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Redmond A, Gaynor K, Naughton S, Clarke M. Recorded Rates of Trauma-Exposure in a Retrospective Epidemiologically Complete First-Episode Psychosis Cohort. Early Interv Psychiatry 2024. [PMID: 39215565 DOI: 10.1111/eip.13610] [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: 05/31/2024] [Revised: 08/09/2024] [Accepted: 08/11/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Trauma plays an important role in the development and maintenance of psychosis. However, it is still under-examined in daily clinical practice. The current study investigated the rates of recording of trauma-exposure in the clinical histories of a first-episode psychosis (FEP) cohort attending an early intervention psychosis service. METHODS This study used a retrospective chart review methodology in a 6-year epidemiologically complete FEP cohort attending an early intervention psychosis service. The Trauma and Life Events Checklist was used to define the rate and types of trauma-exposure reported in clinical histories. The relationships were examined between recorded trauma-exposure and positive and negative symptoms, depression and duration of untreated psychosis at first assessment. RESULTS Trauma-exposure was frequently recorded within clinical histories. Childhood trauma-exposure was recorded in 47.4% of the sample, which is lower than may be expected. No significant relationships between the recorded trauma-exposure and symptom measures were found. A significant relationship was found between interpersonal stressors and positive symptoms, and work-related stress and negative symptoms, highlighting the importance of proximal stressful life events. DISCUSSION This study found that clinicians were frequently recording trauma-exposure in daily practice. However, it was unclear whether the recording of trauma-exposure highlighted led to systematic diagnosis, assessment or treatment of trauma for people with psychosis. The importance of treatment and service planning to include information about trauma-exposure is discussed.
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Affiliation(s)
- Aisling Redmond
- School of Psychology, University College Dublin, Belfield, Dublin, Ireland
| | - Keith Gaynor
- School of Psychology, University College Dublin, Belfield, Dublin, Ireland
- DETECT, Early Intervention in Psychosis Service, Blackrock, Dublin, Ireland
| | - Sean Naughton
- DETECT, Early Intervention in Psychosis Service, Blackrock, Dublin, Ireland
| | - Mary Clarke
- DETECT, Early Intervention in Psychosis Service, Blackrock, Dublin, Ireland
- School of Medicine, University College Dublin, Belfield, Dublin, Ireland
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2
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Epe-Jungeblodt F, Pauli P, Schwab F, Andreatta M. Trauma history and course of therapy in a naturalistic cognitive behavior therapy outpatient sample: An archive data study. J Clin Psychol 2024; 80:1937-1948. [PMID: 38747513 DOI: 10.1002/jclp.23702] [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: 11/03/2023] [Revised: 03/20/2024] [Accepted: 04/30/2024] [Indexed: 07/05/2024]
Abstract
OBJECTIVE Cognitive Behavior Therapy (CBT) is an effective treatment for anxiety and depression disorders. Nonetheless, nearly 50% of all patients do not respond. Besides other factors, nonresponse may be linked to traumatic life events. This study aims to assess the relationship between trauma history, applied therapy interventions, and therapy outcomes. METHODS We analyzed data from 340 CBT outpatients diagnosed with a depression or anxiety disorder and possibly a trauma history treated under naturalistic conditions. Based on their therapy files, we collected information on trauma history, diagnoses, applied interventions, and severity of depression and anxiety symptoms at the start and end of therapy. The relationship between trauma, diagnoses, and intervention use and the development of depression and anxiety symptoms was analyzed using Linear Mixed Models. RESULTS Patients with a trauma history reported higher pre- and posttreatment symptom severity than those without trauma. No differences in applied interventions or decrease in symptom severity were found between patients with and without a trauma history. Specialized interventions were seldom applied. CONCLUSION Although no differences between patients with and without a trauma history were found in therapy response, patients with a trauma history maintained higher levels of symptom severity. These results indicate a need for more personalized interventions and evidence-based guidelines to personalize CBT for patients with a trauma history and high symptom severity.
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Affiliation(s)
- Franziska Epe-Jungeblodt
- Department of Psychology, Biological Psychology, Clinical Psychology, and Psychotherapy, Faculty of Human Sciences, Julius-Maximilians-Universität Würzburg (JMU), Würzburg, Germany
| | - Paul Pauli
- Department of Psychology, Biological Psychology, Clinical Psychology, and Psychotherapy, Faculty of Human Sciences, Julius-Maximilians-Universität Würzburg (JMU), Würzburg, Germany
| | - Frank Schwab
- Department of Media Psychology, Institute Human-Computer-Media, Faculty of Human Sciences, Julius-Maximilians-Universität Würzburg (JMU), Würzburg, Germany
| | - Marta Andreatta
- Department of General Psychiatry and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
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3
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Nagar M, Nakash O. Can I Leave the Past Behind? Associations between Childhood Abuse and Adult Psychopathology. Healthcare (Basel) 2024; 12:412. [PMID: 38338297 PMCID: PMC10855430 DOI: 10.3390/healthcare12030412] [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: 11/22/2023] [Revised: 01/26/2024] [Accepted: 02/02/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Research consistently shows that abuse during childhood is related to adult psychopathology. Information regarding childhood abuse is frequently collected from either previous documentation or from participants' self-reports. OBJECTIVE In the current study, we combined information on reports of childhood abuse from several informants (patients, treating clinicians, and independent interviewer), as well as diagnostic assessments of adult patients based on independent interviewer assessments based on structured diagnostic interviews (SCID) and clinician judgments, to better examine the association between exposure to abuse during childhood and adult psychopathology. PARTICIPANTS AND SETTING A convenience sample of patients in community mental health and hospital-based clinics (N = 170) and their clinicians (N = 80) participated in the study. METHODS Patients and clinicians completed the Clinical Data Form. Patients also completed the Childhood Trauma Questionnaire. Independent interviewer-assessed patients and completed the Familial Experiences Interview. Clinicians completed a diagnostic assessment of their patients based on clinical judgment. Independent interviewers completed the Structured Clinical Interview (SCID). RESULTS Reports of exposure to physical, emotional, and sexual abuse during childhood from all informants correlated with the treating clinician's diagnosis of borderline personality disorder (BPD; r range 0.23-0.37, p < 0.05), but not with SCID diagnosis of BPD. Clinician and SCID diagnosis of post-traumatic stress disorder (PTSD) correlated with patient and interviewer reports of childhood sexual abuse (r range 0.23-0.30, p < 0.05), but there were no correlations with treating clinician's reports of sexual abuse. CONCLUSIONS The association between BPD and childhood abuse is consistent across different ratings and measurements. The study raises questions of the ability of a structured interview to accurately capture BPD and highlights the connection between sexual abuse and PTSD, and the importance of treating clinicians' examination of childhood sexual abuse among their patients.
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Affiliation(s)
- Maayan Nagar
- Department of Criminology, Ariel University, Ariel 4070000, Israel
- School for Social Work, Smith College, Northampton, MA 01063, USA;
| | - Ora Nakash
- School for Social Work, Smith College, Northampton, MA 01063, USA;
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4
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Spidel A, Kealy D. Sexual risk behavior among individuals seeking outpatient mental health services: Associations with childhood emotional neglect and identity dysfunction. Bull Menninger Clin 2023; 87:6-24. [PMID: 36856476 DOI: 10.1521/bumc.2023.87.1.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
This study was developed to examine sexual risk behavior among patients seeking community-based mental health services, including associations with psychological distress, identity dysfunction, and childhood emotional neglect. A mediation model was examined regarding identity dysfunction mediating the link between emotional neglect and sexual risk behavior. A total of 245 outpatients completed questionnaires regarding perceived risky sexual behavior, psychological distress, identity dysfunction, and emotional neglect. Sexual risk behavior was found to be a prevalent issue among individuals seeking outpatient mental health services, with 13% reporting engagement in unsafe sexual practices at least some of the time. Mediation analysis revealed that childhood emotional neglect was indirectly linked with sexual risk behavior through the mediating effect of identity dysfunction. Thus, findings suggest a pathway to sexual risk behaviors through perceived childhood emotional neglect and identity dysfunction. Clinical attention to identity-related vulnerability among this population may be warranted in aiming to mitigate risk-taking associated with sexual practices.
