry, Renmin Hospital of Wuhan University, 238 Jiefang Rd., Wuhan 430060, China
| | - Yiwei Du
- Department of Psychiatry, Renmin Hospital of Wuhan University, 238 Jiefang Rd., Wuhan 430060, China; (Y.X.)
| | - Shanshan Lin
- Department of Psychiatry, Renmin Hospital of Wuhan University, 238 Jiefang Rd., Wuhan 430060, China; (Y.X.)
| | - Cai Nan
- Department of Psychiatry, Renmin Hospital of Wuhan University, 238 Jiefang Rd., Wuhan 430060, China; (Y.X.)
| | - Shenhong Weng
- Department of Psychiatry, Renmin Hospital of Wuhan University, 238 Jiefang Rd., Wuhan 430060, China; (Y.X.)
| |
Collapse
|
73
|
Liu XK, Huang DL, Meng LP, Cheng W, Li YY, Qin LL, Yang A, Zeng F, Zou Q, Li QF. Prevalence and Risk Factors Underlying Occupational Stress and Depression Among Clinical Nurses in Secondary and Tertiary Hospitals of China During COVID-19 Setting. Risk Manag Healthc Policy 2023; 16:1377-1389. [PMID: 37545784 PMCID: PMC10404045 DOI: 10.2147/rmhp.s415349] [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] [Received: 04/25/2023] [Accepted: 07/11/2023] [Indexed: 08/08/2023] Open
Abstract
Aim This study was designed to develop an effective measurement tool for occupational stress among medical staff and to identify the underlying risk factors among clinical nurses in China under depression during and after COVID-19. Methods In the first stage, an occupational stress scale was developed for medical staff based on qualitative and quantitative methods. The dimensions of the scale were based on childhood stress and seven other parameters of working stress. In the second stage, a provincial survey was conducted among clinical nurses in Hainan. The structure of Medical Staff Occupational Stress Scale was tested in secondary and tertiary hospitals. The socio-demographic information, occupational stress (measured using the developed scale), and current depression symptoms (assessed with the nine-item Patient Health Questionnaire) were evaluated. The risk factors for occupational stress-induced depression were tested using multivariate logistic regression. Results The Medical Staff Occupational Stress Scale consisted of 42 items under eight dimensions with strong reliability and validity. Almost 80% of the clinical nurses reported obvious symptoms of depression. Based on multivariate logistical regression analysis, the significant risk factors for depression in nurses at secondary hospitals and tertiary hospitals were childhood stress, teaching stress, relationship with patient stress, and administration stress. Conclusion The Medical Staff Occupational Stress Scale utilized in nursing population is based on strong psychometric features. Childhood stress contributes to occupational stress in nurses. The selection of nurses for clinical work may require evaluation of past history for childhood stress to prevent occupational depression. Teaching stress, relationship with patient stress and administration stress play significant roles in the prevention of depression among clinical nurses.
Collapse
Affiliation(s)
- Xiao-kun Liu
- Clinical Psychology Department, The First Affiliated Hospital of Hainan Medical University, Haikou City, Hainan Province, People’s Republic of China
| | - Dan-ling Huang
- Clinical Psychology Department, The First Affiliated Hospital of Hainan Medical University, Haikou City, Hainan Province, People’s Republic of China
- Neurology Department, Graduate School of Tianjin Medical University, Tianjin City, People’s Republic of China
| | - Li-ping Meng
- Clinical Psychology Department, The First Affiliated Hospital of Hainan Medical University, Haikou City, Hainan Province, People’s Republic of China
| | - Wei Cheng
- Clinical Psychology Department, The First Affiliated Hospital of Hainan Medical University, Haikou City, Hainan Province, People’s Republic of China
| | - Yi-yi Li
- Clinical Psychology Department, The First Affiliated Hospital of Hainan Medical University, Haikou City, Hainan Province, People’s Republic of China
| | - Lu-lu Qin
- Department of Social Medicine and Health Management, School of Medicine, Hunan Normal University, Changsha City, Hunan Province, People’s Republic of China
| | - Ao Yang
- Health Management Department, School of Management of Hainan Medical University, Haikou City, Hainan Province, People’s Republic of China
| | - Fan Zeng
- Graduate School of Hainan Medical University, Haikou City, Hainan Province, People’s Republic of China
| | - Qin Zou
- Clinical Psychology Department, The First Affiliated Hospital of Hainan Medical University, Haikou City, Hainan Province, People’s Republic of China
| | - Qi-fu Li
- Neurology Department, The First Affiliated Hospital of Hainan Medical University, Haikou City, Hainan Province, People’s Republic of China
| |
Collapse
|
74
|
Saarinen A, Keltikangas-Järvinen L, Dobewall H, Sormunen E, Lehtimäki T, Kähönen M, Raitakari O, Hietala J. Childhood family environment predicting psychotic disorders over a 37-year follow-up - A general population cohort study. Schizophr Res 2023; 258:9-17. [PMID: 37392583 DOI: 10.1016/j.schres.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/07/2022] [Accepted: 06/19/2023] [Indexed: 07/03/2023]
Abstract
BACKGROUND Childhood adverse effects and traumatic experiences increase the risk for several psychiatric disorders. We now investigated whether prospectively assessed childhood family environment per se contributes to increased risk for psychotic disorders in adulthood, and whether these family patterns are also relevant in the development of affective disorders. METHODS We used the Young Finns Data (n = 3502). Childhood family environment was assessed in 1980/1983 with previously constructed risk scores: (1) disadvantageous emotional family atmosphere (parenting practices, parents' life satisfaction, parents' mental disorder, parents' alcohol intoxication), (2) adverse socioeconomic environment (overcrowded apartment, home income, parent's employment, occupational status, educational level), and (3) stress-prone life events (home movement, school change, parental divorce, death, or hospitalization, and child's hospitalization). Psychiatric diagnoses (ICD-10 classification) over the lifespan were collected up to 2017 from the national registry of hospital care. Non-affective psychotic disorder and affective disorder groups were formed. RESULTS Frequent stress-prone life events predicted higher likelihood of non-affective psychotic disorders (OR = 2.401, p = 0.001). Adverse socioeconomic environment or emotional family atmosphere did not predict psychotic disorders. Only disadvantageous emotional family atmosphere predicted modestly higher likelihood of affective disorders (OR = 1.583, p = 0.013). CONCLUSIONS Our results suggest that childhood family environment and atmosphere patterns as such contribute to the risk for developing adulthood mental disorders with relative disorder specificity. The results emphasize the importance of both individual and public health preventive initiatives, including family support interventions.
Collapse
Affiliation(s)
- Aino Saarinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | | | | | - Elina Sormunen
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland; Department of Clinical Chemistry, Finnish Cardiovascular Research Center - Tampere, Faculty of Medicine and Health Technology, Tampere University, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Olli Raitakari
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland; Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Jarmo Hietala
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland.
| |
Collapse
|
75
|
Mokwena KE, Magabe S, Ntuli B. Symptoms of Depression, Anxiety and Their Co-Occurrence among Orphaned Children in Sekhukhune District, Limpopo Province. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1279. [PMID: 37628278 PMCID: PMC10453368 DOI: 10.3390/children10081279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/17/2023] [Accepted: 07/24/2023] [Indexed: 08/27/2023]
Abstract
Although both short- and long-term psychological challenges, specifically depression and anxiety, have been reported among orphans, there is a dearth of studies that quantify these disorders in rural settings. The aim of the study was to screen for symptoms of depression, anxiety and their co-occurrence among orphaned school-going children in rural Limpopo province, South Africa. Data were collected among primary school children in 10 schools in two villages in Limpopo province. The Revised Child Anxiety and Depression Scale (RCADS) was used to screen for symptoms of depression, anxiety and their co-occurrence among 308 orphaned learners in the selected schools. A questionnaire was used to collect socio-demographic data. STATA 13 was used to analyse the data. Descriptive statistics were used to determine the symptoms and severity of depression, anxiety and their co-occurrence. The sample of 308 consisted of the majority (60.71%) residing in Maandagshoek and being female (54.22%). Their ages ranged from 8 to 12 years, with a mean of 10.51 years. The prevalence of symptoms of depression, anxiety and co-occurrence of anxiety and depression were 23.05%, 34.09% and 32.14%, respectively. The prevalence of mental health symptoms was high among the sample. There is a need to expand the care of orphans to include mental health and not just limit their care to provide food to vulnerable children.
Collapse
Affiliation(s)
- Kebogile Elizabeth Mokwena
- Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria 0208, South Africa (B.N.)
| | | | | |
Collapse
|
76
|
Muroi K, Ishitsuka M, Hori D, Doki S, Takahashi T, Ikeda T, Saito T, Shinichiro S, Matsuzaki I. Relationships Between Childhood Bullying/Domestic Violence Experience and Insomnia among Employees in Japan. F1000Res 2023; 12:103. [PMID: 37384304 PMCID: PMC10293797 DOI: 10.12688/f1000research.129340.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/13/2023] [Indexed: 07/20/2023] Open
Abstract
OBJECTIVE Traumatic childhood experiences such as domestic violence and bullying have been reported to be associated with insomnia in adulthood. However, little evidence is available for the long-term effects of childhood adversity on workers' insomnia worldwide. Our objective was to examine whether childhood experiences of bullying and domestic violence are associated with insomnia in workers in adulthood. METHODS We used survey data from a cross-sectional study of the Tsukuba Science City Network in Tsukuba City, Japan. Workers aged 20 to 65 years (4509 men and 2666 women) were targeted. Binomial logistic regression analysis was performed with the Athens Insomnia Scale as the objective variable. RESULTS Binomial logistic regression analysis showed that childhood bullying and domestic violence experience of childhood bullying and domestic violence were associated with insomnia. As for the experience of domestic violence, the higher the time of experience, the higher the odds ratio of insomnia. CONCLUSIONS It may be useful to focus on childhood traumatic experiences regarding insomnia in workers. In the future, objective sleep time and sleep efficiency should be evaluated using an activity meter and other methods to verify the effects of bullying and domestic violence experiences.
