Exposure to interpersonal violence and risk for PTSD, depression, delinquency, and binge drinking among adolescents: data from the NSA-R

Emotional reactivity and past self-injurious behavior moderate the association between trauma exposure and fearlessness about death

INTRODUCTION

As suicide remains a global public health concern, recent work has sought to characterize mechanisms underlying the transition from suicidal ideation to action. Acquired capability for suicide, or fearlessness about death, has been identified as one key factor underlying this transition; however, understanding how this capability emerges remains limited. This study sought to extend previous work on the correlates of fearlessness about death by examining its relationship with painful and provocative events and emotional reactivity.

METHODS

We tested the extent to which trait emotional reactivity and past self-injurious behavior moderated the relationship between assaultive trauma exposure and fearlessness about death in a diverse sample of 273 community adults (aged 18-55, M/SD = 32.77/10.78).

RESULTS

A three-way interaction emerged, such that among individuals with heightened emotional reactivity and a history of self-injurious behavior (suicide attempt or non-suicidal self-injury), assaultive trauma was associated with increased fearlessness about death. In contrast, among adults with low emotional reactivity and a history of self-injurious behavior, assaultive trauma was associated with reduced fearlessness about death.

CONCLUSIONS

Results suggest that emotional reactivity may be a key dispositional factor that influences how trauma exposure and self-injurious behavior impact fearlessness about death.

Emotional reactivity linking assaultive trauma and risky behavior: Evidence of differences between cisgender women and men

Accumulating evidence suggests that trauma exposure is positively associated with future engagement in risky behavior, such as substance misuse, aggression, risky sex, and self-harm. However, the psychological factors driving this association and their relevance across gender groups require further clarification. In a community sample of 375 adults with a high rate of trauma exposure (age range: 18-55 years, M = 32.98 years, SD = 10.64; 76.3% assaultive trauma exposure), we examined whether emotional reactivity linked lifetime assaultive trauma exposure with past-month risky behavior. We also explored whether this model differed for cisgender women (n = 178, 47.6%) and men (n = 197, 52.5%). As hypothesized, assaultive trauma was positively related to emotional reactivity, β = .20, SE = 0.03, t(369) = 3.65, p < .001, which, in turn, partially accounted for the association between assaultive trauma and past-month risky behavior, indirect effect: β = .03, SE = 0.01, 95% bootstrapped CI [0.01, 0.06]. Gender moderated this association such that assaultive trauma was indirectly associated with risky behavior via emotional reactivity for women but not for men, index moderation: B = -0.03, SE = 0.02, 95% bootstrapped CI [-0.07, -0.01]. Cross-sectional results suggest that emotional reactivity may be a proximal target for clinical intervention to aid in the reduction of risky behavior among women.

Fear in action: Fear conditioning and alleviation through body movements

Fear memories enhance survival especially when the memories guide defensive movements to minimize harm. Accordingly, fear memories and body movements have tight relationships in animals: Fear memory acquisition results in adapting reactive defense movements, while training active defense movements reduces fear memory. However, evidence in humans is scarce because their movements are typically suppressed in experiments. Here, we tracked adult participants' body motions while they underwent ecologically valid fear conditioning in a 3D virtual space. First, with body motion tracking, we revealed that distinct spatiotemporal body movement patterns emerge through fear conditioning. Second, subsequent training to actively avoid threats with naturalistic defensive actions led to a long-term (24 h) reduction of physiological and embodied conditioned responses, while extinction or vicarious training only transiently reduced the responses. Together, our results highlight the role of body movements in human fear memory and its intervention.

Decision-making for concurrent reward and threat is differentially modulated by trauma exposure and PTSD symptom severity

Trauma exposure, particularly interpersonal violence (IPV) traumas, are significant risk factors for development of mental health disorders, particularly posttraumatic stress disorder (PTSD). Studies attempting to disentangle mechanisms by which trauma confers risk and maintenance of PTSD have often investigated threat or reward learning in isolation. However, real-world decision-making often involves navigating concurrent and conflicting probabilities for threat and reward. We sought to understand how threat and reward learning interact to impact decision-making, and how these processes are modulated by trauma exposure and PTSD symptom severity. 429 adult participants with a range of trauma exposure and symptom severities completed an online version of the two stage Markov task, where participants make a series of decisions towards the goal of obtaining a reward, that embedded an intermediate threat or neutral image along the sequence of decisions to be made. This task design afforded the possibility to differentiate between threat avoidance vs diminished reward learning in the presence of threat, and whether these two processes reflect model-based vs model-free decision-making. Results demonstrated that trauma exposure severity, particularly IPV exposure, was associated with impairment in model-based learning for reward independent of threat, as well as with model-based threat avoidance. PTSD symptom severity was associated with diminished model-based learning for reward in the presence of threat, consistent with a threat-induced impairment in cognitively-demanding strategies for reward learning, but no evidence of heightened threat avoidance. These results highlight the complex interactions between threat and reward learning as a function of trauma exposure and PTSD symptom severity. Findings have potential implications for treatment augmentation and suggest a need for continued research.

A Distinction Without a Difference? A Multi-Method Approach to Understanding PTSD and Depression Symptom Overlap Among Disaster-Exposed Adolescents

Among adolescents exposed to trauma, posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) commonly co-occur. Despite the prevalence of comorbidity, the question of how PTSD and MDD are related and appropriate conceptual models for understanding their linkage in adolescence remains unclear. This study applies a multi-methodological approach to advance conceptual and theoretical understanding of the overlap between PTSD and MDD diagnoses/symptoms. We tested three methodological approaches with three distinct theoretical underpinnings on the structure of each disorder proposed in the literature: confirmatory factor analysis (CFA) with dimensional constructs, latent class analysis (LCA) with person-based categorical constructs, and network analysis with symptom-to-symptom associations. Across the three different analytical approaches, there was a significant overlap between PTSD and MDD. Overall, there was no compelling evidence for distinct boundaries between disorders among trauma-exposed adolescents. Instead, we found considerable evidence that the typical latent-construct-based conceptualizations, whether categorical or dimensional, may need revision.

Associations between binge drinking experience, depressive mood, and suicidality in adolescents: Based on the 2021 Korea Youth Risk Behavior Web-based Survey

BACKGROUND

This study aimed to investigate the associations between binge drinking experience (BDE), depressive mood, and suicidality among Korean adolescents.

METHODS

We analyzed the 17th population-based and cross-sectional data from the Korean Youth Risk Behavior Web-based Survey. Multiple logistic regression analysis was performed to compare BDE, depressive mood, and suicidality by sex.

RESULTS

In 54,848 adolescents, the prevalence of BDE was 5.3 % in boys and 4.4 % in girls. The prevalence of suicidal ideation, plans, and attempts among girls was 7.8 %, 2.4 %, and 1.4 %, respectively. The prevalence of suicide attempts among girls with both BDE and depressive moods was higher than that among boys. Boys with both BDE and depressive mood had 12.60 times and 14.50 times higher adjusted odds ratio (aOR) of suicide ideation and plan, respectively, compared with the non-drinking/non-depressed group. Girls with both BDE and depressive mood had 22.06 times higher aOR of suicide attempts than the non-drinking/non-depressed group.

LIMITATIONS

The study has few limitations including the use of self-report questionnaires, participants' response bias, and lack of diagnosis by mental health professionals.

CONCLUSIONS

These findings represent the prevalence of suicidality among South Korean adolescents with BDE or depressive mood. Since adolescents with both BDE and depressive mood showed particularly high suicidality, it is necessary to establish mental health services, such as proper prevention strategies and targeted interventions.

Intimate Partner Violence and Openness to Online Counseling Among College Students

Intimate partner violence (IPV) is prevalent and has devastating consequences for college students. Online counseling (OC) may be a way to decrease barriers to help. This study seeks to determine openness to OC compared to face-to-face counseling (F2F) by examining: (1) How openness to OC varies depending on college students' personal and IPV characteristics and (2) How these characteristics vary compared to college non-IPV survivors. Two linear regressions were conducted using a sample from a cross sectional survey. First with the entire sample of college students (N = 1,518) to examine characteristics of those more open to OC and second with only those that identified as experiencing IPV (n = 1,211). The results demonstrated that IPV survivors are less open to OC than to F2F counseling (b = -.23, p < .01). For the model with all college students, those who were significantly more open to OC were female (b = -.39, p < .001), identified as LGBT (b = .23, p < .05), or Asian/Pacific Islander (API) (b = .26, p < .05), and had a physical health issue (b = -.19, p < .05). For the model that only analyzed IPV survivors, the same characteristics were shown to be significantly related to openness to OC. More research is needed to explore why IPV survivors are less open to OC compared to F2F counseling. Exploring why characteristics of female, LGBT, and physical health issues lead to openness to OC could help understand what barriers need to be addressed for wider use.

