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Zhang M, Wu C, Lu S, Wang Y, Ma R, Du Y, Wang S, Fang J. Regional brain activity and connectivity associated with childhood trauma in drug-naive patients with obsessive-compulsive disorder. Sci Rep 2024; 14:18111. [PMID: 39103500 PMCID: PMC11300583 DOI: 10.1038/s41598-024-69122-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 07/31/2024] [Indexed: 08/07/2024] Open
Abstract
Obsessive-compulsive disorder (OCD) is characterized by intrusive thoughts and repetitive, compulsive behaviors, with childhood trauma recognized as a contributing factor to its pathophysiology. This study aimed to delineate brain functional aberrations in OCD patients and explore the association between these abnormalities and childhood trauma, to gain insights into the neural underpinnings of OCD. Forty-eight drug-naive OCD patients and forty-two healthy controls (HC) underwent resting-state functional magnetic resonance imaging and clinical assessments, including the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and Childhood Trauma Questionnaire-Short Form (CTQ-SF). Compared to HCs, OCD patients exhibited significantly decreased amplitude of low-frequency fluctuations (ALFF) in the right cerebellum, decreased regional homogeneity (ReHo) in the right cerebellum and right superior occipital lobes (FWE-corrected p < 0.05), which negatively correlated with Y-BOCS scores (p < 0.05). Furthermore, cerebellar ALFF negatively correlated with the CTQ emotional abuse subscale (r = - 0.514, p < 0.01). Mediation analysis revealed that cerebellar ALFF mediated the relationship between CTQ-emotional abuse and Y-BOCS (good model fit: R2 = 0.231, MSE = 14.311, F = 5.721, p < 0.01; direct effect, c' = 0.153, indirect effect, a*b = 0.191). Findings indicated abnormal spontaneous and regional cerebellar activity in OCD, suggesting childhood trauma impacts OCD symptoms through cerebellar neural remodeling, highlighting its importance for clinical treatment selection.
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Affiliation(s)
- Manxue Zhang
- Mental Health Center, Ningxia Medical University General Hospital, Yinchuan, China
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Chujun Wu
- Mental Health Center, Ningxia Medical University General Hospital, Yinchuan, China
| | - Shihao Lu
- Mental Health Center, Ningxia Medical University General Hospital, Yinchuan, China
| | - Yanrong Wang
- Mental Health Center, Ningxia Medical University General Hospital, Yinchuan, China
| | - Rui Ma
- Mental Health Center, Ningxia Medical University General Hospital, Yinchuan, China
| | - Yunyun Du
- Mental Health Center, Ningxia Medical University General Hospital, Yinchuan, China
| | - Shaoxia Wang
- Mental Health Center, Ningxia Medical University General Hospital, Yinchuan, China
| | - Jianqun Fang
- Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, 750004, Ningxia, China.
- Mental Health Center, Ningxia Medical University General Hospital, Yinchuan, China.
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2
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Wislocki K, Kratz HE, Martin G, Becker-Haimes EM. The Relationship Between Trauma Exposure and Obsessive-Compulsive Disorder in Youth: A Systematic Review. Child Psychiatry Hum Dev 2023; 54:1624-1652. [PMID: 35488083 DOI: 10.1007/s10578-022-01352-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/17/2022] [Indexed: 11/28/2022]
Abstract
Extant literature suggests a possible relationship between childhood trauma exposure and the development and trajectory of obsessive-compulsive symptoms (OCS) and obsessive-compulsive disorder (OCD); however, this relationship is poorly understood. We conducted a systematic review that examined trauma exposure and OCS/OCD in youth. Primary inclusion criteria were English-language articles that addressed a sample with participants under 18 years of age. 46 articles met criteria for review, and were categorized into three groups of overlap: Post-traumatic Stress Disorder (PTSD) and OCS or OCD (n = 3), clearly defined Criterion A event trauma exposure and OCS or OCD (n = 30), and less well-defined potential trauma exposure and OCS or OCD (n = 13). There was mixed evidence linking trauma exposure and the development of OCS or OCD in youth. Major methodological limitations preclude formal conclusions. More research on co-occurring trauma exposure and OCD/OCS in youth is needed to advance research and improve treatment.
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Affiliation(s)
- Katherine Wislocki
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St., #3001, Philadelphia, PA, 19104, USA.