Collapse
Affiliation(s)
- Kei Muroi
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Mami Ishitsuka
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Daisuke Hori
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Shotaro Doki
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Tsukasa Takahashi
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Tomohiko Ikeda
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Tamaki Saito
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Sasahara Shinichiro
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Ichiyo Matsuzaki
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
- International Institute for Integrative Sleep Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| |
Collapse
|
77
|
Muroi K, Ishitsuka M, Hori D, Doki S, Takahashi T, Ikeda T, Saito T, Shinichiro S, Matsuzaki I. Relationships Between Childhood Bullying/Domestic Violence Experience and Insomnia among Employees in Japan. F1000Res 2023; 12:103. [PMID: 37384304 PMCID: PMC10293797 DOI: 10.12688/f1000research.129340.2] [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] [Accepted: 07/13/2023] [Indexed: 07/20/2023] Open
Abstract
OBJECTIVE Traumatic childhood experiences such as domestic violence and bullying have been reported to be associated with insomnia in adulthood. However, little evidence is available for the long-term effects of childhood adversity on workers' insomnia worldwide. Our objective was to examine whether childhood experiences of bullying and domestic violence are associated with insomnia in workers in adulthood. METHODS We used survey data from a cross-sectional study of the Tsukuba Science City Network in Tsukuba City, Japan. Workers aged 20 to 65 years (4509 men and 2666 women) were targeted. Binomial logistic regression analysis was performed with the Athens Insomnia Scale as the objective variable. RESULTS Binomial logistic regression analysis showed that childhood bullying and domestic violence experience of childhood bullying and domestic violence were associated with insomnia. As for the experience of domestic violence, the higher the time of experience, the higher the odds ratio of insomnia. CONCLUSIONS It may be useful to focus on childhood traumatic experiences regarding insomnia in workers. In the future, objective sleep time and sleep efficiency should be evaluated using an activity meter and other methods to verify the effects of bullying and domestic violence experiences.
Collapse
Affiliation(s)
- Kei Muroi
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Mami Ishitsuka
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Daisuke Hori
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Shotaro Doki
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Tsukasa Takahashi
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Tomohiko Ikeda
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Tamaki Saito
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Sasahara Shinichiro
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Ichiyo Matsuzaki
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
- International Institute for Integrative Sleep Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| |
Collapse
|
78
|
Mongan D, Raj Susai S, Föcking M, Byrne JF, Zammit S, Cannon M, Cotter DR. Associations between plasma inflammatory markers and psychotic disorder, depressive disorder and generalised anxiety disorder in early adulthood: A nested case-control study. Brain Behav Immun 2023; 111:90-100. [PMID: 37004760 DOI: 10.1016/j.bbi.2023.03.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 03/10/2023] [Accepted: 03/28/2023] [Indexed: 04/04/2023] Open
Abstract
BACKGROUND Low-grade inflammation may occur in association with several mental disorders of early adulthood, though associations with markers of chronic inflammation such as soluble urokinase plasminogen activator receptor (suPAR) are less well-established. We aimed to examine associations between acute and chronic inflammatory markers and mental disorders, as well as psychiatric co-morbidity, in young adults aged 24 years in the Avon Longitudinal Study of Parents and Children. METHODS Included were 781 participants (of 4019 who attended at age 24 years) who completed psychiatric assessments and provided plasma samples. Of these, 377 met criteria for psychotic disorder, depressive disorder or generalised anxiety disorder and 404 did not. Plasma concentrations of IFN-γ, IL-6, IL-8, IL-10, TNF-α, CRP, sVCAM1, sICAM1, suPAR and alpha-2-macroglobulin were measured using immunoassays. Logistic regression compared standardised inflammatory marker levels in cases and controls. Negative binomial regression evaluated associations between inflammatory markers and co-morbidity (number of mental disorders). Models were adjusted for sex, body mass index, cigarette smoking, cannabis use and employment status, then additionally for childhood trauma. RESULTS For psychotic disorder, there was evidence for associations with IL-6 (odds ratio[OR] 1.68, 95 %CI 1.20-2.34) and suPAR (OR 1.74, 95 %CI 1.17-2.58). There was weaker evidence for an association between suPAR and depressive disorder (OR 1.31, 95 %CI 1.05-1.62). There was little evidence for associations between inflammatory markers and generalised anxiety disorder. There was weak evidence for an association between suPAR and co-morbidity (β 0.10, 95 %CI 0.01-0.19). There was little evidence for additional confounding by childhood trauma. CONCLUSIONS There was evidence that 24-year-olds with psychotic disorder had raised plasma IL-6 and suPAR concentrations compared to controls. These findings have implications regarding the role of inflammation in mental disorders in early adulthood.
Collapse
Affiliation(s)
- David Mongan
- Centre for Public Health, Queen's University Belfast, Northern Ireland; Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland.
| | - Subash Raj Susai
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Melanie Föcking
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Jonah F Byrne
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Stan Zammit
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom; National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust, University of Bristol, Bristol, United Kingdom; Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, United Kingdom
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - David R Cotter
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| |
Collapse
|
79
|
Boals A. Illusory posttraumatic growth is common, but genuine posttraumatic growth is rare: A critical review and suggestions for a path forward. Clin Psychol Rev 2023; 103:102301. [PMID: 37331153 DOI: 10.1016/j.cpr.2023.102301] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 05/30/2023] [Accepted: 05/31/2023] [Indexed: 06/20/2023]
Abstract
Over the last 2.5 decades, trauma researchers have increasingly become interested in posttraumatic growth (PTG) - the concept that some people experience growth as a result of trauma exposure. I begin by reviewing extant research on PTG, with a focus on measurement and conceptual issues. Expanding on arguments made by others, I distinguish between three forms of PTG, 1) perceived PTG, which is an individual's beliefs about their own PTG, 2) genuine PTG, which is veridical growth following adversity, and 3) illusory PTG, which is motivated fabrications of PTG. Perceived PTG is extremely common, as over half of individuals exposed to a potentially traumatic event (PTE) report moderate or greater levels of PTG. I review evidence that most self-reports of PTG are greatly exaggerated and argue that perceived PTG is mostly illusory PTG. I propose five reasons for the disconnect between perceived PTG and genuine PTG, including design flaws in the current measurements, emotional biases that favor perceived PTG, the inherent appeal of PTG, cultural expectations, and problems of definition. I then review the empirical evidence concerning the prevalence rate of genuine PTG, coming to the bold conclusion that the occurrence of genuine PTG is very rare, contradicting current fundamental beliefs about PTG. I recommend researchers focus on the key areas of measurement and etiology of genuine PTG, which are necessary to create interventions that foster genuine PTG. I conclude by outlining a path to steer the scientific progression of PTG back in the right direction.
Collapse
Affiliation(s)
- Adriel Boals
- University of North Texas, United States of America.
| |
Collapse
|
80
|
Rosa M, Scassellati C, Cattaneo A. Association of childhood trauma with cognitive domains in adult patients with mental disorders and in non-clinical populations: a systematic review. Front Psychol 2023; 14:1156415. [PMID: 37425159 PMCID: PMC10327487 DOI: 10.3389/fpsyg.2023.1156415] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 06/01/2023] [Indexed: 07/11/2023] Open
Abstract
Although the association between cognitive performances and the onset of psychiatric disorders has been widely investigated, limited research on the role of childhood trauma or early life stress (CT/ELS), and whether this role differs between clinical and non-clinical cohorts is available. This systematic review aims at filling this gap, testing whether the occurrence of CT/ELS and its subtypes are associated with cognitive domains (general cognitive ability, executive functions, working memory, attention, processing speed, verbal/visual memory) in patients with psychiatric disorders and in non-clinical populations. This study followed the PRISMA 2020 guidelines and the Newcastle-Ottawa scale for quality assessment. The search was performed until May 2022. Seventy-four studies were classified as eligible. The graphical representations of the results reported an association between exposure to CT/ELS and worse general cognitive ability, verbal/visual memory, processing speed and attention in patients affected by anxiety, mood and psychotic disorders, and that specific CT/ELS subtypes (physical neglect, physical/sexual abuse) can differentially influence specific cognitive abilities (executive functions, attention, working memory, verbal/visual memory). In non-clinical cohorts we found associations between CT/ELS exposure and impairments in executive functions, processing speed and working memory, while physical neglect was related to general cognitive ability and working memory. Concerning the emotional abuse/neglect subtypes in both populations, the results indicated their involvement in cognitive functioning; however, the few studies conducted are not enough to reach definitive conclusions. These findings suggest an association of CT/ELS with specific cognitive deficits and psychopathology.
