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Zhou JJ, Zhou S. Childhood Interpersonal Trauma and Depression of Middle-Aged and Older Adults in China: The Mediation Effect of Social Integration. J Aging Health 2024; 36:424-435. [PMID: 37615396 DOI: 10.1177/08982643231197081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
Objectives: This study investigates the associations between five types of childhood interpersonal trauma (CIT) and depression in mid-later life, as well as the mediation roles of social integration in the associations. Methods: Two waves of data from a nationally representative survey in China were used, with participants aged 45 years and older (N = 14,180). Measures of CIT included physical abuse, physical neglect, emotional neglect, bullying victimization, and exposure to interparental violence. Binary logistic regression and Karlson-Holm-Breen mediation analysis were used as statistical methods. Results: People who were bullied, physically abused, and witnessed interparental violence during childhood were more likely to develop depression in mid-later years. The associations between CIT and depression were mediated by satisfaction with marriage, satisfaction with children, and perceived social support. Discussion: Although CIT elevates the risk of depression in later life, effective interventions that strengthen integration across family and social domains could benefit mental health.
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Affiliation(s)
- Jia-Jia Zhou
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Kong Hong
- Research Centre for Gerontology and Family Studies, The Hong Kong Polytechnic University, Hung Hom, Kong Hong
| | - Shuai Zhou
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Kong Hong
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2
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Alpheis S, Sinke C, Burek J, Krüger THC, Altenmüller E, Scholz DS. Stress in Musicians with and Without Focal Dystonia Is Not Reflected in Limbic Circuit Activation. Mov Disord 2024. [PMID: 39077793 DOI: 10.1002/mds.29941] [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: 04/06/2024] [Revised: 06/11/2024] [Accepted: 07/08/2024] [Indexed: 07/31/2024] Open
Abstract
BACKGROUND Musicians' dystonia (MD) is a movement disorder with several established risk factors, but the exact pathophysiology remains unknown. Recent research suggests dysfunction in sensory-motor, basal ganglia, cerebellar, and limbic loops as potential causes. Adverse childhood experiences are also considered risk factors. OBJECTIVE This study aimed to investigate whether MD patients have experienced more childhood trauma, leading to increased stress reactivity and neural vulnerability to movement disorders. METHODS Using functional magnetic resonance imaging and the Montreal Imaging Stress Task, 40 MD patients were compared with 39 healthy musicians (HMs). Whole-brain analysis and regions of interest analysis were performed. Parameter estimates and subjective stress levels were compared between groups and correlated with the Childhood Trauma Questionnaire. RESULTS MD patients reported significantly higher childhood trauma scores than healthy control subjects, but they did not differ in their subjective stress experiences. Stress-related activity of limbic areas was neither found in the whole sample nor between the two groups. Instead, increased activity of visual association and temporal areas was observed, but this activation did not differ between patients and HMs. However, patients showed a tendency toward reduced precuneus activity under stress. Adverse childhood experiences were negatively correlated with precuneus, thalamus, and substantia nigra activity across all participants. CONCLUSIONS Overall, MD patients and HMs had similar subjective and neurological reactions to stress but differed in childhood trauma experiences and precuneus activity under stress. Further research about the functional connectivity between precuneus, cerebellum, thalamus, and basal ganglia in musicians is needed. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Stine Alpheis
- Institute of Music Physiology and Musicians' Medicine, Hannover University of Music, Drama and Media, Hannover, Germany
- Department of Musicians' Health, University of Music Lübeck, Lübeck, Germany
- Institute of Medical Psychology, University of Lübeck, Lübeck, Germany
| | - Christopher Sinke
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | | | - Tillmann H C Krüger
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Eckart Altenmüller
- Institute of Music Physiology and Musicians' Medicine, Hannover University of Music, Drama and Media, Hannover, Germany
| | - Daniel S Scholz
- Department of Musicians' Health, University of Music Lübeck, Lübeck, Germany
- Institute of Medical Psychology, University of Lübeck, Lübeck, Germany
- Department of Psychology, University of Lübeck, Lübeck, Germany
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3
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Sheppard M, Rasgado-Toledo J, Duncan N, Elliott R, Garza-Villarreal EA, Muhlert N. Noradrenergic Alterations Associated with Early Life Stress. Neurosci Biobehav Rev 2024:105832. [PMID: 39084582 DOI: 10.1016/j.neubiorev.2024.105832] [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: 05/30/2024] [Revised: 07/14/2024] [Accepted: 07/27/2024] [Indexed: 08/02/2024]
Abstract
Significant stress in childhood or adolescence is linked to both structural and functional changes in the brain in human and analogous animal models. In addition, neuromodulators, such as noradrenaline (NA), show life-long alterations in response to these early life stressors, which may impact upon the sensitivity and time course of key adrenergic activities, such as rapid autonomic stress responses (the 'fight or flight response'). The locus-coeruleus noradrenergic (LC-NA) network, a key stress-responsive network in the brain, displays numerous changes in response to significant early- life stress. Here, we review the relationship between NA and the neurobiological changes associated with early life stress and set out future lines of research that can illuminate how brain circuits and circulating neurotransmitters adapt in response to childhood stressors.
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Affiliation(s)
- Megan Sheppard
- Division of Psychology, Communication and Human Neuroscience, The University of Manchester, Manchester, UK.
| | - Jalil Rasgado-Toledo
- Institute of Neurobiology, Universidad Nacional de México campus Juriquilla, Queretaro, Mexico
| | - Niall Duncan
- Graduate Institute of Mind, Brain and Consciousness, Taipei Medical University, Taiwan
| | - Rebecca Elliott
- Division of Psychology and Mental Health, University of Manchester, Manchester UK
| | | | - Nils Muhlert
- Division of Psychology, Communication and Human Neuroscience, The University of Manchester, Manchester, UK
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4
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Chen J, Cheng X, Wang Q, Wang R, Zhang J, Liu J. Childhood maltreatment predicts poor sleep quality in Chinese adults: The influence of coping style tendencies. J Affect Disord 2024; 363:366-372. [PMID: 39029677 DOI: 10.1016/j.jad.2024.07.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 06/29/2024] [Accepted: 07/16/2024] [Indexed: 07/21/2024]
Abstract
BACKGROUND This longitudinal study assessed the prospective link between childhood maltreatment and sleep quality in adulthood, with a specific focus on examining whether different coping style tendencies influence these associations. METHODS The baseline sample included 1600 adult participants, with 1140 participants successfully followed up 5 years later. The key variables were measured using the Childhood Trauma Questionnaire (CTQ), Simplified Coping Style Questionnaire (SCSQ), and Pittsburgh Sleep Quality Index (PSQI). Generalized linear mixed models were employed to estimate unstandardized β estimates and 95 % confidence intervals (95%CIs). Structural equation modeling was used to test the mediation model. RESULTS Individuals reported childhood maltreatment at baseline were at an increased risk for sleep disturbances at follow-up. Childhood maltreatment negatively predicted the baseline coping style tendency (β = -0.29, P < 0.001), the baseline coping style tendencies negatively predicted the follow-up sleep quality (β = -0.10, P < 0.001), and childhood maltreatment positively predicted the follow-up sleep quality (β = 0.42, P < 0.01). The mediating effect of baseline coping style tendencies between childhood maltreatment and the follow-up sleep quality was significant, with an effect value of 0.03. LIMITATIONS First, the sample was from a single province (Shandong), which limits the generalizability of the findings. Second, recall bias was unavoidable in this adult sample study. CONCLUSIONS Developing positive coping strategies is an important way to reduce the risk of sleep problems in adults with a history of childhood maltreatment.
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Affiliation(s)
- Jie Chen
- Shandong Mental Health Center, Shandong University, Jinan, China
| | - Xiaojing Cheng
- Institute of Mental Health, Occupational Diseases Hospital of Shandong First Medical University, Jinan, China
| | - Qian Wang
- Institute of Mental Health, Occupational Diseases Hospital of Shandong First Medical University, Jinan, China
| | - Ruzhan Wang
- Shandong Mental Health Center, Shandong University, Jinan, China
| | - Jingxuan Zhang
- Shandong Mental Health Center, Shandong University, Jinan, China.
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5
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Stevens SK, Boley R, Pollack M, Hobfoll S, Shankman S, Pinkerton L, Valdespino-Hayden Z, Glover AC, Kaufman M, Dowd S, Zalta AK. The influence of neuropeptide Y (NPY) on the relationship between emotion regulation and mood-related pathology in survivors of childhood interpersonal trauma. J Affect Disord 2024; 362:258-262. [PMID: 38971192 DOI: 10.1016/j.jad.2024.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 06/04/2024] [Accepted: 07/03/2024] [Indexed: 07/08/2024]
Abstract
Neuropeptide Y (NPY) is a 36-amino acid peptide that is widely expressed throughout the limbic system. Recent evidence has highlighted NPY as a marker of resilience to posttraumatic psychopathology, which may be due to its association with neural regions involved with emotion regulation. This study examined whether plasma NPY levels moderated the relationship between emotion regulation and psychopathology in a sample of adult survivors of childhood interpersonal trauma, a population known to be at high risk for psychopathology. Adults exposed to an interpersonal criterion A trauma during childhood (N = 54) were recruited from an urban population at a midwestern medical center and completed a baseline study visit as part of a larger clinical trial. Participants gave a blood sample in order to assess circulating levels of NPY and answered questions related to emotion regulation and mood-related pathology. Results of a moderated multiple regression showed that the overall model was significant R2 = 0.26, F (5, 48) = 3.46, p < .01. Difficulties in emotion regulation was significantly predictive of psychopathology (unstandardized B = 0.032, p < .01), and this relationship was significantly moderated by levels of NPY (unstandardized B = -0.001, p < .05) such that the relationship between emotion regulation and psychopathology was weaker for those with higher levels of NPY. Results suggest that higher levels of NPY may lessen the association between emotion regulation and posttraumatic psychopathology in survivors of childhood interpersonal trauma. Further investigation of the contribution of NPY to psychopathology in this population is warranted. NCT: 02279290.
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Affiliation(s)
- Sarah K Stevens
- Department of Psychological Science, University of California, Irvine, Irvine, CA, United States of America
| | - Randy Boley
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States of America; Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Mark Pollack
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States of America
| | - Stevan Hobfoll
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States of America; STAR: Stress, Anxiety and Resilience Consultants, Sandy, UT, United States of America
| | - Stewart Shankman
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, United States of America
| | - Linzy Pinkerton
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States of America; Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, United States of America
| | - Zerbrina Valdespino-Hayden
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States of America; VA North Texas Health Care System, Fort Worth, TX, United States of America
| | - Angela C Glover
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States of America; Psychology Department, Fordham University, Bronx, NY, United States of America
| | - Michelle Kaufman
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States of America; Department of Psychology, The University of Memphis, Memphis, TN, United States of America
| | - Sheila Dowd
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States of America
| | - Alyson K Zalta
- Department of Psychological Science, University of California, Irvine, Irvine, CA, United States of America; Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States of America.
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Capuia D, da Cruz M, Masseca A, Marques E, Leite P, Mangus AR, Webb EK, Ravichandran C, Ressler KJ, Moreland-Capuia A. Trauma-informed systems change training has transcultural, transcontinental transformative healing power: An analysis of leaders in the United States and Angola, Africa. J Trauma Stress 2024. [PMID: 38837449 DOI: 10.1002/jts.23062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 05/02/2024] [Accepted: 05/02/2024] [Indexed: 06/07/2024]
Abstract
The Institute for Trauma-Informed Systems Change (ITISC) facilitated a 2-day, 12-hr trauma-informed workshop, delivered virtually, using the Training for Change curriculum. The workshop took place in Portuguese in September 2021 with a group of Angolan leaders (N = 51) and in May 2022, in English, with neonatal intensive care unit (NICU) workers from the United States (N = 73). Surveys were administered before (Time [T] 0) and after the workshop (T1) and consisted of demographic questions and the Survey for Trauma-Informed Systems Change (STISC), which assesses system-wide knowledge and attitudes about trauma-informed systems change and the intersection of culture, safety, and acceptance in the workplace. At T1, 18 (35.3%) participants in the Angolan leaders' group and 46 (63.0%) in the NICU group completed the surveys. Mean scores on the STISC Self-Assessed Knowledge and Attitudes subscale and STISC System-Wide Knowledge and Attitudes subscale increased significantly in both groups after the training. Effect sizes were large for self-assessed knowledge and attitudes, Angolan leaders: d = 1.11, NICU: d = 1.97, and small-to-medium for system-wide knowledge and attitudes, Angolan leaders: d = 0.52, NICU: d = 0.38. Limitations include the relatively small sample size and low participation rates for survey responses. Future research should examine the efficacy of the curriculum in larger samples that include individuals from diverse professions and additional countries. Together, the findings provide initial support that this training can be directly translated and implemented on a global scale.