Epidemiology of Childhood Witnessing Domestic Violence and Exploration of Its Relationships With Affective Lability and Suicide Attempts in Chinese Young Adults

Childhood witnessing domestic violence (CWDV) exerts short- and long-term negative impacts on emotional and behavioral health. The present study investigated the epidemiological features of CWDV, and its negative impact on psychological outcomes in a sample of Chinese college students. The mediating role of emotion regulation strategies on CWDV associations with psychological outcomes and gender differences in these relationships were examined. A total of 3,126 respondents (1,034 males; 2,086 females; 6 missing data in gender) completed the study questionnaire, which included demographic characteristics, CWDV, and suicide attempt history items as well as the Emotion Regulation Questionnaire (ERQ) and Affect Lability Scale-18 (ALS-18). Overall, 43.03% of the respondents reported CWDV, including 44.87% of males and 42.09% of females. Higher frequencies of CWDV were found to be related to the following factors: unstable marital status of parents; not being an only child; being a left-behind child, family financial difficulties, consumption of alcohol in the past year, and being in relatively poor physical condition. Among males, ERQ suppression scores were significantly higher for those men who experienced "often or every day" CWDV than for men who indicated that they did not have any history of CWDV (Bonferroni-corrected p = 0.047). More frequent CWDV was associated with higher ALS-18 scores and increased risk of suicide attempts in males and females (p < 0.05), and emotion regulation (suppression) was found to mediate the association between CWDV and affective lability among males. This study revealed high rates of CWDV, and serious impacts of CWDV on mental health in male and female Chinese college students. In males, but not females, emotion regulation strategy use, use of suppression, was found to act as a mediator in the association of CWDV with affective lability. Our findings suggest that interventions for individuals with CWDV should focus on the emotional regulation, which may help them improve mental health, especially in males.

Relative efficacy of psychological interventions following interpersonal trauma on anxiety, depression, substance use, and PTSD symptoms in young people: A meta-analysis

AIM

Interpersonal trauma exposures are associated with anxiety, depression, and substance use in youth populations (aged 12-25 years). This meta-analysis reports on the efficacy of psychological interventions on these symptom domains in addition to post-traumatic stress.

METHODS

Following PRISMA guidelines, a search of electronic databases was performed for randomized controlled trials (RCTs) assessing interventions for young people following interpersonal trauma exposure. Risk of bias was assessed using the Cochrane Risk of Bias tool. Data were analysed using random-effects meta-analyses.

RESULTS

Of the 4832 records screened, 78 studies were reviewed, and 10 RCTs, involving 679 participants (mean age 15.6 years), were analysed. There was a large pooled effect size for post-traumatic stress (7 studies, g = 1.43, 95% CI [0.37, 2.15], p = .002) and substance use (2 studies, g = 0.70, 95% CI [-0.11, 1.22], p < .001) and small effect sizes for anxiety (4 studies, g = 0.30, 95% CI [0.10, 0.49], p = .003), and trend-level effect for depression (10 studies, g = 0.27, 95% CI [0.00, 0.54], p = .052). Heterogeneity was significant for post-traumatic stress and moderate for depression.

CONCLUSIONS

High-quality RCTs of psychological interventions for anxiety, depression, substance use, and post-traumatic stress symptoms in young people exposed to interpersonal trauma are scarce. While available studies show either statistically significant or trend-level efficacy for psychological interventions in reducing these symptoms, wide confidence intervals, heterogeneity and small sample size mean that results need to be interpreted with caution.

Childhood trauma moderates morphometric associations between orbitofrontal cortex and amygdala: implications for pathological personality traits

BACKGROUND

Research has demonstrated that chronic stress exposure early in development can lead to detrimental alterations in the orbitofrontal cortex (OFC)-amygdala circuit. However, the majority of this research uses functional neuroimaging methods, and thus the extent to which childhood trauma corresponds to morphometric alterations in this limbic-cortical network has not yet been investigated. This study had two primary objectives: (i) to test whether anatomical associations between OFC-amygdala differed between adults as a function of exposure to chronic childhood assaultive trauma and (ii) to test how these environment-by-neurobiological effects relate to pathological personality traits.

METHODS

Participants were 137 ethnically diverse adults (48.1% female) recruited from the community who completed a clinical diagnostic interview, a self-report measure of pathological personality traits, and anatomical MRI scans.

RESULTS

Findings revealed that childhood trauma moderated bilateral OFC-amygdala volumetric associations. Specifically, adults with childhood trauma exposure showed a positive association between medial OFC volume and amygdalar volume, whereas adults with no childhood exposure showed the negative OFC-amygdala structural association observed in prior research with healthy samples. Examination of the translational relevance of trauma-related alterations in OFC-amygdala volumetric associations for disordered personality traits revealed that trauma exposure moderated the association of OFC volume with antagonistic and disinhibited phenotypes, traits characteristic of Cluster B personality disorders.

CONCLUSIONS

The OFC-amygdala circuit is a potential anatomical pathway through which early traumatic experiences perpetuate emotional dysregulation into adulthood and confer risk for personality pathology. Results provide novel evidence of divergent neuroanatomical pathways to similar personality phenotypes depending on early trauma exposure.

Unfavorable prognosis and clinical consequences of APOBEC3B expression in breast and other cancers: A systematic review and meta-analysis

INTRODUCTION: Controversy exists regarding the association of apolipoprotein B mRNA editing enzyme catalytic subunit 3B APOBEC3B, (A3B) overexpression and poor prognosis, metastasis, and chemotherapy drug resistance in cancers. Here we conducted a systematic review and meta-analysis to determine its prognostic value and clinicopathological features in breast cancer and some other malignancies. MATERIALS AND METHODS: PubMed, Scopus, Cochrane Library, Web of Science, and EMBASE were searched up to Feb 2022 for the association of A3B with breast, ovarian, gastrointestinal and lung cancers. The pooled hazard ratios with 95% confidence interval (CI) were evaluated to assess disease-free survival (DFS), overall survival (OS), and recurrence-free survival (RFS) in cancers under study. RESULTS: Over 3700 patients were included in this meta-survey. Elevated levels of A3B were significantly related to low OS (pooled HR = 1.30; 95% CI:1.09–1.55, P < 0.01), poor DFS (pooled HR = 1.66; 95% CI:1.17–2.35, P < 0.01) and poor RFS (HR = 1.51, 95% CI:1.11–2.04, P = 0.01). Subgroup analysis revealed that high A3B expression was associated with poor OS in lung (HR = 1.85, 95% CI: 1.40–2.45), and breast cancers (HR = 1.38, 95% CI: 1.00–1.89). High expression of A3B did not display any significant association with clinicopathologic features. CONCLUSION: APOBEC3B overexpression is related to poor OS, DFS and RFS only in some cancer types and no generalized role could be predicted for all cancers.

Laboratory models of post-traumatic stress disorder: The elusive bridge to translation

Post-traumatic stress disorder (PTSD) is a debilitating mental illness composed of a heterogeneous collection of symptom clusters. The unique nature of PTSD as arising from a precipitating traumatic event helps simplify cross-species translational research modeling the neurobehavioral effects of stress and fear. However, the neurobiological progress on these complex neural circuits informed by animal models has yet to produce novel, evidence-based clinical treatment for PTSD. Here, we provide a comprehensive overview of popular laboratory models of PTSD and provide concrete ideas for improving the validity and clinical translational value of basic research efforts in humans. We detail modifications to simplified animal paradigms to account for myriad cognitive factors affected in PTSD, which may contribute to abnormalities in regulating fear. We further describe new avenues for integrating different areas of psychological research underserved by animal models of PTSD. This includes incorporating emerging trends in the cognitive neuroscience of episodic memory, emotion regulation, social-emotional processes, and PTSD subtyping to provide a more comprehensive recapitulation of the human experience to trauma in laboratory research.