Collapse
Affiliation(s)
- Melissa Rosa
- Laboratory of Biological Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Catia Scassellati
- Laboratory of Biological Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Annamaria Cattaneo
- Laboratory of Biological Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| |
Collapse
|
81
|
Bartolomé-Valenzuela M, Pereda N, Guilera G. [Prevalence of adverse and victimization experiences in adult people with severe mental illness in Barcelona]. GACETA SANITARIA 2023; 37:102314. [PMID: 37348295 DOI: 10.1016/j.gaceta.2023.102314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 05/08/2023] [Accepted: 05/09/2023] [Indexed: 06/24/2023]
Abstract
OBJECTIVE To describe the extension of the adverse experiences, including victimization, lived in childhood and adulthood in a sample of people with severe mental illness residing in Barcelona, Spain. METHOD Descriptive, quantitative and cross-sectional study. Adverse and victimization experiences were assessed using 26 items from the Adverse Childhood Experiences Questionnaire (ACE-IQ). Items were included obtain information regarding victimization during adulthood. Seventy-four people with severe mental illness were interviewed (median age: 42.03 years; standard deviation: 9.60). RESULTS All participants reported at least two victimization experiences throughout their lifetime. The most frequent experiences were conventional crimes (87.8%) and victimization by caregivers (86.5%). Before age 18, half of the participants reported having experienced physical violence by their caregivers (52.7%) and almost one out of three reported to have been victim of sexual abuse (32.4%). Women were almost 13 times more likely to experience sexual victimization than men throughout their lifetime (odds ratio: 12.75; 95% confidence interval: 4.19-38.71). CONCLUSIONS Victimization experienced by people with severe mental illness is a widespread problem that has received little attention. The results of this study are consistent with those obtained in previous investigations and underscore the need to translate this knowledge into medical practice into medical practice, considering them in order to develop treatments with a comprehensive approach to mental health.
Collapse
Affiliation(s)
- Marina Bartolomé-Valenzuela
- Grupo de Investigación en Victimización Infantil y Adolescente (GReVIA), Departamento de Psicología Clínica y Psicobiología, Facultad de Psicología, Universidad de Barcelona, Barcelona, España
| | - Noemí Pereda
- Grupo de Investigación en Victimización Infantil y Adolescente (GReVIA), Departamento de Psicología Clínica y Psicobiología, Facultad de Psicología, Universidad de Barcelona, Barcelona, España.
| | - Georgina Guilera
- Grupo de Investigación en Victimización Infantil y Adolescente (GReVIA), Departamento de Psicología Social y Psicología Cuantitativa, Facultad de Psicología, Universidad de Barcelona, Barcelona, España
| |
Collapse
|
82
|
Zhang Q, Wu W, Sheng L, Xi X, Zhou Y, Wen Y, Liu Q. Emotional and Behavioral Changes in Preschool Firstborn Children During Transition to Siblinghood: A Mixed Methods Study. Psychol Res Behav Manag 2023; 16:2029-2044. [PMID: 37292056 PMCID: PMC10246780 DOI: 10.2147/prbm.s411729] [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] [Received: 03/09/2023] [Accepted: 05/31/2023] [Indexed: 06/10/2023] Open
Abstract
Purpose To help firstborn children in families expecting a second child navigate the role transition more smoothly, we investigated the emotional and behavioral changes of firstborn children during the transition to siblinghood (TTS) and the factors that contribute to these changes. Patients and Methods From March to December 2019, a total of 97 firstborn children (Mage=3.00± 0.97, and female = 51) were included in the study through a questionnaire survey of their mothers, and two follow-up visits were conducted in Chongqing, China. Individual in-depth interviews were conducted with 14 mothers. Results Both quantitative and qualitative results suggest that emotional and behavioral problems of firstborn children tend to increase during TTS, particularly in issues such as anxiety/depression, somatic complaints, withdrawal, sleep problems, attention problems, and aggressive behavior, as well as internalization problems, externalization problems and total problems in the quantitative study (P<0.05). A poor father-child relationship may increase emotional and behavioral problems in firstborn children (P=0.05). Further qualitative analysis found that younger age and outgoing personality of the firstborn child may improve the emotional and behavioral problems. Conclusion The firstborn children did have more emotional and behavioral problems during TTS. But these problems can be regulated by family factors and their own characteristics.
Collapse
Affiliation(s)
- Qin Zhang
- School of Public Health, Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Wenyi Wu
- School of Public Health, Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Lulu Sheng
- School of Public Health, Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Xuan Xi
- School of Public Health, Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Yuanke Zhou
- School of Public Health, Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Yi Wen
- Chongqing Health Center for Women and Children, Chongqing, People’s Republic of China
| | - Qin Liu
- School of Public Health, Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, People’s Republic of China
| |
Collapse
|
83
|
Li X, Liu XL, Wang YJ, Zhou DS, Yuan TF. The effects of childhood maltreatment on adolescent non-suicidal self-injury behavior: mediating role of impulsivity. Front Psychiatry 2023; 14:1139705. [PMID: 37304425 PMCID: PMC10250706 DOI: 10.3389/fpsyt.2023.1139705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 05/11/2023] [Indexed: 06/13/2023] Open
Abstract
Background Non-suicidal self-injury (NSSI) severely challenges mental health in adolescents. Childhood maltreatment experience acts as high-risk factor for adolescents to engage in NSSI behaviors. On the other hand, impulsivity or loss of control sets the threshold for NSSI execution. Here we examined the effects of childhood maltreatment on adolescent NSSI-related clinical outcomes and the potential role of impulsivity. Methods We assessed the clinical data of 160 hospitalized NSSI adolescents and recruited 64 age-matched healthy subjects as a control group. The clinical symptoms of NSSI are expressed by the NSSI frequency, depression, and anxiety measured by the Ottawa Self-Injury Inventory, the Beck Depression Inventory, and the Beck Anxiety Inventory. Childhood maltreatment and impulsivity were assessed with Childhood Trauma Questionnaire and Barratt Impulsiveness Scale. Results The results showed that when compared to HC group, NSSI group is more likely to experience childhood maltreatment. Notably, NSSI group with Childhood maltreatment accompanies higher trait impulsivity and exacerbated clinical outcomes, such as NSSI frequency, depression and anxiety symptoms. Mediation analyses indicated that the association between childhood maltreatment and NSSI-related clinical outcomes was partially explained by impulsivity. Conclusion We found that NSSI adolescents have a higher proportion of childhood maltreatment. Impulsivity plays a mediating role between childhood maltreatment and NSSI behaviors.
Collapse
Affiliation(s)
- Xi Li
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Xiao-Li Liu
- Department of Psychiatry, Ningbo Kangning Hospital, Ningbo, China
| | - Yu-Jing Wang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Dong-Sheng Zhou
- Department of Psychiatry, Ningbo Kangning Hospital, Ningbo, China
| | - Ti-Fei Yuan
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Co-innovation Center of Neuroregeneration, Nantong University, Nantong, China
| |
Collapse
|
84
|
Streit F, Völker MP, Klinger-König J, Zillich L, Frank J, Reinhard I, Foo JC, Witt SH, Sirignano L, Becher H, Obi N, Riedel O, Do S, Castell S, Hassenstein MJ, Karch A, Stang A, Schmidt B, Schikowski T, Stahl-Pehe A, Brenner H, Perna L, Greiser KH, Kaaks R, Michels KB, Franzke CW, Peters A, Fischer B, Konzok J, Mikolajczyk R, Führer A, Keil T, Fricke J, Willich SN, Pischon T, Völzke H, Meinke-Franze C, Loeffler M, Wirkner K, Berger K, Grabe HJ, Rietschel M. The interplay of family history of depression and early trauma: associations with lifetime and current depression in the German national cohort (NAKO). FRONTIERS IN EPIDEMIOLOGY 2023; 3:1099235. [PMID: 38523800 PMCID: PMC10959537 DOI: 10.3389/fepid.2023.1099235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 04/28/2023] [Indexed: 03/26/2024]
Abstract
Introduction Family history of depression and childhood maltreatment are established risk factors for depression. However, how these factors are interrelated and jointly influence depression risk is not well understood. The present study investigated (i) if childhood maltreatment is associated with a family history of depression (ii) if family history and childhood maltreatment are associated with increased lifetime and current depression, and whether both factors interact beyond their main effects, and (iii) if family history affects lifetime and current depression via childhood maltreatment. Methods Analyses were based on a subgroup of the first 100,000 participants of the German National Cohort (NAKO), with complete information (58,703 participants, mean age = 51.2 years, 53% female). Parental family history of depression was assessed via self-report, childhood maltreatment with the Childhood Trauma Screener (CTS), lifetime depression with self-reported physician's diagnosis and the Mini-International Neuropsychiatric Interview (MINI), and current depressive symptoms with the depression scale of the Patient Health Questionnaire (PHQ-9). Generalized linear models were used to test main and interaction effects. Mediation was tested using causal mediation analyses. Results Higher frequencies of the childhood maltreatment measures were found in subjects reporting a positive family history of depression. Family history and childhood maltreatment were independently associated with increased depression. No statistical interactions of family history and childhood maltreatment were found for the lifetime depression measures. For current depressive symptoms (PHQ-9 sum score), an interaction was found, with stronger associations of childhood maltreatment and depression in subjects with a positive family history. Childhood maltreatment was estimated to mediate 7%-12% of the effect of family history on depression, with higher mediated proportions in subjects whose parents had a depression onset below 40 years. Abuse showed stronger associations with family history and depression, and higher mediated proportions of family history effects on depression than neglect. Discussion The present study confirms the association of childhood maltreatment and family history with depression in a large population-based cohort. While analyses provide little evidence for the joint effects of both risk factors on depression beyond their individual effects, results are consistent with family history affecting depression via childhood maltreatment to a small extent.
