Childhood emotional maltreatment and mental disorders: Results from a nationally representative adult sample from the United States

Evaluation of the Centers for Disease Control and Prevention's Essentials for Parenting Toddlers and Preschoolers on parent behavioral outcomes

BACKGROUND

The Centers for Disease Control and Prevention's web-based behavioral parent training (BPT) program, Essentials for Parenting Toddlers and Preschoolers (EfP), uses a psychoeducational approach to promote positive parenting and address common parenting challenges. The purpose of this study was to assess the effects of EfP on parenting behavior and whether implementation format impacted behavioral outcomes.

METHODS

A sample of 200 parents of 2- to 4-year-old children were recruited via Internet advertising. Using a repeated single subject, multiple baseline design, parents were randomly assigned to guided navigation (GN; n = 100) or unguided navigation (UN; n = 100) study conditions. Parents were provided secure access to the EfP website and completed 18 weekly surveys. Latent growth curve modeling was used to determine intervention effectiveness on behavioral outcomes.

RESULTS

Latent growth curve modeling indicated both GN and UN study conditions significantly increased use of praise (β = 0.19, p = 0.038) and commands and consequences (β = 0.17, p < 0.001), and decreased corporal punishment use (β = -0.01, p = 0.017) and attitudes promoting corporal punishment (β = -0.01, p < 0.001) over the study period. The UN condition exhibited a significant initial decrease in time-out use that increased over time to match the GN condition.

CONCLUSIONS

This study provides evidence for the effectiveness of EfP in promoting non-violent parenting behavior and increasing positive parenting techniques. The format of EfP implementation made no difference in parenting behaviors over time. Digital BPT programs like EfP provide access to evidence-informed parenting resources and can enhance positive parenting.

Hospital admissions and community health service contacts for mental illness following self-reported child maltreatment: Results from the Childhood Adversity and Lifetime Morbidity (CALM) study

BACKGROUND

Child maltreatment (CM) includes neglect, and several types of abuse, including physical, emotional, and sexual. CM has been associated with a wide range of mental illnesses. Literature examining these illnesses in mid-life is scarce, and the impact of these illnesses on mental health service use is currently unknown.

OBJECTIVE

To examine associations between self-reported CM and subsequent hospital admissions for mental illnesses, and/or community mental health service contacts.

SETTING

Birth cohort study data linked to administrative health data, including hospital admissions and community mental health service contacts, up to the age of 40.

METHODS

Associations between hospital admissions for mental health and community mental health contacts and CM subtypes (neglect, physical abuse, emotional abuse and sexual abuse) were examined using multivariate logistic regression.

RESULTS

Adjusted analyses showed that all subtypes of CM were significantly (p < 0.05) associated with admissions to hospital for any type of mental illness (aOR range 1.87-3.61), non-psychotic mental disorders (aOR range 1.98-3.61), alcohol and/or substance use (aOR range 2.83-5.43), and community mental health service contacts (aOR range 2.44-3.13). Hospital admissions for psychotic mental disorders were significantly associated with physical abuse, emotional abuse, and sexual abuse (aOR range 2.14-3.93).

CONCLUSIONS

The results of this study confirm the current knowledge around CM and subsequent mental health illnesses up to the age of 40, and extend this knowledge to hospital and mental health service use.

Childhood Maltreatment and Longitudinal Epigenetic Aging: NIMHD Social Epigenomics Program

Importance

Child physical and emotional abuse and neglect may affect epigenetic signatures of accelerated aging several years after the exposure.

Objective

To examine the longitudinal outcomes of early-childhood and midchildhood exposures to maltreatment on later childhood and adolescent profiles of epigenetic accelerated aging.

Design, Setting, and Participants

This cohort study used data from the Future of Families and Child Wellbeing Study (enrolled 1998-2000), a US birth cohort study with available DNA methylation (DNAm) data at ages 9 and 15 years (assayed between 2017 and 2020) and phenotypic data at birth (wave 1), and ages 3 (wave 3), 5 (wave 4), 9 (wave 5), and 15 (wave 6) years. Data were analyzed between June 18 and December 10, 2023.

Exposures

Emotional aggression, physical assault, emotional neglect, and physical neglect via the Parent-Child Conflict Tactics Scale at ages 3 and 5 years.

Main Outcomes and Measures

Epigenetic accelerated aging (DNAmAA) was measured using 3 machine learning-derived surrogates of aging (GrimAge, PhenoAge, and DunedinPACE) and 2 machine learning-derived surrogates of age (Horvath and PedBE), residualized for age in months.

Results

A total of 1971 children (992 [50.3%] male) representative of births in large US cities between 1998 and 2000 were included. Physical assault at age 3 years was positively associated with DNAmAA for PhenoAge (β = 0.073; 95% CI, 0.019-0.127), and emotional aggression at age 3 years was negatively associated with PhenoAge DNAmAA (β = -0.107; 95% CI, -0.162 to -0.052). Emotional neglect at age 5 years was positively associated with PhenoAge DNAmAA (β = 0.051; 95% CI, 0.006-0.097). Cumulative exposure to physical assault between ages 3 and 5 years was positively associated with PhenoAge DNAmAA (β = 0.063; 95% CI, 0.003-0.123); emotional aggression was negatively associated with PhenoAge DNAmAA (β = -0.104; 95% CI, -0.165 to -0.043). The association of these measures with age 15 years PhenoAge DNAmAA was almost fully mediated by age 9 years PhenoAge DNAm age acceleration. Similar patterns were found for GrimAge, DunedinPACE, and PhenoAge, but only those for PhenoAge remained after adjustments for multiple comparisons.

Conclusions and Relevance

In this cohort study, altered patterns of DNAmAA were sensitive to the type and timing of child maltreatment exposure and appeared to be associated with more proximate biological embedding of stress.

Psychological maltreatment and substance use among college students: Psychological distress, belongingness, and social support

Substance use in college students is an important public health problem associated with substantial consequences. It is a critical step to examine risk and protective factors associated with substance use to develop prevention and intervention strategies for promoting college students' healthy development and well-being. The present cross-sectional study aimed to examine the mediating role of psychological distress in the relationship between childhood psychological maltreatment and substance use and the moderating effect of social support and belongingness in this association among college students. The sample of this cross-sectional study included 382 emerging adults. Participants included 56.8% female and 43.2% male, and they ranged in age between 20 and 29 years (M = 22.05, SD = 2.17). Findings from the study first confirmed that psychological maltreatment was a significant predictor of social support, belongingness, psychological distress, and substance use. Subsequent results revealed that psychological distress mediated the association between psychological maltreatment and college students' substance use. Also, belongingness and social support had a buffering effect on this association. The findings suggest that psychological maltreatment is a significant risk factor in developing substance use behavior and that belongingness and social support services can serve as protective resources. Based on these results, prevention and intervention services focusing on improving the feeling of belonging and social support could be conducive to the decreased substance use of psychologically maltreated emerging adults.

Pathways between Child Maltreatment, Psychological Symptoms, and Life Satisfaction: A Network Analysis in Adolescent Inpatients

Child maltreatment is a risk factor for mental disorders and decreased life satisfaction during adolescence. We investigated whether child maltreatment would link to life satisfaction both directly and through psychological symptoms, whether these relations would change from admission to discharge after treatment, and which types of maltreatment, symptoms and facets of life satisfaction would be most influential in adolescent inpatients with internalizing mental disorders. N = 896 adolescent receiving inpatient psychotherapeutic treatment completed questionnaires on child maltreatment experiences, current psychopathology and subjective life satisfaction at admission and discharge (n = 765). Main diagnoses were affective (n = 322), eating (n = 447), obsessive-compulsive (n = 70) and anxiety disorders (n = 57). Network models of child maltreatment, psychopathology and life satisfaction nodes were estimated at admission and discharge and compared using network comparison tests. Potential causal shortest pathways were investigated using directed acyclic graphs.Network models were stable with no significant differences between admission and discharge. Strongest nodes of each cluster were "emotional abuse" (child maltreatment), "worthlessness", "thinking about dying" and "feeling lonely" (psychopathology) and "satisfied with life" (life satisfaction) at both admission and discharge. Emotional neglect showed direct connections to life satisfaction, indicating its relevance for therapeutic interventions. At both admission and discharge, "sexual abuse" indirectly predicted lower life satisfaction through psychological symptoms. In conclusion, child maltreatment is directly and indirectly connected to life satisfaction in adolescents with mental disorders. Emotional abuse and neglect were especially important in linking child maltreatment to life satisfaction and psychopathology.

The relationship between childhood maltreatment subtypes and adolescent internalizing problems: The mediating role of maladaptive cognitive emotion regulation strategies

BACKGROUND

While childhood maltreatment is understood to be a significant risk factor for adolescent internalizing problems (depression and anxiety), underlying mechanisms linking each type of maltreatment to internalizing problems in adolescents remain unclear. Moreover, the current state of knowledge regarding the associations between maladaptive cognitive emotion regulation strategies and each type of maltreatment, as well as their impact on adolescent internalizing problems, is limited. Additionally, it remains unclear whether these maladaptive strategies mediate this relationship.

OBJECTIVE

This study sought to investigate the effects of childhood maltreatment types on adolescent internalizing problems and to explore whether the overall and specific types of maladaptive strategies mediate these associations.

METHODS

Using a cross-sectional design, adolescents (N = 7071, Mage = 14.05 years, SDage = 1.54) completed online questionnaires assessing childhood maltreatment, maladaptive cognitive emotion regulation strategies (including rumination, catastrophizing, self-blame, and other-blame), anxiety, and depression. The hypothesized mediating effects were tested using the Lavaan package in R software (4.1.2).