The Role of Socioeconomic Factors on Women's Risk of Being Exposed to Intimate Partner Violence

The most important thing learned about intimate partner violence (IPV) over the last 20 years is that violence is gendered and can be learned after faced and can only be understood in the context of gender inequality. To promote gender equality, a number of legal reforms and policies have been put in place over the last decade. The main problem is that there is relationship between all the socioeconomic and demographic factors. This begs the question, does the high educational level, social and economic status of a woman put her at lower risk of experiencing domestic violence? The study hypothesizes that those socioeconomic factors such as literacy, political rights, urbanization, laws against violence, the annual income of women, and the number of women in the labor force can affect IPV prevalence. The study uses secondary data concerning socioeconomic factors from 26 predominantly Muslim countries in Asia-Pacific and North Africa. Findings from the study show that socioeconomic factors such as literacy, political rights, a higher level of urbanization, and the laws against violence have significant impacts and may decrease the prevalence of IPV. However, other socioeconomic factors such as the annual income of women and increased women in the labor force produced unclear results. The test for collinearity on the impacts of each socioeconomic factor against one another was found to be insignificant.

Beyond the Role of Interpersonal Violence in Predicting Negative Affective Conditions in Adults: An Examination of Hope Components in Chinese College Students

With the growth of positive psychology during the past two decades, increased research has been focused on identifying human virtues that not only foster well-being but also act as positive processes that mitigate the impact of life adversities. Thus, it is useful to examine how positive processes, such as hope, may impact individuals' psychological adjustment following adversities. This study investigated the relationships among interpersonal violence, hope, as a key human strength, and negative affect conditions in a large sample (N = 737) of Chinese male and female (N_female = 409) college students. Participants completed measures assessing prior exposure to interpersonal violence, levels of both hope components (i.e., agency and pathways), negative affect, depressive symptoms, and suicidal ideation. Results from correlational analyses showed that exposure to interpersonal violence was positively and hope was negatively correlated with negative affective conditions. However, hope agency was more strongly correlated with those outcomes than hope pathways. In addition, three separate hierarchical regression analyses indicated that after accounting for demographics (i.e., age and sex) and interpersonal violence, within hope components, only hope agency remained as strong concurrent predictors of negative affective conditions. The present findings in this Chinese sample are consistent with those obtained from Turkey and the United States samples, adding evidence to the more robust role of hope, and hope agency in particular, in predicting negative psychological adjustment associated with interpersonal violence. Efforts made to address the absence of hope agency may be particularly important in future attempts to mitigate negative affective conditions linked to interpersonal violence among Chinese college students.

Value estimation and latent-state update-related neural activity during fear conditioning predict posttraumatic stress disorder symptom severity

Learning theories of posttraumatic stress disorder (PTSD) purport that fear-learning processes, such as those that support fear acquisition and extinction, are impaired. Computational models designed to capture specific processes involved in fear learning have primarily assessed model-free, or trial-and-error, reinforcement learning (RL). Although previous studies indicated that aspects of model-free RL are disrupted among individuals with PTSD, research has yet to identify whether model-based RL, which is inferential and contextually driven, is impaired. Given empirical evidence of aberrant contextual modulation of fear in PTSD, the present study sought to identify whether model-based RL processes are altered during fear conditioning among women with interpersonal violence (IPV)-related PTSD (n = 85) using computational modeling. Model-free, hybrid, and model-based RL models were applied to skin conductance responses (SCR) collected during fear acquisition and extinction, and the model-based RL model was found to provide the best fit to the SCR data. Parameters from the model-based RL model were carried forward to neuroimaging analyses (voxel-wise and independent component analysis). Results revealed that reduced activity within visual processing regions during model-based updating uniquely predicted higher PTSD symptoms. Additionally, after controlling for model-based updating, greater value estimation encoding within the left frontoparietal network during fear acquisition and reduced value estimation encoding within the dorsomedial prefrontal cortex during fear extinction predicted greater PTSD symptoms. Results provide evidence of disrupted RL processes in women with assault-related PTSD, which may contribute to impaired fear and safety learning, and, furthermore, may relate to treatment response (e.g., poorer response to exposure therapy).

Beyond Trauma Exposure: Discrimination and Posttraumatic Stress, Internalizing, and Externalizing Problems Among Detained Youth

According to the race-based traumatic stress model, racial discrimination is proposed to comprise a traumatic experience that results in posttraumatic stress symptoms, as well as internalizing and externalizing problems among youth. Accordingly, a significant body of research has emerged that supports the associations among these constructs. However, the majority of these empirical studies have not accounted for the potential role of traditionally defined traumatic events in these associations. This study investigated whether self-reported racial discrimination was related to posttraumatic stress symptoms, internalizing, and externalizing symptoms above and beyond the impact of other trauma exposures in a sample of 266 detained youth (79% boys, 60% identified as an ethnic minority). Results of hierarchical linear regressions demonstrated that, after accounting for youths' other trauma exposures, racial discrimination accounted for significant variance in the models predicting delinquency and risk-taking but no other externalizing and internalizing problems, or posttraumatic stress symptoms. These findings indicate that racial discrimination may be particularly important for understanding offending behavior among detained youth.

Psychological and Physical Intimate Partner Aggression Are Associated with Broad and Specific Internalizing Symptoms during Pregnancy

Background: Intimate partner violence (IPV) has serious consequences, particularly during high-risk periods such as pregnancy, which poses a significant risk to maternal mental health. However, it is unclear whether IPV presents a broad risk for psychopathology or is specific to distinct diagnoses or symptom dimensions (e.g., panic, social anxiety). Further, the relative impact of physical versus psychological aggression remains unclear. Methods: One hundred and fifty-nine pregnant couples completed surveys assessing psychological and physical intimate partner aggression unfolding in the couple relationship, as well as a range of internalizing symptoms. Results: Psychological and physical aggression were each associated with broad negative affectivity, which underlies mood and anxiety disorders; however, only psychological aggression demonstrated a unique association. Further, for pregnant women, aggression was uniquely associated with several symptom dimensions characteristic of PTSD. In contrast, men demonstrated a relatively heterogeneous symptom presentation in relation to aggression. Conclusion: The present study identifies unique symptom manifestations associated with IPV for couples navigating pregnancy and suggests psychological aggression can be more detrimental to mental health than physical aggression. To promote maternal perinatal mental health, clinicians should screen for covert forms of psychological aggression during pregnancy (e.g., raised voices, insults), trauma-related distress, and symptom elevations in women and their partners.

The relationship of maternal and child methylation of the glucocorticoid receptor NR3C1 during early childhood and subsequent child psychopathology at school-age in the context of maternal interpersonal violence-related post-traumatic stress disorder

INTRODUCTION

Interpersonal violent (IPV) experiences when they begin in childhood and continue in various forms during adulthood often lead to chronic post-traumatic stress disorder (PTSD) that is associated in multiple studies with hypocortisolism and lower percentage of methylation of the promoter region of the gene coding for the glucocorticoid receptor (NR3C1). This prospective, longitudinal study examined the relationship of NR3C1 methylation among mothers with IPV-related PTSD and their toddlers and then looked at the relationship of maternal NR3C1 methylation and child psychopathology at school age.

METHODS

Forty-eight mothers were evaluated for life-events history and post-traumatic stress disorder via structured clinical interview when their children were ages 12-42 months (mean age 26.7 months, SD 8.8). Their children's psychopathology in terms of internalizing symptoms and externalizing behaviors was evaluated using the Child Behavior Checklist at ages 5-9 years (mean age 7 years, SD 1.1). Percentage of methylation for the NR3C1 gene promoter region was assessed from DNA extracted from maternal and child saliva using bisulfite pyrosequencing. Data analysis involved parametric and non-parametric correlations and multiple linear and logistic regression modeling.

RESULTS

Logistic regression models using child NR3C1 methylation as the dependent variable and maternal NR3C1 methylation and PTSD group status as predictors, as well as the interaction indicated that all three of these significantly predicted child NR3C1 methylation. These findings remained significant when controlling for child age, sex and maternal child abuse history. Overall, maternal NR3C1 methylation when children were toddlers was negatively and significantly associated with child externalizing behavior severity at school age.

DISCUSSION

We found that correlations between mothers and their children of NR3C1 methylation levels overall and at all individual CpG sites of interest were significant only in the IPV-PTSD group. The latter findings support that NR3C1 methylation in mothers positively and statistically significantly correlates with NR3C1 methylation in their children only in presence of IPV-PTSD in the mothers. This maternal epigenetic signature with respect to this glucocorticoid receptor is significantly associated with child behavior that may well pose a risk for intergenerational transmission of violence and related psychopathology.

Trauma and US Minority Children and Youth

PURPOSE OF REVIEW

This paper reviews the literature on the prevalence, risk factors, and effects of traumatic experiences on the mental health outcomes of minority youth in the USA.

