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Pétrin R, Bérubé A, St-Pierre É, Blais C. Maternal childhood emotional abuse increases cardiovascular responses to children's emotional facial expressions. PLoS One 2024; 19:e0302782. [PMID: 38713700 DOI: 10.1371/journal.pone.0302782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 04/11/2024] [Indexed: 05/09/2024] Open
Abstract
Parents with a history of childhood maltreatment may be more likely to respond inadequately to their child's emotional cues, such as crying or screaming, due to previous exposure to prolonged stress. While studies have investigated parents' physiological reactions to their children's vocal expressions of emotions, less attention has been given to their responses when perceiving children's facial expressions of emotions. The present study aimed to determine if viewing facial expressions of emotions in children induces cardiovascular changes in mothers (hypo- or hyper-arousal) and whether these differ as a function of childhood maltreatment. A total of 104 mothers took part in this study. Their experiences of childhood maltreatment were measured using the Childhood Trauma Questionnaire (CTQ). Participants' electrocardiogram signals were recorded during a task in which they viewed a landscape video (baseline) and images of children's faces expressing different intensities of emotion. Heart rate variability (HRV) was extracted from the recordings as an indicator of parasympathetic reactivity. Participants presented two profiles: one group of mothers had a decreased HRV when presented with images of children's facial expressions of emotions, while the other group's HRV increased. However, HRV change was not significantly different between the two groups. The interaction between HRV groups and the severity of maltreatment experienced was marginal. Results suggested that experiences of childhood emotional abuse were more common in mothers whose HRV increased during the task. Therefore, more severe childhood experiences of emotional abuse could be associated with mothers' cardiovascular hyperreactivity. Maladaptive cardiovascular responses could have a ripple effect, influencing how mothers react to their children's facial expressions of emotions. That reaction could affect the quality of their interaction with their child. Providing interventions that help parents regulate their physiological and behavioral responses to stress might be helpful, especially if they have experienced childhood maltreatment.
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Affiliation(s)
- Rachel Pétrin
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, Québec, Canada
| | - Annie Bérubé
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, Québec, Canada
| | - Émilie St-Pierre
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, Québec, Canada
| | - Caroline Blais
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, Québec, Canada
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Packard K, Opendak M. Rodent models of early adversity: Impacts on developing social behavior circuitry and clinical implications. Front Behav Neurosci 2022; 16:918862. [PMID: 35990728 PMCID: PMC9385963 DOI: 10.3389/fnbeh.2022.918862] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/08/2022] [Indexed: 11/13/2022] Open
Abstract
Flexible and context-appropriate social functioning is key for survival across species. This flexibility also renders social behavior highly plastic, particularly during early development when attachment to caregiver can provide a template for future social processing. As a result, early caregiving adversity can have unique and lasting impacts on social behavior and even confer vulnerability to psychiatric disorders. However, the neural circuit mechanisms translating experience to outcome remain poorly understood. Here, we consider social behavior scaffolding through the lens of reward and threat processing. We begin by surveying several complementary rodent models of early adversity, which together have highlighted impacts on neural circuits processing social cues. We next explore these circuits underlying perturbed social functioning with focus on dopamine (DA) and its role in regions implicated in social and threat processing such as the prefrontal cortex (PFC), basolateral amygdala (BLA) and the lateral habenula (LHb). Finally, we turn to human populations once more to examine how altered DA signaling and LHb dysfunction may play a role in social anhedonia, a common feature in diagnoses such as schizophrenia and major depressive disorder (MDD). We argue that this translational focus is critical for identifying specific features of adversity that confer heightened vulnerability for clinical outcomes involving social cue processing.
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Affiliation(s)
- Katherine Packard
- Department of Neuroscience, Kennedy Krieger Institute, Baltimore, MD, United States
| | - Maya Opendak
- Department of Neuroscience, Kennedy Krieger Institute, Baltimore, MD, United States
- Solomon H. Snyder Department of Neuroscience, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
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Wadji DL, Tandon T, Ketcha Wanda GJM, Wicky C, Dentz A, Hasler G, Morina N, Martin-Soelch C. Child maltreatment and NR3C1 exon 1 F methylation, link with deregulated hypothalamus-pituitary-adrenal axis and psychopathology: A systematic review. CHILD ABUSE & NEGLECT 2021; 122:105304. [PMID: 34488052 DOI: 10.1016/j.chiabu.2021.105304] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 06/10/2021] [Accepted: 08/26/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Epigenetics offers one promising method for assessing the psychobiological response to stressful experiences during childhood. In particular, deoxyribonucleic acid (DNA) methylation has been associated with an altered hypothalamus-pituitary-adrenal (HPA) axis and the onset of mental disorders. Equally, there are promising leads regarding the association between the methylation of the glucocorticoid receptor gene (NR3C1-1F) and child maltreatment and its link with HPA axis and psychopathology. OBJECTIVE The current study aimed to assess the evidence of a link among child maltreatment, NR3C1-1F methylation, HPA axis deregulation, and symptoms of psychopathology. METHODS We followed the Prisma guidelines and identified 11 articles that met our inclusion criteria. RESULTS We found that eight studies (72.72%) reported increased NR3C1-1F methylation associated with child maltreatment, specifically physical abuse, emotional abuse, sexual abuse, neglect, and exposure to intimate partner violence, while three studies (27.27%) found no significant association. Furthermore, a minority of studies (36.36%) provided additional measures of symptoms of psychopathology or cortisol in order to examine the link among NR3C1-1F methylation, HPA axis deregulation, and psychopathology in a situation of child maltreatment. These results suggest that NR3C1-1F hypermethylation is positively associated with higher HPA axis activity, i.e. increased production of cortisol, as well as symptoms of psychopathology, including emotional lability-negativity, externalizing behavior symptoms, and depressive symptoms. CONCLUSION NR3C1-1F methylation could be one mechanism that links altered HPA axis activity with the development of psychopathology.
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Affiliation(s)
- D L Wadji
- I-Reach Lab, Unit of Clinical and Health Psychology, University of Fribourg, Switzerland.
| | - T Tandon
- I-Reach Lab, Unit of Clinical and Health Psychology, University of Fribourg, Switzerland
| | - G J M Ketcha Wanda
- Clinical psychology Lab, Department of Psychology, University of Yaoundé I, Cameroon
| | - C Wicky
- Department of Biology, University of Fribourg, Switzerland
| | - A Dentz
- I-Reach Lab, Unit of Clinical and Health Psychology, University of Fribourg, Switzerland
| | - G Hasler
- Department of Psychiatric, University of Fribourg, Fribourg, Switzerland
| | - N Morina
- Department of Consultant-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Switzerland
| | - C Martin-Soelch
- I-Reach Lab, Unit of Clinical and Health Psychology, University of Fribourg, Switzerland
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Nishimi K, Choi KW, Cerutti J, Powers A, Bradley B, Dunn EC. Measures of adult psychological resilience following early-life adversity: how congruent are different measures? Psychol Med 2021; 51:2637-2646. [PMID: 32406816 PMCID: PMC7863576 DOI: 10.1017/s0033291720001191] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Psychological resilience - positive psychological adaptation in the context of adversity - is defined and measured in multiple ways across disciplines. However, little is known about whether definitions capture the same underlying construct and/or share similar correlates. This study examined the congruence of different resilience measures and associations with sociodemographic factors and body mass index (BMI), a key health indicator. METHODS In a cross-sectional sample of 1429 African American adults exposed to child maltreatment, we derived four resilience measures: a self-report scale assessing resiliency (perceived trait resilience); a binary variable defining resilience as low depression and posttraumatic stress (absence of distress); a binary variable defining resilience as low distress and high positive affect (absence of distress plus positive functioning); and a continuous variable reflecting individuals' deviation from distress levels predicted by maltreatment severity (relative resilience). Associations between resilience measures, sociodemographic factors, and BMI were assessed using correlations and regressions. RESULTS Resilience measures were weakly-to-moderately correlated (0.27-0.69), though similarly patterned across sociodemographic factors. Women showed higher relative resilience, but lower perceived trait resilience than men. Only measures incorporating positive affect or resiliency perceptions were associated with BMI: individuals classified as resilient by absence of distress plus positive functioning had lower BMI than non-resilient (β = -2.10, p = 0.026), as did those with higher perceived trait resilience (β = -0.63, p = 0.046). CONCLUSION Relatively low congruence between resilience measures suggests studies will yield divergent findings about predictors, prevalence, and consequences of resilience. Efforts to clearly define resilience are needed to better understand resilience and inform intervention and prevention efforts.
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Affiliation(s)
- Kristen Nishimi
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, MA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Karmel W. Choi
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, MA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
- Stanley Center for Psychiatric Research, The Broad Institute of Harvard and MIT, Cambridge, MA
| | - Janine Cerutti
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, MA
| | - Abigail Powers
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Bekh Bradley
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
- Atlanta VA Medical Center, Atlanta, GA
| | - Erin C. Dunn
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
- Stanley Center for Psychiatric Research, The Broad Institute of Harvard and MIT, Cambridge, MA
- Center on the Developing Child at Harvard University, Cambridge, MA
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Fischmann T, Asseburg LK, Green J, Hug F, Neubert V, Wan M, Leuzinger-Bohleber M. Can Psychodynamically Oriented Early Prevention for "Children-at-Risk" in Urban Areas With High Social Problem Density Strengthen Their Developmental Potential? A Cluster Randomized Trial of Two Kindergarten-Based Prevention Programs. Front Psychol 2020; 11:599477. [PMID: 33362662 PMCID: PMC7759147 DOI: 10.3389/fpsyg.2020.599477] [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: 08/27/2020] [Accepted: 11/02/2020] [Indexed: 11/13/2022] Open
Abstract
Children who live on the margins of society are disadvantaged in achieving their developmental potential because of the lack of a necessary stable environment and nurturing care. Many early prevention programs aim at mitigating such effects, but often the evaluation of their long-term effect is missing. The aim of the study presented here was to evaluate such long-term effects in two prevention programs for children-at-risk growing up in deprived social environments focusing on child attachment representation as the primary outcome as well as on self-reflective capacities of teachers taking care of these children. The latter was a key component for promoting resilient behavior in children. Five hundred and twenty-six children aged 36 to 60 months at risk due to immigration status, low family socio-economic status and child behavior were examined in a cluster-randomized study comparing two preventions, the psychodynamic, attachment-based holistic approach EARLY STEPS (ES) with the classroom based FAUSTLOS (FA) for their efficacy. Primary outcome was the child attachment representation measured by the Manchester Child Attachment Story Task (MCAST). Secondary outcomes were derived from (a) the Caregiver-Teacher Report Form (C-TRF: problem behaviors, including anxiety/depressive symptoms, emotional-reactive and somatic problems, social withdrawal, aggressive behavior, and attention deficit), from (b) the Strength and Difficulties Questionnaire (SDQ, parent version: resilience and wellbeing) and (c) Self-Reflective Scales for teachers (SRS: self-reflective capacities of teachers). Compared to baseline, attachment and behavioral problems improved in both programs. ES led to more secure and more organized attachment representations (medium effect sizes). Aggressive behavior and externalizing problems were reduced in the FA group compared with ES, particularly in boys (medium effect sizes). Self-reflective capacities of the teachers increased only in the ES group. High correlation between children's attachment type with the number of social risk factors and the increase of problematic social behavior strongly indicate that an increase in teachers' self-reflective capacities helps to change children's attachment patterns which thus strengthens the resilience of these children-at-risk [An ethical vote from LPPKJP 2009-02-25 was obtained and the trial registered; Clinical trial registration information: The trial was registered 14.02.2012 (DRKS00003500; https://www.drks.de)].