RESULTS

Different maltreatment types had varying effects on adolescent internalizing problems. Emotional neglect, emotional abuse, and sexual abuse significantly affected anxiety and depression, whereas physical neglect and physical abuse did not. Other than physical neglect and physical abuse, overall maladaptive strategies mediated the relationship between the other three types of maltreatment (emotional abuse, emotional neglect, and sexual abuse) and internalizing problems (anxiety and depression). For specific maladaptive strategies, rumination mediated the effects of physical abuse, emotional abuse, emotional neglect, and sexual abuse on internalizing problems (anxiety and depression). In contrast, catastrophizing mediated the relationship between physical neglect, emotional abuse, emotional neglect, sexual abuse and internalizing problems (anxiety and depression).

CONCLUSIONS

These results suggest that the effects of maltreatment types on internalizing problems are different and that maladaptive strategies, particularly rumination and catastrophizing, are important mechanisms through which childhood maltreatment affects internalizing problems. This is a reminder that mental health workers need to consider the different effects of maltreatment types when intervening and recognize the importance of prioritizing interventions for rumination and catastrophizing.

Childhood trauma and alcohol misuse in college students: The moderating role of minimization

BACKGROUND

History of childhood trauma as a risk factor for alcohol misuse in early adulthood is very well documented. Given the associations between childhood trauma and alcohol misuse, more work is needed to understand the factors that influence this relationship.

OBJECTIVE

The purpose of this study was to examine the relationship between childhood trauma, minimization of such events and alcohol misuse in a French college student sample.

PARTICIPANTS AND SETTING

A convenience sampling method was used to recruit students from several colleges located in Western France. The data set included 1180 records with complete responses.

METHODS

This study employed a cross-sectional online survey. Data collection instruments included the Childhood Trauma Questionnaire Short-Form (CTQ-SF) and the Alcohol Use Disorders Identification Test (AUDIT).

RESULTS

The strength of the association between CTQ score and AUDIT total score was increased by minimization score (β = 0.122, p = .07). This result suggests that under-reporting childhood trauma experiences tends to increase the impact of such events on alcohol misuse.

CONCLUSION

These findings suggest that a tendency to minimize threatening childhood events may specifically be related to increased risk of greater alcohol misuse among college students. Therefore, it may be important for clinician to assess minimization of early events in students with a history of childhood trauma.

Unveiling the shadows: Parental perceptions and familial impact of daycare abuse of preschool children

BACKGROUND

Preschoolers are at an increased risk of experiencing abuse, especially from caregivers. Early child abuse has adverse continuances on children's short and long-term development. The majority of previous studies were conducted in the 1990s in the United States, focusing primarily on sexual abuse. Despite the recently increasing public awareness of daycare abuse (DA), empirical studies on this topic have not yet been conducted in Israel.

OBJECTIVE

The current study was designed to examine parents' perceptions regarding the DA of their preschool children.

METHOD

The data were collected through semi-structured, in-depth interviews with 14 parents of children who underwent DA. Qualitative analysis was performed on the narratives of the participants.

FINDINGS

Three main themes were identified: 1) parental shock, 2) community echoes, and 3) ripples of trauma. The study revealed the dramatic consequences of DA on children and their families. The families dealt with the consequences of the traumatic DA event, which destabilized almost every part of their lives. The study found that parents felt alone and without assistance from the authorities while facing the consequences of the DA.

CONCLUSIONS

In examining the parents' perspectives, the current study's findings presented essential empirical knowledge regarding the DA phenomenon and encouraged future studies in this area. This study has the potential to serve as a basis for the creation of professional training programs.

Adverse childhood experiences in mental health of young adults: An exploratory study from Delhi-NCR, India

BACKGROUND

Despite the growing realization regarding the importance of adverse childhood experiences (ACEs) in adult health outcomes, this area of research has received little scientific attention in low- and middle-income countries, including India.

AIMS

To understand the overall and domain-specific association of exposure to ACEs with current depression, anxiety, stress, and well-being among young adults of Delhi-NCR.

METHODS

This cross-sectional study was carried out among 1,812 young adults (aged 18-25 years) of both sexes (68.7% females). Fieldwork was conducted on the campuses of the University of Delhi, Delhi, and Amity University, Noida, India. ACEs, depression, anxiety, stress, and well-being were screened using the Adverse Childhood Experiences International Questionnaire, Beck Depression Inventory-II, Beck Anxiety Inventory, Perceived Stress Scale, and WHO-5 Well-Being Index, respectively.

RESULTS

Exposure to ACEs was found to increase the odds of moderate/severe depression, moderate/severe anxiety, and high stress and decreased the odds of good well-being in a dose-response manner. Being bullied, followed by emotional abuse, was associated with the highest odds of current moderate/severe depression, moderate/severe anxiety, and high stress and the lowest odds of good well-being. Further, while several domains of household dysfunction showed poor association with studied mental health outcomes, domains of abuse and violence were more consistently associated.

CONCLUSIONS

The present study revealed the detrimental impact of ACEs on mental health outcomes among young adults of Delhi-NCR, India, and underscored the relevance of ACEs in the Indian context. Considering the lack of trauma awareness in Indian societies, there is an urgent need to create widespread awareness regarding ACEs and associated health implications.

ACEs and mental health problems as suicidality predictors in Mexican adolescents

BACKGROUND

Various factors, including mental health comorbidity, family dysfunction, interpersonal violence, and community and social violence, cause suicidal behavior. Adverse Childhood Experiences (ACEs) encompass these risk factors and are correlated with mental health problems and suicidal behavior in Mexican adolescents.

METHODS

A survey was conducted among Mexican school-aged adolescents to measure ACEs, MHP symptoms, and suicidal behavior. A binary logistic regression was used to examine the relationship between these variables. The study was conducted with IRB approval, and all participants provided informed consent. Those at risk of suicide were referred for online psychological care.

RESULTS

7325 adolescents participated; 60 % were women, with an average age of 16 years (SD + 1), 87 % of the participants reported at least one ACE, 13 % symptoms of at least one MHP and 10 % suicidal behavior. MHP predictors of suicidal behavior were: conduct problems (OR = 5.67), symptoms of depression (OR = 3.27), obsessive-compulsive disorder (OR = 2.11), somatic problems (OR = 1.98), and attention deficit (OR = 1.69). EAI predictors were: live sexual violence (OR = 2.53), physical violence (OR = 2.21), negligence (OR = 2.05), bullying (OR = 2.10), and a family member with a mental health diagnosis (OR = 1.35). The cumulative effect of ACEs and MHP significantly increased the risk (OR = 78.08).

CONCLUSIONS

5 ACEs and 4 MHP were associated with suicidal behavior; their cumulative effect increased the risk to 78 times.

Approaches for measuring cumulative childhood adversity: A study of youth from 5 sub-Saharan African countries

BACKGROUND

Adverse childhood experiences (ACEs) include forms of abuse, neglect, and household stressors that are potentially early life traumatic experiences. A summed integer count of ACEs is often used to examine cumulative childhood adversity (CCA) but has limitations.

OBJECTIVES

The current study tests two additional methods for measuring CCA using large samples of youth in low- and middle-income countries.

PARTICIPANTS AND SETTING

Pooled data were analyzed from a multi-country, nationally representative sample of youth aged 18-24 years (N = 11,498) who completed the Violence Against Children and Youth Surveys (VACS) in Lesotho, Cote d'Ivoire, Kenya, Namibia, and Mozambique.

METHODS

ACE exposures included: physical, sexual, and emotional violence; witnessing interparental violence; witnessing community violence; orphanhood. CCA was operationalized using an ACE score, ACE impact (standardized regression coefficients from outcome severity), and ACE exposure context (household; intimate partner; peer; community). Associations between CCA with mental distress (MD) were examined by sex using p ≤ 0.05 as the significance level.

RESULTS

Exposure to ≥3 ACEs was associated with MD (p < 0.05) for both sexes. Among females, all contexts contributed to MD except peer ACEs (p < 0.05). Among males, household and community ACEs contributed to MD. High-impact ACEs were associated with MD both sexes. ACE context was the best-fitting model for these data.

CONCLUSIONS

The challenges operationalizing CCA warrant continued research to ensure adversity type, severity, and context lead to validly assessing ACEs impact on child wellbeing.

Differential associations of adverse childhood experiences and mental health outcomes in U.S. military veterans

Adverse childhood experiences (ACEs) are robustly associated with adverse mental health outcomes across the lifespan. Military veterans may be particularly vulnerable to adverse mental health effects of ACEs given their potentially higher prevalence of childhood traumas and compounding effects of military service-related traumas. To date, however, scarce research has examined the differential impact of individual ACEs on mental health outcomes in population-based samples of veterans. To address this gap, we analyzed data from the National Health and Resilience in Veterans Study (NHRVS), which surveyed a nationally representative sample of 4069 U.S. veterans, to examine the association between specific ACEs and major depressive, generalized anxiety, and posttraumatic stress disorders, and suicidal thoughts and behaviors. Results of multivariable logistic regression analyses revealed that emotional neglect and sexual abuse were most consistently associated with these outcomes, even after adjustment for the number of ACEs endorsed. Collectively, results of this study underscore the importance of assessing for specific ACEs-most notably childhood emotional neglect and sexual abuse-and treating these potentially unresolved childhood traumas in veterans.

