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McLoughlin C, McWhirter L, Pisegna K, Tijssen MAJ, Tak LM, Carson A, Stone J. Stigma in functional neurological disorder (FND) - A systematic review. Clin Psychol Rev 2024; 112:102460. [PMID: 38905960 DOI: 10.1016/j.cpr.2024.102460] [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: 12/12/2023] [Revised: 05/10/2024] [Accepted: 06/10/2024] [Indexed: 06/23/2024]
Abstract
OBJECTIVE The purpose of this systematic review was to evaluate stigma and Functional Neurological Disorder (FND) regarding: 1) prevalence and associated factors, 2) the nature and context of stigma in FND, and 3) stigma-reduction interventions. METHODS We searched four relevant databases from inception to December 2023, using search terms relevant to FND and stigma themes. We employed the method of synthesis by "aggregation and configuration" to synthesise and analyse the data into emergent themes. RESULTS We found 127 studies, spanning 148 countries, involving 18,886 participants. Of these, 4889 were patients, 13,123 were healthcare professionals, and 526 were caregivers. Quantitatively, stigma has been mainly studied in patients with functional seizures, and was higher than patients with epilepsy in three studies. Stigma experienced by patients is associated with poorer quality of life and caregiver burden. We found 10 themes and 29 subthemes revealing stigma as a systemic process, with intrapersonal, interpersonal and structural aspects. Few studies examined the perspective of caregivers, the public or online community. We identified six anti-stigma interventions. CONCLUSION Stigma in FND is a layered process, and affects patient quality of life and provision of care. Stigma needs to be addressed from the top structures, at governmental level, so that appropriate care pathways can be created, giving patients with FND parity of esteem with other medical conditions.
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Affiliation(s)
- Caoimhe McLoughlin
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom.
| | - Laura McWhirter
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | | | - Marina A J Tijssen
- UMCG Expertise Centre Movement Disorders Groningen, University of Groningen, Groningen, the Netherlands
| | - Lineke M Tak
- Dimence Alkura, Specialist center Persistent Somatic Symptoms, Nico Bolkensteinlaan 65, 7416 SE Deventer, the Netherlands
| | - Alan Carson
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Jon Stone
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
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Liu Y, Qiu H, Tang F, Huang Z, Gao Y, Wang Y, Wang S, Zhang Y. Association of adverse childhood experiences with poor health condition among middle-aged and elderly adults in the United States: A nationally retrospective cohort study. Psychiatry Res 2024; 338:115977. [PMID: 38823165 DOI: 10.1016/j.psychres.2024.115977] [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: 12/20/2023] [Revised: 04/27/2024] [Accepted: 05/23/2024] [Indexed: 06/03/2024]
Abstract
BACKGROUND The specific effects of adverse childhood experiences (ACEs) in adulthood and senectitude were less known. We aim to examine the relationship between early ACEs and overall health condition as well as specific dimensions in the middle-aged and elderly population. METHODS In the 2019-2021 Behavioral Risk Factor Surveillance System Study, robust Poisson regression models were used to estimate the relationship between ACE exposure and current health status among adults aged 45 ≥ years. RESULTS Of the 195,472 participants, 53.8 % were female and the mean age was 65.0 years. Compared to populations without ACE, ACE exposures were more significantly associated with depression (PR: 2.03, 95 %CI: 1.94-2.21), frequent mental health (PR: 1.85, 95 %CI: 1.74-1.97) and subject cognitive decline (PR: 1.99, 95 %CI:1.85-2.14) than with physical health (PR: 1.37, 95 %CI: 1.32-1.44), with dose-response patterns. The association with mental disorder was especially significant among the elderly population. CONCLUSION Early ACEs are associated with adverse health outcomes that persist into later life, particularly mental disorders and cognitive decline. Poor mental health may indirectly influence associations with ACEs and cognitive decline as well as physical health. Our findings emphasize the importance of lifelong psychological screening and support for the ACE-exposed middle-aged and elderly population.