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Affiliation(s)
- Tamara Fischmann
- International Psychoanalytic University Berlin, Berlin, Germany.,Sigmund-Freud-Institut, Frankfurt am Main, Germany
| | | | - Jonathan Green
- The University of Manchester, Manchester, United Kingdom
| | | | | | - Ming Wan
- The University of Manchester, Manchester, United Kingdom
| | - Marianne Leuzinger-Bohleber
- Sigmund-Freud-Institut, Frankfurt am Main, Germany.,University Medicine Johannes-Gutenberg-University, Mainz, Germany
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Early Life Adversity as a Moderator of Symptom Change following Selective Serotonin Reuptake Inhibitors and Cognitive Behavioral Therapy. COGNITIVE THERAPY AND RESEARCH 2020. [DOI: 10.1007/s10608-020-10158-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Davies PT, Parry LQ, Bascoe SM, Cicchetti D, Cummings EM. Interparental conflict as a curvilinear risk factor of youth emotional and cortisol reactivity. Dev Psychol 2020; 56:1787-1802. [PMID: 32567867 DOI: 10.1037/dev0001037] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
This study examined interparental conflict as a linear and curvilinear predictor of subsequent changes in adolescents' negative emotional reactivity and cortisol functioning during family conflict and, in turn, their psychological difficulties. In addition, adolescents' negative emotional reactivity and cortisol functioning during family conflict were examined as subsequent predictors of their psychological difficulties. Participants included 258 adolescents (52% girls) and their parents and teachers who participated in 3 annual measurement occasions. Adolescents were 13 years old on average (standard deviation [SD] = .57) at the first measurement occasion, were generally from middle- and working-class backgrounds, and identified mostly as White (e.g., 74%). The results of latent-difference score analyses indicated that a multimethod and multiinformant assessment of interparental conflict linearly predicted subsequent changes in observational ratings of adolescent emotional reactivity and their overall cortisol output in response to family conflict over a 1-year period. These changes, in turn, predicted increases in multiinformant reports of adolescent psychological problems over a 2-year period. However, the linear association in the first link in the cascade was qualified by the quadratic effects of interparental conflict as a predictor. Consistent with risk-saturation models, the relatively strong associations among interparental conflict and youth emotional reactivity and cortisol output at mild and moderate exposure to conflict weakened as exposure to conflict reached higher levels. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Diamond-Welch B, Kosloski AE. Adverse childhood experiences and propensity to participate in the commercialized sex market. CHILD ABUSE & NEGLECT 2020; 104:104468. [PMID: 32247917 DOI: 10.1016/j.chiabu.2020.104468] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 02/28/2020] [Accepted: 03/17/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Previous research has tied adverse childhood experiences (ACEs) to a variety of deleterious mental health, physical, and behavioral outcomes. There has been some examination of the relationship between ACEs and selling sexual services, but not on the relation of ACEs to purchasing. OBJECTIVE We hypothesize a cumulative impact of ACEs on the propensity to purchase and buy and sell sex. We further hypothesize that childhood sexual abuse will have unique impacts on buying and selling. PARTICIPANTS & SETTING We recruited participants who had ever/never exchanged money or things of values for sex through Amazon MTurk (n = 930). METHODS Using logistic regression, we examined how cumulative ACEs and each separate ACE increased propensity to buy or sell sex. We controlled for sex, age, race, employment status, and sexuality. RESULTS Utilizing the analysis from cumulative ACEs found that the propensity to buy (odds ratio 1.11***) and sell sex (odds ratio 1.094**) increased as cumulative ACE score increased. Bisexuals had high propensity of both buying (odds ratio 2.12) and selling sex (odds ratio 2.74). Women (odds ratio 0.53) and people of color (odds ratio 0.65) where more likely to sell than others. For odds of buying sex, childhood sexual abuse (odds ratio 1.57) had the most impact. For selling sex, childhood sexual abuse (odds ratio 1.96) and household physical violence (odds ratio 2.73) increased propensity while household mental abuse (odds ratio 0.57) decreased propensity. CONCLUSIONS Understanding the impact of ACEs is important to understand participation as a buyer and seller in the commercialized sex market.
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Miller KM, Briggs HE, Elkins J, Kim I, Mowbray O. Physical Abuse and Adolescent Sexual Behaviors: Moderating Effects of Mental Health Disorders and Substance Use. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2020; 13:55-62. [PMID: 32318228 PMCID: PMC7163811 DOI: 10.1007/s40653-018-0221-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The purpose of the current study was to examine the direct effects of child physical abuse on sexual behaviors and whether mental health problems and substance use moderated the associations between exposure to child physical abuse and sexual behavioral practices among adolescents who participated in the National Comorbidity Survey-Adolescent Supplement (NCS-A). The data show statistically significant relationships between physical abuse and risky sexual behaviors for youth who met the clinical criteria for lifetime Posttraumatic Stress Disorder (PTSD) and reported marijuana use. Data from future studies can inform sexual health practice development with adolescents and emerging adults with a history of physical abuse, marijuana use/abuse and PTSD. These findings underscore the importance of exploring presence of symptoms associated with PTSD and marijuana use as part of a comprehensive biopsychosocial assessment for physically abused adolescents and emerging adults to determine if they are engaging in risky sexual behaviors.
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Affiliation(s)
- Keva M. Miller
- School of Social Work, Portland State University, 1800 SW 6th Ave., Portland, OR 97201 USA
| | | | - Jennifer Elkins
- School of Social Work, University of Georgia, Athens, GA USA
| | - Irang Kim
- School of Social Work, University of Georgia, Athens, GA USA
- Department of Social Work, Northwestern State University of Louisiana, Natchitoches, LA USA
| | - Orion Mowbray
- School of Social Work, University of Georgia, Athens, GA USA
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Carolina Maria Motta Stoffel B, Felix Henrique PK, Flavio P, Lisia VD, Maria Fátima Olivier S, Tatiana HL, Marcelo SC, Marcelo SC. Crack users and violence. What is the relationship between trauma, antisocial personality disorder and posttraumatic stress disorder? Addict Behav 2019; 98:106012. [PMID: 31233950 DOI: 10.1016/j.addbeh.2019.06.001] [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: 01/09/2019] [Revised: 06/01/2019] [Accepted: 06/02/2019] [Indexed: 10/26/2022]
Abstract
TITLE Crack users and violence. What is the relationship between trauma, antisocial personality disorder and posttraumatic stress disorder? BACKGROUND Crack use is frequently related to severe social and psychiatric conditions including Antisocial Personality Disorder (ASPD) and Posttraumatic Stress Disorder (PTSD). Social vulnerabilities increase the frequency of traumatic exposure. The relationship of trauma and psychiatric disorders among crack users is still unclear. OBJECTIVES To describe the characteristics of crack users with ASPD and to verify of the association between ASPD and PTSD, ASPD and each type of traumatic event and the temporality of these events. METHODS Data from a multicenter cross-sectional sample of 733 crack users under treatment in six Brazilian capitals was obtained via interviews with Addiction Severity Index (ASI) 6 and Mini International Neuropsychiatric Interview (MINI). Demographic characteristics, psychiatric diagnosis and trauma history were examined. Descriptive and bivariate analyses were used to assess the relationship between the studied variables. RESULTS More than 80% of crack users with ASPD and >65% without this diagnosis report traumatic experiences. The prevalence of PTSD disorder among those with ASPD (47.3%) is lower than among those without (52.7%) this diagnosis. The traumatic experiences occur either before or after the first episode of drug use. CONCLUSIONS The high prevalence of ASPD and PTSD among crack users and their frequent exposure to severe traumatic events was verified as well as the fact that they are often victims and sometimes perpetrators of violence illustrating the complexity of the relationships between crack use, trauma and comorbidities.
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Repeated three-hour maternal deprivation as a model of early-life stress alters maternal behavior, olfactory learning and neural development. Neurobiol Learn Mem 2019; 163:107040. [DOI: 10.1016/j.nlm.2019.107040] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 07/01/2019] [Accepted: 07/10/2019] [Indexed: 12/30/2022]
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12
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Resilience and cognitive biases mediate the relationship between early exposure to traumatic life events and depressive symptoms in young adults. J Affect Disord 2019; 254:26-33. [PMID: 31082628 DOI: 10.1016/j.jad.2019.05.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 02/18/2019] [Accepted: 05/04/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Early trauma is an important risk factor for depression. However, little is known about the mechanisms of how traumatic life events shape the risk of depression. The present study focused on the mediating role of cognitive biases and mental resilience between early trauma and depressive symptoms in young men and women. METHODS 2218 non-clinical young adults completed an online Computer Assisted Web Interview (CAWI). It comprised selected items from several questionnaires including: a short version of the Center for Epidemiological Studies-Depression (CES-D, five items) questionnaire, the Traumatic Experience Checklist (TEC, three items) and the Childhood Experience of Care and Abuse Questionnaire (CECA.Q, three items), a short version (nine items) of Davos Assessment of Cognitive Biases Scale (DACOBS-18), the abridged version of the Connor-Davidson Resilience Scale (CD-RISC-10). Parallel mediation analyses were performed. The role of gender was considered. RESULTS A significant standardized indirect effect of childhood trauma on depressive symptoms through cognitive biases and resilience was found in the total sample. A standardized direct effect of childhood traumatic life events on depressive symptoms remained also significant, meaning that mediation is complementary. An analysis by gender showed similar results for women and men. LIMITATIONS Sample was limited to non-clinical young adults. The questionnaires were shortened, and items were selected arbitrarily due to the nature of the study (online screening). The data may include biases resulting from the use of self-report scales. CONCLUSIONS Cognitive biases and resilience are important, but not exclusive, mechanisms of the relationship between early trauma and depressive symptoms.