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Affiliation(s)
- Alicia Spidel
- Lecturer in the Criminology Department of Kwantlen Polytechnic University, and a clinician in the Mental Health and Substance Use Services of the Fraser Health Authority, Surrey, British Columbia, Canada
| | - David Kealy
- Associate professor in the Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
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5
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Harvey LR, Hopkins R, Truscott M, Marel C, Slade T, Mills KL. A retrospective chart review of trauma-related documentation in an Australian substance use treatment service. Drug Alcohol Rev 2023; 42:373-383. [PMID: 36377196 PMCID: PMC10947072 DOI: 10.1111/dar.13575] [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: 05/21/2022] [Revised: 09/16/2022] [Accepted: 10/24/2022] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Trauma exposure among clients of substance use treatment services is almost universal and rates of trauma-related symptoms are correspondingly high. This study examined one aspect of clinical care-clinical documentation-and sought to systematically assess the documentation of trauma-related comorbidities and their treatment in a substance use treatment setting. METHODS A retrospective chart review was conducted on a sample of 300 patient records in a public substance use treatment setting. Rates of documentation of trauma-related events, symptoms and treatment, along with variables influencing the documentation of these issues, were examined. RESULTS Trauma-related documentation was present in 45.3% of records. There were documented trauma-related symptoms in 15.3% of records, although treatment activities addressing trauma were only present in 2.3% of records. Being female (odds ratio [OR] 2.58, 95% confidence interval [CI] 1.42, 4.69), having prior mental health treatment (OR 1.82, 95% CI 1.05, 1.12) and having more treatment sessions (OR 1.08, 95% CI = 1.05, 1.12) increased the odds of trauma-related documentation being present, while being in the first episode of treatment (OR 0.49, 95% CI = 0.28, 0.84) decreased the odds. DISCUSSION AND CONCLUSIONS This study highlights significant under documentation of trauma-related comorbidities in substance-use treatment. There is limited evidence of consideration of trauma-related symptoms or diagnoses, and trauma-related comorbidities are rarely included in treatment planning activities. The lack of documented trauma-related information has important clinical and medico-legal implications for patients, and provides evidence to suggest a lack of integration of treatment for trauma-related disorders in substance use settings.
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Affiliation(s)
- Logan R. Harvey
- Matilda Centre for Research in Mental Health and Substance UseThe University of SydneySydneyAustralia
| | - Rachel Hopkins
- Drug Health, Western Sydney Local Health DistrictSydneyAustralia
| | - Melanie Truscott
- Drug Health, Western Sydney Local Health DistrictSydneyAustralia
| | - Christina Marel
- Matilda Centre for Research in Mental Health and Substance UseThe University of SydneySydneyAustralia
| | - Tim Slade
- Matilda Centre for Research in Mental Health and Substance UseThe University of SydneySydneyAustralia
| | - Katherine L. Mills
- Matilda Centre for Research in Mental Health and Substance UseThe University of SydneySydneyAustralia
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6
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Ernst M, Beutel ME, Zwerenz R, Krakau L. Seeing the past in a new light: change in reports of childhood abuse and neglect before and after inpatient psychotherapy and its relevance for change in depression symptoms. Psychother Res 2023; 33:222-234. [PMID: 35790188 DOI: 10.1080/10503307.2022.2088313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVE As changes in mental representations have been discussed as mechanisms of change in psychotherapy, the question arises whether recollections of childhood abuse and neglect are altered as well and how they relate to symptom changes. METHOD Individuals in psychosomatic inpatient treatment (N = 488, 60.5% women) filled out the Childhood Trauma Questionnaire (CTQ) and Patient Health Questionnaire (PHQ-9). Changes in both were investigated with correlations and t-tests. Linear regression analysis was used to test whether CTQ changes predicted symptom changes. Network analysis was performed to ascertain structural connections between somatic and emotional-cognitive depression symptoms and CTQ subscales before and after treatment. RESULTS After treatment (duration in days: M = 52.83, SD = 20.94), patients reported fewer depression symptoms (d = 0.84), while CTQ scores increased slightly (d = 0.11). Changes in the CTQ predicted recovery from depression symptoms in a statistically significant way (β = .133, p = .001). We did not observe changes in the overall network structure between baseline assessment and discharge. CONCLUSION The findings suggest that the evaluation of past experiences can change over multiple weeks of psychotherapy. Further, these updated mental representations, indicating a greater recognition of past adversity, may contribute to symptom relief.
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Affiliation(s)
- Mareike Ernst
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Rüdiger Zwerenz
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Lina Krakau
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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7
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Ha J, Kim Y. Surviving Child Abuse in People With Mental Illness: A Grounded Theory Approach. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:2828-2849. [PMID: 35574841 DOI: 10.1177/08862605221102486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The aim of this qualitative study was to examine the process of surviving child abuse in people with a mental illness in order to develop an explanatory theory. The study utilized the grounded theory approach. Seventeen community-dwelling adults with a mental illness who had experienced child abuse were interviewed. For the in-depth interview, the lifeline interview method was used. Data were collected from July 14, 2019, to February 28, 2020. The constant comparative method was used for analysis, to identify similarities and differences between different statements, and similar phenomena or theories were compared and analyzed continuously. The central phenomena were "losing oneself" and "in a precarious state." Participants used "expressing," "standing on one's own feet," and "avoiding" as coping strategies. Observed outcomes were "making life work for them" and "living with others." The core category was "losing myself, embracing myself as someone in a precarious state, and being reborn as the master of my life." Positive religious coping, having a supportive network, and emotional or physical distance from difficult situations played a major role in surviving participants' experiences of child abuse and being victimized because of their mental illness. Our findings provide a theoretical basis for understanding people with mental illness who have survived child abuse, and suggest that opportunities for sharing their stories, facilitating self-reliance, and avoiding the causes of their difficulties all play a role in their healing process. Based on this study, it is expected that clinical experts and policy developers will be able to formulate evidence-based interventions and policies.
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Affiliation(s)
- Jeongmin Ha
- College of Nursing, 34940Dong-A University, Busan, Korea
| | - Yoonjung Kim
- Faculty of Red Cross College of Nursing, 26729Chung-Ang University, Seoul, Korea
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8
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Grindey A, Bradshaw T. Do different adverse childhood experiences lead to specific symptoms of psychosis in adulthood? A systematic review of the current literature. Int J Ment Health Nurs 2022; 31:868-887. [PMID: 35306711 DOI: 10.1111/inm.12992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 02/18/2022] [Accepted: 03/05/2022] [Indexed: 11/28/2022]
Abstract
Previous research has demonstrated significant associations between adverse childhood experiences (ACEs) and risks of psychosis. Further research has examined underlying mechanisms to understand the relationship between these variables. This review aimed to explore the associations between various ACEs and the development of different psychotic symptoms in adulthood. The Cochrane Library, Cinahl, PsychINFO, Medline, Embase, and Web of Science were searched from January 1980 to November 2021 to ensure a systematic review of relevant literature. Poverty, fostering, adoption, childhood emotional and physical neglect, and childhood physical (CPA), sexual (CSA), and emotional abuse (CEA) significantly correlated with delusions. Significant relationships were found between hallucinations and CSA and CPA. Paranoia correlated with violent adversities including CPA, assault, and witnessing killing. Limited associations were identified for thought disorder and negative symptoms. The findings of this review indicate that there may be a degree of specificity between various ACEs and psychotic symptoms, but these findings are subject to some limitations. The findings also demonstrate the importance of inquiring about and addressing ACE in clinical practice to develop formulations and treatment plans for individuals with psychosis.
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Affiliation(s)
- Ashleigh Grindey
- Home Based Treatment Team, Salford, UK.,Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Tim Bradshaw
- School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
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9
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Neill C, Read J. Adequacy of Inquiry About, Documentation of, and Treatment of Trauma and Adversities: A Study of Mental Health Professionals in England. Community Ment Health J 2022; 58:1076-1087. [PMID: 35094164 DOI: 10.1007/s10597-021-00916-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 11/06/2021] [Indexed: 11/25/2022]
Abstract
This study aimed to ascertain how often staff in community mental health services (CMHSs) in England ask about adverse experiences in childhood and adulthood, including abuse and neglect, how often those experiences are known about and documented by staff, and how staff respond when such experiences are known about and documented. The files of 400 people using four CMHSs in England were reviewed. Only 13% of clinical records contained documentation of any adverse experiences. One percent showed clear evidence that clients had been asked about adversities. People with psychosis diagnoses were less likely to have adverse experiences documented in their file. Rates of responses to adversities of which staff were aware were high, with 90% of records indicating some appropriate support following disclosure. Future research endeavours are recommended, including on reasons for not routinely asking and on type of training needed. Recommendations are made in relation to policy change, staff training and guidelines to improve routine enquiry about adversities. Ultimately, a move to 'trauma-informed' services, already underway in some areas, is required for all mental health services.