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Affiliation(s)
- Yan Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jiamusi University, Jiamusi, China
| | - Hongbin Qiu
- Department of Epidemiology and Biostatistics, School of Public Health, Jiamusi University, Jiamusi, China
| | - Fan Tang
- Department of Epidemiology and Biostatistics, School of Public Health, Jiamusi University, Jiamusi, China
| | - Zemin Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Jiamusi University, Jiamusi, China
| | - Yi Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Jiamusi University, Jiamusi, China
| | - Ye Wang
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education; State Key Laboratory of Frigid Zone Cardiovascular Diseases (SKLFZCD), Harbin, China
| | - Shanjie Wang
- Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education; State Key Laboratory of Frigid Zone Cardiovascular Diseases (SKLFZCD), Harbin, China
| | - Yiying Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Jiamusi University, Jiamusi, China.
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Schwartz A, Galera C, Arsandaux J, Montagni I, Tzourio C. Adverse Childhood Experiences and Illegal Drug Use Among College Students: Findings from a French Sample. Int J Behav Med 2024:10.1007/s12529-023-10256-0. [PMID: 38169052 DOI: 10.1007/s12529-023-10256-0] [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] [Accepted: 12/22/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND While studies have demonstrated the negative impact of adverse childhood experiences (ACEs) on lifelong health, less is known about the relationship between ACEs and illegal drug use. Thus, the objective of the study was to examine the relationship between ACEs and illegal drug use among college students. METHODS French college students between 18 and 30 years enrolled in a university cohort study were eligible for inclusion. Multivariate logistic regression models were conducted for each drug. RESULTS Among the sample (n = 1,157), 30.6% had no ACE exposure, 29.6%, 19.2%, and 20.7% had 1, 2 and ≥ 3 ACEs, respectively. Students with ACEs had a higher likelihood of using illegal drugs (p = 0.0067). After controlling for potential confounders, having ≥ 3 ACEs increased the risk of lifetime use of multiple drugs (aOR:10.9; 95% CI: 4.6-26.0), stimulants (aOR: 3.6; 95% CI:1.7-7.7), hallucinogens (aOR: 2.0; 95% CI: 1.1-3.5), cannabis (aOR: 4.7; 95% CI: 2.7-8.0), and risky illegal drugs (e.g., higher lifetime frequency drug use) (aOR: 2.9; 95% CI: 1.5-5.8). Estimates for illegal drug use were highest with parental substance use (aOR: 2.6; 95% CI; 1.5-4.4), sexual abuse (aOR: 2.3; 95% CI; 1.4-3.8), and divorce (aOR: 1.9; 95% CI: 1.3-2.7). CONCLUSIONS ACEs increase the risk for lifetime illegal drug use and risky drug use in a dose-respondent fashion. These findings suggest that university students with higher levels of ACEs may benefit from additional support and services from clinical practitioners and university administrators.
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Affiliation(s)
- Ashlyn Schwartz
- Univ. Bordeaux, Bordeaux Population Health Research Center, U1219, CHU Bordeaux, 146 Rue Léo Saignat, F-33000, 33076, Inserm, Bordeaux, France.
- Public Health, University of Tennessee-Knoxville, Knoxville, USA.