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Affiliation(s)
- Daniel Capuia
- Angola, Africa Institute for Trauma Informed Systems Change (ITISC), Cacuaco, Angola
| | - Maria da Cruz
- Angola, Africa Institute for Trauma Informed Systems Change (ITISC), Cacuaco, Angola
| | - Ana Masseca
- Angola, Africa Institute for Trauma Informed Systems Change (ITISC), Cacuaco, Angola
| | - Engracia Marques
- Angola, Africa Institute for Trauma Informed Systems Change (ITISC), Cacuaco, Angola
| | - Paulo Leite
- Angola, Africa Institute for Trauma Informed Systems Change (ITISC), Cacuaco, Angola
| | - Alexandra R Mangus
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, Massachusetts, USA
| | - E Kate Webb
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Caitlin Ravichandran
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
- Lurie Center for Autism, Lexington, Massachusetts, USA
| | - Kerry J Ressler
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Alisha Moreland-Capuia
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
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Kranzler HR, Davis CN, Feinn R, Jinwala Z, Khan Y, Oikonomou A, Silva-Lopez D, Burton I, Dixon M, Milone J, Ramirez S, Shifman N, Levey D, Gelernter J, Hartwell EE, Kember RL. Gene × environment effects and mediation involving adverse childhood events, mood and anxiety disorders, and substance dependence. Nat Hum Behav 2024:10.1038/s41562-024-01885-w. [PMID: 38834750 DOI: 10.1038/s41562-024-01885-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 04/10/2024] [Indexed: 06/06/2024]
Abstract
Adverse childhood events (ACEs) contribute to the development of mood and anxiety disorders and substance dependence. However, the extent to which these effects are direct or indirect and whether genetic risk moderates them is unclear. We examined associations among ACEs, mood/anxiety disorders and substance dependence in 12,668 individuals (44.9% female, 42.5% African American/Black, 42.1% European American/white). Using latent variables for each phenotype, we modelled direct and indirect associations of ACEs with substance dependence, mediated by mood/anxiety disorders (the forward or 'self-medication' model) and of ACEs with mood/anxiety disorders, mediated by substance dependence (the reverse or 'substance-induced' model). In a subsample, we tested polygenic scores for the substance dependence and mood/anxiety disorder factors as moderators in the mediation models. Although there were significant indirect paths in both directions, mediation by mood/anxiety disorders (the forward model) was greater than that by substance dependence (the reverse model). Greater genetic risk for substance use disorders was associated with a weaker direct association between ACEs and substance dependence in both ancestry groups (reflecting gene × environment interactions) and a weaker indirect association in European-ancestry individuals (reflecting moderated mediation). We found greater evidence that substance dependence reflects self-medication of mood/anxiety disorders than that mood/anxiety disorders are substance induced. Among individuals at higher genetic risk for substance dependence, ACEs were less associated with that outcome. Following exposure to ACEs, multiple pathways appear to underlie the associations between mood/anxiety disorders and substance dependence. Specification of these pathways could inform individually targeted prevention and treatment approaches.
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Affiliation(s)
- Henry R Kranzler
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
- Mental Illness Research, Education and Clinical Center, Crescenz VAMC, Philadelphia, PA, USA.
| | - Christal N Davis
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Mental Illness Research, Education and Clinical Center, Crescenz VAMC, Philadelphia, PA, USA
| | - Richard Feinn
- Department of Medical Sciences, Frank H. Netter School of Medicine at Quinnipiac University, North Haven, CT, USA
| | - Zeal Jinwala
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Mental Illness Research, Education and Clinical Center, Crescenz VAMC, Philadelphia, PA, USA
| | - Yousef Khan
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Ariadni Oikonomou
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Damaris Silva-Lopez
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Isabel Burton
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Morgan Dixon
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Jackson Milone
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Sarah Ramirez
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Naomi Shifman
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Daniel Levey
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- VA CT Healthcare Center, West Haven, CT, USA
| | - Joel Gelernter
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Departments of Genetics and Neurobiology, Yale University School of Medicine, New Haven, CT, USA
- VA CT Healthcare Center, West Haven, CT, USA
| | - Emily E Hartwell
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Mental Illness Research, Education and Clinical Center, Crescenz VAMC, Philadelphia, PA, USA
| | - Rachel L Kember
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Mental Illness Research, Education and Clinical Center, Crescenz VAMC, Philadelphia, PA, USA
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8
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Eiberg M. Cognitive Functioning of Children in Out-of-Home Care. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2024; 17:217-230. [PMID: 38938961 PMCID: PMC11199474 DOI: 10.1007/s40653-023-00580-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/30/2023] [Indexed: 06/29/2024]
Abstract
PURPOSE Most children who enter out-of-home care (OHC) have been subjected to prolonged maltreatment. Maltreatment potentially contributes to a cumulative deficit in neurocognitive maturation and development that is likely to proceed with the child's placement into OHC and persist throughout adulthood. From the theoretical perspective of how maltreatment may affect the developing brain, this study examines the IQ and executive function of children placed in OHC on standardized, norm-referenced measures. Furthermore, the study investigates the prevalence of serious cognitive delays, defined by scores in the clinical range on the administered instruments. METHODS The study included 153 children in foster care (66% female), aged 6-15 (M = 10.5, SD = 2.1). Independent two-sample t-tests were run to test for significant differences between the sample and the norm population on the applied neuropsychological measures. RESULTS The results showed that discrepancies in cognitive development were global in scope, with the children lagging significantly behind the norm population on all applied measures with discrepancies ranging from 0.61 to 2.10 SD (p < .001). Also, serious developmental delays in all cognitive domains were vastly overrepresented in the sample ranging from 11.3% (IQ) to 66.0% (executive function). CONCLUSIONS The results document a very high prevalence of cognitive deficits and delays among the children in the sample. The implications of identifying the neurocognitive effects of maltreatment in the practices of the child welfare system are discussed in terms of developing suitable assessment and intervention strategies.
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Affiliation(s)
- Misja Eiberg
- VIVE - The Danish Center for Social Science Research, Herluf Trolles gade 11, 1052 , Copenhagen, Denmark
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9
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Tapia G, Teysseyre J, Bréhonnet R, Baud A, Gauvreau G, Gray M, Oprescu F. Childhood trauma and alcohol misuse in college students: The moderating role of minimization. CHILD ABUSE & NEGLECT 2024; 152:106749. [PMID: 38581770 DOI: 10.1016/j.chiabu.2024.106749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/16/2024] [Accepted: 03/11/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND History of childhood trauma as a risk factor for alcohol misuse in early adulthood is very well documented. Given the associations between childhood trauma and alcohol misuse, more work is needed to understand the factors that influence this relationship. OBJECTIVE The purpose of this study was to examine the relationship between childhood trauma, minimization of such events and alcohol misuse in a French college student sample. PARTICIPANTS AND SETTING A convenience sampling method was used to recruit students from several colleges located in Western France. The data set included 1180 records with complete responses. METHODS This study employed a cross-sectional online survey. Data collection instruments included the Childhood Trauma Questionnaire Short-Form (CTQ-SF) and the Alcohol Use Disorders Identification Test (AUDIT). RESULTS The strength of the association between CTQ score and AUDIT total score was increased by minimization score (β = 0.122, p = .07). This result suggests that under-reporting childhood trauma experiences tends to increase the impact of such events on alcohol misuse. CONCLUSION These findings suggest that a tendency to minimize threatening childhood events may specifically be related to increased risk of greater alcohol misuse among college students. Therefore, it may be important for clinician to assess minimization of early events in students with a history of childhood trauma.
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Affiliation(s)
| | | | - Rémi Bréhonnet
- Groupe Excelia La Rochelle, 17024 La Rochelle Cedex 1, France
| | - Alexandra Baud
- Groupe Excelia La Rochelle, 17024 La Rochelle Cedex 1, France
| | | | - Marion Gray
- Faculty of Health, Engineering and Sciences, University of Southern Queensland, Ipswich, Australia
| | - Florin Oprescu
- Cluster for Health Improvement, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Maroochydore, Australia
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10
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Bailey C, Shaw J, Harris A. Adolescents and sexual assault: A critical integrative review. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2024; 73:337-359. [PMID: 38303610 DOI: 10.1002/ajcp.12740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 12/19/2023] [Accepted: 01/03/2024] [Indexed: 02/03/2024]
Abstract
Adolescents are sexually assaulted at remarkably high rates. Adolescents are also unique given the specific dynamics of adolescent sexual assault, their current stage in human development, their limited legal standing and rights, and their experiences navigating postassault services and resources. While literature exists within each of these domains, it is somewhat disconnected and overlooks how adolescents are often relegated to the margins in research and practice. The purpose of this integrative review is to (1) provide a more complete understanding of adolescent sexual assault and survivors' nuanced needs; (2) frame adolescent survivors as a too-often-overlooked oppressed group that researchers and responders must consider and center in their work, lest contribute to their further marginalization; and (3) inspire and orient social justice-minded scholar activists to various action steps to take to center and prioritize adolescents in research and practice. Through our intersectional feminist approach, we offer specific action steps for social justice-minded scholar activists to recenter adolescents in their research and practice.
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Affiliation(s)
- Caroline Bailey
- Department of Psychology, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Jessica Shaw
- Department of Psychology, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Abril Harris
- School of Social Work, University of Washington, Seattle, Washington, USA
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11
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Peterson CS, Zhu Y, Germine LT, Dunn EC. Associations Between Childhood Trauma Characteristics and Theory of Mind in Adults: Results From a Large, Diverse Sample. Child Psychiatry Hum Dev 2024; 55:719-730. [PMID: 36168019 PMCID: PMC10942752 DOI: 10.1007/s10578-022-01442-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/07/2022] [Indexed: 01/25/2023]
Abstract
Theory of mind (ToM) is an essential social cognitive process encompassing abilities to represent and understand others' mental states. Although previous reports linked childhood trauma to social cognitive deficits, how characteristics of trauma exposure, such as subtype or timing, affect ToM remains unaddressed. Using data from a diverse adult sample (n = 2200), we tested whether exposure type and first exposure timing of common childhood trauma associated with ToM. Neither interpersonal loss (β = - 0.25, p = 0.170, [- 0.61, 0.10]) nor child maltreatment (β = - 0.21, p = 0.369, [- 0.66, 0.25]) was associated with lower ToM. There was no effect of timing of age at which trauma was experienced (F = 2.19, p = 0.087). While we did not identify age-dependent effects, future studies should examine links between timing or chronicity of prospectively reported childhood trauma and social cognition. Understanding of how childhood experiences shape ToM could reveal mechanisms underlying social cognition development and inform prevention efforts.
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Affiliation(s)
- Claire S Peterson
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA.
- Medical Scientist Training Program, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Yiwen Zhu
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Laura T Germine
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Erin C Dunn
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Center On the Developing Child, Harvard University, Cambridge, MA, USA
- Henry and Alison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, USA
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12
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Duffy KA, Sammel MD, Johnson RL, Morrison KE, Bale TL, Epperson CN. Sex Differences in Stress-Induced Cortisol Response Among Infants of Mothers Exposed to Childhood Adversity. Biol Psychiatry 2024:S0006-3223(24)01350-7. [PMID: 38821195 DOI: 10.1016/j.biopsych.2024.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 05/13/2024] [Accepted: 05/17/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) increase risk for mental illness in women and their children, and dysregulation of the hypothalamic-pituitary-adrenal axis may play a role. The impact of ACEs on the hypothalamic-pituitary-adrenal axis may be strongest when ACEs occur prepubertally and in people who are exposed to abuse ACEs. METHODS To test this, we measured salivary cortisol in 96 mother-infant dyads while mothers were separated from their infants, who were experiencing a laboratory stressor. Mothers completed the Adverse Childhood Experiences Questionnaire; ACEs that occurred prepubertally (pACEs) were measured, and mother-infant dyads were grouped based on maternal pACE history as follows: no pACEs, ≥1 pACEs with abuse, or ≥1 pACEs but no abuse. RESULTS Mothers with ≥1 pACEs exhibited decreases in cortisol (relative to preinfant stressor), which differed significantly from the cortisol increase experienced by mothers with no pACEs, regardless of abuse presence (p = .001) or absence (p = .002). These pACE groups did not differ from one another (p = .929). Significant sex differences in infant cortisol were observed in infants of mothers with ≥1 pACEs (regardless of abuse) but not in infants of mothers with no pACEs. When mothers had experienced ≥1 pACEs, males showed decreases in cortisol in response to a stressor whereas females demonstrated increases, and males and females differed significantly when their mothers had ≥1 pACEs with (p = .025) and without (p = .032) abuse. CONCLUSIONS Regardless of maternal exposure to childhood abuse, in response to a stressor, pACEs were associated with lower cortisol response in mothers and sex differences in 6-month-old infants, with males showing a lower cortisol response than females.
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Affiliation(s)
- Korrina A Duffy
- Department of Psychiatry, University of Colorado School of Medicine Anschutz, Medical Campus, Aurora, Colorado
| | - Mary D Sammel
- Department of Psychiatry, University of Colorado School of Medicine Anschutz, Medical Campus, Aurora, Colorado; Department of Biostatistics and Informatics, University of Colorado School of Public Health, Anschutz Medical Campus, Aurora, Colorado
| | - Rachel L Johnson
- Department of Biostatistics and Informatics, University of Colorado School of Public Health, Anschutz Medical Campus, Aurora, Colorado
| | - Kathleen E Morrison
- Department of Psychology, West Virginia University, Morgantown, West Virginia
| | - Tracy L Bale
- Department of Psychiatry, University of Colorado School of Medicine Anschutz, Medical Campus, Aurora, Colorado
| | - C Neill Epperson
- Department of Psychiatry, University of Colorado School of Medicine Anschutz, Medical Campus, Aurora, Colorado; Department of Family Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado.
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13
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Chang YW, Buerke M, Galfalvy H, Szanto K. Childhood trauma is associated with early-onset but not late-onset suicidal behavior in late-life depression. Int Psychogeriatr 2024; 36:371-384. [PMID: 37642013 PMCID: PMC10902201 DOI: 10.1017/s1041610223000662] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
OBJECTIVES To examine the relationship between childhood traumatic experiences and early and late-onset suicidal behavior among depressed older adults. DESIGN Cross-sectional study. SETTING Inpatient and outpatient psychiatric services in Pennsylvania. PARTICIPANTS Our sample included 224 adults aged 50+ (M ± SD = 62.5 ± 7.4) recruited into three depressed groups: (1) 84 suicide attempters, (2) 44 suicide ideators, and (3) 58 non-suicidal comparisons, and a non-psychiatric healthy comparison group (N = 38). MEASUREMENTS The Childhood Trauma Questionnaire measured experiences of childhood trauma such as emotional abuse, physical abuse, emotional neglect, physical neglect, and sexual abuse. RESULTS Attempters were separated into early- and late-onset based on age of first attempt using a statistical algorithm that identified a cutoff age of 30 years old. Overall, we found group differences in emotional and physical abuse and neglect in both genders and sexual abuse in females, but not in males. Early-onset attempters experienced more childhood emotional abuse and neglect than late-onset attempters and were more likely to have experienced multiple forms of abuse. They also experienced more emotional abuse and neglect than all comparison groups. Consistently, early-onset attempters more often met criteria for current or lifetime PTSD relative to late-onset attempters and most comparison groups. Late-onset attempters had similar levels of childhood trauma as other depressed groups. CONCLUSIONS Our study reaffirms that there are distinct pathways to suicidal behavior in older adults based on their age of first suicide attempt and that trauma experienced in childhood has long-lasting emotional and behavioral consequences, even into late life.