Bidirectional relationship between borderline personality features and depressive symptoms in early adolescence: A school-based cohort study

Depressive symptoms is a public health concern worldwide, and adolescents may experience more depressive symptoms. Although the relationship between borderline personality features (BPFs) disorder and depressive symptoms has been established, it is unclear whether the longitudinal relationship between them is unidirectional or bidirectional and whether these symptoms are different between boys and girls. In this study, Chinese adolescents (1608 total and separately 972 for boys and 636 girls) were enrolled between September 2019 and September 2021, and we analyzed the data using a cross-lagged model. The results suggested a bidirectional relationship between BPFs and depressive symptoms in boys (β = 0.191 and 0.117, P < 0.001). However, in girls, depressive symptoms were predicted based on BPFs (β = 0.225, P < 0.001), whereas BPFs were not predicted based on depressive symptoms (β = 0.035, P = 0.535). The findings suggest that borderline personality traits and depressive symptoms are only bilaterally associated in girls, which also provides important evidence for the treatment and prevention of adolescent BPFs and depressive symptoms.

Childhood emotional maltreatment and sensitivity to social rejection in emerging adults

BACKGROUND

Enhanced responsiveness to social rejection may be a transdiagnostic mechanism through which childhood emotional maltreatment predisposes individuals to interpersonal and mental health problems. To investigate this mechanism, as a first step, more detailed investigations are needed regarding the assumed association of childhood emotional maltreatment with rejection sensitivity in later life.

OBJECTIVE

The present work examines the hypothesis that among different subtypes of childhood maltreatment, in particular forms of emotional maltreatment (emotional abuse and neglect) relate to rejection sensitivity in emerging adults.

PARTICIPANTS AND SETTING

In study 1, 311 emerging adults (18-25 years) participated in a retrospective cross-sectional assessment. In study 2, 78 emerging adults (18-25 years) were included in an experiment (O-Cam paradigm) which involved the experience of social rejection (vs. inclusion).

METHODS

Study 1 investigates whether intensities of childhood emotional abuse and neglect have unique associations with trait rejection sensitivity, when considering all maltreatment subtypes (emotional abuse, sexual abuse, physical abuse, emotional neglect, physical neglect) simultaneously. Study 2 examined whether childhood emotional abuse and neglect moderate the experience of social rejection in terms of need depletion, sadness and anger after social rejection (vs. inclusion).

RESULTS

Study 1 indicates that emotional abuse and neglect have unique associations with rejection sensitivity. Study 2 results show that only a higher intensity of emotional abuse has extensive effects on need depletion and sadness after social rejection (vs. inclusion).

CONCLUSIONS

In particular, experiences of childhood emotional abuse may relate to rejection sensitivity in young adulthood.

Association of Childhood Emotional Maltreatment with Adolescents' Psychopathology: A Systematic Review and Meta-Analysis

Childhood Emotional Maltreatment (CEM) is a significant but under-studied risk factor for impaired mental health, with adolescents being particularly susceptible. This systematic review and meta-analysis, prospectively registered in PROSPERO as CRD42022383005, aims to synthesize the findings of studies investigating the association between CEM and adolescent psychopathology, making it the first attempt to the best of our knowledge. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, a comprehensive search (PubMed, Scopus, PsycINFO, Science Direct, Embase, and ProQuest) yielded 12,224 studies, from which 72 were included in the qualitative synthesis. The meta-analysis was conducted on 76 effect sizes (ranging from 0.01 to 0.57) extracted from 56 studies. The assessment of publication bias utilized funnel plots, Egger's regression test, and the trim and fill method, if required. Additionally, a predictor analysis investigated the influence of study-level variables on the CEM-psychopathology association. Results revealed a significant positive correlation between CEM and adolescent psychopathology (Pooled association: 0.24-0.41) Furthermore, assessment of publication bias indicated no significant bias. The predictor analysis suggested minimal influence of study-level variables. The study underscores the urgent need to address CEM as a crucial risk factor for adolescent psychopathology. The significant positive correlation between CEM and psychopathological outcomes highlights the detrimental effects of CEM on adolescents. Awareness, prevention efforts, and targeted interventions are essential to mitigate these effects. Further studies with culturally diverse and larger sample sizes are required, with emphasis on methodological rigor, given that most of the identified studies showed a high risk of bias.

Professional Perspectives on Children's Health Assets: A Delphi Study

This study aims to describe a local community expert's perspective on the identification of and access to children's health assets and to gather proposals to promote children's health and well-being within their community. The health asset approach is essential for health promotion, and there is evidence of its benefits to individuals' or communities' health when this approach is observed. Children's health assets are gaining increasing interest, but the literature that captures the perception of professionals working with children is scarce. Qualitative research designed with Delphi methodology was carried out with the participation of 25 professionals working in a neighbourhood with children and families. The participants stated that this neighbourhood was a good environment for the healthy and happy growth of children but pointed out that there were inequities. They emphasised the importance of economic and physical security and feeling loved. The absolute best aspects of the neighbourhood according to these experts were its support networks, mutual help, educational and health services, and green spaces, and the most deficient aspects were the possibility of a hopeful future and emotional support within the family unit. Poverty and/or the scarcity of economic resources were identified as the main barriers to accessing health assets. Special difficulties in access to health for migrant and Roma children were also identified. The panel of experts made concrete action proposals. It was recommended to support resources and services that already exist in their community. The experts prioritised work with families, education, working in conjunction with vulnerable groups, community participation, and networking.

Child maltreatment among deaf and hard-of-hearing adolescent students: associations with depression and anxiety

Objective

Child abuse and neglect have several short- and long-term consequences for the victim. Though Deaf and Hard-of-Hearing children are at higher risk of being maltreated as compared to hearing children, little research in Saudi Arabia has focused on this population. To determine the prevalence of child maltreatment and to examine its association with depression and anxiety among a sample of Deaf and Hard-of-Hearing students in Saudi Arabia, recruited from secondary schools in southern Saudi Arabia.

Methods

The sample included 186 Deaf and Hard-of-Hearing students aged 14-17 years (M = 15.7 years; SD = 3.41 years). Data were collected using the Child Abuse Self-Report Scale, Center for Epidemiological Studies Depression Scale for Children, and Generalized Anxiety Disorder Questionnaire. Bivariate and Linear regression analyses were conducted using SPSS 20.

Results

About 47.3% of the students were exposed severe to very severe child maltreatment. The severity of maltreatment varied based on parents' educational and income level, number of children in the family, the Deaf and Hard-of-Hearing student's gender, and parents' hearing status. Linear regression analysis indicated that child maltreatment was a significant predictor of depression and anxiety in this sample.

Conclusion

Considering the socio-demographic factors influencing the prevalence of maltreatment in the present study, it seems important to work with parents of Deaf and Hard-of-Hearing children to improve their skills in rearing a child with special needs. Addressing the social stigma and social barriers experienced by DHH individuals through familial, institutional, and community interventions may be a first step toward long-term prevention of maltreatment among DHH children.

Mediating effect of suicidal ideation in the association between child abuse and premenstrual syndrome among female adults

INTRODUCTION

Premenstrual symptoms encompass a range of physical, emotional, and behavioral changes that cyclically occur before menstruation. Childhood abuse has been associated with subsequent mental health challenges, yet its relationship with exacerbating premenstrual symptoms remains an understudied area. Furthermore, suicidal ideation often emerges from traumatic backgrounds such as child abuse, creating another layer of complexity. Given the rising suicide rates in Lebanon, and the concurrent increase in reported child abuse cases, this research focuses on the role of suicidal ideation as a mediator between child abuse and premenstrual syndrome.

METHODS

This cross-sectional study involved 915 female university students in Lebanon. Participants completed an online questionnaire encompassing demographic details, health lifestyle, the Premenstrual Symptoms Screening Tool (PSST), Columbia-Suicide Severity Rating Scale (C-SSRS), and Child Abuse Self Report Scale (CASRS-12). The mediation analysis was conducted using PROCESS MACRO v3.4 model 4; three pathways derived from this analysis: pathway A from the independent variable to the mediator, pathway B from the mediator to the dependent variable, Pathway C indicating the direct effect from the independent to the dependent variable.

RESULTS

The results of the mediation analysis showed that suicidal ideation mediated the association between all types of child abuse and the presence of PMS. Higher psychological (Beta = 0.21; p < 0.001), neglect (Beta = 0.02; p = 0.017), physical (Beta = 0.19; p < 0.001) and sexual (Beta = 0.20, p < 0.001) child abuse were significantly associated with higher suicidal ideation, which was significantly associated with the presence of PMS (Beta = 0.38, p = 0.001; Beta = 0.57, p < 0.001; Beta = 0.45, p < 0.001; and Beta = 0.50, p < 0.001) respectively. Finally, higher psychological (Beta = 0.17, p < 0.001), physical (Beta = 0.11, p = 0.024), but not sexual (Beta = 0.07, p = 0.198) child abuse was directly and significantly associated with the presence of PMS, whereas higher neglect (Beta = -0.06, p = 0.007) was significantly associated lower odds of having PMS.

CONCLUSION

This study highlights the mediating role of suicidal ideation in the complex association between different types of childhood abuse and premenstrual symptoms. The findings emphasize the need for trauma-informed care and tailored interventions to address the diverse impact of these factors. Recognizing the intricate relationships between child abuse, suicidal ideation, and PMS can aid healthcare providers in comprehensively addressing young women's mental and reproductive well-being. Trauma-informed care, tailored interventions and awareness of potential connections between childhood maltreatment are essential in managing these complex challenges.

