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Hautle LL, Kurath J, Jellestad L, Lüönd AM, Wingenbach TSH, Jansson B, Pfaltz MC. Larger comfortable interpersonal distances in adults exposed to child maltreatment: The role of depressive symptoms and social anxiety. Br J Psychol 2024. [PMID: 38651545 DOI: 10.1111/bjop.12705] [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: 10/17/2022] [Revised: 03/15/2024] [Accepted: 03/24/2024] [Indexed: 04/25/2024]
Abstract
Previous studies report a preference for larger comfortable interpersonal distance (CIPD) in individuals with child maltreatment (CM) when being approached by others. Yet, research on approaching others, as opposed to being approached, as well as on potential effects of social anxiety and depression is lacking. We investigated if CM and depressive symptoms influence CIPD and if social anxiety mediates the possible association of CM and CIPD when approaching a female stranger. One hundred ten participants with CM (CM) and 58 participants without CM (non-CM) experiences performed the stop-distance paradigm and stopped first when feeling uncomfortable (D1) and again when feeling very uncomfortable (D2). CM experiences were associated with a preference for larger CIPD, independent of depressive symptoms. All CM subtypes were associated with a larger D2. The relationship between CM and CIPD was partially mediated by social anxiety. These novel findings can help to develop interventions strengthening socially relevant skills and processes in those affected by CM, targeting alterations in social anxiety and depression.
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Affiliation(s)
- Lara-Lynn Hautle
- Medical Faculty, University of Zurich, Zürich, Switzerland
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zürich, Switzerland
| | - Jennifer Kurath
- Medical Faculty, University of Zurich, Zürich, Switzerland
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zürich, Switzerland
| | - Lena Jellestad
- Medical Faculty, University of Zurich, Zürich, Switzerland
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zürich, Switzerland
| | - Antonia M Lüönd
- Medical Faculty, University of Zurich, Zürich, Switzerland
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zürich, Switzerland
| | - Tanja S H Wingenbach
- Medical Faculty, University of Zurich, Zürich, Switzerland
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zürich, Switzerland
- School of Human Sciences, Faculty of Education, Health, and Human Sciences, University of Greenwich, London, UK
| | - Billy Jansson
- Department of Psychology and Social Work, Mid Sweden University, Östersund, Sweden
| | - Monique C Pfaltz
- Medical Faculty, University of Zurich, Zürich, Switzerland
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zürich, Switzerland
- Department of Psychology and Social Work, Mid Sweden University, Östersund, Sweden
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Witt A, Sachser C, Fegert JM. Scoping review on trauma and recovery in youth after natural disasters: what Europe can learn from natural disasters around the world. Eur Child Adolesc Psychiatry 2024; 33:651-665. [PMID: 35426528 PMCID: PMC10894166 DOI: 10.1007/s00787-022-01983-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 03/29/2022] [Indexed: 11/27/2022]
Abstract
In the last decade, Europe has seen a rise in natural disasters. Due to climate change, an increase of such events is predicted for the future. While natural disasters have been a rare phenomenon in Europe so far, other regions of the world, such as Central and North America or Southeast Asia, have regularly been affected by Hurricanes and Tsunamis. The aim of the current study is to synthesize the literature on child development in immediate stress, prolonged reactions, trauma, and recovery after natural disasters with a special focus on trajectories of (mal-)adaptation. In a literature search using PubMed, Psychinfo and EBSCOhost, 15 studies reporting about 11 independent samples, including 11,519 participants aged 3-18 years, were identified. All studies identified resilience, recovery, and chronic trajectories. There was also evidence for delayed or relapsing trajectories. The proportions of participants within each trajectory varied across studies, but the more favorable trajectories such as resilient or recovering trajectory were the most prevalent. The results suggested a more dynamic development within the first 12 months post-disaster. Female gender, a higher trauma exposure, more life events, less social support, and negative coping emerged as risk factors. Based on the results, a stepped care approach seems useful for the treatment of victims of natural disasters. This may support victims in their recovery and strengthen their resilience. As mental health responses to disasters vary, a coordinated screening process is necessary, to plan interventions and to detect delayed or chronic trauma responses and initiate effective interventions.