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Affiliation(s)
- Ya-Wen Chang
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Morgan Buerke
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Hanga Galfalvy
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA
| | - Katalin Szanto
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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14
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Huang Z, Bai H, Yang Z, Zhang J, Wang P, Wang X, Zhang L. Bridging childhood to adulthood: the impact of early life stress on acute stress responses. Front Psychiatry 2024; 15:1391653. [PMID: 38699445 PMCID: PMC11064211 DOI: 10.3389/fpsyt.2024.1391653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 03/28/2024] [Indexed: 05/05/2024] Open
Abstract
Background Childhood trauma exerts enduring impacts on the physical and psychological well-being of individuals in adulthood, influencing their daily functioning. This study aims to investigate the impact of childhood trauma on stress recovery in adults, concentrating on heart rate variations during acute stress exposure. Methods A cohort of 126 participants completed the Childhood Trauma Questionnaire (CTQ) and underwent the Trier Social Stress Test (TSST) to elicit acute stress, with continuous heart rate (HR) monitoring for stress recovery assessment. Results The results revealed a negative correlation between childhood trauma and stress recovery, prominently observed in instances of emotional neglect and abuse. Individuals with heightened childhood trauma exhibited protracted stress recovery following acute stress exposure. Conclusion Childhood traumatic experiences were associated with the recovery from acute stress, as indicated by heart rate indices. These findings contribute to the foundational framework for psychological interventions tailored to individuals with a history of childhood trauma.
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Affiliation(s)
- Zheng Huang
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Huizhi Bai
- Key Laboratory of Modern Teaching Technology, Ministry of Education, Shaanxi Normal University, Xi’an, China
| | - Ziyu Yang
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Jingyu Zhang
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Peishan Wang
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xiaoyu Wang
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Liang Zhang
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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15
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Lim L, Talozzi L, Howells H. Atypical brain structural connectivity and social cognition in childhood maltreatment and peer victimisation. BMC Psychiatry 2024; 24:287. [PMID: 38627646 PMCID: PMC11022413 DOI: 10.1186/s12888-024-05759-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 04/11/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Childhood maltreatment (CM) is associated with neurobiological aberrations and atypical social cognition. Few studies have examined the neural effects of another common early-life interpersonal stressor, namely peer victimisation (PV). This study examines the associations between tract aberrations and childhood interpersonal stress from caregivers (CM) and peers (PV), and explores how the observed tract alterations are in turn related to affective theory of mind (ToM). METHODS Data from 107 age-and gender-matched youths (34 CM [age = 19.9 ± 1.68; 36%male], 35 PV [age = 19.9 ± 1.65; 43%male], 38 comparison subjects [age = 20.0 ± 1.66; 42%male] were analysed using tractography and whole-brain tract-based spatial statistics (TBSS). RESULTS At the whole-brain level using TBSS, the CM group had higher fractional anisotropy (FA) than the PV and comparison groups in a cluster of predominantly limbic and corpus callosal pathways. Segmented tractography indicated the CM group had higher FA in right uncinate fasciculus compared to both groups. They also had smaller right anterior thalamic radiation (ATR) tract volume than the comparison group and higher left ATR FA than the PV group, with these metrics associated with higher emotional abuse and enhanced affective ToM within the CM group, respectively. The PV group had lower inferior fronto-occipital fasciculus FA than the other two groups, which was related to lower affective ToM within the PV group. CONCLUSION Findings suggest that exposure to early-life stress from caregivers and peers are differentially associated with alterations of neural pathways connecting the frontal, temporal and occipital cortices involved in cognitive and affective control, with possible links to their atypical social cognition.
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Affiliation(s)
- Lena Lim
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore.
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK.
| | - Lia Talozzi
- Neurology and Neurological Sciences, Stanford University, California, USA
| | - Henrietta Howells
- Laboratory of Motor Control, Department of Medical Biotechnology and Translational Medicine, University of Milan and Humanitas Research Hospital, Milan, Italy
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16
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Rosado N, McKenzie J, Charleston E, Ford-Paz RE. The Forensic Assessment for Immigration Relief (FAIR) clinic: A faculty-led, pediatric clinic model. J Forensic Leg Med 2024; 103:102685. [PMID: 38657334 DOI: 10.1016/j.jflm.2024.102685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 04/04/2024] [Accepted: 04/17/2024] [Indexed: 04/26/2024]
Abstract
Since 2019, the number of children apprehended by the United States Custom and Border Patrol at the southern border continues to increase. Many of these children are fleeing violence and extreme poverty and qualify for several forms of humanitarian relief. Trained pediatric health professionals have an essential role to play in documenting evidence to support their petitions. The goal of a forensic medical and psychological evaluation is to establish the facts related to the reported incident(s), provide forensic evidence to support these claims, and provide an expert opinion on the degree to which a finding correlates with the client's reports through a written affidavit. Research studies have demonstrated a significant increase in asylum grant rate for cases that include an evaluation. As demand for forensic evaluations has grown, multiple clinic models have emerged, including volunteer networks, student-led clinics, and faculty-led clinics. The Forensic Assessment for Immigration Relief (FAIR) Clinic offers a sustainable infrastructure while emphasizing the training of pediatric healthcare professionals on the conduct of trauma-informed, culturally attuned, and developmentally appropriate forensic evaluations. This paper outlines the year-long process of developing and launching a clinic specializing in pediatric forensic medical and psychological evaluations as a blueprint for replication.
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Affiliation(s)
- Norell Rosado
- Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E Chicago Ave, Box # 16, Chicago, IL, 60611, USA; Northwestern University Feinberg School of Medicine, 420 E Superior St, Chicago, IL, 60611, USA
| | - James McKenzie
- Meharry Medical College, 1005 Dr D.B. Todd Jr., Blvd, Nashville, TN, 37208, USA.
| | - Elizabeth Charleston
- Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E Chicago Ave, Box # 16, Chicago, IL, 60611, USA
| | - Rebecca E Ford-Paz
- Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E Chicago Ave, Box # 16, Chicago, IL, 60611, USA; Northwestern University Feinberg School of Medicine, 420 E Superior St, Chicago, IL, 60611, USA
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17
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Barreca J, Swiggum M. Trauma-Informed Care in Pediatric Physical Therapy as a Standard Precaution: The Time Is Here. Pediatr Phys Ther 2024; 36:278-284. [PMID: 38568276 DOI: 10.1097/pep.0000000000001095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
In this special communication, an overview of the research on trauma, resilience, and action items for the pediatric physical therapist (PT) is addressed. The experiences of early childhood, positive and negative, impact overall development and well-being throughout the lifespan. Childhood trauma can include exposure to abuse, neglect, violence, racism, or medical procedures. These adverse childhood experiences are associated with poor physical and mental health outcomes that can extend into adulthood and can appear in the pediatric rehabilitative realm as caregivers who become labeled noncompliant. Trauma is common and impacts all children; however, some populations, such as children with disabilities, have greater risk for experiencing adversity. An individual's trauma history is not always visible, necessitating a standard approach. Pediatric PTs must take an intentional approach to address the detrimental effects of trauma on those we serve. Many organizations recommend adopting trauma-informed care as the standard of care for all populations.
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Affiliation(s)
- Jessica Barreca
- Center for Interprofessional Education and Research (Dr Barreca), Saint Louis University, Saint Louis, Missouri; Doctor of Physical Therapy Program (Dr Swiggum), Wingate University, Wingate, North Carolina
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18
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Kamran Z, Kazi A. Association Between Harsh Disciplinary Methods and Child Functioning in Children Aged 7-14 Years in Punjab, Pakistan. JOURNAL OF INTERPERSONAL VIOLENCE 2024:8862605241239449. [PMID: 38504471 DOI: 10.1177/08862605241239449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
Despite having adverse physical and mental health outcomes, harsh disciplinary methods are commonly practiced all over the world. This study aims to measure the harsh disciplinary actions taken by parents and their association with child functioning in children, aged 7 to 14 years in Punjab, Pakistan. This study is based on secondary data obtained from the United Nations Children's Fund (UNICEF's) Multiple Indicator Cluster Survey, conducted in the Punjab province from 2017 to 2018. Parents/caregivers of 19,721 children were included in the analysis. Questionnaire-based interviews were conducted, and the data collection form included sociodemographic information, questions on different "Methods of Child Discipline" and the "Child functioning module." The data was analyzed using STATA 15.0. Multiple logistic regression analysis was conducted to calculate the adjusted odds ratio and 95% CI exploring the association between harsh disciplinary methods and child functioning. More than 50% of children were exposed to severe physical, psychological, and emotional disciplinary methods. Exposure to severe physical aggression was associated with increased difficulty in learning (2.60 [1.27, 5.31]), remembering (2.83 [1.47, 5.44]), controlling behavior (1.63 [1.21, 2.18]), anxiety (1.98 [1.25, 3.13]), depression (2.57 [1.57, 4.22]) and making friends (1.94 [1.01, 3.79]). Whereas moderate physical aggression and psychological aggression were associated with (1.48 [1.19, 1.84]) and 1.5 times (1.20, 1.84) increase in difficulty in controlling behavior, respectively. Nonviolent actions were associated with protective odds for self-care (0.33 [0.17, 0.65]), communication (0.51 [0.27, 0.96]), learning (0.56 [0.33, 0.95]), remembering (0.62 [0.39, 0.90]), concentration (0.50 [0.31, 0.80]), anxiety (0.60 [0.46, 0.79]) and depression (0.67 [0.49, 0.92]). Severe disciplinary methods are detrimental to the child's personal care, mental, social, emotional, and psychological well-being, whereas nonviolent actions are associated with positive child functioning. In a third-world country such as Pakistan, this topic is widely undiscovered and understudied, thus emphasizing the need for awareness and education of parents and healthcare providers.
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Affiliation(s)
- Zaibunnisa Kamran
- Medical College, Aga Khan University, Karachi, Pakistan
- Princess Nora Bent Abdullah Research Chair for Women Health, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Ambreen Kazi
- Princess Nora Bent Abdullah Research Chair for Women Health, King Saud University Medical City, Riyadh, Saudi Arabia
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19
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Setyorini S, Rahayu DS, Efastri SM, Pranoto H, Susilaningsih CY, Wijayanti W, Novitasari Z. 'Children's psychological well-being: a cornerstone for a healthier World's future'. J Public Health (Oxf) 2024; 46:e209-e210. [PMID: 37717954 DOI: 10.1093/pubmed/fdad185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 09/02/2023] [Indexed: 09/19/2023] Open
Affiliation(s)
- Setyorini Setyorini
- Departement of Guidance and Counseling, Faculty of Training and Education, Universitas Kristen Satya Wacana, Salatiga, Indonesia
| | - Dwi Sri Rahayu
- Department of Guidance and Counseling, Faculty of Training and Education, Universitas Katolik Widya Mandala Surabaya-Kampus Kota Madiun, Madiun, Indonesia
| | - Sean Marta Efastri
- Departement of Guidance and Counseling, Faculty of Training and Education, Universitas Lancang Kuning, Riau, Indonesia
| | - Hadi Pranoto
- Departement of Guidance and Counseling, Faculty of Training and Education, Universitas Muhammadiyah Metro, Lampung, Indonesia
| | - Chaterina Yeni Susilaningsih
- Department of Guidance and Counseling, Faculty of Training and Education, Universitas Katolik Widya Mandala Surabaya-Kampus Kota Madiun, Madiun, Indonesia
| | - Wenny Wijayanti
- Department of Guidance and Counseling, Faculty of Training and Education, Universitas Katolik Widya Mandala Surabaya-Kampus Kota Madiun, Madiun, Indonesia
| | - Zeti Novitasari
- Departmenet of Guidance and Counseling, Faculty of Training and Education, Universitas Nahdlatul Ulama Sunan Giri, Bojonegoro, Indonesia
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20
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Chen YJ, Lu ML, Chiu YH, Chen C, Santos VHJ, Goh KK. Linking childhood trauma to the psychopathology of schizophrenia: the role of oxytocin. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2024; 10:24. [PMID: 38388569 PMCID: PMC10883944 DOI: 10.1038/s41537-024-00433-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 12/31/2023] [Indexed: 02/24/2024]
Abstract
Childhood trauma has been linked to schizophrenia, but underlying biological mechanisms remain elusive. This study explored the potential role of plasma oxytocin as a mediator in the relationship between childhood trauma and the psychopathology of schizophrenia. 160 patients with schizophrenia and 80 age- and sex-matched healthy controls were assessed for childhood trauma experiences using the Childhood Trauma Questionnaire and structured interviews. Psychopathology was evaluated using the Positive and Negative Syndrome Scale and plasma oxytocin levels were measured. Results showed that patients with schizophrenia had lower oxytocin levels and higher childhood trauma scores than healthy controls. There was a significant correlation between childhood trauma scores and psychopathology, with plasma oxytocin levels being inversely associated with psychopathology, except for positive symptoms. Hierarchical regression analysis indicated that both childhood trauma scores and plasma oxytocin levels significantly predicted psychopathology. Plasma oxytocin levels partially mediated the relationship between childhood trauma and schizophrenia psychopathology. This study underscores the potential role of oxytocin in bridging the gap between childhood trauma and schizophrenia.
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Affiliation(s)
- Yuan-Jung Chen
- Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Mong-Liang Lu
- Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yi-Hang Chiu
- Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chenyi Chen
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan
- The Innovative and Translational Research Center of Brain Consciousness, Taipei Medical University, Taipei, Taiwan
| | - Vitor Hugo Jesus Santos
- Department of Psychiatry and Mental Health, Faculty of Health Sciences (FCS-UBI), Cova da Beira University Hospital Center, Covilhã, Portugal
| | - Kah Kheng Goh
- Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan.
