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Bruffaerts R, Caywood K, Axinn WG. Early-life risk factors for depression among young adults in the United States general population: Attributable risks and gender differences. J Affect Disord 2024; 363:206-213. [PMID: 39025438 DOI: 10.1016/j.jad.2024.07.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 07/11/2024] [Accepted: 07/14/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND This study adopts individual and societal-level approaches to examine the contribution of childhood risk factors to major depressive episodes (MDE) in 2526 American young adults. METHODS Nationally representative data from the 2017 U.S. Panel Study of Income Dynamics - Transition into Adulthood Supplement (PSID-TAS) were analyzed using multivariate methods to assess the impact of parental mental illness, childhood adversities, childhood mental disorders, and childhood physical conditions. Adjusted odds ratios and population attributable risk proportions (PARPs) are calculated to estimate the proportion of MDE cases related to risk factors. RESULTS The 12-month prevalence of positive screens for MDE was 25.4 %. Approximately 34 % of these were attributable to childhood mental disorders, 24 % to childhood physical conditions, 21 % to childhood adversities, and 16 % to parental mental illness. Childhood and parental depression were critical risk factors, both at the individual (odds ratio exceeding 2) and societal (PARP approximately 24 %) levels. Gender-specific risk factors were identified, with childhood physical abuse and childhood anxiety disorders constituting risk factors for females, and childhood externalizing disorders and childhood headaches as risk factors for males. Approximately 60 % of U.S. young adult MDE cases are attributable to risk factors before age 18. LIMITATIONS Possible over reporting of MDE may have biased the associations between predictors and depression. CONCLUSIONS Exposure to depression at a young age-one's own or parental depression-is a robust risk factor for both genders. Policies and interventions focused at alleviating the societal burden of depression should value its generational transmission.
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Affiliation(s)
- Ronny Bruffaerts
- Center for Public Health Psychiatry, Universitair Psychiatrisch Centrum-KU Leuven, Leuven, Belgium
| | - Kelsi Caywood
- Department of Sociology, Population Studies Center and Survey Research Center, University of Michigan, Ann Arbor, MI, United States of America
| | - William G Axinn
- Department of Sociology, Population Studies Center and Survey Research Center, University of Michigan, Ann Arbor, MI, United States of America.
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Santelices MP, Barrera P, Undurraga C, Valenzuela E, Viviani P, Hamilton J, Murillo J. Analyzing the relationship between individual and cumulative score of adverse childhood experiences (ACEs) with self-reported mental health disorders in Chile. CHILD ABUSE & NEGLECT 2024; 155:106997. [PMID: 39208600 DOI: 10.1016/j.chiabu.2024.106997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 08/06/2024] [Accepted: 08/14/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Adverse Childhood Experiences (ACEs) are widely recognized as significant predictors of poor mental health in adulthood. Latin America presents several unique challenges regarding ACEs, such as higher prevalence of violence and income and political inequality. However, little is known about this issue from nationally representative samples in the region, particularly in Chile. OBJECTIVE This investigation examines the association between individual and cumulative ACE scores and seven self-reported mental health conditions (substance abuse, depression, PTSD, generalized anxiety, suicide ideation, non-suicidal self-harm, and learning disorders) in a representative Chilean urban sample. METHODS A representative urban sample of 2101 adult Chileans completed the International Adverse Childhood Experiences Questionnaire (ACE-IQ) and disclosed any prior mental health diagnoses. RESULTS Around 40 % of the sample had experienced four or more ACEs in their lifetime. For these individuals, the risk of reporting a mental health disorder was significantly higher. Several logistic regression analyses were conducted to address the associations between ACEs and the seven mental health conditions. Notably, sexual abuse, bullying, and exposure to collective violence were the ACEs most strongly associated with self-reported mental health issues. Additionally, a cumulative ACE score was found to be a significant predictor of having a previous mental health diagnosis. CONCLUSIONS We found a significant predictive association between exposure to collective violence and six out of the seven self-reported mental health disorders. Similarly, sexual abuse demonstrated an association with all mental health conditions. Finally, individuals who experienced four or more ACEs had a notably higher chance of reporting a previous mental health diagnosis. We recommend conducting further ACE research in Latin America due to its cultural and contextual singularities.
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Affiliation(s)
| | - Pablo Barrera
- Pontificia Universidad Católica de Chile, Chile; Centro CUIDA, Chile.
| | | | | | - Paola Viviani
- Pontificia Universidad Católica de Chile, Chile; Centro CUIDA, Chile.
| | - James Hamilton
- Pontificia Universidad Católica de Chile, Chile; Centro CUIDA, Chile; Fundación para la Confianza, Chile
| | - José Murillo
- Pontificia Universidad Católica de Chile, Chile; Centro CUIDA, Chile; Fundación para la Confianza, Chile.
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Chen P, Li Y, Zadrozny S, Seifer R, Belger A. Polygenic risk, childhood abuse and gene x environment interactions with depression development from middle to late adulthood: A U.S. national life-course study. Prev Med 2024; 185:108048. [PMID: 38906275 DOI: 10.1016/j.ypmed.2024.108048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 05/31/2024] [Accepted: 06/16/2024] [Indexed: 06/23/2024]
Abstract
OBJECTIVE Utilizing national longitudinal data, this study examines how polygenic depression risk and childhood abuse interactively influence the life-course development of depressive conditions from middle to late adulthood. METHOD Data from 7512 participants (4323 females and 3189 males) of European ancestry aged 51-90, retrieved from the U.S. Health and Retirement Study (1992-2020), were analyzed. Childhood physical abuse and polygenic depression score were the primary predictors. Depressive symptoms were assessed using the Center for Epidemiologic Studies-Depression (CESD) scale, and clinical depression risk was a binary indicator. Growth-curve linear mixed and logit mixed-effects models were conducted for analysis. RESULTS Increasing polygenic depression scores were associated with elevated CES-D levels and potential risks of clinical depression. Males experienced more detrimental effects of childhood abuse on depression development from ages 51 to 90 years. In contract, non-maltreated females generally exhibited higher depressive symptoms and clinical depression risk than males. A significant interactive effect was found between polygenic depression risk and childhood abuse among males. Higher depression levels and clinical risk were observed with increasing polygenic depression score among maltreated males, surpassing those of females with standardized polygenic score ≥0 from age 51 to 90 years. CONCLUSIONS The interaction between childhood abuse and genetic factors significantly shaped lifelong depression trajectories in males, while the negative impact of abusive parenting remained constant regardless of polygenic depression risk among females. Individualized prevention and intervention strategies could be crucial in mitigating lifelong depression development, especially for high-genetic-risk males with a history of childhood physical abuse.
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Affiliation(s)
- Ping Chen
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Yi Li
- Department of Sociology, The University of Macau, China
| | - Sabrina Zadrozny
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ronald Seifer
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Aysenil Belger
- Department of Psychiatry, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; The Intellectual and Developmental Disabilities Research Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Yu J, Pu F, Yang G, Hao M, Zhang H, Zhang J, Cao X, Zhu L, Wan Y, Wang X, Liu Z. Sex-Specific Association Between Childhood Adversity and Accelerated Biological Aging. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2309346. [PMID: 38704685 PMCID: PMC11234451 DOI: 10.1002/advs.202309346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 03/19/2024] [Indexed: 05/07/2024]
Abstract
Is childhood adversity associated with biological aging, and if so, does sex modify the association, and do lifestyle and mental health mediate the association? A lifespan analysis is conducted using data on 142 872 participants from the UK Biobank to address these questions. Childhood adversity is assessed through the online mental health questionnaire (2016), including physical neglect, physical abuse, emotional neglect, emotional abuse, sexual abuse, and a cumulative score. Biological aging is indicated by telomere length (TL) measured from leukocyte DNA using qPCR, and the shorter TL indicates accelerated biological aging; a lifestyle score is constructed using body mass index, physical activity, drinking, smoking, and diet; mental disorder is assessed using depression, anxiety, and insomnia at the baseline survey. The results reveal a sex-specific association such that childhood adversity is associated with shorter TL in women after adjusting for covariates including polygenic risk score for TL, but not in men. Unhealthy lifestyle and mental disorder partially mediate the association in women. The proportions of indirect effects are largest for sexual and physical abuse. These findings highlight the importance of behavioral and psychological interventions in promoting healthy aging among women who experienced childhood adversity, particularly sexual and physical abuse.
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Affiliation(s)
- Jie Yu
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Fan Pu
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Gan Yang
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Meng Hao
- Human Phenome Institute and State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, School of Life Sciences, Fudan University, Shanghai, 200433, China
| | - Hui Zhang
- Human Phenome Institute and State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, School of Life Sciences, Fudan University, Shanghai, 200433, China
- National Clinical Research Center for Ageing and Medicine, Huashan Hospital, Fudan University, Shanghai, 200433, China
| | - Jingyun Zhang
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Xingqi Cao
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Lijun Zhu
- Zhejiang Provincial Key Laboratory for Diagnosis and Treatment of Aging and Physic-chemical Injury Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Yuhui Wan
- MOE Key Laboratory of Population Health across Life Cycle/Anhui Provincial Key Laboratory of Population Health and Aristogenics, and Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, 230032, China
| | - Xiaofeng Wang
- Human Phenome Institute and State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, School of Life Sciences, Fudan University, Shanghai, 200433, China
- National Clinical Research Center for Ageing and Medicine, Huashan Hospital, Fudan University, Shanghai, 200433, China
| | - Zuyun Liu
- Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, and Department of Big Data in Health Science School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, 310058, China
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Bérubé A, Pétrin R, Blais C. Parental depression moderates the relationship between childhood maltreatment and the recognition of children expressions of emotions. Front Psychiatry 2024; 15:1374872. [PMID: 38903632 PMCID: PMC11188386 DOI: 10.3389/fpsyt.2024.1374872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 03/05/2024] [Indexed: 06/22/2024] Open
Abstract
Background Sensitivity plays a crucial role in parenting as it involves the ability to perceive and respond appropriately to children's signals. Childhood maltreatment and depression can negatively impact adults' ability to recognize emotions, but it is unclear which of these factors has a greater impact or how they interact. This knowledge is central to developing efficient, targeted interventions. This paper examines the interaction between parents' depressive symptoms and childhood maltreatment and its influence on their ability to recognize the five basic emotions (happiness, anger, sadness, fear, and disgust) in children's faces. Method The sample consisted of 52 parents. Depressive symptoms were measured by the depression subscale of the Brief Symptom Inventory-18 (BSI-18), and maltreatment history was assessed by the Childhood Trauma Questionnaire (CTQ). Children's emotional stimuli were morphed images created using The Child Affective Facial Expression (CAFE) database. Results Our findings indicate that depressive symptoms moderate the relationship between parents' history of childhood maltreatment and emotion recognition skills. Parents with higher depressive symptoms had lower emotion recognition accuracy when they had not experienced maltreatment. When childhood maltreatment was severe, emotion recognition skills were more consistent across all levels of depression. The relationship between depression and emotion recognition was primarily linked to recognizing sadness in children's faces. Conclusion These findings highlight how different experiences can affect parental abilities in emotion recognition and emphasize the need for interventions tailored to individual profiles to improve their effectiveness.
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Affiliation(s)
- Annie Bérubé
- Ricochet, Department of Psychoeducation and Psychology, University of Quebec in Outaouais, Gatineau, QC, Canada
- Centre de Recherche Universitaire sur les Jeunes et les Familles (CRUJeF), Trois-Rivières, QC, Canada
| | - Rachel Pétrin
- Ricochet, Department of Psychoeducation and Psychology, University of Quebec in Outaouais, Gatineau, QC, Canada
| | - Caroline Blais
- Social and Visual Perception Laboratory, Department of Psychoeducation and Psychology, University of Quebec in Outaouais, Gatineau, QC, Canada
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Prachason T, Mutlu I, Fusar-Poli L, Menne-Lothmann C, Decoster J, van Winkel R, Collip D, Delespaul P, De Hert M, Derom C, Thiery E, Jacobs N, Wichers M, van Os J, Rutten BPF, Pries LK, Guloksuz S. Gender differences in the associations between childhood adversity and psychopathology in the general population. Soc Psychiatry Psychiatr Epidemiol 2024; 59:847-858. [PMID: 37624463 PMCID: PMC11087312 DOI: 10.1007/s00127-023-02546-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 08/14/2023] [Indexed: 08/26/2023]
Abstract
PURPOSE To explore gender differences of the associations between childhood adversity (CA) subtypes and psychiatric symptoms in the general population. METHODS Data of 791 participants were retrieved from a general population twin cohort. The Symptom Checklist-90 Revised (SCL-90) and the Childhood Trauma Questionnaire were used to assess overall psychopathology with nine symptom domains scores and total CA with exposure to five CA subtypes, respectively. The associations between CA and psychopathology were analyzed in men and women separately and were subsequently compared. RESULTS Total CA was associated with total SCL-90 and all symptom domains without significant gender differences. However, the analyses of CA subtypes showed that the association between emotional abuse and total SCL-90 was stronger in women compared to men [χ2(1) = 4.10, P = 0.043]. Sexual abuse was significantly associated with total SCL-90 in women, but emotional neglect and physical neglect were associated with total SCL-90 in men. Exploratory analyses of CA subtypes and SCL-90 subdomains confirmed the pattern of gender-specific associations. In women, emotional abuse was associated with all symptom domains, and sexual abuse was associated with all except phobic anxiety and interpersonal sensitivity. In men, emotional neglect was associated with depression, and physical neglect was associated with phobic anxiety, anxiety, interpersonal sensitivity, obsessive-compulsive, paranoid ideation, and hostility subdomains. CONCLUSION CA is a trans-syndromal risk factor regardless of gender. However, differential associations between CA subtypes and symptom manifestation might exist. Abuse might be particularly associated with psychopathology in women, whereas neglect might be associated with psychopathology in men.