Global Trends in the Incidence of Anxiety Disorders From 1990 to 2019: Joinpoint and Age-Period-Cohort Analysis Study

BACKGROUND

Anxiety disorders (ADs) are the most common mental illness with high prevalence, chronicity, and comorbidity. Despite rapid economic and cultural development, the global incidence of ADs continues to increase, with predominance in male individuals.

OBJECTIVE

To address the above issues, we analyzed the dynamic trends of the global incidence and disease burden of ADs from 1990 to 2019 and their different effects on age, period, and birth cohort and predicted the future trend of AD incidence.

METHODS

The data were obtained from the Global Burden of Disease study in 2019. A joinpoint regression model was used to calculate the annual percent change in AD incidence, and age-period-cohort analysis was used to estimate the independent effects of age, period, and cohort. Nordpred age-period-cohort analysis was used to predict the incidence of ADs from 2020 to 2044.

RESULTS

The age-standardized incidence rate of ADs increased by 1.06% for both sexes, and the age-standardized disability-adjusted life-year (DALY) rate (ASDR) decreased by 0.12%. Joinpoint regression indicated that increments in average annual percent changes in the age-standardized incidence rate (0.068 vs 0.012) and ASDR (0.035 vs -0.015) for ADs globally were higher among male individuals than female individuals. The age-period-cohort analyses revealed that the relative risk (RR) of the incidence and DALYs of ADs among people of different sexes increased with age in adolescence and middle age and then decreased. For the period effect, the RR of incidence decreased, whereas the RR of DALYs increased in both sexes. Moreover, the RR of the incidence gradually increased and DALYs slowly decreased with birth year for both male and female individuals. New cases of ADs in male individuals are predicted to increase in the coming 25 years.

CONCLUSIONS

This study provided the changing trend of the global incidence and disease burden of ADs in the past 3 decades, indicating that early prevention and effective control cannot be ignored. We analyzed the age-period-cohort effect of potential trends in ADs and predicted future incidence trends. The results suggest that we should take active intervention measures, focusing on high-risk groups and developing effective management and control policies to reduce the global burden of disease.

How does emotional abuse affect adolescents' non-suicidal self-injury urges? A moderated chain mediation model

BACKGROUND

Studying non-suicidal self-injury (NSSI) among adolescents has high clinical significance. Its urges have been identified as a potential predictor of NSSI behavior and may serve as a crucial intervention target.

OBJECTIVE

This study uses a moderated chain mediation model to explore the relationship between emotional abuse and adolescent NSSI urges. Additionally, we examine the mediating roles of ego depletion and self-esteem and the moderating effect of resilience.

PARTICIPANTS AND SETTING

We recruited 1129 Chinese adolescents (age M = 16.68; SD = 0.78; 49.4 % men) from secondary vocational schools in China.

METHODS

We assessed emotional abuse, ego depletion, self-esteem, and NSSI urges in a longitudinal investigation across two time points (T1: March 2023, T2: June 2023).

RESULTS

After controlling for age, sex, NSSI urges and self-esteem at T1, our study validates a moderated chain mediation model and finds that the mediating effect via self-esteem is 0.026 (95%CI = [0.011,0.046]), and the chain mediating effect via ego depletion and self-esteem is 0.031 (95%CI = [0.022,0.045]), whereas the direct effect of emotional abuse T1 on NSSI urges T2 is not significant (DE = 0.082, 95%CI = [-0.002, 0.167]) and the mediating effect via ego depletion is also not significant (IE = -0.003, 95%CI = [-0.022, 0.015]). Resilience moderates the impact of emotional abuse on ego depletion (β = 0.09, p < 0.01).

CONCLUSIONS

These findings suggest that ego depletion and self-esteem are potential mechanisms related to emotional abuse and adolescents' NSSI urges, whereas resilience can play a moderating role in reducing ego depletion.

Sibling support exchange in late adulthood moderates the long-term impact of childhood neglect on psychological outcomes

Objectives: Sibling relationships are often the longest-lasting and serve as a source of support and comfort for many older adults. The current study examined the moderating effect of sibling support exchange in the association between childhood maltreatment and mental health outcomes.Method: Using data from the Wisconsin Longitudinal Study (WLS), we analyzed a sample of older adults whose selected sibling was alive across the three data collections (baseline N = 4,041). Longitudinal multilevel regression models were estimated.Results: Key results showed that a history of neglect was associated with decreased psychological well-being, and all three forms of childhood maltreatment were related to increased depressive symptoms. We also found that sibling support exchange mitigated the negative mental health effects of childhood neglect.Conclusion: Our findings suggest that siblings may be uniquely positioned to support older adults who grew up in a neglectful family environment. Older adults may be encouraged to promote resilience by strengthening their sibling relationships.

Relations between childhood psychological maltreatment and mental health dimensions within a higher-order model

Background

Experiences of childhood psychological maltreatment have been found to be associated with various mental health outcomes, and this association persists into adulthood.

Objective

This study investigated whether some types of psychological maltreatment are more harmful than others; whether the harms associated with different types of psychological maltreatment are generalized or specific to particular domains of psychopathology; and whether the associations vary by gender.

Method

Participants (N = 544, 63.9 % mother as primary caregiver) were Chinese adults from various regions in China. Participants completed measures of childhood psychological maltreatment experiences perpetrated by their primary caregiver and the mental health outcomes of depression, anxiety, anger, physical aggression, and hostility. The data were analyzed in a hierarchical model in which depression and anxiety were defined as indicators of an internalizing factor, while anger, physical aggression, and hostility were defined as indicators of an externalizing factor. Internalizing and externalizing then defined a higher-order general psychopathology factor. The results suggested equivalent harms of psychological abuse and psychological neglect. Further, the associations between psychological maltreatment and mental health were not unique to specific symptom domains but showed broadband associations with general psychopathology.

Results

These findings suggest that trans-diagnostic interventions may be the most effective approach for addressing the mental health impacts of psychological maltreatment.

Conclusion

Childhood psychological maltreatment may pose a broadband risk for any and all forms of psychopathology.

The Rating of Emotional Abuse in Childhood (REACH) Questionnaire: A new self-report measure assessing history of childhood emotional abuse

BACKGROUND

A history of childhood emotional abuse (CEA) is prevalent among adults with affective disorders; therefore, a comprehensive measure of it is vital. The Rating of Emotional Abuse in Childhood Questionnaire (REACH) was developed to assess history of CEA in relation to parental behaviours of threat, ignoring, humiliation/denigration, scapegoating, antipathy, and overcontrol/conditionality in a single measure. This paper investigated the psychometric properties of REACH in a community sample and proposes values for classifying individuals as high-risk for CEA.

METHOD

A convenience sample of N = 483 adults (Female, 78.3%) was recruited to complete questionnaires that included the REACH alongside measures of mental health, insecure attachment, emotion regulation, and childhood abuse. A subset of participants (n = 198) completed the REACH 7 days later.

RESULTS

Factor analysis indicated a 2-factor model provided a good fit. Factors were named 'threatening' and 'devaluing'. A total scale score of CEA was also recommended. The threatening, devaluing, and total scales demonstrated strong psychometric properties with high internal consistency, test-retest reliability, and convergent validity, while cutoff values for identifying a high-risk CEA group demonstrated good discriminant utility.

CONCLUSIONS

The results support REACH as a valid measure and suggest a history of CEA should be measured in relation to threatening and devaluing CEA as they represent unique dimensions of CEA even though they often co-occur.

Psychometric properties of the Hungarian childhood trauma questionnaire short form and its validity in patients with adult attention-deficit hyperactivity disorder or borderline personality disorder

BACKGROUND

Compelling evidence supports the role of childhood traumatization in the etiology of psychiatric disorders, including adult attention-deficit hyperactivity disorder (aADHD) and borderline personality disorder (BPD). The aim of this study was to examine the psychometric properties of the Hungarian version of the Childhood Trauma Questionnaire Short Form (H-CTQ-SF) and to investigate the differences between patients diagnosed with aADHD and BPD in terms of early traumatization.

METHODS

Altogether 765 (mean age = 32.8 years, 67.7% women) patients and control subjects were enrolled from different areas of Hungary. Principal component analysis and confirmatory factor analysis were carried out to explore the factor structure of H-CTQ-SF and test the validity of the five-factor structure. Discriminative validity was assessed by comparing clinical and non-clinical samples. Subsequently, aADHD and BPD subgroups were compared with healthy controls to test for the role of early trauma in aADHD without comorbid BPD. Convergent validity was explored by measuring correlations with subscales of the Personality Inventory for DSM-5 (PID-5).

RESULTS

The five scales of the H-CTQ-SF demonstrated adequate internal consistency and reliability values. The five-factor model fitted the Hungarian version well after exclusion of one item from the physical neglect scale because of its cross-loading onto the emotional neglect subscale. The H-CTQ-SF effectively differentiated between the clinical and non-clinical samples. The BPD, but not the aADHD group showed significant differences in each CTQ domain compared with the healthy control group. All CTQ domains, except for physical abuse, demonstrated medium to high correlations with PID-5 emotional lability, anxiousness, separation insecurity, withdrawal, intimacy avoidance, anhedonia, depressivity, suspiciousness, and hostility subscales.