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Neurobiology of maternal regulation of infant fear: the role of mesolimbic dopamine and its disruption by maltreatment. Neuropsychopharmacology 2019; 44:1247-1257. [PMID: 30758321 PMCID: PMC6784970 DOI: 10.1038/s41386-019-0340-9] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 01/31/2019] [Accepted: 02/05/2019] [Indexed: 02/06/2023]
Abstract
Child development research highlights caregiver regulation of infant physiology and behavior as a key feature of early life attachment, although mechanisms for maternal control of infant neural circuits remain elusive. Here we explored the neurobiology of maternal regulation of infant fear using neural network and molecular levels of analysis in a rodent model. Previous research has shown maternal suppression of amygdala-dependent fear learning during a sensitive period. Here we characterize changes in neural networks engaged during maternal regulation and the transition to infant self-regulation. Metabolic mapping of 2-deoxyglucose uptake during odor-shock conditioning in postnatal day (PN)14 rat pups showed that maternal presence blocked fear learning, disengaged mesolimbic circuitry, basolateral amygdala (BLA), and plasticity-related AMPA receptor subunit trafficking. At PN18, when maternal presence only socially buffers threat learning (similar to social modulation in adults), maternal presence failed to disengage the mesolimbic dopaminergic system, and failed to disengage both the BLA and plasticity-related AMPA receptor subunit trafficking. Further, maternal presence failed to block threat learning at PN14 pups following abuse, and mesolimbic dopamine engagement and AMPA were not significantly altered by maternal presence-analogous to compromised maternal regulation of children in abusive relationships. Our results highlight three key features of maternal regulation: (1) maternal presence blocks fear learning and amygdala plasticity through age-dependent suppression of amygdala AMPA receptor subunit trafficking, (2) maternal presence suppresses engagement of brain regions within the mesolimbic dopamine circuit, and (3) early-life abuse compromises network and molecular biomarkers of maternal regulation, suggesting reduced social scaffolding of the brain.
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Opendak M, Sullivan RM. Unique infant neurobiology produces distinctive trauma processing. Dev Cogn Neurosci 2019; 36:100637. [PMID: 30889546 PMCID: PMC6969239 DOI: 10.1016/j.dcn.2019.100637] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 12/11/2018] [Accepted: 03/07/2019] [Indexed: 12/31/2022] Open
Abstract
Trauma experienced in early life has unique neurobehavioral outcomes related to later life psychiatric sequelae. Recent evidence has further highlighted the context of infant trauma as critical, with trauma experienced within species-atypical aberrations in caregiving quality as particularly detrimental. Using data from primarily rodent models, we review the literature on the interaction between trauma and attachment in early life, which highlights the role of the caregiver's presence in engagement of attachment brain circuitry and suppressing threat processing by the amygdala. Together these data suggest that infant trauma processing and its enduring effects are impacted by both the immaturity of brain areas for processing trauma and the unique functioning of the early-life brain, which is biased towards forming robust attachments regardless of the quality of care. Understanding the critical role of the caregiver in further altering early life brain processing of trauma is important for developing age-relevant treatment and interventions.
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Affiliation(s)
- Maya Opendak
- Emotional Brain Institute, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA; Child Study Center, Child & Adolescent Psychiatry, New York University School of Medicine, New York, USA.
| | - Regina M Sullivan
- Emotional Brain Institute, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA; Child Study Center, Child & Adolescent Psychiatry, New York University School of Medicine, New York, USA
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15
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The effects of childhood maltreatment and anxiety proneness on neuropsychological test performance in non-clinical older adolescents. J Affect Disord 2019; 243:133-144. [PMID: 30243193 DOI: 10.1016/j.jad.2018.09.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 07/30/2018] [Accepted: 09/09/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND The effect of childhood maltreatment (CM) on neuropsychological performance is well established, but the effect of anxiety proneness (AP) on such performance has been underexplored. We assessed the predictive ability of CM and AP, and their interaction, in non-clinical adolescents, for a range of previously documented neuropsychological deficits. METHODS Multiple linear regression models were used to assess the unique and combined influences of CM and AP on neuropsychological performance in 104 non-clinical adolescents, who underwent both neuropsychiatric and neuropsychological assessment. RESULTS The interaction of CM and AP was associated with poorer performance in executive functioning skills, processing speed, and estimated IQ. CM and AP were uniquely associated with verbal working memory performance, while verbal and visual memory performance and learning, and visuo-spatial ability, were not associated with either CM, AP or the interaction of CM and AP. LIMITATIONS The use of self-report measures to determine participants' levels of CM, AP, and depression. The CTQ-SF, a retrospective self-report measure, may have introduced recall bias. The neuropsychological evaluation was not conducted in the Xhosa language, the first language of most African participants. Most instruments utilized have not been validated in a South African adolescent sample. The impact of important moderator variables (e.g., age of onset of maltreatment) was not assessed. CONCLUSIONS Increased levels of CM and AP may be risk markers for poor performance in several key neuropsychological domains. Our findings underscore the importance of assessing the impact of both CM and anxiety-related temperamental traits on neuropsychological performance.
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Abstract
INTRODUCTION Depression and posttraumatic stress disorder (PTSD) are two complex and debilitating psychiatric disorders that result in poor life and destructive behaviors against self and others. Currently, diagnosis is based on subjective rather than objective determinations leading to misdiagnose and ineffective treatments. Advances in novel neurobiological methods have allowed assessment of promising biomarkers to diagnose depression and PTSD, which offers a new means of appropriately treating patients. Areas covered: Biomarkers discovery in blood represents a fundamental tool to predict, diagnose, and monitor treatment efficacy in depression and PTSD. The potential role of altered HPA axis, epigenetics, NPY, BDNF, neurosteroid biosynthesis, the endocannabinoid system, and their function as biomarkers for mood disorders is discussed. Insofar, we propose the identification of a biomarker axis to univocally identify and discriminate disorders with large comorbidity and symptoms overlap, so as to provide a base of support for development of targeted treatments. We also weigh in on the feasibility of a future blood test for early diagnosis. Expert commentary: Potential biomarkers have already been assessed in patients' blood and need to be further validated through multisite large clinical trial stratification. Another challenge is to assess the relation among several interdependent biomarkers to form an axis that identifies a specific disorder and secures the best-individualized treatment. The future of blood-based tests for PTSD and depression is not only on the horizon but, possibly, already around the corner.
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Affiliation(s)
- Dario Aspesi
- a The Psychiatric Institute, Department of Psychiatry , University of Illinois at Chicago , Chicago , IL , USA
| | - Graziano Pinna
- a The Psychiatric Institute, Department of Psychiatry , University of Illinois at Chicago , Chicago , IL , USA
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Sterling S, Chi F, Weisner C, Grant R, Pruzansky A, Bui S, Madvig P, Pearl R. Association of behavioral health factors and social determinants of health with high and persistently high healthcare costs. Prev Med Rep 2018; 11:154-159. [PMID: 30003015 PMCID: PMC6039851 DOI: 10.1016/j.pmedr.2018.06.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 05/23/2018] [Accepted: 06/25/2018] [Indexed: 01/27/2023] Open
Abstract
A high proportion of U.S. health care costs are attributable to a relatively small proportion of patients. Understanding behavioral and social factors that predict initial and persistent high costs for these "high utilizers" is critical for health policy-makers. This prospective observational study was conducted at Kaiser Permanente Northern California (KPNC), an integrated healthcare delivery system with 4.1 million members. A stratified random sample of high-cost vs. non-high-cost adult KPNC members matched by age, gender, race/ethnicity, type of health insurance, and medical severity (N = 378) was interviewed between 3/14/2013 and 3/20/2014. Data on health care costs and clinical diagnoses between 1/1/2008 and 12/31/2012 were derived from the electronic health record (EHR). Social-economic status, depression symptoms, adverse childhood experiences (ACEs), interpersonal violence, financial stressors, neighborhood environment, transportation access, and patient activation and engagement were obtained through telephone interviews. Initial and subsequent high-cost status were defined as being classified in top 20% cost levels over 1/1/2009-12/31/2011 and 1/1/2012-12/31/2012, respectively. Psychiatric diagnosis (OR 2.55, 95% CI 1.52-4.29, p < 0.001), financial stressors (OR 1.97, 95% CI 1.19-3.26, p = 0.009), and ACEs (OR 1.10, 95% CI 1.00-1.20, p = 0.051) predicted initial high-cost status. ACEs alone predicted persistent high-cost status in the subsequent year (OR 1.12, 95% CI 1.00-1.25, p = 0.050). Non-medical factors such as psychiatric problems, financial stressors and adverse childhood experiences contribute significantly to the likelihood of high medical utilization and cost. Efforts to predict and reduce high utilization must include measuring and potentially addressing these factors.