Collapse
Affiliation(s)
- Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Maja P. Völker
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Johanna Klinger-König
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Lea Zillich
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Josef Frank
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Iris Reinhard
- Department of Biostatistics, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Jerome C. Foo
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Stephanie H. Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Lea Sirignano
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Heiko Becher
- Institute of Global Health, University Hospital Heidelberg, Heidelberg, Germany
| | - Nadia Obi
- Institute of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Oliver Riedel
- Leibniz-Institut für Präventionsforschung und Epidemiologie – BIPS, Bremen, Deutschland
| | - Stefanie Do
- Leibniz-Institut für Präventionsforschung und Epidemiologie – BIPS, Bremen, Deutschland
| | - Stefanie Castell
- Department for Epidemiology, Helmholtz Centre for Infection Research (HZI), Braunschweig, Germany
| | - Max J. Hassenstein
- Department for Epidemiology, Helmholtz Centre for Infection Research (HZI), Braunschweig, Germany
- PhD Programme “Epidemiology”, Braunschweig-Hannover, Germany
| | - André Karch
- Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany
| | - Andreas Stang
- Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany
| | - Börge Schmidt
- Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany
| | - Tamara Schikowski
- IUF—Leibniz Institute for Environmental Medicine, Düsseldorf, Germany
| | - Anna Stahl-Pehe
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research, University of Düsseldorf, Düsseldorf, Germany
| | - Hermann Brenner
- Network Ageing Research (NAR), Heidelberg University, Heidelberg, Germany
- Division of Clinical Epidemiology & Ageing Research, German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - Laura Perna
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Karin Halina Greiser
- German Cancer Research Centre (DKFZ) Heidelberg, Div. of Cancer Epidemiology, Heidelberg, Germany
| | - Rudolf Kaaks
- German Cancer Research Centre (DKFZ) Heidelberg, Div. of Cancer Epidemiology, Heidelberg, Germany
| | - Karin B. Michels
- Institute for Prevention and Cancer Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Claus-Werner Franzke
- Institute for Prevention and Cancer Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum Munchen, German Research Centre for Environmental Health, Neuherberg, Germany
- Chair of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Medical Faculty, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Beate Fischer
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Julian Konzok
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Rafael Mikolajczyk
- Institute for Medical Epidemiology, Biometrics and Informatics (IMEBI), Interdisciplinary Centre for Health Sciences, Medical School of the Martin Luther University Halle-Wittenberg, Halle, Germany
- German Center for Mental Health, Site Jena-Magdeburg-Halle, Jena, Germany
| | - Amand Führer
- Institute for Medical Epidemiology, Biometrics and Informatics (IMEBI), Interdisciplinary Centre for Health Sciences, Medical School of the Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Thomas Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Institute for Clinical Epidemiology and Biometry, University of Wuerzburg, Wuerzburg, Germany
- State Institute of Health, Bavarian Health and Food Safety Authority, Bad Kissingen, Germany
| | - Julia Fricke
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Stefan N. Willich
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Tobias Pischon
- Max-Delbrueck-Centre for Molecular Medicine in the Helmholtz Association (MDC), Molecular Epidemiology Research Group, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Max-Delbrueck-Centre for Molecular Medicine in the Helmholtz Association (MDC), Biobank Technology Platform, Berlin, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Claudia Meinke-Franze
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Markus Loeffler
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany
- Leipzig Research Center for Civilization Diseases (LIFE), University of Leipzig, Leipzig, Germany
| | - Kerstin Wirkner
- Leipzig Research Center for Civilization Diseases (LIFE), University of Leipzig, Leipzig, Germany
| | - Klaus Berger
- Institute of Epidemiology & Social Medicine, University of Muenster, Muenster, Germany
| | - Hans J. Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| |
Collapse
|
85
|
Linsen F, Broeder C, Sep MSC, Verhoeven JE, Bet PM, Penninx BWJH, Meijer OC, Vinkers CH. Glucocorticoid Receptor (GR) antagonism as disease-modifying treatment for MDD with childhood trauma: protocol of the RESET-medication randomized controlled trial. BMC Psychiatry 2023; 23:331. [PMID: 37170109 PMCID: PMC10173560 DOI: 10.1186/s12888-023-04830-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 04/29/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is a heterogeneous psychiatric disorder. Childhood trauma (CT, emotional/physical/sexual abuse or neglect before the age of 18) is one of the largest and most consistent risk factors for development and poor course of MDD. Overactivity of the HPA-axis and the stress hormone cortisol is thought to play a role in the vulnerability for MDD following exposure to CT. Rodent experiments showed that antagonism of the glucocorticoid receptor (GR) at adult age reversed the effects of early life stress. Similarly, we aim to target MDD in individuals with CT exposure using the GR antagonist mifepristone. METHODS The RESET-medication study is a placebo-controlled double-blind randomized controlled trial (RCT) which aims to include 158 adults with MDD and CT. Participants will be randomized (1:1) to a 7-day treatment arm of mifepristone (1200 mg/day) or a control arm (placebo). Participants are allowed to receive usual care for MDD including antidepressants. Measurements include three face-to-face meetings at baseline (T0), day 8 (T1), week 6 (T2), and two online follow-up meetings at 12 weeks (T3) and 6 months (T4). A subgroup of participants (N = 80) are included in a fMRI sub-study (T0, T2). The main study outcome will be depressive symptom severity as measured with the Inventory of Depressive Symptomatology-Self Rated (IDS-SR) at T2. Secondary outcomes include, among others, depressive symptom severity at other time points, disability, anxiety, sleep and subjective stress. To address underlying mechanisms mifepristone plasma levels, cortisol, inflammation, epigenetic regulation and fMRI measurements are obtained. DISCUSSION The RESET-medication study will provide clinical evidence whether GR antagonism is a disease-modifying treatment for MDD in individuals exposed to CT. If effective, this hypothesis-driven approach may extend to other psychiatric disorders where CT plays an important role. TRIAL REGISTRATION The trial protocol has been registered 01-02-2022 on ClinicalTrials.gov with ID "NCT05217758".
Collapse
Affiliation(s)
- F Linsen
- Department of Psychiatry, Amsterdam University Medical Center Location Vrije Universiteit Amsterdam, Amsterdam, 1081 HV, The Netherlands.
- Department of Anatomy & Neurosciences, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, 1081 HV, The Netherlands.
| | - C Broeder
- Department of Psychiatry, Amsterdam University Medical Center Location Vrije Universiteit Amsterdam, Amsterdam, 1081 HV, The Netherlands
- Department of Anatomy & Neurosciences, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, 1081 HV, The Netherlands
| | - M S C Sep
- Department of Psychiatry, Amsterdam University Medical Center Location Vrije Universiteit Amsterdam, Amsterdam, 1081 HV, The Netherlands
- GGZ inGeest Mental Health Care, Amsterdam, 1081 HJ, The Netherlands
| | - J E Verhoeven
- Department of Psychiatry, Amsterdam University Medical Center Location Vrije Universiteit Amsterdam, Amsterdam, 1081 HV, The Netherlands
- GGZ inGeest Mental Health Care, Amsterdam, 1081 HJ, The Netherlands
| | - P M Bet
- Department of Clinical Pharmacology and Pharmacy, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, 1081 HV, the Netherlands
| | - B W J H Penninx
- Department of Psychiatry, Amsterdam University Medical Center Location Vrije Universiteit Amsterdam, Amsterdam, 1081 HV, The Netherlands
- Amsterdam Public Health, Mental Health Program and Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress Program, Amsterdam, The Netherlands
| | - O C Meijer
- Division of Endocrinology, Department of Internal Medicine, Leiden University Medical Center, Leiden University, Leiden, 2333 ZA, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden University, Leiden, 2333 ZA, the Netherlands
| | - C H Vinkers
- Department of Psychiatry, Amsterdam University Medical Center Location Vrije Universiteit Amsterdam, Amsterdam, 1081 HV, The Netherlands
- Department of Anatomy & Neurosciences, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, 1081 HV, The Netherlands
- GGZ inGeest Mental Health Care, Amsterdam, 1081 HJ, The Netherlands
- Amsterdam Public Health, Mental Health Program and Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress Program, Amsterdam, The Netherlands
| |
Collapse
|
86
|
Zhang W, Tang Y, Wu Q, Zhou N, Lin X. Oppositional Defiant Disorder Symptoms and Multi-level Family Factors in Chinese Migrant Children: A Network Perspective. Res Child Adolesc Psychopathol 2023:10.1007/s10802-023-01074-9. [PMID: 37162687 DOI: 10.1007/s10802-023-01074-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2023] [Indexed: 05/11/2023]
Abstract
Based on the network theory of mental disorders, this study used network analysis to examine the network of ODD symptoms and multilevel family factors and identify the most crucial family factors influencing ODD symptoms in children. A total of 718 Chinese migrant children aged 7-14 years participated in this study. This study measured ODD symptoms, family system-level variables (3 factors), family dyadic-level variables (6 factors), and family individual-level variables (6 factors) with factors selected based on the multilevel family factors theory of ODD symptoms. The results indicated that (1) "annoy" was the center symptom of ODD, (2) "annoy" and "vindictive" was the main bridge connecting the multilevel family factors, and (3) family cohesion at the family system level, parent-child conflict at the family dyadic level, and parental depression at the family individual level were critical central and bridging influencing factors. The findings of this study highlight the critical role of "annoy" and "vindictive" symptoms in the activation of ODD symptom networks in children and provide a basis for future improvements in diagnostic criteria. These potential core and bridge factors might become key intervention targets for childhood ODD.
Collapse
Affiliation(s)
- Wenrui Zhang
- Institute of Developmental Psychology, School of Psychology, Beijing Normal University, Beijing, 100875, China
| | - Yingying Tang
- Institute of Developmental Psychology, School of Psychology, Beijing Normal University, Beijing, 100875, China
- Department of Human Development and Family Sciences, The University of Texas at Austin, Austin, 78705, United States
| | - Qinglu Wu
- Institute of Advanced Studies in Humanities and Social Sciences, Beijing Normal University at Zhuhai, Zhuhai, China
| | - Nan Zhou
- Faculty of Education, University of Macau, Macau, China
| | - Xiuyun Lin
- Institute of Developmental Psychology, School of Psychology, Beijing Normal University, Beijing, 100875, China.
