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Almeida TC, Cardoso J, Matos AF, Murça A, Cunha O. Adverse childhood experiences and aggression in adulthood: The moderating role of positive childhood experiences. CHILD ABUSE & NEGLECT 2024; 154:106929. [PMID: 38968757 DOI: 10.1016/j.chiabu.2024.106929] [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: 03/28/2024] [Revised: 06/20/2024] [Accepted: 06/27/2024] [Indexed: 07/07/2024]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) have a significant impact on a person's psychological development and predispose them to various harmful consequences in adulthood, such as different forms of aggression. Contrarily, positive childhood experiences (PCEs) operate as protective factors, buffering against the adverse effects of ACEs and promoting adaptive behaviors and psychological well-being. However, the role of PCEs in the relationship between ACEs and aggression remains relatively unexplored. OBJECTIVE To explore the moderation role of PCEs in the relationship between ACEs and aggression and its different components across sexes in a community sample. METHODS A sample of 1541 Portuguese adults answered an online protocol with a sociodemographic questionnaire, the Benevolent Childhood Experiences Scale, the Childhood History Questionnaire, and the Buss-Perry Aggression Questionnaire. RESULTS ACEs were positively correlated with aggression, including physical and verbal aggression, anger, and hostility, with women reporting a higher prevalence of ACEs and higher levels of anger. Men revealed higher scores in physical and verbal aggression. Furthermore, moderation analyses clarified the moderating effect of PCEs on the relationship between ACEs and aggression in women and between ACEs and anger in both sexes. PCEs attenuate the adverse impact of ACEs, reducing aggression and anger levels. CONCLUSIONS This study stresses the complex interplay between childhood experiences and adult aggression, highlighting the differential effects of ACEs and PCEs across men and women. By clarifying these dynamics, interventions can be tailored to bolster protective factors like PCEs. This will ultimately foster healthier developmental trajectories and reduce the prevalence of aggression in adulthood.
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Affiliation(s)
- Telma Catarina Almeida
- Egas Moniz School of Health & Science, 2829-511 Caparica, Almada, Portugal; Egas Moniz Center for Interdisciplinary Research (CiiEM), 2829-511 Caparica, Almada, Portugal; LabPSI - Laboratório de Psicologia Egas Moniz, 2829-511 Caparica, Almada, Portugal.
| | - Jorge Cardoso
- Egas Moniz School of Health & Science, 2829-511 Caparica, Almada, Portugal; Egas Moniz Center for Interdisciplinary Research (CiiEM), 2829-511 Caparica, Almada, Portugal; LabPSI - Laboratório de Psicologia Egas Moniz, 2829-511 Caparica, Almada, Portugal
| | | | - Ana Murça
- Egas Moniz School of Health & Science, 2829-511 Caparica, Almada, Portugal
| | - Olga Cunha
- Lusófona University, HEI-Lab: Digital Human-Environment Interaction Labs, Porto, Portugal
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Kindermann D, Rollmann I, Orth M, Friederich HC, Nikendei C. Direct and indirect effects of adverse and protective childhood experiences on symptom improvement in psychotherapy. Psychother Res 2024; 34:774-789. [PMID: 37706484 DOI: 10.1080/10503307.2023.2254917] [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: 03/15/2023] [Accepted: 08/29/2023] [Indexed: 09/15/2023] Open
Abstract
To investigate the effects of adverse and protective childhood experiences on symptom improvement in outpatient psychotherapy. We evaluated n = 648 completed outpatient psychodynamic psychotherapies. First, we estimated the rate of symptom improvement for each patient using a two-stage hierarchical linear model. We then calculated the direct and indirect influences of childhood experiences on the improvement rate using a structural equation model. Personality functioning, according to the Operationalized Psychodynamic Diagnosis system, was examined as being a possible mediating factor. The presence of adverse childhood experiences was directly associated with a slower improvement rate in psychotherapy. Moreover, a higher number of adverse childhood experiences was associated with greater impairments in the ability to communicate as one dimension of personality functioning, which in turn was associated with a slower improvement of symptoms. Protective childhood experiences were associated with fewer impairments in specific dimensions of personality functioning, but had no direct effect on the improvement rate. Adverse childhood experiences can directly influence the course of psychotherapy. In addition, the communication dimension of personality functioning appears to be a central mediator on which adverse and protective childhood experiences act antagonistically and can thus indirectly affect the improvement rate in psychotherapy.
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Affiliation(s)
- David Kindermann
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Ivo Rollmann
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Maximilian Orth
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Christoph Nikendei
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
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Greene E, Austin G, Henneman A. Adverse childhood experiences among doctor of pharmacy students. CURRENTS IN PHARMACY TEACHING & LEARNING 2024; 16:327-334. [PMID: 38480066 DOI: 10.1016/j.cptl.2024.03.001] [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: 08/29/2023] [Revised: 02/27/2024] [Accepted: 03/03/2024] [Indexed: 04/22/2024]
Abstract
OBJECTIVE Adverse Childhood Experiences (ACEs) have demonstrated negative impact on physical, emotional, and cognitive health outcomes. This study aimed to assess prevalence of ACEs among Doctor of Pharmacy (PharmD) students, and their associations with mental health, substance use, academic performance, and sleep patterns. METHODS A cross-sectional survey was conducted on PharmD students at a private University. ACE scores, mental health history, substance use, academic performance, and sleep habits were self-reported. Descriptive statistics and chi-square tests were used for analysis. RESULTS From 54 participants across all cohorts of students in the curriculum (response rate: 19%), 48% reported ≥4 ACEs. A majority of students reported having been diagnosed with or sought treatment for depression (56%) or anxiety (67%), while 42.9% reported a history of contemplating suicide. Participants with ACE scores of ≥4 were more likely to have sought treatment for depression, any mental health condition, contemplated suicide, or used alcohol for mental health purposes. No differences in academic performance based on ACE scores were found. CONCLUSION High numbers of ACEs were common and linked to mental illness, suicidality, and use of alcohol for mental health purposes. While no direct academic impact was found in this small sample size, adopting a trauma-informed approach is crucial to supporting student well-being. Further research in this area is needed to optimize interventions to support academic and professional success among students with ≥4 ACEs.
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Affiliation(s)
- Elisa Greene
- Belmont University College of Pharmacy and Health Sciences, 1900 Belmont Blvd, Nashville, TN 37212, United States of America.
| | - Gary Austin
- Belmont University College of Pharmacy and Health Sciences, 1900 Belmont Blvd, Nashville, TN 37212, United States of America.
| | - Amy Henneman
- Belmont University College of Pharmacy and Health Sciences, 1900 Belmont Blvd, Nashville, TN 37212, United States of America; Department of Integrated Medical Education, Belmont University Thomas F. Frist, Jr. College of Medicine, 1900 Belmont Blvd, Nashville, TN 37212, United States of America.
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Lhaksampa TC, Grant B, Fix RL. The Impact of Early Violence Exposure on Adolescent Flourishing : Is There Light at the End of the Tunnel? JOURNAL OF PREVENTION (2022) 2024; 45:269-285. [PMID: 38289562 DOI: 10.1007/s10935-024-00765-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/30/2023] [Indexed: 04/02/2024]
Abstract
Child maltreatment (CM) and intimate partner violence (IPV) are prevalent in the United States and associated with negative mental and physical health outcomes. Thus far, research and clinical care have focused on reducing symptoms of illness, but little is known about whether or how CM and IPV exposure can lead to flourishing in adolescence. To examine the impact of CM and IPV exposure on adolescent mental and physical flourishing as well as moderators and mediators affecting this pathway. A secondary data analysis of 2,232 children in the Future of Families Child Wellbeing Study (FFCWS) was conducted to examine waves 1-6 including variables on CM/IPV, general flourishing, mental flourishing, BMI, and healthy eating. Race, socioeconomic status (SES), and gender were included as moderators; depression and anxiety were included as mediating variables. Adolescent boys experienced significantly more general flourishing (β = 4.00, p < .001). There were significant direct effects of CM (p = .025) and anxiety (p = .019) on well-being, and anxiety mediated the pathway from CM to mental flourishing (CI [0.001, 0.017]). Depression (CI [0.001, 0.026]) and anxiety (CI [-0.023, - 0.005]) mediated the pathway from CM to BMI. Our findings indicated that exposure to CM and IPV impacted the likelihood of adolescent flourishing. Future research should evaluate whether and how these flourishing outcomes could be modified.
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Affiliation(s)
- Tenzin C Lhaksampa
- Moore Center for the Prevention of Child Sexual Abuse, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA.