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Affiliation(s)
- Stacy Sterling
- Division of Research, Kaiser Permanente Northern California, United States
| | - Felicia Chi
- Division of Research, Kaiser Permanente Northern California, United States
| | - Constance Weisner
- Division of Research, Kaiser Permanente Northern California, United States
- University of California, San Francisco, United States
| | - Richard Grant
- Division of Research, Kaiser Permanente Northern California, United States
| | | | - Sandy Bui
- The Permanente Medical Group, United States
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Poole JC, Dobson KS, Pusch D. Do adverse childhood experiences predict adult interpersonal difficulties? The role of emotion dysregulation. CHILD ABUSE & NEGLECT 2018; 80:123-133. [PMID: 29604503 DOI: 10.1016/j.chiabu.2018.03.006] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 02/17/2018] [Accepted: 03/02/2018] [Indexed: 05/07/2023]
Abstract
Adverse childhood experiences (ACEs) are risk factors for interpersonal difficulties in adulthood, however the mechanism that underlies this association is unknown. The current study investigated the association of a wide range of ACEs with interpersonal difficulties in adulthood, and tested whether emotion dysregulation mediated the relationship between ACEs and interpersonal difficulties. Patients over the age of 18 were recruited from primary care clinics (N = 4006). Participants completed self-report questionnaires that assessed ACEs, emotion dysregulation, and interpersonal difficulties. Results indicated that, after controlling for a range of demographic variables, each type of ACE significantly predicted increased interpersonal difficulties and that cumulative ACEs predicted increased interpersonal difficulties, F(8, 3137) = 39.68, p < .001, R2 = 0.09. Further, emotion dysregulation mediated the association between ACEs and interpersonal difficulties, B = 0.79, SE = 0.09, 95% CI [0.64, 0.97]. These findings emphasize the role of childhood adversity on interpersonal functioning in adulthood, and highlight emotion dysregulation as a mechanism by which this association occurs. Results have the potential to inform preventative and treatment efforts to improve adaptive outcomes among individuals with a history of childhood adversity.
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19
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Op den Kelder R, Van den Akker AL, Geurts HM, Lindauer RJL, Overbeek G. Executive functions in trauma-exposed youth: a meta-analysis. Eur J Psychotraumatol 2018; 9:1450595. [PMID: 33488998 PMCID: PMC7803075 DOI: 10.1080/20008198.2018.1450595] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
An earlier meta-analysis and review indicated that trauma exposure may be related to lower levels of executive functioning in youth. Since different developmental trajectories were found for three core executive functions, the present study focused on working memory, inhibition, and cognitive flexibility specifically. We conducted a multi-level meta-analysis on 55 studies and 322 effect sizes published between 2001 and 2017 that were retrieved from MEDLINE, Embase, and PsycINFO. The 8070 participants in selected studies were aged 2-25 years. We investigated whether the association between constructs would be moderated by trauma-specific moderators (onset, duration, and type), and study (age, gender, ethnicity, and socio-economic status) and measurement (quality) characteristics. We found small to medium effect sizes for working memory (d = -0.49), inhibition (d = -0.46), and cognitive flexibility (d = -0.44). Moderator analyses showed that, for working memory, when studies used low-quality measurements the effect size was significantly stronger than when studies used high-quality measurements.Compared to single trauma-exposed youth, violence-exposed/abused and foster care/adopted youth showed more problems in inhibition, and foster care/adopted youth showed more problems in cognitive flexibility. Our findings imply that trauma-exposed youth have lower levels of executive functions. Clinical practice should incorporate problems in executive functioning, especially working memory, inhibition, and cognitive flexibility, in assessment and treatment guidelines.
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Affiliation(s)
- Rosanne Op den Kelder
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands.,De Bascule Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
| | - Alithe L Van den Akker
- Research Institute of Child Development and Education/Research Priority Area YIELD, University of Amsterdam, Amsterdam, The Netherlands
| | - Hilde M Geurts
- Department of Psychology (Brain & Cognition)/Research Priority Area YIELD, University of Amsterdam, Amsterdam, The Netherlands.,Dr. Leo Kannerhuis, Autism Clinic, Doorwerth, The Netherlands
| | - Ramón J L Lindauer
- De Bascule Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands.,Department of Child and Adolescent Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Geertjan Overbeek
- Research Institute of Child Development and Education/Research Priority Area YIELD, University of Amsterdam, Amsterdam, The Netherlands
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20
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Lahat A, Tang A, Tanaka M, Van Lieshout RJ, MacMillan HL, Schmidt LA. Longitudinal Associations Among Child Maltreatment, Resting Frontal Electroencephalogram Asymmetry, and Adolescent Shyness. Child Dev 2018; 89:746-757. [DOI: 10.1111/cdev.13060] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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21
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Simpson S, Mercer S, Simpson R, Lawrence M, Wyke S. Mindfulness-Based Interventions for Young Offenders: a Scoping Review. Mindfulness (N Y) 2018; 9:1330-1343. [PMID: 30294385 PMCID: PMC6153893 DOI: 10.1007/s12671-018-0892-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Youth offending is a problem worldwide. Young people in the criminal justice system have frequently experienced adverse childhood circumstances, mental health problems, difficulties regulating emotions and poor quality of life. Mindfulness-based interventions can help people manage problems resulting from these experiences, but their usefulness for youth offending populations is not clear. This review evaluated existing evidence for mindfulness-based interventions among such populations. To be included, each study used an intervention with at least one of the three core components of mindfulness-based stress reduction (breath awareness, body awareness, mindful movement) that was delivered to young people in prison or community rehabilitation programs. No restrictions were placed on methods used. Thirteen studies were included: three randomized controlled trials, one controlled trial, three pre-post study designs, three mixed-methods approaches and three qualitative studies. Pooled numbers (n = 842) comprised 99% males aged between 14 and 23. Interventions varied so it was not possible to identify an optimal approach in terms of content, dose or intensity. Studies found some improvement in various measures of mental health, self-regulation, problematic behaviour, substance use, quality of life and criminal propensity. In those studies measuring mindfulness, changes did not reach statistical significance. Qualitative studies reported participants feeling less stressed, better able to concentrate, manage emotions and behaviour, improved social skills and that the interventions were acceptable. Generally low study quality limits the generalizability of these findings. Greater clarity on intervention components and robust mixed-methods evaluation would improve clarity of reporting and better guide future youth offending prevention programs.
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Affiliation(s)
- Sharon Simpson
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland G12 9LX UK
| | - Stewart Mercer
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland G12 9LX UK
| | - Robert Simpson
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland G12 9LX UK
| | - Maggie Lawrence
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland G4 0BA UK
| | - Sally Wyke
- College of Social Science, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland UK
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22
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Lee KY, Li CY, Chang KC, Lu TH, Chen YY. Age at Exposure to Parental Suicide and the Subsequent Risk of Suicide in Young People. CRISIS 2018; 39:27-36. [DOI: 10.1027/0227-5910/a000468] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Background: We investigated the age at exposure to parental suicide and the risk of subsequent suicide completion in young people. The impact of parental and offspring sex was also examined. Method: Using a cohort study design, we linked Taiwan's Birth Registry (1978–1997) with Taiwan's Death Registry (1985–2009) and identified 40,249 children who had experienced maternal suicide (n = 14,431), paternal suicide (n = 26,887), or the suicide of both parents (n = 281). Each exposed child was matched to 10 children of the same sex and birth year whose parents were still alive. This yielded a total of 398,081 children for our non-exposed cohort. A Cox proportional hazards model was used to compare the suicide risk of the exposed and non-exposed groups. Results: Compared with the non-exposed group, offspring who were exposed to parental suicide were 3.91 times (95% confidence interval [CI] = 3.10–4.92 more likely to die by suicide after adjusting for baseline characteristics. The risk of suicide seemed to be lower in older male offspring (HR = 3.94, 95% CI = 2.57–6.06), but higher in older female offspring (HR = 5.30, 95% CI = 3.05–9.22). Stratified analyses based on parental sex revealed similar patterns as the combined analysis. Limitations: As only register-based data were used, we were not able to explore the impact of variables not contained in the data set, such as the role of mental illness. Conclusion: Our findings suggest a prominent elevation in the risk of suicide among offspring who lost their parents to suicide. The risk elevation differed according to the sex of the afflicted offspring as well as to their age at exposure.
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Affiliation(s)
- Kuan-Ying Lee
- Department of General Psychiatry, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan
- Department of Public Health, College of Medicine, National Cheng-Kung University, Tainan, Taiwan
| | - Chung-Yi Li
- Department of Public Health, College of Medicine, National Cheng-Kung University, Tainan, Taiwan
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Kun-Chia Chang
- Department of General Psychiatry, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan
- Department of Public Health, College of Medicine, National Cheng-Kung University, Tainan, Taiwan
| | - Tsung-Hsueh Lu
- Department of Public Health, College of Medicine, National Cheng-Kung University, Tainan, Taiwan
| | - Ying-Yeh Chen
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
- Institute of Public Health and Department of Public Health, National Yang-Ming University, Taipei, Taiwan
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23
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Tang A, Miskovic V, Lahat A, Tanaka M, MacMillan H, Van Lieshout RJ, Schmidt LA. Trajectories of resting frontal brain activity and psychopathology in female adolescents exposed to child maltreatment. Dev Psychobiol 2017; 60:67-77. [DOI: 10.1002/dev.21585] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Accepted: 09/19/2017] [Indexed: 12/27/2022]
Affiliation(s)
- Alva Tang
- Department of Psychology, Neuroscience & Behaviour; McMaster University; Hamilton Ontario Canada
| | - Vladimir Miskovic
- Department of Psychology; State University of New York at Binghamton; Binghamton New York
| | - Ayelet Lahat
- Department of Psychology, Neuroscience & Behaviour; McMaster University; Hamilton Ontario Canada
| | - Masako Tanaka
- Department of Psychiatry & Behavioural Neurosciences; McMaster University; Hamilton Ontario Canada
| | - Harriet MacMillan
- Department of Psychiatry & Behavioural Neurosciences; McMaster University; Hamilton Ontario Canada
- Department of Pediatrics; McMaster University; Hamilton Ontario Canada
| | - Ryan J. Van Lieshout
- Department of Psychiatry & Behavioural Neurosciences; McMaster University; Hamilton Ontario Canada
| | - Louis A. Schmidt
- Department of Psychology, Neuroscience & Behaviour; McMaster University; Hamilton Ontario Canada
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Straub J, Klaubert LM, Schmiedgen S, Kirschbaum C, Goldbeck L. Hair cortisol in relation to acute and post-traumatic stress symptoms in children and adolescents. ANXIETY STRESS AND COPING 2017; 30:661-670. [PMID: 28745078 DOI: 10.1080/10615806.2017.1355458] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND We report on the preliminary results of two independent studies that (1) compare the hair cortisol concentrations (HCC) of healthy controls with patients displaying post-traumatic stress symptoms (PTSS, study 1+2), (2) investigate whether pre-trauma HCC are predictive for the development of acute stress symptoms (ASS) and PTSS (study 1) and (3) determine whether HCC correlate with PTSS in a clinical sample of children (study 2). METHODS In study 1, the clinical symptoms of 35 minors were examined one (T1) and seven weeks (T2) after surgery following an accident. Hair samples were taken after the accident that reflect cortisol secretion over the past three months before the accident (healthy controls). In study 2, HCC and PTSS symptoms were cross-sectionally assessed in 22 minors who had experienced a psychological trauma. RESULTS The HCC of patients with PTSS were lower than the HCC of healthy controls (study 1+2). Secondary analyses showed that HCC were significantly lower in male PTSS patients than in male healthy controls, whereas the HCC in females were comparably low in both groups. Pre-trauma HCC did not predict the total ASS and PTSS scores (study 1) and HCC were not directly related to the total PTSS scores (study 2).