RECENT FINDINGS

The USA has an increasing number of children and youth from minority backgrounds. Research reveals that traumatic experiences disproportionately affect minority youth. These experiences include historical/generational trauma, immigration and acculturation stressors, natural and manmade disasters, experiences of discrimination, family violence, and community violence. The COVID-19 pandemic has also disproportionately affected minority youth resulting in illness and hospitalizations. Despite the higher incidence of trauma exposure, minority youth are less likely to access medical and mental health care. These disparities are resulting in increasing rates of depression, anxiety, post-traumatic stress, substance use disorders, and suicide in minority youth. Recognizing and understanding the impact of trauma is critical to the healthy development and successful functioning of minority youth, and to the success of our nation.

ACE domains and depression: Investigating which specific domains are associated with depression in adulthood

BACKGROUND

The study of adverse childhood experiences (ACEs) has shown deleterious effects throughout adulthood. Little attention, however, is given to specific ACE domains as they relate to mental health outcomes, as most studies use cumulative ACE score models.

OBJECTIVE

The current study disaggregates ACEs domains to investigate their independent effect (while controlling for each other and other demographic covariates) on receiving a depression diagnosis as an adult.

PARTICIPANTS AND SETTING

Data were obtained from the Behavioral Risk Factor Surveillance Survey (BRFSS; N = 52,971).

METHODS

To control and account for the numerical number of ACEs, separate models were run among each ACE score (e.g., those with an ACE score of exactly two, three, etc.). An aggregate model with all participants is also included.

RESULTS

Across all ACE scores, those with a history of family mental illness had the highest likelihood of receiving a depression diagnosis. The second strongest association were those with sexual abuse. No other trends were found among the six other domains. Further, those with a combination of family mental illness and sexual abuse had the highest odds of depression.

CONCLUSIONS

Mental health providers should consider the numerical number of ACEs as well as the specific ACE domains (specifically, family mental illness and sexual abuse). Additionally, this provides evidence for a possible weighting schema for the ACEs scale.

Diverse Long-Term Effects of Childhood Exposure to Intimate Partner Violence: Development of Externalizing Behaviors in Males and Females

Using data from all three waves of the Project on Human Development in Chicago Neighborhoods (PHDCN) longitudinal cohort study, this article examined the long-term effects of intimate partner violence (IPV) exposure during childhood and early adolescence on subsequent externalizing behaviors (i.e., delinquency, violence, and drug offenses). A propensity score matching (PSM) was employed to match a group of individuals reporting childhood/adolescence IPV exposure to those not exposed to IPV on key variables. Longitudinal latent class analyses (LLCA) were then utilized to estimate the longitudinal developmental trajectories of externalizing behaviors separately for the IPV- and non-IPV-exposed males and females and compared with each other. PSM revealed that there were small but significant differences in mean levels of externalizing behaviors between IPV-exposed and non-IPV-exposed youth at Waves 2 and 3. Furthermore, LLCA indicated that there were three distinct developmental trajectories of externalizing behaviors among the IPV-exposed males but four distinct developmental trajectories of externalizing behaviors among the IPV-exposed females, non-IPV-exposed males, and non-IPV-exposed females. Overall, the IPV-exposed males had the largest number of life-course-persistent offenders as well as adolescents who started their offending at a very early age but rapidly declined by the end of the study period. However, the non-IPV-exposed males', albeit smaller, life-course-persistent group displayed by far the highest levels of externalizing behaviors of the entire sample. Females in the present study were largely similar to each other in the development of externalizing behaviors, regardless of IPV exposure. Policy implications are discussed.

Systematic Review of Functional MRI Applications for Psychiatric Disease Subtyping

Background: Psychiatric disorders have been historically classified using symptom information alone. Recently, there has been a dramatic increase in research interest not only in identifying the mechanisms underlying defined pathologies but also in redefining their etiology. This is particularly relevant for the field of personalized medicine, which searches for data-driven approaches to improve diagnosis, prognosis, and treatment selection for individual patients. Methods: This review aims to provide a high-level overview of the rapidly growing field of functional magnetic resonance imaging (fMRI) from the perspective of unsupervised machine learning applications for disease subtyping. Following the PRISMA guidelines for protocol reproducibility, we searched the PubMed database for articles describing functional MRI applications used to obtain, interpret, or validate psychiatric disease subtypes. We also employed the active learning framework ASReview to prioritize publications in a machine learning-guided way. Results: From the 20 studies that met the inclusion criteria, five used functional MRI data to interpret symptom-derived disease clusters, four used it to interpret clusters derived from biomarker data other than fMRI itself, and 11 applied clustering techniques involving fMRI directly. Major depression disorder and schizophrenia were the two most frequently studied pathologies (35% and 30% of the retrieved studies, respectively), followed by ADHD (15%), psychosis as a whole (10%), autism disorder (5%), and the consequences of early exposure to violence (5%). Conclusions: The increased interest in personalized medicine and data-driven disease subtyping also extends to psychiatric disorders. However, to date, this subfield is at an incipient exploratory stage, and all retrieved studies were mostly proofs of principle where further validation and increased sample sizes are craved for. Whereas results for all explored diseases are inconsistent, we believe this reflects the need for concerted, multisite data collection efforts with a strong focus on measuring the generalizability of results. Finally, whereas functional MRI is the best way of measuring brain function available to date, its low signal-to-noise ratio and elevated monetary cost make it a poor clinical alternative. Even with technology progressing and costs decreasing, this might incentivize the search for more accessible, clinically ready functional proxies in the future.

Associations between posttraumatic stress symptoms, perceived social support and psychological distress among disaster-exposed Chinese young adults: A three-wave longitudinal mediation model

Research has documented a strong association between perceived social support, posttraumatic stress symptoms (PTSS), and psychological distress (PD) among people exposed to natural disasters. However, the direction of associations between these factors remains unclear. This study examined possible mediational relationships among perceived social support, PTSS, and PD. A three-wave longitudinal design (6 months intervals) was employed in a sample of 341 Chinese university students (M_age = 21.24, SD = 2.72; 75.7% female) aged 18 to 34 who were directly exposed to a typhoon that occurred in Macao, China, during August 2017. Results indicated that perceived social support at T2 mediated the linkage between PTSS at T1 and PD at T3, and that PTSS at T2 significantly mediated the relationship between PD at T1 and perceived social support at T3. This three-wave longitudinal study highlights the key role of perceived social support on the aggravating effect of acute PTSS on long-term psychological problems, and demonstrates that adverse psychological health outcomes negatively affect the perception of supportive social resources in the context of a natural disaster.

Gang Involvement, Mental Health Difficulties and Exposure to Violence in 11-16-Year-Old School Students

Background and goals:

The current study investigated the relationship between gang involvement and multiple mental health difficulties; anxiety, depression, paranoia, victim trauma and perpetrator trauma. Additionally, it examined the mediating influence of an individual’s exposure to violence within this relationship.

Method:

One hundred adolescents aged 11-16 years old completed two questionnaires and an interview which investigated their friendship groups, exposure to violence and mental well-being. Eighteen participants were identified as current or ex-gang members and the other eighty-two were classified as the nongang comparison group.

Results:

Findings show that gang members displayed more symptoms of depression and perpetrator trauma compared to non-gang members. The relationship between gang involvement and these mental health difficulties was mediated by exposure to violence.

Conclusions:

Discussion focuses on the need for researchers, practitioners and policymakers to acknowledge the relationship between gang involvement and mental health difficulties and implement additional strategies to support young people currently or previously involved in gangs.

The predictive capacity of AUDIT and AUDIT-C among adolescents in a one-year follow-up study

AIM

The Alcohol Use Disorders Identification Test (AUDIT) has been validated for use with adolescents to screen their harmful alcohol consumption. How well AUDIT or its derivative consumption version AUDIT-C predicts the development of problematic alcohol use among adolescents remains unknown. The aim of our study was to examine the predictive capacity of AUDIT and AUDIT-C among adolescents in a one-year follow-up.

METHODS

Finnish adolescents (N = 337) were examined at baseline with AUDIT and one year later with the Schedule for Affective Disorders and Schizophrenia for School-Age Children - Present and Lifetime version (K-SADS-PL) interview to assess alcohol problem use. Test characteristics and regression models were analyzed in predicting alcohol problem use.

RESULTS

The sensitivity of AUDIT (cut-off ≥5) was 0.809 and specificity 0.621 in predicting alcohol problem use among adolescents one year later. The positive test posterior probability was 0.51. For those who screened negative at baseline, the positive test posterior probability was 0.13. With AUDIT-C (cut-off ≥3), the posterior probabilities were 0.47 and 0.12, respectively (sensitivity 0.855, specificity 0.529). The odds ratio was 6.95 for those screening positive with AUDIT and 6.59 with AUDIT-C at baseline to have alcohol problem use one year later.