- Bloomberg School of Public Health, Hopkins University, 625 N Broadway Suite 897, Baltimore, MD, 21205, USA.
| | - Bradley Grant
- School of Medicine, Johns Hopkins University, Kennedy Krieger Institute, Baltimore, MD, 21205, USA
| | - Rebecca L Fix
- Moore Center for the Prevention of Child Sexual Abuse, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
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Krohner S, Town J, Cannoy CN, Schubiner H, Rapport LJ, Grekin E, Lumley MA. Emotion-Focused Psychodynamic Interview for People with Chronic Musculoskeletal Pain and Childhood Adversity: A Randomized Controlled Trial. THE JOURNAL OF PAIN 2024; 25:39-52. [PMID: 37479050 DOI: 10.1016/j.jpain.2023.07.017] [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: 03/20/2023] [Revised: 06/25/2023] [Accepted: 07/14/2023] [Indexed: 07/23/2023]
Abstract
Childhood adversity and emotional conflicts are associated with the presence and severity of chronic musculoskeletal pain (CMP), yet common treatments for CMP do not address such risk factors. We developed a single session, emotion-focused psychodynamic interview, based on Emotional Awareness and Expression Therapy and Intensive Short-term Psychodynamic Therapy, and we tested the interview's effects on pain-related outcomes and potential psychological mediators in a randomized, controlled trial. Adults (N = 91; ages 21-70, M = 44.64; 87.9% women) reporting CMP and at least 3 adverse childhood experiences completed measures at baseline and 6-week follow-up. Participants were randomized to immediate interview or waitlist control conditions. The 90-minute interview was conducted via videoconference, and the interviewer elicited disclosure of adversities and conflicts, linked these with pain, and encouraged the experience and expression of adaptive emotions. Analyses indicated that conditions did not differ significantly on change in pain severity; however, compared to control, the interview led to a significantly greater reduction in pain interference (P = .016, ηp2 = .05) and a similar trend for anxiety (P = .058, ηp2 = .04). The interview also significantly changed several potential mediators: pain-related anxiety (P = .008, ηp2 = .06), pain controllability (P = .016, ηp2 = .06), and psychological (P < .001, ηp2 = .15) and brain attributions (P = .022, ηp2 = .05) for pain. Participants viewed the interview as very valuable. We conclude that addressing childhood adversities and conflicts in a psychodynamic interview is beneficial for people with CMP. PERSPECTIVE: This study found that, compared to waitlist control, a 90-minute, remotely-administered, emotion-focused, psychodynamic interview improved pain interference, and anxiety among adults with chronic musculoskeletal pain and childhood adversity. Intensive emotional work can be done in a single session to the benefit of patients with chronic musculoskeletal pain.
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Affiliation(s)
- Shoshana Krohner
- Department of Psychology, Wayne State University, Detroit, Michigan
| | - Joel Town
- Centre for Emotions & Health, Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Ciara N Cannoy
- Department of Psychology, Wayne State University, Detroit, Michigan
| | - Howard Schubiner
- Department of Internal Medicine, Ascension Health / Providence Park Hospital, Michigan State University, Southfield, Michigan
| | - Lisa J Rapport
- Department of Psychology, Wayne State University, Detroit, Michigan
| | - Emily Grekin
- Department of Psychology, Wayne State University, Detroit, Michigan
| | - Mark A Lumley
- Department of Psychology, Wayne State University, Detroit, Michigan
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van den Heuvel LL, Assim A, Koning M, Nöthling J, Seedat S. Childhood maltreatment and internalizing/externalizing disorders in trauma-exposed adolescents: Does posttraumatic stress disorder (PTSD) severity have a mediating role? Dev Psychopathol 2023:1-13. [PMID: 38017689 DOI: 10.1017/s0954579423001414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
Childhood maltreatment is associated with wide-ranging psychopathology at all stages of life. In the current study, we investigated whether posttraumatic stress disorder (PTSD) severity mediated the association between childhood maltreatment and internalizing and externalizing disorders among 262 South African trauma-exposed adolescents (aged 12-18 years). Childhood maltreatment and PTSD symptom severity were assessed using the Childhood Trauma Questionnaire and the Child PTSD Checklist, respectively. Psychiatric disorders were assessed utilizing the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime version and were grouped into internalizing or externalizing disorders. Hierarchal logistic regression was used to assess the association of childhood maltreatment subtype with internalizing and externalizing disorders, controlling for age and gender, with PTSD symptom severity added to the final model. We found that sexual abuse was significantly associated with internalizing disorders, although this effect was no longer significant when PTSD was added to the model demonstrating that PTSD mediated the association between sexual abuse and internalizing disorders. Physical abuse, but not PTSD, was associated with externalizing disorders. Physical abuse, emotional neglect, and PTSD were associated with comorbid internalizing and externalizing disorders. These findings have implications for intervention and prevention strategies targeted at trauma-exposed adolescents with a history of childhood maltreatment.
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Affiliation(s)
- Leigh Luella van den Heuvel
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Genomics of Brain Disorders, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Ayesha Assim
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Milo Koning
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Jani Nöthling
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Genomics of Brain Disorders, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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7
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Bush NR, Noroña-Zhou A, Coccia M, Rudd KL, Ahmad SI, Loftus CT, Swan SH, Nguyen RHN, Barrett ES, Tylavsky FA, Mason WA, Karr CJ, Sathyanarayana S, LeWinn KZ. Intergenerational transmission of stress: Multi-domain stressors from maternal childhood and pregnancy predict children's mental health in a racially and socioeconomically diverse, multi-site cohort. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1625-1636. [PMID: 36735003 PMCID: PMC10397362 DOI: 10.1007/s00127-022-02401-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 12/12/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE Despite growing recognition that unfortunately common maternal stress exposures in childhood and pregnancy may have intergenerational impacts on children's psychiatric health, studies rarely take a life course approach. With child psychopathology on the rise, the identification of modifiable risk factors is needed to promote maternal and child well-being. In this study, we examined associations of maternal exposure to childhood traumatic events (CTE) and pregnancy stressful life events (PSLE) with child mental health problems in a large, sociodemographically diverse sample. METHODS Participants were mother-child dyads in the ECHO-PATHWAYS consortium's harmonized data across three U.S. pregnancy cohorts. Women completed questionnaires regarding their own exposure to CTE and PSLE, and their 4-6-year-old child's mental health problems using the Child Behavior Checklist (CBCL). Regression analyses estimated associations between stressors and child total behavior problems, adjusting for confounders. RESULTS Among 1948 dyads (child age M = 5.13 (SD = 1.02) years; 38% Black, 44% White; 8.5% Hispanic), maternal history of CTE and PSLE were independently associated with children's psychopathology: higher CTE and PSLE counts were related to higher total problems ([ßCTE = 0.11, 95% CI [.06, .16]; ßSLE = 0.21, 95% CI [.14, 0.27]) and greater odds of clinical levels of problems (ORCTE = 1.41; 95% CI [1.12, 1.78]; ORPSLE = 1.36; 95% CI [1.23, 1.51]). Tests of interaction showed PSLEs were more strongly associated with child problems for each additional CTE experienced. CONCLUSION Findings confirm that maternal exposure to CTE and PSLE are independently associated with child mental health, and history of CTE exacerbates the risk associated with PSLE, highlighting intergenerational risk pathways for early psychopathology. Given the prevalence of these exposures, prevention and intervention programs that reduce childhood trauma and stress during pregnancy will likely positively impact women's and their children's health.
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Affiliation(s)
- Nicole R Bush
- Department of Psychiatry and Behavioral Sciences, San Francisco (UCSF), Weill Institute for Neurosciences, University of California, Box 0110, 550 16th Street, CA, 94143, San Francisco, USA.
- Department of Pediatrics, UCSF, San Francisco, CA, USA.
| | - Amanda Noroña-Zhou
- Department of Pediatrics, UCSF, San Francisco, CA, USA
- Center for Health and Community, Division of Developmental Medicine UCSF, San Francisco, CA, USA
| | - Michael Coccia
- Center for Health and Community, Division of Developmental Medicine UCSF, San Francisco, CA, USA
| | - Kristen L Rudd
- Center for Health and Community, Division of Developmental Medicine UCSF, San Francisco, CA, USA
| | - Shaikh I Ahmad
- Department of Pediatrics, UCSF, San Francisco, CA, USA
- Center for Health and Community, Division of Developmental Medicine UCSF, San Francisco, CA, USA
| | - Christine T Loftus
- Department of Occupational and Environmental Health Sciences, University of Washington, Seattle, WA, USA
| | - Shanna H Swan
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ruby H N Nguyen
- Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Emily S Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Frances A Tylavsky
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, TN, USA
| | - W Alex Mason
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, TN, USA
| | - Catherine J Karr
- Department of Occupational and Environmental Health Sciences, University of Washington, Seattle, WA, USA
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Sheela Sathyanarayana
- Department of Occupational and Environmental Health Sciences, University of Washington, Seattle, WA, USA
- Department of Pediatrics, University of Washington, Seattle, WA, USA
- Seattle Children's Research Institute, Seattle, WA, USA
| | - Kaja Z LeWinn
- Department of Psychiatry and Behavioral Sciences, San Francisco (UCSF), Weill Institute for Neurosciences, University of California, Box 0110, 550 16th Street, CA, 94143, San Francisco, USA
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Lee N, Pigott TD, Watson A, Reuben K, O'Hara K, Massetti G, Fang X, Self-Brown S. Childhood Polyvictimization and Associated Health Outcomes: A Systematic Scoping Review. TRAUMA, VIOLENCE & ABUSE 2023; 24:1579-1592. [PMID: 35220817 DOI: 10.1177/15248380211073847] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Background: Polyvictimization, the experience of multiple types of victimization, is associated with detrimental health outcomes. Despite extensive research on the health consequences of polyvictimization, one challenge in understanding this literature lies in the varied operationalized definitions of polyvictimization and health outcomes. This scoping review provides the volume of the current literature on this topic, documents the varied constructs of polyvictimization and associated health outcomes, identifies knowledge gaps, and guides future research directions. Method: A systematic search of English-language original articles that presented quantitative associations of childhood polyvictimization and health outcomes was performed through six-database searches, a gray literature search, and citation mining from June 2020 to January 2021. The varied constructs of polyvictimization, health outcomes, and other study characteristics were extracted. Results: A total of 96 studies were included. Two ways of creating continuous variables (30.21%) and four ways of constructing categorical variables (72.92%) were identified for operationalizing polyvictimization. The majority of health outcomes were mental, behavioral, or social (96.88%), while slightly more than 10% of studies examined physical health (11.46%) or general health conditions (10.42%), respectively. More than half of studies used U.S. samples (56.25%). Conclusions: The varied constructs of polyvictimization suggests that there is a need to establish a valid polyvictimization construct that is consistently agreed upon in the research community. Findings summarize the specific health outcomes that can be targeted for further investigation and prevention efforts. Findings also suggest that the study of resilience and coping education for childhood polyvictims is sorely needed.