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Affiliation(s)
- Joana Straub
- a Department of Child and Adolescent Psychiatry and Psychotherapy , University of Ulm , Ulm , Germany
| | - Lena Marie Klaubert
- a Department of Child and Adolescent Psychiatry and Psychotherapy , University of Ulm , Ulm , Germany
| | - Susann Schmiedgen
- b Institute of Biological Psychology, Technische Universität Dresden , Dresden , Germany
| | - Clemens Kirschbaum
- b Institute of Biological Psychology, Technische Universität Dresden , Dresden , Germany
| | - Lutz Goldbeck
- a Department of Child and Adolescent Psychiatry and Psychotherapy , University of Ulm , Ulm , Germany
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25
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The mediating roles of cortisol reactivity and executive functioning difficulties in the pathways between childhood histories of emotional insecurity and adolescent school problems. Dev Psychopathol 2017; 29:1483-1498. [PMID: 28397610 DOI: 10.1017/s0954579417000402] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
This study tested a hypothesized cascade in which children's insecure representations of the interparental relationship increase their school problems by altering children's cortisol reactivity to stress and their executive functioning. Participants included 235 families. The first of five measurement occasions occurred when the children were in kindergarten (M age = 6 years), and they were followed through the transition to high school. The results indicated that children's histories of insecure representations of the interparental relationship during the early school years were associated with executive functioning difficulties in adolescence (M age = 14 years). This in turn predicted subsequent increases in school adjustment difficulties 1 year later. In addition, elevated cortisol reactivity to interadult conflict mediated the association between early histories of insecurity and subsequent executive function problems in adolescence.
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26
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Opendak M, Gould E, Sullivan R. Early life adversity during the infant sensitive period for attachment: Programming of behavioral neurobiology of threat processing and social behavior. Dev Cogn Neurosci 2017; 25:145-159. [PMID: 28254197 PMCID: PMC5478471 DOI: 10.1016/j.dcn.2017.02.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Revised: 01/03/2017] [Accepted: 02/04/2017] [Indexed: 02/06/2023] Open
Abstract
Animals, including humans, require a highly coordinated and flexible system of social behavior and threat evaluation. However, trauma can disrupt this system, with the amygdala implicated as a mediator of these impairments in behavior. Recent evidence has further highlighted the context of infant trauma as a critical variable in determining its immediate and enduring consequences, with trauma experienced from an attachment figure, such as occurs in cases of caregiver-child maltreatment, as particularly detrimental. This review focuses on the unique role of caregiver presence during early-life trauma in programming deficits in social behavior and threat processing. Using data primarily from rodent models, we describe the interaction between trauma and attachment during a sensitive period in early life, which highlights the role of the caregiver's presence in engagement of attachment brain circuitry and suppressing threat processing by the amygdala. These data suggest that trauma experienced directly from an abusive caregiver and trauma experienced in the presence of caregiver cues produce similar neurobehavioral deficits, which are unique from those resulting from trauma alone. We go on to integrate this information into social experience throughout the lifespan, including consequences for complex scenarios, such as dominance hierarchy formation and maintenance.
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Affiliation(s)
- Maya Opendak
- Emotional Brain Institute, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA; Child Study Center, Child & Adolescent Psychiatry, New York University School of Medicine, New York, USA.
| | - Elizabeth Gould
- Department of Psychology, Princeton University, Princeton, NJ, USA
| | - Regina Sullivan
- Emotional Brain Institute, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA; Child Study Center, Child & Adolescent Psychiatry, New York University School of Medicine, New York, USA
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Lewin L, Farkas K, Niazi M. Mother-Child Relational Quality of Women in Substance Abuse Treatment. J Am Psychiatr Nurses Assoc 2017; 23:50-60. [PMID: 27738085 DOI: 10.1177/1078390316673715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Mothers who abuse substances are more likely to have impaired parenting and lose custody of their young children. OBJECTIVE The pilot study described mother-child relational quality of women in substance abuse treatment. The identification of mothers' perceptions of being parented, current level of depression, discrete and potentially modifiable mothering behaviors, and self-appraisals of their role. DESIGN The descriptive study implemented audio-video-recorded mother-child interactions for coding. RESULTS Twenty-nine dyads participated with children age 4 weeks to 5 years. Mothers had lower levels of caring from their parents and moderate depression that was correlated with many of the relational quality behaviors. Eleven of 29 maternal behaviors were coded as concerning. Reflections by mothers revealed modest, yet confident self-appraisals of their maternal role. CONCLUSIONS Women who experienced higher depression demonstrated lower maternal quality. Some maternal behaviors were identified as less optimal although many were strengths.
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Affiliation(s)
- Linda Lewin
- 1 Linda Lewin, PhD, PMHCNS-BC, Wayne State University, Detroit, MI, USA
| | - Kathleen Farkas
- 2 Kathleen Farkas, PhD, LISW, Case Western Reserve University, Cleveland, OH, USA
| | - Maryam Niazi
- 3 Maryam Niazi, RN, MSN, PMHNP-BC, Access Ohio, Columbus, OH, USA
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28
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Cobbett S. Reaching the hard to reach: quantitative and qualitative evaluation of school-based arts therapies with young people with social, emotional and behavioural difficulties. EMOTIONAL AND BEHAVIOURAL DIFFICULTIES 2016. [DOI: 10.1080/13632752.2016.1215119] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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29
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Tatham EL, Ramasubbu R, Gaxiola-Valdez I, Cortese F, Clark D, Goodyear B, Foster J, Hall GB. White matter integrity in major depressive disorder: Implications of childhood trauma, 5-HTTLPR and BDNF polymorphisms. Psychiatry Res Neuroimaging 2016; 253:15-25. [PMID: 27261564 DOI: 10.1016/j.pscychresns.2016.04.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 04/22/2016] [Accepted: 04/25/2016] [Indexed: 11/24/2022]
Abstract
This study examined the impact of childhood neglect, serotonin transporter (5-HTTLPR) and brain derived neurotrophic factor (BDNF) polymorphisms on white matter (WM) integrity in major depressive disorder (MDD) using diffusion tensor imaging (DTI). Fifty-five medication-free MDD patients and 18 controls underwent diffusion tensor imaging scanning, genotyping and completed the Childhood Trauma Questionnaire. Tract based spatial statistics (TBSS) findings revealed reduced fractional anisotropy (FA) in the MDD group in the anterior internal capsule. 5-HTTLPR-S'L' heterozygotes in the MDD group exhibited reduced FA in the internal capsule relative to S'S' and reduced FA in corona radiata compared to L'L'. Probabilistic tractography revealed higher FA in the uncinate fasciculus (UF) for BDNF val/val genotype relative to met-carriers, particularly in individuals with high depression severity. High depression severity and experiences of childhood physical or emotional neglect predicted higher FA in the UF and superior longitudinal fasciculus. Reductions in FA were identified for subgroups of MDD patients who were 5-HTTLPR heterozygotes and BDNF-met carriers. An association between emotional/physical neglect and FA was observed in subjects with high depressive symptoms. Our findings suggest that WM connectivity within frontal and limbic regions are affected by depression and influenced by experiences of neglect and genetic risk factors.
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Affiliation(s)
- Erica L Tatham
- McMaster Integrative Neuroscience Discovery and Study Program, McMaster University, Hamilton, Ontario, Canada
| | - Rajamannar Ramasubbu
- Department of Psychiatry, and Clinical Neurosciences, Hotchkiss Brain Institute, Mathison Center for Mental Health Research and Education, University of Calgary, Alberta, Canada
| | | | | | - Darren Clark
- Department of Psychiatry, and Clinical Neurosciences, Hotchkiss Brain Institute, Mathison Center for Mental Health Research and Education, University of Calgary, Alberta, Canada
| | | | - Jane Foster
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Geoffrey B Hall
- McMaster Integrative Neuroscience Discovery and Study Program, McMaster University, Hamilton, Ontario, Canada; Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, Ontario, Canada.
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Mogi K, Ishida Y, Nagasawa M, Kikusui T. Early weaning impairs fear extinction and decreases brain-derived neurotrophic factor expression in the prefrontal cortex of adult male C57BL/6 mice. Dev Psychobiol 2016; 58:1034-1042. [DOI: 10.1002/dev.21437] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Accepted: 05/23/2016] [Indexed: 12/11/2022]
Affiliation(s)
- Kazutaka Mogi
- Department of Animal Science and Biotechnology; Azabu University; Sagamihara Kanagawa Japan
| | - Yuiko Ishida
- Department of Animal Science and Biotechnology; Azabu University; Sagamihara Kanagawa Japan
| | - Miho Nagasawa
- Department of Animal Science and Biotechnology; Azabu University; Sagamihara Kanagawa Japan
| | - Takefumi Kikusui
- Department of Animal Science and Biotechnology; Azabu University; Sagamihara Kanagawa Japan
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31
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Shors TJ, Millon EM. Sexual trauma and the female brain. Front Neuroendocrinol 2016; 41:87-98. [PMID: 27085856 DOI: 10.1016/j.yfrne.2016.04.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 04/11/2016] [Accepted: 04/12/2016] [Indexed: 01/01/2023]
Abstract
Sexual aggression and violence against women (VAM) are not only social problems; they are mental health problems. Women who experience sexual trauma often express disruptions in emotional and cognitive processes, some of which lead to depression and post-traumatic stress disorder (PTSD). Animal models of neurogenesis and learning suggest that social yet aggressive interactions between a pubescent female and an adult male can disrupt processes of learning related to maternal care, which in turn reduce survival of new neurons in the female hippocampus. Mental and Physical (MAP) Training is a novel clinical intervention that was translated from neurogenesis research. The intervention, which combines meditation and aerobic exercise, is currently being used to help women learn to recover from traumatic life experiences, especially those related to sexual violence and abuse.