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Affiliation(s)
- Thanavadee Prachason
- Department of Psychiatry, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Irem Mutlu
- Institute of Graduate Programs, Department of Clinical Psychology, Istanbul Bilgi University, Istanbul, Turkey
| | - Laura Fusar-Poli
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Claudia Menne-Lothmann
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | | | - Ruud van Winkel
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
- Department of Neurosciences, University Psychiatric Centre KU Leuven, KU Leuven, Leuven, Belgium
| | - Dina Collip
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Philippe Delespaul
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Marc De Hert
- University Psychiatric Centre Katholieke Universiteit Leuven, Kortenberg, Belgium
- Department of Neurosciences, Centre for Clinical Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium
- Leuven Brain Institute, Katholieke Universiteit Leuven, Leuven, Belgium
- Antwerp Health Law and Ethics Chair, University of Antwerp, Antwerp, Belgium
| | - Catherine Derom
- Department of Obstetrics and Gynecology, Ghent University Hospitals, Ghent University, Ghent, Belgium
| | - Evert Thiery
- Department of Neurology, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Nele Jacobs
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
- Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands
| | - Marieke Wichers
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jim van Os
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
- Department of Psychiatry, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands
- Department of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College London, London, UK
| | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Lotta-Katrin Pries
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Sinan Guloksuz
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
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Zhao J, Sun R, Shangguan M. Childhood psychological maltreatment and social anxiety in college students: The roles of parasympathetic nervous system activity and parent-child separation experience. CHILD ABUSE & NEGLECT 2024; 151:106723. [PMID: 38461709 DOI: 10.1016/j.chiabu.2024.106723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 02/09/2024] [Accepted: 02/28/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND Childhood psychological maltreatment is a risk factor for social anxiety in adulthood. Parent-child separation, as one of the most serious adversities in early life, may exacerbate the risk of psychological maltreatment and influence the interactions between childhood psychological maltreatment and biological sensitivity to stress in relation to social anxiety. However, there has been a dearth of work on this issue. OBJECTIVE This study investigated the interactive effects between childhood psychological maltreatment and parasympathetic nervous system (PNS) activity on social anxiety in college students by comparing those who experienced parent-child separation versus those who did not. Potential sex differences in the aforementioned associations were tested as an exploratory aim. PARTICIPANTS AND SETTING Data were obtained from 264 college students (Mage = 18.45 years, SD = 0.69), including 156 students who experienced parent-child separation and 108 students without this experience. METHODS Participants completed measures of childhood psychological maltreatment and social anxiety and reported their parent-child separation experience. The data of PNS activity, measured by respiratory sinus arrhythmia (RSA) reactivity, were obtained during the Trier Social Stress Test (TSST) in the lab. RESULTS Childhood psychological maltreatment was positively associated with college students' social anxiety. RSA reactivity moderated the relationship between childhood psychological maltreatment and college students' social anxiety, and the moderating role of RSA reactivity varied with parent-child separation experience and sex. CONCLUSIONS Parent-child separation experience influenced the biosocial interactions between childhood psychological maltreatment and PNS activity in relation to individuals' social anxiety, and this effect persisted in adulthood.
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Affiliation(s)
- Jingxin Zhao
- Department of Psychology, Shandong Normal University, Jinan, China.
| | - Rui Sun
- Department of Psychology, Shandong Normal University, Jinan, China
| | - Mengqi Shangguan
- Department of Psychology, Shandong Normal University, Jinan, China
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Mekonnen BD, Tsega SS. Child sexual abuse and its determinants among children in Addis Ababa Ethiopia: Systematic review and meta-analysis. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0001979. [PMID: 38569122 PMCID: PMC10990560 DOI: 10.1371/journal.pgph.0001979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 02/29/2024] [Indexed: 04/05/2024]
Abstract
Child sexual abuse is a significant public health concern and a breach of basic human rights affecting millions of children each year globally. It is typically not reported by victims, hence it remains usually concealed. Except for single studies with varying reports, there is no national studies conducted on child sexual abuse in Ethiopia. Therefore, this review determined the pooled magnitude and determinants of sexual abuse among children in Ethiopia. Potential articles were searched from PubMed, Science Direct, Scopus, and Web of science using relevant searching key terms. The Joanna Briggs Institute (JBI) critical appraisal checklist was used to evaluate the quality of all selected articles. Data were analyzed using STATA Version 14 software. Publication bias was checked using Egger's test and funnel plot. Cochran's chi-squared test and I2 values were used to assess heterogeneity. A random-effects model was applied during meta-analysis. The pooled prevalence of sexual abuse among 5,979 children in Ethiopia was 41.15% (95% CI: 24.44, 57.86). Sex of children (OR: 2.14, 95%CI: 1.12, 4.06), smoking (OR: 4.48, 95%CI: 1.26, 76.79), khat chewing (OR: 3.68, 95%CI: 1.62, 21.93), and alcohol use (OR: 4.77, 95%CI: 2.22, 10.25) were the determinants of child sexual abuse. The main perpetrators of sexual abuse against children were neighbors, boy/girlfriends, family members, school teachers, and stranger person. Child sexual abuse commonly took place in the victim's or perpetrator's home, school, and neighbor's home. This review revealed that the magnitude of child sexual abuse in Ethiopia was relatively high and multiple factors determined the likelihood of sexual violence against children. Thus, policy-makers and concerned stakeholders should strengthen comprehensive sexual and reproductive health education to reduce the magnitude and consequences of child sexual abuse. Moreover, support with special attention should be given to children with mental illness and physical disabilities.
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Affiliation(s)
| | - Sintayehu Simie Tsega
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Resch F, Parzer P. [Anxiety and depression in adolescents]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:374-382. [PMID: 38456934 PMCID: PMC10995088 DOI: 10.1007/s00103-024-03849-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 02/15/2024] [Indexed: 03/09/2024]
Abstract
Anxiety and depression among young people had already increased in the years before the COVID-19 pandemic and then experienced a significant increase again during the pandemic. In this article the different clinical forms of expression of these emotional syndromes are presented in detail and the developmental paths of a combination of both disorders are also explained. Even subclinical forms of anxiety and depression already have clear clinical implications and impair the developmental tasks of adolescence. The "avolitional depression" (depression with severe drive disorders) is mentioned as a special form. Pathogenetic building blocks-from genetic vulnerability to psychosocial stressors-come up for discussion in light of the fact that anxiety and depression are about twice as common in adolescent females as in males. The embedding of the disorders in current events shows the special importance of the self-reflective emotion of shame in the adolescent development process. The scarcity and dysfunctionality of emotional dialogue between significant caregivers and children must be cautioned against. Its role in adolescents' self-regulation and affect regulation should not be underestimated. Finally, an overview of the most important therapeutic measures for anxiety and depression in adolescence is presented.
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Affiliation(s)
- Franz Resch
- Klinik für Kinder und Jugendpsychiatrie, Universitätsklinikum Heidelberg, Blumenstraße 8, 69115, Heidelberg, Deutschland.
| | - Peter Parzer
- Klinik für Kinder und Jugendpsychiatrie, Universitätsklinikum Heidelberg, Blumenstraße 8, 69115, Heidelberg, Deutschland
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10
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Friedel E, Abels I, Henze GI, Haering S, Buspavanich P, Stadler T. [Depression in the field of tension of gender roles]. DER NERVENARZT 2024; 95:298-307. [PMID: 38361114 DOI: 10.1007/s00115-024-01616-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/15/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND The distribution of depression and suicidal ideation by gender reveals a gender paradox: women are at least twice as likely to be diagnosed with depressive disorders but have a lower suicide rate than men. In contrast, the suicide rate of men is at least three times higher than women, while the prevalence of depressive disorders is only half as high. Although these differences have long been known the reasons for this paradox are still not fully understood. AIM OF THE ARTICLE AND METHOD The aim of this narrative review article is to discuss possible explanatory models regarding gender differences in depressive disorders. Aspects related to stress processing and traumatization are considered as well as sociological and biological factors. This article summarizes information that was considered particularly relevant in the interdisciplinary dialogue regarding possible explanatory factors for gender differences in depressive disorders. RESULTS The summarized studies indicate that women and men differ in certain aspects of stress processing and trauma exposure but men do not have a lower risk of disease as a result. On the contrary, the frequency of depressive disorders in men seems to be underestimated due to an atypical symptom manifestation. DISCUSSION The implementation of knowledge about gender-specific vulnerability in the training of physicians and psychotherapists, the systematic assessment of gender beyond binary classifications as well as further diversity domains in research and healthcare as well as gender-sensitive and diversity-sensitive prevention strategies could contribute to the resolution of the gender paradox.
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Affiliation(s)
- Eva Friedel
- Klinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.
- Forschungsbereich Mind and Brain, Klinik für Psychiatrie und Psychotherapie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland.
| | - Ingar Abels
- Klinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
- Stellvertretende Zentrale Frauen- und Gleichstellungsbeauftragte, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - Gina-Isabelle Henze
- Klinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
- Forschungsbereich Mind and Brain, Klinik für Psychiatrie und Psychotherapie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - Stephanie Haering
- Arbeitsbereich Geschlechterforschung in der Medizin, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - Pichit Buspavanich
- Klinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
- Arbeitsbereich Geschlechterforschung in der Medizin, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
- Institut für Sexualwissenschaft und Sexualmedizin, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Medizinische Hochschule Brandenburg Theodor Fontane, Fakultät Gesundheitswissenschaften Brandenburg, Neuruppin, Deutschland
| | - Turu Stadler
- Arbeitsbereich Geschlechterforschung in der Medizin, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
- Insitute of Applied Health Sciences, University of Aberdeen, Aberdeen, Großbritannien
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11
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Para S, Shahrokhi H, Maserat E, Mohammadzadeh Z. Design and evaluation of child abuse web-based application for parent education & strengthen. BMC Public Health 2024; 24:710. [PMID: 38443811 PMCID: PMC10916122 DOI: 10.1186/s12889-024-18248-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 03/01/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Child abuse is one of the major health and social problems in the world and has severe short-term and long-term consequences on children's psychological, social and physical functioning. One of the effective strategies to control and prevent child abuse is training parent through web-based applications. The aim of this study is to design and evaluation of child abuse web-based application for parent education and strengthen. METHODS This study is an applied-developmental study that performed in Razi Educational and Therapeutic Center in Tabriz. The study consisted of three main phases. The requirements assessment and design phases were completed between November 2022 and February 2023. The research community was parents referring to Razi Center and convenience sampling was used to select the samples. In firststage, a questionnaire was designed by searching in library sources and consulting with specialists for needs assessment and application design. The questionnaire was completed by psychiatric specialists, health information management and health information technology.Finally, the usability of designed application was evaluated with the participation of 30 parents and specialists. RESULTS Based on the identified information elements and capabilities, a child abuse web-based application was designed. Application capabilities were such as concepts of child abuse, prevention and treatment strategies, parenting skills, childrens behavioral disorders, child abuse laws and interaction with clinical specialists. Finally, the result of the web-based application usability evaluation was evaluated at a good level equal to an average of 7.6 out of a total of 9 points. CONCLUSIONS The possibility of expressing experiences, exchanging message, attractiveness, ease of use, and accessibility of parents, they were designed as application features. The usability of the web-based application was satisfactory to users in various of overall functionality, display, terminology, learning ability and overall application capability.
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Affiliation(s)
- Sharif Para
- Department of Health Information Technology, Student Research Committee, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hassan Shahrokhi
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elham Maserat
- Department of Medical Informatics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Zeinab Mohammadzadeh
- Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Daneshgah St, 5165665811, Tabriz, Iran.
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12
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Frewen P, Vincent A, Olff M. Childhood trauma histories in men and women assessed by the childhood attachment and relational trauma screen (CARTS) and the global psychotrauma screen (GPS): Results from the global collaboration on traumatic stress (GC-TS). CHILD ABUSE & NEGLECT 2024; 149:106610. [PMID: 38184904 DOI: 10.1016/j.chiabu.2023.106610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 12/01/2023] [Accepted: 12/17/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Whether there are biological sex differences in rates of childhood trauma exposure perpetrated by female versus male biological parents remains largely unknown. Moreover, the relative risk posed by various vulnerability factors for transdiagnostic mental health outcomes among females vs. males in adulthood has received insufficient attention. OBJECTIVE To compare biological sex differences in the long-term impact of childhood abuse and neglect on transdiagnostic mental health outcomes, especially comparing the outcomes of childhood maltreatment perpetrated by biological mothers vs. fathers. PARTICIPANTS AND SETTING 3129 participants (2784 female [89 %]) were recruited online, the majority (82 %) of whom endorsed having a childhood trauma history and a high number of mental health problems. METHODS Online surveys were administered. Specifically, the Childhood Attachment and Relational Trauma Screen (CARTS) was completed as a relationally-contextualized screening measure of both positive and traumatic-neglectful experiences during childhood, comparing severity of perpetration by male vs. female biological parents. Further, the Global Psychotrauma Screen (GPS) was completed to assess the relative risk of five vulnerability factors, including childhood abuse and neglect, for long-term transdiagnostic mental health outcomes. Statistical analyses elucidate group differences between males and females primarily by way of t-tests and associated effect sizes (Cohen's d). RESULTS Biological sex differences were shown for childhood maltreatment perpetration by male vs. female biological parents, wherein responses to CARTS showed that females reported that their biological mothers exhibited less positivity (d = 0.21), less attachment security (d = 0.22), more negative feelings toward them (d = 0.28), were more emotionally abusive (d = 0.17), and held more negative relational beliefs about them (d = 0.24). Comparably, males reported that their biological fathers were more physically abusive (d = 0.15) and that they held more negative relational beliefs toward their fathers (d = 0.25). Risk factors including having a history of childhood trauma and neglect were associated with transdiagnostic mental health problems among both females (d = 0.57) and males (d = 0.46), with other risk factors evidencing similar results. CONCLUSIONS Childhood trauma and neglect is a risk factor for transdiagnostic mental health outcomes among both females and males, although the two biological sexes may exhibit different levels of risk of being maltreated by female and male biological parents. Specifically, females reported having more emotionally abusive biological mothers, while males reported having more physically abusive biological fathers.
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Affiliation(s)
- Paul Frewen
- Department of Psychiatry, Western University, 1151 Richmond St, London, ON N6A 3K7, Canada; Department of Psychology, Western University, 1151 Richmond St, London, ON N6A 3K7, Canada.
| | - Andrew Vincent
- Department of Psychology, Western University, 1151 Richmond St, London, ON N6A 3K7, Canada
| | - Miranda Olff
- Amsterdam University Medical Centers, University of Amsterdam, ARQ National Psychotrauma Center, The Netherlands, 1012 WX Amsterdam, Netherlands
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13
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Melamed DM, Botting J, Lofthouse K, Pass L, Meiser-Stedman R. The Relationship Between Negative Self-Concept, Trauma, and Maltreatment in Children and Adolescents: A Meta-Analysis. Clin Child Fam Psychol Rev 2024; 27:220-234. [PMID: 38386241 PMCID: PMC10920440 DOI: 10.1007/s10567-024-00472-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2024] [Indexed: 02/23/2024]
Abstract
Experiencing trauma in childhood is a global public health issue linked to worse physical and mental health outcomes, including Post-Traumatic Stress Disorder (PTSD). Self-concept is a transdiagnostic concept linked to various psychopathologies and understanding its unique relationship to trauma is important. This meta-analysis aimed to understand the size of the effect between trauma and maltreatment and self-concept in children and adolescents. The current meta-analysis searched PubMed, PILOTS, PsycINFO, and Web of Science databases. Inclusion criteria involved studies with defined trauma exposure, valid measures of self-concept, and participants' mean age under 18 years old. One-hundred-and-thirty-four studies were included in the meta-analysis (N = 255,334). A random-effects meta-analysis was performed. A small negative relationship was observed between trauma exposure and self-concept (r = - 0.20, 95% CI - 0.22, - 0.18). This relationship was significantly moderated by some variables (type and nature of trauma exposure) but not others (participant gender, type of self-concept measure, quality of studies, country economic status). A small relationship between trauma exposure and negative self-concept in children and adolescents was detected, with repeated trauma exposure and type of trauma exposure moderating this relationship. This provides important directions for clinical practice around providing support for those exposed or most vulnerable to experiencing trauma.