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Affiliation(s)
- NaeHyung Lee
- School of Public Health, Georgia State University, Atlanta, GA, USA
- Center for Research on Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | - Terri Deocampo Pigott
- School of Public Health, Georgia State University, Atlanta, GA, USA
- College of Education & Human Development, Georgia State University, Atlanta, GA, USA
| | - Ashley Watson
- School of Public Health, Georgia State University, Atlanta, GA, USA
- Center for Research on Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | - Katherine Reuben
- School of Public Health, Georgia State University, Atlanta, GA, USA
- Center for Research on Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | - Kathryn O'Hara
- School of Public Health, Georgia State University, Atlanta, GA, USA
- Center for Research on Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | - Greta Massetti
- School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Xiangming Fang
- School of Public Health, Georgia State University, Atlanta, GA, USA
- Center for Research on Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | - Shannon Self-Brown
- School of Public Health, Georgia State University, Atlanta, GA, USA
- Center for Research on Interpersonal Violence, Georgia State University, Atlanta, GA, USA
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Ha J, Kim Y. Surviving Child Abuse in People With Mental Illness: A Grounded Theory Approach. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:2828-2849. [PMID: 35574841 DOI: 10.1177/08862605221102486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The aim of this qualitative study was to examine the process of surviving child abuse in people with a mental illness in order to develop an explanatory theory. The study utilized the grounded theory approach. Seventeen community-dwelling adults with a mental illness who had experienced child abuse were interviewed. For the in-depth interview, the lifeline interview method was used. Data were collected from July 14, 2019, to February 28, 2020. The constant comparative method was used for analysis, to identify similarities and differences between different statements, and similar phenomena or theories were compared and analyzed continuously. The central phenomena were "losing oneself" and "in a precarious state." Participants used "expressing," "standing on one's own feet," and "avoiding" as coping strategies. Observed outcomes were "making life work for them" and "living with others." The core category was "losing myself, embracing myself as someone in a precarious state, and being reborn as the master of my life." Positive religious coping, having a supportive network, and emotional or physical distance from difficult situations played a major role in surviving participants' experiences of child abuse and being victimized because of their mental illness. Our findings provide a theoretical basis for understanding people with mental illness who have survived child abuse, and suggest that opportunities for sharing their stories, facilitating self-reliance, and avoiding the causes of their difficulties all play a role in their healing process. Based on this study, it is expected that clinical experts and policy developers will be able to formulate evidence-based interventions and policies.
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Affiliation(s)
- Jeongmin Ha
- College of Nursing, 34940Dong-A University, Busan, Korea
| | - Yoonjung Kim
- Faculty of Red Cross College of Nursing, 26729Chung-Ang University, Seoul, Korea
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Feng JY, Hwa HL, Shen ACT, Hsieh YP, Wei HS, Huang CY. Patterns and trajectories of children's maltreatment experiences in Taiwan: Latent transition analysis of a nationally representative longitudinal study. CHILD ABUSE & NEGLECT 2023; 135:105951. [PMID: 36395698 DOI: 10.1016/j.chiabu.2022.105951] [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: 08/08/2022] [Revised: 10/28/2022] [Accepted: 11/07/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Little is known about the patterns of child maltreatment change over time and vary according to gender and child protective services (CPS) experience in Taiwan. OBJECTIVE To examine the latent status and the trajectories of child maltreatment and to identify effects that gender and CPS have on these statuses and trajectories in Taiwan. PARTICIPANTS AND SETTING A national proportionately stratified sample of 6233 4th-grade students were recruited from 314 elementary schools in Taiwan, and followed up at 6th and 8th graders. A total of 1908 students completed valid data at all three time points was analyzed. METHODS Latent class analysis and latent transition analysis were used to identify the number of latent variables and the patterns of child maltreatment. Multiple-group model was used to test with gender difference. RESULTS Four latent maltreatment statuses were identified: high all maltreatment, high psychological maltreatment, high neglect, and no/low maltreatment. A reduction in maltreatment severity occurred over time was found. The percentage of students in the "high all maltreatment" and "high neglect" groups decreased whereas those in the "high psychological maltreatment" and "no/low maltreatment" groups increased. Differences in the transition probabilities of latent maltreatment status by gender was revealed. The percentage of CPS recipients in the "high all maltreatment" decreased over time. CONCLUSIONS This study highlighted the dynamic nature of child maltreatment and described the timing, continuity, and change that characterizes children's exposure to maltreatment in Taiwan. Policies and interventions geared toward early detection, mitigation, and prevention of child maltreatment are needed.
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Affiliation(s)
- Jui-Ying Feng
- Department of Nursing, College of Medicine, National Cheng Kung University, 1 University Rd., Tainan 70101, Taiwan; Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Rd., Tainan 70403, Taiwan.
| | - Hsiao-Lin Hwa
- Department and Graduate Institute of Forensic Medicine, National Taiwan University, 1, Sec. 1, Jen Ai Rd., Taipei 10051, Taiwan; The National Taiwan University Children and Family Research Center, 1, Sec. 4, Roosevelt Rd., Taipei 10617, Taiwan.
| | - April Chiung-Tao Shen
- The National Taiwan University Children and Family Research Center, 1, Sec. 4, Roosevelt Rd., Taipei 10617, Taiwan; Department of Social Work, National Taiwan University, 1, Sec. 4, Roosevelt Rd., Taipei 10617, Taiwan.
| | - Yi-Ping Hsieh
- Department of Social Work, University of North Dakota, 225 Centennial Drive, Stop 7135, Grand Forks, ND 58202, USA.
| | - Hsi-Sheng Wei
- Department of Social Work, College of Social Sciences, National Taipei University, 151, University Rd., San Shia District, New Taipei City 23741, Taiwan.
| | - Ching-Yu Huang
- School of Psychology, Keele University, Staffordshire ST5 5BG, UK.
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11
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Hagelquist JO, Jensen CH, Bloch MS, Rasmussen H. A mentalization-based approach to healing children exposed to adverse experiences: Tools for residential care. Bull Menninger Clin 2023; 87:83-103. [PMID: 36856474 DOI: 10.1521/bumc.2023.87.1.83] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
It is well documented how adverse childhood experiences can inhibit child development and mentalizing ability and lead to high risk of developmental psychopathology. Mentalization-based treatment (MBT) has been established as an effective approach to treatment for a long range of psychopathologies with both in- and outpatient treatment, yet the evidence base for effective clinical interventions that can help guide professionals working in residential care on how to support the development of neglected and traumatized children is underdeveloped. This article demonstrates a mentalization-based approach to understanding and working with children in residential care, and offers practical models and tools as well as considerations on implementation that are beneficial and easy to apply, demonstrated through cases. The STORM model and "Obtaining Skills" screening tool may be helpful models for professionals addressing mentalization in children while working in challenging environments such as with traumatized and neglected children.
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Affiliation(s)
| | | | - Marie Skaalum Bloch
- Psychologist, Specialist, and Supervisor at the Center for Mentalising, Gistrup, Denmark
| | - Heino Rasmussen
- Partner in management at the Center for Mentalising, Århus, Denmark
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12
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Lee N, Osborne M, Massetti G, Watson A, Self-Brown S. Associations Among Age of First Experience of Violence, Type of Victimization, Polyvictimization, and Mental Distress in Nigerian Females. Violence Against Women 2022; 28:2992-3012. [PMID: 34894889 PMCID: PMC9189236 DOI: 10.1177/10778012211038973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study explored associations of age of first victimization, sexual violence (SV), physical violence (PV), polyvictimization, and mental distress among females in Nigeria (n = 1,766, 13-24 years old) using the nationally representative 2014 Nigeria Violence Against Children Survey. Multinomial logistic regressions were performed. Nigerian females reporting SV victimization and polyvictimization were more likely to experience higher mental distress. The older the female was at the time of PV victimization, the greater the risk for mental distress. Violence is prevalent in Nigeria and its impact on youth's health is severe. However, evidence-based and data-driven policies and programs can reduce and prevent violence.