| | - Cédric Galera
- Univ. Bordeaux, Bordeaux Population Health Research Center, U1219, CHU Bordeaux, 146 Rue Léo Saignat, F-33000, 33076, Inserm, Bordeaux, France
- Charles Perrens Hospital, Bordeaux, France
| | - Julie Arsandaux
- Univ. Bordeaux, Bordeaux Population Health Research Center, U1219, CHU Bordeaux, 146 Rue Léo Saignat, F-33000, 33076, Inserm, Bordeaux, France
| | - Ilaria Montagni
- Univ. Bordeaux, Bordeaux Population Health Research Center, U1219, CHU Bordeaux, 146 Rue Léo Saignat, F-33000, 33076, Inserm, Bordeaux, France
| | - Christophe Tzourio
- Univ. Bordeaux, Bordeaux Population Health Research Center, U1219, CHU Bordeaux, 146 Rue Léo Saignat, F-33000, 33076, Inserm, Bordeaux, France
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Gilgoff R, Mengelkoch S, Elbers J, Kotz K, Radin A, Pasumarthi I, Murthy R, Sindher S, Harris NB, Slavich GM. The Stress Phenotyping Framework: A multidisciplinary biobehavioral approach for assessing and therapeutically targeting maladaptive stress physiology. Stress 2024; 27:2327333. [PMID: 38711299 PMCID: PMC11219250 DOI: 10.1080/10253890.2024.2327333] [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: 10/23/2023] [Accepted: 03/02/2024] [Indexed: 05/08/2024] Open
Abstract
Although dysregulated stress biology is becoming increasingly recognized as a key driver of lifelong disparities in chronic disease, we presently have no validated biomarkers of toxic stress physiology; no biological, behavioral, or cognitive treatments specifically focused on normalizing toxic stress processes; and no agreed-upon guidelines for treating stress in the clinic or evaluating the efficacy of interventions that seek to reduce toxic stress and improve human functioning. We address these critical issues by (a) systematically describing key systems and mechanisms that are dysregulated by stress; (b) summarizing indicators, biomarkers, and instruments for assessing stress response systems; and (c) highlighting therapeutic approaches that can be used to normalize stress-related biopsychosocial functioning. We also present a novel multidisciplinary Stress Phenotyping Framework that can bring stress researchers and clinicians one step closer to realizing the goal of using precision medicine-based approaches to prevent and treat stress-associated health problems.
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Affiliation(s)
- Rachel Gilgoff
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Palo Alto, CA, USA
| | - Summer Mengelkoch
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Jorina Elbers
- Trauma recovery Program, HeartMath Institute, Boulder Creek, CA, USA
| | | | | | - Isha Pasumarthi
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Palo Alto, CA, USA
| | - Reanna Murthy
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Palo Alto, CA, USA
| | - Sayantani Sindher
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Palo Alto, CA, USA
| | | | - George M. Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
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Yuan Y, Chen L, Yang C, Xie T. Early childhood SARS experience leads to long-lasting impacts on adulthood mental health in China. Sci Rep 2023; 13:22572. [PMID: 38114642 PMCID: PMC10730901 DOI: 10.1038/s41598-023-49970-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 12/14/2023] [Indexed: 12/21/2023] Open
Abstract
The association between pandemic experience and immediate mental health risks, such as depression, is well-documented, yet the long-term effects remain unclear. This study examines the impact of early childhood exposure to the 2003 SARS pandemic on adulthood mental health after 17 years in China, using data from the 2020 China Family Panel Studies (CFPS). The analysis included 6289 participants, aged 3 to 30 years during the SARS outbreak, with an average age of 35.3 years at the time of survey. Adulthood mental health was assessed using Center for Epidemiologic Studies Depression Scale (CESD) and an indicator of clinical depression. The severity of local SARS outbreaks was assessed by cumulative cases per 10,000 population. Results show that each additional case per 10,000 population was linked to a 1.617-fold (95% confidence interval (CI): 1.425-1.836) increase in odds of depression after 17 years for younger children (aged 3-12 years in 2003) relative to older cohorts (aged 13-30). This risk was higher in children from rural areas (adjusted odds ratio (aOR) 3.64; 95% CI 2.92-4.55), with poor physical health (1.98; 1.59-2.48), and from low-income families (2.87; 2.03-4.05). The childhood pandemic experience elevated the probability of developing depression-prone personality traits, which contributes to the enduring impact of childhood pandemic experiences on adulthood mental health. These findings highlight the long-lasting psychological impact of early-childhood pandemic exposure, underscoring the need for targeted interventions to mitigate its effects on the younger generation and emphasizing the importance of monitoring long-term mental health and personality development in children post-pandemics, particularly in light of COVID-19.