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Affiliation(s)
- Caitlin Neill
- School of Psychology, University of East London, Water Lane, London, E15 4LZ, UK
| | - John Read
- School of Psychology, University of East London, Water Lane, London, E15 4LZ, UK.
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10
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Bungener SL, Post L, Berends I, Steensma TD, de Vries ALC, Popma A. Talking About Sexuality With Youth: A Taboo in Psychiatry? J Sex Med 2022; 19:421-429. [PMID: 35105513 DOI: 10.1016/j.jsxm.2022.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 12/28/2021] [Accepted: 01/01/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Young people who have psychiatric problems are more likely than their peers to endure difficulties during their sexual and gender identity development. AIM This study aims to examine the communication between mental health care providers and their patients about the topics of relations, sexuality and gender identity, including a description of professionals' attitudes toward these topics and the factors that contribute to and inhibit communication. METHODS Study participants (n = 242, response rate = 31%) were a representative sample of a large multicenter cohort of 768 mental health care professionals (eg, medical doctors, psychiatrists, psychologists, group counselors, parent counselors) of 7 institutions and 5 solo practices in the Netherlands, who completed a survey on communication about sexuality and gender identity with their young patients (age 12-21 years). OUTCOMES Sexuality and gender identity are infrequently discussed by mental health care providers with their young patients or their patients' parents. RESULTS Of the study sample, 99.5 % valued sexuality as an important topic to discuss with their patients. However, only 17.1% of the professionals reported that they discussed sexuality-related issues with the majority (>75%) of their patients (adolescents: 19.9%, parents: 14.4%) Additionally, only 2.3 % of the participants discussed gender nonconformity regularly with patients. Information about sexual side effects of prescribed medication was infrequently (20.3%) provided: antidepressants (40.0%), antipsychotics (34.0%), benzodiazepines (5.1%) and stimulants (2.4%). The most frequently cited reasons for not discussing these topics were a lack of awareness, own feelings of discomfort, and the patients' supposed feelings of shame. There was no gender differences observed. CLINICAL IMPLICATIONS Recommendations for professionals include to be aware of these topics, initiating age-appropriate conversation and use inclusive language. STRENGTHS AND LIMITATIONS The present study included a diverse and representative group of mental health care professionals. Frequency of sexual communication was based on self-report, which brings a risk of bias. CONCLUSION Despite a recognized need to engage in age-appropriate communication about sexuality and gender identity in youth mental health care, mental health providers seem to remain hesitant to discuss such topics. Bungener SL, Post L, Berends I, et al. Talking About Sexuality With Youth: A Taboo in Psychiatry?. J Sex Med 2022;19:421-429.
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Affiliation(s)
- Sara L Bungener
- Center of Expertise on Gender Dysphoria, Department of Child and Adolescent Psychiatry, Department of Medical Psychology, Amsterdam University Medical Centers, Amsterdam, the Netherlands.
| | - Laura Post
- Center of Expertise on Gender Dysphoria, Department of Child and Adolescent Psychiatry, Department of Medical Psychology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Inez Berends
- Center of Expertise on Gender Dysphoria, Department of Child and Adolescent Psychiatry, Department of Medical Psychology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Thomas D Steensma
- Center of Expertise on Gender Dysphoria, Department of Child and Adolescent Psychiatry, Department of Medical Psychology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Annelou L C de Vries
- Center of Expertise on Gender Dysphoria, Department of Child and Adolescent Psychiatry, Department of Medical Psychology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Arne Popma
- Center of Expertise on Gender Dysphoria, Department of Child and Adolescent Psychiatry, Department of Medical Psychology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
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Eisenbarth H, Garofalo C. The Role of Psychopathic Traits in Explaining Associations Between Childhood Traumatic Experiences and Aggression. J Pers Disord 2021; 35:38-55. [PMID: 33779279 DOI: 10.1521/pedi_2021_35_507] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The present study reports on a preregistered investigation of the potential mediating role of the triarchic psychopathy components Boldness, Meanness, and Disinhibition for associations between childhood traumatic experiences (CTE) and aggression. Three nonclinical samples (total N = 1,729; 1,176 women, 68.02%) completed self-report instruments of CTE, triarchic psychopathy traits, reactive and proactive aggression (Samples 1 and 2), and general aggression (Sample 3). Cross-sectional path analyses revealed that both Meanness and Disinhibition consistently mediated associations between CTE and aggression. These indirect effects were consistent across gender, even though the direct effect of Meanness on proactive aggression was stronger in men than in women (Samples 1 and 2). Finally, Boldness had weak negative associations with childhood traumatic experiences in all three samples, but no direct association with aggression. Taken together, these correlational findings suggest potential developmental mechanisms linking early traumatic experiences to adult aggression through elevated levels of psychopathic traits.
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Affiliation(s)
| | - Carlo Garofalo
- Victoria University of Wellington, New Zealand.,Tilburg University, Tilburg, The Netherlands
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12
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Leppäkoski T, Vuorenmaa M, Paavilainen E. Psychological and physical abuse towards four-year-old children as reported by their parents: A national Finnish survey. CHILD ABUSE & NEGLECT 2021; 118:105127. [PMID: 34139384 DOI: 10.1016/j.chiabu.2021.105127] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 05/11/2021] [Accepted: 05/17/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND In Finnish society, child maltreatment is a health and social problem with harmful consequences. Identifying families at risk may help preventing child maltreatment recurrence. OBJECTIVE The aim of this nationwide retrospective cross-sectional study was to describe the child- and family-related risk factors associated with physical and psychological abuse experienced by 4-year-old children. METHODS This study analyzed nationwide survey data collected by the Finnish Institute for Health and Welfare. Overall, 17,009 parents (46%) visiting at a child health clinic filled out the survey consent form. For 8720 children, one or both parents completed the questionnaire (24%). Analyses were carried out using χ2 tests and binary logistic regression. RESULTS Of the 4-year-olds, 44% had experienced at least one form of psychological abuse and 14% physical abuse. These forms of violence co-occurred in 25% of the reported cases (p < 001). Intimate partner violence (IPV) and child maltreatment co-occurred in 19.6% of psychological abuse (p < .001) and 22.5% of physical abuse cases (p < .001). Parents exposed to IPV was the risk factor most likely to predict an increased risk for both psychological abuse (OR 4.01, CI 3.41-4.72; p < .001), and physical abuse (OR 2.19, CI 1.81-2.64; p < .001). Approving of hair-pulling or pinching the child (i.e., using corporal punishment) was most likely to predict an increased risk of physical abuse (OR 13.70, CI 11.69-16.06; p < .001). CONCLUSIONS The findings emphasize the importance of preventing all forms of child maltreatment by identifying families at risk and supporting parenthood according to families' needs.
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Affiliation(s)
- Tuija Leppäkoski
- Dept of Health Sciences, Faculty of Social Sciences, Tampere University, Finland.
| | - Maaret Vuorenmaa
- Finnish Institute for Health and Welfare (THL), City of Helsinki, Finland.
| | - Eija Paavilainen
- Dept of Health Sciences, Faculty of Social Sciences, Tampere University, Finland; South Ostrobothnia Hospital District, Finland.
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13
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Werbeloff N, Hilge Thygesen J, Hayes JF, Viding EM, Johnson S, Osborn DP. Childhood sexual abuse in patients with severe mental Illness: Demographic, clinical and functional correlates. Acta Psychiatr Scand 2021; 143:495-502. [PMID: 33779997 PMCID: PMC8252558 DOI: 10.1111/acps.13302] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 03/21/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To use data from electronic health records (EHRs) to describe the demographic, clinical and functional correlates of childhood sexual abuse (CSA) in patients with severe mental illness (SMI), and compare their clinical outcomes (admissions and receipt of antipsychotic medications) to those of patients with no recorded history of CSA. METHODS We applied a string-matching technique to clinical text records of 7000 patients with SMI (non-organic psychotic disorders or bipolar disorder), identifying 619 (8.8%) patients with a recorded history of CSA. Data were extracted from both free-text and structured fields of patients' EHRs. RESULTS Comorbid diagnoses of major depressive disorder, post-traumatic stress disorder and personality disorders were more prevalent in patients with CSA. Positive psychotic symptoms, depressed mood, self-harm, substance use and aggression were also more prevalent in this group, as were problems with relationships and living conditions. The odds of inpatient admissions were higher in patients with CSA than in those without (adjusted OR = 1.95, 95% CI: 1.64-2.33), and they were more likely to have spent more than 10 days per year as inpatients (adjusted OR = 1.32, 95% CI: 1.07-1.62). Patients with CSA were more likely to be prescribed antipsychotic medications (adjusted OR = 2.48, 95% CI: 1.69-3.66) and be given over 75% of the maximum recommended daily dose (adjusted OR = 1.72, 95% CI: 1.44-2.04). CONCLUSION Data-driven approaches are a reliable, promising avenue for research on childhood trauma. Clinicians should be trained and skilled at identifying childhood adversity in patients with SMI, and addressing it as part of the care plan.