CONCLUSIONS

Our study confirmed the psychometric properties of the H-CTQ-SF, an easy-to-administer, non-invasive, ethically sound questionnaire. In aADHD patients without comorbid BPD, low levels of traumatization in every CTQ domain were comparable to those of healthy control individuals. Thus, the increased level of traumatization found in previous studies of aADHD might be associated with the presence of comorbid BPD. Our findings also support the role of emotional neglect, emotional abuse and sexual abuse in the development of BPD.

Is teacher violence a form of betrayal trauma? Relationship with mental health problems among young adults

BACKGROUND

Childhood trauma is one of the most preventable risk factors for mental health problems. Considering the substantial amount of time that young people spend in school during their early years, it is important to understand the potential impacts of teachers' behaviors on students' mental health.

OBJECTIVES

This study examined the relationship between exposure to teacher violence and mental health problems.

PARTICIPANTS AND SETTING

An international sample of young adults aged 18 to 24 (N = 283).

METHODS

Participants completed self-report measures of childhood trauma, exposure to teacher violence, depressive symptoms, post-traumatic stress, and alcohol misuse.

RESULTS

Exposure to teacher violence could be reliably and validly measured using the Teacher Violence Scale (TVS). Current mental health problems - including depressive symptoms, post-traumatic stress, and alcohol misuse - were associated with exposure to teacher violence during high school years, but not with childhood non-betrayal trauma.

CONCLUSIONS

Our findings expand the application of the betrayal trauma theory to school settings and point to the importance of preventing and managing teacher violence. It is important to provide more support and training to teachers and enhance monitoring measures in schools. More research on the prevalence and correlates of exposure to teacher violence is needed. We also provided first evidence supporting the reliability and validity of the English version of the TVS to facilitate future research.

Associations between 11 parental discipline behaviours and child outcomes across 60 countries

OBJECTIVES

To test associations between 11 caregiver aggressive and non-aggressive discipline behaviours and outcomes (aggression, distraction and prosocial peer relations) of children under 5 years in low-income and middle-income countries (LMICs).

PARTICIPANTS

Data came from the fourth (2009-2013) and fifth (2012-2017) rounds of the UNICEF Multiple Indicator Cluster Surveys. Analyses were restricted to households with children under 5 years, leaving a sample of 229 465 respondents across 60 LMICs. Data were analysed using Bayesian multilevel logistic regression.

RESULTS

Verbal reasoning (80%) and shouting (66%) were the most common parental discipline behaviours towards young children. Psychological and physical aggression were associated with higher child aggression and distraction. Compared with not using verbal reasoning, verbal reasoning was associated with lower odds of aggression (OR)=0.92, 95% credible interval (CI)=0.86 to 0.99) and higher odds of prosocial peer relations (OR=1.30, 95% CI=1.20 to 1.42). Taking away privileges was associated with higher odds of distraction (OR=1.09, 95% CI=1.03 to 1.15) and lower odds of prosocial peer relations (OR=0.92, 95% CI=0.87 to 0.98). Giving the child something else to do was associated with higher odds of distraction (OR=1.06, 95% CI=1.01 to 1.12). The results indicated country-level variation in the associations between parenting behaviours and child socioemotional outcomes.

CONCLUSIONS

Psychological and physical aggression were disadvantageous for children's socioemotional development across countries. Only verbal reasoning was associated with positive child socioemotional development. No form of psychological aggression or physical aggression benefited child socioemotional development in any country. Greater emphasis should be dedicated to reducing parental use of psychological and physical aggression across cultural contexts.

A Systematic Review of the Prevalence and Correlates of Emotional Violence by Teachers

There is increasing evidence for the deleterious impact of emotional violence on children`s well-being and development. This systematic review focused on a) the prevalence and (b) correlates of emotional violence by teachers. A literature search of quantitative and peer-reviewed studies published in English between 1980 and April 2021 was conducted. Eighty-four studies met the inclusion criteria. Studies represented all geographical regions of the world, were predominantly cross-sectional and of moderate quality. Studies were heterogeneous in terms of their samples, conceptualization, and measurement of emotional violence. Results indicated that emotional violence by teachers is prevalent across cultural settings, although large variations within and between regions are noted. It is related to mental health, behavioral and academic problems of children above and beyond physical violence by teachers and victimization by peers and parents. Boys are at higher risk of experiencing emotional violence by teachers than girls. Family dysfunction, low socioeconomic status (of the family or the community), and violent school environments appear to increase risk as well. The observed patterns of co-occurrence of emotional violence with physical violence by teachers and victimization by peers as well as perpetration of violence against peers and teachers lend support to notions of poly-victimization and cycles of violence in the school settings. Future research should use representative surveys, examine antecedents, and consequences of emotional violence by teachers using longitudinal and experimental designs and evaluate interventions to prevent emotional violence by teachers.

The influence of childhood emotional neglect experience on brain dynamic functional connectivity in young adults

Background: Childhood emotional neglect (CEN) confers a great risk for developing multiple psychiatric disorders; however, the neural basis for this association remains unknown. Using a dynamic functional connectivity approach, this study aimed to examine the effects of CEN experience on functional brain networks in young adults.Method: In total, 21 healthy young adults with CEN experience and 26 without childhood trauma experience were recruited. The childhood trauma experience was assessed using the childhood trauma questionnaire (CTQ), and eligible participants underwent resting-state functional MRI. Sliding windows and k-means clustering were used to identify temporal features of large-scale functional connectivity states (frequency, mean dwell time, and transition numbers).Result: Dynamic analysis revealed two separate connection states: state 1 was more frequent and characterized by extensive weak connections between the brain regions. State 2 was relatively infrequent and characterized by extensive strong connections between the brain regions. Compared to the control group, the CEN group had a longer mean dwell time in state 1 and significantly decreased transition numbers between states 1 and 2.Conclusion: The CEN experience affects the temporal properties of young adults' functional brain connectivity. Young adults with CEN experience tend to be stable in state 1 (extensive weak connections between the brain regions), reducing transitions between states, and reflecting impaired metastability or functional network flexibility.

The Effect of Emotional Neglect on Cyberbullying among Rural Chinese Left-behind Adolescents-Mediating Role of Social Anxiety

BACKGROUND

Cyberbullying is a globally shared youth problem-a problem of the interpersonal conflicts and contradictions that emerge during the socialization of adolescents. In particular, the issue of cyberbullying among rural left-behind adolescents needs to be given high priority. However, previous studies have paid little attention to how emotional neglect and social anxiety affect the cyberbullying behavior of rural left-behind adolescents. Therefore, this study was based on cognitive-behavioral theory to investigate the relationship between emotional neglect, cyberbullying, and social anxiety.

METHODS

This study used the Emotional Neglect Scale, the Cyberbullying Scale, and the Social Anxiety Scale to conduct an anonymous online survey of 1429 rural left-behind adolescents in China.

RESULTS

(1) Emotional neglect, social anxiety, and cyberbullying showed a two-way positive correlation. (2) The direct effect of emotional neglect on rural left-behind youth cyberbullying was significant (β = 0.14, p < 0.00). (3) Social anxiety showed a partial mediating effect in the process of emotional neglect affecting rural left-behind youth cyberbullying, with a mediating effect of 26.32%.

CONCLUSIONS

The results have positive implications for improving relevant policies and constructing mechanisms for protecting the rights and interests of rural left-behind adolescents.

Identification of biopsychological trait markers in functional neurological disorders

Stress is a well-known risk factor to develop a functional neurological disorder, a frequent neuropsychiatric medical condition in which patients experience a variety of disabling neurological symptoms. Only little is known about biological stress regulation, and how it interacts with predisposing biological and psychosocial risk factors. Dysregulation of the hypothalamic-pituitary-adrenal axis in patients with functional neurological disorders has been postulated, but its relationship to preceding psychological trauma and brain anatomical changes remains to be elucidated. We set out to study the hypothalamic-pituitary-adrenal axis analysing the cortisol awakening response and diurnal baseline cortisol in 86 patients with mixed functional neurological symptoms compared to 76 healthy controls. We then examined the association between cortisol regulation and the severity and duration of traumatic life events. Finally, we analysed volumetric brain alterations in brain regions particularly sensitive to psychosocial stress, acting on the assumption of the neurotoxic effect of prolonged cortisol exposure. Overall, patients had a significantly flatter cortisol awakening response (P < 0.001) and reported longer (P = 0.01) and more severe (P < 0.001) emotional neglect as compared to healthy controls. Moreover, volumes of the bilateral amygdala and hippocampus were found to be reduced in patients. Using a partial least squares correlation, we found that in patients, emotional neglect plays a role in the multivariate pattern between trauma history and hypothalamic-pituitary-adrenal axis dysfunction, while cortisol did not relate to reduced brain volumes. This suggests that psychological stress acts as a precipitating psychosocial risk factor, whereas a reduced brain volume rather represents a biological predisposing trait marker for the disorder. Contrarily, an inverse relationship between brain volume and cortisol was found in healthy controls, representing a potential neurotoxic effect of cortisol. These findings support the theory of reduced subcortical volumes representing a predisposing trait factor in functional neurological disorders, rather than a state effect of the illness. In summary, this study supports a stress-diathesis model for functional neurological disorders and showed an association between different attributes of trauma history and abnormalities in hypothalamus-pituitary-adrenal axis function. Moreover, we suggest that reduced hippocampal and amygdalar volumes represent a biological 'trait marker' for functional neurological disorder patients, which might contribute to a reduced resilience to stress.

The prevalence of emotional abuse in children living in Sub-Saharan Africa - A systematic review

OBJECTIVES

This study is meant to put a focus on the prevalence of emotional abuse in low-income states like the Sub-Saharan region.