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Affiliation(s)
- Daniela M Melamed
- Department of Clinical Psychology and Psychological Therapies, University of East Anglia, Norwich Research Park, Norwich, Norfolk, NR4 7TJ, UK
| | - Jessica Botting
- Department of Clinical Psychology and Psychological Therapies, University of East Anglia, Norwich Research Park, Norwich, Norfolk, NR4 7TJ, UK
| | - Katie Lofthouse
- Department of Clinical Psychology and Psychological Therapies, University of East Anglia, Norwich Research Park, Norwich, Norfolk, NR4 7TJ, UK
| | - Laura Pass
- Department of Clinical Psychology and Psychological Therapies, University of East Anglia, Norwich Research Park, Norwich, Norfolk, NR4 7TJ, UK
| | - Richard Meiser-Stedman
- Department of Clinical Psychology and Psychological Therapies, University of East Anglia, Norwich Research Park, Norwich, Norfolk, NR4 7TJ, UK.
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14
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Bruffaerts R, Axinn WG. Associations Between Forced Intercourse and Subsequent Depression Among Women in the U.S. General Population. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:471-480. [PMID: 38158510 PMCID: PMC10872405 DOI: 10.1007/s10508-023-02774-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 11/29/2023] [Accepted: 11/29/2023] [Indexed: 01/03/2024]
Abstract
Forced intercourse is a high prevalence experience among US women, with high potential to produce subsequent major depressive episodes (MDE). However, the extent to which prior risk factors are associated with the timing of both sexual assault experiences and subsequent MDE onset is not known. The aim of this study was to document the associations between childhood depression, subsequent forced intercourse, and later MDE. We used retrospective information on childhood depression, forced intercourse, and MDE after forced intercourse from female respondents in the nationally representative 2017 US Panel Study of Income Dynamics-Transition to Adulthood Supplement (PSID-TAS, N = 1298, response rate: 87%). Multivariable logistic regression estimated these associations, controlling for age, race, poverty, religiosity, family history of depression, and adverse childhood experiences (such as parental physical abuse or parental violence). Women who experienced childhood depression (prevalence: 15%) had 2.57 times the odds of experiencing forced intercourse after depression onset, even after adjusting for these other risk factors. However, even though childhood depression is a powerful risk factor for later MDE, independent of that women who experienced forced intercourse had 2.28 times the odds of experiencing MDE after the occurrence of forced intercourse, adjusting for childhood depression and other risk factors. This study provided the first clear evidence for time-ordered associations between forced intercourse and subsequent MDE among women in the general population.
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Affiliation(s)
- Ronny Bruffaerts
- Center for Public Health Psychiatry, Universitair Psychiatrisch Centrum-KU Leuven, Leuven, Belgium
| | - William G Axinn
- Institute for Social Research, University of Michigan, 426 Thompson St., PO Box 1248, Ann Arbor, MI, 48106-1248, USA.
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15
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Wagner B, Böhm M, Grafiadeli R. Efficacy of an internet-based written imagery rescripting intervention for survivors of institutional childhood abuse - A randomized controlled trial. CHILD ABUSE & NEGLECT 2024; 147:106557. [PMID: 38029559 DOI: 10.1016/j.chiabu.2023.106557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 10/15/2023] [Accepted: 11/12/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND Institutional childhood abuse can have a long-term impact on the survivors' mental health, however, treatment for this group is limited and not always accessible. An internet-based intervention was developed, with the aim to reduce psychological sequelae relating to institutional abuse. OBJECTIVE This study aimed to examine the efficacy of an online imagery rescripting intervention for survivors of institutional abuse, through assessing symptoms of depression, anxiety, PTSD, and CPTSD. PARTICIPANTS AND SETTING Seventy-two adult survivors of institutional childhood abuse in the former German Democratic Republic were randomized either to the intervention (n = 38) or to the waitlist condition (n = 34). The intervention consisted of 10 modules, based on written imagery rescripting, and involved asynchronous therapist contact. METHODS Primary outcomes included symptoms of depression (PHQ-9), anxiety (GAD-7), PTSD (ITQ), and CPTSD (ITQ DSO). The intervention condition was assessed at baseline, post-intervention, 3-, and 6-month follow-up. RESULTS Intention-to-treat analyses revealed a significant symptom reduction from baseline to post-assessment with medium to large effects for all main outcomes (d = 0.45 to d = 0.76), in favor of the intervention condition. Significant interactions between condition (intervention vs. wailist) and time (baseline vs. post-assesment) were revealed for all main outcomes (p < .001 to p = .024). The effects were maintained at follow-up. CONCLUSIONS The results suggest online writing-based imagery rescripting as a promising treatment option for adults formerly institutionalized in residential care. Future research is needed to explore its effectiveness for other groups of patients suffering from abuse and neglect.
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Affiliation(s)
| | - Maya Böhm
- Medical School Berlin, Berlin, Germany; Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
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16
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Glaser F, Pruckner GJ. A hard pill to swallow? Parental health shocks and children's mental health. HEALTH ECONOMICS 2023; 32:2768-2800. [PMID: 37670414 DOI: 10.1002/hec.4752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 07/08/2023] [Accepted: 08/12/2023] [Indexed: 09/07/2023]
Abstract
Based on comprehensive administrative health record data from Austria, this study examines how children's mental health responds to a severe parental health shock. To account for the endogeneity of a serious parental illness, our sample is restricted to children who experience the health shock of a parent at some point in time and we exploit the timing of shocks in a dynamic DID setting. We find a positive causal effect of parental health shocks on children's mental health care utilization. Affected children have higher medical attendance for the treatment of mental illnesses, consume more psychotropic drugs, and are more likely to be hospitalized with mental and behavioral disorders. A significant increase in the utilization of antidepressants, anxiolytics, and sedatives can be observed for older children, girls and children with a white-collar family background. Our findings have important policy implications for children's access to psychotherapies and mental health care after experiencing a traumatic household event.
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Affiliation(s)
- Felix Glaser
- Department of Economics, Johannes Kepler University Linz, Linz, Austria
- Christian Doppler Laboratory for Aging, Health, and the Labor Market, Linz, Austria
| | - Gerald J Pruckner
- Department of Economics, Johannes Kepler University Linz, Linz, Austria
- Christian Doppler Laboratory for Aging, Health, and the Labor Market, Linz, Austria
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17
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Bordignon E, Miranda VIA, de Mola Zanatti CL, Menezes AMB, da Silva HDG, Wehrmeister FC, Murray J. Child maltreatment associates with violent victimization in young adulthood: a Brazilian birth cohort study. BMC Public Health 2023; 23:2287. [PMID: 37985981 PMCID: PMC10658884 DOI: 10.1186/s12889-023-17245-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 11/16/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Maltreatment in childhood may leave people vulnerable to further experiences of violence and more severe effects of stress later in life. Longitudinal studies of risk for violent victimisation after maltreatment are lacking in low- and middle-income countries. The objective of this study was to quantify the risk for violent victimization in the family and community in young adulthood following experiences of childhood maltreatment (experiences of physical, emotional and sexual abuse and neglect) up to age 15 years in an urban Brazilian population. METHODS 3246 participants in a prospective, population-based birth cohort study in Pelotas, Rio Grande do Sul, Brazil, were assessed at birth, 15 and 22 years. Sociodemographic factors were reported by mothers at birth and adolescents at age 15 years. Maltreatment and violent victimisation were self-reported in confidential questionnaires at 15 and 22, respectively. Multinomial logistic regression analyses estimated the association between having experienced any maltreatment and later experiences of family and community violence in young adulthood (no adult violence, violence only in the family context, only in the community, or both violence in the family and community), adjusting for sociodemographic factors. RESULTS 39% of females and 27% of males reported any maltreatment up to age 15 years. At 22 years, rates of past year violence in the family or community were 17.6% for females and 20.2% for males. Maltreatment was strongly associated with community violence (Females: OR = 2.96, CI = 1.83-4.80; Males: OR = 2.01, 95%CI = 1.01-4.00) and its co-occurrence with family violence (Females: OR = 2.33, 95%CI = 1.34-4.04; Males: OR = 3.20, 95%CI = 1.82-5.65) in young adulthood, after adjustment for background sociodemographic factors. CONCLUSION Childhood maltreatment is an important risk factor for later violent victimisation in both the family and community context. The effects of repeated trauma through the life-course needs research and clinical attention.
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Affiliation(s)
- Eveline Bordignon
- Postgraduate Program in Epidemiology, Department of Social Medicine, Federal University of Pelotas, Pelotas, RS, Brazil
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil
| | - Vanessa Iribarrem Avena Miranda
- Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil
- Postgraduate Program in Public Health, Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC, Brazil
| | | | - Ana Maria Baptista Menezes
- Postgraduate Program in Epidemiology, Department of Social Medicine, Federal University of Pelotas, Pelotas, RS, Brazil
| | | | - Fernando César Wehrmeister
- Postgraduate Program in Epidemiology, Department of Social Medicine, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Joseph Murray
- Postgraduate Program in Epidemiology, Department of Social Medicine, Federal University of Pelotas, Pelotas, RS, Brazil.
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18
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Telfar S, McLeod GFH, Dhakal B, Henderson J, Tanveer S, Broad HET, Woolhouse W, Macfarlane S, Boden JM. Child abuse and neglect and mental health outcomes in adulthood by ethnicity: Findings from a 40-year longitudinal study in New Zealand/Aotearoa. CHILD ABUSE & NEGLECT 2023; 145:106444. [PMID: 37703676 DOI: 10.1016/j.chiabu.2023.106444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 08/23/2023] [Accepted: 08/30/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND Longitudinal studies consistently report adverse long-term outcomes of childhood maltreatment. Little is known about the impact of childhood maltreatment on mental health among a marginalized population (New Zealand Māori); therefore, we cannot assume the effects of maltreatment are the same across the population. OBJECTIVE Associations were examined between childhood sexual abuse (CSA), childhood physical punishment (CPP) and childhood neglect (CN) (<16 years) and mental health outcomes 18-40 years, by ethnicity (Māori/non-Māori). PARTICIPANTS AND SETTING Data from the Christchurch Health and Development Study, a study of a birth cohort of 1265 children born in Christchurch in 1977. By age 40, 17.8 % (n = 191) reported New Zealand Māori ethnic identity; 82.2 % (n = 883) were non-Māori. METHODS CSA, CPP (<16 years) were measured at 18, 21 years; CN was measured at 40 years. Major depression, anxiety disorder, suicidal ideation, alcohol abuse/dependence and cannabis abuse/dependence were measured at ages 21, 25, 30, 35 and 40 years. Childhood confounding variables controlled. Analyses were extended to include Māori ethnicity. RESULTS After statistical adjustment, experience of severe childhood maltreatment increased odds of mental health problems 1.8-2.6×, compared to no maltreatment; the effects of maltreatment were similar for males and females. For Māori, some higher rates of mental health problems were seen among those maltreated, no statistically significant associations were detected after Bonferroni correction (among severe maltreatment vs. no maltreatment). Limitations should be considered when interpreting results. CONCLUSIONS Exposure to childhood maltreatment has long-term effects into middle-age. Further research employing culturally-sensitive approaches may help clarify Māori childhood maltreatment outcomes.
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Affiliation(s)
- S Telfar
- Department of Psychology, Speech & Hearing, University of Canterbury, Christchurch, New Zealand
| | - G F H McLeod
- Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.
| | - B Dhakal
- Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - J Henderson
- Department of Psychology, Speech & Hearing, University of Canterbury, Christchurch, New Zealand
| | - S Tanveer
- Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - H E T Broad
- Department of Psychology, Speech & Hearing, University of Canterbury, Christchurch, New Zealand
| | - W Woolhouse
- Psychotherapist, ChatRoom Psychotherapy, Christchurch, New Zealand
| | - S Macfarlane
- Te Kura o te Mātauranga - Institute of Education, College of Humanities & Social Sciences, Te Kunenga ki Pūrehuroa - Massey University, New Zealand
| | - J M Boden
- Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
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Fereidooni F, Daniels JK, D Krause-Utz A, Hagenaars MA, Smeets T, Heins J, Dorahy MJ, Emmerik AAPV, de Jong PJ, Hoekstra S, Warrens MJ, Lommen MJJ. Childhood maltreatment and adulthood victimization: An evidence-based model. J Psychiatr Res 2023; 167:46-62. [PMID: 37832203 DOI: 10.1016/j.jpsychires.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 09/12/2023] [Accepted: 10/05/2023] [Indexed: 10/15/2023]
Abstract
There is ample evidence showing that childhood maltreatment increases two to three fold the risk of victimization in adulthood. Various risk factors, including posttraumatic stress disorder (PTSD) symptoms, dissociation, self-blame, and alcohol abuse are related to revictimization. Although previous research examined associations between risk factors for revictimization, the evidence is limited and the proposed models mostly include a handful of risk factors. Therefore, it is critical to investigate a more comprehensive model explaining the link between childhood maltreatment and adulthood (re)victimization. Accordingly, this study tested a data-driven theoretical path model consisting of 33 variables (and their associations) that could potentially enhance understanding of factors explaining revictimization. Cross-sectional data derived from a multi-wave study were used for this investigation. Participants (N = 2156, age mean = 19.94, SD = 2.89) were first-year female psychology students in the Netherlands and New Zealand, who responded to a battery of questionnaires and performed two computer tasks. The path model created by structural equation modelling using modification indices showed that peritraumatic dissociation, PTSD symptoms, trauma load, loneliness, and drug use were important mediators. Attachment styles, maladaptive schemas, meaning in life, and sex motives connected childhood maltreatment to adulthood victimization via other factors (i.e., PTSD symptoms, risky sex behavior, loneliness, emotion dysregulation, and sex motives). The model indicated that childhood maltreatment was associated with cognitive patterns (e.g., anxious attachment style), which in turn were associated with emotional factors (e.g., emotion dysregulation), and then with behavioral factors (e.g., risky sex behavior) resulting in revictimization. The findings of the study should be interpreted in the light of the limitations. In particular, the cross-sectional design of the study hinders us from ascertaining that the mediators preceded the outcome variable.