- The Innovative and Translational Research Center of Brain Consciousness, Taipei Medical University, Taipei, Taiwan.
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21
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González-Alemañy E, Ostrosky F, Lozano A, Lujan A, Perez M, Castañeda D, Diaz K, Lara R, Sacristan E, Bobes MA. Brain structural change associated with Cognitive Behavioral Therapy in maltreated children. Brain Res 2024; 1825:148702. [PMID: 38070819 DOI: 10.1016/j.brainres.2023.148702] [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: 08/12/2023] [Revised: 11/30/2023] [Accepted: 12/01/2023] [Indexed: 01/28/2024]
Abstract
BACKGROUND Severely maltreatment child is a harmful social factor that can disrupt normal neurodevelopment. Two commonly reported effects of maltreatment are post-traumatic stress disorder (PTSD) symptoms and brain structural and functional alteration. While Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) is effectively used to reduce PTSD symptoms in maltreated children, yet, its impact on brain structural alterations has not been fully explored. This study investigated whether TF-CBT can attenuate alterations in brain structures associated with PTSD in middle childhood. METHODS The study evaluated the longitudinal effects of Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) on post-traumatic stress disorder (PTSD) symptoms and gray matter volume (GMV) in two groups of children under 12 years old: maltreated children (MC) and healthy non- maltreatmentd children (HC). Structural magnetic resonance images T1 were obtained before and after TF-CBT in the MC group, while the HC group was scanned twice within the same time interval. Voxel-based morphometry (VBM) was used to analyze GMV changes over time. RESULTS After TF-CBT, maltreated children showed significantly reduced PTSD symptoms. Furthermore, a significant group-by-time interaction effect was observed in certain areas of the Left Temporal, Left Occipital, and bilateral Frontal Cortex, the Basal Ganglia and Cerebellum. These interaction effects were driven by a GMV decrease in the MC group compared to the HC group. GMV changes can be predicted with clinical improvement in the left Middle Temporal gyrus, left Precuneus, and Cerebellum. CONCLUSIONS Our results suggest that TF-CBT intervention in very young maltreated children may have an effect on gray matter. This evidence demonstrates the importance of timely intervention when neuroplasticity mechanisms may be activated.
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Affiliation(s)
| | | | | | | | | | | | | | - Rafael Lara
- Centro Nacional de Investigación en Imagenología e instrumentación Médica (CI3M, Universidad Nacional Autónoma de México UNAM), México.
| | - Emilio Sacristan
- Centro Nacional de Investigación en Imagenología e instrumentación Médica (CI3M, Universidad Nacional Autónoma de México UNAM), México.
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22
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Cooper H, Jennings BJ, Kumari V, Willard AK, Bennetts RJ. The association between childhood trauma and emotion recognition is reduced or eliminated when controlling for alexithymia and psychopathy traits. Sci Rep 2024; 14:3413. [PMID: 38341493 PMCID: PMC10858958 DOI: 10.1038/s41598-024-53421-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 01/31/2024] [Indexed: 02/12/2024] Open
Abstract
Emotion recognition shows large inter-individual variability, and is substantially affected by childhood trauma as well as modality, emotion portrayed, and intensity. While research suggests childhood trauma influences emotion recognition, it is unclear whether this effect is consistent when controlling for interrelated individual differences. Further, the universality of the effects has not been explored, most studies have not examined differing modalities or intensities. This study examined childhood trauma's association with accuracy, when controlling for alexithymia and psychopathy traits, and if this varied across modality, emotion portrayed, and intensity. An adult sample (N = 122) completed childhood trauma, alexithymia, and psychopathy questionnaires and three emotion tasks: faces, voices, audio-visual. When investigating childhood trauma alone, there was a significant association with poorer accuracy when exploring modality, emotion portrayed, and intensity. When controlling for alexithymia and psychopathy, childhood trauma remained significant when exploring emotion portrayed, however, it was no longer significant when exploring modality and intensity. In fact, alexithymia was significant when exploring intensity. The effect sizes overall were small. Our findings suggest the importance of controlling for interrelated individual differences. Future research should explore more sensitive measures of emotion recognition, such as intensity ratings and sensitivity to intensity, to see if these follow accuracy findings.
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Affiliation(s)
- Holly Cooper
- Division of Psychology, College of Health, Medicine, and Life Sciences, Brunel University London, Uxbridge, UB8 3PH, UK.
| | - Ben J Jennings
- Division of Psychology, College of Health, Medicine, and Life Sciences, Brunel University London, Uxbridge, UB8 3PH, UK
| | - Veena Kumari
- Division of Psychology, College of Health, Medicine, and Life Sciences, Brunel University London, Uxbridge, UB8 3PH, UK
| | - Aiyana K Willard
- Division of Psychology, College of Health, Medicine, and Life Sciences, Brunel University London, Uxbridge, UB8 3PH, UK
| | - Rachel J Bennetts
- Division of Psychology, College of Health, Medicine, and Life Sciences, Brunel University London, Uxbridge, UB8 3PH, UK.
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23
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Murck H, Fava M, Cusin C, Fatt CC, Trivedi M. Brain ventricle and choroid plexus morphology as predictor of treatment response in major depression: Findings from the EMBARC study. Brain Behav Immun Health 2024; 35:100717. [PMID: 38186634 PMCID: PMC10767278 DOI: 10.1016/j.bbih.2023.100717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 01/09/2024] Open
Abstract
Recent observations suggest a role of the volume of the cerebral ventricle volume, corpus callosum (CC) segment volume, in particular that of the central-anterior part, and choroid plexus (CP) volume for treatment resistance of major depressive disorder (MDD). An increased CP volume has been associated with increased inflammatory activity and changes in the structure of the ventricles and corpus callosum. We attempt to replicate and confirm that these imaging markers are associated with clinical outcome in subjects from the EMBARC study, as implied by a recent pilot study. The EMBARC study is a placebo controlled randomized study comparing sertraline vs. placebo in patients with MDD to identify biological markers of therapy resistance. Association of baseline volumes of the lateral ventricles (LVV), choroid plexus volume (CPV) and volume of segments of the CC with treatment response after 4 weeks treatment was evaluated. 171 subjects (61 male, 110 female) completed the 4 week assessments; gender and age were taken into account for this analyses. As previously reported, no treatment effect of sertraline vs. placebo was observed, therefore the study characterized prognostic markers of response in the pooled population. Change in depression severity was identified by the ratio of the Hamilton-Depression rating scale 17 (HAMD-17) at week 4 divided by the HAMD-17 at baseline (HAMD-17 ratio). Volumes of the lateral ventricles and choroid plexi were positively correlated with the HAMD-17 ratio, indication worse outcome with larger ventricles and choroid plexus volumes, whereas the volume of the central-anterior corpus callosum was negatively correlated with the HAMD-17 ratio. Responders (n = 54) had significantly smaller volumes of the lateral ventricles and CP compared to non-responders (n = 117), whereas the volume of mid-anterior CC was significantly larger compared to non-responders (n = 117), confirming our previous findings. In an exploratory way associations between enlarged LVV and CPV and signs of lipid dysregulation were observed. In conclusion, we confirmed that volumes of lateral ventricles, choroid plexi and the mid-anterior corpus callosum are associated with clinical improvement of depression and may be indicators of metabolic/inflammatory activity.
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Affiliation(s)
- Harald Murck
- Dept. of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Maurizio Fava
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Cristina Cusin
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Cherise Chin Fatt
- The University of Texas Southwestern Medical Center, Department of Psychiatry, Center for Depression Research and Clinical Care, Dallas, USA
| | - Madhukar Trivedi
- The University of Texas Southwestern Medical Center, Department of Psychiatry, Center for Depression Research and Clinical Care, Dallas, USA
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Kerbage H, Elbejjani M, El-Hage W, Purper-Ouakil D. 'Life should go on': a qualitative inquiry of parental reactions, experiences, and perceived needs following adolescents' recent traumatic exposure. Eur J Psychotraumatol 2024; 15:2299660. [PMID: 38285906 PMCID: PMC10826792 DOI: 10.1080/20008066.2023.2299660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 12/19/2023] [Indexed: 01/31/2024] Open
Abstract
Background: Parents have a significant role in supporting children who have been exposed to traumatic events. Little is known about parental experiences and needs in the wake of traumatic exposure, which could help in designing tailored early interventions.Objective: This qualitative study explored experiences, perceived needs, and factors impacting those needs being met, in parents of adolescents aged 11-16 years who had been exposed in the past 3 months to a potentially traumatic event, in the city of Montpellier, France.Method: We purposively sampled 34 parents of 25 adolescents aged 11-16 years meeting the inclusion criteria and used semi-structured in-depth interviews. Thematic analysis was applied using a multistage recursive coding process.Results: Parents lacked trauma-informed explanations to make sense of their child's reduced functioning. They experienced stigma attached to the victim label and were reluctant to seek help. School avoidance and lack of collaboration with schools were major obstacles experienced by parents. Parents trying to navigate conflicting needs fell into two distinct categories. Those who experienced distressing levels of shame and guilt tended to avoid discussing the traumatic event with their child, pressuring them to resume life as it was before, despite this perpetuating conflictual interactions. Others adapted by revisiting their beliefs that life should go on as it was before and by trying to come up with new functional routines, which improved their relationship with their child and helped them to restore a sense of agency and hope, but at the cost of questioning their parental role.Conclusions: Key domains of parental experiences could provide potential early intervention targets, such as psychoeducation on traumatic stress, representations about recovery and the victim status, parent-child communication, and involvement of schools and primary caregivers. Further research is needed to validate the impact of these domains in early post-traumatic interventions.
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Affiliation(s)
- Hala Kerbage
- Department of Child and Adolescent Psychiatry, Saint-Eloi University Hospital, Montpellier, France
- Center for Epidemiology and Population Health (CESP) INSERM U1018, Developmental Psychiatry Team, Paris-Saclay University, Paris, France
| | - Martine Elbejjani
- Clinical Research Institute, Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Wissam El-Hage
- UMR 1253, iBrain, University of Tours, INSERM, Tours, France
| | - Diane Purper-Ouakil
- Department of Child and Adolescent Psychiatry, Saint-Eloi University Hospital, Montpellier, France
- Center for Epidemiology and Population Health (CESP) INSERM U1018, Developmental Psychiatry Team, Paris-Saclay University, Paris, France
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Borrelli G, Lamberti Zanardi A, Scognamiglio C, Cinquegrana V, Perrella R. The relationship between childhood interpersonal and non-interpersonal trauma and autobiographical memory: a systematic review. Front Psychol 2024; 15:1328835. [PMID: 38298520 PMCID: PMC10827865 DOI: 10.3389/fpsyg.2024.1328835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 01/04/2024] [Indexed: 02/02/2024] Open
Abstract
Childhood trauma can have negative effects on several domains of mental functioning, including Autobiographical Memory (AM). Conflicting results emerge in the scientific literature regarding the effects of childhood trauma on AM. In this review, we explored the relationship between the childhood trauma and AM, classifying childhood trauma as interpersonal, non-interpersonal and overall (interpersonal and non-interpersonal). We carried out a systematic literature review, following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA statement). From searching the PubMed, Scopus, and Web of Science databases, we identified 48 studies conducted from 2014 to 2023, which were included when they: (a) were written in English, (b) investigated the relationship between AM and childhood trauma, (c) included a sample of children, adolescents, or adults who had experienced childhood interpersonal and/or non-interpersonal trauma. Of the 48 eligible studies, 29 referred to trauma of an interpersonal nature, 12 to trauma of a non-interpersonal nature, and 7 to overall trauma. Regarding the relationship between childhood trauma and AM, 24 studies found a negative relationship between childhood interpersonal trauma and AM; among the articles on non-interpersonal trauma, 10 studies found no relevant relationship; in the studies on overall trauma, 4 articles found negative relationship between overall trauma and AM. The literature explored in our systematic review supports the prevalence of a negative relationship between interpersonal childhood trauma and AM. This relationship is present regardless of psychiatric disorders (e.g., Depression, Post Traumatic Stress Disorder, and Personality Disorders), and in the presence of the latter, AM results even more fragmented. Future research should use more accurate methodologies in identifying and classifying childhood trauma in order to more precisely determine its effect on AM.
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Affiliation(s)
- Giovanni Borrelli
- Department of Human Sciences, Guglielmo Marconi University, Rome, Italy
| | | | | | - Vincenza Cinquegrana
- Department of Psychology, University of Study of Campania “Luigi Vanvitelli”, Caserta, Italy
| | - Raffaella Perrella
- Department of Psychology, University of Study of Campania “Luigi Vanvitelli”, Caserta, Italy
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Yun S, Jo SH, Jeon HJ, Choo B, Seok JH, Shin H, Kim IY, Choi SW, Koo BH. Neurophysiological insights into impaired mentalization in borderline personality disorder an electroencephalography study. Front Psychiatry 2024; 14:1293347. [PMID: 38268560 PMCID: PMC10806161 DOI: 10.3389/fpsyt.2023.1293347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 12/22/2023] [Indexed: 01/26/2024] Open
Abstract
Introduction Borderline personality disorder (BPD) is characterized by interpersonal and emotional instabilities, recurring suicidal tendencies, and feelings of emptiness. Childhood adverse event is reported in 70%-80% of cases involving BPD. Furthermore, the deficiency in mentalization capacity plays a significant role in emotion dysregulation and social interaction problems within individuals with BPD. This study explored the relationship among childhood adverse experiences, mentalization capacity, and neurophysiological activity in patients with BPD. Methods Resting-state electroencephalography was used to identify the neural correlates associated with childhood adversity and mentalization deficits. The participants included 45 patients with BPD and 15 healthy controls. Results The BPD group exhibited reduced alpha activity during eyes-closed rest, indicating heightened arousal even during relaxation. Correlations were found between the power spectral density (PSD) and mentalization capacity in the delta and theta ranges, suggesting an association between PSD and emotional awareness and expression. Gamma activity negatively correlated with psychic equivalence, implying a blurring of the boundaries between internal mental experiences and the external world. Conclusion These findings offer insights into the pathophysiology of BPD, provide potential diagnostic markers, and suggest personalized treatment approaches based on mentalization traits.