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Affiliation(s)
- NaeHyung Lee
- Department of Health Policy and Behavioral Sciences, School of Public Health, 1373Georgia State University, Atlanta, GA, USA
- National SafeCare Training and Research Center, 1373Georgia State University, Atlanta, GA, USA
- Center for Research of Interpersonal Violence, 1373Georgia State University, Atlanta, GA, USA
| | - Melissa Osborne
- Department of Health Policy and Behavioral Sciences, School of Public Health, 1373Georgia State University, Atlanta, GA, USA
- National SafeCare Training and Research Center, 1373Georgia State University, Atlanta, GA, USA
- Center for Research of Interpersonal Violence, 1373Georgia State University, Atlanta, GA, USA
| | - Greta Massetti
- Division of Violence Prevention, 1242Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ashley Watson
- Department of Health Policy and Behavioral Sciences, School of Public Health, 1373Georgia State University, Atlanta, GA, USA
- National SafeCare Training and Research Center, 1373Georgia State University, Atlanta, GA, USA
- Center for Research of Interpersonal Violence, 1373Georgia State University, Atlanta, GA, USA
| | - Shannon Self-Brown
- Department of Health Policy and Behavioral Sciences, School of Public Health, 1373Georgia State University, Atlanta, GA, USA
- National SafeCare Training and Research Center, 1373Georgia State University, Atlanta, GA, USA
- Center for Research of Interpersonal Violence, 1373Georgia State University, Atlanta, GA, USA
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Madiga MC, Mokwena K. Depression Symptoms among Family Members of Nyaope Users in the City of Tshwane, South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074097. [PMID: 35409779 PMCID: PMC8998108 DOI: 10.3390/ijerph19074097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/26/2022] [Accepted: 03/01/2022] [Indexed: 12/04/2022]
Abstract
Substance abuse brings major negative social and health impacts in South Africa. Nyaope, a cocktail drug commonly used in the Tshwane townships, has been well documented to be highly addictive and very difficult to quit. The resultant difficulties include financial, social, and mental, specifically depression and anxiety. This study aims to quantify the depression levels among family members with nyaope users in Tshwane, South Africa. The study used a quantitative cross-sectional design to collect data in nine Tshwane communities. The patient health questionnaire-9 (PHQ-9) screening tool and demographic data collection questionnaires were used to collect data from a sample of 390 male and female family members who included mothers, fathers, grandparents, aunts, uncles, partners, and siblings of nyaope users, and who share a home with them. The ages of the participants ranged from 18 to 87 years, with a mean age of 47 years, while the ages of the nyaope users ranged from 17 to 55 years, with a mean age of 30 years. Depression scores ranged from 0 to 27 with a mean of 7. Depressive symptoms, as measured by the PHQ-9 scores of 5 and above, were reported by 49% of the sample. The levels of depression symptoms ranged from mild to severe, and the severity was higher among female, unemployed, and single participants. As with many others, these participants were not diagnosed and therefore were not treated. The study, therefore, identified that living with nyaope users is associated with the development of different levels of depression symptoms and has resulted in reduced quality of life among family members. The study recommends interventions that intentionally focus on families who live with individuals who are addicted to nyaope. Those interventions should focus on screening and treatment of depression and other mental disorders.
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Affiliation(s)
| | - Kebogile Mokwena
- Substance Abuse and Population Mental Health, Sefako Makgatho Health Sciences University, Pretoria 0204, South Africa;
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14
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Xu Y, Ajdacic-Gross V, Müller M, Buadze A, Seifritz E, Kleim B, von Känel R, Wagner EYN, Strippoli MPF, Castelao E, Preisig M, Vandeleur CL. Childhood adversity patterns differentially cluster with mental disorders and socioeconomic indicators in a large Swiss community sample. Compr Psychiatry 2022; 112:152282. [PMID: 34749059 DOI: 10.1016/j.comppsych.2021.152282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 09/24/2021] [Accepted: 10/15/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Exposure to childhood adversities (CHAD) has been found to be strongly associated with individuals' mental health and social development. Recently, it has been suggested that certain CHAD patterns exist in the population, which are more closely related to individuals' later mental health than the simple summation of adversities. The current study aims 1) to establish CHAD patterns based on self-reported child abuse and family dysfunction and 2) to assess their associations with mental disorders and sociodemographic indicators reported in adulthood. METHODS Data used in this cross-sectional study were derived from the representative CoLaus/PsyCoLaus population-based cohort (N = 5111, 35 to 88 years). Latent class analysis was conducted for the identification of CHAD patterns, while their associations with mental disorders and socioeconomic achievements (e. g. education and income) were investigated using correspondence analysis. RESULTS Four CHAD patterns emerged. While the majority (70.7%) of the sample showed an overall low adversity pattern (c1), 13.6% had not been raised by both of their biological parents due to divorce or being placed in foster home (c2), 11.0% had been raised by conflictive / dysfunctional / abusive parents (c3), and 4.7% showed high overall adversities (c4). Patterns c3 and c4 were most strongly associated with various mental disorders, especially c3 with internalizing anxiety disorders, while c2 was closely related to lower educational achievement. CONCLUSIONS Four CHAD patterns characterised by varying levels of child abuse and family dysfunction existed in this community sample. They yielded distinct associations with mental disorders and socioeconomic indicators.
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Affiliation(s)
- Yanhua Xu
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.
| | - Vladeta Ajdacic-Gross
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Mario Müller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Anna Buadze
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Birgit Kleim
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - En-Young N Wagner
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Marie-Pierre F Strippoli
- Department of Psychiatry, Center for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Enrique Castelao
- Department of Psychiatry, Center for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Martin Preisig
- Department of Psychiatry, Center for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Caroline L Vandeleur
- Department of Psychiatry, Center for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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15
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Stout DM, Powell S, Kangavary A, Acheson DT, Nievergelt CM, Kash T, Simmons AN, Baker DG, Risbrough VB. Dissociable impact of childhood trauma and deployment trauma on affective modulation of startle. Neurobiol Stress 2021; 15:100362. [PMID: 34258336 PMCID: PMC8259305 DOI: 10.1016/j.ynstr.2021.100362] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 12/26/2022] Open
Abstract
Trauma disorders are often associated with alterations in aversive anticipation and disruptions in emotion/fear circuits. Heightened or blunted anticipatory responding to negative cues in adulthood may be due to differential trauma exposure during development, and previous trauma exposure in childhood may also modify effects of subsequent trauma in adulthood. The aim of the current investigation was to examine the contributions of childhood trauma on affective modulation of startle before and after trauma exposure in adulthood (a combat deployment). Adult male participants from the Marine Resilience Study with (n = 1145) and without (n = 1312) a history of reported childhood trauma completed an affective modulation of startle task to assess aversive anticipation. Affective startle response was operationalized by electromyography (EMG) recording of the orbicularis oculi muscle in response to acoustic stimuli when anticipating positive and negative affective images. Startle responses to affective images were also assessed. Testing occurred over three time-points; before going on a 7 month combat deployment and 3 and 6 months after returning from deployment. Startle response when anticipating negative images was greater compared to pleasant images across all three test periods. Across all 3 time points, childhood trauma was consistently associated with significantly blunted startle when anticipating negative images, suggesting reliable effects of childhood trauma on aversive anticipation. Conversely, deployment trauma was associated with increased startle reactivity post-deployment compared to pre-deployment, which was independent of childhood trauma and image valence. These results support the hypothesis that trauma exposure during development vs. adulthood may have dissociable effects on aversive anticipation and arousal mechanisms. Further study in women and across more refined age groups is needed to test generalizability and identify potential developmental windows for these differential effects.
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Affiliation(s)
- Daniel M. Stout
- VA Center of Excellence for Stress and Mental Health (CESAMH), USA
- VA San Diego Healthcare System, USA
- University of California San Diego, USA
| | - Susan Powell
- VA San Diego Healthcare System, USA
- University of California San Diego, USA
| | | | - Dean T. Acheson
- VA Center of Excellence for Stress and Mental Health (CESAMH), USA
- VA San Diego Healthcare System, USA
- University of California San Diego, USA
| | - Caroline M. Nievergelt
- VA Center of Excellence for Stress and Mental Health (CESAMH), USA
- VA San Diego Healthcare System, USA
- University of California San Diego, USA
| | | | - Alan N. Simmons
- VA Center of Excellence for Stress and Mental Health (CESAMH), USA
- VA San Diego Healthcare System, USA
- University of California San Diego, USA
| | - Dewleen G. Baker
- VA Center of Excellence for Stress and Mental Health (CESAMH), USA
- VA San Diego Healthcare System, USA
- University of California San Diego, USA
| | - Victoria B. Risbrough
- VA Center of Excellence for Stress and Mental Health (CESAMH), USA
- VA San Diego Healthcare System, USA
- University of California San Diego, USA
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16
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Intergenerational Trauma and Its Relationship to Mental Health Care: A Qualitative Inquiry. Community Ment Health J 2021; 57:631-643. [PMID: 32804293 DOI: 10.1007/s10597-020-00698-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 08/12/2020] [Indexed: 10/23/2022]
Abstract
Intergenerational trauma is a discrete form of trauma which occurs when traumatic effects are passed across generations without exposure to the original event. This qualitative study aimed to explore how psychiatrists understand intergenerational trauma in respect to their practice, for the purposes of identifying interventions for addressing intergenerational trauma in public mental health services. Findings revealed that psychiatrists observe intergenerational trauma frequently in their roles and try to opportunistically promote awareness of trauma with adults, and refer families to external services for supportive interventions. They feel powerless when faced with directly intervening with intergenerational trauma and required restructuring of their roles to adequately address it in public settings. Findings have implications for training, advocacy and research on the relationship between trauma and mental illness. Alongside this, there is an indicated need for examination of how systems can ensure access to appropriate services once organisations become trauma-informed.