METHODOLOGY

Searching PubMed, Google scholar, and web of science during February and April 2021 a total of 2264 articles were identified, 27 met the inclusion criteria. We added the results of 13 VAC (Violence Against Children and Youth) studies, conducted by UNICEF capturing information about experienced sexual, physical, or emotional violence in 13-24-year-olds, as well as 56 MIC (Multiple Indicator Cluster) studies, conducted by the CDC to research the disciplinary methods used with children aged 1-14 years in the past month by older household members. Finally, in a meta-analytic approach, we aimed to calculate a pooled estimate of the prevalence.

RESULTS

The included studies depicted a wide range in prevalence rates across countries. For example, while the VAC study in Lesotho in 2018 showed low incidence rates of emotional violence (6.9 % Females, 3.8 % Males), the average prevalence recorded by the MIC study was as high as 57.8 % for females and 59.2 % for males. On average, the MIC studies displayed a higher incidence and the discrepancy of prevalence of emotional abuse between females and males was small. Calculating a pooled estimate of the prevalence was not possible, due to the heterogeneity of the data.

CONCLUSIONS

In general countries displayed a high prevalence. A standardized use of a uniform definition of emotional abuse might help to display a more homogenous data set in the future, giving the opportunity for pooled estimates of prevalence.

Sleep problems mediate the influence of childhood emotional maltreatment on adolescent non-suicidal self-injury: The moderating effect of rumination

BACKGROUND

Non-suicidal self-injury (NSSI) is a highly serious public health problem among adolescents in China, and childhood emotional maltreatment has been found to be a risk factor for NSSI.

OBJECTIVE

Little is known about the longitudinal association between childhood emotional maltreatment and NSSI as well as its underlying mediating and moderating mechanisms. Thus, we hypothesized whether sleep problems mediated the association between childhood emotional maltreatment and NSSI, and whether this indirect effect was moderated by rumination.

PARTICIPANTS AND SETTING

A total of 1987 Chinese adolescents (56.1 % males; ages 10 to 14, M = 12.32, SD = 0.53) completed self-report questionnaires regarding childhood emotional maltreatment, sleep problems, rumination non-suicidal self-injury (NSSI) in three waves.

METHODS

Structural equation model was used to test a moderated mediation model, with gender, age and socioeconomic status and baseline measures as covariates.

RESULTS

Childhood emotional maltreatment was significantly associated with NSSI, and this association was mediated by sleep problems. Moderated mediation analyses revealed that rumination intensified the relation between childhood emotional maltreatment and sleep problems as well as the relation between sleep problems and NSSI.

CONCLUSIONS

Findings of this study demonstrate a relationship among childhood emotional maltreatment, sleep problems, rumination and NSSI. Interventions that target sleep problems and rumination may be beneficial for reducing NSSI for at-risk adolescents.

The relationship between child maltreatment and social anxiety: A meta-analysis

BACKGROUND

Globally, child maltreatment has become a serious problem, affecting individuals' physical and mental health. This meta-analysis aimed to explore the association between child maltreatment and social anxiety.

METHODS

MEDLINE, PsycINFO, EMBASE, Scopus, and Web of Science were searched for articles published by October 2021. Newcastle-Ottawa Quality Assessment Scale (NOS) was used to evaluate the quality of studies. Maltreatment type, sample setting, age, country and measurement instruments were analyzed as moderators.

RESULTS

Twenty-nine studies met the inclusion criteria. Child maltreatment was positively correlated with social anxiety (r = 0.201, 95 % CI [0.171, 0.230]). The moderating effect of maltreatment subtypes was significant whether divided into three types (Q_b = 12.152, p = .002), or five types (Q_b = 11.574, p = .021). Specifically, emotional maltreatment (r = 0.251, 95 % CI [0.201, 0.298]) had a stronger relationship with social anxiety than physical (r = 0.138, 95 % CI [0.085, 0.191]; Q_b = 9.312, p = .002) and sexual maltreatment (r = 0.153, 95 % CI [0.108, 0.197]; Q_b = 9.197, p = .002). However, there was no significant difference in the effect size between physical and sexual maltreatment (Q_b = 0.096, p = .757). Other variables (age, sample setting and country) were not significant moderators.

LIMITATIONS

Only twenty-nine studies were included, and there was high heterogeneity among the studies, the interpretation of the results should be cautious.

CONCLUSIONS

This meta-analysis confirmed the relationship between child maltreatment and social anxiety, especially highlight the harmfulness of emotional maltreatment.

The functions of binge eating scale (FBES): Development and preliminary psychometric validation

OBJECTIVE

Binge eating within binge-eating disorder (BED) is a behaviour widely understood as a response to dietary restraint and emotion dysregulation. However, qualitative literature suggests that a wider range of functions of binge eating exist, with associations between functions of binge eating and adverse childhood experiences highlighted across this research. The present study sought to develop a scale to measure a wide range of functions of binge eating within BED. A secondary aim was to examine the relationship between these functions and adverse childhood experiences (ACEs).

METHOD

The researchers developed an initial item pool for the Functions of Binge Eating Scale (FBES) and invited experts within the eating disorder (ED) field (n = 22) to review the items. The refined item pool was administered online to adults with self-reported binge eating symptoms (N = 882), along with related measures to establish scale validity.

RESULTS

Exploratory and confirmatory factor analyses produced an eight-factor structure (emotion regulation, hedonic hunger, compensatory eating, numbness/dissociation, emotion expression, self-punishment, control, self-protection). The scale demonstrated good internal reliability and adequate construct and predictive validity. Results also showed that functions theoretically related to childhood maltreatment were predicted by ACEs.

DISCUSSION

Findings extend our understanding of the range of functions of binge eating experienced in BED. Additionally, findings indicate that type of adverse childhood experience predicts functions of binge eating. Initial validation of the FBES suggests that functions of binge eating are wider than previously understood. Accordingly, clinicians are encouraged to explore and target more complex processes which might perpetuate binge-eating behaviour.

The influence of childhood maltreatment on trait depression in patients with major depressive disorder: A moderated mediation model of rumination and mindful attention awareness

Major depressive disorder (MDD) is one of the most prevalent psychiatric disorders. Individuals who were exposed to childhood maltreatment might be an especially vulnerable group and were more likely to meet the diagnostic criteria for depression than those who were not. Trait depression refers to a personality trait predisposition to depression, expressed as the frequency of symptoms rather than a transient depressive mood state. Clarifying the relationship between childhood maltreatment and trait depression in patients with MDD has therefore become an important field of research. Childhood Trauma Questionnaire-Short Form (CTQ-SF), Ruminative Responses Scale (RRS), State-Trait Depression Scale (ST-DEP), and Mindful Attention Awareness Scale (MAAS) were used as research instruments. SPSS 23.0 statistical software was used for statistical analysis and examined the moderated mediation models. A total of 288 patients with MDD were included in this study. After standardization of the variables, the model revealed childhood maltreatment was positively associated with trait depression (β = 0.215, p < 0.001) and that rumination partially mediated the effect between childhood trauma and trait depression. Mindfulness moderated the association between rumination and trait depression in depressed patients (β = 0.171, p < 0.001). Simple slope tests showed that rumination significantly predicted trait depression in patients with high levels of mindfulness (bsimple = 0.460, p < 0.001, 95%CI = [0.339, 0.581]), while this predictive effect was not significant in patients with low levels (bsimple = 0.119, p = 0.097, 95%CI = [-0.022, 0.261]). After adding mediating variables, we found that the negative impact of childhood maltreatment on trait depression was both directly and indirectly through the patients' own ruminative levels. However, mindfulness performed a critical moderating role in the overall mediating model, aggravating the negative impact of childhood maltreatment on trait depression. There are several limitations in this study: the history of childhood maltreatment was reviewed and reported; the MAAS was a single-dimensional questionnaire that fails to measure the content of other mindfulness factors; cross-sectional data could not be used to infer the causal relationship between variables.

Examining the Effects of Adverse Childhood Experiences and Gender on Trauma-Informed Intervention Outcomes

Purpose

The prevalence of Adverse Childhood Experiences (ACEs) and their link to negative behavioral and health outcomes is well documented, but very few studies have empirically examined the effect of ACEs on intervention outcomes. There is also emerging evidence of gender differences in vulnerability to developing traumatic symptoms, which relates to intervention outcomes. The current study examined the effects of ACEs and gender on trauma-informed intervention outcomes in a community-based clinical setting.

Methods

The study includes data from children who were treated with trauma-informed intervention services grounded in the Attachment, Self-Regulation, and Competency (ARC) framework from 2017 to 2019. ACE scores are measured as a total across 10 items and different types, maltreatment versus family dysfunction, at intake. Children's trauma-related symptoms are assessed at intake and every 90 days under the ARC framework. In order to examine the changes of traumatic symptoms over time, a total of 362 children with three time points are included for the current analyses using Multilevel modeling with SAS PROC MIXED.

Results

The study found that a trauma-informed intervention based on the ARC framework was effective in reducing children's trauma related symptoms until they experienced 6 or more ACEs. The intervention effect, however, did not hold when children's ACEs were cumulated to 7 or more. The study also revealed gender differences in intervention outcomes.

Conclusions

The finding has significant implications for early detection and preventative intervention efforts with children's ACEs before their ACEs further cumulate to a higher number. Gender difference should be considered in intervention planning and monitored during the intervention process.