- Department of Psychological Science, University of California, Irvine, CA, USA.
| | - Hilary E Kratz
- Department of Psychology, La Salle University, Philadelphia, PA, USA
| | - Gerald Martin
- Department of Psychology, La Salle University, Philadelphia, PA, USA
| | - Emily M Becker-Haimes
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St., #3001, Philadelphia, PA, 19104, USA
- Hall Mercer Community Mental Health, University of Pennsylvania Health System, Philadelphia, PA, USA
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3
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Soffer-Dudek N. Obsessive-compulsive symptoms and dissociative experiences: Suggested underlying mechanisms and implications for science and practice. Front Psychol 2023; 14:1132800. [PMID: 37051604 PMCID: PMC10084853 DOI: 10.3389/fpsyg.2023.1132800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 03/03/2023] [Indexed: 03/29/2023] Open
Abstract
A strong and specific link between obsessive-compulsive disorder or symptoms (OCD/S) and a tendency for dissociative experiences (e.g., depersonalization-derealization, absorption and imaginative involvement) cannot be explained by trauma and is poorly understood. The present theoretical formulation proposes five different models conceptualizing the relationship. According to Model 1, dissociative experiences result from OCD/S through inward-focused attention and repetition. According to Model 2, dissociative absorption causally brings about both OCD/S and associated cognitive risk factors, such as thought-action fusion, partly through impoverished sense of agency. The remaining models highlight common underlying causal mechanisms: temporo-parietal abnormalities impairing embodiment and sensory integration (Model 3); sleep alterations causing sleepiness and dreamlike thought or mixed sleep-wake states (Model 4); and a hyperactive, intrusive imagery system with a tendency for pictorial thinking (Model 5). The latter model relates to Maladaptive Daydreaming, a suggested dissociative syndrome with strong ties to the obsessive-compulsive spectrum. These five models point to potential directions for future research, as these theoretical accounts may aid the two fields in interacting with each other, to the benefit of both. Finally, several dissociation-informed paths for further developing clinical intervention in OCD are identified.
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Affiliation(s)
- Nirit Soffer-Dudek
- The Consciousness and Psychopathology Laboratory, Department of Psychology, Ben-Gurion University of the Negev, Be’er Sheva, Israel
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4
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Raposo-Lima C, Moreira P, Magalhães R, Ferreira S, Sousa N, Picó-Pérez M, Morgado P. Differential patterns of association between resting-state functional connectivity networks and stress in OCD patients. Prog Neuropsychopharmacol Biol Psychiatry 2022; 118:110563. [PMID: 35569618 DOI: 10.1016/j.pnpbp.2022.110563] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 04/11/2022] [Accepted: 05/02/2022] [Indexed: 10/18/2022]
Abstract
Obsessive-compulsive disorder (OCD) is a highly prevalent psychiatric disorder that is characterized by its complex pathophysiology and heterogenous presentation. Multiple studies to date have identified a variety of factors that are involved in the development of symptoms, but little is known about how these affect brain function. In this study, we have tried to understand how stress, one of the most studied risk factors for OCD, may influence resting-state functional connectivity (rsFC) by comparing resting brain activity of OCD patients with healthy control subjects, while assessing self-reported levels of perceived stress using the Perceived Stress Scale-10 (PSS-10). Seventy-five OCD patients and seventy-one healthy matched control subjects were enrolled in this study, where we used a data-driven, independent component analysis approach. Our results show differences in connectivity between patients and healthy controls involving the dorsal attention (DAN) and lateral visual networks, with patients presenting increased rsFC within the DAN and decreased rsFC within the lateral visual network. Moreover, connectivity in the anterior default mode (aDMN), dorsal attention and basal ganglia networks was associated with PSS scores in OCD patients. Specifically, rsFC within the DAN and aDMN was positively correlated with PSS scores, while the opposite was observed for the basal ganglia network. This study is the first to report such association between rsFC alterations and self-reported stress levels. Our findings are relevant in the context of OCD pathophysiology given evidence of functional dysconnectivity involving the same networks in previous OCD studies and the possible involvement of these changes in the generation of obsessions.