CONCLUSIONS

AUDIT has utility in screening youth at risk for developing alcohol problem use. It has significant predictive capacity in detecting risk especially among adolescents with depression.

Posttraumatic Stress, Academic Performance, and Future Orientation as Pathways to Community Violence Exposure and Sexual Risk among African American Youth in Chicago's Southside

Posttraumatic stress, low academic performance, and future orientation as pathways from community violence exposure to sexual risk-taking behavior were examined among 753 African American youth in a large urban school district, ranging from ages of 13 to 24 years. Youth completed a self-report instrument. Youth completed a self-report instrument of Exposure to Violence Probe, University of California at Los Angeles' PTSD Reaction Index Adolescent Version, and Coopersmith's Self-Esteem Scale. Structural equation modeling was performed to examine relationships among the major study variables. Results indicated that community violence exposure was not directly associated with sexual risk behavior. However, community violence exposure had a significantly positive impact on posttraumatic stress, which was associated with low future orientation and sexual risk behavior. Findings suggest that targeted interventions need to consider variables that mediate the association between violence exposure and sexual risk behavior, which can reduce poor sexual health outcomes among urban youth who are exposed to violence in their community.

Prior Interpersonal Violence Exposure and Experiences During and After a Disaster as Predictors of Posttraumatic Stress Disorder and Depression Among Adolescent Victims of the Spring 2011 Tornadoes

The purpose of the current report was to examine prior history of exposure to interpersonal violence (IPV), as compared with prior accident or prior disaster exposure, experiences during and after a disaster, and demographic variables as predictors of past month posttraumatic stress disorder (PTSD) and depression severity among adolescents exposed to the tornadoes in Alabama and Missouri. IPV exposure has been consistently identified as a unique category of potentially traumatic events (PTE) that significantly increases risk for development of PTSD and other difficulties relative to other event types among adolescents. A population-based sample of adolescents and caregivers (N = 2,000) were recruited randomly from tornado-affected communities in Alabama and Joplin, Missouri. Participants completed structured telephone interviews on an average of 8.8 months posttornado. Prior history of IPV was prevalent (36.5%), as was reported history of accidents (25.9%) and prior disaster exposure (26.9%). Negative binomial regression analyses with PTSD and depression symptom counts for past month as outcome variables indicated that history of predisaster IPV was most robustly related to PTSD and depression symptoms, such that those with a history of IPV endorsed over 3 times the number of symptoms than those without IPV history. Final model statistics indicated that female gender, physical injury to caregiver, concern about others' safety, prior disaster, prior accident, and prior IPV exposure were also related to PTSD. Predictors of depression symptoms were similar with the exception that concern about others' safety was not a predictor and age was a predictor in the final model. It is important to evaluate potential additive effects of IPV history in addition to recent disaster exposure variables and to consider such history when developing interventions aimed to reduce or prevent symptoms of PTSD and depression among adolescents recently exposed to disaster.

Affective Drinking Motives, Delinquency and Binge Drinking: A Comparison of Male and Female High School Seniors

Aim

The purpose of this study was to determine whether the association between affective drinking motives, delinquency and binge drinking varied as a function of sex and if so, whether delinquency moderated the relationship between affective drinking motives and binge drinking in late adolescent males and females.

Methods

Participants were 623 (257 males, 366 females) high school seniors from the 2018 Monitoring the Future study. A principal components analysis was initially performed to create component scores for the first factor of a 15-item drinking motives scale subsequently labeled affective drinking motives. These scores, along with sex and a measure of delinquency, were then entered into a three-way interaction. The interaction was found to correlate significantly with binge drinking. Because of the significant three-way interaction, analyses were performed on male and female participants separately.

Results

Analyses conducted on male participants revealed a moderate correlation between affective drinking motives and binge drinking but no evidence of an interaction between affective drinking motives and delinquency. Analyses performed on female participants, on the other hand, identified a significant main effect for affective drinking motives and a negative interaction between affective drinking motives and delinquency, indicating that the relationship between affective drinking motives and binge drinking was strongest when delinquency was low.

Conclusions

These results suggest that while delinquency had no apparent impact on the affective drinking motive–binge drinking correlation in boys, low delinquency clearly amplified the counter-binge drinking effects of low affective drinking motives in girls.

Childhood assaultive trauma and physical aggression: Links with cortical thickness in prefrontal and occipital cortices

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Childhood assaultive trauma exposure is linked to less cortical thickness.

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Cortical thickness in prefrontal regions is inversely associated with aggression.

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Prefrontal thickness mediated the link between trauma exposure and aggression.

Although the link between childhood maltreatment and violence perpetration in adulthood (i.e., the “cycle of violence”) is well-documented, the neural mechanisms driving these processes remain relatively unknown. The objectives of this study were to investigate whether cortical thickness in adulthood varies as a function of childhood assaultive trauma exposure and whether such neurobiological markers of early trauma relate to the perpetration of aggression across the lifespan. In a sample of 138 ethnically-diverse men and women, whole-brain analysis of the cortical mantle revealed that individuals with exposure to assaultive trauma before age 13 had less cortical thickness in two clusters that survived multiple comparison correction: a region that peaked in the left lateral orbitofrontal cortex (OFC) and a region peaking in the right pericalcarine cortex. Diminished cortical thickness in the left OFC cluster was, in turn, associated with greater physical aggression, and mediation analysis revealed that reductions in cortical thickness in this left prefrontal region partially accounted for the association between exposure to childhood assaultive trauma and lifetime perpetration of aggression in adulthood. Findings extend previous investigations into the morphological correlates of early assaultive trauma by implicating reductions in cortical thickness as a potential mechanism linking early violence exposure to violence perpetration that extends into adulthood.

Crime Victimization and Suicidal Ideation Among Colombian College Students: The Role of Depressive Symptoms, Familism, and Social Support

Crime victimization is one of the most pressing public health concerns in Latin America. Young people in the region are at particularly high risk of victimization. The present study examined exposure to crime victimization as a risk factor for depressive symptoms and suicidal ideation, and the protective effects of familism and social support in a community sample of Colombian college students. Data (N = 424) came from the Juventud Project (The Emergent Adults Project), a cross-sectional study of college students, 18 to 29 years old (M = 20.8, SD = 2.5; 63% female; 75.5% lived with their families), attending an urban public university in Southern Colombia. Data were collected between March and June of 2014 through anonymous, self-administered surveys. Conditional process analysis was used to test a model in which crime victimization was directly and indirectly associated with suicidal ideation via depressive symptoms, with familism and social support as moderators of this association while controlling for gender, age, and socioeconomic status. Overall, 58.9% of participants reported at least one crime victimization event in the past year. The most common types of victimization were being robbed without the threat of harm (29.8%) and being robbed with a weapon (24.8%). Male participants reported more instances of crime victimization than female participants. Levels of depressive symptoms that could be clinically significant were reported by 30.2% of participants, and suicidal ideation was reported by 31% of participants. The association between crime victimization and suicidal ideation was fully mediated by depressive symptoms. Social support, but not familism, moderated this association; social support weakened the link between depressive symptoms and suicidal ideation. Findings suggest that crime victimization may be a significant risk for depressive symptoms and suicidal ideation among college students in Colombia, and that social support may protect from the harmful mental health effects of crime victimization.

Child Maltreatment Typologies and Intimate Partner Violence: Findings From a Danish National Study of Young Adults

The association between exposure to childhood maltreatment and subsequent intimate partner violence (IPV) has been well documented. Recently, there has been increased attention to IPV in adolescence and young adulthood, with studies demonstrating that IPV peaks in young adulthood. Data were collected from a Danish national study conducted by The Danish National Centre for Social Research in 2008 and 2009. A sample of 4,718 young adults (aged 24) was randomly selected using the total birth cohort of children born in 1984. Structured interviews were conducted with 2,980 participants equating to a response rate of 63%. Childhood maltreatment including emotional, sexual, and multiple abuse experiences and being female and a young parent were used to test the association with experiencing IPV victimization. Bivariate associations showed that all variables were significantly associated with experiencing IPV. When the variables were entered into a multivariate binary logistic regression analysis, being female indicated the strongest association (odds ratio [OR] = 13.96), followed by experiencing childhood sexual abuse (OR = 10.90) and experiencing multiple types of abuse (OR = 6.49). Results suggest that among the child maltreatment typologies, sexual abuse is the dominant factor associated with IPV. The current study extends the literature conducted on a young adult population by demonstrating that early adverse experiences and being female and a parent are associated with IPV in young adulthood. These findings suggest prevention programs should be targeted in early adolescence to support young people to establish and maintain positive and healthy relationships that promote safe conflict resolution strategies.