Latent profiles of childhood psychological maltreatment and their links to adult mental health in China and the UK

BACKGROUND

Though links between childhood maltreatment and mental health have been established, little known about how specific types of childhood maltreatment tend to cluster and how the resulting patterns of exposure impact mental health outcomes.

METHOD

The current study used latent profile analyses in Chinese (N = 544) and UK (N = 589) samples to identify childhood psychological maltreatment profiles (i.e., profiles of psychological abuse, psychological neglect, and psychological non-support) in different country contexts, and their associations with a range of mental health (i.e., depression, anxiety, anger, physical aggression, verbal aggression, and hostility), and broader well-being (i.e., self-esteem) outcomes. Unadjusted as well as analyses adjusted for adverse childhood experiences (ACEs) were conducted.

RESULTS

Four profiles were identified in both samples, but their nature differed between the Chinese sample ("Psychological Non-support", "Low-Maltreated", "High-Maltreated", and "Severe-Maltreated") and the UK sample ("Low-Maltreated", "Moderate-Maltreated", "High-Maltreated", and "Severe-Maltreated"). Individuals in the "Psychological Non-support" in China and "Low-Maltreated" class in the UK displayed better mental health outcomes-lower levels of depression, anxiety, and aggression, and higher self-esteem. In contrast, individuals in the "Severe-Maltreated" profiles in both the Chinese and UK samples displayed poorer mental health outcomes-higher depression, anxiety, and aggression, and lower self-esteem. Interventions and prevention efforts are needed for individuals categorized in profiles affected by psychological maltreatment.

CONCLUSION

This study highlights the importance of using targeted intervention or prevention to prevent psychological maltreatment, as well as improve mental health outcomes in individuals who have experienced psychological maltreatment.

The relationship between childhood emotional neglect experience and depressive symptoms and prefrontal resting functional connections in college students: The mediating role of reappraisal strategy

Childhood emotional neglect (CEN) has a relatively high incidence rate and substantially adverse effects. Many studies have found that CEN is closely related to emotion regulation and depression symptoms. Besides, the functional activity of the prefrontal lobe may also be related to them. However, the relationships between the above variables have not been thoroughly studied. This study recruited two groups of college students, namely, those with primary CEN (neglect group) and those without childhood trauma (control group), to explore the relationships among CEN, adulthood emotion regulation, depressive symptoms, and prefrontal resting functional connections. The methods used in this study included the Childhood Trauma Questionnaire (CTQ), Emotion Regulation Questionnaire (ERQ), Beck Depression Inventory-II (BDI-II) and resting-state functional magnetic resonance imaging (rs-fMRI). The results showed that compared with the control group, the neglect group utilized the reappraisal strategy less frequently and displayed more depressive symptoms. The prefrontal functional connections with other brain regions in the neglect group were more robust than those in the control group using less stringent multiple correction standards. Across the two groups, the functional connection strength between the right orbitofrontal gyrus and the right middle frontal gyrus significantly negatively correlated with the ERQ reappraisal score and positively correlated with the BDI-II total score; the ERQ reappraisal score wholly mediated the relationship between the functional connection strength and the BDI-II total score. It suggests that primary CEN may closely correlate with more depressive symptoms in adulthood. Furthermore, the more robust spontaneous activity of the prefrontal lobe may also be closely associated with more depressive symptoms by utilizing a reappraisal strategy less frequently.

Primary and secondary callous-unemotional traits in adolescence are associated with distinct maladaptive and adaptive outcomes in adulthood

While phenotypically indistinguishable with respect to callousness, individuals with primary and secondary callous-unemotional (CU) traits may show different developmental outcomes. This research predominantly comprised cross-sectional studies of male participants with a focus on maladaptive correlates. Thus, the present study examined whether youth with primary and secondary CU traits identified in Grade 7 reported distinct maladaptive outcomes (internalizing, externalizing, and substance use problems; criminal offenses; and sexual and partner experiences) and adaptive outcomes (health and wellbeing, education, and employment) in adulthood at age 25. We also examined sex differences. Participants included the high-risk control and normative samples from the Fast Track project (N = 754, male = 58%, Black = 46%). Youth with secondary CU traits reported higher levels of adult internalizing and externalizing psychopathology, a greater number of sexual partners and risky sexual behavior, and a greater number of violent offenses, compared with individuals with primary CU traits and those with low CU and anxiety symptoms. Conversely, youth with primary CU traits and low symptoms had higher wellbeing and happiness scores than those with secondary CU traits. Finally, there was differentiation on outcomes between female primary and secondary CU variants and male primary and secondary CU variants.

The influence of childhood emotional neglect on emotional face processing in young adults

Childhood emotional neglect (CEN) refers to a failure to meet the basic emotional needs of a child, which can seriously impact interpersonal communication and psychological health in young adults. Emotional face processing is critical in interpersonal communication; however, whether CEN affects this processing in young adults has not been investigated. Therefore, the current study aimed to explore the effects of CEN on emotional face processing in young adults. Using the Child Trauma Questionnaire, an online survey was conducted with 5010 students from four universities in Tianjin, China. After online interviews and diagnosis by professional doctors, we obtained 20 participants with CEN (CEN group) and 20 without CEN (control group). None of the participants had any mental diseases. A 2 × 4 mixed design was used to investigate the differences in accuracy and response time when identifying the valence of the emotional faces. Compared to the control group, the CEN group identified the valence of all emotional faces more slowly, but there was no significant difference between the two groups in terms of accuracy. CEN caused delayed emotional face processing in young adults, which may be related to unresponsive, unavailable, and limited emotional interaction patterns between parents and their children.

Intergenerational impact of childhood trauma on hair cortisol concentrations in mothers and their young infants

Background

Alterations in stress regulation and function of the hypothalamic-pituitary-adrenal (HPA) axis during infancy may be a risk factor for the development of psychopathology later in life. Maternal childhood trauma, depression, anxiety and stressful life events are individually associated with HPA axis dysregulation. Less is known about their interdependent influence on maternal and infant stress regulation in at risk populations. In a sample of mothers with a history of depressive-, and/or anxiety disorders and their infants we explored if a history of maternal childhood trauma, current depressive and anxiety symptomatology, and recent life events were associated with maternal and infant long-term cortisol levels three months postpartum.

Methods

Data were available of 89 mothers and 49 infants. All mothers fulfilled criteria for a lifetime depressive or anxiety disorder. Diagnosis was established with a diagnostic interview. Current depressive symptomatology was assessed with the Edinburgh Postnatal Depression Scale (EPDS), current anxiety with the State-Trait Anxiety Inventory (STAI), maternal childhood trauma with the Childhood Trauma Questionnaire (CTQ) and recent life events with the Everyday Problem Checklist (EPC). Maternal and infant hair cortisol concentrations (HCC) were quantified with liquid chromatography with tandem mass spectrometry (LC-MS/MS) three months after birth. Total scores of the CTQ and subscales, EPDS, STAI, and EPC were regressed on maternal and infant HCC using regression analyses. Differences in HCC regarding trauma history were tested with t-tests. Potential confounders were identified and adjusted for.

Results

In regression analyses, a positive curvilinear relationship was found between CTQ total score and maternal HCC (n = 83, B = 0.076, SE 0.033, p = .021), but not for current depression (n = 88, B = -0.001, SE 0.011, p = .931), current anxiety (n = 88, B = 0.002, SE 0.004, p = .650) or recent life events (n = 89, B = 0.018, SE 0.032, p = .568). Analyses were adjusted for confounders. A negative linear relationship was found between maternal CTQ score and infant HCC (n = 49, β = -0.264, B = -0.006, SE 0.003, p = .052), but not for current maternal depression (n = 45, β = -0.182, B = -0.011, SE 0.008, p = .164), current maternal anxiety (n = 45, β = -0.209, B = -0.005, SE 0.003, p = .113) or recent life events (n = 46, β = -0.128, B = -0.022, SE 0.023, p = .325). Analyses were adjusted for relevant infant hair characteristics. Specifically, maternal emotional and physical neglect were related to HCC in both mothers and infants.

Conclusions

Results suggest that maternal childhood trauma is more prominent in altering maternal and infant long-term cortisol levels than perinatal depressive and anxiety symptomatology or recent life stressors in mothers with a history of depressive and/or anxiety disorders, and their infants. As infants of mothers with psychopathology are at increased risk for later psychiatric disease, future studies should investigate the interplay of possible risk factors for transgenerational transmission, intra-uterine programming of the HPA axis, including (epi-)genetic phenomena, of the HPA axis, and the influence of parenting impairment.

Childhood emotional maltreatment, maladaptive coping and obsessive-compulsive symptoms in patients with obsessive-compulsive disorder

Previous studies have reported childhood emotional maltreatment (CEM) to be associated with specific obsessive-compulsive (OC) symptoms, but maladaptive coping, which may be the underlying mechanism in this relationship, has not been evaluated yet. Thus, the present study aimed to examine the effects of CEM on the OC symptoms of responsibility for harm and unacceptable thoughts, as well as obsessive-compulsive disorder (OCD) severity, through maladaptive coping, including cognitive avoidance, experiential avoidance and emotional suppression in OCD patients (n = 360). The results showed that CEM had direct effects, as well as indirect effects via cognitive and experiential avoidance and emotional suppression, on responsibility for harm and unacceptable thoughts. In addition, the indirect effect of CEM on OCD severity was significantly mediated by the roles of cognitive avoidance and experiential avoidance. The present study adds new literature to evidence indicating the role of early childhood events in developing and maintaining OCD in which adverse maladaptive coping related to unpleasant childhood abuse plays an important role in OCD. More precisely, OCD patients who experience a history of CEM may further use maladaptive coping to cope with their distress and subsequently experience responsibility for harm, unacceptable thoughts and severe OCD.