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Affiliation(s)
- Fatemeh Fereidooni
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, the Netherlands
| | - Judith K Daniels
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, the Netherlands.
| | - Anne D Krause-Utz
- Department of Clinical Psychology, Leiden University, the Netherlands
| | | | - Tom Smeets
- Department of Medical and Clinical Psychology, Tilburg University, the Netherlands
| | - Jenna Heins
- Department of Psychology, University of Canterbury, Christchurch, New Zealand
| | - Martin J Dorahy
- Department of Psychology, University of Canterbury, Christchurch, New Zealand
| | | | - Peter J de Jong
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, the Netherlands
| | - Steven Hoekstra
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, the Netherlands
| | - Matthijs J Warrens
- Department of Educational Sciences, University of Groningen, the Netherlands
| | - Miriam J J Lommen
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, the Netherlands
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20
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Li J, Jin Y, Xu S, Luo X, Wilson A, Li H, Wang X, Sun X, Wang Y. Anxiety and Depression Symptoms among Youth Survivors of Childhood Sexual Abuse: A Network Analysis. BMC Psychol 2023; 11:278. [PMID: 37717011 PMCID: PMC10504753 DOI: 10.1186/s40359-023-01275-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 08/08/2023] [Indexed: 09/18/2023] Open
Abstract
BACKGROUND Previous studies have frequently reported a high prevalence of co-occurring anxiety and depression among people who experienced stressful events in childhood. However, few have noted the symptomatic relationship of this comorbidity among childhood sexual abuse (CSA) survivors. Therefore, this study's objectives were as follows: (1) to examine the relationship across symptoms between anxiety and depression among CSA survivors; (2) to compare differences between male and female network structures among CSA survivors. METHODS A total of 63 Universities and Colleges in Jilin Province, China, covered 96,218 participants in this study, a sub-set data of which met the criteria of CSA was analyzed with the network analysis. The Childhood Trauma Questionnaire-Short Form (CTQ-SF), measured CSA. Anxiety was measured by the seven-item Generalized Anxiety Disorder Scale (GAD-7), and depression was measured by the Patient Health Questionnaire (PHQ-9). The sex difference between anxiety and depression among CSA survivors was compared. RESULTS 3,479 college students reported the experience of CSA (CTQ-SF total scores ≥ 8), with a prevalence of 3.62% (95% CI: 3.50-3.73%). Among CSA survivors, control worry, sad mood, and energy were central and bridge symptoms of the anxiety and depression network. Meanwhile, male CSA survivors appeared to have a stronger correlation between guilt and suicide, but female CSA survivors seemed to have a stronger correlation between control worry and suicide. Moreover, the edge of control worry-relax-afraid was stronger in the male network, while the edge of restless-relax was stronger in the female network. CONCLUSION Control worry, sad mood, and energy are crucial to offer targeted treatment and to relieve anxiety and depression symptoms for CSA survivors. Guilt needs more attention for male CSA survivors, while control worry remains more important for female CSA survivors to reduce suicidal ideation and suicide attempts.
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Affiliation(s)
- Jiaqi Li
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Yu Jin
- College of Education for the Future, Beijing Normal University, Beijing, China
| | - Shicun Xu
- Northeast Asian Research Center, Jilin University, Changchun, China.
- Department of Population, Resources, and Environment, Northeast Asian Studies College, Jilin University, Changchun, China.
- China Center for Aging Studies and Social-Economic Development, Jilin University, Changchun, China.
| | - Xianyu Luo
- College of Education for the Future, Beijing Normal University, Beijing, China
| | - Amanda Wilson
- Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Hui Li
- School of Public Health, Jilin University, Changchun, China
| | - Xiaofeng Wang
- Northeast Asian Research Center, Jilin University, Changchun, China
| | - Xi Sun
- Department of Population, Resources, and Environment, Northeast Asian Studies College, Jilin University, Changchun, China
| | - Yuanyuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.
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21
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Castillo-Navarrete JL, Vicente B, Schmidt K, Moraga-Escobar E, Rojas-Ponce R, Lagos P, Macaya X, Guzman-Castillo A. Interaction of Val66Met BDNF and 5-HTTLPR polymorphisms with prevalence of post-earthquake 27-F PTSD in Chilean population. PeerJ 2023; 11:e15870. [PMID: 37692110 PMCID: PMC10484206 DOI: 10.7717/peerj.15870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 07/18/2023] [Indexed: 09/12/2023] Open
Abstract
Post-traumatic stress (PTSD) disorder is a mental health condition that can occur after experiencing or witnessing a traumatic event. The 27-F earthquake that struck Chile in 2010 was one such event that had a significant impact on the mental health of the population. A study was conducted to investigate the prevalence of PTSD and its associated factors among survivors of this earthquake. The study was a longitudinal design, involving a sample of 913 patients aged 18 to 75 years who attended 10 Primary Care Centers in Concepción, Chile. The Composite International Diagnostic Interview (CIDI) was used to assess both depressive episodes (DE) and PTSD before and after the earthquake. The study also involved genotyping studies using saliva samples from the participants, specifically focusing on the Val66Met and 5-HTTLPR polymorphisms. Statistical analysis was performed to examine the association between different variables and the presence of PTSD. These variables included demographic factors, family history of psychiatric disorders, DE, childhood maltreatment experiences, and critical traumatic events related to the earthquake. The results showed that the incidence of post-earthquake PTSD was 11.06%. No significant differences were found between the groups of participants who developed post-earthquake PTSD regarding the Val66Met or 5-HTTLPR polymorphisms. However, a significant association was found between the concomitant diagnosis of DE and the development of post-earthquake PTSD. The presence of DE doubled the risk of developing post-earthquake PTSD. The number of traumatic events experienced also had a statistically significant association with an increased risk of developing post-earthquake PTSD. The study's limitations include the potential interference of different DE subtypes, the complexity of quantifying the degree of earthquake exposure experienced by each individual, and events entailing social disruption, such as looting, that can profoundly influence distress. In conclusion, the study found that PTSD following the 27-F earthquake in Chile was associated with a concomitant diagnosis of DE and the number of traumatic events experienced. The study did not find a significant association between PTSD and the Val66Met or 5-HTTLPR polymorphisms. The researchers recommend that mental health professionals should prioritize the detection and treatment of concomitant depressive episodes and exposure to critical traumatic events in survivors of disasters. They also suggest that further research is needed to better understand the relationship between genetic factors and post-disaster PTSD.
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Affiliation(s)
- Juan-Luis Castillo-Navarrete
- Programa Neurociencias, Psiquiatría y Salud Mental, NEPSAM, Universidad de Concepción, Concepción, Chile
- Departamento de Tecnología Médica, Facultad de Medicina, Universidad de Concepción, Concepción, Chile
- Programa Doctorado Salud Mental, Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Concepción, Concepción, Chile
| | - Benjamin Vicente
- Programa Neurociencias, Psiquiatría y Salud Mental, NEPSAM, Universidad de Concepción, Concepción, Chile
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Concepción, Concepción, Chile
| | - Kristin Schmidt
- Programa Neurociencias, Psiquiatría y Salud Mental, NEPSAM, Universidad de Concepción, Concepción, Chile
- Programa Doctorado Salud Mental, Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Concepción, Concepción, Chile
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Concepción, Concepción, Chile
| | - Esteban Moraga-Escobar
- Programa Neurociencias, Psiquiatría y Salud Mental, NEPSAM, Universidad de Concepción, Concepción, Chile
| | - Romina Rojas-Ponce
- Programa Neurociencias, Psiquiatría y Salud Mental, NEPSAM, Universidad de Concepción, Concepción, Chile
- Programa Doctorado Salud Mental, Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Concepción, Concepción, Chile
- Departamento de Farmacología, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
| | - Paola Lagos
- Programa Neurociencias, Psiquiatría y Salud Mental, NEPSAM, Universidad de Concepción, Concepción, Chile
- Departamento de Farmacología, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
| | - Ximena Macaya
- Programa Neurociencias, Psiquiatría y Salud Mental, NEPSAM, Universidad de Concepción, Concepción, Chile
- Facultad de Odontología, Universidad de Concepción, Concepción, Chile
| | - Alejandra Guzman-Castillo
- Programa Neurociencias, Psiquiatría y Salud Mental, NEPSAM, Universidad de Concepción, Concepción, Chile
- Programa Doctorado Salud Mental, Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Concepción, Concepción, Chile
- Departamento de Ciencias Básicas y Morfología, Facultad de Medicina, Universidad Católica de la Santísima Concepción, Concepción, Chile
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Zhang ZZ, Moeckel C, Mustafa M, Pham H, Olson AE, Mehta D, Dorn LD, Engeland CG, Shenk CE. The association of epigenetic age acceleration and depressive and anxiety symptom severity among children recently exposed to substantiated maltreatment. J Psychiatr Res 2023; 165:7-13. [PMID: 37441927 PMCID: PMC10529086 DOI: 10.1016/j.jpsychires.2023.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 07/15/2023]
Abstract
Child maltreatment is a major risk factor for both depressive and anxiety disorders. However, many children exposed to maltreatment never meet diagnostic threshold for either disorder while experiencing only transitory symptoms post-exposure. Recent research suggests DNA methylation adds predictive value in explaining variation in the onset and course of multiple psychiatric disorders following exposure to child maltreatment. Epigenetic age acceleration (EAA), the biological aging of cells not attributable to chronological aging, is a stress-sensitive biomarker capturing genome-wide variation in DNA methylation with the potential to identify children who have been maltreated at greatest risk for depressive and anxiety disorders. The current study examined two EAA clocks appropriate for the pediatric population, the Horvath and Pediatric Buccal Epigenetic (PedBE) clocks, and their associations with depressive and anxiety symptom severity following child maltreatment. Children (N = 71) 8-15 years of age, all of whom were exposed to substantiated child maltreatment in the 12 months prior to study entry, were enrolled. Risk modeling adjusting for several confounders revealed that EAA estimated via the Horvath clock was significantly associated with more severe depressive and anxiety symptoms. The PedBE clock was not associated with either depressive or anxiety symptom severity. Sensitivity analyses demonstrated that EAA via the Horvath clock robustly predicted depressive and anxiety symptom severity across multiple modeling scenarios. Our findings advance existing research suggesting EAA, as estimated with the Horvath clock, may be a promising biomarker for identifying children at greatest risk for more severe depressive and anxiety symptoms following maltreatment.
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Affiliation(s)
- Zhenyu Z Zhang
- Department of Psychology, The Pennsylvania State University, University Park, PA, USA.
| | - Camille Moeckel
- The Pennsylvania State University College of Medicine, Hershey, PA, USA.
| | - Manal Mustafa
- The Pennsylvania State University College of Medicine, Hershey, PA, USA.
| | - Hung Pham
- The Child Study Center, Yale University, New Haven, CT, USA.
| | - Anneke E Olson
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA.
| | - Divya Mehta
- Centre for Genomics and Personalised Health, Queensland University of Technology, Brisbane, Queensland, Australia; School of Biomedical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia.
| | - Lorah D Dorn
- Ross and Carol Nese College of Nursing, The Pennsylvania State University, University Park, PA, USA.
| | - Christopher G Engeland
- Ross and Carol Nese College of Nursing, The Pennsylvania State University, University Park, PA, USA; Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA.
| | - Chad E Shenk
- The Pennsylvania State University College of Medicine, Hershey, PA, USA; Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA.
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23
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Torres Soler C, Kanders SH, Rehn M, Olofsdotter S, Åslund C, Nilsson KW. A Three-Way Interaction of Sex, PER2 rs56013859 Polymorphism, and Family Maltreatment in Depressive Symptoms in Adolescents. Genes (Basel) 2023; 14:1723. [PMID: 37761863 PMCID: PMC10531402 DOI: 10.3390/genes14091723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/25/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023] Open
Abstract
The prevalence of depressive symptoms in adolescents is 12-18% and is twice as frequent in females. Sleep problems and thoughts of death are depressive symptoms or co-occurrent phenomena. Family maltreatment is a risk factor for later depressive symptoms and the period circadian regulator (PER) has been studied in relation to neurotransmitters, adaptation to stress, and winter depression. The purpose of this work was to study the relation of the three-way interactions of sex, PER2 rs56013859, and family maltreatment in relation to core depressive symptoms, sleep complaints, and thoughts of death and suicide in self-reports from a cohort of Swedish adolescents in 2012, 2015, and 2018. Cross-sectional and longitudinal analyses with linear and logistic regressions were used to study the relationships to the three outcomes. The three-way interaction was related to core depressive symptoms at both baseline and six years later. In contrast, the model did not show any relation to the other dependent variables. At 13-15 years, a sex-related differential expression was observed: females with the minor allele C:C/C:T exposed to family maltreatment showed higher levels of core depressive symptoms. Six years later, the trend was inverted among carriers of minor alleles.
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Affiliation(s)
- Catalina Torres Soler
- Centre for Clinical Research, Region Västmanland, Uppsala University, 721 89 Västerås, Sweden
| | - Sofia H. Kanders
- Centre for Clinical Research, Region Västmanland, Uppsala University, 721 89 Västerås, Sweden
| | - Mattias Rehn
- Centre for Clinical Research, Region Västmanland, Uppsala University, 721 89 Västerås, Sweden
| | - Susanne Olofsdotter
- Centre for Clinical Research, Region Västmanland, Uppsala University, 721 89 Västerås, Sweden
- Department of Psychology, Uppsala University, 751 05 Uppsala, Sweden
| | - Cecilia Åslund
- Centre for Clinical Research, Region Västmanland, Uppsala University, 721 89 Västerås, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, 751 05 Uppsala, Sweden
| | - Kent W. Nilsson
- Centre for Clinical Research, Region Västmanland, Uppsala University, 721 89 Västerås, Sweden
- Department of Neuroscience, Uppsala University, 751 05 Uppsala, Sweden
- The School of Health, Care and Social Welfare, Mälardalen University, 721 23 Västerås, Sweden
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24
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Stein SF, Rios JM, Gearhardt AN, Nuttall AK, Riley HO, Kaciroti N, Rosenblum KL, Lumeng JC, Miller AL. Food addiction and dietary restraint in postpartum women: The role of childhood trauma exposure and postpartum depression. Appetite 2023; 187:106589. [PMID: 37146651 PMCID: PMC11079996 DOI: 10.1016/j.appet.2023.106589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 04/18/2023] [Accepted: 05/03/2023] [Indexed: 05/07/2023]
Abstract
The early postpartum period is a sensitive time for understanding women's high-risk eating (i.e., eating behavior associated with negative health outcomes) given potential long-term eating behavior implications for infants. Food addiction and dietary restraint are two high-risk eating phenotypes associated with long-term negative health outcomes that have been theoretically linked. Yet, no research has considered how much these constructs overlap during the early postpartum period. The present study sought to characterize these two high-risk eating phenotypes in postpartum women to examine whether these are distinct constructs with specific etiologies and to inform future targets of intervention. Women (N = 277) in the early postpartum period reported on high-risk eating, childhood trauma exposure, depression symptoms, and pre-pregnancy weight. Women's height was measured and pre-pregnancy BMI was calculated. We conducted bivariate correlations and path analysis to characterize the relationship between food addiction and dietary restraint, controlling for pre-pregnancy BMI. Results showed that food addiction and dietary restraint were not significantly associated and that women's childhood trauma exposure and postpartum depression were associated with food addiction but not dietary restraint. Sequential mediation revealed that higher levels of childhood trauma exposure were associated with worse postpartum depression and, in turn, greater food addiction during the early postpartum period. Findings suggest that food addiction and dietary restraint have distinct psychosocial predictors and etiological pathways, which suggests important construct validity differences between the two high-risk eating phenotypes. Interventions seeking to address food addiction in postpartum women and mitigate the impact of this high-risk eating phenotype on the next generation may benefit from treating postpartum depression, especially in women with histories of childhood trauma exposure.