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Affiliation(s)
- Nomi Werbeloff
- The Louis and Gabi Weisfeld School of Social WorkBar Ilan UniversityRamat GanIsrael,Division of PsychiatryUniversity College LondonLondonUK
| | - Johan Hilge Thygesen
- Camden and Islington NHS Foundation TrustLondonUK,Institute of Health InformaticsUniversity College LondonLondonUK
| | - Joseph F. Hayes
- Division of PsychiatryUniversity College LondonLondonUK,Camden and Islington NHS Foundation TrustLondonUK
| | - Essi M. Viding
- Division of Psychology & Language SciencesUniversity College LondonLondonUK
| | - Sonia Johnson
- Division of PsychiatryUniversity College LondonLondonUK,Camden and Islington NHS Foundation TrustLondonUK
| | - David P.J. Osborn
- Division of PsychiatryUniversity College LondonLondonUK,Camden and Islington NHS Foundation TrustLondonUK
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14
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Kaplan MJ, Privitera MD, Meziane-Tani A. Characteristics of men with conversion disorder. Epilepsy Behav 2021; 114:107556. [PMID: 33246898 DOI: 10.1016/j.yebeh.2020.107556] [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: 07/03/2020] [Revised: 10/09/2020] [Accepted: 10/09/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Women comprise the majority of subjects with conversion disorders in nearly all studies. The authors previously identified 96 subjects with psychogenic non-epileptic seizures (PNES) and found that female sex, alexithymia and childhood trauma were strongly correlated with the development of PNES. In order to characterize men with PNES, the authors collected questionnaire data on a series of male subjects recruited from an epilepsy monitoring unit (EMU). METHODS Only male patients admitted to the EMU were asked to complete the Toronto Alexithymia Scale-20 (TAS-20) and the Childhood Trauma Questionnaire (CTQ). Results were correlated with diagnosis at discharge, either epileptic seizures (ES) or PNES. RESULTS Ninety-two subjects submitted complete questionnaire data. Sixty-nine subjects (74%) were diagnosed with ES, 13 subjects (14%) were diagnosed with PNES and 10 subjects (11%) had an undetermined diagnosis. There were no significant differences on the TAS-20 or the CTQ by diagnosis. CONCLUSION In this sample of men admitted to an EMU there was no difference in the extent of alexithymia or childhood trauma between men with ES and PNES. There was a small number of men with a PNES diagnosis, which may have limited our ability to identify differences in the groups. The clear correlation of childhood trauma and alexithymia with development of conversion disorder in women could not be demonstrated in men.
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Affiliation(s)
- Marcia J Kaplan
- University of Cincinnati College of Medicine, Dept. of Psychiatry, United States.
| | - Michael D Privitera
- University of Cincinnati College of Medicine, Dept. of Neurology, United States
| | - Assia Meziane-Tani
- University of Cincinnati College of Medicine, Dept. of Neurology, United States
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15
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Binnie V, Le Brocque R, Jessup M, Johnston ANB. Adult frequent presentation to emergency departments and adverse childhood experiences: a scoping review. Australas Emerg Care 2020; 24:264-279. [PMID: 33358578 DOI: 10.1016/j.auec.2020.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 11/16/2020] [Accepted: 11/25/2020] [Indexed: 01/24/2023]
Abstract
BACKGROUND Extensive literature reports the influence of childhood adversity on adult health, however few studies have explored these life antecedents in people who frequently present to the emergency department. This review synthesizes literature exploring childhood adversity influences on emergency department presentations, if and how it is identified, and interventions addressing the health care needs of this group. METHODS Eight electronic databases were searched. Arksey and O'Malley's framework guided this review, and a quality appraisal was undertaken. Searches included all published studies until August 2020. RESULTS Twenty-one articles were included in this review. They revealed that childhood adversity is common among adults who frequently attend the emergency department. It impacts physical and psychological health into adulthood and there is no standardized approach described to documenting childhood adversity, nor any consistent intervention reported by emergency departments to address its sequelae in adulthood. CONCLUSIONS Several studies call for screening, intervention, and education to identify and address impacts of childhood adversity for patients who frequently present to the emergency department. However, reliable high-level studies exploring these topics specific to the emergency department are uncommon. Consequently, definitive interventions to address the healthcare needs of this group is lacking and warrants further research.
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Affiliation(s)
- Vicki Binnie
- School of Nursing Midwifery and Social Work, The University of Queensland, St Lucia, Qld, 4072, Australia.
| | - Robyne Le Brocque
- School of Nursing Midwifery and Social Work, The University of Queensland, St Lucia, Qld, 4072, Australia
| | - Melanie Jessup
- School of Nursing Midwifery and Social Work, The University of Queensland, St Lucia, Qld, 4072, Australia
| | - Amy N B Johnston
- School of Nursing Midwifery and Social Work, The University of Queensland, St Lucia, Qld, 4072, Australia; Department of Emergency Medicine, Princess Alexandra Hospital, Metro South Hospital and Health Service, Brisbane, Qld, 4102, Australia
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16
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Haney K, LeBeau K, Bodner S, Czizik A, Young ME, Hart M. Sex Trafficking in the United States: A Scoping Review. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2020; 17:714-748. [PMID: 32678726 DOI: 10.1080/26408066.2020.1765934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE Human trafficking is a public health social work issue. This review aimed to present the current state (nature and extent) of sex trafficking research, categorize best practices, and identify recommendations for professionals. METHODS Comprehensive literature searches of online databases were conducted to identify eligible articles from January 2000 to March 2019. RESULTS The search yielded 467 studies, 87 met the predetermined criteria for inclusion. Seven themes identified: awareness, identification, at-risk populations, health issues, implementation of trafficking legislation, service and program implementation, and exploiters. DISCUSSION AND IMPLICATIONS FOR PRACTICE Findings indicate the need for additional research to determine the most effective practices to increase awareness and identification, widespread TVPA implementation, reduce risk factors and resulting health disparities, offer services to survivors and prevention of potential victims. CONCLUSION There should be significant efforts to enhance all sex trafficking research in the United States to implement effective, sustainable and evidence-based interdisciplinary interventions.
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Affiliation(s)
- Kanathy Haney
- Health Sciences, Palm Beach State College , Lake Worth, Florida, USA
- Department of Epidemiology, University of Florida , Gainesville, Florida, USA
| | - Kelsea LeBeau
- Department of Epidemiology, University of Florida , Gainesville, Florida, USA
| | - Samantha Bodner
- Department of Epidemiology, University of Florida , Gainesville, Florida, USA
| | - Annika Czizik
- Department of Medical Geography in Public Health, University of Florida , Gainesville, Florida, USA
| | - Mary Ellen Young
- Department of Occupational Therapy, University of Florida , Gainesville, Florida, USA
| | - Mark Hart
- Department of Epidemiology, University of Florida , Gainesville, Florida, USA
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17
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Reiter H, Humphreys L. Exposure, Relaxation, and Rescripting Therapy for Trauma-Related Nightmares With Psychiatric Inpatients: A Case Series. Clin Case Stud 2020. [DOI: 10.1177/1534650120953614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Research has shown that posttraumatic stress disorder (PTSD) is a highly prevalent diagnosis for psychiatric patients, yet individualized care and treatment is limited in the inpatient acute care sector. Two case studies are presented which examine the use of Exposure, Relaxation, and Rescripting Therapy (ERRT) for chronic trauma-related nightmares, within a private acute care inpatient psychiatric hospital setting. ERRT is empirically supported with efficacy for veteran and civilian populations, however no research to date has been conducted with psychiatric inpatients. Two participants diagnosed with PTSD, suffering distressing trauma-related nightmares, completed ERRT over three sessions during their psychiatric hospital admission, with the aim of reducing the frequency and severity of nightmares and related psychological symptoms. PTSD, depression, sleep quality and quantity, and nightmare frequency and related distress, were measured pre-treatment, during treatment, and follow-up at one, 3 and 6 months. Only one participant reported ongoing nightmares by the third week of the intervention, with both participants reporting an absence of nightmares at the one and 3-month follow-ups, but mixed results by the 6-month follow-up. One participant also reported a reduction in PTSD symptoms and a mild improvement in depression. The results offer some preliminary support for the provision of ERRT for the treatment of trauma-related nightmares for psychiatric inpatients.