- Beijing Key Laboratory of Applied Experimental Psychology, School of Psychology, Beijing Normal University, Beijing, 100875, China.
| |
Collapse
|
87
|
Li T, Mao Z, Zhao L, Sun Y, Wang C, Bo Q. Childhood trauma and its influence on the clinical features of bipolar disorder. CHILD ABUSE & NEGLECT 2023; 141:106203. [PMID: 37088009 DOI: 10.1016/j.chiabu.2023.106203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 04/03/2023] [Accepted: 04/16/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Childhood trauma is an environmental risk factor for bipolar disorder (BD), But its influence on the clinical features of BD has not been examined sufficiently. OBJECTIVE We compared the childhood trauma between patients with BD and healthy controls (HCs) and determined how childhood trauma impacts clinical features, such as severity, mood episodes, and disease duration. PARTICIPANTS AND SETTING The study population comprised patients with BD (in a state of euthymia or depression, n = 90) and HCs (n = 94). METHODS The Structured Clinical Interview for DSM-IV Axis I Disorders was used to diagnose BD and ascertain its clinical features. The Childhood Trauma Questionnaire (CTQ) was used to assess childhood trauma. RESULTS The total CTQ score and scores for the CTQ subscales emotional abuse, sexual abuse, emotional neglect, and physical neglect, significantly differed between the BD and HC groups. Emotional abuse was correlated with higher Hamilton Anxiety Rating Scale (HARS) score and more frequent mood episodes; emotional neglect was correlated with higher HARS score, longer disease duration, and more mood episodes; and total CTQ score was positively correlated with HARS score, disease duration, and mood episodes. Regression analysis showed that emotional neglect significantly predicted HARS score, Hamilton Depression Rating Scale score, and disease duration in the BD group (P < 0.05). CONCLUSIONS Patients with BD have more serious childhood trauma. General childhood trauma, emotional abuse, and emotional neglect negatively affect the clinical features of BD.
Collapse
Affiliation(s)
- Tian Li
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China
| | - Zhen Mao
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China
| | - Lei Zhao
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China
| | - Yue Sun
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China
| | - Chuanyue Wang
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China
| | - Qijing Bo
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China.
| |
Collapse
|
88
|
Berhe O, Moessnang C, Reichert M, Ma R, Höflich A, Tesarz J, Heim CM, Ebner-Priemer U, Meyer-Lindenberg A, Tost H. Dose-dependent changes in real-life affective well-being in healthy community-based individuals with mild to moderate childhood trauma exposure. Borderline Personal Disord Emot Dysregul 2023; 10:14. [PMID: 37076921 PMCID: PMC10116660 DOI: 10.1186/s40479-023-00220-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 03/28/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND Childhood trauma exposures (CTEs) are frequent, well-established risk factor for the development of psychopathology. However, knowledge of the effects of CTEs in healthy individuals in a real life context, which is crucial for early detection and prevention of mental disorders, is incomplete. Here, we use ecological momentary assessment (EMA) to investigate CTE load-dependent changes in daily-life affective well-being and psychosocial risk profile in n = 351 healthy, clinically asymptomatic, adults from the community with mild to moderate CTE. FINDINGS EMA revealed significant CTE dose-dependent decreases in real-life affective valence (p = 0.007), energetic arousal (p = 0.032) and calmness (p = 0.044). Psychosocial questionnaires revealed a broad CTE-related psychosocial risk profile with dose-dependent increases in mental health risk-associated features (e.g., trait anxiety, maladaptive coping, loneliness, daily hassles; p values < 0.003) and a corresponding decrease in factors protective for mental health (e.g., life satisfaction, adaptive coping, optimism, social support; p values < 0.021). These results were not influenced by age, sex, socioeconomic status or education. CONCLUSIONS Healthy community-based adults with mild to moderate CTE exhibit dose-dependent changes in well-being manifesting in decreases in affective valence, calmness and energy in real life settings, as well as a range of established psychosocial risk features associated with mental health risk. This indicates an approach to early detection, early intervention, and prevention of CTE-associated psychiatric disorders in this at-risk population, using ecological momentary interventions (EMI) in real life, which enhance established protective factors for mental health, such as green space exposure, or social support.
Collapse
Affiliation(s)
- Oksana Berhe
- Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Square J5, 68159, Mannheim, Germany
| | - Carolin Moessnang
- Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Square J5, 68159, Mannheim, Germany
| | - Markus Reichert
- Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Square J5, 68159, Mannheim, Germany
- Department of eHealth and Sports Analytics, Faculty of Sport Science, Ruhr-University Bochum, Bochum, Germany
| | - Ren Ma
- Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Square J5, 68159, Mannheim, Germany
| | - Anna Höflich
- Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Square J5, 68159, Mannheim, Germany
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
- Department of Psychiatry and Psychotherapy, Karl Landsteiner University of Health Sciences, Tulln, Austria
| | - Jonas Tesarz
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Christine M Heim
- Institute of Medical Psychology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- College of Health & Human Development, The Pennsylvania State University, University Park, PA, USA
| | - Ulrich Ebner-Priemer
- Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Square J5, 68159, Mannheim, Germany
- mHealth Lab, Department of Applied Psychology, Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Square J5, 68159, Mannheim, Germany
| | - Heike Tost
- Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Square J5, 68159, Mannheim, Germany.
| |
Collapse
|
89
|
Gonzalez-Casals H, Vives J, Bosque-Prous M, Folch C, Drou-Roget G, Muntaner C, Vives-Cases C, Barbaglia MG, Colom J, Espelt A. Gender inequalities in the prevalence of low mood and related factors in schooled adolescents during the 2019-2020 school year: DESKcohort project. J Affect Disord 2023; 333:305-312. [PMID: 37084966 DOI: 10.1016/j.jad.2023.04.058] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 04/03/2023] [Accepted: 04/14/2023] [Indexed: 04/23/2023]
Abstract
BACKGROUND Mood disorders are the second most prevalent mental disorders in childhood and adolescence. Many undiagnosed people manifest subthreshold symptoms, like low mood, and present worse prognoses than asymptomatic healthy subjects. The aim of this study was to estimate the prevalence of low mood, gender inequalities, and associated factors, in 12- to 18-year-old adolescents in the rural and medium-sized urban areas of Central Catalonia during the 2019-2020 academic year. METHODS Cross-sectional study with data from a cohort of high-schooled students (2019-2020), with a convenience sample of 6428 adolescents from the Central region of Catalonia (48.3 % boys and 51.7 % girls). Prevalence of low mood was estimated by gender and exposure variables, and ratios were obtained using Poisson regression models, adjusting for several exposure variables one by one, and for all of them jointly. RESULTS The prevalence of low mood was 18.6 %, with statistically significant differences between genders (11.6 %, 95 % CI: 10.5-12.8 in boys and 25.1 %, 95 % CI: 23.7-26.6 in girls). Being an immigrant, dieting, and daily tobacco smoking were only associated with low mood in girls, whereas risky alcohol consumption was only associated in boys. Sexual violence was found to account for 36.2 % of low mood problems in girls. LIMITATIONS The main limitation of the study is its cross-sectional design, which means that no casual relationships can be extracted of this study. CONCLUSIONS The prevalence of low mood varies between the sexes, highlighting the importance of developing gender-specific interventions to reduce its incidence in young people, considering the factors associated with this condition.
Collapse
Affiliation(s)
- Helena Gonzalez-Casals
- Department of Epidemiology and Methodology of Social and Health Sciences, Faculty of Health Sciences of Manresa, Universitat de Vic - Universitat Central de Catalunya (UVic-UCC), Av. Universitària, 4-6, 08242 Manresa, Spain
| | - Jaume Vives
- Department of Psychobiology and Methodology in Health Sciences, Universitat Autònoma de Barcelona (UAB), C/de Ca n'Altayó, s/n, 08193 Bellaterra, Spain
| | - Marina Bosque-Prous
- Faculty of Health Sciences, Universitat Oberta de Catalunya, Rambla del Poblenou, 156, 08018 Barcelona, Spain; Department of Psychobiology and Methodology in Health Sciences, Universitat Autònoma de Barcelona (UAB), C/de Ca n'Altayó, s/n, 08193 Bellaterra, Spain.