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Affiliation(s)
- Ye Yuan
- School of Economics, Peking University, No. 5 Yiheyuan Road, Haidian District, Beijing, 100871, China.
- Institute for Global Health and Development, Peking University, Beijing, China.
| | - Litian Chen
- School of Economics, Peking University, No. 5 Yiheyuan Road, Haidian District, Beijing, 100871, China
| | - Chao Yang
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China
- Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Tingting Xie
- School of Economics, Central University of Finance and Economics, Beijing, China
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Esterov D, Hines E, Neumann AA, Mara KC, Weaver AL. The Association of Adverse Childhood Experiences with Long-term Mood and Anxiety Disorders After Childhood Traumatic Brain Injury: A Population-based Case-Control Study. Arch Phys Med Rehabil 2023; 104:2075-2083. [PMID: 37467935 PMCID: PMC10792097 DOI: 10.1016/j.apmr.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/31/2023] [Accepted: 07/10/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVE To assess the association between ACEs and the development of psychiatric disorders by age 25 among individuals who sustained TBI prior to age 10. DESIGN Population-based case-control study. SETTING Olmsted County, Minnesota. PARTICIPANTS 566 individuals (N=566) who sustained a TBI prior to age 10 were identified and classified using a validated TBI classification system. Among these individuals, cases with a subsequent mood or anxiety disorder prior to age 25 were identified through clinical diagnostic codes and manual record review. For each case, a 1:1 matched control was randomly selected from individuals with a pediatric TBI who did not have a mood/anxiety disorder prior to the matched case's mood/anxiety disorder. INTERVENTIONS Not applicable MAIN OUTCOME MEASURES: Development of a mood/anxiety disorder. RESULTS Among the 114 matched pairs of individuals with a TBI prior to age 10, a subsequent mood/anxiety diagnosis was significantly associated with a history of 10 of 14 ACE categories and with having an ACE score ≥1 (odds ratio 5.17; 95% confidence interval 2.78-9.59). CONCLUSIONS This is the first population-based study to the authors' knowledge showing that among children who sustained a TBI prior to age 10, those who experienced ACEs are at increased risk of developing a mood or anxiety disorder.
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Affiliation(s)
- Dmitry Esterov
- Department of Physical Medicine and Rehabilitation Mayo Clinic, Rochester MN.
| | - Emily Hines
- Department of Physical Medicine and Rehabilitation Mayo Clinic, Rochester MN
| | - Alyssa A Neumann
- Division of Neurocognitive Disorders, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Kristin C Mara
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Amy L Weaver
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
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Villagrán A, Lund C, Duncan R, Ingvar Lossius M. Adverse life events in patients with functional seizures: Assessment in clinical practice and association with long-term outcome. Epilepsy Behav 2023; 148:109456. [PMID: 37804600 DOI: 10.1016/j.yebeh.2023.109456] [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: 07/06/2023] [Revised: 09/08/2023] [Accepted: 09/21/2023] [Indexed: 10/09/2023]
Abstract
BACKGROUND A history of adverse life events (ALE) is a risk factor for functional seizures (FS). Their influence on long-term outcome remains unclear. International guidelines recommend assessing ALE in patients presenting with associated disorders. It is not clear to what extent patients evaluated for FS are regularly asked about ALE. OBJECTIVES We hypothesised that the presence of ALE would relate to worse outcome at follow-up and, that the rate of detection of ALE in clinical work-up would be inferior to that based on self-report questionnaires. METHODS 53 patients with FS from the National Centre for Epilepsy in Norway, aged 16-62 years were included. Symptom severity, health-related quality of life (HRQoL), and antecedent ALE were assessed at baseline. Medical records were examined for disclosure of ALE. At a mean of 70.45 (SD 29.0, range 22-130) months after inclusion, participants were inquired about FS status, FS-related health care utilization and HRQoL. FINDINGS A history of emotional abuse documented in the medical record was an independent risk factor for worse HRQoL at follow-up. Prevalence of ALE documented in medical records was lower compared with rates measured by a self-report questionnaire. CONCLUSIONS These findings indicate an association between antecedent ALE and HRQoL years after diagnosis. A substantial proportion of the adverse life events by a self-report questionnaire had not been documented in the clinical records. CLINICAL IMPLICATIONS The supplemental use of a self-report questionnaire in the diagnostic work-up of patients with FS may be valuable for detecting ALE.