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Affiliation(s)
- Helen Reiter
- Charles Sturt University, Bathurst, New South Wales, Australia
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18
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Lloyd S, Larivée A. Time, trauma, and the brain: How suicide came to have no significant precipitating event. SCIENCE IN CONTEXT 2020; 33:299-327. [PMID: 34096495 DOI: 10.1017/s0269889721000065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
In this article, we trace shifting narratives of trauma within psychiatric, neuroscience, and environmental epigenetics research. We argue that two contemporary narratives of trauma - each of which concerns questions of time and psychopathology, of the past invading the present - had to be stabilized in order for environmental epigenetics models of suicide risk to be posited. Through an examination of these narratives, we consider how early trauma came to be understood as playing an etiologically significant role in the development of suicide risk. Suicide, in these models, has come to be seen as a behavior that has no significant precipitating event, but rather an exceptional precipitating neurochemical state, whose origins are identified in experiences of early traumatic events. We suggest that this is a part of a broader move within contemporary neurosciences and biopsychiatry to see life as post: seeing life as specific form of post-traumatic subjectivity.
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19
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Smith DM, Blake JJ, Luo W, Keith VM, Gilreath T. Subtypes of Girls Who Engage in Serious Delinquency and Their Young Adult Outcomes. PSYCHOLOGY OF WOMEN QUARTERLY 2020. [DOI: 10.1177/0361684320918243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Girls are increasingly becoming involved with the juvenile justice system; however, what brings girls to engage in delinquency or what obstacles these girls face later in life resulting from adolescent criminal behavior is understudied. In the present study, we used latent class analysis to identify subtypes of risks among adolescent girls ( N = 1,174) who have engaged in delinquent behaviors and mixture modeling to determine what distal psychological, social, educational, and economic outcomes in young adulthood are associated with each subtype. Four adolescent subtypes were identified, which were distinguished primarily based on the severity of their self-reported victimization experiences and mental health concerns. Classes with higher levels of victimization experiences tended to report more engagement with delinquent behavior in adolescence and had a larger proportion of Black and Hispanic girls than lower-victimization classes. Identified classes differed from each other on distal (i.e., young adulthood) measures of economic instability, educational attainment, drug use, depression, and adult arrests. Generally, latent classes which were characterized by higher rates of victimization and mental health concerns and lower educational performance in adolescence fared worse in young adulthood. Implications for those who care for girls who engage in delinquency, including suggestions for using trauma and culture informed screening, prevention, and intervention services, and directions for future research are discussed. Additional online materials for this article are available on PWQ’s website at http://journals.sagepub.com/doi/suppl/0361684320918243 .
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Affiliation(s)
- Danielle M. Smith
- Department of Child and Adolescent Psychiatry, Kaiser Permanente San Jose Medical Center, CA, USA
| | - Jamilia J. Blake
- Department of Educational Psychology, Texas A&M University, College Station, USA
| | - Wen Luo
- Department of Educational Psychology, Texas A&M University, College Station, USA
| | - Verna M. Keith
- Department of Sociology, University of Alabama at Birmingham, USA
| | - Tameka Gilreath
- Department of Health and Kinesiology, Texas A&M University, College Station, USA
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20
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Nagar M, Nakash O, Westen D. Unpacking childhood experiences of abuse: Can clinicians identify their patients' History of Abuse? J Trauma Dissociation 2020; 21:396-408. [PMID: 31973658 DOI: 10.1080/15299732.2020.1719264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Emotional, physical and sexual abuse, have been consistently linked to mental health problems in adults. Previous research found that mental health providers rarely ask their patients about their childhood experiences of abuse. No study to date has examined the convergence of clinicians' and patients' reports of childhood abuse. The current study applied a multi-method, multi-informant approach to explore the concordance between patients' reports of childhood experiences of abuse and clinicians' identification of their patients' history of abuse. Assessment of an independent interviewer was included. A convenience sample of clinicians (N = 80) and their patients (N = 170) in mental health clinics in care-as-usual settings participated in the study. To assess the history of abuse clinicians and patients completed the Clinical Data Form, patients additionally completed the Childhood Trauma Questionnaire. Independent interviewer completed the Familial Experiences Interview. Findings show that across all informants, exposure to emotional abuse was most prevalent, followed by physical abuse and least prevalent was sexual abuse. Additionally, clinicians reported lower prevalence of physical and sexual abuse among their patients as compared with the patient and independent interviewer's reports. Moderate to strong correlations were observed between clinicians, patients and independent interviewer reports of emotional, physical and sexual childhood abuse. Moreover, the severity of the patient's history of abuse was related to greater accuracy in clinicians' reports. Clinicians are advised to collect explicit information regarding childhood abuse through interviews or valid measures. Clinicians should pay special attention when assessing patients with moderate severity of childhood abuse since they are frequently under-identified.
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Affiliation(s)
- Maayan Nagar
- School for Social Work, Smith College, Northampton, MA, USA
| | - Ora Nakash
- School for Social Work, Smith College, Northampton, MA, USA.,Baruch Ivcher School of Psychology, Interdisciplinary Center (IDC), Herzliya, Israel
| | - Drew Westen
- Department of Psychology and Psychiatry, Emory University, Atlanta, GA, USA
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21
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McGreevy S, Boland P. Sensory-based interventions with adult and adolescent trauma survivors. IRISH JOURNAL OF OCCUPATIONAL THERAPY 2020. [DOI: 10.1108/ijot-10-2019-0014] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PurposeAn emerging evidence base, and increased awareness of the effects of trauma on the body, advocates a sensory-based approach to treatment with posttraumatic stress and complex trauma survivors. This paper aims to identify, analyse and summarise the empirical evidence for the sensory-based interventions, which occupational therapists are using in the treatment of adult and adolescent trauma survivors.Design/methodology/approachAn integrative review of the literature was undertaken. Both empirical and conceptual papers were included. An inductive approach and constant comparative method were used to understand and synthesise the research.FindingsThe literature search yielded 18 papers describing the types of sensory-based interventions used, sensory processing (SP) patterns and the context and evidence for sensory-based occupational therapy practice with trauma survivors. Nine of the studies were empirical and nine were conceptual and review papers. Themes identified included: atypical SP patterns; type of sensory-based intervention used with trauma survivors; and transdisciplinary treatment programmes can reduce the symptoms of trauma.Practical implicationsSensory-based interventions with adult and adolescent trauma survivors are emerging as promising areas of practice and research in the literature. Although empirical data is limited, the sensory needs of the body in processing trauma experiences is becoming more recognised and are supported by the atypical SP patterns identified in survivors. A sensory-based, transdisciplinary approach to treatment has the potential to be effective in treating the trauma survivor.Originality/valueWith a skill base in sensory integration and occupational analysis, occupational therapists have much to offer the field of trauma studies. This review begins to address the gap in the literature, recommending more rigorous controlled outcome research with larger sample sizes, person-centred studies focussing on the trauma survivor’s perspective and continuing professional development and mentorship for occupational therapists working with this population.
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22
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Quidé Y. Identifying the Long-term Brain Changes Associated With Childhood Trauma Exposure Using Data-Driven Machine Learning Techniques. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 4:686-687. [PMID: 31395212 DOI: 10.1016/j.bpsc.2019.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 06/13/2019] [Indexed: 11/18/2022]
Affiliation(s)
- Yann Quidé
- School of Psychiatry, University of New South Wales (UNSW), Sydney, New South Wales, Australia; Neuroscience Research Australia, Randwick, New South Wales, Australia.