| | - Cinta Folch
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Generalitat de Catalunya, Carretera de Canyet, s/n, 08916 Badalona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - Gemma Drou-Roget
- Department of Epidemiology and Methodology of Social and Health Sciences, Faculty of Health Sciences of Manresa, Universitat de Vic - Universitat Central de Catalunya (UVic-UCC), Av. Universitària, 4-6, 08242 Manresa, Spain
| | - Carles Muntaner
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Toronto, ON M6H 1B7, Canada
| | - Carmen Vives-Cases
- Department of Community Nursing, Preventive Medicine and Public Health and Science History, Universidad de Alicante, Ctra. De San Vicente del Raspeig, s/n, 03690 Alicante, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - María Gabriela Barbaglia
- Agència de Salut Pública de Barcelona, Pl. de Lesseps, 1, 08023 Barcelona, Spain; Department de Experimental and Health Sciences, Univeristat Pompeu Fabra, Plaça de la Mercè, 10-12, 08002 Barcelona, Spain
| | - Joan Colom
- Sub-Direcció General d'Addiccions, VIH, Infeccions de Transmissió Sexual i Hepatitis Víriques, Agència de Salut Pública de Catalunya, Departament de Salut, Generalitat de Catalunya, Carrer de Roc Boronat, 81-95, 08005 Barcelona, Spain
| | - Albert Espelt
- Department of Psychobiology and Methodology in Health Sciences, Universitat Autònoma de Barcelona (UAB), C/de Ca n'Altayó, s/n, 08193 Bellaterra, Spain; Department of Epidemiology and Methodology of Social and Health Sciences, Faculty of Health Sciences of Manresa, Universitat de Vic - Universitat Central de Catalunya (UVic-UCC), Av. Universitària, 4-6, 08242 Manresa, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| |
Collapse
|
90
|
Liu Q, Song X, Zhou X, Huang L, Zhang X, Wang L, Zhu S, Lan C, Yang W, Zhao W. Regional superficial amygdala resting-state functional connectivity in adults infers childhood maltreatment severity. PSYCHORADIOLOGY 2023; 3:kkad004. [PMID: 38666120 PMCID: PMC11003424 DOI: 10.1093/psyrad/kkad004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/11/2023] [Accepted: 04/17/2023] [Indexed: 04/28/2024]
Abstract
Background Childhood maltreatment (CM) is a potential risk factor for some neuropsychiatric disorders in adulthood (e.g. depression and anxiety) and alters trajectories of brain development. Accumulating evidence suggests that functional connectivity of the limbic system, especially the amygdala, is highly associated with childhood maltreatment, although not all studies have found this. These inconsistent results may be due to differential alterations of amygdala resting-state functional connectivity (rsFC) following childhood maltreatment. Objective Our aim was to investigate the relationship between the rsFC of amygdala subregions and CM severity, as well as to develop a stable rsFC-based model for inferring the severity of CM. Methods In this study, we employed the Childhood Trauma Questionnaire (CTQ) to assess CM severity in each individual. We explored the relationship between the rsFC of amygdala subregions (i.e. centromedial -CMA, basolateral -BLA, superficial-SFA amygdala) and CM experience in a discovery dataset of n = 110 healthy Chinese participants by linear multiple regression analysis. Subsequent dimensional and categorical approach were performed to elucidate the relationship between rsFCs and CM severity and CM subtypes, respectively. A support vector regression model was then conducted to validate the associations between rsFCs and total CTQ scores. Moreover, we also verified the model into another independent replication dataset (n = 38). Results Our findings suggested that childhood maltreatment was negatively associated with rsFC between the right superficial amygdala and perigenual anterior cingulate cortex (pgACC)/postcentral gyrus (PCG) but not the other two amygdala subregions. Moreover, SFA-pgACC coupling was more associated with physical neglect whereas the SFA-PCG was more related to emotional neglect. In addition, supervised machine learning confirmed that using these two rsFCs as predictors could stably estimate continuous maltreatment severity in both discovery and replication datasets. Conclusion The current study supports that the rsFCs of superficial amygdala are related to childhood maltreatment and which may be a potential biomarker for the effects of childhood maltreatment-related psychiatric disorders (i.e. depression and anxiety).
Collapse
Affiliation(s)
- Qi Liu
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Xinwei Song
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Xinqi Zhou
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu 610066, China
| | - Linghong Huang
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Xiaodong Zhang
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Lan Wang
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Siyu Zhu
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Chunmei Lan
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Wenxu Yang
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Weihua Zhao
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 611731, China
- Institute of Electronic and Information Engineering of UESTC in Guangdong, Dongguan 523808, China
| |
Collapse
|
91
|
McGINTY BETH. The Future of Public Mental Health: Challenges and Opportunities. Milbank Q 2023; 101:532-551. [PMID: 37096616 PMCID: PMC10126977 DOI: 10.1111/1468-0009.12622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 09/30/2022] [Accepted: 01/06/2023] [Indexed: 04/26/2023] Open
Abstract
Policy Points Social policies such as policies advancing universal childcare to expand Medicaid coverage of home- and community-based care for seniors and people with disabilities and for universal preschool are the types of policies needed to address social determinants of poor mental health. Population-based global budgeting approaches like accountable care and total cost of care models have the potential to improve population mental health by incentivizing health systems to control costs while simultaneously improving outcomes for the populations they serve. Policies expanding reimbursement for services delivered by peer support specialists are needed. People with lived experience of mental illness are uniquely well suited to helping their peers navigate treatment and other support services.
Collapse
|
92
|
Gholizadegan Rayat S, Nasseri N, Fariborzi E, Saffariantoosi M. Effectiveness of Psycho-Religious Sexuality Education upon Anger and Depression of Iranian Female Adolescents: The Relationship of Quality Family Relationships and Birth Order. JOURNAL OF RELIGION AND HEALTH 2023; 62:1070-1089. [PMID: 36538141 PMCID: PMC9765359 DOI: 10.1007/s10943-022-01716-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
Sexually active adolescents tend to have a wider range of psychosocial problems, including depression, anger, poor academic achievement, low self-esteem, and substance use. Developing a high-quality and curriculum-based comprehensive sexuality education (CSE) program is of great importance for adolescents following Iranian culture. Due to the lack of such an educational program, the purpose of this study was to investigate the effectiveness of psycho-religious CSE upon anger and depression of Iranian female adolescents, as well as the relationship of quality family relationships and birth order. The research design is quasi-experimental with pre-test and post-test with experimental and control groups. The statistical population of this study comprised all Iranian female adolescents aged 15 to 18 years in Mashhad who participated in this workshop voluntarily. For data collection, the Child and Adolescent Depression Inventory and Spielberger's State-Trait Anger Expression Inventory (STAXI) were used. SPSS 21 software and analysis of variance (ANOVA) and covariance (ANCOVA) were used for data analysis. The results showed that there was a significant difference in the mean difference between depression and anger in the control and experimental groups (p-Value < 0.05). The results also showed a significant relationship between birth order and the quality of family relationships on depression and anger. Psycho-religious-based SE can reduce depression and anger in female students. These findings can be used in planning educational interventions with a psycho-religious-based approach to reducing anger, depressive symptoms and dangerous sexual behaviors among adolescents.
Collapse
Affiliation(s)
| | - Naziasadat Nasseri
- Department of Educational Sciences, Mashhad Branch, Islamic Azad University, Mashhad, Iran
| | - Elham Fariborzi
- Department of Educational Sciences, Mashhad Branch, Islamic Azad University, Mashhad, Iran
| | | |
Collapse
|
93
|
Li W, Lai W, Guo L, Wang W, Li X, Zhu L, Shi J, Teopiz KM, McIntyre RS, Lu C. Childhood maltreatment and subsequent depressive symptoms: a prospective study of the sequential mediating role of self-esteem and internalizing/externalizing problems. BMC Psychiatry 2023; 23:179. [PMID: 36941572 PMCID: PMC10026476 DOI: 10.1186/s12888-023-04654-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 03/06/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Depression among adolescents is a seriously disabling public health problem with an extremely high prevalence. Identifying risk factors of depression at an early stage is important to reduce the disease burden. Childhood maltreatment (CM) is one of the major risk factors for depression. The key mediating processes that how CM affects the development of depression, however, still need further clarification. The present study tested the mediating effect of self-esteem, internalizing problems, and externalizing problems between CM and depressive symptoms. Potential sex differences in the foregoing associations were also explored. METHODS A three-wave longitudinal study was carried out among 1,957 middle and high school students from 69 classes in 10 public schools in the Guangdong province of China. Data collection started when students were in grades 7 and 10 (median age: 13.0, range: 11-18) between January and April 2019, and the students were followed up once a year thereafter. Self-reported CM, depressive symptoms, self-esteem, internalizing and externalizing problems, and other demographics were collected. The multiple serial mediation analysis was conducted. RESULTS We found that CM was positively related to subsequent internalizing and externalizing problems, as well as depressive symptoms, while self-esteem was negatively related to depressive symptoms. Serial mediation analysis indicated that self-esteem (mediator 1) and internalizing problems (mediator 2) sequentially mediated the path from CM to depressive symptoms in the overall and male population. Moreover, with externalizing problems as mediator 2, self-esteem (mediator 1) acted as a partial mediator in the association between CM and depressive symptoms in males, whereas externalizing problems played a complete mediating role in females. CONCLUSION Findings revealed that self-esteem and internalizing problems sequentially mediated the influence of CM on depressive symptoms whereas externalizing problems played an independent mediating role. In addition, sex differences need to be taken into consideration when designing prevention and intervention strategies, given the different psychosocial processes between boys and girls.