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Affiliation(s)
- Andreas Witt
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Steinhövelstraße 1, 89073, Ulm, Germany.
| | - Cedric Sachser
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Steinhövelstraße 1, 89073, Ulm, Germany
| | - Jörg M Fegert
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Steinhövelstraße 1, 89073, Ulm, Germany
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Haag AC, Bonanno GA, Chen S, Herd T, Strong-Jones S, Spiva S, Noll JG. Understanding posttraumatic stress trajectories in adolescent females: A strength-based machine learning approach examining risk and protective factors including online behaviors. Dev Psychopathol 2023; 35:1794-1807. [PMID: 35635211 PMCID: PMC9708933 DOI: 10.1017/s0954579422000475] [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] [Indexed: 11/07/2022]
Abstract
Heterogeneity in the course of posttraumatic stress symptoms (PTSS) following a major life trauma such as childhood sexual abuse (CSA) can be attributed to numerous contextual factors, psychosocial risk, and family/peer support. The present study investigates a comprehensive set of baseline psychosocial risk and protective factors including online behaviors predicting empirically derived PTSS trajectories over time. Females aged 12-16 years (N = 440); 156 with substantiated CSA; 284 matched comparisons with various self-reported potentially traumatic events (PTEs) were assessed at baseline and then annually for 2 subsequent years. Latent growth mixture modeling (LGMM) was used to derive PTSS trajectories, and least absolute shrinkage and selection operator (LASSO) logistic regression was used to investigate psychosocial predictors including online behaviors of trajectories. LGMM revealed four PTSS trajectories: resilient (52.1%), emerging (9.3%), recovering (19.3%), and chronic (19.4%). Of the 23 predictors considered, nine were retained in the LASSO model discriminating resilient versus chronic trajectories including the absence of CSA and other PTEs, low incidences of exposure to sexual content online, minority ethnicity status, and the presence of additional psychosocial protective factors. Results provide insights into possible intervention targets to promote resilience in adolescence following PTEs.
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Affiliation(s)
- Ann-Christin Haag
- Department of Counseling and Clinical Psychology, Columbia University Teachers College, New York, NY, USA
| | - George A. Bonanno
- Department of Counseling and Clinical Psychology, Columbia University Teachers College, New York, NY, USA
| | - Shuquan Chen
- Department of Counseling and Clinical Psychology, Columbia University Teachers College, New York, NY, USA
| | - Toria Herd
- College of Health and Human Development, Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | - Sienna Strong-Jones
- College of Health and Human Development, Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | - Sunshine Spiva
- College of Health and Human Development, Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | - Jennie G. Noll
- College of Health and Human Development, Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
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Haslam Z, Taylor EP. The relationship between child neglect and adolescent interpersonal functioning: A systematic review. CHILD ABUSE & NEGLECT 2022; 125:105510. [PMID: 35078090 DOI: 10.1016/j.chiabu.2022.105510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 01/13/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Neglect is a highly prevalent, yet historically understudied form of maltreatment. Recent research has revealed the far reaching and unique effects that neglect has on subsequent cognitive, behavioural and socio-emotional development, and on long-term physical and mental health outcomes. Adolescent interpersonal functioning is important to explore given the significant relational transitions that occur during this stage of development, and the known impact that these social changes can have on future life outcomes. OBJECTIVE This systematic review synthesises the literature exploring the relationship between neglect and adolescent interpersonal functioning in peer relationships. METHODS Seven databases and three grey literature sites were systematically searched, and identified records screened against inclusion criteria. RESULTS Twenty-one articles were included in the final sample, exploring five different indicators of adolescent interpersonal functioning. Around half of the papers investigating quality of peer relationships found that neglect, particularly emotional neglect, is associated with reduced relationship quality, and there is consistent evidence that neglect increases the risk of gang involvement and deviant peer affiliation. CONCLUSIONS These findings may be used to strengthen a trauma-informed approach to work with adolescents. Research on neglect and adolescent romantic relationships is sparse. Overall, the literature is varied and further research using longitudinal data and consistent measures of neglect would be of value.
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Affiliation(s)
- Zoe Haslam
- School of Health in Social Science, University of Edinburgh, Edinburgh, Scotland EH8 9AG, UK
| | - Emily P Taylor
- School of Health in Social Science, University of Edinburgh, Edinburgh, Scotland EH8 9AG, UK.
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[Pilot Evaluation of a New Treatment Concept for Children to Improve Emotion Regulation and Stress Resilience. START-Kids: Stress-Arousal-Regulation-Treatment for Kids]. Prax Kinderpsychol Kinderpsychiatr 2021; 70:679-698. [PMID: 34898413 DOI: 10.13109/prkk.2021.70.8.679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Emotional Dysregulation is a frequent challenge in clinical child psychiatric contexts. The Stress-Arousal-Regulation-Treatment for Children aged six to twelve (START-Kids, Dixius u. Möhler, 2021a), was developed as low threshold treatment tool for children with emotional dysregulation. The program is based on principles of dialectic behavioral therapy. The present article focuses feasibility and a first evaluation of this innovative treatment tool for emotionally dysregulated children. 23 child psychiatric patients aged six to twelve years took part in this eight weeks program with two group sessions at 60 min per week. Immediately before and after treatment personality functioning was assessed with the Levels of Personality Functioning Questionnaire LoPF-Q E and OPD-KJ2-SF E. There was no drop-out. Significant positive changes could be found after treatment with regard to therapists' and a trend for parent's ratings. Limitations are small sample size and lack of a treatment-as-usual-control group. START-Kids is an innovative program with high amount of feasibility and a positive influence on aspects of personality functions in children. Future studies, specifically a randomized controlled trial of START-Kids is warranted.