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Affiliation(s)
- Catarina Raposo-Lima
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS-3Bs PT Government Associate Laboratory, Braga, Guimarães, Portugal; Clinical Academic Center - Braga, Braga, Portugal
| | - Pedro Moreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS-3Bs PT Government Associate Laboratory, Braga, Guimarães, Portugal; Clinical Academic Center - Braga, Braga, Portugal; Psychology Research Centre (CIPsi), School of Psychology, University of Minho, Braga, Portugal
| | - Ricardo Magalhães
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS-3Bs PT Government Associate Laboratory, Braga, Guimarães, Portugal; Clinical Academic Center - Braga, Braga, Portugal
| | - Sónia Ferreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS-3Bs PT Government Associate Laboratory, Braga, Guimarães, Portugal; Clinical Academic Center - Braga, Braga, Portugal
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS-3Bs PT Government Associate Laboratory, Braga, Guimarães, Portugal; Clinical Academic Center - Braga, Braga, Portugal
| | - Maria Picó-Pérez
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS-3Bs PT Government Associate Laboratory, Braga, Guimarães, Portugal; Clinical Academic Center - Braga, Braga, Portugal
| | - Pedro Morgado
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS-3Bs PT Government Associate Laboratory, Braga, Guimarães, Portugal; Clinical Academic Center - Braga, Braga, Portugal; Hospital de Braga, Braga, Portugal.
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Abstract
Obsessive-compulsive disorder (OCD) has a worldwide prevalence of 2%-3%. Characterized by the presence of either one or two core symptoms-obsessions and compulsions-it generally runs a chronic course and may cause serious functional impairment. Though previously thought to be of psychogenic origin, the pathophysiology of OCD is now understood to be more complex. A multitude of environmental factors have been shown to contribute to the development of OCD, including infection, neonatal complications, childhood trauma, occurrence of stressful events, and brain injury. It has also been proposed that genetic vulnerability may play a role in OCD pathology, although candidate genes have yet to be identified. Likewise, although it is widely accepted that stress plays a role in OCD pathophysiology, the mechanisms remain unclear. Observations from the clinics indicate that stress may serve as both a triggering and aggravating factor, meaning it can prompt symptoms to appear while also contributing to their exacerbation. Additionally, dysfunction of the hypothalamic-pituitary-adrenal axis and impaired stress response have been identified in OCD patients. In this review, we analyze the role of stress in the pathophysiology of OCD, complemented by relevant findings from recent animal studies.
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6
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Salomon-Small G, Somer E, Harel-Schwarzmann M, Soffer-Dudek N. Maladaptive Daydreaming and Obsessive-Compulsive Symptoms: A confirmatory and exploratory investigation of shared mechanisms. J Psychiatr Res 2021; 136:343-350. [PMID: 33636690 DOI: 10.1016/j.jpsychires.2021.02.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 12/17/2020] [Accepted: 02/08/2021] [Indexed: 11/18/2022]
Abstract
Maladaptive Daydreaming (MD) is a newly proposed mental disorder characterized by excessive, vivid fantasy activity impairing functioning. There is a high comorbidity of MD with Obsessive-Compulsive Spectrum Symptoms (OCSS), yet the mechanisms responsible for this relationship are still unclear. The present study set out to explore the relationship between MD and OCSS by: (1) examining dissociation, trauma, sense of control, and mind-wandering as potential mediators; (2) exploring whether MD is more strongly related to obsessions or compulsions; and (3) identifying patterns of specific obsessions and/or compulsions common in an MD sample. A group of 510 participants with self-identified MD completed a battery of online questionnaires. Dissociation and sense of control significantly mediated the MD-OCSS association. MD was moderately related to both obsessions and compulsions but was significantly more strongly related to the former. Frequently endorsed obsessions and compulsions among MD participants included checking and repetition compulsions, intrusive obsessions, and body-related obsessions and compulsions. We conclude that dissociative mechanisms, including dissociative absorption, play a major role in the relationship between MD and OCSS and may lead to consequent checking when transitioning back to reality, altered embodiment, intrusive images, and thoughts, and an impaired sense of mental control. Clinicians working with OCSS should be aware of the possible role of MD in the development or maintenance of symptoms. Future work should develop useful interventions for this type of shared psychopathology.
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Affiliation(s)
- Gabrielle Salomon-Small
- The Consciousness and Psychopathology Laboratory, Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | - Eli Somer
- School of Social Work, University of Haifa, Haifa, Israel.