Collapse
Affiliation(s)
- Wenyan Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Rd 2, Guangzhou, 510080, China
| | - Wenjian Lai
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Rd 2, Guangzhou, 510080, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Rd 2, Guangzhou, 510080, China
| | - Wanxin Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Rd 2, Guangzhou, 510080, China
| | - Xiuwen Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Rd 2, Guangzhou, 510080, China
| | - Liwan Zhu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Rd 2, Guangzhou, 510080, China
| | - Jingman Shi
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Rd 2, Guangzhou, 510080, China
| | - Kayla M Teopiz
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
- Department of Pharmacology, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Rd 2, Guangzhou, 510080, China.
| |
Collapse
|
94
|
Souama C, Lamers F, Milaneschi Y, Vinkers CH, Defina S, Garvert L, Stein F, Woofenden T, Brosch K, Dannlowski U, Galenkamp H, de Graaf R, Jaddoe VWV, Lok A, van Rijn BB, Völzke H, Cecil CAM, Felix JF, Grabe HJ, Kircher T, Lekadir K, Have MT, Walton E, Penninx BWJH. Depression, cardiometabolic disease, and their co-occurrence after childhood maltreatment: an individual participant data meta-analysis including over 200,000 participants. BMC Med 2023; 21:93. [PMID: 36907864 PMCID: PMC10010035 DOI: 10.1186/s12916-023-02769-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 02/03/2023] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Childhood maltreatment is associated with depression and cardiometabolic disease in adulthood. However, the relationships with these two diseases have so far only been evaluated in different samples and with different methodology. Thus, it remains unknown how the effect sizes magnitudes for depression and cardiometabolic disease compare with each other and whether childhood maltreatment is especially associated with the co-occurrence ("comorbidity") of depression and cardiometabolic disease. This pooled analysis examined the association of childhood maltreatment with depression, cardiometabolic disease, and their comorbidity in adulthood. METHODS We carried out an individual participant data meta-analysis on 13 international observational studies (N = 217,929). Childhood maltreatment comprised self-reports of physical, emotional, and/or sexual abuse before 18 years. Presence of depression was established with clinical interviews or validated symptom scales and presence of cardiometabolic disease with self-reported diagnoses. In included studies, binomial and multinomial logistic regressions estimated sociodemographic-adjusted associations of childhood maltreatment with depression, cardiometabolic disease, and their comorbidity. We then additionally adjusted these associations for lifestyle factors (smoking status, alcohol consumption, and physical activity). Finally, random-effects models were used to pool these estimates across studies and examined differences in associations across sex and maltreatment types. RESULTS Childhood maltreatment was associated with progressively higher odds of cardiometabolic disease without depression (OR [95% CI] = 1.27 [1.18; 1.37]), depression without cardiometabolic disease (OR [95% CI] = 2.68 [2.39; 3.00]), and comorbidity between both conditions (OR [95% CI] = 3.04 [2.51; 3.68]) in adulthood. Post hoc analyses showed that the association with comorbidity was stronger than with either disease alone, and the association with depression was stronger than with cardiometabolic disease. Associations remained significant after additionally adjusting for lifestyle factors, and were present in both males and females, and for all maltreatment types. CONCLUSIONS This meta-analysis revealed that adults with a history of childhood maltreatment suffer more often from depression and cardiometabolic disease than their non-exposed peers. These adults are also three times more likely to have comorbid depression and cardiometabolic disease. Childhood maltreatment may therefore be a clinically relevant indicator connecting poor mental and somatic health. Future research should investigate the potential benefits of early intervention in individuals with a history of maltreatment on their distal mental and somatic health (PROSPERO CRD42021239288).
Collapse
Affiliation(s)
- Camille Souama
- Department of Psychiatry, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands.
- Amsterdam Public Health, Mental Health Program, Amsterdam, The Netherlands.
| | - Femke Lamers
- Department of Psychiatry, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, The Netherlands
| | - Yuri Milaneschi
- Department of Psychiatry, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Stress, and Sleep Program, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Complex Trait Genetics, Amsterdam, The Netherlands
| | - Christiaan H Vinkers
- Department of Psychiatry, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Stress, and Sleep Program, Amsterdam, The Netherlands
- Department Anatomy & Neurosciences, Amsterdam University Medical Center Location Vrije Universiteit Amsterdam, 1081 HV, Amsterdam, The Netherlands
- GGZ inGeest Mental Health Care, 1081 HJ, Amsterdam, The Netherlands
| | - Serena Defina
- Erasmus University Medical Center Rotterdam, Department of Child and Adolescent Psychiatry/Psychology, Rotterdam, The Netherlands
- Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Linda Garvert
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, 17475, Greifswald, Germany
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Tom Woofenden
- Department of Psychology, University of Bath, Bath, UK
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Henrike Galenkamp
- Department of Public and Occupational Health, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Ron de Graaf
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Vincent W V Jaddoe
- Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Paediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Anja Lok
- Department of Psychiatry, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Bas B van Rijn
- Department of Obstetrics and Fetal Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Henry Völzke
- Institute for Community Medicine, SHIP/KEF, University Medicine Greifswald, Greifswald, Germany
| | - Charlotte A M Cecil
- Erasmus University Medical Center Rotterdam, Department of Child and Adolescent Psychiatry/Psychology, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Molecular Epidemiology, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - Janine F Felix
- Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Paediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, 17475, Greifswald, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Karim Lekadir
- Faculty of Mathematics and Computer Science, Artificial Intelligence in Medicine Lab, University of Barcelona, Barcelona, Spain
| | - Margreet Ten Have
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Esther Walton
- Department of Psychology, University of Bath, Bath, UK
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Stress, and Sleep Program, Amsterdam, The Netherlands
| |
Collapse
|
95
|
Kisely S, Leske S, Arnautovska U, Siskind D, Warren N, Northwood K, Suetani S, Najman JM. A 40-year study of child maltreatment over the early life course predicting psychiatric morbidity, using linked birth cohort and administrative health data: protocol for the Childhood Adversity and Lifetime Morbidity (CALM) study. BJPsych Open 2023; 9:e50. [PMID: 36880844 PMCID: PMC10044170 DOI: 10.1192/bjo.2023.29] [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: 03/08/2023] Open
Abstract
BACKGROUND Child maltreatment is a major public health issue worldwide. Retrospective studies show a strong association between self-reported child maltreatment and poor mental and physical health problems. Prospective studies that use reports to statutory agencies are less common, and comparisons of self- and agency-reported abuse in the same cohort even rarer. AIMS This project will link state-wide administrative health data with prospective birth cohort data (N = 7223) from Brisbane in Queensland, Australia (including notifications to child protection agencies), to compare psychiatric outcomes in adulthood of agency- and self-reported child maltreatment while minimising attrition bias. METHOD We will compare people with all forms of self- and agency-reported child maltreatment to the rest of the cohort, adjusting for confounding in logistic, Cox or multiple regression models based on whether outcomes are categorical or continuous. Outcomes will be hospital admissions, emergency department presentations or community/out-patient contacts for ICD-10 psychiatric diagnoses, suicidal ideation and self-harm as recorded in the relevant administrative databases. CONCLUSIONS This study will track the life course outcomes of adults after having experienced child maltreatment, and so provide an evidence-based understanding of the long-term health and behavioural consequences of child maltreatment. It will also consider health outcomes that are particularly relevant for adolescents and young adults, especially in relation to prospective notifications to statutory agencies. Additionally, it will identify the overlap and differences in outcome for two different sources of child maltreatment identification in the same cohort.
Collapse
Affiliation(s)
- Steve Kisely
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Australia; Departments of Psychiatry, Community Health and Epidemiology, Dalhousie University, Canada; and Addiction and Mental Health Services, Metro South Addiction and Mental Health Service, Australia
| | - Stuart Leske
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Australia
| | - Urska Arnautovska
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Australia; and Addiction and Mental Health Services, Metro South Addiction and Mental Health Service, Australia
| | - Dan Siskind
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Australia; and Addiction and Mental Health Services, Metro South Addiction and Mental Health Service, Australia
| | - Nicola Warren
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Australia; and Addiction and Mental Health Services, Metro South Addiction and Mental Health Service, Australia
| | - Korinne Northwood
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Australia; and Addiction and Mental Health Services, Metro South Addiction and Mental Health Service, Australia
| | | | - Jake Moses Najman
- School of Public Health, The University of Queensland, Australia; and School of Social Sciences, The University of Queensland, Australia
| |
Collapse
|
96
|
Kenntemich L, von Hülsen L, Schäfer I, Böttche M, Lotzin A. Profiles of risk factors for depressive and anxiety symptoms during the COVID-19 pandemic: A latent class analysis. Psychiatry Res 2023; 323:115150. [PMID: 36913873 PMCID: PMC9985930 DOI: 10.1016/j.psychres.2023.115150] [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: 12/05/2022] [Revised: 02/27/2023] [Accepted: 03/04/2023] [Indexed: 03/07/2023]
Abstract
The COVID-19 pandemic has caused a high burden in the general population. The exposure to an accumulation of risk factors, as opposed to a single risk, may have been associated with higher levels of depressive and anxiety symptoms during the pandemic. This study aimed to (1) identify subgroups of individuals with distinct constellations of risk factors during the COVID-19 pandemic and (2) investigate differences in levels of depressive and anxiety symptoms. German participants (N = 2245) were recruited between June-September 2020 through an online survey (ADJUST study). Latent class analysis (LCA) and multiple group analyses (Wald-tests) were conducted to identify profiles of risk factors and examine differences in symptoms of depression (PHQ-9) and anxiety (GAD-2). The LCA included 14 robust risk factors of different domains, for example, sociodemographic (e.g., age), health-related (e.g., trauma), and pandemic-related (e.g., reduced income) factors. The LCA identified three risk profiles: High sociodemographic risk (11.7%), high social and moderate health-related risk (18.0%), and low general risk (70.3%). Individuals with high sociodemographic risk reported significantly higher symptom levels of depression and anxiety than the remaining groups. A better understanding of risk factor profiles could help to develop targeted prevention and intervention programs during pandemics.