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Affiliation(s)
- Sara F Stein
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA; School of Social Work, University of Michigan, 1080 S. University Ave., Ann Arbor, MI, 48109, USA.
| | - Julia M Rios
- Department of Psychology, University of Michigan College of Literature, Science and the Arts, 530 Church St., Ann Arbor, MI, 48109, USA
| | - Ashley N Gearhardt
- Department of Psychology, University of Michigan College of Literature, Science and the Arts, 530 Church St., Ann Arbor, MI, 48109, USA
| | - Amy K Nuttall
- Department of Human Development and Family Studies, Michigan State University, 552 West Circle Drive, East Lansing, MI, 48824, USA
| | - Hurley O Riley
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Niko Kaciroti
- Department of Biostatistics, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Katherine L Rosenblum
- Department of Psychiatry, Michigan Medicine, 4250 Plymouth Rd., Ann Arbor, MI, 48109, USA
| | - Julie C Lumeng
- Department of Pediatrics, Michigan Medicine, 1522 Simpson Rd. East., Ann Arbor, MI, 48109, USA
| | - Alison L Miller
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
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25
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Kim YM, Oh R, Cho SH, June KJ, Lee JY, Cho HJ, Khang YH. The association of women's experience of abuse in childhood with depression during pregnancy and the role of emotional support as a moderator. PLoS One 2023; 18:e0289044. [PMID: 37494390 PMCID: PMC10370752 DOI: 10.1371/journal.pone.0289044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 07/11/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND This study aimed to examine the prevalence of antenatal depression and experience of abuse during childhood, to analyze the association between having experienced childhood abuse and depression during pregnancy, and to explore the role of emotional support as a moderator of that association. METHODS In total, 44,770 pregnant women were analyzed from the self-administered registry for risk assessment at community public health centers in Seoul, Republic of Korea, for home visiting service provision between 2015 and 2019. The Edinburgh Postnatal Depression Scale (EPDS) was applied for the assessment of depression. The adjusted effects of childhood abuse experience on antepartum depression according to emotional support as an effect moderator were estimated. RESULTS Depression was present in 2,451 pregnant women (5.5%), and 1,506 (3.4%) reported having experienced physical, emotional, or sexual abuse in childhood. After adjustment of covariates, pregnant women who had experienced abuse during childhood had EPDS scores 2.79 points higher than pregnant women without such experiences, and those who lacked emotional support during adulthood had 4.96 points higher than their counterparts. The difference in EPDS scores based on childhood abuse experience among women who reported emotional support (2.86) was larger than the difference in EPDS scores among those with no emotional support (1.91) (P for interaction = 0.0106). CONCLUSIONS The experience of abuse in early life and emotional support in later life are both independently important for understanding antenatal depression in Korean women. More comprehensive emotional support is needed for pregnant women who experienced abuse in childhood.
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Affiliation(s)
- Yu-Mi Kim
- The Support Team for the Seoul Healthy First Step Project, Seoul, Korea
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea
- School of Public Health, Hanyang University College of Medicine, Seoul, Korea
| | - Rora Oh
- School of Public Health, Seoul National University, Seoul, Korea
| | - Sung-Hyun Cho
- The Support Team for the Seoul Healthy First Step Project, Seoul, Korea
- College of Nursing, Research Institute of Nursing Science, Seoul National University, Seoul, Korea
| | - Kyung Ja June
- The Support Team for the Seoul Healthy First Step Project, Seoul, Korea
- Department of Nursing, Soonchunhyang University, Cheonan, Korea
| | - Ji Yun Lee
- The Support Team for the Seoul Healthy First Step Project, Seoul, Korea
- College of Nursing, Kangwon National University, Chuncheon, Korea
| | - Hong-Jun Cho
- The Support Team for the Seoul Healthy First Step Project, Seoul, Korea
- Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young-Ho Khang
- The Support Team for the Seoul Healthy First Step Project, Seoul, Korea
- Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
- Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, Korea
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26
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Wang Y, Chen X, Zhou K, Zhang H. A Meta-Analysis of the Effects of Childhood Maltreatment on Elderly Depression. TRAUMA, VIOLENCE & ABUSE 2023; 24:1593-1607. [PMID: 35232293 DOI: 10.1177/15248380211073838] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Background: The present study aimed to synthesize the effects of five types of child maltreatment (physical abuse, emotional abuse, sexual abuse, physical neglect and emotional neglect) on late-life depression.Method: Four English-language databases (Web of Science, PsycINFO and PsycARTICLES, PubMed, and Cochrane Library) and three Chinese databases (China National Knowledge Infrastructure, Wanfang Database, and Weipu Database) were systematically reviewed, and data related to the association between child maltreatment and late-life depression were extracted. Ten studies involving 30,308 older adults were included, and the effect sizes were pooled using random-effect models.Findings: Except for sexual abuse, four types of child maltreatment were found to be positively associated with late-life depression. Physical abuse, emotional abuse and physical neglect were associated with elderly depression (PA: OR = 1.73, 95% CI = 1.55-1.95, p < .001; EA: OR = 1.92, 95% CI = 1.73-2.12, p < .001; PN: OR = 2.05, 95% CI = 1.15-3.67, p < .01) at a small level, and emotional neglect was associated with elderly depression (OR = 3.25, 95% CI = 1.43-7.39, p < .001) at an approximately moderate level. Gender moderated the relationship between physical neglect, emotional neglect, and late-life depression.Conclusion: Our findings highlight the significance of child maltreatment in the development of late-life depression, and underscore the need for future research and practice to explore potential ways to address late-life depression among older adults who suffered child maltreatment.
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Affiliation(s)
- Yang Wang
- Department of Social Work and Social Policy, Renmin University of China, Beijing, China
| | - Xiaoxuan Chen
- Department of Social Work and Social Policy, Renmin University of China, Beijing, China
| | - Ke Zhou
- Department of Social Work and Social Policy, Renmin University of China, Beijing, China
| | - Huiping Zhang
- Department of Social Work and Social Policy, Renmin University of China, Beijing, China
- Center for Studies of Sociological Theory and Method, Renmin University of China, Beijing, China
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27
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Gauthier-Duchesne A, Hébert M, Blais M, Wekerle C. Differential Profiles of Sexually Abused Adolescent Boys. JOURNAL OF CHILD SEXUAL ABUSE 2023; 32:655-673. [PMID: 37335029 DOI: 10.1080/10538712.2023.2226652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 04/03/2023] [Accepted: 06/07/2023] [Indexed: 06/21/2023]
Abstract
Victims of child sexual abuse (CSA) are a heterogeneous population. Several characteristics may influence the outcomes associated with this adverse childhood experience, including personal (e.g. age) and CSA characteristics (e.g. relationship to the perpetrator). This study relied on a person-centered approach to account for this heterogeneity and focused on adolescent boys, an understudied population. Data were drawn from a representative sample of high school students aged 14 to 18 years old in Quebec, Canada. A total of 3.9% (n = 138) of boys reported CSA. Various CSA characteristics (severity, relationship to the perpetrator, and number of events) were used as indicators to derive classes. A four-class solution emerged from the latent class analysis: CSA in a sports context (6%), intrafamilial CSA (8%), extrafamilial CSA (52%) and multiple CSA (34%). The multiple CSA profile included boys who were sexually abused in multiple situations by different perpetrators and who were victims of acts involving penetration. The exploration of correlates associated with class membership revealed that adolescent boys included in the multiple CSA profile were distinguished by higher rates of delinquent behaviors and alcohol and drug use. They were more likely than members of other latent classes to belong to sexual minorities. This exploratory study sheds light on sexually victimized adolescent boys and the deleterious consequences that may affect them, particularly boys who have experienced multiple CSA events. We conclude that prevention efforts should focus on the demystification of sexual trauma among boys and on using trauma-informed care approaches for adolescent externalizing behaviors.
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Affiliation(s)
| | - Martine Hébert
- Université du Québec à Montréal, Montréal, Québec, Canada
| | - Martin Blais
- Université du Québec à Montréal, Montréal, Québec, Canada
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28
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Zhou J, Feng L, Hu C, Pao C, Zou Z, Wang G. Gender-specific associations between types of childhood maltreatment and major depressive disorder: A matched case-control study. Asia Pac Psychiatry 2023; 15:e12538. [PMID: 37280130 DOI: 10.1111/appy.12538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 05/12/2023] [Accepted: 05/25/2023] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Major depressive disorder (MDD) has been found to be nearly twice as prevalent in females as in males. One hypothesis proposed that abused females were particularly prone to MDD. We aim to examine the sex-specific associations between various types of childhood trauma and MDD. METHODS In this study, 290 outpatients diagnosed with MDD were recruited from Beijing Anding Hospital, and 290 healthy volunteers were recruited from neighborhoods nearby the hospital, with sex, age, and family history matched. Childhood Trauma Questionnaire-Short Form (CTQ-SF) developed by Bernstein et al. was used to assess the severity of five different types of childhood abuse and neglect. McNemar's test and conditional logistic regression models with potential confounders (i.e., marital status, educational level, and body mass index) controlled were used to explore the sex-specific associations between different types of childhood maltreatment and MDD. RESULTS In the full sample, patients with MDD showed a significant higher rate of any childhood maltreatment (i.e., emotional abuse, sexual abuse, physical abuse, emotional neglect, and physical neglect). Among females, all types of childhood abuse were statistically significant. For males, significant differences were only found in emotional abuse and in emotional neglect. CONCLUSION It would appear that MDD in the outpatients is associated with any type of childhood trauma in women and emotional abuse or neglect in men.
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Affiliation(s)
- Jia Zhou
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Lei Feng
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Changqing Hu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Christine Pao
- Mental Health and Behavioral Science Service, Bruce W. Carter VA Medical Center, Miami, Florida, USA
| | - Zhiyong Zou
- Institute of Child and Adolescent Health, Peking University School of Public Health; National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Gang Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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29
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Russotti J, Herd T, Handley ED, Toth SL, Noll JG. Patterns of Mother, Father, and Peer Attachment Quality as Moderators of Child Maltreatment Risk for Depression and PTSD Symptoms in Adolescent Females. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:6888-6914. [PMID: 36695104 PMCID: PMC10050148 DOI: 10.1177/08862605221138654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Child maltreatment (CM) is a robust risk factor for adolescent depressive and post-traumatic stress disorder (PTSD) symptoms. Quality attachment relationships have been posited as a protective factor but findings are equivocal and studies have not adequately considered the complex network of interpersonal relationships that adolescents rely on. The current study applied a person-centered approach to (a) identify subgroups of adolescent females characterized by distinct patterns of attachment quality with peers, fathers, and mothers and (b) determine if the effect of maltreatment on depressive and PTSD symptoms varied as a function of distinct patterns of attachment quality. Data came from a prospective, longitudinal cohort study of 464 racially diverse and adolescent females designed to examine the developmental sequelae of substantiated CM (260 maltreated and 204 demographically matched, nonmaltreated comparisons). Latent profile analysis (LPA) revealed four profiles of attachment characterized by: (a) above-average attachment quality across all three relationships (N = 207, 44.6%); (b) below-average quality with father and friends and above-average quality with mothers (N = 128, 27.6%); (c) below-average quality across all three relationships (N = 106, 22.9%); and (d) very low-(-1 SD) quality with mothers and above-average quality with fathers and friends (N = 23, 5.0%). Moderation models revealed that cumulative maltreatment exposure resulted in greater adolescent depressive symptoms only for those with a profile of attachment consisting of very low-quality maternal attachment and high-quality father and friend attachments. Profiles did not significantly moderate the effect of maltreatment on PTSD symptoms. Results identify subgroups of maltreatment survivors most vulnerable to the development of depression in adolescence. Such groups should be targets for the provision of finite clinical resources with clinical interventions that seek to promote healthy maternal attachment relationships to mitigate the impact of maltreatment on depression.
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Affiliation(s)
| | - Toria Herd
- The Pennsylvania State University, State College, USA
| | | | | | - Jennie G Noll
- The Pennsylvania State University, State College, USA
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30
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Andrews K, Khoury JE, Tiwari A, Kirupaharan S, Gonzalez A. Maternal History of Child Maltreatment and Household Chaos: Examining the Mediating Role of Maternal and Child Psychopathology. CHILD MALTREATMENT 2023; 28:221-231. [PMID: 35266834 DOI: 10.1177/10775595221081795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Caregiver history of childhood maltreatment can have pervasive effects on familial and household dynamics. Maternal history of child maltreatment (MCM) is linked to maternal depressive symptoms and offspring behavioural problems. Further, maternal and child mental health are associated with chaotic home environments. In this study, we examined the potential mediating roles of maternal depressive symptoms and child behavioural problems in the association between MCM and household chaos. A sample of 133 mother-child dyads participated in home visits during which mothers completed questionnaires measuring their history of child maltreatment, depressive symptoms, household chaos and child behaviour problems. Mothers also conducted videotaped home tours related to household chaos. Structural equation modelling results indicated that MCM was indirectly associated with higher household chaos via elevated maternal depressive symptoms and child externalizing, but not internalizing behaviour problems. Interventions aimed at mitigating the effects of MCM on maternal and child psychopathology may positively influence household dynamics.