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Affiliation(s)
- Tracey J Shors
- Behavioral and Systems Neuroscience, Department of Psychology, Center for Collaborative Neuroscience, Rutgers University, 152 Frelinghuysen Road Room 201, Piscataway, NJ 08854, USA.
| | - Emma M Millon
- Behavioral and Systems Neuroscience, Department of Psychology, Center for Collaborative Neuroscience, Rutgers University, 152 Frelinghuysen Road Room 201, Piscataway, NJ 08854, USA
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School-Related Outcomes of Traumatic Event Exposure and Traumatic Stress Symptoms in Students: A Systematic Review of Research from 1990 to 2015. SCHOOL MENTAL HEALTH 2016. [DOI: 10.1007/s12310-016-9175-2] [Citation(s) in RCA: 132] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kanatsou S, Ter Horst JP, Harris AP, Seckl JR, Krugers HJ, Joëls M. Effects of Mineralocorticoid Receptor Overexpression on Anxiety and Memory after Early Life Stress in Female Mice. Front Behav Neurosci 2016; 9:374. [PMID: 26858618 PMCID: PMC4726803 DOI: 10.3389/fnbeh.2015.00374] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 12/30/2015] [Indexed: 11/29/2022] Open
Abstract
Early-life stress (ELS) is a risk factor for the development of psychopathology, particularly in women. Human studies have shown that certain haplotypes of NR3C2, encoding the mineralocorticoid receptor (MR), that result in gain of function, may protect against the consequences of stress exposure, including childhood trauma. Here, we tested the hypothesis that forebrain-specific overexpression of MR in female mice would ameliorate the effects of ELS on anxiety and memory in adulthood. We found that ELS increased anxiety, did not alter spatial discrimination and reduced contextual fear memory in adult female mice. Transgenic overexpression of MR did not alter anxiety but affected spatial memory performance and enhanced contextual fear memory formation. The effects of ELS on anxiety and contextual fear were not affected by transgenic overexpression of MR. Thus, MR overexpression in the forebrain does not represent a major resilience factor to early life adversity in female mice.
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Affiliation(s)
- Sofia Kanatsou
- Department of Translational Neuroscience, Brain Center Rudolf Magnus, University Medical Center UtrechtUtrecht, Netherlands; Swammerdam Institute for Life Sciences, Center for Neuroscience, University of AmsterdamAmsterdam, Netherlands
| | - Judith P Ter Horst
- Swammerdam Institute for Life Sciences, Center for Neuroscience, University of Amsterdam Amsterdam, Netherlands
| | - Anjanette P Harris
- Endocrinology Unit, Centre for Cardiovascular Science, Queen's Medical Research Institute, The University of Edinburgh Edinburgh, UK
| | - Jonathan R Seckl
- Endocrinology Unit, Centre for Cardiovascular Science, Queen's Medical Research Institute, The University of Edinburgh Edinburgh, UK
| | - Harmen J Krugers
- Swammerdam Institute for Life Sciences, Center for Neuroscience, University of Amsterdam Amsterdam, Netherlands
| | - Marian Joëls
- Department of Translational Neuroscience, Brain Center Rudolf Magnus, University Medical Center Utrecht Utrecht, Netherlands
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Opendak M, Sullivan RM. Unique neurobiology during the sensitive period for attachment produces distinctive infant trauma processing. Eur J Psychotraumatol 2016; 7:31276. [PMID: 27837581 PMCID: PMC5106868 DOI: 10.3402/ejpt.v7.31276] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 06/28/2016] [Accepted: 07/31/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Trauma has neurobehavioral effects when experienced at any stage of development, but trauma experienced in early life has unique neurobehavioral outcomes related to later life psychiatric sequelae. Recent evidence has further highlighted the context of infant trauma as a critical variable in determining its immediate and enduring consequences. Trauma experienced from an attachment figure, such as occurs in cases of caregiver child maltreatment, is particularly detrimental. METHODS Using data primarily from rodent models, we review the literature on the interaction between trauma and attachment in early life, which highlights the role of the caregiver's presence in engagement of attachment brain circuitry and suppressing threat processing by the amygdala. We then consider how trauma with and without the caregiver produces long-term changes in emotionality and behavior, and suggest that these experiences initiate distinct pathways to pathology. RESULTS Together these data suggest that infant trauma processing and its enduring effects are impacted by both the immaturity of brain areas for processing trauma and the unique functioning of the early-life brain, which is biased toward processing information within the attachment circuitry. CONCLUSION An understanding of developmental differences in trauma processing as well as the critical role of the caregiver in further altering early life brain processing of trauma is important for developing age-relevant treatment and interventions.
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Affiliation(s)
- Maya Opendak
- Emotional Brain Institute, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA.,Child Study Center, Child & Adolescent Psychiatry, New York University School of Medicine, New York, NY, USA;
| | - Regina M Sullivan
- Emotional Brain Institute, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA.,Child Study Center, Child & Adolescent Psychiatry, New York University School of Medicine, New York, NY, USA
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Fuller-Thomson E, Hooper SR. The association between childhood physical abuse and dyslexia: findings from a population-based study. JOURNAL OF INTERPERSONAL VIOLENCE 2015; 30:1583-1592. [PMID: 24981005 DOI: 10.1177/0886260514540808] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The objective of this study was to determine the relationship between a history of dyslexia and childhood physical abuse in a large population-based epidemiological sample. It was hypothesized that the prevalence of dyslexia would be significantly higher in individuals who reported a childhood history of physical abuse in comparison to those who did not report such a history. A secondary analysis examined data from respondents 18 years and older from the Saskatchewan and Manitoba sample of the 2005 Canadian Community Health Survey (CCHS). There were 13,640 respondents ages 18 and older. Due to missing data, the final sample size was 13,054 respondents. One third (34.8%) of respondents who reported they had been physically abused during their childhood or adolescence also reported being diagnosed with dyslexia in comparison with 7.2% of those who did not report being physically abused (p < .001). Initial adjustments for sociodemographic variables produced an odds ratio (OR) for dyslexia that was more than 7 times higher (OR = 7.09; 95% confidence interval [CI] = [4.42, 11.35]) for those who had reported being physically abused in comparison with their peers who did not report such a history; with additional adjustments for other adverse childhood experiences, these odds decreased only slightly to 6.09 times higher (95% CI = [3.58, 10.35]). Further research is needed to understand the mechanism linking physical abuse and dyslexia.
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Affiliation(s)
| | - Stephen R Hooper
- University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
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Abstract
This study assessed the effects of premenstrual syndrome (PMS) and menstrual phases on the hypothalamic-pituitary-adrenal (HPA) axis, sympathetic nervous system axis and psychological responses to the Trier Social Stress Test (TSST). Thirty-six PMS women (mean age 21.69 ± 2.16 years) and 36 control women (mean age 22.03 ± 2.48 years) participated in the TSST task, either in the follicular phase or in the late luteal phase (each group N = 18). Saliva samples, heart rate and subjective stress levels were collected for seven time points throughout the test (10, 20, 30, 40, 55, 70 and 100 min). The results indicated that in comparison with control women, PMS women displayed blunted cortisol stress responses to the TSST irrespective of the menstrual phases, as indexed by the cortisol levels across time, area under the curve with respect to ground (AUCg) and peak change scores of cortisol. The results also demonstrated that the measurements indexed by cortisol levels across time, AUCg and peak change scores of heart rate were smaller in women tested during the late luteal phase than during the follicular phase. Correlation results indicated that AUCg was negatively correlated with PMS scores. These results suggest that measures of cortisol, rather than heart rate or subjective responses to stress, may be most closely associated with PMS. Furthermore, hypo-reactivity of the HPA axis may be pathologically relevant to PMS because it predicts heightened PMS severity.
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Affiliation(s)
- Yamei Huang
- Beijing Key Laboratory of Applied Experimental Psychology, School of Psychology, Beijing Normal University , Beijing , China
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Aversa LH, Lemmer J, Nunnink S, McLay RN, Baker DG. Impact of childhood maltreatment on physical health-related quality of life in U.S. active duty military personnel and combat veterans. CHILD ABUSE & NEGLECT 2014; 38:1382-1388. [PMID: 24690164 DOI: 10.1016/j.chiabu.2014.03.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 02/17/2014] [Accepted: 03/08/2014] [Indexed: 06/03/2023]
Abstract
Previous studies have found an association between childhood maltreatment (CM) and health-related quality of life (HRQoL), and to a lesser extent have considered whether psychiatric symptoms may explain the relationship. This study aimed to further our understanding of the link between CM and HRQoL by testing whether posttraumatic stress disorder (PTSD) or depressive symptoms mediate the relationship between childhood maltreatment and physical HRQoL. Mediation models were examined in a sample of male Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) active duty and combat veterans (n=249). PTSD and depressive symptoms mediated the relationship between CM and overall physical HRQoL, as well as participation in daily activities due to physical health, bodily pain, and social functioning. Mediation of the relationship between childhood maltreatment and physical and social functioning by depression and PTSD symptoms may lend support to neurobiological hypotheses that childhood maltreatment sensitizes the nervous system and after repeated trauma may lead to the development of psychiatric symptoms, which have a major impact on morbidity and mortality.