| | | | - Nirit Soffer-Dudek
- The Consciousness and Psychopathology Laboratory, Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
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7
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LeMoult J, Humphreys KL, Tracy A, Hoffmeister JA, Ip E, Gotlib IH. Meta-analysis: Exposure to Early Life Stress and Risk for Depression in Childhood and Adolescence. J Am Acad Child Adolesc Psychiatry 2020; 59:842-855. [PMID: 31676392 DOI: 10.1016/j.jaac.2019.10.011] [Citation(s) in RCA: 257] [Impact Index Per Article: 64.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 09/21/2019] [Accepted: 10/22/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Early life stress (ELS) is associated with increased risk for the development of major depressive disorder (MDD) in adulthood; however, the degree to which ELS is associated with an early onset of MDD (ie, during childhood or adolescence) is not known. In this meta-analysis, we estimated the associations between ELS and the risk for onset of MDD before age 18 years. In addition, we examined the associations between eight specific forms of ELS (ie, sexual abuse, physical abuse, poverty, physical illness/injury, death of a family member, domestic violence, natural disaster, and emotional abuse) and risk for youth-onset MDD. METHOD We conducted a systematic search in scientific databases for studies that assessed both ELS and the presence or absence of MDD before age 18 years. We identified 62 journal articles with a total of 44,066 unique participants. We assessed study quality using the Newcastle-Ottawa Scale. When heterogeneous effect sizes were detected, we tested whether demographic and/or methodological factors moderated the association between ELS and MDD. RESULTS Using a random-effects meta-analysis, we found that individuals who experienced ELS were more likely to develop MDD before the age of 18 years than were individuals without a history of ELS (odds ratio = 2.50; 95% confidence interval 2.08, 3.00). Separate meta-analyses revealed a range of associations with MDD: whereas some types of ELS (eg, poverty) were not associated with MDD, other types (eg, emotional abuse) were associated more strongly with MDD than was ELS considered more broadly. CONCLUSION These findings provide important evidence that the adverse effect of ELS on MDD risk manifests early in development, prior to adulthood, and varies by type of ELS.
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Affiliation(s)
| | | | | | | | - Eunice Ip
- University of British Columbia, Vancouver
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8
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Tedgård E, Råstam M, Wirtberg I. Struggling with one's own parenting after an upbringing with substance abusing parents. Int J Qual Stud Health Well-being 2018; 13:1435100. [PMID: 29482480 PMCID: PMC5827643 DOI: 10.1080/17482631.2018.1435100] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/28/2018] [Indexed: 11/19/2022] Open
Abstract
AIM To add to our knowledge concerning the key elements involved in the individual's experience of growing up with substance abusing parents and the resulting challenges this involved for their own parenthood. METHODS In-depth interviews were conducted with 19 parents who had participated in a mental health intervention programme. All had experienced substance abusing parents in their family of origin. Qualitative content analysis was used to analyse the data. They also completed a self-report questionnaire assessing their attachment style. RESULT Participants reported a high incidence of emotional abuse and neglect coupled with inadequate support from the community. Their own parental role was influenced by high parental stress and a majority had an insecure attachment style. CONCLUSIONS All participants had experienced a very difficult childhood which was reinforced by the fact that they received little support from society. Their childhood experience and the resulting challenges that this created in their own parenting role could negatively influence their own children's ability to form a secure psychosocial development. It is therefore important to develop instruments that can help to identify children who were raised in misuse families in order to accommodate the transgenerational effects of growing up with substance abusing parents.
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Affiliation(s)
- Eva Tedgård
- Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Lund University, Lund, Sweden
- Offices for Healthcare “Sund”, Child and Adolescent Psychiatry, Infant and Toddler Unit, Malmö, Sweden
| | - Maria Råstam
- Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Lund University, Lund, Sweden
- Gillberg Neuropsychiatry Center, Institute of Neuroscience and Physiology University of Gothenburg, Göteborg, Sweden
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9
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Keiski P, Flinck A, Kaunonen M, Paavilainen E. Childhood experiences of female family-violence perpetrators. Perspect Psychiatr Care 2018; 54:251-257. [PMID: 28714060 DOI: 10.1111/ppc.12231] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 06/05/2017] [Accepted: 06/18/2017] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To explore the childhood experiences of women who have perpetrated family-violence and voluntarily sought help. DESIGN AND METHODS The qualitative design includes in-depth, unstructured individual interviews with 19 women who have perpetrated family-violence. FINDINGS The categories of maltreatment exposure, parental capability, and a role of the sensitive, good girl are identified and described in this article. PRACTICE IMPLICATIONS The findings provide guidance for nurses who encounter families at risk of female family-violence perpetration and for those developing preventive interventions for female family-violence perpetrators whose family-of-origin issues are essential in processing issues of self.