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17
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Spencer AE, Valentine SE, Sikov J, Yule AM, Hsu H, Hallett E, Xuan Z, Silverstein M, Fortuna L. Principles of Care for Young Adults With Co-Occurring Psychiatric and Substance Use Disorders. Pediatrics 2021; 147:229-239. [PMID: 33386320 PMCID: PMC8276159 DOI: 10.1542/peds.2020-023523f] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/23/2020] [Indexed: 01/22/2023] Open
Abstract
Over 50% of young adults (defined as individuals aged 18-25 years) with substance use disorders (SUDs) have at least 1 co-occurring psychiatric disorder, and the presence of co-occurring disorders worsens SUD outcomes. Treatment of both co-occurring psychiatric disorders and SUDs in young adults is imperative for optimal treatment, yet many barriers exist to achieving this goal. We present a series of evidence-informed principles of care for young adults with co-occurring psychiatric disorders derived by a workgroup of experts convened by Boston Medical Center's Grayken Center for Addiction. The 3 principles are as follows: (1) young adults should receive integrated mental health and addiction care across treatment settings; (2) care should be responsive to the needs of young adults exposed to trauma and other adverse childhood experiences; and (3) treatment programs should regularly assess and respond to the evolving mental health needs, motivations, and treatment goals of young adults with co-occurring disorders. Our guidance for each principle is followed by a review of the evidence supporting that principle, as well as practice considerations for implementation. More research among young adults is critical to identify effective treatments and service systems for those with co-occurring disorders.
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Affiliation(s)
- Andrea E Spencer
- Departments of Psychiatry and
- Boston Medical Center, Boston, Massachusetts; and
| | - Sarah E Valentine
- Departments of Psychiatry and
- Boston Medical Center, Boston, Massachusetts; and
| | - Jennifer Sikov
- Departments of Psychiatry and
- Boston Medical Center, Boston, Massachusetts; and
| | - Amy M Yule
- Departments of Psychiatry and
- Boston Medical Center, Boston, Massachusetts; and
| | - Heather Hsu
- Boston Medical Center, Boston, Massachusetts; and
- Pediatrics, School of Medicine, and
| | | | - Ziming Xuan
- School of Public Health, Boston University, Boston, Massachusetts
| | - Michael Silverstein
- Boston Medical Center, Boston, Massachusetts; and
- Pediatrics, School of Medicine, and
| | - Lisa Fortuna
- Department of Psychiatry, University of California San Francisco, San Francisco, California
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18
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Haahr-Pedersen I, Perera C, Hyland P, Vallières F, Murphy D, Hansen M, Spitz P, Hansen P, Cloitre M. Females have more complex patterns of childhood adversity: implications for mental, social, and emotional outcomes in adulthood. Eur J Psychotraumatol 2020; 11:1708618. [PMID: 32002142 PMCID: PMC6968572 DOI: 10.1080/20008198.2019.1708618] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 11/19/2019] [Accepted: 12/11/2019] [Indexed: 12/20/2022] Open
Abstract
Background: Adverse childhood experiences (ACEs) have been identified as an important public health problem with serious implications. Less well understood is how distinct configurations of childhood adversities carry differential risks for mental health, emotional, and social outcomes later in life. Objective: To determine if distinct profiles of childhood adversities exist for males and females and to examine if unique associations exist between the resultant latent profiles of childhood adversities and multiple indicators of mental health and social and emotional wellbeing in adulthood. Method: Participants (N = 1,839) were a nationally representative household sample of adults currently residing in the USA and the data were collected via online self-report questionnaires. Latent class analysis was used to identify the optimal number of classes to explain ACE co-occurrence among males and females, separately. ANOVAs, chi-square tests, and t-tests were used to compare male and female classes across multiple mental health, emotional, and social wellbeing variables in adulthood. Results: Females were significantly more likely than males to report a range of ACEs and mental health, social, and emotional difficulties in adulthood. Two- and four-class models were identified as the best fit for males and females, respectively, indicating more complexity and variation in ACE exposures among females. For males and female, ACEs were strongly associated with poorer mental health, emotional, and social outcomes in adulthood. Among females, growing up in a dysfunctional home environment was a significant risk factor for adverse social outcomes in adulthood. Conclusions: Males and females have distinct patterns of childhood adversities, with females experiencing more complex and varied patterns of childhood adversity. These patterns of ACEs were associated with numerous negative mental, emotional, and social outcomes among both sexes.
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Affiliation(s)
- Ida Haahr-Pedersen
- Trinity Centre for Global Health, School of Psychology, Trinity College Dublin, Dublin, Ireland
- The Danish Children Centre for the Capital Region, Copenhagen, Denmark
| | - Camila Perera
- Trinity Centre for Global Health, School of Psychology, Trinity College Dublin, Dublin, Ireland
- International Federation of the Red Cross Centre for Psychosocial Support hosted by Danish Red Cross, Copenhagen, Denmark
| | - Philip Hyland
- Trinity Centre for Global Health, School of Psychology, Trinity College Dublin, Dublin, Ireland
- Department of Psychology, Maynooth University, Kildare, Ireland
| | - Frédérique Vallières
- Trinity Centre for Global Health, School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - David Murphy
- Trinity Centre for Global Health, School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Maj Hansen
- ThRIVE, Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Pernille Spitz
- The Danish Children Centre for the Capital Region, Copenhagen, Denmark
| | - Pernille Hansen
- International Federation of the Red Cross Centre for Psychosocial Support hosted by Danish Red Cross, Copenhagen, Denmark
| | - Marylène Cloitre
- National Center for PTSD, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
- School of Medicine, New York University, New York, NY, USA
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19
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Chandler GE, Kalmakis KA, Chiodo L, Helling J. The Efficacy of a Resilience Intervention Among Diverse, At-Risk, College Athletes: A Mixed-Methods Study. J Am Psychiatr Nurses Assoc 2020; 26:269-281. [PMID: 31747846 DOI: 10.1177/1078390319886923] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND: Adverse childhood experiences (ACEs) have been associated with psychological and physiological disease, and risky health behaviors. A person's ability to be resilient may protect them from these negative health outcomes, as resilience has been associated with increased emotional awareness, coping, belonging, and greater likelihood of good health and well-being. AIMS: The purpose of this pilot study was to assess the efficacy of a strengths-based resilience intervention to improve access to internal and external resources that effect perceptions of stress, resilience, emotional awareness, and belonging among student-athletes. METHODS: A mixed-methods design was used to examine variables of interest between intervention and control groups. A sample of 56 college athletes completed surveys and engaged in expressive writing during a 5-week resilience intervention. RESULTS: Self-report data indicated that student-athletes in the intervention group improved decision making, lowered perceived stress, and increased resilience compared with controls. Of note, participants with ACEs showed greater increments of positive change in emotional awareness scales than participants without ACEs. Descriptions of emotion management, authentic connections, and increased ability to request support from others were identified in the qualitative data. CONCLUSIONS: A strengths-based course designed to increase resilience-offered as academic and athletic stress is mounting-provided a unique opportunity to promote student-athlete success. Participants gained skills key to victory on and off the field, including health-promoting behaviors, a sense of belonging, persistence, and the ability to negotiate external resources.