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23
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Vaillancourt-Morel MP, Rellini AH, Godbout N, Sabourin S, Bergeron S. Intimacy Mediates the Relation Between Maltreatment in Childhood and Sexual and Relationship Satisfaction in Adulthood: A Dyadic Longitudinal Analysis. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:803-814. [PMID: 30353373 DOI: 10.1007/s10508-018-1309-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 03/02/2018] [Accepted: 09/15/2018] [Indexed: 06/08/2023]
Abstract
Trauma theories suggest that childhood maltreatment (CM) may partly explain intimacy problems in romantic relationships. However, empirical studies have yielded conflicting findings, likely due to the varying conceptualizations of intimacy. Findings that support long-term negative effects of CM on sexual and relationship satisfaction are almost exclusively based on cross-sectional intra-individual data, precluding the examination of mediating pathways and of dyadic interactions between individuals reporting CM and their partners. This study used a dyadic perspective to examine the associations between CM and the different components of intimacy based on the interpersonal process model of intimacy: self-disclosure, perceived partner disclosure, and perceived partner responsiveness. We also tested the mediating role of these intimacy components at Time 1 in the relations between CM and sexual and relationship satisfaction 6 months later. A sample of 365 heterosexual couples completed self-report questionnaires. Results of path analyses within an actor-partner interdependence framework showed that women and men's higher levels of CM did not affect self-disclosure, but was negatively associated with their own perception of partner disclosure and responsiveness. In turn, women and men's perception of partner responsiveness at Time 1 was positively associated with their own sexual satisfaction, as well as their own and their partner's relationship satisfaction at Time 2. Thus, perception of partner responsiveness mediated the associations between CM and poorer sexual and relationship satisfaction. The overall findings may inform the development of couple intervention that targets the enhancement of intimacy to promote sexual and relationship well-being in couples where one partner experienced CM.
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Affiliation(s)
- Marie-Pier Vaillancourt-Morel
- Département de Psychologie, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal, QC, H3C 3J7, Canada.
| | | | - Natacha Godbout
- Département de Sexologie, Université du Québec à Montréal, Montréal, QC, Canada
| | | | - Sophie Bergeron
- Département de Psychologie, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal, QC, H3C 3J7, Canada
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24
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Clausen AN, Aupperle RL, Yeh HW, Waller D, Payne J, Kuplicki R, Akeman E, Paulus M. Machine Learning Analysis of the Relationships Between Gray Matter Volume and Childhood Trauma in a Transdiagnostic Community-Based Sample. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 4:734-742. [PMID: 31053534 DOI: 10.1016/j.bpsc.2019.03.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 03/01/2019] [Accepted: 03/01/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Childhood trauma is a significant risk factor for adult psychopathology. Previous investigations have implicated childhood trauma-related structural changes in anterior cingulate, dorsolateral prefrontal and orbitofrontal cortex, and hippocampus. Using a large transdiagnostic community sample, the goal of this investigation was to differentially associate regional gray matter (GM) volume with childhood trauma severity specifically, distinct from adult psychopathology. METHODS A total of 577 non-treatment-seeking adults (n = 207 men) completed diagnostic, childhood trauma, and structural magnetic resonance imaging assessments with regional GM volume estimated using FreeSurfer. Elastic net analysis was conducted in a nested cross-validation framework, with GM volumes, adult psychopathology, age, education, sex, and magnetic resonance imaging coil type as potential predictors for childhood trauma severity. RESULTS Elastic net identified age, education, sex, medical condition, adult psychopathology, and 13 GM regions as predictors of childhood trauma severity. GM regions identified included right caudate; left pallidum; bilateral insula and cingulate sulcus; left superior, inferior, and orbital frontal regions; and regions within temporal and parietal lobes and cerebellum. CONCLUSIONS Results from this large, transdiagnostic sample implicate GM volume in regions central to current neurobiological theories of trauma (e.g., prefrontal cortex) as well as additional regions involved in reward, interoceptive, attentional, and sensory processing (e.g., striatal, insula, and parietal/occipital cortices). Future longitudinal studies examining the functional impact of structural changes in this broader network of regions are needed to clarify the role each may play in longer-term outcomes following trauma.
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Affiliation(s)
- Ashley N Clausen
- Laureate Institute for Brain Research, Tulsa, Oklahoma; VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham VA Healthcare System, Durham, North Carolina; Duke Brain Imaging and Analysis Center, Duke Medical University, Durham, North Carolina.
| | - Robin L Aupperle
- Laureate Institute for Brain Research, Tulsa, Oklahoma; Department of Community Medicine, University of Tulsa, Tulsa, Oklahoma; Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, Oklahoma
| | - Hung-Wen Yeh
- Laureate Institute for Brain Research, Tulsa, Oklahoma
| | - Darcy Waller
- Department of Psychology, University of Iowa, Iowa City, Iowa
| | - Janelle Payne
- Laureate Institute for Brain Research, Tulsa, Oklahoma
| | | | | | - Martin Paulus
- Laureate Institute for Brain Research, Tulsa, Oklahoma; Department of Community Medicine, University of Tulsa, Tulsa, Oklahoma; Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, Oklahoma
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25
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Kealy D, Lee E. Childhood trauma among adult clients in Canadian community mental health services: Toward a trauma-informed approach. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2019. [DOI: 10.1080/00207411.2018.1521209] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- David Kealy
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Eunjung Lee
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
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26
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Rafiq S, Campodonico C, Varese F. The relationship between childhood adversities and dissociation in severe mental illness: a meta-analytic review. Acta Psychiatr Scand 2018; 138:509-525. [PMID: 30338524 DOI: 10.1111/acps.12969] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/30/2018] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Several studies have observed that dissociative experiences are frequently reported by individuals with severe mental illness (SMI), especially amongst patients that report a history of adverse/traumatic life experiences. This review examined the magnitude and consistency of the relationship between childhood adversity (sexual abuse, physical abuse, emotional abuse, neglect, bullying, natural disasters and mass violence) and dissociation across three SMI diagnostic groups: schizophrenia, bipolar disorder and personality disorders. METHOD A database search (EMBASE, PubMed and PsycINFO) identified 30 eligible empirical studies, comprising of 2199 clinical participants. Effect sizes representing the relationship between exposure to childhood adversity and dissociation were examined and integrated using a random-effects meta-analysis. RESULTS The results indicated that exposure to childhood trauma was associated with heightened dissociation across SMIs. Positive significant associations were also found between specific childhood adversities and dissociation, with aggregated effect sizes in the small-to-moderate range. CONCLUSION These findings support calls for the routine assessment of traumatic experiences in clients with SMIs presenting with dissociative symptoms and the provision of adequate therapeutic support (e.g. trauma-focused therapies) to manage and resolve these difficulties.
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Affiliation(s)
- S Rafiq
- School of Health Sciences, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - C Campodonico
- School of Health Sciences, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - F Varese
- School of Health Sciences, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.,Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
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27
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Kealy D, Rice SM, Ogrodniczuk JS, Spidel A. Childhood trauma and somatic symptoms among psychiatric outpatients: Investigating the role of shame and guilt. Psychiatry Res 2018; 268:169-174. [PMID: 30029065 DOI: 10.1016/j.psychres.2018.06.072] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 05/25/2018] [Accepted: 06/22/2018] [Indexed: 11/26/2022]
Abstract
Previous research suggests a link between experiences of childhood maltreatment and adult somatic symptom distress. Contributing mechanisms, however, are not yet well understood. It is possible that shame and guilt may function as mediators in the relationship between childhood trauma and adult somatic distress. The present study was developed to investigate the relationship between childhood maltreatment and adult somatic distress, including the potential mediating role of shame and guilt, among psychiatric outpatients. Using data from a sample of 99 Canadian psychiatric outpatients, mediation models with shame and guilt as parallel mediators were evaluated for relationships between childhood emotional abuse, sexual abuse, emotional neglect, and somatic symptoms. Controlling for current depressive symptoms, a significant indirect effect was found for the relationship between emotional abuse and shame, but not guilt, in contributing to somatic symptoms. A similar result was obtained regarding the mediating role of shame in the relationship between emotional neglect and somatic symptoms. Mediation was non-significant regarding childhood sexual abuse, which was directly related to somatic distress after controlling for depressive symptoms. The findings provide further evidence of the link between childhood trauma and somatic symptom distress, with shame as a mechanism for the effects of emotional abuse and neglect.