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Affiliation(s)
- Seokho Yun
- Department of Psychiatry, Yeungnam University Hospital, Yeungnam University College of Medicine, Daegu, Republic of Korea
| | - So-Hye Jo
- Department of Psychiatry, Yeungnam University Hospital, Yeungnam University College of Medicine, Daegu, Republic of Korea
| | - Hye-Jin Jeon
- Department of Psychiatry, Yeungnam University Hospital, Yeungnam University College of Medicine, Daegu, Republic of Korea
| | - Bokyung Choo
- Industry-Academic Cooperations, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jeong-Ho Seok
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyunkyung Shin
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - In-Young Kim
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sun-Woo Choi
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Bon-Hoon Koo
- Department of Psychiatry, Yeungnam University Hospital, Yeungnam University College of Medicine, Daegu, Republic of Korea
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27
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Nkrumah RO, von Schröder C, Demirakca T, Schmahl C, Ende G. Cortical volume alteration in the superior parietal region mediates the relationship between childhood abuse and PTSD avoidance symptoms: A complementary multimodal neuroimaging study. Neurobiol Stress 2024; 28:100586. [PMID: 38045556 PMCID: PMC10689271 DOI: 10.1016/j.ynstr.2023.100586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/19/2023] [Accepted: 11/01/2023] [Indexed: 12/05/2023] Open
Abstract
Background Adverse childhood experiences (ACE), which can be separated into abuse and neglect, contribute to the development of post-traumatic stress symptoms (PTSS). However, which brain structures are mainly affected by ACE as well as the mediating role these brain structures play in ACE and PTSS relationship are still being investigated. The current study tested the effect of ACE on brain structure and investigated the latter's mediating role in ACE-PTSS relationship. Methods A total of 78 adults with self-reported ACE were included in this study. Participants completed the childhood trauma questionnaire (CTQ) and a Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) to ascertain ACE history and PTSS, respectively. T1w images and diffusion MRI scans were then acquired to assess cortical morphometry and white matter (WM) integrity in fibre tracts connecting key areas where ACE-related cortical volume alterations were observed. Results The combined effect of ACE was negatively associated with total grey matter volume and local cortical area in the right superior parietal region (rSP). Childhood abuse was negatively related to right superior parietal volume after controlling for neglect and overall psychological burden. The right superior parietal volume significantly mediated the relationship between childhood abuse and avoidance-related PTSS. Post-hoc analyses showed that the indirect relation was subsequently moderated by dissociative symptoms. Lastly, a complementary examination of the WM tracts connected to abuse-associated cortical GM regions shows that abuse was negatively related to the normalised fibre density of WM tracts connected to the right superior parietal region. Conclusion We provide multimodal structural evidence that ACE in the first years of life is related to alterations in the right superior brain region, which plays a crucial role in spatial processing and attentional functioning. Additionally, we highlight that the cortical volume alteration in this region may play a role in explaining the relationship between childhood abuse and avoidance symptoms.
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Affiliation(s)
- Richard Okyere Nkrumah
- Department of Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159, Mannheim, Germany
| | - Claudius von Schröder
- Department of Psychosomatic Medicine & Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159, Mannheim, Germany
| | - Traute Demirakca
- Department of Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159, Mannheim, Germany
| | - Christian Schmahl
- Department of Psychosomatic Medicine & Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159, Mannheim, Germany
| | - Gabriele Ende
- Department of Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159, Mannheim, Germany
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28
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Chang HM, Chen C, Lu ML, Jou S, Santos VHJ, Goh KK. The interplay of childhood trauma, oxytocin, and impulsivity in predicting the onset of methamphetamine use. CHILD ABUSE & NEGLECT 2024; 147:106579. [PMID: 38048654 DOI: 10.1016/j.chiabu.2023.106579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 11/19/2023] [Accepted: 11/23/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Childhood trauma is associated with substance use disorders, including methamphetamine use disorder (MUD). Oxytocin, involved in social bonding, stress regulation, and reward processing, may influence addiction vulnerability and impulsivity in individuals with a history of childhood trauma. OBJECTIVE To investigate the relationships among childhood trauma, oxytocin levels, impulsivity, and the age of first methamphetamine use in individuals with MUD. PARTICIPANTS AND SETTING The study included 298 male participants (148 individuals with MUD and 150 healthy controls) from both probation offices and psychiatric clinics. METHODS Childhood trauma was assessed using the Childhood Trauma Questionnaire-Short Form (CTQ-SF), impulsivity with the Barratt Impulsiveness Scale-11 (BIS-11), and plasma oxytocin levels were obtained. RESULTS Individuals with MUD exhibited higher levels of childhood trauma, impulsivity, and lower plasma oxytocin levels compared to healthy controls. Childhood trauma was associated with a younger age of first methamphetamine use, higher impulsivity, and lower oxytocin levels among individuals with MUD. Plasma oxytocin levels partially mediated the relationship between childhood trauma and both the age of first methamphetamine use and impulsivity. Serial mediation analysis demonstrated that oxytocin levels and impulsivity sequentially mediated the relationship between childhood trauma and the age of first methamphetamine use. CONCLUSIONS The findings reveal the complex interplay among childhood trauma, oxytocin, impulsivity, and methamphetamine use, emphasizing the importance of considering these factors in prevention and intervention strategies for MUD. Future research should explore oxytocin and impulsivity-focused interventions to mitigate the effects of childhood trauma and reduce MUD development risk.
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Affiliation(s)
- Hu-Ming Chang
- Department of Addiction Sciences, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan; Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chenyi Chen
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Mind, Brain and Consciousness, College of Humanities and Social Sciences, Taipei Medical University, Taipei, Taiwan; Neuroscience Research Center, Taipei Medical University Hospital, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; The Innovative and Translational Research Center for Brain Consciousness, Taipei Medical University, Taipei, Taiwan
| | - Mong-Liang Lu
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Susyan Jou
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Graduate School of Criminology, National Taipei University, Taipei, Taiwan
| | - Vitor Hugo Jesus Santos
- Department of Psychiatry and Mental Health, Faculty of Health Sciences (FCS-UBI), Cova da Beira University Hospital Center, Covilhã, Portugal
| | - Kah Kheng Goh
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan; The Innovative and Translational Research Center for Brain Consciousness, Taipei Medical University, Taipei, Taiwan; Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
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29
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Sun Y, Blewitt C, Minson V, Bajayo R, Cameron L, Skouteris H. Trauma-informed Interventions in Early Childhood Education and Care Settings: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2024; 25:648-662. [PMID: 37042258 PMCID: PMC10666515 DOI: 10.1177/15248380231162967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Trauma in early childhood is a significant public health concern. Early Childhood Education and Care (ECEC) services are uniquely positioned to buffer the negative impact of early childhood trauma on children. This scoping review synthesized studies evaluating trauma-informed interventions in ECEC settings through a systematic search of four relevant online databases (PsycINFO, Medline, ERIC, A+ Education). Fourteen studies met the inclusion criteria, with 12 ECEC center-based trauma-informed interventions evaluated. Types and components of trauma-informed interventions, outcomes, and measures are presented. Findings suggest that trauma-informed interventions in ECEC settings are nascent but growing. Increasingly, programs are adopting multi-tiered system of support to address early childhood trauma, with these models suggesting promising results. The predominant focus of ECEC center-based trauma-informed interventions was upskilling teachers through training and coaching, with studies focused on assessment of teacher-level outcomes. Child, organization, and caregiver-level outcomes are not explored to the same extent, with evaluation of organizational outcomes relying predominately on qualitative methods. Whilst the short-term outcomes of trauma-informed approaches in ECEC have been examined, longer-term impacts and the causal mechanistic pathways of such programs have yet to be explored.
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Affiliation(s)
- Yihan Sun
- Monash University, Melbourne, VIC, Australia
| | | | | | - Rachael Bajayo
- Alannah & Madeline Foundation, Melbourne, VIC, Australia
| | - Lee Cameron
- Alannah & Madeline Foundation, Melbourne, VIC, Australia
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30
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Albertina EA, Barch DM, Karcher NR. Internalizing Symptoms and Adverse Childhood Experiences Associated With Functional Connectivity in a Middle Childhood Sample. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024; 9:50-59. [PMID: 35483606 PMCID: PMC9596616 DOI: 10.1016/j.bpsc.2022.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 03/13/2022] [Accepted: 04/09/2022] [Indexed: 05/11/2023]
Abstract
BACKGROUND Research has found overlapping associations in adults of resting-state functional connectivity (RSFC) to both internalizing disorders (e.g., depression, anxiety) and a history of traumatic events. The present study aimed to extend this previous research to a younger sample by examining RSFC associations with both internalizing symptoms and adverse childhood experiences (ACEs) in middle childhood. METHODS We used generalized linear mixed models to examine associations between a priori within- and between-network RSFC with child-reported internalizing symptoms and ACEs using the Adolescent Brain Cognitive Development dataset (N = 10,168, mean age = 9.95 years, SD = 0.627). RESULTS We found that internalizing symptoms and ACEs were associated with both multiple overlapping and unique RSFC network patterns. Both ACEs and internalizing symptoms were associated with a reduced anticorrelation between the default mode network and the dorsal attention network. However, internalizing symptoms were uniquely associated with lower within-network default mode network connectivity, while ACEs were uniquely associated with both lower between-network connectivity of the auditory network and cingulo-opercular network, and higher within-network frontoparietal network connectivity. CONCLUSIONS The present study points to overlap in the RSFC associations with internalizing symptoms and ACEs, as well as important areas of specificity in RSFC associations. Many of the RSFC associations found have been previously implicated in attentional control functions, including modulation of attention to sensory stimuli. This may have critical importance in understanding internalizing symptoms and outcomes of ACEs.
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Affiliation(s)
- Emily A Albertina
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, Missouri.
| | - Deanna M Barch
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, Missouri
| | - Nicole R Karcher
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, Missouri
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31
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Enthoven ASD, Gangadin SS, de Haan L, Veling W, de Vries EFJ, Doorduin J, Begemann MJH, Sommer IEC. The association of childhood trauma with depressive and negative symptoms in recent onset psychosis: a sex-specific analysis. Psychol Med 2023; 53:7795-7804. [PMID: 37435649 PMCID: PMC10755234 DOI: 10.1017/s0033291723001824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 06/04/2023] [Accepted: 06/05/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND Childhood trauma may impact the course of schizophrenia spectrum disorders (SSD), specifically in relation to the increased severity of depressive or negative symptoms. The type and impact of trauma may differ between sexes. In a large sample of recent-onset patients, we investigated the associations of depressive and negative symptoms with childhood trauma and whether these are sex-specific. METHODS A total of 187 first-episode psychosis patients in remission (Handling Antipsychotic Medication: Long-term Evaluation of Targeted Treatment study) and 115 recent-onset SSD patients (Simvastatin study) were included in this cross-sectional study (men: n = 218; women: n = 84). Total trauma score and trauma subtypes were assessed using the Childhood Trauma Questionnaire Short Form; depressive and negative symptoms were rated using the Positive And Negative Symptoms Scale. Sex-specific regression analyses were performed. RESULTS Women reported higher rates of sexual abuse than men (23.5% v. 7.8%). Depressive symptoms were associated with total trauma scores and emotional abuse ratings in men (β: 0.219-0.295; p ≤ 0.001). In women, depressive symptoms were associated with sexual abuse ratings (β: 0.271; p = 0.011). Negative symptoms were associated with total trauma score and emotional neglect ratings in men (β: 0.166-0.232; p ≤ 0.001). Negative symptoms in women were not linked to childhood trauma, potentially due to lack of statistical power. CONCLUSIONS Depressive symptom severity was associated with different types of trauma in men and women with recent-onset SSD. Specifically, in women, depressive symptom severity was associated with childhood sexual abuse, which was reported three times as often as in men. Our results emphasize the importance of sex-specific analyses in SSD research.
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Affiliation(s)
- Anne-Sophie D. Enthoven
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Biomedical Sciences of Cells and Systems, and Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Shiral S. Gangadin
- Department of Biomedical Sciences of Cells and Systems, and Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Lieuwe de Haan
- Department of Early Psychosis, Amsterdam UMC, Academic Medical Center, Amsterdam, The Netherlands
| | - Wim Veling
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Erik F. J. de Vries
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Janine Doorduin
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - HAMLETT and OPHELIA Consortium
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Marieke J. H. Begemann
- Department of Biomedical Sciences of Cells and Systems, and Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Iris E. C. Sommer
- Department of Biomedical Sciences of Cells and Systems, and Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Donnelly KA, Goyal MK. The Epidemiology of Violence Exposure in Children. Pediatr Clin North Am 2023; 70:1057-1068. [PMID: 37865430 DOI: 10.1016/j.pcl.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2023]
Abstract
Exposure to violence remains a significant issue for children in the United States. The COVID-19 pandemic exacerbated many of these exposures. Violence unequally impacts children of color and lesbian, gay, bisexual, transgender, and questioning youth. Pediatricians can and must continue to advocate and intervene to decrease pediatric violence exposure and its effects.