Biotypes of functional brain engagement during emotion processing differentiate heterogeneity in internalizing symptoms and interpersonal violence histories among adolescent girls

Youth exposed to early life interpersonal violence (IPV) demonstrate heterogeneous clinical symptoms. Studies based on univariate methods suggest that neurocircuitry related to emotion processing explains heterogeneity in internalizing symptoms. Here, we use a multivariate, data-driven method of identifying distinct functional brain activation profiles (i.e., "biotypes") and test whether these biotypes differentiate internalizing symptoms among IPV-exposed youth. 114 adolescent girls (n = 38 with no IPV exposure or psychopathology; n = 76 with IPV exposure and heterogeneous internalizing symptoms), aged 11-17, completed an emotion processing task during fMRI. To identify distinct biotypes of brain engagement profiles, data-driven clustering analysis was applied to patterns of voxel activation, constrained within a mask of distributed regions implicated in emotion processing. Resulting biotypes (BT1-3) were compared on measures of IPV exposure and internalizing symptoms, as well as symptom reduction during Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) among a subset of participants (n = 21). Cluster analyses identified three biotypes, differentiated by engagement of medial prefrontal, anterior insula, hippocampus, parietal, and ventral visual cortex during emotion processing. BT1 exhibited low levels of IPV exposure and internalizing symptoms. BT2 exhibited elevated levels of IPV, except sexual assault, and demonstrated moderate severity across internalizing symptom domains. BT3 exhibited elevated severity across all IPV and internalizing symptom domains. Greater symptom reduction during TF-CBT was associated with increased pre-to post-treatment changes in similarity with BT1. These results demonstrate distinct profiles of emotion processing neurocircuitry that differentiate heterogeneity in internalizing symptoms in IPV-exposed adolescent girls.

Interpersonal Trauma and Risk of Depression Among Adolescents: The Mediating and Moderating Effect of Interpersonal Relationship and Physical Exercise

Interpersonal trauma in adolescent is an important public health concern. Depression can be a main consequence of interpersonal trauma, which subsequently results in various negative mental health outcomes. Previous research has investigated the independent effects of interpersonal trauma, interpersonal relationships and physical exercise on the risk of depression. However, the interaction effect of the three factors on depression remains unclear. We aim to investigate the associations between these potential factors and depression in adolescents, and explore the interaction effect of the three aforementioned factors. A cross-sectional study was conducted in Shenzhen, China, in 2017. A total of 1,883 adolescents from 11 middle schools and high schools were recruited. Demographic information, depressive symptoms, physical exercise, interpersonal relationships, interpersonal trauma, and academic record were collected through the use of standardized questionnaires. A linear regression model was performed to explore the association between these variables and depression. Pathway analysis was used to explore the role of potential mediators and moderators. The results showed that interpersonal trauma and poorer interpersonal relationships were significantly associated with depression (p < 0.05). We identified a mediating role of interpersonal relationships in the relationship between interpersonal trauma and depression, and a moderating role of physical exercise between interpersonal trauma and interpersonal relationships. This is the first study to examine the interaction effects of interpersonal trauma, interpersonal relationships and physical exercise on depression in adolescents. The current study therefore provides insights into factors which impact the mental health of adolescents. Through examining these factors one can gain further insight into potential factors associated with depression and therefore then develop more tailored interventions in order to support adolescents' mental well-being.

Interpersonal trauma exposure and startle reactivity to uncertain threat in individuals with alcohol use disorder

BACKGROUND

Exposure to interpersonal trauma is highly prevalent within individuals with alcohol use disorder (AUD); however, the mechanisms underlying the pathway between trauma exposure and AUD are unclear. Preliminary evidence suggests that heightened reactivity to threats that are uncertain (U-threat) may characterize individuals with AUD and interpersonal trauma exposure and contribute to alcohol abuse within this subgroup of individuals; however, this hypothesis has yet to be tested.

METHOD

The aim of the study was to examine whether heightened reactivity to U-threat characterizes individuals with AUD and a history of interpersonal trauma. Specifically, the study compared defensive reactivity to U-threat (and predictable threat [P-threat]) in those with: 1) AUD and a history of interpersonal trauma (AUD + Trauma); 2) AUD and no history of interpersonal trauma (AUD-Trauma); and 3) matched controls. Participants (N = 77) completed a well-validated threat-of-shock task and startle eyeblink potentiation was collected as an index of aversive responding.

RESULTS

Results revealed a group by threat condition interaction (F[4, 142] = 3.17, p = 0.03; ηG2 = 0.08) such that individuals with AUD + Trauma exhibited greater startle reactivity to U-threat, but not P-threat, compared with individuals with AUD-Trauma and controls (who did not differ from each other). The findings were significant even when controlling for current anxiety and depression symptoms.

CONCLUSIONS

Within individuals with AUD, those with a history of interpersonal trauma exposure may be a neurobiologically unique subtype characterized by exaggerated U-threat reactivity and high levels of anticipatory anxiety. Reactivity to U-threat may be a promising alcohol use prevention and intervention target for trauma-exposed individuals.

Polyvictimization, Related Symptoms, and Familial and Neighborhood Contexts as Longitudinal Mediators of Racial/Ethnic Disparities in Violence Exposure Across Adolescence

African American and Hispanic adolescent experience more violence exposure relative to White youth. The present study examined the mediating role of posttraumatic stress symptoms (PTSS), delinquency, earlier victimization, and familial and neighborhood factors in disparities in future victimization. The study utilized data from the National Survey of Adolescents-Replication (N = 3,312), which consists of three waves of data collected approximately 1 year apart. A series of path models, tested polyvictimization, PTSS, delinquency, familial socioeconomic factors, and neighborhood safety as mediators of disparities in new polyvictimization. All cross-lagged and autoregressive paths positively predicted past-year polyvictimization and mediated longitudinal disparities. Familial socioeconomic variables and neighborhood safety mediated initial violence exposure disparities. Overall, results indicate that prior violence exposure, related mental health symptoms, and familial and neighborhood factors account for significant portions of disparities in new violence exposure across adolescence.

A technology-augmented intervention to prevent peer violence and depressive symptoms among at-risk emergency department adolescents: Protocol for a randomized control trial

BACKGROUND

Peer violence and depressive symptoms are increasingly prevalent among adolescents, and for many, use the emergency department (ED) as their primary source of healthcare. Brief in-person interventions and longitudinal text-message-based interventions are feasible, acceptable, and may be effective in reducing peer violence and depressive symptoms when delivered in the ED setting. This paper presents the study design and protocol for an in-ED brief intervention (BI) and text messaging program (Text).

METHODS

This study will be conducted in a pediatric ED which serves over 50,000 pediatric patients per year. Recruitment of study participants began in August 2018 and anticipated to continue until October 2021. The study will enroll 800 adolescents (ages13-17) presenting to the ED for any reason who self-report past-year physical peer violence and past-two week mild-to-moderate depressive symptoms. The study will use a factorial randomized trial to test both overall intervention efficacy and determine the optimal combination of intervention components. A full 2 × 2 factorial design randomizes patients at baseline to 1) BI or no BI; and 2) Text or no Text. Peer violence and depressive symptoms improvements will be measured at 2, 4, and 8 months through self-report and medical record review.

DISCUSSION

This study has important implications for the progress of the greater field of mobile health interventions, as well as for adolescent violence and depression prevention in general. This proposal has high clinical and public health significance with high potential scalability, acceptability, and impact.

Reductions in Parental Use of Corporal Punishment on Pre-School Children Following Participation in the Moms' Empowerment Program

Corporal punishment is a widely used and widely endorsed form of parental discipline. Inter-partner violence places enormous stress upon women. The rate of corporal punishment is higher in homes where other types of domestic violence are also occurring. This study compares two groups: those who participated in an intervention for women exposed to intimate partner violence (The Moms' Empowerment Program [MEP]) and those in a comparison group. Using standardized measures, women in both groups were assessed at baseline and at the end of the program, 5 weeks later. The 113 mothers who participated in the MEP program had significantly improved their parenting, such that they had less use of physical punishment post-intervention. Findings suggest that a relatively brief community-based intervention program can reduce the use of parental physical punishment even in disadvantaged populations coping with stressful circumstances.