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Affiliation(s)
- Krysta Andrews
- Department of Psychiatry and Behavioural Neurosciences, 62703McMaster University, Hamilton, ON, Canada
| | - Jennifer E Khoury
- Department of Psychiatry and Behavioural Neurosciences, 62703McMaster University, Hamilton, ON, Canada
- Offord Centre for Child Studies, 62703McMaster University, Hamilton, ON, Canada
| | - Ashwini Tiwari
- Institute of Public and Preventive Health, 1421Augusta University, Augusta, GA, USA
| | | | - Andrea Gonzalez
- Department of Psychiatry and Behavioural Neurosciences, 62703McMaster University, Hamilton, ON, Canada
- Offord Centre for Child Studies, 62703McMaster University, Hamilton, ON, Canada
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Lai CLJ, Fan Y, Man HY, Huang Y. Childhood adversity and depression in Chinese populations: A multilevel meta-analysis of studies using the Childhood Trauma Questionnaire (CTQ). Asian J Psychiatr 2023; 84:103582. [PMID: 37043908 DOI: 10.1016/j.ajp.2023.103582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/11/2023] [Accepted: 04/05/2023] [Indexed: 04/14/2023]
Abstract
To estimate the association between childhood adversity (CA) and depression in Chinese populations in studies using the Childhood Trauma Questionnaire (CTQ), a literature retrieval from established databases between 2005 and 2020 was conducted. A total 40 eligible studies with 145 effect sizes were included in subsequent analyses. Using a multi-level meta-analysis, we found a pooled effect size of r = 0.24, p < 0.001, CI = [0.20, 0.27] for the association between CA and depression. No publication bias was shown by Egger's test, t (160) = -0.27, p = 0.79. The between-study variance was moderate but significant, with 39.75% of the total variance attributable to differences between studies. Results of moderation analysis based on subtypes of CA showed that emotional abuse was associated most strongly with depression. In addition, results of moderation analysis focusing on geographic regions and CTQ subscales showed that the association between SA and depression was stronger in Southern than Central China. Our findings demonstrated clearly the advantages of using a multi-level approach to arrive at a more accurate estimate of pooled effect sizes. The differential associations between CTQ subscales and depression and the moderating effect of geographic regions on the association between sexual abuse and depression point clearly to the need of increased attention to the effects of CA subtypes and socio-cultural factors in future research on CA and mental disorders. These findings provide a preliminary empirical basis for researchers to address specific hypotheses of associations between CA subtypes and specific mental disorders in China.
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Affiliation(s)
- Chuk-Ling Julian Lai
- Psychophysiology Laboratory, Department of Social and Behavioral Sciences, City University of Hong Kong, Hong Kong Special Administrative Region of China.
| | - Yuying Fan
- Psychophysiology Laboratory, Department of Social and Behavioral Sciences, City University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Hoi Yun Man
- Psychophysiology Laboratory, Department of Social and Behavioral Sciences, City University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Yi Huang
- Department of Psychology, Lingnan University, Hong Kong Special Administrative Region of China.
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Langevin R, Kern A, Fernet M, Brassard A. Emerging Adults' Adverse Life Events and Psychological Functioning: A Comparison Based on Intergenerational Trajectories of Child Maltreatment. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:5774-5804. [PMID: 36213948 PMCID: PMC9969488 DOI: 10.1177/08862605221127214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Intergenerational continuity of child maltreatment (CM) is a well-documented phenomenon of concern; however, its effects on the child's level of exposure to CM, as well as subsequent trauma exposure and adult functioning remain undocumented. The present study aimed to further explore the intergenerational effects of CM by comparing emerging adults (EA; ages 18-25) on their exposure to CM, adult victimization, and psychological functioning according to their mother's CM histories. One hundred and eighty-five mothers and their EA completed independently an online survey measuring sociodemographics, material deprivation, CM, adult victimization, and psychological functioning. The participating dyads (primarily White and female-identifying) were recruited online through social media, universities, and advertisements in non-profit organizations throughout Canada. Findings revealed that maternal histories of CM were associated with increased neglectful and physically abusive acts endured in childhood for maltreated EA. Maternal histories of CM, regardless of the EA' victimization status, were associated with a higher EA' number of adulthood interpersonal-but not non-interpersonal-traumas experienced. While a maternal history of CM was a risk factor for intimate partner violence (IPV) in maltreated EA, it was protective for non-maltreated EA. Maltreated EA with maltreated versus non-maltreated mothers presented more psychological difficulties, but only if they also reported material deprivation. Practitioners working with children at-risk or exposed to CM should document parents' histories of CM and take that into account in their assessments and intervention practices. This study also provides further evidence to support social policies targeting the family system as a whole.
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Collins S, Orth T, Brunton R, Dryer R. Child abuse and wellbeing: Examining the roles of self-compassion and fear of self. CHILD ABUSE & NEGLECT 2023; 138:106089. [PMID: 36764171 DOI: 10.1016/j.chiabu.2023.106089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 01/29/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Childhood abuse is linked to poorer well-being, yet some survivors show no prolonged effect, suggesting multifinality. Men and women also differ in the experience and sequelae of abuse supporting gender-specific analyses. To assist in circumventing poor outcomes associated with child abuse, this study examined fear of self (FoS) and self-compassion (SC) as risk and protective factors between child abuse and well-being. METHOD Australian women (N = 1302, Mage = 47.28 [13.63]) completed an online assessment of childhood abuse, psychological distress, perceived quality of life, SC, FoS. Moderated-moderation examined the different abuses as predictors of psychological distress and quality of life (QoL) and FoS and SC as primary and secondary moderators, respectively. RESULTS Physical abuse did not predict psychological distress or QoL. FoS and SC were independent predictors of distress and QoL. Similarly, childhood sexual abuse was not found to predict distress or QoL. FoS and SC were independent predictors of distress and QoL. There was also an interaction between childhood sexual abuse and SC in predicting QoL. A moderated-moderation was found for the relationship between child sexual abuse and distress. Psychological abuse predicted distress and QoL, and FoS and SC both moderated this relationship. Moreover, a moderated-moderation was observed for the relationship between psychological abuse and QoL. CONCLUSIONS Greater FoS is associated with poorer outcomes for child abuse survivors; SC may mitigate this impact. Psychological abuse was the strongest predictor of well-being. Interventions that increase SC and raise awareness of psychological abuse and its impacts are needed.
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Wiss DA, Prelip ML, Upchurch DM, von Ehrenstein OS, Tomiyama AJ, Gorbach PM, Shoptaw SJ. Association between Childhood Maltreatment and Depressive and Anxiety Symptoms among Men Who Have Sex with Men in Los Angeles. J Urban Health 2023; 100:327-340. [PMID: 36826734 PMCID: PMC9951846 DOI: 10.1007/s11524-023-00719-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/13/2023] [Indexed: 02/25/2023]
Abstract
Adverse childhood experiences (ACEs) have been associated with poor mental health outcomes in adulthood. Childhood maltreatment is related to both depressive and anxiety symptoms. Our objective was to investigate these associations among low-income, mostly Black and Latino men who have sex with men (MSM), as these may be a particularly vulnerable population group. Data come from a longitudinal study of MSM with varied substance use behaviors (n = 321) collected between August 2014 and April 2022. Cumulative, childhood maltreatment ACEs, and the single ACE of childhood sexual abuse were investigated as potential predictors of self-reported depressive and anxiety symptoms in mixed-effects logistic and ordinal regression models. There was no evidence of a dose-response relationship between the number of ACEs and the predicted probability of depressive and anxiety symptoms. Compared to MSM reporting fewer than five ACEs, those with five or more ACEs had approximately double the odds ratio of reporting depressive (OR = 1.93; 95% CI: 1.04-3.60) and anxiety symptoms (OR = 2.21; 95% CI: 1.05-4.68). The dimension of childhood maltreatment had a more robust prediction of depressive symptoms than the dimension of household dysfunction across all models. The association between childhood sexual abuse history and depressive symptoms remained after adjustment for the other nine ACEs (OR = 2.27; 95% CI: 1.11-4.68). The ordinal logistic model suggested that cumulative ACEs more than triple the odds of being in a higher anxiety category (OR = 3.12; 95% CI: 1.58-6.14), with associations reported for childhood maltreatment ACEs (OR = 1.31; 95% CI: 1.06-1.66) and childhood sexual abuse (OR = 1.93; 95% CI: 0.89-4.21). Childhood maltreatment ACEs, particularly childhood sexual abuse, are salient predictors of depressive and anxiety symptoms among adult urban MSM. Mitigating the impact of childhood maltreatment requires understanding the additional burden of social distress often faced by MSM throughout the life course.
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Affiliation(s)
- David A Wiss
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, 650 Young Drive South, Los Angeles, CA, 90095, USA.
| | - Michael L Prelip
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, 650 Young Drive South, Los Angeles, CA, 90095, USA
| | - Dawn M Upchurch
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, 650 Young Drive South, Los Angeles, CA, 90095, USA
| | - Ondine S von Ehrenstein
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, 650 Young Drive South, Los Angeles, CA, 90095, USA
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, 650 Young Drive South, Los Angeles, CA, 90095, USA
| | - A Janet Tomiyama
- Department of Psychology, University of California Los Angeles, 502 Portola Plaza, Los Angeles, CA, 90095, USA
| | - Pamina M Gorbach
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, 650 Young Drive South, Los Angeles, CA, 90095, USA
| | - Steven J Shoptaw
- Department of Family Medicine, David Geffen School of Medicine, University of California Los Angeles, 10880 Wilshire Blvd, Los Angeles, CA, 90024, USA
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Lotto CR, Altafim ERP, Linhares MBM. Maternal History of Childhood Adversities and Later Negative Parenting: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2023; 24:662-683. [PMID: 34342253 DOI: 10.1177/15248380211036076] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Adverse childhood experiences negatively impact future violence, victimization, perpetration, health, and lifelong development. The aim of the present study was to systematically review the scientific evidence of empirical studies on the association between maternal childhood adversity in a familial context, including maltreatment, household challenges, and later maternal negative parenting. A search was performed in the PubMed, PsycINFO, Web of Science, SciELO, and LILACS databases, using the combination of the following keywords: (neglect OR abuse OR maltreatment OR harsh parenting OR punishment OR discipline OR negative parenting practices) AND (adverse childhood experiences OR early adversity OR cycle of violence OR cycle of maltreatment OR history of maltreatment) AND (mother OR maternal). The results of 29 studies showed predominantly significant direct associations between maternal childhood adversities and negative parenting with their children (83%). Parental stress was also significantly associated with a maternal history of childhood adversities. Focusing on the type of maltreatment practices, there were similar intergenerational transmission types: homotypic and heterotypic. Few studies have examined the protective factors that could buffer the negative impact of a maternal childhood history of adversities on later negative parenting.
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Affiliation(s)
- Camila Regina Lotto
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, State of São Paulo, Brazil
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Manrique-Millones D, Gómez-Baya D, Wiium N. The Importance of the 5Cs of Positive Youth Development to Depressive Symptoms: A Cross-Sectional Study with University Students from Peru and Spain. Behav Sci (Basel) 2023; 13:bs13030280. [PMID: 36975305 PMCID: PMC10045354 DOI: 10.3390/bs13030280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/09/2023] [Accepted: 03/18/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Prior research has documented the protective role of the 5Cs of Positive Youth Development (PYD) on adjustment problems, such as depressive symptoms. Nonetheless, more research is needed, especially in non-US contexts. The main objective of the present study was to assess associations between the 5Cs and depressive symptoms in Peru and Spain, considering gender differences across contexts. METHODS Cross-sectional data was collected from undergraduate students from Peru [n = 250] and Spain [n = 1044]. RESULTS The results revealed significant negative associations of Competence, Confidence, Character and Connection with depressive symptoms, while Caring was positively and significantly related to depressive symptoms in both samples. Regarding gender differences, female undergraduates in both samples reported high levels of Caring, while Competence was predominant among males compared to females in both countries. Likewise, higher scores in Competence and Confidence were registered among Peruvian male undergraduates compared to Spanish students, while Caring and Character were more prevalent in Spanish female undergraduates compared to Peruvian students. CONCLUSIONS These findings confirm the importance of targeting the 5Cs of PYD alongside the role of gender and country context in intervention programs, put together to address the mental health of students in Peru and Spain.
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Affiliation(s)
- Denisse Manrique-Millones
- Facultad de Ciencias de la Salud, Carrera de Psicología, Universidad Científica del Sur, Lima 15067, Peru
| | - Diego Gómez-Baya
- Department of Social, Developmental and Educational Psychology, Universidad de Huelva, 21007 Huelva, Spain
| | - Nora Wiium
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, 5020 Bergen, Norway
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Souama C, Lamers F, Milaneschi Y, Vinkers CH, Defina S, Garvert L, Stein F, Woofenden T, Brosch K, Dannlowski U, Galenkamp H, de Graaf R, Jaddoe VWV, Lok A, van Rijn BB, Völzke H, Cecil CAM, Felix JF, Grabe HJ, Kircher T, Lekadir K, Have MT, Walton E, Penninx BWJH. Depression, cardiometabolic disease, and their co-occurrence after childhood maltreatment: an individual participant data meta-analysis including over 200,000 participants. BMC Med 2023; 21:93. [PMID: 36907864 PMCID: PMC10010035 DOI: 10.1186/s12916-023-02769-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 02/03/2023] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Childhood maltreatment is associated with depression and cardiometabolic disease in adulthood. However, the relationships with these two diseases have so far only been evaluated in different samples and with different methodology. Thus, it remains unknown how the effect sizes magnitudes for depression and cardiometabolic disease compare with each other and whether childhood maltreatment is especially associated with the co-occurrence ("comorbidity") of depression and cardiometabolic disease. This pooled analysis examined the association of childhood maltreatment with depression, cardiometabolic disease, and their comorbidity in adulthood. METHODS We carried out an individual participant data meta-analysis on 13 international observational studies (N = 217,929). Childhood maltreatment comprised self-reports of physical, emotional, and/or sexual abuse before 18 years. Presence of depression was established with clinical interviews or validated symptom scales and presence of cardiometabolic disease with self-reported diagnoses. In included studies, binomial and multinomial logistic regressions estimated sociodemographic-adjusted associations of childhood maltreatment with depression, cardiometabolic disease, and their comorbidity. We then additionally adjusted these associations for lifestyle factors (smoking status, alcohol consumption, and physical activity). Finally, random-effects models were used to pool these estimates across studies and examined differences in associations across sex and maltreatment types. RESULTS Childhood maltreatment was associated with progressively higher odds of cardiometabolic disease without depression (OR [95% CI] = 1.27 [1.18; 1.37]), depression without cardiometabolic disease (OR [95% CI] = 2.68 [2.39; 3.00]), and comorbidity between both conditions (OR [95% CI] = 3.04 [2.51; 3.68]) in adulthood. Post hoc analyses showed that the association with comorbidity was stronger than with either disease alone, and the association with depression was stronger than with cardiometabolic disease. Associations remained significant after additionally adjusting for lifestyle factors, and were present in both males and females, and for all maltreatment types. CONCLUSIONS This meta-analysis revealed that adults with a history of childhood maltreatment suffer more often from depression and cardiometabolic disease than their non-exposed peers. These adults are also three times more likely to have comorbid depression and cardiometabolic disease. Childhood maltreatment may therefore be a clinically relevant indicator connecting poor mental and somatic health. Future research should investigate the potential benefits of early intervention in individuals with a history of maltreatment on their distal mental and somatic health (PROSPERO CRD42021239288).