Family income buffers the relationship between childhood adverse experiences and putamen volume

Adverse experiences and family income in childhood have been associated with altered brain development. While there is a large body of research examining these associations, it has primarily used cross-sectional data sources and studied adverse experiences and family income in isolation. However, it is possible that low family income and adverse experiences represent dissociable and potentially interacting profiles of risk. To address this gap in the literature, we examined brain structure as a function of adverse experiences in childhood and family income in 158 youths with up to five waves of MRI data. Specifically, we assessed the interactive effect of these two risk factors on six regions of interest: hippocampus, putamen, amygdala, nucleus accumbens, caudate, and thalamus. Adverse experiences and family income interacted to predict putamen volume (B = 0.086, p = 0.011) but only in participants with family income one standard deviation below the mean (slope estimate = -0.11, p = 0.03). These results suggest that adverse experiences in childhood result in distinct patterns of brain development across the socioeconomic gradient. Given previous findings implicating the role of the putamen in psychopathology-related behaviors, these results emphasize the importance of considering life events and socioeconomic context when evaluating markers of risk. Future research should include interactive effects of environmental exposures and family income to better characterize risk for psychopathology in diverse samples.

Focal Dystonia and the Stress Network: The Role of Stress Vulnerability and Adverse Childhood Experiences in the Development of Musician's Dystonia

Musician's dystonia is often described as a neurological disorder, resulting from reduced inhibition in the basal ganglia and the cerebellum and dysfunctional cortical plasticity. However, several studies over the last decades support the hypothesis that psychological factors play an important role in the aetiology of dystonia, contradicting its classification as "purely neurological". Especially adverse childhood experiences (ACEs) such as neglect, maltreatment, or household dysfunction may influence the sensorimotor system, additionally to the impact they have on psychological traits. They are known to alter limbic networks, such as the amygdala, the hippocampus, and the stress response via the hypothalamus-pituitary-adrenal (HPA) axis and might also affect the cortico-striatal-thalamo-cortical loop that is vital for correct motor movement learning. Especially a higher activity of the basolateral amygdala could be important by increasing the consolidation of dysfunctional motor memories in stressful situations.Therefore, this chapter explores how musician's dystonia might be a result of dysfunctional stress-coping mechanisms, additionally to the already established neurological alterations.

You Hurt Me, so I Hurt Myself and Others: How Does Childhood Emotional Maltreatment Affect Adolescent Violent Behavior and Suicidal Ideation?

Violent behavior and suicidal ideation are two major public health problems, with the former representing outward attack and the latter characterizing inward attack. The effects of emotional maltreatment in childhood will continue into adolescence. This study explores the impact of childhood emotional maltreatment on adolescent violent behavior/suicidal ideation and its mechanism. Participants were 3,600 adolescents (average age is 16.21 ± 0.99) from the middle east of China. They completed questionnaires measuring emotional maltreatment in childhood, deviant peer affiliation, depression, violent behavior, and suicidal ideation in adolescence. After controlling for demographic variables, we found that deviant peer affiliation and depression mediated between childhood emotional maltreatment and adolescent violent behavior/suicidal ideation. Multi-group analysis results showed that males' deviant peer affiliation would contribute to their violent behaviors. Among female groups, deviant peer affiliation and depression were risk factors for violent behavior and suicidal ideation. a) cross-sectional design was used in this study; b) all the measures were self-reported. Preventing emotional maltreatment in childhood can help reduce violent behavior and suicidal ideation by reducing deviant peer affiliation and depression in adolescence. Males who experienced emotional maltreatment in childhood are more likely to show violent behaviors shaped by external factors such as deviant peer affiliation. In contrast, females' interpersonal orientation and internalizing factors both influence their external and internal aggressive behaviors.

Childhood Trauma and Dissociation Correlates in Alcohol Use Disorder: A Cross-Sectional Study in a Sample of 587 French Subjects Hospitalized in a Rehabilitation Center

This study aimed to determine whether dissociative symptoms and childhood trauma (CT) may help identify a specific subgroup of patients among those hospitalized for alcohol use disorder (AUD). We assessed 587 patients hospitalized for an AUD in a French addiction rehabilitation center (cross-sectional study) regarding dissociative symptoms (DES-taxon), childhood trauma (CTQ), depression (BDI), anxiety (STAI-state and STAI-trait), posttraumatic stress disorder (PTSD; PCL-5), and AUD symptoms (AUDIT). We ran a hierarchical cluster analysis and compared the clusters in terms of dissociation and CT, as well as AUD, depressive, anxiety, and PTSD symptoms. We identified three clusters of patients: (1) patients with low AUD severity and low dissociation (LALD); (2) patients with high AUD severity and low dissociation (HALD); (3) patients with high AUD severity and high dissociation (HAHD). Patients from the HAHD group had significantly higher dissociation and more severe depression, anxiety, and PTSD symptoms than those with LALD and HALD. They also reported more emotional and sexual abuse than those with LALD. Among patients with an AUD, those with high dissociation may constitute an independent subgroup that exhibits a higher prevalence for CT and higher AUD severity, as well as higher depression, anxiety, and PTSD symptoms. Patients with more severe AUD and associated psychiatric symptoms should be systematically screened for dissociation and provided with tailor-based treatments.

Discrepancies in youth self-report and case file report of maltreatment and association with internalizing and externalizing symptoms

BACKGROUND

Childhood maltreatment is a potential risk factor for the later development of psychopathology (Jaffee, 2017). However, there is no gold standard for identifying victims of child maltreatment, and when multiple informants - such as case files and youth self-report - are used, these sources often disagree (Cooley & Jackson, 2022).

OBJECTIVE

The current study aimed to explore discrepancies between youth self-report and case file report of maltreatment and examine how these discrepancies related to internalizing and externalizing symptoms.

PARTICIPANTS/SETTING

Participants were 470 youth living in foster care between the ages of 8 and 18 and their caregivers.

METHODS

Latent class analysis (LCA) was used to create novel groups based on informant discrepancies.

RESULTS

Agreement between informants was in the poor-to-fair agreement range for all types of maltreatment. Latent class analysis identified a 3-class solution with significant group differences on both externalizing (Χ² (2, N = 470) = 6.16, p = 0.05) and internalizing symptoms (Χ² (2, N = 470) = 6.10, p = 0.05). Specifically, those in the "self-report only" class had significantly higher symptoms than those in the "neither informant/case file only" class for both internalizing and externalizing behavior.

CONCLUSIONS

Case files and youth self-report of maltreatment are discrepant. Youth self-report of maltreatment history may be more closely linked to psychopathology than case file report of maltreatment. Researchers and practitioners should look to youth self-report rather than relying solely on case files when determining risk for psychopathology.

Longstanding health risk across the life course: The influence of early-life experience on health status throughout the life span

This study tracked the longstanding effect of childhood adversities on health status over the course of a life. This study used the data from China Health and Retirement Longitudinal Study which was a nationally representative survey and documented the generation who had arrived in the middle- and old-age phase and experienced the difficult time in the early founding of PR China in their childhood. Results shown the significant associations between multiple forms of children adversities (economic distress, child neglect, child abuse, lack of friends, parental mental health problems) and health status in adolescence (from 0.068 to 0.102, p<0.01), and health status in mid and late adulthood, including self-rated general health problems (from 0.039 to 0.061, p<0.01), chronic conditions (from 0.014 to 0.120, p<0.01 except for lack of friends), body aches (from 0.016 to 0.062, p<0.01 except for child neglect), and depression (from 0.047 to 0.112, p<0.01). Meanwhile, results also shown an underlying pathway (i.e., health status in adolescence) linking childhood adversities and health status in mid and late adulthood. Results suggested that the experience of multiple forms of adversities in childhood represented a substantial source of health risk throughout life.

Do Adult Attachment Style or Personality Mediate the Relationship Between Childhood Maltreatment and Late-Life Depression in Poor Communities?

OBJECTIVE

Childhood maltreatment is associated with late-life depression. Preliminary evidence indicates that personality characteristics, in particular neuroticism and extroversion, and an anxious attachment style mediate this association. The objective is to evaluate 3 models, in which personality and attachment are considered mediators between childhood maltreatment and late-life depression in a socioeconomically disadvantaged Brazilian population.

METHODS

This study included participants (n = 260) from socioeconomically disadvantaged neighborhoods of Porto Alegre, Brazil, who completed measures of childhood maltreatment (Childhood Trauma Questionnaire - CTQ), personality characteristics (NEO-Five Factor Inventory), attachment styles (Relationship Scales Questionnaire), and geriatric depression (Mini-International Neuropsychiatric Interview-Plus). General multiple and sequential mediation analyses were used to test for possible associations.

RESULTS

Attachment anxiety but not attachment avoidance is a mediator between childhood maltreatment and geriatric depression. Neuroticism is a full mediator. At that, attachment anxiety was found to be a predictor of neuroticism. Finally, sequential mediation analysis shows a path from childhood maltreatment to geriatric depression through attachment anxiety and neuroticism.

CONCLUSIONS

The results suggest a pathway from childhood maltreatment to anxious attachment, which in turn predicts higher neuroticism that itself may favor late-life depression. This hypothesis could have implications for older adults living in low socioeconomic settings in that treating the high-risk group of maltreated children may help prevent late-life depression.