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Affiliation(s)
- David Kealy
- Department of Psychiatry, University of British Columbia, #420-5950 University Blvd, Vancouver, BC V6T 1Z3, Canada.
| | - Simon M Rice
- Orygen, Centre for Youth Mental Health, University of Melbourne, 35 Poplar Rd, Parkville, VIC 3052, Australia
| | - John S Ogrodniczuk
- Department of Psychiatry, University of British Columbia, #420-5950 University Blvd, Vancouver, BC V6T 1Z3, Canada
| | - Alicia Spidel
- White Rock/South Surrey Mental Health and Substance Use Services, 15521 Russell Avenue, White Rock, BC, Canada V4B 2R4
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28
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Fidalgo TM, Sanchez ZM, Caetano SC, Andreoni S, Sanudo A, Chen Q, Martins SS. Exposure to violence: associations with psychiatric disorders in Brazilian youth. BRAZILIAN JOURNAL OF PSYCHIATRY 2018; 40:277-283. [PMID: 29451584 PMCID: PMC6899398 DOI: 10.1590/1516-4446-2016-2122] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 06/27/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The effects of exposure to violent events in adolescence have not been sufficiently studied in middle-income countries such as Brazil. The aims of this study are to investigate the prevalence of psychiatric disorders among 12-year-olds in two neighborhoods with different socioeconomic status (SES) levels in São Paulo and to examine the influence of previous violent events and SES on the prevalence of psychiatric disorders. METHODS Students from nine public schools in two neighborhoods of São Paulo were recruited. Students and parents answered questions about demographic characteristics, SES, urbanicity and violent experiences. All participants completed the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) to obtain DSM-IV diagnoses. The data were analyzed using weighted logistic regression with neighborhood stratification after adjusting for neighborhood characteristics, gender, SES and previous traumatic events. RESULTS The sample included 180 individuals, of whom 61.3% were from low SES and 39.3% had experienced a traumatic event. The weighted prevalence of psychiatric disorders was 21.7%. Having experienced a traumatic event and having low SES were associated with having an internalizing (adjusted OR = 5.46; 2.17-13.74) or externalizing disorder (adjusted OR = 4.33; 1.85-10.15). CONCLUSIONS Investment in reducing SES inequalities and preventing violent events during childhood may improve the mental health of youths from low SES backgrounds.
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Affiliation(s)
- Thiago M Fidalgo
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Zila M Sanchez
- Departamento de Medicina Preventiva, UNIFESP, São Paulo, SP, Brazil
| | - Sheila C Caetano
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Solange Andreoni
- Departamento de Medicina Preventiva, UNIFESP, São Paulo, SP, Brazil
| | - Adriana Sanudo
- Departamento de Medicina Preventiva, UNIFESP, São Paulo, SP, Brazil
| | - Qixuan Chen
- Mailman School of Public Health, Columbia University, New York, USA
| | - Sílvia S Martins
- Mailman School of Public Health, Columbia University, New York, USA
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Read J, Harper D, Tucker I, Kennedy A. Do adult mental health services identify child abuse and neglect? A systematic review. Int J Ment Health Nurs 2018; 27:7-19. [PMID: 28815844 DOI: 10.1111/inm.12369] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/23/2017] [Indexed: 11/26/2022]
Abstract
Child abuse and neglect play a causal role in many mental health problems. Knowing whether users of mental health services were abused or neglected as children could be considered essential for developing comprehensive formulations and effective treatment plans. In the present study we report the findings of a systematic review, using independent searches of three databases designed to discover how often mental health staff find out whether their clients were abused or neglected as children. Twenty-one relevant studies were identified. Most people who use mental health services are never asked about child abuse or neglect. The majority of cases of child abuse or neglect are not identified by mental health services. Only 28% of abuse or neglect cases identified by researchers are found in the clients' files: emotional abuse, 44%; physical abuse, 33%; sexual abuse, 30%; emotional neglect, 17%; and physical neglect, 10%. Between 0% and 22% of mental health service users report being asked about child abuse. Men and people diagnosed with psychotic disorders are asked less than other people. Male staff ask less often than female staff. Some improvement over time was found. Policies compelling routine enquiry, training, and trauma-informed services are required.
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Affiliation(s)
- John Read
- School of Psychology, University of East London, London, UK
| | - David Harper
- School of Psychology, University of East London, London, UK
| | - Ian Tucker
- School of Psychology, University of East London, London, UK
| | - Angela Kennedy
- Tees, Esk and Wear Valleys National Health Service Foundation Trust, Darlington, UK
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30
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Knight C. Trauma-informed supervision: Historical antecedents, current practice, and future directions. CLINICAL SUPERVISOR 2018. [DOI: 10.1080/07325223.2017.1413607] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Carolyn Knight
- School of Social Work, University of Maryland, Baltimore County, Baltimore, Maryland, United States
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31
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Xu R, Yang J, Feng C, Wu H, Huang R, Yang Q, Li Z, Xu P, Gu R, Luo YJ. Time is nothing: emotional consistency of autobiographical memory and its neural basis. Brain Imaging Behav 2017; 12:1053-1066. [PMID: 28980133 DOI: 10.1007/s11682-017-9778-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The emotional aspect of autobiographical memories (AMs) is associated with self-related processing, which plays an important role in mental health. However, the emotional consistency dimension of AMs and its neural underpinnings remain largely unexplored. Twenty-five healthy participants were involved in this study. Participants were first asked to recall important AMs and assess the emotional ratings of each AM. Four weeks later, they were asked to retrieve the details of both positive and negative AMs during functional magnetic resonance imaging (fMRI) scanning. Behavioral results showed that the emotional valence of negative memories changed more strongly than positive memories over time (i.e., lower consistency). fMRI data showed that the activation level of the precuneus was positively correlated with self-rating valence consistency in the positive AM condition. Additionally, the precuneus connected to a key region of the self-referential network, the medial prefrontal cortex, in both the positive and negative AM conditions. Finally, the precuneus showed stronger connections with the inferior parietal lobule when comparing the positive with the negative AM conditions. Our results suggest that the precuneus is a key area of emotional consistency in positive AMs; this brain area may be involved in the maintenance of a positive self-image by strengthening positive AMs.
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Affiliation(s)
- Rui Xu
- National Key Laboratory of Cognitive Neuroscience and Leaning, Beijing Normal University, Beijing, 100875, China.,Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Juan Yang
- Faculty of Psychology, Southwest University, Chongqing, 400715, China
| | - Chunliang Feng
- National Key Laboratory of Cognitive Neuroscience and Leaning, Beijing Normal University, Beijing, 100875, China
| | - Haiyan Wu
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Ruiwang Huang
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, School of Psychology, South China Normal University, Guangzhou, 510631, China
| | - Qiuli Yang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Zhihao Li
- Shenzhen Key Laboratory of Affective and Social Neuroscience, Shenzhen University, Shenzhen, 518060, China.,Center for Emotion and Brain, Shenzhen Institute of Neuroscience, Shenzhen, 518057, China
| | - Pengfei Xu
- Shenzhen Key Laboratory of Affective and Social Neuroscience, Shenzhen University, Shenzhen, 518060, China.,Center for Emotion and Brain, Shenzhen Institute of Neuroscience, Shenzhen, 518057, China
| | - Ruolei Gu
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China. .,Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China.
| | - Yue-Jia Luo
- Shenzhen Key Laboratory of Affective and Social Neuroscience, Shenzhen University, Shenzhen, 518060, China. .,Center for Emotion and Brain, Shenzhen Institute of Neuroscience, Shenzhen, 518057, China.
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32
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Impact of child maltreatment on meaning in life in psychiatric patients. Psychiatry Res 2017; 251:204-211. [PMID: 28214436 DOI: 10.1016/j.psychres.2017.02.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 01/11/2017] [Accepted: 02/11/2017] [Indexed: 10/20/2022]
Abstract
Child maltreatment (CM) worsens prognosis and quality of life in several psychiatric conditions. Meaning in life is a construct which relates to the sense of purpose that one can perceive in life, and is a key aspect of recovery in psychiatric patients. The lasting impact of CM on meaning in life and its mediating variables have not been studied in patients with chronic persistent psychiatric conditions. One hundred and sixty-six patients with bipolar disorder (N=35), psychotic disorder (N=73), anorexia nervosa (N=30) or borderline personality disorder (N=28) were assessed for meaning in life (revised version of the Life Regard Index (LRI-R)), for CM (Childhood Trauma Questionnaire (CTQ)) and for internalized/externalized psychopathology. CM was associated with a lower LRI score. Structural Equation Modeling showed that internalized psychopathology (depression, hopelessness and low self-esteem) was the main mediator of the impact of CM on meaning in life. The direct effect of CM on meaning in life was not significant. Having suffered from negligence or abuse during childhood is associated with lower meaning in life in adults with persistent and pervasive psychiatric disorders. Treating depressive symptoms and improving self-esteem may improve meaning in life in patients with severe mental disorders who were affected by CM.