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Affiliation(s)
- Camille Souama
- Department of Psychiatry, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands.
- Amsterdam Public Health, Mental Health Program, Amsterdam, The Netherlands.
| | - Femke Lamers
- Department of Psychiatry, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, The Netherlands
| | - Yuri Milaneschi
- Department of Psychiatry, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Stress, and Sleep Program, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Complex Trait Genetics, Amsterdam, The Netherlands
| | - Christiaan H Vinkers
- Department of Psychiatry, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Stress, and Sleep Program, Amsterdam, The Netherlands
- Department Anatomy & Neurosciences, Amsterdam University Medical Center Location Vrije Universiteit Amsterdam, 1081 HV, Amsterdam, The Netherlands
- GGZ inGeest Mental Health Care, 1081 HJ, Amsterdam, The Netherlands
| | - Serena Defina
- Erasmus University Medical Center Rotterdam, Department of Child and Adolescent Psychiatry/Psychology, Rotterdam, The Netherlands
- Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Linda Garvert
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, 17475, Greifswald, Germany
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Tom Woofenden
- Department of Psychology, University of Bath, Bath, UK
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Henrike Galenkamp
- Department of Public and Occupational Health, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Ron de Graaf
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Vincent W V Jaddoe
- Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Paediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Anja Lok
- Department of Psychiatry, Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Bas B van Rijn
- Department of Obstetrics and Fetal Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Henry Völzke
- Institute for Community Medicine, SHIP/KEF, University Medicine Greifswald, Greifswald, Germany
| | - Charlotte A M Cecil
- Erasmus University Medical Center Rotterdam, Department of Child and Adolescent Psychiatry/Psychology, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Molecular Epidemiology, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - Janine F Felix
- Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Paediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, 17475, Greifswald, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Karim Lekadir
- Faculty of Mathematics and Computer Science, Artificial Intelligence in Medicine Lab, University of Barcelona, Barcelona, Spain
| | - Margreet Ten Have
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Esther Walton
- Department of Psychology, University of Bath, Bath, UK
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Stress, and Sleep Program, Amsterdam, The Netherlands
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Storrie CL, Kitissou K, Messina A. The Effects of Severe Childhood Physical and Sexual Abuse on Adult Socioeconomic Prosperity. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:55-68. [PMID: 36776634 PMCID: PMC9908797 DOI: 10.1007/s40653-022-00499-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/03/2022] [Indexed: 06/18/2023]
Abstract
Our study utilizes Adverse Childhood Experience (ACE) scores to estimate the relationship between forced sexual intercourse and physical abuse on socioeconomic outcomes in adulthood. ACEs have been shown to have long-term negative impacts on health, mental health, and cognition. We expand upon the literature that analyzes the effects of ACEs on human capital investment and adult socioeconomic outcomes by focusing on the ACE scores pertaining to repeated physical and forced sexual abuse in childhood. Specifically, we estimate probit models using data from the Behavioral Risk Factor Surveillance System to measure the marginal effects of childhood sexual abuse (CSA) and physical abuse on the probability of high school completion, unemployment, and the likelihood of living in poverty in adulthood. We find adults who suffered physical abuse in childhood are more likely to live in poverty. Adult survivors of CSA are less likely to finish high school and more likely to live in poverty. The likelihood of high school noncompletion increases when the individual suffered both forms of abuse. We also find that only those who suffered both forms of abuse in childhood had a greater likelihood of being unemployed and high school noncompletion. We find the negative socioeconomic impact in adulthood is larger for women than for men, implying gender heterogeneity in outcomes of CSA and physical abuse. Researchers should control for the correlation between sexual abuse and physical abuse in childhood, particularly in women, when estimating their effects on socioeconomic outcomes.
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Affiliation(s)
- Christine L. Storrie
- Department of Economics, 324B Netzer Administration Building, SUNY Oneonta (607) 436-3602, Oneonta, NY 13820 USA
| | - Kpoti Kitissou
- Department of Economics, 324B Netzer Administration Building, SUNY Oneonta (607) 436-3602, Oneonta, NY 13820 USA
| | - Anthony Messina
- Department of Economics, 324B Netzer Administration Building, SUNY Oneonta (607) 436-3602, Oneonta, NY 13820 USA
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Evli M, Şimşek N, Işıkgöz M, Öztürk Hİ. Internet addiction, insomnia, and violence tendency in adolescents. Int J Soc Psychiatry 2023; 69:351-361. [PMID: 35470724 DOI: 10.1177/00207640221090964] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION There is limited information on how the tendency to violence in adolescents is affected by internet addiction and insomnia. This study will contribute to the literature in revealing the effect of internet addiction on insomnia and violence tendency in adolescents. METHODS The data were collected between 26/May/2021 and 06/July/2021. A total of 2,502 adolescents studying in 9th and 12th grades were included in the study. Data were collected with the adolescent information form, Internet Addiction Scale-Short Form, Bergen Insomnia Scale, and Violence Tendency Scale. Descriptive statistics, independent samples t-test, one-way analysis of variance, correlation, and simple linear regression analyzes were used in the analysis of data. RESULTS Participants were 15.92 ± 1.19 years old and 70.80% were women. While internet addiction do not change according to gender, and violence tendency mean scores do not change according to having a device to use the internet, the study variable mean score changes according to all the other socio-demographic variables included in our study. There is a positive relationship between internet addiction, violence tendency, and insomnia. Furthermore, while internet addiction explained 22.1% of insomnia scores, 18.8% of the variance changes in the violence tendency scores, insomnia explained 11.8% of violence tendency scores. CONCLUSION Although the scale scores of the adolescents in our study were below the average, internet addiction is common problem necessitates working on the subject. In our study, there is a significant relationship between internet addiction, insomnia and tendency to violence, and internet addiction predicts other variables.
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Affiliation(s)
- Mahmut Evli
- Department of Psychiatric and Mental Health Nursing, Faculty of Health Sciences, Erciyes University, Kayseri, Turkey
| | - Nuray Şimşek
- Department of Psychiatric and Mental Health Nursing, Faculty of Health Sciences, Erciyes University, Kayseri, Turkey
| | - Mahmut Işıkgöz
- Department of Guidance and Psychological Counseling Services, Expert Psychological Counselor, Kocasinan Guidance and Research Center, Kayseri, Turkey
| | - Halil İbrahim Öztürk
- Department of Guidance and Psychological Counseling Services, Expert Psychological Counselor, Kocasinan Guidance and Research Center, Kayseri, Turkey
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Rimular K, Berzenski SR. Elements of Control Differentiate Associations Between Childhood Emotional Abuse and Anxiety Symptoms. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:135-143. [PMID: 36776632 PMCID: PMC9908806 DOI: 10.1007/s40653-022-00485-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/19/2022] [Indexed: 06/18/2023]
Abstract
Among adolescents experiencing childhood maltreatment, there exists wide variability regarding the development and maintenance of anxious symptoms. Existing research has identified the protective role of effortful control against childhood anxiety (Raines et al. in Child Psychiatry and Human Development, 2021). The current study aimed to uncover how distinct elements of effortful control differentially diminish or intensify anxiety symptoms arising from a perceived lack of control following childhood emotional abuse (CEA). 467 college student participants provided reports of their experience with childhood emotional abuse, locus of control, anxiety symptoms, and effortful control via in-person surveys. We explored three categories of effortful control: inhibitory control (the capacity to suppress inappropriate behavior), attentional control (the capacity to focus or shift attention), and activational control (the capacity to perform an action despite a strong tendency to avoid). Consistent with our hypotheses, results revealed that CEA predicted increased anxiety symptoms. External LOC significantly mediated the relationship between CEA and anxiety. When effortful control was broken down into its component elements, higher inhibitory control acted as a protective factor for locus of control driven anxiety, whereas higher levels of activational control acted as a risk factor. Attentional control was not a significant moderator. These findings stress the importance of identifying risk and protective factors that contribute to resilience, and may aid in the development of interventions targeted to specific aspects of effortful control.
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Affiliation(s)
- Kristen Rimular
- Department of Psychology, California State University, Northridge, 18111 Nordhoff St., Northridge, CA 91330 USA
| | - Sara R. Berzenski
- Department of Psychology, California State University, Northridge, 18111 Nordhoff St., Northridge, CA 91330 USA
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Zühlsdorff K, López-Cruz L, Dutcher EG, Jones JA, Pama C, Sawiak S, Khan S, Milton AL, Robbins TW, Bullmore ET, Dalley JW. Sex-dependent effects of early life stress on reinforcement learning and limbic cortico-striatal functional connectivity. Neurobiol Stress 2023; 22:100507. [PMID: 36505960 PMCID: PMC9731893 DOI: 10.1016/j.ynstr.2022.100507] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 12/13/2022] Open
Abstract
Major depressive disorder (MDD) is a stress-related condition hypothesized to involve aberrant reinforcement learning (RL) with positive and negative stimuli. The present study investigated whether repeated early maternal separation (REMS) stress, a procedure widely recognized to cause depression-like behaviour, affects how subjects learn from positive and negative feedback. The REMS procedure was implemented by separating male and female rats from their dam for 6 h each day from post-natal day 5-19. Control rat offspring were left undisturbed during this period. Rats were tested as adults for behavioral flexibility and feedback sensitivity on a probabilistic reversal learning task. A computational approach based on RL theory was used to derive latent behavioral variables related to reward learning and flexibility. To assess underlying brain substrates, a seed-based functional MRI connectivity analysis was applied both before and after an additional adulthood stressor in control and REMS rats. Female but not male rats exposed to REMS stress showed increased response 'stickiness' (repeated responses regardless of reward outcome). Following repeated adulthood stress, reduced functional connectivity from the basolateral amygdala (BLA) to the dorsolateral striatum (DLS), cingulate cortex (Cg), and anterior insula (AI) cortex was observed in females. By contrast, control male rats exposed to the second stressor showed impaired learning from negative feedback (i.e., non-reward) and reduced functional connectivity from the BLA to the DLS and AI compared to maternally separated males. RL in male rats exposed to REMS was unaffected. The fMRI data further revealed that connectivity between the mOFC and other prefrontal cortical and subcortical structures was positively correlated with response 'stickiness'. These findings reveal differences in how females and males respond to early life adversity and subsequent stress. These effects may be mediated by functional divergence in resting-state connectivity between the basolateral amygdala and fronto-striatal brain regions.
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Affiliation(s)
- Katharina Zühlsdorff
- Department of Psychology, University of Cambridge, Downing Site, Cambridge, CB2 3EB, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, CB2 3EB, UK
| | - Laura López-Cruz
- Faculty of Science, Technology, Engineering & Mathematics, The Open University, Walton Hall, Kents Hill, Milton Keynes, MK7 6AA, UK
| | - Ethan G. Dutcher
- Department of Psychology, University of Cambridge, Downing Site, Cambridge, CB2 3EB, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, CB2 3EB, UK
| | - Jolyon A. Jones
- Department of Psychology, University of Cambridge, Downing Site, Cambridge, CB2 3EB, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, CB2 3EB, UK
| | - Claudia Pama
- Department of Psychology, University of Cambridge, Downing Site, Cambridge, CB2 3EB, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, CB2 3EB, UK
| | - Stephen Sawiak
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, CB2 3EB, UK
- Department of Physiology, Development and Neuroscience, University of Cambridge, Downing Site, Cambridge, CB2 3EB, UK
- Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Box 65, Cambridge, CB2 0QQ, UK
| | - Shahid Khan
- GlaxoSmithKline Research & Development, Stevenage, UK
| | - Amy L. Milton
- Department of Psychology, University of Cambridge, Downing Site, Cambridge, CB2 3EB, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, CB2 3EB, UK
| | - Trevor W. Robbins
- Department of Psychology, University of Cambridge, Downing Site, Cambridge, CB2 3EB, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, CB2 3EB, UK
| | - Edward T. Bullmore
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, CB2 3EB, UK
- Department of Psychiatry, Herchel Smith Building for Brain and Mind Sciences, Forvie Site, Cambridge, CB2 0SZ, UK
| | - Jeffrey W. Dalley
- Department of Psychology, University of Cambridge, Downing Site, Cambridge, CB2 3EB, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, CB2 3EB, UK
- Department of Psychiatry, Herchel Smith Building for Brain and Mind Sciences, Forvie Site, Cambridge, CB2 0SZ, UK
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Neilson EC, Schraufnagel TJ, George WH, Davis KC. The Effects of Childhood Sexual Abuse, Mental Health, and Motives for Sex on Sexual Risk-Taking Among United States Men Who Have Sex with Women. JOURNAL OF CHILD SEXUAL ABUSE 2023; 32:3-21. [PMID: 36515168 PMCID: PMC9911360 DOI: 10.1080/10538712.2022.2155284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 11/10/2022] [Accepted: 11/21/2022] [Indexed: 06/17/2023]
Abstract
This study assessed the role of mental health symptoms and motives for sex in the association between childhood sexual abuse (CSA) and sexual risk-taking among men who have sex with women (MSW). The sample consisted of young adult (ages 21 to 30), non-monogamous MSW (N = 532) who reported having condomless sex at least once in the past year. Due to alcohol-related aims from two larger studies from which the data were analyzed, participation was excluded to men who regularly consumed alcohol (3 to 35 weekly drinks) and reported no symptoms of alcohol use disorder. Participants answered background questionnaires in lab and then completed a six-week, follow-up survey assessing the number of sex partners and condom use during the prior six weeks. CSA survivors reported greater mental health symptoms and sex motives related to coping, self-affirmation, and partner approval relative to non-survivors. CSA, sex for partner approval, and sex to enhance motives were positively associated with the number of sex partners. Participants endorsing self-affirmation sex motives reported higher condom use than those who did not. CSA contributes to long-term mental and sexual health outcomes among MSW. Identifying and treating depressive and anxiety symptoms and motives for sex may improve sexual health among CSA survivors.