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Affiliation(s)
- Antonia Villagrán
- National Centre for Epilepsy, Division of Clinical Neuroscience, Oslo University Hospital, Member of the ERN EpiCARE, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Caroline Lund
- Department of Neurohabilitation, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway; National Centre for Rare Epilepsy-Related Disorders, Oslo University Hospital, Oslo, Norway
| | - Roderick Duncan
- Department of Neurology, Christchurch Hospital, Christchurch, New Zealand
| | - Morten Ingvar Lossius
- National Centre for Epilepsy, Division of Clinical Neuroscience, Oslo University Hospital, Member of the ERN EpiCARE, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Rehan ST, Khan Z, Shuja SH, Salman A, Hussain HU, Abbasi MS, Razak S, Cheema HA, Swed S, Surani S. Association of adverse childhood experiences with adulthood multiple sclerosis: A systematic review of observational studies. Brain Behav 2023; 13:e3024. [PMID: 37128143 PMCID: PMC10275535 DOI: 10.1002/brb3.3024] [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: 01/07/2023] [Revised: 03/12/2023] [Accepted: 04/10/2023] [Indexed: 05/03/2023] Open
Abstract
INTRODUCTION Adverse childhood experiences (ACEs) are proposed to increase the risk of developing multiple sclerosis (MS) later in life. This systematic review aimed to explore the correlation between ACEs and MS development, age of onset, quality of life in MS patients and MS relapse rates. METHODS We searched a total of six databases in June 2022 and retrieved the relevant studies. The population included adult (18+) individuals who either had been diagnosed or were at risk for developing MS and also had exposure to ACEs. Our primary outcomes include the risks of MS development, age of MS onset, and MS relapse rate in patients who were exposed to different types of ACEs. RESULTS A total of 11 studies were included in our review. A study reported that among 300 women diagnosed with MS, 71 (24%) reported a history of childhood abuse; moreover, with further research, it was concluded that ACEs were associated with the development of MS. Abuse that occurred 2-3 times per week was associated with an 18.81-fold increased risk of having MS when compared to the unexposed sample. The relapse rate of MS was found to be substantially greater in severe cases of ACEs compared to individuals who did not report any ACEs. CONCLUSIONS Results support a significant association between ACEs and the development of MS; individuals with a positive history of ACEs develop MS symptoms earlier. Moreover, the severity of ACEs is also linked with increased relapse rates of MS.