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Affiliation(s)
- Katie A Donnelly
- Children's National Hospital, The George Washington University, 111 Michigan Avenue NW, Washington, DC 20010, USA.
| | - Monika K Goyal
- Children's National Hospital, The George Washington University, 111 Michigan Avenue NW, Washington, DC 20010, USA
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33
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Smeeth D, May AK, Karam EG, Rieder MJ, Elzagallaai AA, van Uum S, Pluess M. Risk and resilience in Syrian refugee children: A multisystem analysis. Dev Psychopathol 2023; 35:2275-2287. [PMID: 37933522 DOI: 10.1017/s0954579423000433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
Refugee children are often exposed to substantial trauma, placing them at increased risk for mental illness. However, this risk can be mitigated by a capacity for resilience, conferred from multiple ecological systems (e.g., family, community), including at an individual biological level. We examined the ability of hair cortisol concentrations and polygenic scores for mental health to predict risk and resilience in a sample of Syrian refugee children (n = 1359). Children were categorized as either at-risk or resilient depending on clinical thresholds for posttraumatic stress disorder, depression, and externalizing behavior problems. Logistic regression was used to examine main and interacting effects while controlling for covariates. Elevated hair cortisol concentrations were significantly associated with reduced resilience (odds ratio (OR)=0.58, 95%CI [0.40, 0.83]) while controlling for levels of war exposure. Polygenic scores for depression, self-harm, and neuroticism were not found to have any significant main effects. However, a significant interaction emerged between hair cortisol and polygenic scores for depression (OR=0.04, 95%CI [0.003 0.47]), suggesting that children predisposed to depression were more at risk for mental health problems when hair cortisol concentrations were high. Our results suggest that biomarkers (separately and in combination) might support early identification of refugee children at risk for mental health problems.
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Affiliation(s)
- Demelza Smeeth
- Biological and Experimental Psychology, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
| | - Andrew K May
- Biological and Experimental Psychology, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
| | - Elie G Karam
- Department of Psychiatry and Clinical Psychology, St Georges Hospital University Medical Center, Beirut, Lebanon
| | - Michael J Rieder
- Physiology and Pharmacology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Abdelbaset A Elzagallaai
- Physiology and Pharmacology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Stan van Uum
- Division of Endocrinology and Metabolism, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Michael Pluess
- Biological and Experimental Psychology, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
- Department of Psychological Sciences, School of Psychology, University of Surrey, Guildford, UK
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Wamser RA, Walker HE, Sager J. Physical Health Outcomes of Trauma Exposure Across the Lifespan. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:12025-12045. [PMID: 37565310 DOI: 10.1177/08862605231190670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
Trauma exposure and posttraumatic stress symptoms (PTSS) are established risk factors for poorer physical health. Prior work has focused on childhood adversities and PTSS in relation to physical health conditions, but trauma exposure over the lifespan has been overlooked. Further, the associations between trauma and PTSS and other physical health markers, such as diet and exercise, are less clear. Very little is known regarding how different trauma types (i.e., interpersonal, non-interpersonal), may be tied to aspects of physical health. To expand this area of research, this study aimed to: (a) examine the links between cumulative trauma and PTSS, and body mass index (BMI), diet, and exercise; and (b) investigate the relations between interpersonal and non-interpersonal trauma and these three health indices, while controlling for PTSS. Participants were 493 Midwestern University students (Mage = 23.87, standard deviation [SD] = 6.90, range = 18-63; 79.3% female; 57.4% White). Cumulative trauma corresponded with higher BMIs and less exercise use (B = 0.10; B = -0.09), while PTSS were unrelated. Conversely, PTSS were tied to greater consumption of added sugars (B = 0.11), and cumulative trauma was not linked with diet. Interpersonal and non-interpersonal traumas were not tied to BMI or exercise, although interpersonal trauma and PTSS were linked with greater sugar intake and non-interpersonal trauma was associated with fruit and vegetable consumption. Trauma exposure and PTSS may have complicated and distinct associations with physical health indices, such as BMI, diet, and exercise, and additional research is needed to further parse out these relations.
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Hinchey LME, Chammaa M, Ruvolo Grasser L, Saad B, Gorski K, Javanbakht A. What happened matters: Trauma type and cumulative trauma exposure in refugee youth psychopathology. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2023:2024-29468-001. [PMID: 38032625 PMCID: PMC11136876 DOI: 10.1037/tra0001618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
OBJECTIVE Trauma exposure-a contributor to psychological risk for refugee youth-is typically assessed using cumulative indices; however, recent findings indicate that trauma type may better predict psychological outcomes. This study investigated the utility of two methods of classifying trauma exposure-cumulative trauma and exposure to specific types of trauma (i.e., trauma subtypes)-in predicting the severity of symptoms related to posttraumatic stress disorder (PTSD) and anxiety for refugee youth. METHOD 96 Syrian and Iraqi youth resettled as refugees in the United States self-reported trauma exposure and psychological symptoms. Multiple regression was used to assess the variance in symptom severity explained by specific trauma subtypes (i.e., victimization, death threat, and accidental/injury) as compared to cumulative trauma scores. RESULTS Multiple regression models predicting PTSD revealed cumulative trauma (b = 0.07; p = .004) and death threat trauma (b = 0.16; p = .001) as significant predictors of PTSD symptom severity; notably, death threat trauma was the only subtype associated with PTSD and explained more variance than cumulative trauma scores (10.3% and 8.4%, respectively). Cumulative trauma, but no specific trauma subtype, was associated with anxiety (b = .03; p = .043); however, this relation did not survive correction for multiple comparisons. CONCLUSION Focused trauma assessment-particularly consideration of death threat trauma and cumulative trauma exposures-may be useful in evaluating the risk of PTSD symptoms in refugee youth, whereas symptoms related to anxiety may be driven by other factors. These findings can be leveraged toward focused identification of youth at highest risk for PTSD symptoms, to improve prevention and early intervention efforts. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Liza M E Hinchey
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine
| | - May Chammaa
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine
| | - Lana Ruvolo Grasser
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine
| | - Bassem Saad
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine
| | - Kathleen Gorski
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine
| | - Arash Javanbakht
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine
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Goodon H, Gawaziuk J, Comaskey B, Afifi TO, Château D, Brownell M, Sareen J, Morgan C, Logsetty S, Spiwak R. Investigating social determinants of child health and their implications in reducing pediatric traumatic injury: A framework and 17-year retrospective case-control study protocol. PLoS One 2023; 18:e0294734. [PMID: 38011128 PMCID: PMC10681167 DOI: 10.1371/journal.pone.0294734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 10/31/2023] [Indexed: 11/29/2023] Open
Abstract
INTRODUCTION Traumatic physical injuries are the number one cause of hospitalization and death among children in Canada. The majority of these injuries are preventable. The burden from injury can be reduced through prevention programs tailored to at-risk groups, however, existing research does not provide a strong explanation of how social factors influence a child's risk of injury. We propose a theoretical framework to better understand social factors and injury in children and will examine the association between these social factors and physical traumatic injury in children using large population-wide data. METHODS AND ANALYSIS We will examine data from 11,000 children hospitalized for traumatic physical injury and 55,000 matched uninjured children by linking longitudinal administrative and clinical data contained at the Manitoba Centre for Health Policy. We will examine 14 social determinants of child health measures from our theoretical framework, including receipt of income assistance, rural/urban status, socioeconomic status, children in care, child mental disorder, and parental factors (involvement with criminal justice system, education, social housing, immigration status, high residential mobility, mother's age at first birth, maternal Axis I mental disorder, maternal Axis II mental disorder and maternal physical disorder) to identify groups and periods of time when children are at greatest risk for traumatic physical injury. A conditional multivariable logistic regression model will be calculated (including all social determinant measures) to determine odds ratios and adjusted odds ratios (95% confidence interval) for cases (injured) and controls (non-injured). ETHICS AND DISSEMINATION Health Information Privacy Committee (HIPC No. 2017/2018-75) and local ethics approval (H2018-123) were obtained. Once social measures have been identified through statistical modelling, we will determine how they fit into a Haddon matrix to identify appropriate areas for intervention. Knowing these risk factors will guide decision-makers and health policy.
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Affiliation(s)
- Hunter Goodon
- Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Justin Gawaziuk
- Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Brenda Comaskey
- Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Tracie O. Afifi
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Psychiatry, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Dan Château
- ANU College of Health and Medicine, Australian National University, Canberra, Australia
- Data Analysis in Population Health Hub, National Centre for Epidemiology and Population Health, Canberra, Australia
| | - Marni Brownell
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
- Manitoba Centre for Health Policy, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jitender Sareen
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Psychiatry, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Cora Morgan
- Assembly of Manitoba Chiefs, Winnipeg, Manitoba, Canada
| | - Sarvesh Logsetty
- Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Psychiatry, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
- Firefighters Burn Unit, Health Sciences Centre, Winnipeg, Manitoba, Canada
| | - Rae Spiwak
- Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
- Manitoba Centre for Health Policy, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
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Yao K, Chen P, Zhou H, Ruan J, Chen D, Yang X, Zhou Y. The effect of childhood trauma on suicide risk: the chain mediating effects of resilience and mental distress. BMC Psychiatry 2023; 23:865. [PMID: 37990217 PMCID: PMC10664623 DOI: 10.1186/s12888-023-05348-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 11/04/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Suicide is the fourth leading cause of death among young people aged 15-29 years. A large number of studies have found that mental disorder in adulthood is closely related to childhood trauma, and the relationship between childhood trauma and suicide risk is influenced by resilience and mental distress. This study aimed to explore the effects of childhood trauma on suicide risk among young people and the potential roles of resilience and mental distress in the relationship between childhood trauma on suicide risk. METHODS A cross-sectional survey was conducted among 742 young adults who were in graduate school stage from multiple provinces and cities in China. The Childhood Trauma Questionnaire (CTQ-Short Form), Connor-Davison Resilience Scale (CD-RISC) and Suicide Behavior Questionnaire-Revised (SBQ-R) were used to measure young adults' childhood trauma, resilience and suicide risk, respectively. 9-items Patient Health Questionnaire (PHQ-9) and 7-items self-report Generalized Anxiety Disorder Scale (GAD-7) were used together to measure mental distress. Correlation analysis was performed to explore the initial relationships among the main variables. Structural equation modeling (SEM) was conducted to examine the chain mediating effects of resilience and mental distress in the relationship between childhood trauma and suicide risk. RESULTS The structural equation modeling produced goodness of fit indices (χ2 /df = 3.668, p < 0.001, RMSEA = 0.060, NFI = 0.959, CFI = 0.969, GFI = 0.969, TLI = 0.955). Childhood trauma significantly predicted suicide risk (β = 0.232, p < 0.001) and mental distress (β = 0.181, p < 0.001), which had negative effect on resilience (β = -0.233, p < 0.001). Resilience negatively affected mental distress (β = -0.483, p < 0.001) and suicide risk (β = -0.142, p = 0.001), while mental distress positively associated with suicide risk (β = 0.219, p < 0.001). CONCLUSION The current study revealed that resilience and mental distress played chain-mediating roles in the relationship between childhood trauma and suicide risk. This suggests that we should view the suicide risk of graduate students from a comprehensive perspective.
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Affiliation(s)
- Kaimin Yao
- Department of Psychology, School of Public Health, Southern Medical University, Shatai South Road, Guangzhou, 510515, Guangdong, China
| | - Peiyi Chen
- Department of Psychology, School of Public Health, Southern Medical University, Shatai South Road, Guangzhou, 510515, Guangdong, China
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, Guangdong, China
| | - Hui Zhou
- Department of Psychology, School of Public Health, Southern Medical University, Shatai South Road, Guangzhou, 510515, Guangdong, China
| | - Jiajia Ruan
- Department of Psychology, School of Public Health, Southern Medical University, Shatai South Road, Guangzhou, 510515, Guangdong, China
| | - Dan Chen
- Student Affairs Office, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Xueling Yang
- Department of Psychology, School of Public Health, Southern Medical University, Shatai South Road, Guangzhou, 510515, Guangdong, China.
- Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, Guangdong, China.
| | - You Zhou
- Student Affairs Office, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China.
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Hanson RF, Zhu V, Are F, Espeleta H, Wallis E, Heider P, Kautz M, Lenert L. Initial development of tools to identify child abuse and neglect in pediatric primary care. BMC Med Inform Decis Mak 2023; 23:266. [PMID: 37978498 PMCID: PMC10656827 DOI: 10.1186/s12911-023-02361-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 11/02/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Child abuse and neglect (CAN) is prevalent, associated with long-term adversities, and often undetected. Primary care settings offer a unique opportunity to identify CAN and facilitate referrals, when warranted. Electronic health records (EHR) contain extensive information to support healthcare decisions, yet time constraints preclude most providers from thorough EHR reviews that could indicate CAN. Strategies that summarize EHR data to identify CAN and convey this to providers has potential to mitigate CAN-related sequelae. This study used expert review/consensus and Natural Language Processing (NLP) to develop and test a lexicon to characterize children who have experienced or are at risk for CAN and compared machine learning methods to the lexicon + NLP approach to determine the algorithm's performance for identifying CAN. METHODS Study investigators identified 90 CAN terms and invited an interdisciplinary group of child abuse experts for review and validation. We then used NLP to develop pipelines to finalize the CAN lexicon. Data for pipeline development and refinement were drawn from a randomly selected sample of EHR from patients seen at pediatric primary care clinics within a U.S. academic health center. To explore a machine learning approach for CAN identification, we used Support Vector Machine algorithms. RESULTS The investigator-generated list of 90 CAN terms were reviewed and validated by 25 invited experts, resulting in a final pool of 133 terms. NLP utilized a randomly selected sample of 14,393 clinical notes from 153 patients to test the lexicon, and .03% of notes were identified as CAN positive. CAN identification varied by clinical note type, with few differences found by provider type (physicians versus nurses, social workers, etc.). An evaluation of the final NLP pipelines indicated 93.8% positive CAN rate for the training set and 71.4% for the test set, with decreased precision attributed primarily to false positives. For the machine learning approach, SVM pipeline performance was 92% for CAN + and 100% for non-CAN, indicating higher sensitivity than specificity. CONCLUSIONS The NLP algorithm's development and refinement suggest that innovative tools can identify youth at risk for CAN. The next key step is to refine the NLP algorithm to eventually funnel this information to care providers to guide clinical decision making.