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Affiliation(s)
- Laura H Aversa
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Jennifer Lemmer
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Sarah Nunnink
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA
| | | | - Dewleen G Baker
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA; Veterans Affairs Center of Excellence for Stress and Mental Health, San Diego, CA, USA
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Rood BD, Calizo LH, Piel D, Spangler ZP, Campbell K, Beck SG. Dorsal raphe serotonin neurons in mice: immature hyperexcitability transitions to adult state during first three postnatal weeks suggesting sensitive period for environmental perturbation. J Neurosci 2014; 34:4809-21. [PMID: 24695701 PMCID: PMC3972713 DOI: 10.1523/jneurosci.1498-13.2014] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Revised: 02/21/2014] [Accepted: 02/25/2014] [Indexed: 11/21/2022] Open
Abstract
Trauma during early life is a major risk factor for the development of anxiety disorders and suggests that the developing brain may be particularly sensitive to perturbation. Increased vulnerability most likely involves altering neural circuits involved in emotional regulation. The role of serotonin in emotional regulation is well established, but little is known about the postnatal development of the raphe where serotonin is made. Using whole-cell patch-clamp recording and immunohistochemistry, we tested whether serotonin circuitry in the dorsal and median raphe was functionally mature during the first 3 postnatal weeks in mice. Serotonin neurons at postnatal day 4 (P4) were hyperexcitable. The increased excitability was due to depolarized resting membrane potential, increased resistance, increased firing rate, lack of 5-HT1A autoreceptor response, and lack of GABA synaptic activity. Over the next 2 weeks, membrane resistance decreased and resting membrane potential hyperpolarized due in part to potassium current activation. The 5-HT1A autoreceptor-mediated inhibition did not develop until P21. The frequency of spontaneous inhibitory and excitatory events increased as neurons extended and refined their dendritic arbor. Serotonin colocalized with vGlut3 at P4 as in adulthood, suggesting enhanced release of glutamate alongside enhanced serotonin release. Because serotonin affects circuit development in other brain regions, altering the developmental trajectory of serotonin neuron excitability and release could have many downstream consequences. We conclude that serotonin neuron structure and function change substantially during the first 3 weeks of life during which external stressors could potentially alter circuit formation.
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Affiliation(s)
- Benjamin D. Rood
- Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, and
- Department of Anesthesiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania 19104
| | - Lyngine H. Calizo
- Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, and
| | - David Piel
- Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, and
| | - Zachary P. Spangler
- Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, and
| | - Kaitlin Campbell
- Department of Anesthesiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania 19104
| | - Sheryl G. Beck
- Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, and
- Department of Anesthesiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania 19104
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Agapidaki E, Souliotis K, Christogiorgos S, Zervas L, Leonardou A, Kolaitis G, Giannakopoulos G, Dimitrakaki C, Tountas Y. A theory-based educational intervention to pediatricians in order to improve identification and referral of maternal depression: a quasi-experimental study. Ann Gen Psychiatry 2013; 12:37. [PMID: 24266909 PMCID: PMC3874664 DOI: 10.1186/1744-859x-12-37] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 10/01/2013] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Maternal depression has a negative impact on both the mother and child's physical and mental health, as well as impairs parenting skills and pediatric health care utilization. The pediatricians' role in identification and management of maternal depression is well established. Although it can be successfully and easily treated, maternal depression remains under-recognized and under-treated. Despite the heightened emphasis, there is lack of interventions to pediatricians in order to improve detection and management of maternal depression. METHODS To address this gap, an educational intervention based on the 'Health Belief Model' was developed, implemented, and evaluated. The present quasi-experimental study, aimed to assess the pediatricians' knowledge, self-efficacy, beliefs, and attitudes toward maternal depression at baseline and post-intervention measurements. A total of 43 randomly selected primary care pediatricians residing in Athens completed a 59-item survey by mail in 2011. Pediatricians in the intervention group received a toolkit about the recognition and management of maternal depression, while pediatricians in the control group received a leaflet about mental health. Descriptive statistics, t test, chi-square, Fisher's exact test, and analysis of variance were used for the statistical analysis. RESULTS Post-intervention measurement revealed differences at a statistical significance level between the two groups, in the following variables: beliefs, attitudes, self- efficacy, perceived barriers, and management practices of maternal depression. Furthermore, at post-measurement, pediatricians in the intervention group demonstrated increased perceived responsibility and increased self-efficacy for detection and referral of maternal depression. CONCLUSIONS Educational interventions to pediatricians seem to be beneficial for the improvement of the pediatricians' knowledge, self-efficacy, and attitudes regarding maternal depression. Studies using large, representative population samples are needed to provide evidence if the training interventions to pediatricians for maternal depression are translated to changes in their clinical practice and improved the patients' health outcomes.
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Affiliation(s)
- Eirini Agapidaki
- Center for Health Services Research, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Alexandroupoleos st, 25, Athens 115 27, Greece.
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De Bellis MD, Woolley DP, Hooper SR. Neuropsychological findings in pediatric maltreatment: relationship of PTSD, dissociative symptoms, and abuse/neglect indices to neurocognitive outcomes. CHILD MALTREATMENT 2013; 18:171-83. [PMID: 23886642 PMCID: PMC3769175 DOI: 10.1177/1077559513497420] [Citation(s) in RCA: 95] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Maltreated (n = 38), maltreated + posttraumatic stress disorder (PTSD; n = 60), and control youth (n = 104) underwent comprehensive neuropsychological testing. The two maltreated groups performed significantly lower on IQ, academic achievement, and nearly all of the neurocognitive domains than controls. Maltreated + PTSD performed significantly worse than maltreated youth without PTSD on a task in the visuospatial domain that assessed higher order visuoconstructive abilities. No group differences were evident on the fine motor domain. PTSD diagnosis duration negatively correlated with the visuospatial, and dissociation negatively correlated with the attention domain. Cumulative lifetime maltreatment types experienced negatively correlated with academic achievement. Sexual abuse negatively correlated with language and memory functions after controlling for other maltreatment types. These data support the adverse effects of maltreatment on neuropsychological functions in youth and suggest that all child protective services identified youth should be comprehensively examined for the integrity of their neuropsychological functioning and academic skills, regardless of the presence or absence of mental health symptoms.
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Affiliation(s)
- Michael D De Bellis
- Department of Psychiatry and Behavioral Sciences, Duke University Medical School, Durham, NC, USA.
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Fowler JC, Allen JG, Oldham JM, Frueh BC. Exposure to interpersonal trauma, attachment insecurity, and depression severity. J Affect Disord 2013; 149:313-8. [PMID: 23507367 DOI: 10.1016/j.jad.2013.01.045] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Accepted: 01/30/2013] [Indexed: 11/20/2022]
Abstract
BACKGROUND Exposure to traumatic events is a nonspecific risk factor for psychiatric symptoms including depression. The trauma-depression link finds support in numerous studies; however, explanatory mechanisms linking past trauma to current depressive symptoms are poorly understood. This study examines the role that attachment insecurity plays in mediating the relationship between prior exposure to trauma and current expression of depression severity. METHODS Past trauma and attachment anxiety and avoidance were assessed at baseline in a large cohort (N=705) of adults admitted to a specialized adult psychiatric hospital with typical lengths of stay ranging from 6 to 8 weeks. Depression severity was assessed at day 14 of treatment using the Beck Depression Inventory-II. RESULTS Interpersonal trauma (e.g., assaults, abuse) was correlated with depression severity, whereas exposure to impersonal trauma (e.g., natural disasters, accidents) was not. Adult attachment partially mediated the relationship between past interpersonal trauma and depression severity at day 14 among psychiatric inpatients. LIMITATIONS Measure of trauma exposure did not systematically differentiate the age of exposure or relationship to the perpetrator. Individuals scoring high on the self-report attachment measure may be prone to over-report interpersonal traumas. CONCLUSIONS Treatment of depression in traumatized patients should include an assessment of attachment insecurity and may be fruitful target for intervention.
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Maternal separation with early weaning: a rodent model providing novel insights into neglect associated developmental deficits. Dev Psychopathol 2013; 24:1401-16. [PMID: 23062306 DOI: 10.1017/s095457941200079x] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Child neglect is the most prevalent form of child maltreatment in the United States, and poses a serious public health concern. Children who survive such episodes go on to experience long-lasting psychological and behavioral problems, including higher rates of post-traumatic stress disorder symptoms, depression, alcohol and drug abuse, attention-deficit/hyperactivity disorder, and cognitive deficits. To date, most research into the causes of these life-long problems has focused on well-established targets such as stress responsive systems, including the hypothalamus-pituitary-adrenal axis. Using the maternal separation and early weaning model, we have attempted to provide comprehensive molecular profiling of a model of early-life neglect in an organism amenable to genomic manipulation: the mouse. In this article, we report new findings generated with this model using chromatin immunoprecipitation sequencing, diffuse tensor magnetic resonance imaging, and behavioral analyses. We also review the validity of the maternal separation and early weaning model, which reflects behavioral deficits observed in neglected humans including hyperactivity, anxiety, and attentional deficits. Finally, we summarize the molecular characterization of these animals, including RNA profiling and label-free proteomics, which highlight protein translation and myelination as novel pathways of interest.
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Abstract
Kindheitstraumata gehören zu den Hauptursachen chronischer psychischer und körperlicher Störungen. Posttraumatische Belastungsstörungen können schon bei Kindern und Jugendlichen auftreten, oft mit einer entwicklungstypischen Ausgestaltung und begleitet von komorbiden Störungen. Die evidenzbasierte Diagnostik und Behandlung von betroffenen Kindern und Jugendlichen umfasst eine systematische Exploration möglicher traumatischer Lebenserfahrungen, eine gründliche klinische Diagnostik zur Abgrenzung der posttraumatischen Stresssymptome und anderer begleitender Störungen, sowie die Durchführung einer traumafokussierten Psychotherapie. Bislang unterversorgte Kinder und Jugendliche aus Risikogruppen, wie z. B. Heimkinder, Pflegekinder und lebensbedrohlich erkrankte und verletzte Kinder, könnten durch eine bessere interdisziplinäre Versorgung rechtzeitiger einer evidenzbasierten Traumatherapie zugeführt werden.