VGLUT2 rs2290045 genotype moderates environmental sensitivity to alcohol-related problems in three samples of youths

The importance of Vesicular Glutamate Transporter 2 (VGLUT2)-mediated neurotransmission has been highlighted in studies on addiction-related phenotypes. The single nucleotide polymorphism rs2290045 in VGLUT2 has been associated with alcohol dependence, but it is unknown whether or how this association is affected by environmental factors. The present study determined whether the association of alcohol-related problems with the rs2290045 in the VGLUT2 gene was modified by negative and positive environmental factors. Three samples were included: a clinical sample of 131 adolescents followed from age 17 to 22; a general population sample of 1794 young adults; and a general population sample of 1687 adolescents followed from age 14 to 17. DNA was extracted from saliva and the rs2290045 (T/C) was genotyped. Alcohol-related problems were assessed using the Alcohol Use Disorders Identification Test. Stressful life events (SLE) and parenting were assessed by questionnaires. Gene-environment interactions were investigated using a dual statistical approach. In all samples (effect sizes 0.6-6.2%), and consistent with the differential susceptibility framework, T carriers exposed to SLE reported more alcohol-related problems if they had experienced poor parenting, and lower alcohol-related problems if they had received supportive parenting. T carriers not exposed to SLE reported higher alcohol-related problems if they had received supportive parenting and lower alcohol-related problems if they had received poor parenting. Among CC carriers, alcohol-related problems did not vary as a function of negative and positive environmental factors. In conclusion, in three samples of youths, alcohol-related problems were associated with an interaction of VGLUT2 rs2290045, SLE, and parenting.

Impact of Violence and Relationship Abuse on Grades of American Indian/Alaska Native Undergraduate College Students

Violence and relationship abuse are pervasive public health problems that have a range of negative effects, with exceptionally high prevalence among ethno-racial minority youth. This study assesses the prevalence of these types of violence among American Indian/Alaska Native (AI/AN) students and examines the impact of victimization on academic performance of AI/AN and non-AI/AN student populations using self-reported college health survey data. Results show that students who identified fully or partially as AI/AN reported markedly higher rates of all types of violence/abuse than did other students, and students who had experienced violence/abuse had lower grade point averages (GPAs) compared with those who had not. Recommendations for future research and direct practice with AI/AN students are discussed.

Does development moderate the effect of early life assaultive violence on resting-state networks? An exploratory study

Current neurocircuitry models of PTSD do not account for developmental effects, despite that early life assaultive violence is a potent risk factor for PTSD. Here, we preliminarily evaluated developmental stage as a moderator of the effect of early life assaultive violence on resting-state connectivity amongst regions associated with emotion generation and regulation using fMRI. Participants were adult women (n = 25) and adolescent girls (n = 36) who had or had not experienced early life assaultive violence. We found significant interactions between developmental stage and trauma exposure on resting-state functional connectivity (FC). Left amygdala connectivity with the left ventral anterior cingulate gyrus (BA 32) was reduced among trauma-exposed compared to control adolescents, but increased among trauma-exposed compared to control adults. A corresponding pattern of results was identified for FC between rostral anterior cingulate gyrus seed region and a similar right ventral anterior superior frontal gyrus cluster. Increased FC in both regions for assaulted adult women scaled positively with self-reported emotion regulation difficulties. Our results should be viewed tentatively due to sample limitations, but provide impetus to examine whether neurocircuitry models of PTSD may be strengthened by accounting for developmental stage.

Exposure to parental and community violence and the relationship to bullying perpetration and victimization among early adolescents: A parallel process growth mixture latent transition analysis

This study examined heterogeneity in parental and community violence exposure during middle school and its association with bullying perpetration and victimization in high school. Youth (N = 1,611) in four Midwestern middle schools participated. Parallel process growth mixture latent transition analysis was used to understand how trajectory profiles of middle school violence exposure was associated with high school bullying profiles. Impulsivity, depression, school belonging, and delinquency were assessed as moderators of the transition probabilities. A three class solution was found for violence exposure: decreasing parental violence/increasing community violence (n = 103; 6.4%), stable high parental violence and low community violence (n = 1,027; 63.7%), and increasing parental violence and stable high community violence (n = 481; 29.8%). Similarly, a three class solution was found for high school bullying: High Bullying Perpetration and High Victimization class (n = 259; 16%), Victimization only (n = 1145; 71%), and low all class (n = 207; 13%). The largest proportion of youth transitioning into the high bullying and high victimization class were from the decreasing parental violence/increasing community violence. Depression, impulsivity, school belonging, and delinquency all had various moderating effects on transition probabilities. Our findings make it apparent that early forms of parental and community violence are associated with aggressive behaviors and experiences with victimization during high school. Prevention and intervention efforts should target individuals who display early and chronic patterns of exposure to violence as these individuals have the greatest risk of later aggressive and victimization in high school.

Intimate partner violence, health, sexuality, and academic performance among a national sample of undergraduates

OBJECTIVE

To determine the association between intimate partner violence (IPV) and academic performance among heterosexual and sexual minority undergraduates, including whether health mediates this relationship.

PARTICIPANTS

A national sample of undergraduate students aged 18-24 years old who completed the 2011-2014 National College Health Assessment IIb (N = 85,071).

METHODS

We used structural equation modeling to create a latent variable of IPV victimization (stalking, physical, sexual, and emotional violence) in order to test its relationship with health (physical and mental) and two indicators of academic performance (GPA and perceived academic difficulties), according to participants' sexual identity (heterosexual, lesbian, gay, bisexual, and unsure).

RESULTS

Regardless of sexual identity, undergraduates who reported IPV were more likely to have lower GPA and increased academic difficulties. Health mediates this relationship, such that IPV reduces health, which negatively affects performance.

CONCLUSIONS

IPV poses a serious threat to undergraduates' health and educational success. Findings warrant universal prevention and intervention.

Behavioral Health of Gulf Coast Residents 6 Years After the Deepwater Horizon Oil Spill: The Role of Trauma History

OBJECTIVE

The purpose of this study was to examine the associations between oil spill exposure, trauma history, and behavioral health 6 years after the Deepwater Horizon oil spill (DHOS). We hypothesized that prior trauma would exacerbate the relationship between oil spill exposure and behavioral health problems.

METHODS

The sample included 2,520 randomly selected adults in coastal areas along the Gulf of Mexico. Participants reported their level of oil spill exposure, trauma history, depression, anxiety/worry, illness anxiety, and alcohol use.

RESULTS

Individuals with more traumatic experiences had a significantly higher risk for all measured behavioral health problems after controlling for demographic factors and DHOS exposure. Those with higher levels of DHOS exposure were not at greater risk for behavioral health problems after controlling for prior trauma, with the exception of illness anxiety. There was no evidence that trauma history moderated the association between DHOS exposure and behavioral health.

CONCLUSIONS

Findings suggest that trauma exposure may be a better indicator of long-term behavioral health risk than DHOS exposure among disaster-prone Gulf Coast residents. DHOS exposure may be a risk factor for illness anxiety but not more general behavioral health concerns. Trauma history did not appear to exacerbate risk for behavioral health problems among Gulf residents exposed to the DHOS. (Disaster Med Public Health Preparedness. 2019;13:497-503).

Differential Roles of the Salience Network During Prediction Error Encoding and Facial Emotion Processing Among Female Adolescent Assault Victims

BACKGROUND

Early-life assaultive violence exposure is a potent risk factor for posttraumatic stress disorder (PTSD) and other mood and anxiety disorders. Neurocircuitry models posit that increased risk is mediated by heightened emotion processing in a salience network including the dorsal anterior cingulate cortex, anterior insula, and amygdala. However, the processes of reinforcement learning (RL) also engage the salience network and are implicated in responses to early-life trauma and PTSD. To define their relative roles in response to early-life trauma and PTSD symptoms, the current study compared engagement of the salience network during emotion processing and RL as a function of early-life assault exposure.

METHODS

Adolescent girls (n = 30 girls who had previously been physically or sexually assaulted; n = 30 healthy girls for comparison) 11 to 17 years of age completed two types of tasks during functional magnetic resonance imaging: a facial emotion processing task and an RL task using either social or nonsocial stimuli. Independent component analysis was used to identify a salience network and characterize its engagement in response to emotion processing and prediction error encoding during the RL tasks.

RESULTS

Assault was related to greater reactivity of the salience network during emotion processing. By contrast, we found lesser encoding of negative prediction errors in the salience network, particularly during the social RL task, in girls who had been assaulted. The dysfunction of salience network activity during emotion processing and prediction error encoding was not associated with PTSD symptoms.

CONCLUSIONS

These results suggest that hyper- versus hypoactivity of the salience network among trauma-exposed youths depends on the cognitive-affective domain.