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33
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Sampson M, Read J. Are mental health staff getting better at asking about abuse and neglect? Int J Ment Health Nurs 2017; 26:95-104. [PMID: 27600259 DOI: 10.1111/inm.12237] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 03/18/2016] [Accepted: 03/30/2016] [Indexed: 11/30/2022]
Abstract
This study ascertained the extent to which abuse and neglect are identified and recorded by mental health services. A comprehensive audit of 250 randomly selected files from four community mental health centres in Auckland, New Zealand was conducted, using similar methodology to that of a 1997 audit in the same city so as to permit comparisons. Significant increases, compared to the 1997 audit, were found in the rates of child sexual and physical abuse, and adulthood sexual assault (but not adulthood physical assault) identified in the files. Identification of physical and emotional neglect, however, was poor. Male service users were asked less often than females; and male staff enquired less often than female staff. People with a diagnosis indicative of psychosis, such as 'schizophrenia', tended to be asked less often and had significantly lower rates of abuse/neglect identified. Despite the overall improvement, mental health services are still missing significant amounts of childhood and adulthood adversities, especially neglect. All services need clear policies that all service users be asked about both abuse and neglect, whatever their gender or diagnosis, and that staff receive training that address the barriers to asking and to responding therapeutically to disclosures.
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Affiliation(s)
- Maria Sampson
- Taylor Centre, Auckland District Health Board, Auckland, New Zealand
| | - John Read
- School of Psychology, University of East London, Stratford Campus, London, UK
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Abstract
BACKGROUND This study examines relationships between childhood adversity and the presence of characteristic symptoms of schizophrenia. It was hypothesised that total adversity exposures would be significantly higher in individuals exhibiting these symptoms relative to patients without. Recent proposals that differential associations exist between specific psychotic symptoms and specific adversities was also tested, namely: sexual abuse and hallucinations, physical abuse and delusions, and fostering/adoption and delusions. METHOD Data were collected through auditing 251 randomly selected medical records, drawn from adult patients in New Zealand community mental health centres. Information was extracted on presence and subtype of psychotic symptoms and exposure to ten types of childhood adversity, including five types of abuse and neglect. RESULTS Adversity exposure was significantly higher in patients experiencing hallucinations in general, voice hearing, command hallucinations, visions, delusions in general, paranoid delusions and negative symptoms than in patients without these symptoms. There was no difference in adversity exposure in patients with and without tactile/olfactory hallucinations, grandiose delusions or thought disorder. Indication of a dose-response relationship was detected, in that total number of adversities significantly predicted total number of psychotic symptoms. Although fostering/adoption was associated with paranoid delusions, the hypothesised specificity between sexual abuse and hallucinations, and physical abuse and delusions, was not found. The two adversities showing the largest number of associations with psychotic symptoms were poverty and being fostered/adopted. CONCLUSIONS The current data are consistent with a model of global and cumulative adversity, in which multiple exposures may intensify psychosis risk beyond the impact of single events. Implications for clinical intervention are discussed.
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Kealy D, Sierra-Hernandez CA, Ogrodniczuk JS. Childhood emotional support and borderline personality features in a sample of Canadian psychiatric outpatients. Int J Soc Psychiatry 2016; 62:452-4. [PMID: 27220722 DOI: 10.1177/0020764016650214] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Despite links between early relational experiences and psychopathology, data regarding childhood emotional neglect among Canadian mental health services users are scarce. AIMS To explore the absence of emotional support experiences reported by Canadian psychiatric outpatients, and to examine the relationship between childhood emotional support and borderline personality disorder (BPD) features. METHODS A survey regarding childhood emotional support was completed by consecutively admitted adult outpatients, along with self-report assessments of symptom distress and BPD features. RESULTS A substantial proportion of outpatients reported absent emotional support experiences. After controlling for the effects of age and symptom distress, childhood emotional support was found to be significantly negatively associated with BPD features. CONCLUSION The findings add further support to the need for clinical attention to the early relational experiences of mental health service users.
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Affiliation(s)
- David Kealy
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | | | - John S Ogrodniczuk
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
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36
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Cunningham T, Shannon C, Crothers I, Hoy K, Fitzsimmons C, McCann R, O’Hare J, Mulholland C. The perspectives of people with psychosis about participating in trauma-related research. PSYCHOSIS-PSYCHOLOGICAL SOCIAL AND INTEGRATIVE APPROACHES 2016. [DOI: 10.1080/17522439.2016.1145729] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Twylla Cunningham
- School of Psychology, Queens University of Belfast, Belfast, Northern Ireland
| | - Ciaran Shannon
- School of Psychology, Queens University of Belfast, Belfast, Northern Ireland
| | - Ivor Crothers
- Department of Clinical Psychology, Southern Health & Social Care Trust, Craigavon Area Hospital, Portadown, Northern Ireland
| | - Katrina Hoy
- Department of Clinical Psychology, South Eastern Health & Social Care Trust, Downshire Hospital, Downpatrick, Northern Ireland
| | - Carly Fitzsimmons
- Department of Clinical Psychology, Southern Health & Social Care Trust, Craigavon Area Hospital, Portadown, Northern Ireland
| | - Riona McCann
- Department of Psychiatry, Southern Health & Social Care Trust, Craigavon Area Hospital, Portadown, Northern Ireland
| | - John O’Hare
- Department of Psychiatry, Southern Health & Social Care Trust, Craigavon Area Hospital, Portadown, Northern Ireland
| | - Ciaran Mulholland
- School of Medicine, Queens University of Belfast, Belfast, Northern Ireland
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37
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Xiao CL, Gavrilidis E, Lee S, Kulkarni J. Do mental health clinicians elicit a history of previous trauma in female psychiatric inpatients? J Ment Health 2016; 25:359-365. [DOI: 10.3109/09638237.2016.1139074] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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38
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Minimization of Childhood Maltreatment Is Common and Consequential: Results from a Large, Multinational Sample Using the Childhood Trauma Questionnaire. PLoS One 2016; 11:e0146058. [PMID: 26815788 PMCID: PMC4729672 DOI: 10.1371/journal.pone.0146058] [Citation(s) in RCA: 122] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 12/11/2015] [Indexed: 11/21/2022] Open
Abstract
Childhood maltreatment has diverse, lifelong impact on morbidity and mortality. The Childhood Trauma Questionnaire (CTQ) is one of the most commonly used scales to assess and quantify these experiences and their impact. Curiously, despite very widespread use of the CTQ, scores on its Minimization-Denial (MD) subscale—originally designed to assess a positive response bias—are rarely reported. Hence, little is known about this measure. If response biases are either common or consequential, current practices of ignoring the MD scale deserve revision. Therewith, we designed a study to investigate 3 aspects of minimization, as defined by the CTQ’s MD scale: 1) its prevalence; 2) its latent structure; and finally 3) whether minimization moderates the CTQ’s discriminative validity in terms of distinguishing between psychiatric patients and community volunteers. Archival, item-level CTQ data from 24 multinational samples were combined for a total of 19,652 participants. Analyses indicated: 1) minimization is common; 2) minimization functions as a continuous construct; and 3) high MD scores attenuate the ability of the CTQ to distinguish between psychiatric patients and community volunteers. Overall, results suggest that a minimizing response bias—as detected by the MD subscale—has a small but significant moderating effect on the CTQ’s discriminative validity. Results also may suggest that some prior analyses of maltreatment rates or the effects of early maltreatment that have used the CTQ may have underestimated its incidence and impact. We caution researchers and clinicians about the widespread practice of using the CTQ without the MD or collecting MD data but failing to assess and control for its effects on outcomes or dependent variables.
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Cunningham T, Shannon C, Crothers I, Hoy K, Fitzsimmons C, McCann R, O’Hare J, Mulholland C. Enquiring about traumatic experiences in psychosis: A comparison of case notes and self-report questionnaires. PSYCHOSIS-PSYCHOLOGICAL SOCIAL AND INTEGRATIVE APPROACHES 2016. [DOI: 10.1080/17522439.2015.1115542] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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40
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Abstract
PURPOSE OF REVIEW Recent studies on mental health consequences of violence against women and girls were reviewed in a range of situations. RECENT FINDINGS Although several studies continued to show cross-sectional associations between child sexual abuse (CSA) and mental health outcomes, a few prospective studies showed a robust association between CSA and depression. Studies on the impact of dating violence are still at a nascent stage and focus on antecedents of violence rather than its consequences. Women at higher risk, such as adolescents, migrants, the homeless, and women in the perinatal period have been studied and specific vulnerabilities identified. Women reporting bidirectional violence had higher rates of depression and post-traumatic stress disorder (PTSD). Cumulative violence, severity of violence, and recent violence are associated with higher morbidity. Studies among women in conflict zones have emphasized the role of different forms of sexual and physical violence on mental health. SUMMARY Newer emerging areas that need more research include mental health consequences of women in conflict zones and among same sex relationships. There are also few studies on the violence experience of both older women and adolescents. The need to better delineate the psychopathology of complex manifestations of PTSD is underscored.
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