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Affiliation(s)
| | - Zayeema Khan
- Department of MedicineDow University of Health SciencesKarachiPakistan
| | - Syed Hasan Shuja
- Department of MedicineDow University of Health SciencesKarachiPakistan
| | - Afia Salman
- Department of MedicineDow University of Health SciencesKarachiPakistan
| | - Hassan ul Hussain
- Department of MedicineDow University of Health SciencesKarachiPakistan
| | | | - Sufyan Razak
- Department of MedicineDow University of Health SciencesKarachiPakistan
| | | | - Sarya Swed
- Faculty of MedicineAleppo UniversityAleppoSyria
| | - Salim Surani
- Adjunct Clinical Professor of MedicineTexas A&M UniversityCollege StationTexasUSA
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Peckham H. Introducing the Neuroplastic Narrative: a non-pathologizing biological foundation for trauma-informed and adverse childhood experience aware approaches. Front Psychiatry 2023; 14:1103718. [PMID: 37283710 PMCID: PMC10239852 DOI: 10.3389/fpsyt.2023.1103718] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 04/20/2023] [Indexed: 06/08/2023] Open
Abstract
Most people accessing mental health services have adverse childhood experiences (ACEs) and/or histories of complex trauma. In recognition of this, there are calls to move away from medical model approaches and move toward trauma-informed approaches which privilege the impact of life experience over underlying pathology in the etiology of emotional and psychological suffering. Trauma-informed approaches lack a biological narrative linking trauma and adversity to later suffering. In its absence, this suffering is diagnosed and treated as a mental illness. This study articulates the Neuroplastic Narrative, a neuroecological theory that fills this gap, conceptualizing emotional and psychological suffering as the cost of surviving and adapting to the impinging environments of trauma and adversity. The Neuroplastic Narrative privileges lived experience and recognizes that our experiences become embedded in our biology through evolved mechanisms that ultimately act to preserve survival in the service of reproduction. Neuroplasticity refers to the capacity of neural systems to adapt and change. Our many evolved neuroplastic mechanisms including epigenetics, neurogenesis, synaptic plasticity, and white matter plasticity allow us to learn from, and adapt to, past experiences. This learning and adaption in turn allows us to better anticipate and physiologically prepare for future experiences that (nature assumes) are likely to occur, based on past experiences. However, neuroplastic mechanisms cannot discriminate between experiences; they function to embed experience regardless of the quality of that experience, generating vicious or virtuous cycles of psychobiological anticipation, to help us survive or thrive in futures that resemble our privileged or traumatic pasts. The etiology of suffering that arises from this process is not a pathology (a healthy brain is a brain that can adapt to experience) but is the evolutionary cost of surviving traumatizing environments. Misidentifying this suffering as a pathology and responding with diagnosis and medication is not trauma-informed and may cause iatrogenic harm, in part through perpetuating stigma and exacerbating the shame which attends complex trauma and ACEs. As an alternative, this study introduces the Neuroplastic Narrative, which is situated within an evolutionary framework. The Neuroplastic Narrative complements both Life History and Attachment Theory and provides a non-pathologizing, biological foundation for trauma-informed and Adverse Childhood Experience aware approaches.
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Affiliation(s)
- Haley Peckham
- Centre for Mental Health Nursing, School of Health Sciences, University of Melbourne, Carlton, VIC, Australia
- Department of Psychology, University of Exeter, Exeter, United Kingdom
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Yu W, Li S, Xiao W, Li X, Wang R, Liu J, Zhang S, Wan Y. Childhood maltreatment and non-suicidal self-injury among Chinese college students: The moderating roles of social phobia and perceived family economic status. CHILD ABUSE & NEGLECT 2023; 139:106113. [PMID: 36933367 DOI: 10.1016/j.chiabu.2023.106113] [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: 10/13/2022] [Revised: 02/07/2023] [Accepted: 02/16/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Non-suicidal self-injury is a heavy burden on affected college students with rippling effects throughout their lives. Childhood maltreatment is strongly associated with non-suicidal self-injury among college students. However, it remains unclear whether perceived family economic status and social phobia exert significant moderating effects on the relationship between childhood maltreatment and non-suicidal self-injury. OBJECTIVE This study aimed to identify the perceived family economic status and social phobia moderating the association between childhood maltreatment and non-suicidal self-injury. PARTICIPANTS AND SETTING This study used data (N = 5297) from two local medical colleges in Anhui province, China. METHODS Respondents completed questionnaires on childhood maltreatment, non-suicidal self-injury, social phobia and perceived family economic status online. Data were analyzed using Spearman's correlation followed by multiple moderation models. RESULTS The association between childhood maltreatment and non-suicidal self-injury was moderated by social phobia (β = 0.03, p < 0.05) and perceived family economic status (β = -0.30, p < 0.05). When considered together, both factors were found to play synergistic roles in the association between childhood maltreatment and non-suicidal self-injury in college students (β = 0.08, p < 0.001). CONCLUSION Our findings highlight that experience of childhood maltreatment, elevated social phobia, and low perceived family economic status increase the risk of non-suicidal self-injury. Future researches are recommended to conduct interventions from a more holistic perspective and integrate perceived family economic status as a relevant factor along with social phobia in coping with non-suicidal self-injury in college students.