Collapse
Affiliation(s)
- Laura Kenntemich
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg Eppendorf, Hamburg, Germany; Department of Psychology, MSH Medical School Hamburg, Hamburg, Germany.
| | - Leonie von Hülsen
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Ingo Schäfer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Maria Böttche
- Division of Clinical Psychological Intervention, Freie Universität Berlin, Germany; Forschungsabteilung, Zentrum ÜBERLEBEN, Berlin, Germany
| | - Annett Lotzin
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg Eppendorf, Hamburg, Germany; Department of Psychology, MSH Medical School Hamburg, Hamburg, Germany
| |
Collapse
|
97
|
Imperatori C, Barchielli B, Corazza O, Carbone GA, Prevete E, Montaldo S, De Rossi E, Massullo C, Tarsitani L, Ferracuti S, Pasquini M, Biondi M, Farina B, Bersani FS. The Relationship Between Childhood Trauma, Pathological Dissociation, and Behavioral Addictions in Young Adults: Findings from a Cross-Sectional Study. J Trauma Dissociation 2023; 24:348-361. [PMID: 36814178 DOI: 10.1080/15299732.2023.2181479] [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: 02/24/2023]
Abstract
Interactions between childhood trauma (CT) and dissociation can contribute to psychiatric disturbances. We explored this phenomenon in relation to behavioral addictions (BAs) in a sample (n = 633) of young adults (age: 18-34 years). Self-report measures investigating CT, dissociation, and symptoms related to gambling disorder, internet gaming disorder, problematic social media use, exercise dependence and compulsive buying were used. Scales related to BAs were summarized into a single measure ("Total Behavioral Addiction Index" - TBAI) for inferential analyses. A model analyzing the direct and indirect effects of CT on TBAI through the mediation of pathological dissociation was performed, controlling for confounding factors. Measures on CT, dissociation, and TBAI were significantly associated with each other (all p < .001). The total effect of CT on TBAI was significant (B = 0.063; CI: 0.045; 0.081); pathological dissociation significantly mediated such association (B = 0.023; CI: 0.013; 0.036). Our findings support the possibility that the interaction between CT and dissociation contributes to increase disturbances related to BAs.
Collapse
Affiliation(s)
- Claudio Imperatori
- Cognitive and Clinical Psychology Laboratory, Department of Human Sciences, European University of Rome, Rome, Italy
| | - Benedetta Barchielli
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Ornella Corazza
- Department of Clinical, Pharmaceutical and Biological Sciences, University of Hertfordshire, Hatfield, UK
| | - Giuseppe Alessio Carbone
- Cognitive and Clinical Psychology Laboratory, Department of Human Sciences, European University of Rome, Rome, Italy
| | - Elisabeth Prevete
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Simone Montaldo
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Elena De Rossi
- Cognitive and Clinical Psychology Laboratory, Department of Human Sciences, European University of Rome, Rome, Italy
| | - Chiara Massullo
- Experimental Psychology Laboratory, Department of Education, Roma Tre University, Rome, Italy
| | - Lorenzo Tarsitani
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Stefano Ferracuti
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Massimo Biondi
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Benedetto Farina
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | | |
Collapse
|
98
|
Popovic D, Falkai P. The Neurobiological and Epigenetic Links Between Negative Life Events and Behavioral Disturbances in Adolescent Youth. Biol Psychiatry 2023; 93:298-299. [PMID: 36653106 DOI: 10.1016/j.biopsych.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 12/02/2022] [Indexed: 01/18/2023]
Affiliation(s)
- David Popovic
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany; International Max Planck Research School for Translational Psychiatry, Munich, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany.
| |
Collapse
|
99
|
Guillen-Burgos H, Moreno-Lopez S, Acevedo-Vergara K, Pérez-Florez M, Pachón-Garcia C, Gálvez-Flórez JF. Risk of childhood trauma exposure and severity of bipolar disorder in Colombia. Int J Bipolar Disord 2023; 11:7. [PMID: 36763206 PMCID: PMC9918651 DOI: 10.1186/s40345-023-00289-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 02/01/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Bipolar disorder (BD) is higher in developing countries. Childhood trauma exposure is a common environmental risk factor in Colombia and might be associated with a more severe course of bipolar disorder in Low-Middle Income-Countries. We carried out the first case-control study in Colombia using a structural clinical interview and the Childhood Trauma Questionnaire-Short Form (CTQ-SF) to describe the prevalence and association between trauma exposure during childhood with a severe course of illness (early age onset, rapid cycling, ideation or suicide attempt, or ≥ 3 hospitalization) in a sample of BD patients. RESULTS A total of 114 cases and 191 controls evaluated showed the following results. Cases included 61.4% BD type I and 38.6% BD type II. The median age was 31.5 years (IQR, 75-24) for BD patients and 31 years old (IQR, 38-24) for healthy controls. A higher prevalence of childhood trauma was evidenced in cases compared to controls. Emotional abuse, physical abuse, sexual abuse, physical neglect and emotional neglect evidenced a strong association with severe bipolar disorder (OR = 3.42, p < .001; OR = 4.68, p < .001; OR = 4.30, p = .003; OR = 5.10, p < .001; OR = 5.64, p < .001, respectively). CONCLUSIONS This is the first association study between childhood trauma exposure as a higher risk for a severe course of illness in BD patients in Colombian. Our findings highlight the higher prevalence of childhood trauma in bipolar patients and the strong association of childhood trauma with severe bipolar disorder. These findings are relevant for screening and evaluating childhood trauma exposure during the course of BD patients.
Collapse
Affiliation(s)
- Hernán Guillen-Burgos
- Center for Clinical and Translational Research, La Misericordia Clinica Internacional, Barranquilla, Colombia. .,School of Health Science, Universidad Simon Bolivar, Carrera 54 No 64-222, Barranquilla, Colombia. .,Instituto Cardiovascular del Cesar, Valledupar, Colombia.
| | - Sergio Moreno-Lopez
- grid.7247.60000000419370714School of Medicine, Universidad de Los Andes, Bogotá, Colombia ,Otolaryngology and Allergology Research Group, Unidad Médico Quirúrgica de Otorrinolaringología (UNIMEQ‐ORL), Bogotá, Colombia
| | - Kaleb Acevedo-Vergara
- Center for Clinical and Translational Research, La Misericordia Clinica Internacional, Barranquilla, Colombia
| | - Manuel Pérez-Florez
- Center for Clinical and Translational Research, La Misericordia Clinica Internacional, Barranquilla, Colombia
| | - Catherine Pachón-Garcia
- Center for Clinical and Translational Research, La Misericordia Clinica Internacional, Barranquilla, Colombia
| | - Juan Francisco Gálvez-Flórez
- Center for Clinical and Translational Research, La Misericordia Clinica Internacional, Barranquilla, Colombia ,Zerenia Clinics, Bogotá, Colombia ,Latin American Society of Liaison Psychiatry (SOLAPSIQUE), Bogotá, Colombia
| |
Collapse
|
100
|
Samaey C, Lecei A, Achterhof R, Hagemann N, Hermans KSFM, Hiekkaranta AP, Kirtley OJ, Reininghaus U, Boets B, Myin-Germeys I, van Winkel R. The role of identity in the development of depressive, anxiety, and psychosis symptoms in adolescents exposed to childhood adversity. J Adolesc 2023. [PMID: 36737250 DOI: 10.1002/jad.12145] [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: 08/12/2022] [Revised: 01/18/2023] [Accepted: 01/19/2023] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Childhood adversity is a major risk factor for psychiatric disorders and has especially been associated with an admixture of depressive, anxiety, and psychosis symptoms. Identity formation, a main developmental task during adolescence, may be impacted by these adverse experiences and act as an important process in the association between childhood adversity and psychopathology. METHODS We investigated the association between childhood adversity, identity formation, and depressive, anxiety, and psychosis symptoms cross-sectionally in 1913 Flemish adolescents between 11 and 20 years old (mean = 13.76, SD = 1.86). Adolescents completed questionnaires during the first wave of the SIGMA study between January 2018 and May 2019. RESULTS Childhood interpersonal adversity was associated with increased identity confusion and decreased identity synthesis. Additionally, identity confusion was associated with increased self-reported levels of psychopathology and potentially mediated the association between childhood adversity and psychopathology. CONCLUSION This study highlights the importance of promoting healthy identity formation in adolescents with and without exposure to adverse childhood experiences.
Collapse
Affiliation(s)
- Celine Samaey
- KU Leuven, Department of Neurosciences, Research Group Psychiatry, Center for Clinical Psychiatry, Leuven, Belgium
| | - Aleksandra Lecei
- KU Leuven, Department of Neurosciences, Research Group Psychiatry, Center for Clinical Psychiatry, Leuven, Belgium
| | - Robin Achterhof
- KU Leuven, Department of Neurosciences, Research Group Psychiatry, Center for Contextual Psychiatry, Leuven, Belgium
| | - Noëmi Hagemann
- KU Leuven, Department of Neurosciences, Research Group Psychiatry, Center for Contextual Psychiatry, Leuven, Belgium
| | - Karlijn S F M Hermans
- Strategy and Academic Affairs, Administration and Central Services, Leiden University, Leiden, The Netherlands
| | - Anu P Hiekkaranta
- KU Leuven, Department of Neurosciences, Research Group Psychiatry, Center for Contextual Psychiatry, Leuven, Belgium
| | - Olivia J Kirtley
- KU Leuven, Department of Neurosciences, Research Group Psychiatry, Center for Contextual Psychiatry, Leuven, Belgium
| | - Ulrich Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Baden-Württemberg, Germany.,ESRC Centre for Society and Mental Health and Social Epidemiology Research Group, King's College London, London, London, UK
| | - Bart Boets
- KU Leuven, Department of Neurosciences, Research Group Psychiatry, Center for Developmental Psychiatry, Leuven, Belgium.,KU Leuven, Leuven Autism Research (LAuRes), Leuven, Belgium
| | - Inez Myin-Germeys
- KU Leuven, Department of Neurosciences, Research Group Psychiatry, Center for Contextual Psychiatry, Leuven, Belgium
| | - Ruud van Winkel
- KU Leuven, Department of Neurosciences, Research Group Psychiatry, Center for Clinical Psychiatry, Leuven, Belgium.,KU Leuven, University Psychiatric Center (UPC), Leuven, Belgium
| |
Collapse
|