Domestic and intimate partner violence among pregnant women in a low resource setting in South Africa: a facility-based, mixed methods study

BACKGROUND

Rates of violence against women are reported to be highest in Africa compared to other continents. We aimed to determine associations between mental illness, demographic, psychosocial and economic factors with experience of intimate partner violence (IPV) among pregnant women in a low resource setting in Cape Town and to explore the contextual elements pertaining to domestic violence.

METHODS

We recruited adult women attending antenatal services at a primary-level maternity facility. Demographic, socioeconomic and psychosocial data were collected by questionnaire. The Expanded Mini- International Neuropsychiatric Interview (MINI) Version 5.0.0 was used to assess mental health status and the Revised Conflict Tactic Scale (CTS2) used to assess IPV in the six months prior to the study. Non-parametric tests, Wilcoxon sum of rank test, Fisher Exact and two sample T test and multicollinearity tests were performed. Descriptive, bivariate and logistic regression analyses were conducted to identify associations between the outcome of interest and key predictors. A probability value of p ≤ 0.05 was selected. From counselling case notes, a thematic content analysis was conducted to describe contextual factors pertaining to forms of domestic violence (DV).

RESULTS

The prevalence of IPV was 15% of a sample of 376 women. Women who were food insecure, unemployed, in stable but unmarried relationships, had experienced any form of past abuse and were not pleased about the current pregnancy were more likely to experience IPV. MINI-defined mental health problems and a history of mental illness were significantly associated with IPV. Qualitative analysis of 95 counselling case notes revealed that DV within the household was not limited to intimate partners and, DV in this context was often perceived as 'normal' behaviour by the participants.

CONCLUSIONS

This study contributes towards a greater understanding of the risk profile for IPV amongst pregnant women in low-income settings. Adversity, including food insecurity and mental ill-health are closely associated with IPV during the antenatal period. Advocates against violence against pregnant women are advised to consider that violence in the home may be perpetrated by non-intimate partners and may by enabled by a pervasive belief in the acceptability of the violence.

Adolescent clinical populations and associations between trauma and behavioral and emotional problems

OBJECTIVE

Trauma exposure is common during childhood and adolescence and is associated with youth emotional and behavioral problems. The present study adds to the current literature on trauma exposure among adolescent clinical populations by examining the association between trauma exposure and adolescent self-report of emotional and behavioral problems broadly, including internalizing and externalizing symptoms, in addition to the trauma-specific symptoms of posttraumatic stress disorder (PTSD).

METHOD

This study included 94 female (64%) and male (36%) adolescents, ages 13-19, representing 4 clinical populations: those seeking inpatient psychiatry, outpatient psychiatry, residential substance abuse, and outpatient medical services. Adolescents self-reported trauma history and internalizing, externalizing, and PTSD symptoms.

RESULTS

Most adolescents reported experiencing at least 1 traumatic event (83%; M = 2.28, SD = 1.83). Multiple regression analyses controlling for age, race/ethnicity, gender, and treatment setting indicated a greater number of types of trauma are associated with externalizing symptoms (β = .31, p < .01) and PTSD symptoms (β = .35, p < .01).

CONCLUSION

Trauma is a common experience among adolescents, particularly those presenting for behavioral health services, making trauma-informed care essential in these service delivery settings. Treatment that addresses adolescent risk behaviors and prevents recurrent trauma may be particularly important given the negative impact of multiple traumatic events on developing adolescents. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Impulsivity and Comorbid PTSD and Binge Drinking

OBJECTIVE

Trauma exposure is common, with estimates of 28% to 90% of adults reporting at least one traumatic event over their lifetime. Those exposed to traumatic events are at risk for alcohol misuse (i.e., binge drinking), posttraumatic stress disorder (PTSD), or both. A potential underlying mechanism for this comorbidity is increased impulsivity-the tendency to act rashly. Little work to date has examined the impact of different impulsogenic traits on this comorbidity.

METHODS

This study (n = 162) investigated trauma-exposed young adults (aged 21-30) who had endorsed a lifetime interpersonal trauma. In addition, three impulsogenic traits (motor, nonplanning, and attentional) were measured.

RESULTS

Over and above the covariates for age, gender, race, and traumatic events, greater attentional impulsivity was associated with greater likelihood of meeting criteria for PTSD and binge drinking, compared to meeting criteria for PTSD, binge drinking, or neither. Neither nonplanning impulsivity nor motor impulsivity exerted unique effects.

CONCLUSIONS

Young adults who report difficulty attending to immediate stimuli within their environment may be unable to think about and/or process the traumatic event, potentially increasing risk for PTSD and maladaptive coping skills to manage this distress (e.g., alcohol misuse, binge drinking).

[Alcohol consumption and physical violence among adolescents: which is the predictor?]

The scope of this integrative review was to investigate the association between alcohol consumption and physical violence in the literature, with an emphasis on identifying the predictor between them. A search was conducted in the Lilacs, Medline and SciELO databases, adopting "violence," "alcohool drinking" and "adolescent" as descriptors. It included articles published between 2005 and 2014 that analyzed the association between alcohol consumption and physical violence using multivariate analysis. Of the total of 1667 articles located, 29 met the inclusion criteria. Alcohol consumption was investigated more as a predictor of involvement in physical violence when the teenager is the perpetrator or the victim of violence, with a significant association found in 19 studies. However, when victimization was investigated as a predictor (7 studies), most of these (6) revealed no significant association with the intake of alcoholic beverages. The consumption of alcohol has proven to be the predictor of physical violence for both the teen perpetrator and for the adolescent victim of violence. However, having been the victim of violence in childhood and adolescence may also lead adolescents to alcohol consumption.

Large-scale brain organization during facial emotion processing as a function of early life trauma among adolescent girls

Background

A wealth of research has investigated the impact of early life trauma exposure on functional brain activation during facial emotion processing and has often demonstrated amygdala hyperactivity and weakened connectivity between amygdala and medial PFC (mPFC). There have been notably limited investigations linking these previous node-specific findings into larger-scale network models of brain organization.

Method

To address these gaps, we applied graph theoretical analyses to fMRI data collected during a facial emotion processing task among 88 adolescent girls (n = 59 exposed to direct physical or sexual assault; n = 29 healthy controls), aged 11-17, during fMRI. Large-scale organization indices of modularity, assortativity, and global efficiency were calculated for stimulus-specific functional connectivity using an 883 region-of-interest parcellation.

Results

Among the entire sample, more severe early life trauma was associated with more modular and assortative, but less globally efficient, network organization across all stimulus categories. Among the assaulted girls, severity of early life trauma and PTSD diagnoses were both simultaneously related to increased modular brain organization. We also found that more modularized network organization was related both to amygdala hyperactivation and weakened connectivity between amygdala and medial PFC.

Conclusions

These results demonstrate that early life trauma is associated with enhanced brain organization during facial emotion processing and that this pattern of brain organization might explain the commonly observed association between childhood trauma and amygdala hyperactivity and weakened connectivity with mPFC. Implications of these results for neurocircuitry models are discussed.

Genetic and psychosocial predictors of alcohol use trajectories among disaster-exposed adolescents

BACKGROUND AND OBJECTIVES

Adolescent alcohol misuse is associated with numerous long-term adverse outcomes, so we examined predictors of alcohol use among disaster-exposed adolescents, a group at-risk for alcohol misuse.

METHODS

The current study (n = 332) examined severity of tornado-related exposure, posttraumatic stress disorder (PTSD) symptoms, emotional support, and a genetic risk sum score (GRSS) as predictors of alcohol use trajectories.

RESULTS

Severity of exposure interacted with the GRSS to predict both intercept (12-month follow up quantity of alcohol use) and growth rate. Emotional support also interacted with adolescent PTSD symptoms to predict intercept and growth rate.

DISCUSSION AND CONCLUSIONS

Adolescents with greater severity of disaster exposure and high genetic risk comprise a high risk group, on which efforts to prevent alcohol use should be focused. Additionally, emotional support is essential in buffering the effects of PTSD symptoms on alcohol use outcomes among adolescents.

SCIENTIFIC SIGNIFICANCE

Toward the aim of reducing adolescent alcohol misuse following disaster exposure, there is utility in inserting immediate supports (e.g., basic resources) into communities/families that have experienced significant disaster-related severity, particularly among adolescents at high levels of genetic risk for alcohol use/misuse. Additionally, prevention efforts aimed at improving emotional supports for adolescents with more PTSD symptoms may reduce propensity for alcohol misuse following disaster. This information can be easily incorporated into existing web-based interventions. (Am J Addict 2017;26:623-631).