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Affiliation(s)
- Lutz Goldbeck
- Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie der Universität Ulm
| | - Franz Petermann
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
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Matthews AK, Cho YI, Hughes TL, Johnson TP, Alvy L. The influence of childhood physical abuse on adult health status in sexual minority women: the mediating role of smoking. Womens Health Issues 2013; 23:e95-102. [PMID: 23415321 DOI: 10.1016/j.whi.2012.11.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Revised: 10/16/2012] [Accepted: 11/30/2012] [Indexed: 11/17/2022]
Abstract
BACKGROUND Among women in the general population, childhood physical abuse (CPA) is associated with poor adult health status and engagement in health risk behaviors. Sexual minority women (SMW) are at elevated risk of CPA, have higher rates of smoking, and may be at higher risk for poorer general health. In this study, we examined the influences of CPA on health status in a diverse sample of SMW. We hypothesized that SMW with a history of CPA would report poorer health than those without such histories and that early onset of smoking-an important health risk behavior-would mediate the relationship between CPA and current health status. METHODS Structural equation modeling was used to evaluate the influence of CPA on early health risk behavior (i.e., age of smoking onset) and current perceived health status in a community based sample of 368 SMW. RESULTS More than one fifth of the sample (21.5%) reported a history of CPA. One fourth of the sample was current smokers; the average age of smoking onset was 19 to 20 years old. The mean level of self-rated health status was between "fair" and "good." When relationships were simultaneously estimated, the effect of CPA on health status was mediated by two sequential smoking factors: CPA was associated with earlier age of smoking onset, and age of smoking onset was associated with current smoker status. Being a current smoker had a negative effect on perceived health status. IMPLICATIONS FOR PRACTICE AND/OR POLICY These results suggest that tobacco use is an important pathway by which CPA influences current health status. Prevention and early intervention initiatives should focus on the reduction of CPA among SMW to eliminate the long-term health consequences of adverse childhood events among SMW.
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Affiliation(s)
- Alicia K Matthews
- Department of Health Systems Sciences, College of Nursing, University of Illinois at Chicago, Chicago, Illinois 60612, USA.
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Habetha S, Bleich S, Weidenhammer J, Fegert JM. A prevalence-based approach to societal costs occurring in consequence of child abuse and neglect. Child Adolesc Psychiatry Ment Health 2012; 6:35. [PMID: 23158382 PMCID: PMC3540003 DOI: 10.1186/1753-2000-6-35] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Accepted: 11/08/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Traumatization in childhood can result in lifelong health impairment and may have a negative impact on other areas of life such as education, social contacts and employment as well. Despite the frequent occurrence of traumatization, which is reflected in a 14.5 percent prevalence rate of severe child abuse and neglect, the economic burden of the consequences is hardly known. The objective of this prevalence-based cost-of-illness study is to show how impairment of the individual is reflected in economic trauma follow-up costs borne by society as a whole in Germany and to compare the results with other countries' costs. METHODS From a societal perspective trauma follow-up costs were estimated using a bottom-up approach. The literature-based prevalence rate includes emotional, physical and sexual abuse as well as physical and emotional neglect in Germany. Costs are derived from individual case scenarios of child endangerment presented in a German cost-benefit-analysis. A comparison with trauma follow-up costs in Australia, Canada and the USA is based on purchasing power parity. RESULTS The annual trauma follow-up costs total to a margin of EUR 11.1 billion for the lower bound and to EUR 29.8 billion for the upper bound. This equals EUR 134.84 and EUR 363.58, respectively, per capita for the German population. These results conform to the ones obtained from cost studies conducted in Australia (lower bound) and Canada (upper bound), whereas the result for the United States is much lower. CONCLUSION Child abuse and neglect result in trauma follow-up costs of economically relevant magnitude for the German society. Although the result is well in line with other countries' costs, the general lack of data should be fought in order to enable more detailed future studies. Creating a reliable cost data basis in the first place can pave the way for long-term cost savings.
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Affiliation(s)
- Susanne Habetha
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Steinhoevelstr, 5, Ulm, 89075, Germany.
| | - Sabrina Bleich
- Rehabilitation and Organization Division, Baden-Wuerttemberg Registered Hospital Association, Association of Hospitals, Rehabilitation- and Care Establishments, Birkenwaldstraße 151, Stuttgart, 70191, Germany
| | - Jörg Weidenhammer
- IGSF Institute for Health System Research GmbH, Schauenburgerstr, 116, 24118, Kiel, Germany
| | - Jörg M Fegert
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Steinhoevelstr. 5, Ulm, 89075, Germany
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Pervanidou P, Chrousos GP. Posttraumatic stress disorder in children and adolescents: neuroendocrine perspectives. Sci Signal 2012; 5:pt6. [PMID: 23047921 DOI: 10.1126/scisignal.2003327] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Posttraumatic stress disorder (PTSD) is a syndrome of distress that develops after exposure to traumatic life experiences. Dysregulation of both the hypothalamic-pituitary-adrenal (HPA) axis and the locus caeruleus/norepinephrine-sympathetic nervous system (LC/NE-SNS) is associated with the pathophysiology of the disorder. Studies have demonstrated a neuroendocrine profile unique to adults with PTSD, with centrally elevated corticotropin-releasing hormone (CRH), low cortisol in the periphery, and elevated catecholamines. Traumatic stress experiences in early life are strong predisposing factors for later PTSD development. In addition, early life stress programs the developing brain to overreact to future stressors. In children and adolescents involved in motor vehicle accidents, we found that high evening salivary cortisol and morning serum interleukin 6 concentrations were predictive of PTSD development 6 months later. We demonstrated a progressive divergence of the HPA and LC/NE-SNS axes of the stress system, which may be part of the pathophysiologic mechanism responsible for PTSD maintenance. An initial elevation of cortisol in the aftermath of the trauma, followed by a gradual normalization and finally low cortisol secretion, together with a gradual elevation of catecholamines over time, may represent the natural history of neuroendocrine changes in pediatric PTSD. Thus, the low cortisol concentrations found in adults with PTSD may reflect prior trauma and might represent a biologic vulnerability factor for later PTSD development.
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Affiliation(s)
- Panagiota Pervanidou
- Unit of Developmental and Behavioral Pediatrics, First Department of Pediatrics, University of Athens Medical School, Aghia Sophia Children's Hospital, 115 27 Athens, Greece.
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Carrion VG, Kletter H. Posttraumatic stress disorder: shifting toward a developmental framework. Child Adolesc Psychiatr Clin N Am 2012; 21:573-91. [PMID: 22800995 DOI: 10.1016/j.chc.2012.05.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article reviews the current classification of posttraumatic stress disorder and its limitations when applied to youth. Distinctions are made between single-event and multiple-event traumas. Diagnosis, neurobiology, treatment development, and treatment outcomes are presented. A summary of current empirical interventions is provided. The authors present implications for future research and for clinical practice.
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Affiliation(s)
- Victor G Carrion
- Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, Stanford School of Medicine, Stanford University, 401 Quarry Road, Stanford, CA 94305, USA.
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Grace PJ, Willis DG. Nursing responsibilities and social justice: An analysis in support of disciplinary goals. Nurs Outlook 2012; 60:198-207. [DOI: 10.1016/j.outlook.2011.11.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Revised: 11/14/2011] [Accepted: 11/22/2011] [Indexed: 11/25/2022]
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Markowitsch HJ, Staniloiu A. The impairment of recollection in functional amnesic states. Cortex 2012; 49:1494-510. [PMID: 22824728 DOI: 10.1016/j.cortex.2012.05.020] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Revised: 05/09/2012] [Accepted: 06/08/2012] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Functional amnesia refers to various forms of amnesia, which have no direct organic brain basis. Psychological stress and trauma were etiologically linked to its development across various cultures. METHODS We have studied several patients with functional amnesia, employing neuropsychological and neuroimaging methods. Herein we provide a review of the current understanding of the phenomenology, neuropsychology and neurobiology of functional amnesia, which we illustrate by reference to five own case descriptions and other cases presented in the literature. RESULTS Functional amnesia is mostly of retrograde nature and presents in the form of a memory blockade or repression to recollect episodic-autobiographical events, which may cover the whole past life. Sometimes, the recollection impairment is localized to certain time epochs. In comparison to functional retrograde amnesia, functional isolated anterograde amnesia is much rarer and data on its neurobiology are scant. In patients with functional amnesia with pronounced retrograde episodic-autobiographical memory impairments, we identified changes in brain metabolism, above all reductions in the temporo-frontal regions of the right hemisphere. Recently, even subtle structural changes in the white matter of the (right) frontal cortex were described in functional retrograde amnesia by other researchers. CONCLUSIONS The disruption in recollection in functional amnesia is often accompanied by changes in personality dimensions, pertaining to cognition (self-related processing, theory of mind), autonoetic consciousness and affectivity. This suggests that functional amnesia is a multifaceted condition. We hypothesize that the recollection deficit in functional retrograde amnesia primarily reflects a desynchronization between a frontal lobe system, important for autonoetic consciousness, and a temporo-amygdalar system, important for evaluation and emotions. Despite assumptions that functional amnesia can always be reversed, several cases of functional amnesia were found to follow a chronic course, suggesting a need for longitudinal prospective studies to quantify possible global cognitive deterioration over time and its neural underpinnings.
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Shin SH, Miller DP. A longitudinal examination of childhood maltreatment and adolescent obesity: results from the National Longitudinal Study of Adolescent Health (AddHealth) Study. CHILD ABUSE & NEGLECT 2012; 36:84-94. [PMID: 22398304 DOI: 10.1016/j.chiabu.2011.08.007] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2011] [Revised: 08/02/2011] [Accepted: 08/13/2011] [Indexed: 05/22/2023]
Abstract
OBJECTIVES We sought to explore the association between childhood maltreatment (e.g., neglect, physical and sexual abuse) and longitudinal growth trajectories of body mass index (BMI) from adolescence to young adulthood. METHODS We used latent curve modeling to examine data from the National Longitudinal Study of Adolescent Health (N=8,471), pooling years 1995-2008. Relative weight was indicated by BMI. RESULTS Children who experienced neglect had a faster average rate of BMI growth over time compared to children who experienced no childhood maltreatment. In addition, the co-occurrence of childhood neglect and physical abuse was related to increased levels of BMI at baseline, even after adjustment for 14 separate child and parental demographic and psychosocial characteristics. Parental obesity and education, child birth place, and family income were also associated with both baseline BMI and the rate of change in BMI over time. CONCLUSION Childhood neglect plays a role in the development of adolescent obesity. Future research should examine potential mediators or moderators of the longitudinal relation between childhood neglect and adolescent and young adult obesity including impulsivity, depression, and compulsive eating behavior.
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Affiliation(s)
- Sunny Hyucksun Shin
- Boston University, School of Social Work, 264 Bay State Road, Boston, MA 02215, USA
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