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Affiliation(s)
| | - Karen A Kalmakis
- Karen A. Kalmakis, PhD, MPH, FNP, FAANP, University of Massachusetts Amherst, MA, USA
| | - Lisa Chiodo
- Lisa Chiodo, PhD, University of Massachusetts Amherst, MA, USA
| | - Jim Helling
- Jim Helling, LICSW, University of Massachusetts Amherst, MA, USA
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20
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Hazzard VM, Bauer KW, Mukherjee B, Miller AL, Sonneville KR. Associations between childhood maltreatment latent classes and eating disorder symptoms in a nationally representative sample of young adults in the United States. CHILD ABUSE & NEGLECT 2019; 98:104171. [PMID: 31546098 PMCID: PMC6885127 DOI: 10.1016/j.chiabu.2019.104171] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 07/30/2019] [Accepted: 08/30/2019] [Indexed: 05/31/2023]
Abstract
BACKGROUND Childhood maltreatment is associated with eating disorders, but types of childhood maltreatment often co-occur. OBJECTIVE To examine associations between childhood maltreatment patterns and eating disorder symptoms in young adulthood. PARTICIPANTS AND SETTING Data came from the National Longitudinal Study of Adolescent to Adult Health (N = 14,322). METHODS Latent class analysis was conducted, using childhood physical neglect, physical abuse, and sexual abuse as model indicators. Logistic regression models adjusted for demographic covariates were conducted to examine associations between childhood maltreatment latent classes and eating disorder symptoms. RESULTS In this nationally representative sample of U.S. young adults (mean age = 21.82 years), 7.3% of participants reported binge eating-related concerns, 3.8% reported compensatory behaviors, and 8.6% reported fasting/skipping meals. Five childhood maltreatment latent classes emerged: "no/low maltreatment" (78.5% of the sample), "physical abuse only" (11.0% of the sample), "multi-type maltreatment" (7.8% of the sample), "physical neglect only" (2.1% of the sample), and "sexual abuse only" (0.6% of the sample). Compared to participants assigned to the "no/low maltreatment" class, participants assigned to the "multi-type maltreatment" class were more likely to report binge eating-related concerns (odds ratio = 1.97; 95% confidence interval [CI]: 1.52, 2.56) and fasting/skipping meals (OR = 1.85; 95% CI: 1.46, 2.34), and participants assigned to the "physical abuse only" class were more likely to report fasting/skipping meals (OR = 1.35; 95% CI: 1.04, 1.76). CONCLUSIONS This study provides evidence that distinct childhood maltreatment profiles are differentially associated with eating disorder symptoms. Individuals exposed to multi-type childhood maltreatment may be at particularly high risk for eating disorders.
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Affiliation(s)
- Vivienne M Hazzard
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.
| | - Katherine W Bauer
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA; Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan, USA
| | - Bhramar Mukherjee
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, USA; Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Alison L Miller
- Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan, USA; Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Kendrin R Sonneville
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA; Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan, USA
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21
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Associations of childhood trauma and childhood mental disorder with past-year mental disorder in military and civilian employed men. Psychiatry Res 2019; 280:112482. [PMID: 31377663 DOI: 10.1016/j.psychres.2019.112482] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 07/09/2019] [Accepted: 07/10/2019] [Indexed: 11/23/2022]
Abstract
Childhood factors are pivotal to understanding mental health over the lifespan. However, there is a dearth of research exploring childhood trauma and childhood disorder simultaneously in determining adult mental disorder. We aimed to analyze childhood trauma and childhood disorder in determining past-year disorder in military and civilian employed men aged 18-60 years. Data derived from the 2010 Australian Defence Force (ADF) Mental Health Prevalence and Wellbeing Study, and the 2007 Australian Bureau of Statistics National Survey of Mental Health and Wellbeing were analysed using logistic regression and Generalised Structural Equation Modelling (GSEM). All major findings were consistent across both populations. The association between childhood disorder and past-year disorder remained after controlling for demographics, childhood and adult trauma (and service factors in the ADF). Childhood non-interpersonal trauma was not associated with past-year disorder in either population. The pathway between childhood trauma and past-year disorder was fully mediated by the spectrum of common childhood disorders, but not by childhood anxiety, depression or alcohol use disorders alone. Identification, intervention and prevention of childhood disorders is imperative. Investment in interventions targeting the influence of childhood traumatic events on the whole spectrum of childhood disorder, not only PTSD or anxiety, is a priority.
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22
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Myllyaho T, Siira V, Wahlberg KE, Hakko H, Läksy K, Roisko R, Niemelä M, Räsänen S. Interaction of genetic vulnerability to schizophrenia and family functioning in adopted-away offspring of mothers with schizophrenia. Psychiatry Res 2019; 278:205-212. [PMID: 31226546 DOI: 10.1016/j.psychres.2019.06.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 06/12/2019] [Accepted: 06/13/2019] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The aim of this study was to examine the association of family functioning to psychiatric disorders of adoptees with and without genetic vulnerability to schizophrenia. METHODS The data is based on the Finnish Adoptive Family Study of Schizophrenia. The study sample consisted of 346 adoptive families, of which 175 adoptees had high (HR) and 171 low (LR) genetic risk for schizophrenia. DSM-III-R was used for diagnostic criteria. Family functioning was assessed using the Global Family Ratings. Childhood adversities covered early parental divorce and death occurring before 18 years of age of the adoptees. RESULTS Approximately two thirds of the adoptees had lived in families with mildly dysfunctional processes (30%) or dysfunctional processes (28.4%). An increased likelihood for psychiatric disorders of the adoptees was related to dysfunctional family processes both in HR (OR = 4.8, 95% CI 2-11.4) and LR (OR = 2.6, 95% CI 1.1-6.3) adoptees, but not to early parental death or divorce. CONCLUSIONS The risk for psychiatric disorders was increased for adoptees in families with dysfunctional processes, especially for those adoptees with genetic vulnerability to schizophrenia. These results emphasize the importance of policies and practices that aim to strengthen and support family functioning.
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Affiliation(s)
- Toni Myllyaho
- Faculty of Medicine, Department of Psychiatry, University of Oulu, P.O. Box 5000, Oulu 90014, Finland.
| | - Virva Siira
- Faculty of Education, University of Oulu, P.O. Box 2000, Oulu 90014, Finland.
| | - Karl-Erik Wahlberg
- Faculty of Medicine, Department of Psychiatry, University of Oulu, P.O. Box 5000, Oulu 90014, Finland
| | - Helinä Hakko
- Department of Psychiatry, Oulu University Hospital, P.O. Box 26, Oulu 90029, Finland
| | - Kristian Läksy
- Social Security Institute of Finland (SSI), Helsinki, Finland
| | - Riikka Roisko
- Department of Psychiatry, Oulu University Hospital, P.O. Box 26, Oulu 90029, Finland
| | - Mika Niemelä
- Department of Psychiatry, Oulu University Hospital, P.O. Box 26, Oulu 90029, Finland; Department of Medicine, Center for Life Course Health Research, University of Oulu, P.O. Box 5000, Oulu 90014, Finland
| | - Sami Räsänen
- Department of Psychiatry, Oulu University Hospital, P.O. Box 26, Oulu 90029, Finland
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Identifying Distinct Latent Classes of Adverse Childhood Experiences Among US Children and Their Relationship with Childhood Internalizing Disorders. Child Psychiatry Hum Dev 2019; 50:668-680. [PMID: 30796680 DOI: 10.1007/s10578-019-00871-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study aimed to determine the relationship between latent classes of adverse childhood experience (ACEs) and internalizing disorders (anxiety and depression) among US children. The 2016 National Survey of Children's Health data for children aged 6-17 was used. Latent class analysis was performed to identify distinct sub-types of ACE exposures and survey-weighted logistic regression models were employed to determine whether these classes were associated with any or comorbid childhood internalizing disorders, after controlling for meaningful covariates. Four latent classes were identified: income hardship, divorce, mental health or substance abuse exposure, and high ACEs overall. Children in three of the four classes were significantly more likely to have any childhood internalizing disorder when compared to children reporting no ACEs, while children in all classes were significantly more likely to have a comorbid history of anxiety and depression. Thus, children exposed to ACEs should receive necessary mental health screenings and treatments.
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Profiles of childhood trauma and psychopathology: US National Epidemiologic Survey. Soc Psychiatry Psychiatr Epidemiol 2018; 53:1207-1219. [PMID: 29725700 DOI: 10.1007/s00127-018-1525-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 04/25/2018] [Indexed: 10/17/2022]
Abstract
PURPOSE Childhood trauma may increase vulnerability to numerous specific psychiatric disorders, or a generalised liability to experience dimensions of internalising or externalising psychopathology. We use a nationally representative sample (N = 34,653) to examine the long-term consequences of childhood trauma and their combined effect as predictors of subsequent psychopathology. METHODS Data from the US National Epidemiologic Survey on Alcohol and Related Conditions were used. Latent class analysis was used to identify childhood trauma profiles and multinomial logistic regression to validate and explore these profiles with a range of associated demographic and household characteristics. We used Structural Equation Modelling to substantiate initial latent class analysis findings by investigating a range of mental health diagnoses. Internalising and externalising domains of psychopathology were regressed on trauma profiles and associated demographic and household characteristics. We used Differential Item Functioning to examine associations between the trauma groups and a number of psychiatric disorders within internalising and externalising dimensions of mental health. RESULTS We found a 3-class model of childhood trauma in which 85% of participants were allocated to a low trauma class; 6% to a multi-type victimization class (reporting exposures for all the child maltreatment criteria); and 9% to a situational trauma class (exposed to a range of traumas). Confirmatory Factor Analysis revealed an internalising-externalising spectrum was used to represent lifetime reporting patterns of mental health disorders. Both trauma groups showed specific gender and race/ethnicity differences, related family discord and increased psychopathology. Additionally, we found significant associations between the trauma groups and specific diagnoses within the internalising-externalising spectrum of mental health. CONCLUSIONS The underlying patterns in the exposure to types of interpersonal and non-interpersonal traumas and associated mental health highlight the need to screen for particular types of childhood traumas when individuals present with symptoms of psychiatric disorders.