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Affiliation(s)
| | - Vivienne Zhu
- Medical University of South Carolina, Charleston, SC, USA
| | | | | | | | - Paul Heider
- Medical University of South Carolina, Charleston, SC, USA
| | - Marin Kautz
- Medical University of South Carolina, Charleston, SC, USA
| | - Leslie Lenert
- Medical University of South Carolina, Charleston, SC, USA
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Oláh B, Fekete Z, Kuritárné Szabó I, Kovács-Tóth B. Validity and reliability of the 10-Item Adverse Childhood Experiences Questionnaire (ACE-10) among adolescents in the child welfare system. Front Public Health 2023; 11:1258798. [PMID: 38045975 PMCID: PMC10691263 DOI: 10.3389/fpubh.2023.1258798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 11/02/2023] [Indexed: 12/05/2023] Open
Abstract
Introduction Multiple evidence suggests that the vast majority of children in the Child Welfare System (CWS) are victims of early, chronic, and multiple adverse childhood experiences. However, the 10-item version of the Adverse Childhood Experiences Questionnaire (ACE-10) has never been tested in such a particularly vulnerable population as adolescents living in the CWS. We aimed to assess the psychometric properties of the ACE-10 in a community sample of 240 Hungarian adolescents placed in family style group care (FGC) setting. Methods Demographic data, the 10-item version of the Adverse Childhood Experiences Questionnaire (ACE-10), the Strengths and Difficulties Questionnaire (SDQ), and the HBSC Bullying Measure were used. Results Our results showed acceptable internal consistency (α = 0.701) and item-total correlations (rpb = 0.25-0.65, p < 0.001). However, our results also reflect that item 6 ("Parental separation/divorce") is weakly correlated with both the cumulative ACE score and the rest of the questionnaire items. When item 6 is removed, the 9-item version of the ACE produces more favorable consistency results (α = 0.729). Strong and significant associations of the cumulative ACE score with emotional and behavioral symptoms and bully victimization confirm the concurrent criterion validity of both versions of the instrument. Discussion Our findings suggest that ACE-9 and ACE-10 are viable screening tools for adverse childhood experiences in the CWS contributing to the advancement of trauma-informed care. We recommend considering the use of either the 9-item or the 10- item version in the light of the characteristics of the surveyed population. The implications and limitations are discussed.
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Affiliation(s)
- Barnabás Oláh
- Department of Behavioural Sciences, University of Debrecen Faculty of Medicine, Debrecen, Hungary
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Zita Fekete
- Department of Behavioural Sciences, University of Debrecen Faculty of Medicine, Debrecen, Hungary
| | - Ildikó Kuritárné Szabó
- Department of Behavioural Sciences, University of Debrecen Faculty of Medicine, Debrecen, Hungary
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Beáta Kovács-Tóth
- Department of Behavioural Sciences, University of Debrecen Faculty of Medicine, Debrecen, Hungary
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Majeed-Ariss R, Mattison M, Rodriguez PM, White C. Exploring the similarities and differences amongst service users with and without learning disabilities attending Saint Marys Sexual Assault Referral Centre. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:1288-1296. [PMID: 37503887 DOI: 10.1111/jar.13147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 02/23/2023] [Accepted: 07/14/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND People with learning disabilities are over-represented amongst Sexual Assault Referral Centre service users. This work aims to explore the similarities and differences between service users with and without learning disabilities. METHOD Medical notes of 52 service users likely to have a learning disability were compared with 52 service users not likely to have a learning disability (according to the Learning Disability Screening Questionnaire); all of whom attended Saint Marys SARC for a forensic medical examination during a 12-month period. RESULTS Significant associations were found between the likelihood of learning disability and relationship to perpetrator; location of assault; alcohol use; time taken to present to SARC; domestic violence; self-harm; suicide attempts and mental health service involvement. CONCLUSIONS People with learning disabilities in the sexually assaulted population are more likely to present with intersecting vulnerabilities emphasising the need for timely, accessible and appropriate patient-centred care for this group.
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Affiliation(s)
- Rabiya Majeed-Ariss
- Saint Mary's Sexual Assault Referral Centre, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | | | - Pablo M Rodriguez
- Saint Mary's Sexual Assault Referral Centre, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Catherine White
- Saint Mary's Sexual Assault Referral Centre, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
- Institute for Addressing Strangulation Sexual Offences, Manchester, UK
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Kranzler H, Davis C, Feinn R, Jinwala Z, Khan Y, Oikonomou A, Silva-Lopez D, Burton I, Dixon M, Milone J, Ramirez S, Shifman N, Levey D, Gelernter J, Hartwell E, Kember R. Adverse Childhood Events, Mood and Anxiety Disorders, and Substance Dependence: Gene x Environment Effects and Moderated Mediation. RESEARCH SQUARE 2023:rs.3.rs-3483320. [PMID: 37961429 PMCID: PMC10635374 DOI: 10.21203/rs.3.rs-3483320/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Background Adverse childhood events (ACEs) contribute to the development of mood and anxiety disorders and substance dependence. However, the extent to which these effects are direct or indirect and whether genetic risk moderates them is unclear. Methods We examined associations among ACEs, mood/anxiety disorders, and substance dependence in 12,668 individuals (44.9% female, 42.5% African American/Black, 42.1% European American/White). We generated latent variables for each phenotype and modeled direct and indirect effects of ACEs on substance dependence, mediated by mood/anxiety disorders (forward or "self-medication" model) and of ACEs on mood/anxiety disorders, mediated by substance dependence (reverse or "substance-induced" model). In a sub-sample, we also generated polygenic scores for substance dependence and mood/anxiety disorder factors, which we tested as moderators in the mediation models. Results Although there were significant indirect effects in both directions, mediation by mood/anxiety disorders (forward model) was greater than by substance dependence (reverse model). Greater genetic risk for substance dependence was associated with a weaker direct effect of ACEs on substance dependence in both the African- and European-ancestry groups (i.e., gene-environment interaction) and a weaker indirect effect in European-ancestry individuals (i.e., moderated mediation). Conclusion We found greater evidence that substance dependence results from self-medication of mood/anxiety disorders than that mood/anxiety disorders are substance induced. Among individuals at higher genetic risk for substance dependence who are more likely to develop a dependence diagnosis, ACEs exert less of an effect in promoting that outcome. Following exposure to ACEs, multiple pathways lead to mood/anxiety disorders and substance dependence. Specification of these pathways could inform individually targeted prevention and treatment approaches.
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Affiliation(s)
| | | | | | - Zeal Jinwala
- University of Pennsylvania Perelman School of Medicine
| | - Yousef Khan
- University of Pennsylvania Perelman School of Medicine
| | | | | | - Isabel Burton
- University of Pennsylvania Perelman School of Medicine
| | - Morgan Dixon
- University of Pennsylvania Perelman School of Medicine
| | | | - Sarah Ramirez
- University of Pennsylvania Perelman School of Medicine
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Kranzler HR, Davis CN, Feinn R, Jinwala Z, Khan Y, Oikonomou A, Silva-Lopez D, Burton I, Dixon M, Milone J, Ramirez S, Shifman N, Levey D, Gelernter J, Hartwell EE, Kember RL. Adverse Childhood Events, Mood and Anxiety Disorders, and Substance Dependence: Gene X Environment Effects and Moderated Mediation. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.10.24.23297419. [PMID: 37961309 PMCID: PMC10635185 DOI: 10.1101/2023.10.24.23297419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Background Adverse childhood events (ACEs) contribute to the development of mood and anxiety disorders and substance dependence. However, the extent to which these effects are direct or indirect and whether genetic risk moderates them is unclear. Methods We examined associations among ACEs, mood/anxiety disorders, and substance dependence in 12,668 individuals (44.9% female, 42.5% African American/Black, 42.1% European American/White). We generated latent variables for each phenotype and modeled direct and indirect effects of ACEs on substance dependence, mediated by mood/anxiety disorders (forward or "self-medication" model) and of ACEs on mood/anxiety disorders, mediated by substance dependence (reverse or "substance-induced" model). In a sub-sample, we also generated polygenic scores for substance dependence and mood/anxiety disorder factors, which we tested as moderators in the mediation models. Results Although there were significant indirect effects in both directions, mediation by mood/anxiety disorders (forward model) was greater than by substance dependence (reverse model). Greater genetic risk for substance dependence was associated with a weaker direct effect of ACEs on substance dependence in both the African- and European-ancestry groups (i.e., gene-environment interaction) and a weaker indirect effect in European-ancestry individuals (i.e., moderated mediation). Conclusion We found greater evidence that substance dependence results from self-medication of mood/anxiety disorders than that mood/anxiety disorders are substance induced. Among individuals at higher genetic risk for substance dependence who are more likely to develop a dependence diagnosis, ACEs exert less of an effect in promoting that outcome. Following exposure to ACEs, multiple pathways lead to mood/anxiety disorders and substance dependence. Specification of these pathways could inform individually targeted prevention and treatment approaches.
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Affiliation(s)
- Henry R. Kranzler
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA 19104
- Mental Illness Research, Education and Clinical Center, Crescenz VAMC, Philadelphia, PA 19104
| | - Christal N. Davis
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA 19104
- Mental Illness Research, Education and Clinical Center, Crescenz VAMC, Philadelphia, PA 19104
| | - Richard Feinn
- Department of Medical Sciences, Frank H. Netter School of Medicine at Quinnipiac University, North Haven, CT 06473
| | - Zeal Jinwala
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA 19104
- Mental Illness Research, Education and Clinical Center, Crescenz VAMC, Philadelphia, PA 19104
| | - Yousef Khan
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA 19104
| | - Ariadni Oikonomou
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA 19104
| | - Damaris Silva-Lopez
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA 19104
| | - Isabel Burton
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA 19104
| | - Morgan Dixon
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA 19104
| | - Jackson Milone
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA 19104
| | - Sarah Ramirez
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA 19104
| | - Naomi Shifman
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA 19104
| | - Daniel Levey
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT and VA CT Healthcare Center, 950 Campbell Avenue, West Haven, CT 06516, USA
| | - Joel Gelernter
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT and VA CT Healthcare Center, 950 Campbell Avenue, West Haven, CT 06516, USA
- Departments of Genetics and Neurobiology, Yale University School of Medicine, New Haven, CT and VA CT Healthcare Center, 950 Campbell Avenue, West Haven, CT 06516, USA
| | - Emily E. Hartwell
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA 19104
- Mental Illness Research, Education and Clinical Center, Crescenz VAMC, Philadelphia, PA 19104
| | - Rachel L. Kember
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA 19104
- Mental Illness Research, Education and Clinical Center, Crescenz VAMC, Philadelphia, PA 19104
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Stevens SK, Williams DP, Thayer JF, Zalta AK. Differential Associations of Childhood Abuse and Neglect With Adult Autonomic Regulation and Mood-Related Pathology. Psychosom Med 2023; 85:682-690. [PMID: 37506294 DOI: 10.1097/psy.0000000000001239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/30/2023]
Abstract
OBJECTIVE This study assessed whether different types of childhood maltreatment (i.e., abuse versus neglect) had differential relationships with heart rate variability (HRV) and baroreflex sensitivity. In addition, this study tested the indirect effect of maltreatment subtypes on adult mood-related psychopathology via HRV, and whether these relationships differed in those with HRV above and below established clinical cutoffs. METHODS Secondary analysis was performed using the Midlife Development in the United States data set ( N = 967; Mage = 55; 58.4% female; 75.9% White). In a single study visit, autonomic measurements were captured at rest, during two cognitive stressors (Stroop and MATH tasks), and during recovery after the tasks. Structural equation modeling was used to assess the relationships between key variables during all three measurement periods. RESULTS Resting pathways from abuse and neglect to baroreflex sensitivity were nonsignificant, as was the pathway from HRV to mood-related pathology. Notably, greater abuse was significantly predictive of lower HRV (standardized β = -0.42, p = .009), whereas greater neglect was significantly predictive of higher HRV (standardized β = 0.32, p = .034). In addition, higher abuse was significantly predictive of greater adult symptoms (standardized β = 0.39, p < .001), but neglect was not found to be related to adult mood-related pathology. Significant relationships between variables were only found in those with low HRV. CONCLUSIONS Although cross-sectional, our findings provide further evidence that low HRV may be a transdiagnostic endophenotype for mood-related pathology and suggest that greater differentiation between abuse and neglect is appropriate when investigating the impact of childhood maltreatment on adult health outcomes.
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Affiliation(s)
- Sarah K Stevens
- From the Department of Psychological Science, University of California-Irvine, Irvine, California
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Spinelli TR, Bruckner E, Jordan N, Kisiel CL. Trauma is only part of the story: Strengths moderate the relationship between trauma and needs for older youth in foster care. J Adolesc 2023; 95:1435-1448. [PMID: 37455384 DOI: 10.1002/jad.12217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/01/2023] [Accepted: 07/04/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION Many youth in foster care endure traumatic experiences (TE) that can lead to lasting negative outcomes. However, the identification of strengths may mitigate the impact of TE. METHODS This study examines the frequency and distribution of identified strengths; whether strengths moderate the association between TE and various outcomes; and whether certain strengths have a larger moderation effect on the association between TE and life domain functioning. Administrative and clinical data, including the Child and Adolescent Needs and Strengths (CANS) assessment, were examined for 3324 transition age youth and emerging adults in out-of-home foster care in the United States. Participants were males and females between 14.5 and 21 years old. Pearson's chi-square tests of association were conducted to determine whether identification of strengths varied significantly by sex or race/ethnicity. Negative binomial regressions were used to determine whether strengths modified the association between TE and needs domains. RESULTS Of 11 measured strengths, 56% of youth had 7 or more strengths identified as centerpiece strengths, and 20% had all 11. No significant differences in identification of strengths were found across sex or race/ethnicity. All strengths significantly moderated the association of TE and outcomes across CANS domains tested. While cumulative strengths had the largest overall moderation effects, identification of education setting, coping and savoring skills, and interpersonal strengths as centerpiece strengths had the largest moderation effect among specific strengths. CONCLUSIONS Findings suggest assessing, identifying, and bolstering strengths may help to promote well-being after trauma exposure.