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Affiliation(s)
- WeiQiang Yu
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China; MOE Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Hefei, Anhui, China
| | - ShuQin Li
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China; MOE Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Hefei, Anhui, China
| | - Wan Xiao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China; MOE Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Hefei, Anhui, China
| | - Xin Li
- School of Clinical Medical, Anqing Medical College, Anhui, China
| | - Rui Wang
- Information Technology Office, Anqing Medical College, Anhui, China
| | - Jing Liu
- Department of Nursing, Faculty of Medicine, Union University of Huainan, Anhui, China
| | - Shichen Zhang
- Shool of Public Health and Health Management, Anhui Medical College, Anhui, China.
| | - Yuhui Wan
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China; MOE Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Hefei, Anhui, China.
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11
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Subramanian I, McDaniels B, Farahnik J, Mischley LK. Childhood Trauma and Parkinson Disease: Associations of Adverse Childhood Experiences, Disease Severity, and Quality of Life. Neurol Clin Pract 2023; 13:e200124. [PMID: 36891464 PMCID: PMC9987208 DOI: 10.1212/cpj.0000000000200124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 11/04/2022] [Indexed: 02/22/2023]
Abstract
Background and Objectives Childhood trauma has been shown to be associated with adverse health outcomes that can last a lifetime. The effects of trauma have not been evaluated in a Parkinson disease (PD) population. The goal of this study was to survey individuals with PD to evaluate whether the intensity of childhood trauma is associated with individual symptoms, overall disease severity, or quality of life. Methods An Internet-based observational survey was designed to evaluate modifiable variables associated with PD progression. In this cross-sectional analysis, adverse childhood experiences (ACEs) were used as a measure of childhood trauma, patient-reported outcomes in PD for the primary measure of PD severity, and Patient-Reported Outcomes Measurement Information System (PROMIS) Global for quality of life (QoL). Results Seven hundred twelve of 900 participants (79%) responded to the questions related to childhood trauma. Among respondents, QoL decreased as incidence of childhood trauma increased. Individuals with ACE scores 4 or higher reported greater symptom severity for 45% of the variables tested, including apathy, muscle pain, daytime sleepiness, restless leg syndrome, depression, fatigue, comprehension, and anxiety (p < 0.05) compared with individuals with trauma scores of zero. Discussion These data suggest childhood trauma is associated with a mild increase in overall patient-reported PD severity, specifically mood and other nonmotor and motor symptoms. While the associations were statistically significant, the impact of trauma was less robust than previously described predictors of severity, such as diet, exercise, and social connection. Future research should attempt to include more diverse populations, attempt to improve the response rate of these sensitive questions, and, most importantly, determine whether the adverse outcomes associated with childhood trauma can be mitigated with lifestyle modification, psychosocial support, and intervention in adulthood.