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Heinonen E, Knekt P, Härkänen T, Virtala E, Lindfors O. Childhood adversities as predictors of improvement in psychiatric symptoms and global functioning in solution-focused and short- and long-term psychodynamic psychotherapy during a 5-year follow-up. J Affect Disord 2018; 235:525-534. [PMID: 29689505 DOI: 10.1016/j.jad.2018.04.033] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 03/15/2018] [Accepted: 04/04/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Childhood adversities are frequent among adults who seek treatment for depression or anxiety. These disorders are commonly treated by psychotherapy. Yet it is not known if specific types or durations of psychotherapy are particularly suited for patients who have suffered various early adversities. METHODS 221 depressed and anxious adult outpatients from community, student, occupational, and private healthcare services filled the Childhood Family Atmosphere Questionnaire. They were randomly assigned to short- (solution-focused or psychodynamic) or long-term (psychodynamic) psychotherapy. Outcome was assessed via patient questionnaires and clinician interviews of psychiatric symptoms and global functioning during a 5-year follow-up. Linear regression analyses were conducted. RESULTS Less separations from caregivers expectedly predicted better outcomes in all therapies; unexpectedly, so did greater abuse. Family unhappiness and parental problems predicted faster or greater improvement when patients were assigned to a short- or long-term psychodynamic therapy model. LIMITATIONS As patients with psychotic, substance abuse, and severe personality disorders were screened out, findings might not generalize to these patient groups. CONCLUSIONS Patients with certain childhood adversities appear to respond with faster or greater improvement when the psychotherapy model is explicitly focused on working through the potential connections between past and current problems. If confirmed by in-depth studies, the findings may help match psychotherapeutic models with given patient complaints, as well as fine-tune different psychosocial interventions to individual needs for optimizing treatment outcomes.
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Affiliation(s)
| | - Paul Knekt
- National Institute for Health and Welfare, Finland
| | | | - Esa Virtala
- National Institute for Health and Welfare, Finland
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26
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Abstract
BACKGROUND AND PURPOSE Over half of Americans reports a history of adverse childhood experiences (ACEs), which have been associated with many chronic health conditions. Yet primary care providers infrequently screen patients for ACEs and fail to consider the relationship between ACEs and adult health. Therefore, the purposes of this study were to test the effectiveness and feasibility of a screening interview for ACEs and to confirm the prevalence of ACEs among individuals with chronic health conditions. METHODS Screening interviews were conducted with 71 adults in a primary care setting. Patients' ACE history, nurse practitioner comfort with screening, time to screen, and patient follow-up care recommendations were gathered through questionnaires. Adverse childhood experience prevalence was analyzed by descriptive statistics. Relationships between ACEs, number of clinic visits, time to screen, and follow-up care recommendations were analyzed by bivariate statistics. CONCLUSIONS Over half of participants reported more than four ACEs, with ACEs common among participants with chronic health conditions (93%). Adverse childhood experience scores were positively correlated with number of clinic visits, time to screen, and recommendations for follow-up care. Findings support screening primary care patients for ACEs. IMPLICATIONS FOR PRACTICE Adverse childhood experiences are prevalent among primary care patients with chronic conditions. Using interviews to screen for ACEs in primary care settings is effective and feasible.
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Design, rationale and feasibility of a multidimensional experimental protocol to study early life stress. Contemp Clin Trials Commun 2018; 7:33-43. [PMID: 29696166 PMCID: PMC5898516 DOI: 10.1016/j.conctc.2017.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 04/06/2017] [Accepted: 05/03/2017] [Indexed: 11/24/2022] Open
Abstract
There is a rapidly accumulating body of evidence regarding the influential role of early life stress (ELS) upon medical and psychiatric conditions. While self-report instruments, with their intrinsic limitations of recall, remain the primary means of detecting ELS in humans, biological measures are generally limited to a single biological system. This paper describes the design, rationale and feasibility of a study to simultaneously measure neuroendocrine, immune and autonomic nervous system (ANS) responses to psychological and physiological stressors in relation to ELS. Five healthy university students were recruited by advertisement. Exclusion criteria included chronic medical conditions, psychotic disorders, needle phobia, inability to tolerate pain, and those using anti-inflammatory medications. They were clinically interviewed and physiological recordings made over a two-hour period pre, during and post two acute stressors: the cold pressor test and recalling a distressing memory. The Childhood Trauma Questionnaire and the Parental Bonding Index were utilised to measure ELS. Other psychological measures of mood and personality were also administered. Measurements of heart rate, blood pressure, respiratory rate, skin conductance, skin blood flow and temporal plasma samples were successfully obtained before, during and after acute stress. Participants reported the extensive psychological and multisystem physiological data collection and stress provocations were tolerable. Most (4/5) participants indicated a willingness to return to repeat the protocol, indicating acceptability. Our protocol is viable and safe in young physically healthy adults and allows us to assess simultaneously neuroendocrine, immune and autonomic nervous system responses to stressors in persons assessed for ELS.
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Key Words
- ANS, Autonomic nervous system
- Adverse-childhood-events
- CPT, Cold pressor test
- CTQ, Childhood Trauma Questionnaire
- Childhood-stress
- Childhood-trauma questionnaire
- DASS, Depression, Anxiety and Stress Scale
- DS14, Type D Scale
- ECG, lectrocardiogram
- ELS, Early life stress
- EPQRs, Eysenck Personality Questionnaire Revised – short form
- HPA, Hypothalamic-pituitary-adrenal
- PBI, Parental Bonding Instrument
- PTSD, Post-traumatic Stress Disorder
- Parental-bonding-instrument
- RDM, Recall of distressing memory
- Type D scale (DS14)
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28
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Katan EA. The impact of abuse and neglect in childhood on the development of substance use disorders. Zh Nevrol Psikhiatr Im S S Korsakova 2018; 118:16-21. [DOI: 10.17116/jnevro20181181216-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Frodl T, Janowitz D, Schmaal L, Tozzi L, Dobrowolny H, Stein DJ, Veltman DJ, Wittfeld K, van Erp TG, Jahanshad N, Block A, Hegenscheid K, Völzke H, Lagopoulos J, Hatton SN, Hickie IB, Frey EM, Carballedo A, Brooks SJ, Vuletic D, Uhlmann A, Veer IM, Walter H, Schnell K, Grotegerd D, Arolt V, Kugel H, Schramm E, Konrad C, Zurowski B, Baune BT, van der Wee NJ, van Tol MJ, Penninx BW, Thompson PM, Hibar DP, Dannlowski U, Grabe HJ. Childhood adversity impacts on brain subcortical structures relevant to depression. J Psychiatr Res 2017; 86:58-65. [PMID: 27918926 PMCID: PMC5564511 DOI: 10.1016/j.jpsychires.2016.11.010] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 11/14/2016] [Accepted: 11/18/2016] [Indexed: 01/25/2023]
Abstract
Childhood adversity plays an important role for development of major depressive disorder (MDD). There are differences in subcortical brain structures between patients with MDD and healthy controls, but the specific impact of childhood adversity on such structures in MDD remains unclear. Thus, aim of the present study was to investigate whether childhood adversity is associated with subcortical volumes and how it interacts with a diagnosis of MDD and sex. Within the ENIGMA-MDD network, nine university partner sites, which assessed childhood adversity and magnetic resonance imaging in patients with MDD and controls, took part in the current joint mega-analysis. In this largest effort world-wide to identify subcortical brain structure differences related to childhood adversity, 3036 participants were analyzed for subcortical brain volumes using FreeSurfer. A significant interaction was evident between childhood adversity, MDD diagnosis, sex, and region. Increased exposure to childhood adversity was associated with smaller caudate volumes in females independent of MDD. All subcategories of childhood adversity were negatively associated with caudate volumes in females - in particular emotional neglect and physical neglect (independently from age, ICV, imaging site and MDD diagnosis). There was no interaction effect between childhood adversity and MDD diagnosis on subcortical brain volumes. Childhood adversity is one of the contributors to brain structural abnormalities. It is associated with subcortical brain abnormalities that are relevant to psychiatric disorders such as depression.