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Affiliation(s)
- Pia Keiski
- Faculty of Social Sciences, Health Sciences, University of Tampere, Tampere, Finland.,School of Health Care, Tampere University of Applied Sciences, Tampere, Finland
| | - Aune Flinck
- Faculty of Social Sciences, Health Sciences, University of Tampere, Tampere, Finland.,National Institute for Health and Welfare, Helsinki, Finland
| | - Marja Kaunonen
- Faculty of Social Sciences, Health Sciences, University of Tampere, Tampere, Finland
| | - Eija Paavilainen
- Faculty of Social Sciences, Health Sciences, University of Tampere, Tampere, Finland
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10
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Adams TG, Kelmendi B, Brake CA, Gruner P, Badour CL, Pittenger C. The role of stress in the pathogenesis and maintenance of obsessive-compulsive disorder. ACTA ACUST UNITED AC 2018. [PMID: 29527593 PMCID: PMC5841259 DOI: 10.1177/2470547018758043] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Individuals with obsessive-compulsive disorder often identify psychosocial stress
as a factor that exacerbates their symptoms, and many trace the onset of
symptoms to a stressful period of life or a discrete traumatic incident.
However, the pathophysiological relationship between stress and
obsessive-compulsive disorder remains poorly characterized: it is unclear
whether trauma or stress is an independent cause of obsessive-compulsive
disorder symptoms, a triggering factor that interacts with a preexisting
diathesis, or simply a nonspecific factor that can exacerbate
obsessive-compulsive disorder along with other aspects of psychiatric
symptomatology. Nonetheless, preclinical research has demonstrated that stress
has conspicuous effects on corticostriatal and limbic circuitry. Specifically,
stress can lead to neuronal atrophy in frontal cortices (particularly the medial
prefrontal cortex), the dorsomedial striatum (caudate), and the hippocampus.
Stress can also result in neuronal hypertrophy in the dorsolateral striatum
(putamen) and amygdala. These neurobiological effects mirror reported neural
abnormalities in obsessive-compulsive disorder and may contribute to an
imbalance between goal-directed and habitual behavior, an imbalance that is
implicated in the pathogenesis and expression of obsessive-compulsive disorder
symptomatology. The modulation of corticostriatal and limbic circuits by stress
and the resultant imbalance between habit and goal-directed learning and
behavior offers a framework for investigating how stress may exacerbate or
trigger obsessive-compulsive disorder symptomatology.
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Affiliation(s)
- T G Adams
- School of Medicine - Department of Psychiatry, Yale University.,Clinical Neuroscience Division of the VA National Center for PTSD
| | - B Kelmendi
- School of Medicine - Department of Psychiatry, Yale University.,Clinical Neuroscience Division of the VA National Center for PTSD
| | - C A Brake
- University of Kentucky, Department of Psychology
| | - P Gruner
- School of Medicine - Department of Psychiatry, Yale University
| | - C L Badour
- University of Kentucky, Department of Psychology
| | - C Pittenger
- School of Medicine - Department of Psychiatry, Yale University.,Clinical Neuroscience Division of the VA National Center for PTSD.,Child Study Center, Yale University.,Department of Psychology, Yale University
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11
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Gander M, George C, Pokorny D, Buchheim A. Assessing Attachment Representations in Adolescents: Discriminant Validation of the Adult Attachment Projective Picture System. Child Psychiatry Hum Dev 2017; 48:270-282. [PMID: 27016937 PMCID: PMC5323491 DOI: 10.1007/s10578-016-0639-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The contribution of attachment to human development and clinical risk is well established for children and adults, yet there is relatively limited knowledge about attachment in adolescence due to the poor availability of construct valid measures. The Adult Attachment Projective Picture System (AAP) is a reliable and valid instrument to assess adult attachment status. This study examines for the first time the discriminant validity of the AAP in adolescents. In our sample of 79 teenagers between 15 and 18 years, 42 % were classified as secure, 34 % as insecure-dismissing, 13 % as insecure-preoccupied and 11 % as unresolved. The results demonstrated discriminant validity for using the AAP in that age group, with no associations between attachment classifications and verbal intelligence, social desirability, story length or sociodemographic variables. These results poise the AAP to be used in clinical intervention and large-scale research investigating normative and atypical developmental correlates and sequelae of attachment, including psychopathology in adolescence.
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Affiliation(s)
- Manuela Gander
- Institute of Psychology, University of Innsbruck, 6020, Innsbruck, Austria. .,Department of Child and Adolescent Psychiatry, Medical University of Innsbruck, 6020, Innsbruck, Austria.
| | - Carol George
- Psychology Department, Mills College, Oakland, CA 94613 USA
| | - Dan Pokorny
- Psychosomatic Medicine and Psychotherapy, Ulm University, 89081 Ulm, Germany
| | - Anna Buchheim
- Institute of Psychology, University of Innsbruck, 6020 Innsbruck, Austria
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