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Affiliation(s)
- Indu Subramanian
- David Geffen School of Medicine (IS), UCLA, Department of Neurology, Los Angeles, CA; SW PADRECC (IS), West Los Angeles, Veterans Administration, CA; Department of Rehabilitation and Health Services (BM), University of North Texas, Denton; Bastyr University Research Institute (JF, LKM); and Department of Radiology (LKM), University of Washington
| | - Bradley McDaniels
- David Geffen School of Medicine (IS), UCLA, Department of Neurology, Los Angeles, CA; SW PADRECC (IS), West Los Angeles, Veterans Administration, CA; Department of Rehabilitation and Health Services (BM), University of North Texas, Denton; Bastyr University Research Institute (JF, LKM); and Department of Radiology (LKM), University of Washington
| | - Joshua Farahnik
- David Geffen School of Medicine (IS), UCLA, Department of Neurology, Los Angeles, CA; SW PADRECC (IS), West Los Angeles, Veterans Administration, CA; Department of Rehabilitation and Health Services (BM), University of North Texas, Denton; Bastyr University Research Institute (JF, LKM); and Department of Radiology (LKM), University of Washington
| | - Laurie K Mischley
- David Geffen School of Medicine (IS), UCLA, Department of Neurology, Los Angeles, CA; SW PADRECC (IS), West Los Angeles, Veterans Administration, CA; Department of Rehabilitation and Health Services (BM), University of North Texas, Denton; Bastyr University Research Institute (JF, LKM); and Department of Radiology (LKM), University of Washington
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Gilgoff R, Schwartz T, Owen M, Bhushan D, Burke Harris N. Opportunities to Treat Toxic Stress. Pediatrics 2023; 151:190226. [PMID: 36450652 DOI: 10.1542/peds.2021-055591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/28/2022] [Indexed: 12/03/2022] Open
Affiliation(s)
- Rachel Gilgoff
- Aurrera Health Group, Sacramento, California.,UCLA-UCSF ACEs Aware Family Resilience Network, Los Angeles, California
| | | | - Mikah Owen
- UCLA-UCSF ACEs Aware Family Resilience Network, Los Angeles, California
| | - Devika Bhushan
- Office of the California Surgeon General, Sacramento, California
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Mei X, Li J, Li ZS, Huang S, Li LL, Huang YH, Liu J. Psychometric evaluation of an Adverse Childhood Experiences (ACEs) measurement tool: an equitable assessment or reinforcing biases? HEALTH & JUSTICE 2022; 10:34. [PMID: 36445502 PMCID: PMC9706892 DOI: 10.1186/s40352-022-00198-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Utilizing Adverse Childhood Experiences (ACEs) measurement scales to assess youths' adversities has expanded exponentially in health and justice studies. However, most of the ACEs assessment scales have yet to meet critical psychometric standards, especially for key demographic and minority groups. It is critical that any assessment or screening tool is not reinforcing bias, warranting the need for validating ACEs tools that are equitable, reliable and accurate. The current study aimed to examine the structural validity of an ACEs scale. Using data from the 2019 Behavioral Risk Factor Surveillance System (BRFSS), which collected of 97,314 responses collected from adults across sixteen states. This study assessed the psychometric properties and measurement invariance of the ACEs tool under the structural equation modeling framework. RESULTS We found the 11-item ACEs screening tool as a second-order factor with three subscales, all of which passed the measurement invariance tests at metric and scalar levels across age, race, sex, socioeconomic status, gender identity, and sexual orientation. We also found that minority groups experienced more childhood adversity with small effect size, with the exception of the gender identity. CONCLUSION The ACEs measurement scale from the BRFSS is equitable and free from measurement bias regardless of one's age, race, sex, socioeconomic status, gender identity, and sexual orientation, and thus is valid to be used to compare group mean differences within these groups. The scale is a potentially valid, viable, and predictive risk assessment in health and justice and research settings to identify high-risk groups or individuals for treatments.
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Affiliation(s)
- Xiaohan Mei
- California State University, Los Angeles, 5151 State University Dr, Los Angeles, CA 90032 USA
| | - Jiayu Li
- Washington State University, Pullman, WA 99164-2520 USA
| | - Zhi-Shu Li
- Shenyang Open University, Shisiwei Rd, Heping District, Shenyang, Liaoning 110003 China
| | - Shun Huang
- Beijing Hospital, 1 Dahua Rd, Dongcheng, Beijing, 100051 China
| | - Li-Li Li
- Shenyang Maternity and Child Health Hospital, 41 Shenzhou Street, Shenhe District, Shenyang, 110000 China
| | - Yang-Hong Huang
- Shenyang Women and Children’s Hospital, No. 87 Danan street, Shenhe District, 110000 Shenyang, China
| | - Jianhong Liu
- University of Macau, Avenida da Universidade Taipa, Macau, 999078 China
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