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Affiliation(s)
- Elizabeth C Neilson
- Department of Psychology, Eastern Michigan University, Ypsilanti, MI, United States
| | | | - William H George
- Department of Psychology, University of Washington, Seattle, WA, United States
| | - Kelly Cue Davis
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States
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Bounoua N, Sadeh N. Dimensions of childhood maltreatment and adult risky behaviors: Differential affective and inhibitory control mechanisms. CHILD ABUSE & NEGLECT 2022; 134:105877. [PMID: 36152530 DOI: 10.1016/j.chiabu.2022.105877] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/30/2022] [Accepted: 09/07/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND While childhood maltreatment has been identified as a robust risk factor for a myriad of poor outcomes, significant gaps in our understanding still remain regarding mechanisms of this risk transmission across the lifespan. OBJECTIVE Informed by recent dimensional models, the objective of this study was to examine how unique dimensions of childhood maltreatment relate to adult risky behaviors via interactions between cognitive control and affective processes across Positive and Negative Valence Systems. PARTICIPANTS AND SETTING Our sample consisted of 110 community adults (M/SDage = 31.92/10.58 years old, 52.7 % male). METHODS Participants completed a neuropsychological test of inhibitory control and self-report measures of childhood maltreatment, recent adult risky behaviors, and indices of affective processing. RESULTS Moderated-mediation analyses revealed that childhood experiences of neglect and abuse exhibited distinct mechanisms of risk transmission related to adult risky behaviors. Specifically, disruptions in inhibitory control and reward-related processes were linked to adult risky behavior in the context of Childhood Deprivation (95%CI = -0.166/-0.002), whereas negative affective processes were associated with adult risky behavior in the context of Childhood Threat (95 % CI = 0.015/0.157). CONCLUSIONS Findings provide empirical support for novel dimensional theories of childhood maltreatment and suggest that distinct regulatory processes are impacted by these early life experiences, which may confer risk into adulthood.
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Affiliation(s)
- Nadia Bounoua
- University of Delaware, Department of Psychological and Brain Sciences, United States of America.
| | - Naomi Sadeh
- University of Delaware, Department of Psychological and Brain Sciences, United States of America
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Fung HW, Lam SKK, Chien WT, Hung SL, Ling HWH, Lee VWP, Wang EK. Interpersonal stress mediates the relationship between childhood trauma and depressive symptoms: Findings from two culturally different samples. Aust N Z J Psychiatry 2022:48674221138501. [PMID: 36440622 DOI: 10.1177/00048674221138501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Childhood trauma is associated with adulthood depressive symptoms, but very few studies explored potential social and interpersonal mediators behind this association. This study made the first attempt to test the potential mediating effects of interpersonal stress in the associations between childhood betrayal and non-betrayal trauma and depressive symptoms. METHOD We analyzed data in a sample of English-speaking adults from diverse backgrounds (from 19 different countries, mainly from Western countries) (N = 468). We then replicated and compared the results with those in another convenience sample of Chinese-speaking younger adults with different cultural backgrounds and mental health status (N = 205). RESULTS The results in both samples indicated that (1) childhood betrayal trauma had a stronger relationship with depressive symptoms than childhood non-betrayal trauma and that (2) interpersonal stress was a significant mediator in the relationship between childhood betrayal trauma and depressive symptoms, even when childhood non-betrayal trauma was included as a covariate. The indirect effect of childhood non-betrayal trauma on depressive symptoms through interpersonal stress was not consistent in two samples. CONCLUSIONS Our findings point to the importance of taking social and interpersonal contexts into account when investigating, preventing and managing depression in trauma-exposed populations. Early social interventions such as family interventions, interpersonal skills training and building social resources may have the potential to change the trajectory of the development of mental health problems in trauma survivors.
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Affiliation(s)
- Hong Wang Fung
- Department of Social Work, Hong Kong Baptist University, Kowloon, Hong Kong
| | - Stanley Kam Ki Lam
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Suet Lin Hung
- Department of Social Work, Hong Kong Baptist University, Kowloon, Hong Kong
| | - Henry Wai-Hang Ling
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong
| | | | - Edward Ks Wang
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Ramírez Labbé S, Santelices MP, Hamilton J, Velasco C. Adverse Childhood Experiences: Mental Health Consequences and Risk Behaviors in Women and Men in Chile. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121841. [PMID: 36553287 PMCID: PMC9776590 DOI: 10.3390/children9121841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/09/2022] [Accepted: 11/14/2022] [Indexed: 11/29/2022]
Abstract
Studies conducted worldwide indicate that adverse childhood experiences (ACEs) are among the most intense and frequent sources of stress, considerably influencing mental and physical health while also resulting in risk behaviors in adulthood. METHODOLOGY We used data from the Pilot National Survey of Adversity and Sexual Abuse in Childhood (2020), conducted by CUIDA UC, which comprises the Adverse Childhood Experiences International Questionnaire [ACE-IQ] (Adapted). The cross-sectional methodology used made it possible to directly calculate the prevalence of adverse childhood experiences in the population sampled, at a single point in time. We performed a bivariate and univariate descriptive analysis, a correlation analysis, and a multivariate analysis, all of which will be detailed in the section entitled "General Data Analysis Procedure". RESULTS We found equally high rates of adverse childhood experiences in men and women, with community violence exhibiting the highest prevalence. We found significant low- to moderate-sized associations between the multiple types of ACEs considered and mental health problems, substance use problems, criminal behaviors, and intrafamily violence (IFV), which differed between men and women. Significant correlations were detected between the ACE score and mental health, substance use, criminal behaviors, and IFV in both men and women. Importantly, ACEs were found to be predictors of all of these variables, with differences observed between men and women. CONCLUSIONS Nearly all participants reported having had at least one ACE and more than half reported had four or more ACEs. Those who had had four or more ACEs were more likely to report problems throughout their life. Having an ACE of any type was found to be a better predictor of mental health problems and IFV in men than in women and might be a stronger risk factor for substance use and criminal behaviors in women than in men.
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Affiliation(s)
- Sofía Ramírez Labbé
- Escuela de Psicología, Pontificia Universidad Católica de Chile, Vicuña Mackenna 4860, Macul, Santiago, 7810000, Chile
| | - María Pía Santelices
- Escuela de Psicología, Pontificia Universidad Católica de Chile, Vicuña Mackenna 4860, Macul, Santiago, 7810000, Chile
- Centro de Investigación del Abuso y la Adversidad Temprana, CUIDA, Santiago 7810000, Chile
- Correspondence:
| | - James Hamilton
- Centro de Investigación del Abuso y la Adversidad Temprana, CUIDA, Santiago 7810000, Chile
- Departamento de Salud Pública, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago 7810000, Chile
| | - Carolina Velasco
- Escuela de Trabajo Social, Pontificia Universidad Católica de Chile, Santiago 7810000, Chile
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Sorkhou M, Rashid T, Dere J, Uliaszek A. Psychological Distress in Treatment-Seeking University Students: An Intersectional Examination of Asian Identity and Gender Identity. JOURNAL OF COLLEGE STUDENT PSYCHOTHERAPY 2022. [DOI: 10.1080/87568225.2022.2145252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Maryam Sorkhou
- Addictions Division, Center for Addictions and Mental Health, Toronto, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Canada
| | - Tayyab Rashid
- Department of Psychology, University of Toronto Scarborough, Toronto, Ontario, Canada
| | - Jessica Dere
- Department of Psychology, University of Toronto Scarborough, Toronto, Ontario, Canada
| | - Amanda Uliaszek
- Addictions Division, Center for Addictions and Mental Health, Toronto, Canada
- Department of Psychology, University of Toronto Scarborough, Toronto, Ontario, Canada
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Zhan X, Li K, Zheng Y, Yang G, Luo X. A chain multiple mediation model reveals the association between abuse and depression in Chinese adolescents. Front Public Health 2022; 10:1023749. [PMID: 36466489 PMCID: PMC9714438 DOI: 10.3389/fpubh.2022.1023749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 10/31/2022] [Indexed: 11/18/2022] Open
Abstract
Background Depression is a common mental disorder in Chinese adolescents. Identifying its risk factors will facilitate early prevention. As abuse is reported to be a great risk factor of depression, it is necessary to identify factors mediating the relation between abuse and depression. Objective This study aims to investigate the association between abuse and depression by investigating the mediating role of academic stress, social anxiety, and generalized anxiety to offer insights for depression prevention. Participants and setting We investigated adolescents in urban and rural areas in Wansheng District of Chongqing city in China. This study included a total of 14,108 students from secondary and primary schools, among whom 7,086 were men (50.2%) and 7,022 were women (49.8%). The participants aged from 11 to 17 with an average age of 13.58 (M = 13.58, SD = 1.86). Methods A questionnaire survey was conducted among the participants between October and December in 2020. The following questionnaires were adopted: DSM-5 Patient Health Questionnaire for Adolescents, DSM-5 Severity Measure for Generalized Anxiety Disorder, The International Society for Prevention of Child Abuse and Neglect Child Abuse Screening Tool, DSM-5 Severity Measure for Social Anxiety Disorder (Social Phobia), and Study Stress Scale. Results The lifetime prevalence of abuse was high in Chinese adolescents. The direct effect value from abuse to depression was 0.05, the total mediating effect value was 0.14, and the overall effect value was 0.19. According to the mediating effect analysis, the direct and indirect effects from abuse to depression were significant, and the mediating effect accounted for 73.68% of the total effect, suggesting that 73.68% of the effects of abuse to depression are mediated by academic stress, social anxiety, and generalized anxiety. Conclusions Academic stress, social anxiety and generalized anxiety play a chain multiple mediating role in the association between abuse and depression, which sheds light on the prevention of depression in the future.
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Affiliation(s)
- Xiaoqing Zhan
- Department of Medical English, School of Basic Medical Sciences, Army Medical University, Chongqing, China
| | - Kuiliang Li
- School of Psychology, Army Medical University, Chongqing, China
| | - Yingcan Zheng
- School of Psychology, Army Medical University, Chongqing, China
| | - Guoyu Yang
- School of Psychology, Army Medical University, Chongqing, China,Guoyu Yang
| | - Xi Luo
- Department of Medical English, School of Basic Medical Sciences, Army Medical University, Chongqing, China,*Correspondence: Xi Luo
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Girish M, Lev-Wiesel R, Bhattacharyya A, Binson B. Emotional, Physical, and Sexual Abuse Reflected in Self-Figure drawings of Indian Street Children. ARTS IN PSYCHOTHERAPY 2022. [DOI: 10.1016/j.aip.2022.101986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Su YY, Li M, D'Arcy C, Caron J, O'Donnell K, Meng X. To what extent do social support and mastery mediate the association between childhood maltreatment and depression? A sequential causal mediation analysis. Epidemiol Psychiatr Sci 2022; 31:e77. [PMID: 36263598 PMCID: PMC9677445 DOI: 10.1017/s2045796022000609] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AIMS This study aimed to examine the independent roles of various childhood maltreatment (CM) subtypes in the development of depression; quantify the joint mediation effect of social support and mastery in the association between subtypes of CM and depression and examine the additional contribution of mastery beyond the effect that is operating through social support to this relationship. METHODS Data analysed were from the Zone d'Épidémiologie Psychiatrique du Sud-Ouest de Montréal, an ongoing longitudinal population-based study. In total, 1351 participants with complete information on the studied variables were included. The propensity score matching and inverse-probability weighted regression adjustment estimation methods were used to minimise the potential confounding in the relationship between CM and major depression. We then used inverse odds ratio-weighted estimation to estimate the direct effects of maltreatment and indirect effects of social support and mastery. RESULTS We found that exposures to all maltreatment subtypes increased the risk of subsequent depression. The joint mediating effect of social support and mastery explained 37.63-46.97% of the association between different maltreatment subtypes and depression. The contribution of these two mediators differed by maltreatment subtypes, with social support being the major contributor to the mediating effect. CONCLUSIONS The findings of the study not only provide scientific evidence on the importance of psychosocial attributes in the development of major depression but also suggest that prevention and invention strategies should focus on these psychosocial attributes to effectively break the vicious cycle of CM on major depression.
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Affiliation(s)
- Y. Y. Su
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Douglas Research Centre, Montreal, QC, Canada
| | - M. Li
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Douglas Research Centre, Montreal, QC, Canada
| | - C. D'Arcy
- School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada
- Department of Psychiatry, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - J. Caron
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Douglas Research Centre, Montreal, QC, Canada
| | - K. O'Donnell
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Douglas Research Centre, Montreal, QC, Canada
- Yale Child Study Center & Department of Obstetrics Gynecology & Reproductive Sciences, Yale School of Medicine, Yale University, New Haven, CT, USA
- Child & Brain Development Program, CIFAR, Toronto, ON, Canada
| | - X. Meng
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Douglas Research Centre, Montreal, QC, Canada
- Author for correspondence: X. Meng, E-mail:
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Marín-Navarrete R, Sánchez-Domínguez R, Pérez-López A, Saracco-Alvarez R. Addictive disorders, psychiatric symptoms, and potentially traumatic events in individuals with disabilities. Front Psychol 2022; 13:936184. [PMID: 36312133 PMCID: PMC9606598 DOI: 10.3389/fpsyg.2022.936184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 09/20/2022] [Indexed: 11/23/2022] Open
Abstract
Background/Objectives Individuals with disabilities (IWD) have a higher risk of potentially traumatic events (PTEs) either in childhood or adulthood, increasing the risk of suicide attempts, mental disorders, and substance use disorder. The aim of this study was to explore the association between substance use, psychiatric symptoms and suicidal behavior with PTEs. A Multisite cross-sectional study was conducted. Materials and methods The sample includes 1,098 participants with any type of disability (motor, intellectual, visual, and mixed) located in Mexico City. Traumatic events, violence, discrimination, addictive disorders, and psychiatric disorders were examined. Multivariate logistic regression models were conducted. Data was collected between September–October 2014. Results People with motor or visual disability have a higher prevalence in nicotine use disorder (NUD), generalize anxiety disorder (GAD), mayor depression disorder (MDD), want to be dead, and lifetime suicide attempts. Intellectual disability group only presents GAD and MDD. All disability groups have a high prevalence of PTEs. Verbal violence in childhood, sexual abuse, discrimination and serious accidents had a strong impact in the development of NUD, psychiatric symptoms and suicidal behavior. Conclusion These findings show the relevance of develop specific tools for detection, referral and treatment, in order to improve the mental health of people with disabilities.
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Affiliation(s)
- Rodrigo Marín-Navarrete
- Division of Research and Translational Education, Centros de Integración Juvenil, Mexico City, Mexico
| | - Ricardo Sánchez-Domínguez
- Division of Research and Translational Education, Centros de Integración Juvenil, Mexico City, Mexico
| | - Alejandro Pérez-López
- Division of Clinical Research, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Ricardo Saracco-Alvarez
- Division of Clinical Research, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico
- *Correspondence: Ricardo Saracco-Alvarez,
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