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Affiliation(s)
- Tawny R Spinelli
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Ellie Bruckner
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Neil Jordan
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Cassandra L Kisiel
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
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Xie H, Shih CH, Aldoohan SD, Wall JT, Wang X. Hypothalamus volume mediates the association between adverse childhood experience and PTSD development after adulthood trauma. Transl Psychiatry 2023; 13:274. [PMID: 37542036 PMCID: PMC10403516 DOI: 10.1038/s41398-023-02576-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 07/25/2023] [Accepted: 07/27/2023] [Indexed: 08/06/2023] Open
Abstract
The hypothalamus is critical for regulation of the hypothalamic-pituitary-adrenal (HPA) axis and response to stress. Adverse childhood experience (ACE) can affect brain structure, which may contribute to development of posttraumatic stress disorder (PTSD) after subsequent adult trauma. It is unclear, however, if ACE history is particularly associated with aspects of hypothalamic structure which contribute to development of PTSD. To address this issue, the present study longitudinally assessed hypothalamic volumes and their associations with ACE and early post-trauma stress symptoms in subjects who did or did not develop PTSD during 12 months after adult trauma. 109 subjects (18-60 years, F/M = 75/34) completed the PTSD Checklist (PCL) questionnaire for post-trauma stress symptoms, the Childhood Trauma Questionnaire (CTQ) for ACE assessment, and an initial MRI brain scan for hypothalamic volume measurement, within 2 weeks after adult trauma. At post-trauma 12 months, subjects underwent a subsequent PTSD diagnosis interview using the Clinician-Administered PTSD Scale (CAPS), and a follow-up MRI scan. Left and right hypothalamus volumes at 2 weeks after adult trauma negatively correlated with CTQ scores. Right hypothalamus volume at this early time mediated an association between ACE and PTSD symptoms 12 months later. Right hypothalamus volumes also remained persistently smaller from 2 weeks to 12 months after trauma in survivors who developed PTSD. These results suggest that smaller right hypothalamus volume may be related to ACE history in ways that contribute to PTSD development after trauma in adulthood.
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Affiliation(s)
- Hong Xie
- Department of Neurosciences, University of Toledo, Toledo, OH, USA.
| | - Chia-Hao Shih
- Department of Emergency Medicine, University of Toledo, Toledo, OH, USA
| | | | - John T Wall
- Department of Neurosciences, University of Toledo, Toledo, OH, USA
| | - Xin Wang
- Department of Psychiatry, University of Toledo, Toledo, OH, USA
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Gürsoy MY, Mechmet FC. Correlations between childhood trauma and depression, anxiety, and stress levels in nurses. Arch Psychiatr Nurs 2023; 45:164-168. [PMID: 37544694 DOI: 10.1016/j.apnu.2023.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 04/19/2023] [Accepted: 06/24/2023] [Indexed: 08/08/2023]
Abstract
AIMS This study aims to determine correlations between childhood trauma and depression, anxiety, and stress levels in nurses. METHODS This cross-sectional study was conducted among nurses in Turkey from August to September 2022. A total of 395 nurses were included in the study. Data were collected through an online survey using a personal information form, the Childhood Trauma Questionnaire (CTQ-28), and the Depression, Anxiety, and Stress Scale (DASS 21). RESULTS The mean score of the CTQ-28 total scale was 51.6, and emotional neglect was the most common type of abuse. The prevalence of moderate-to-extremely severe depression, anxiety, and stress was 34.7 %, 42.2 %, and 18.3 %, respectively. Emotional abuse and emotional neglect subscales of the CTQ were independently related to all three DASS subscale scores. CONCLUSION This study revealed that the emotional abuse and neglect experienced in childhood are related to the nurses' current stress, anxiety, and depression levels.
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Affiliation(s)
- Melike Yalçın Gürsoy
- Canakkale Onsekiz Mart University, Çanakkale Faculty of Health Sciences, Terzioglu Campus, Canakkale/Center, Turkey.
| | - Fatme Chousko Mechmet
- Çanakkale Onsekiz Mart University, School of Graduate Studies, M.Sc. Program in Nursing, Canakkale/Center, Turkey
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Lee ARYB, Low CE, Yau CE, Li J, Ho R, Ho CSH. Lifetime Burden of Psychological Symptoms, Disorders, and Suicide Due to Cancer in Childhood, Adolescent, and Young Adult Years: A Systematic Review and Meta-analysis. JAMA Pediatr 2023; 177:790-799. [PMID: 37345504 PMCID: PMC10288378 DOI: 10.1001/jamapediatrics.2023.2168] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 04/26/2023] [Indexed: 06/23/2023]
Abstract
Importance A cancer diagnosis and treatment may result in highly traumatic periods with lasting psychological consequences for children, adolescent, and young adult patients with cancer (CYACs). Early identification and management may prevent long-term psychological morbidity and suicide. Objective To analyze risk, severity, and risk factors for depression, anxiety, psychotic disorders, and suicide in CYACs and noncancer comparators. Data Sources Literature search of PubMed, MEDLINE, Embase, PsycINFO, CINAHL, and PubMed Central from January 1, 2000, to November 18, 2022. Study Selection Full-length articles in peer-reviewed journals that measured and reported risk and/or severity of depression, anxiety, psychotic disorders, and suicide mortality in CYACs and a noncancer comparator group. Data Extraction and Synthesis Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines were followed with prospective PROSPERO registration. Main Outcomes and Measures Risk ratios (RRs) were used for dichotomous outcomes, and standardized mean differences (SMDs) were used for continuous outcomes. SMDs were defined as follows: 0.2, small; 0.5, medium; and 0.8, large. Sources of heterogeneity and risk factors were investigated using sensitivity, subgroup, and meta-regression analyses. Results From 7319 records, 52 studies were included. Meta-analyses revealed that CYACs were at increased lifetime risk of severe symptoms or a disorder of depression (RR, 1.57; 95% CI, 1.29-1.92), anxiety (RR, 1.29; 95% CI, 1.14-1.47), and psychotic disorders (RR, 1.56; 95% CI, 1.36-1.80) relative to both matched controls and their siblings. Overall suicide mortality was not significantly elevated (RR, 1.63; 95% CI, 0.78-3.40). The mean severity of depression was found to be elevated in CYACs receiving treatment (SMD, 0.44; 95% CI, 0.13-0.74) and long-term survivors (SMD, 0.18; 95% CI, 0.02-0.33). The mean severity of anxiety was found to be elevated only during treatment (SMD, 0.16; 95% CI, 0.03-0.20). Conclusions and Relevance Findings of this systematic review and meta-analysis suggest that CYACs may experience lasting psychological burden long into survivorship. Timely identification, preventive efforts, and psycho-oncological intervention for psychological comorbidity are recommended.
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Affiliation(s)
- Ainsley Ryan Yan Bin Lee
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Chen Ee Low
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Chun En Yau
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jiaqi Li
- School of Clinical Medicine, University of Cambridge, Addenbrooke’s Hospital, Cambridge, United Kingdom
| | - Roger Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Psychological Medicine, National University Hospital, Singapore
| | - Cyrus Su Hui Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Psychological Medicine, National University Hospital, Singapore
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Zhou Z, Lo CKM, Chan KL, Chung RSY, Pell JP, Minnis H, Shiels PG, Ip P, Ho FK. Child maltreatment and telomere length in middle and older age: retrospective cohort study of 141 748 UK Biobank participants. Br J Psychiatry 2023; 223:377-381. [PMID: 36946056 DOI: 10.1192/bjp.2023.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
BACKGROUND There is evidence that child maltreatment is associated with shorter telomere length in early life. AIMS This study aims to examine if child maltreatment is associated with telomere length in middle- and older-age adults. METHOD This was a retrospective cohort study of 141 748 UK Biobank participants aged 37-73 years at recruitment. Leukocyte telomere length was measured with quantitative polymerase chain reaction, and log-transformed and scaled to have unit standard deviation. Child maltreatment was recalled by participants. Linear regression was used to analyse the association. RESULTS After adjusting for sociodemographic characteristics, participants with three or more types of maltreatment presented with the shortest telomere lengths (β = -0.05, 95% CI -0.07 to -0.03; P < 0.0001), followed by those with two types of maltreatment (β = -0.02, 95% CI -0.04 to 0.00; P = 0.02), referent to those who had none. When adjusted for depression and post-traumatic stress disorder, the telomere lengths of participants with three or more types of maltreatment were still shorter (β = -0.04, 95% CI -0.07 to -0.02; P = 0.0008). The telomere lengths of those with one type of maltreatment were not significantly different from those who had none. When mutually adjusted, physical abuse (β = -0.05, 95% CI -0.07 to -0.03; P < 0.0001) and sexual abuse (β = -0.02, 95% CI -0.04 to 0.00; P = 0.02) were independently associated with shorter telomere length. CONCLUSIONS Our findings showed that child maltreatment is associated with shorter telomere length in middle- and older-aged adults, independent of sociodemographic and mental health factors.
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Affiliation(s)
- Ziyi Zhou
- School of Health and Wellbeing, University of Glasgow, UK
| | - Camilla K M Lo
- Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong
| | - Ko Ling Chan
- Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong
| | | | - Jill P Pell
- School of Health and Wellbeing, University of Glasgow, UK
| | - Helen Minnis
- School of Health and Wellbeing, University of Glasgow, UK
| | - Paul G Shiels
- Institute of Cancer Studies, University of Glasgow, UK
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong
| | - Frederick K Ho
- School of Health and Wellbeing, University of Glasgow, UK
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Agathis NT, Annor FB, Xu L, Swedo E, Chiang L, Coomer R, Hegle J, Patel P, Forster N, O’Malley G, Ensminger AL, Kamuingona R, Andjamba H, Nshimyimana B, Manyando M, Massetti GM. Strong Father-Child Relationships and Other Positive Childhood Experiences, Adverse Childhood Experiences, and Sexual Risk Factors for HIV among Young Adults Aged 19-24 Years, Namibia, 2019: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6376. [PMID: 37510608 PMCID: PMC10378761 DOI: 10.3390/ijerph20146376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 07/07/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023]
Abstract
Using cross-sectional data from the 2019 Namibia Violence Against Children and Youth Survey and sex-stratified multivariable models, we assessed the associations between four different positive childhood experiences (PCEs) and having ≥3 adverse childhood experiences (ACEs), including ≥3 ACE-PCE interaction terms, and seven sexual risk factors for HIV acquisition among young adults aged 19-24 years. One PCE, having a strong father-child relationship, was inversely associated with two risk factors among women (lifetime transactional sex (OR, 0.4; 95% CI, 0.2-0.7) and recent age-disparate sexual relationships (OR, 0.3; 95% CI, 0.2-0.5)), and significantly interacted with having ≥3 ACEs for three risk factors among women (not knowing a partner's HIV status, infrequently using condoms, and ever having an STI) and one among men (having multiple sexual partners in the past year). The other PCEs were significantly associated with ≤1 HIV risk factor and had no significant interaction terms. Strong father-child relationships may reduce HIV acquisition risk and mitigate the effect of childhood adversity on HIV risk among young adults in Namibia.
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Affiliation(s)
- Nickolas T. Agathis
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Francis B. Annor
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Likang Xu
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Elizabeth Swedo
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Laura Chiang
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Rachel Coomer
- Division of Global HIV and TB, Global Health Center, Centers for Disease Control and Prevention, Private Bag, Windhoek 12029, Namibia
| | - Jennifer Hegle
- Division of Global HIV and TB, Global Health Center, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Pragna Patel
- Division of Global HIV and TB, Global Health Center, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Norbert Forster
- International Training and Education Center for Health, Department of Global Health, University of Washington, Seattle, WA 98195, USA
| | - Gabrielle O’Malley
- International Training and Education Center for Health, Department of Global Health, University of Washington, Seattle, WA 98195, USA
| | - Alison L. Ensminger
- International Training and Education Center for Health, Department of Global Health, University of Washington, Seattle, WA 98195, USA
| | - Rahimisa Kamuingona
- Ministry of Gender Equality, Poverty Eradication, and Social Welfare, Private Bag, Windhoek 13359, Namibia
| | - Helena Andjamba
- Ministry of Gender Equality, Poverty Eradication, and Social Welfare, Private Bag, Windhoek 13359, Namibia
| | - Brigitte Nshimyimana
- Ministry of Gender Equality, Poverty Eradication, and Social Welfare, Private Bag, Windhoek 13359, Namibia
| | - Molisa Manyando
- US Agency for International Development, Washington, DC 20004, USA
| | - Greta M. Massetti
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
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Rivi V, Rigillo G, Toscano Y, Benatti C, Blom JMC. Narrative Review of the Complex Interaction between Pain and Trauma in Children: A Focus on Biological Memory, Preclinical Data, and Epigenetic Processes. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1217. [PMID: 37508714 PMCID: PMC10378710 DOI: 10.3390/children10071217] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/07/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023]
Abstract
The incidence and collective impact of early adverse experiences, trauma, and pain continue to increase. This underscores the urgent need for translational efforts between clinical and preclinical research to better understand the underlying mechanisms and develop effective therapeutic approaches. As our understanding of these issues improves from studies in children and adolescents, we can create more precise preclinical models and ultimately translate our findings back to clinical practice. A multidisciplinary approach is essential for addressing the complex and wide-ranging effects of these experiences on individuals and society. This narrative review aims to (1) define pain and trauma experiences in childhood and adolescents, (2) discuss the relationship between pain and trauma, (3) consider the role of biological memory, (4) decipher the relationship between pain and trauma using preclinical data, and (5) examine the role of the environment by introducing the importance of epigenetic processes. The ultimate scope is to better understand the wide-ranging effects of trauma, abuse, and chronic pain on children and adolescents, how they occur, and how to prevent or mitigate their effects and develop effective treatment strategies that address both the underlying causes and the associated physiological and psychological effects.
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Affiliation(s)
- Veronica Rivi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Giovanna Rigillo
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Ylenia Toscano
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Cristina Benatti
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
- Centre of Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Johanna Maria Catharina Blom
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
- Centre of Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, 41125 Modena, Italy
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