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Affiliation(s)
- Thomas Frodl
- Department of Psychiatry and Psychotherapy, Otto von Guericke University of Magdeburg, Germany; Department of Psychiatry, University of Dublin, Trinity College, Dublin, Ireland.
| | - Deborah Janowitz
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Germany
| | - Lianne Schmaal
- Department of Psychiatry and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands,Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Leonardo Tozzi
- Department of Psychiatry and Psychotherapy, Otto von Guericke University of Magdeburg, Germany,Department of Psychiatry, University of Dublin, Trinity College, Dublin, Ireland
| | - Henrik Dobrowolny
- Department of Psychiatry and Psychotherapy, Otto von Guericke University of Magdeburg, Germany
| | - Dan J. Stein
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - Dick J. Veltman
- Department of Psychiatry and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Katharina Wittfeld
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Greifswald, Germany
| | - Theo G.M. van Erp
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Department of Neurology, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Andrea Block
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Germany,Sociology of Physical Activity and Health, Department of Health Sciences, University of Potsdam, Germany
| | - Katrin Hegenscheid
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Germany
| | - Jim Lagopoulos
- Brain and Mind Centre, University of Sydney, Camperdown, Australia,Sunshine Coast Mind and Neuroscience – Thompson Institute, University of The Sunshine Coast, QLD, Australia
| | - Sean N. Hatton
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
| | - Ian B. Hickie
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
| | - Eva Maria Frey
- Department of Psychiatry, University of Regensburg, Regensburg, Germany
| | - Angela Carballedo
- Department of Psychiatry and Psychotherapy, Otto von Guericke University of Magdeburg, Germany,Trinity College Institute of Neuroscience, Trinity College Dublin, Ireland
| | - Samantha J. Brooks
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - Daniella Vuletic
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - Anne Uhlmann
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - Ilya M. Veer
- Charité Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, Division of Mind and Brain Research, Berlin, Germany
| | - Henrik Walter
- Charité Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, Division of Mind and Brain Research, Berlin, Germany
| | - Knut Schnell
- Department of General Psychiatry, University Hospital Heidelberg, Germany
| | - Dominik Grotegerd
- Department of Psychiatry and Psychotherapy, University of Münster, Germany
| | - Volker Arolt
- Department of Psychiatry and Psychotherapy, University of Münster, Germany
| | - Harald Kugel
- Department of Clinical Radiology, University of Münster, Germany
| | - Elisabeth Schramm
- Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Germany,Psychiatric University Clinic, Basel, Switzerland
| | - Carsten Konrad
- Department of Psychiatry and Psychotherapy, Agaplesion Diakoniklinikum, Rotenburg, Germany,Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Germany
| | - Bartosz Zurowski
- Center for Integrative Psychiatry, University of Lübeck, Lübeck, Germany
| | - Bernhard T. Baune
- Discipline of Psychiatry, School of Medicine, University of Adelaide, SA 5005 Adelaide, Australia
| | - Nic J.A. van der Wee
- Department of Psychiatry, Leiden Institute for Brain and Cognition and Leiden Center for Translational Neuroscience, Leiden, The Netherlands
| | - Marie-Jose van Tol
- Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Brenda W.J.H. Penninx
- Department of Psychiatry and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Paul M. Thompson
- Imaging Genetics Center, Department of Neurology, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Derrek P. Hibar
- Imaging Genetics Center, Department of Neurology, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Udo Dannlowski
- Department of Psychiatry and Psychotherapy, University of Münster, Germany,Department of Psychiatry, University of Marburg, Germany
| | - Hans J. Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Germany,German Center for Neurodegenerative Diseases (DZNE), Rostock, Greifswald, Germany,Helios Hospital Stralsund, Germany
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Gupta A, Mayer EA, Acosta JR, Hamadani K, Torgerson C, van Horn JD, Chang L, Naliboff B, Tillisch K, Labus JS. Early adverse life events are associated with altered brain network architecture in a sex- dependent manner. Neurobiol Stress 2017; 7:16-26. [PMID: 28239631 PMCID: PMC5318542 DOI: 10.1016/j.ynstr.2017.02.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 01/25/2017] [Accepted: 02/11/2017] [Indexed: 01/23/2023] Open
Abstract
INTRODUCTION Early adverse life events (EALs) increase the risk for chronic medical and psychiatric disorders by altering early neurodevelopment. The aim of this study was to examine associations between EALs and network properties of core brain regions in the emotion regulation and salience networks, and to test the influence of sex on these associations. METHODS Resting-state functional and diffusion tensor magnetic resonance imaging were obtained in healthy individuals (61 men, 63 women). Functional and anatomical network properties of centrality and segregation were calculated for the core regions of the two networks using graph theory. Moderator analyses were applied to test hypotheses. RESULTS The type of adversity experienced influences brain wiring differently, as higher general EALs were associated with decreased functional and anatomical centrality in salience and emotion regulation regions, while physical and emotional EALs were associated with increased anatomical centrality and segregation in emotion regulation regions. Sex moderated the associations between EALs and measures of centrality; with decreased centrality of salience and emotion regulation regions with increased general EALs in females, and increased centrality in salience regions with higher physical and emotional EALs in males. Increased segregation of salience regions was associated with increased general EALs in males. Centrality of the amygdala was associated with physical symptoms, and segregation of salience regions was correlated with higher somatization in men only. CONCLUSIONS Emotion regulation and salience regions are susceptible to topological brain restructuring associated with EALs. The male and female brains appear to be differently affected by specific types of EALs.
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Affiliation(s)
- Arpana Gupta
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, United States; Department of Medicine, UCLA, Los Angeles, CA, United States; UCLA Vatche and Tamar Manoukian Division of Digestive Diseases, UCLA, Los Angeles, CA, United States
| | - Emeran A Mayer
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, United States; Department of Medicine, UCLA, Los Angeles, CA, United States; Department of Psychiatry, UCLA, Los Angeles, CA, United States; UCLA Vatche and Tamar Manoukian Division of Digestive Diseases, UCLA, Los Angeles, CA, United States; Ahmanson-Lovelace Brain Mapping Center, UCLA, Los Angeles, CA, United States
| | - Jonathan R Acosta
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, United States
| | - Kareem Hamadani
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, United States
| | - Carinna Torgerson
- The Institute for Neuroimaging and Informatics (INI) and Laboratory of NeuroImaging (LONI), Keck School of Medicine at USC, Los Angeles, CA, United States
| | - John D van Horn
- The Institute for Neuroimaging and Informatics (INI) and Laboratory of NeuroImaging (LONI), Keck School of Medicine at USC, Los Angeles, CA, United States
| | - Lin Chang
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, United States; Department of Medicine, UCLA, Los Angeles, CA, United States; UCLA Vatche and Tamar Manoukian Division of Digestive Diseases, UCLA, Los Angeles, CA, United States
| | - Bruce Naliboff
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, United States; Department of Medicine, UCLA, Los Angeles, CA, United States; Department of Psychiatry, UCLA, Los Angeles, CA, United States; UCLA Vatche and Tamar Manoukian Division of Digestive Diseases, UCLA, Los Angeles, CA, United States; UCLA Brain Research Institute, Los Angeles, CA, United States
| | - Kirsten Tillisch
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, United States; Department of Medicine, UCLA, Los Angeles, CA, United States; UCLA Vatche and Tamar Manoukian Division of Digestive Diseases, UCLA, Los Angeles, CA, United States; Department of Integrative Medicine, GLA VHA, Los Angeles, CA, United States
| | - Jennifer S Labus
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, United States; Department of Medicine, UCLA, Los Angeles, CA, United States; Department of Psychiatry, UCLA, Los Angeles, CA, United States; UCLA Vatche and Tamar Manoukian Division of Digestive Diseases, UCLA, Los Angeles, CA, United States; UCLA Brain Research Institute, Los Angeles, CA, United States
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Markova V, Sandal GM. Lay Explanatory Models of Depression and Preferred Coping Strategies among Somali Refugees in Norway. A Mixed-Method Study. Front Psychol 2016; 7:1435. [PMID: 27713719 PMCID: PMC5031692 DOI: 10.3389/fpsyg.2016.01435] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 09/07/2016] [Indexed: 11/13/2022] Open
Abstract
Objective: Refugees are at high risk of experiencing mental health problems due to trauma in their pasts and to acculturation stress as they settle in a new country. To develop efficient health services that meet the needs of refugees from different regions, an understanding is required of how they make sense of and prefer to cope with mental health problems. This study aims to investigate lay explanatory models of depression and preferred coping strategies among Somali refugees in Norway. Methods: The study used a mixed-method design with a vignette describing a moderately depressed person based on ICD-10 criteria. Firstly, a survey study was performed among Somali refugees (n = 101). Respondents were asked to give advice to the vignette character and complete the Cross-Cultural Depression Coping Inventory and the General Help-Seeking Questionnaire. Secondly, focus group interviews (n = 10) were conducted separately with males and females to examine the relationship between the explanatory models of depression and the preferred coping strategies. Results: The participants showed a strong preference for coping with depression by religious practices and reliance on family, friends, and their ethnic/religious community, rather than by seeking professional treatment from public health services (e.g., medical doctors, psychologists). Depressive symptoms were conceptualized as a problem related to cognition (thinking too much) and emotion (sadness), but not to biological mechanisms, and they were thought to result from spiritual possession, stress as a result of social isolation, and/or past trauma. Independently of time in exile, the participants showed a strong identification with their ethnic origin and associated values. Because participants emphasized the need to obey and follow the views of elders, fathers, and spiritual leaders, these authorities seemed to be "gatekeepers" for access to mental health services. Conclusion: The results highlight that mental health programs for Somali refugees should actively involve the ethnic community, including spiritual leaders, in order to reach patients in need and to foster treatment compliance.
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Affiliation(s)
- Valeria Markova
- Department of Pulmonology, Haukeland University HospitalBergen, Norway
| | - Gro M. Sandal
- Department of Psychosocial Science, University of BergenBergen, Norway
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