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Evaluation of an Early Intervention Model for Child and Adolescent Victims of Interpersonal Violence. CHILDREN-BASEL 2021; 8:children8100941. [PMID: 34682206 PMCID: PMC8534372 DOI: 10.3390/children8100941] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/14/2021] [Accepted: 10/18/2021] [Indexed: 11/16/2022]
Abstract
Only the minority of youth exposed to traumatic events receive mental health care, as trauma-informed clinical services are lacking or are poorly accessible. In order to bridge this gap, the Outpatient Trauma Clinic (OTC) was founded, an easily accessible early, short-time intervention, with onward referral to follow-up treatment. This report presents the OTC's interventional approach and first outcome data. Using a retrospective naturalistic design, we analyzed trauma- and intervention-related data of the sample (n = 377, 55.4% female, mean age 10.95, SD = 4.69). Following drop-out analyses, predictors for treatment outcome were identified by logistic regression. The majority (81.9%) was suffering from posttraumatic stress disorder (PTSD) or adjustment disorders. Around one forth dropped out of treatment; these cases showed higher avoidance symptoms at presentation. In 91%, psychological symptoms improved. Experience of multiple traumatic events was the strongest predictor for poor treatment outcome (B = -0.823, SE = 0.313, OR = 0.439, 95% CI 0.238-0.811). Around two thirds were connected to follow-up treatment. The OTC realized a high retention rate, initial improvement of symptoms and referral to subsequent longer-term psychotherapeutic treatment in the majority. Further dissemination of comparable early intervention models is needed, in order to improve mental health care for this vulnerable group.
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Jung E, Ahn JS, Han J, Kim MH. Trajectories of Psychopathology According to Continuation or Discontinuation of Child Abuse: A Longitudinal Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18178968. [PMID: 34501559 PMCID: PMC8430668 DOI: 10.3390/ijerph18178968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/18/2021] [Accepted: 08/19/2021] [Indexed: 11/16/2022]
Abstract
Long-term exposure to childhood abuse and occurrence of mental illness are positively correlated. Using long-term tracking data in Korea, we identified the characteristics of children and adolescents who experienced abuse and impact thereof on their psychopathology. Using the Korea Welfare Panel data, 354 teenagers in grades 4–6 of elementary school participated, were assessed at baseline, and monitored 3 years later. They were categorized into Never, Occurrence, Continuation, and Discontinuation groups according to changes in the abuse experienced. Psychopathology was evaluated using K-CBCL. Childhood abuse experience significantly affected psychopathology. At the baseline, the Continuation and Discontinuation groups had a higher severity of psychopathology than the Never group. Psychopathology at the baseline was associated with whether the patient experienced abuse that year. In the follow-up observation, the risk of psychopathology in the Occurrence and Continuation groups was higher than that in the Never group. The Discontinuation group had decreased psychopathology, which was not clinically significant in the follow-up observation (INT aRR = 2.09; 95% CI 0.61–7.13, EXT aRR = 4.23; 95% CI 1.12–16.07). Stopping abuse in late childhood reduces adolescents’ psychopathology in the long term, meaning they can recover their normal developmental trajectory according to risk groups and provide effective interventions including discontinuation of abuse.
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Affiliation(s)
| | | | - Jaehyun Han
- Correspondence: (J.H.); (M.-H.K.); Tel.: +82-33-741-0034 (J.H. & M.-H.K.); Fax: +82-33-741-1260 (J.H. & M.-H.K.)
| | - Min-Hyuk Kim
- Correspondence: (J.H.); (M.-H.K.); Tel.: +82-33-741-0034 (J.H. & M.-H.K.); Fax: +82-33-741-1260 (J.H. & M.-H.K.)
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Abstract
Legal Aspects of Child Protection Several legal codes (e. g. family, social and criminal law) are of importance in child protection cases in Germany. The intention of legal codes differs between family law (relations between family members), social law (support for families) and criminal law (penal aspects). Mental health professionals have to know the prevailing legal norms concerning child-welfare. Collaborative work between medicine and youth welfare and child protection services (CPS) requires a weighing of data protection issues and the risk for the child. German child protection law provides a stepped model for health care professionals to inform CPS. This includes a careful weighing of the risk for child abuse and own competences to provide support. Medical personnel should be aware of several further legislative regulations concerning child protection issues.
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Sokol RL, Goldstick J, Zimmerman MA, Muzik M, Rosenblum KL, Miller AL. Transitions into and out of post-traumatic stress among children involved in the child welfare system. CHILDREN AND YOUTH SERVICES REVIEW 2020; 118:105384. [PMID: 32921859 PMCID: PMC7485932 DOI: 10.1016/j.childyouth.2020.105384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE To describe the transition patterns into and out of post-traumatic stress (PTS) for youth and identify social supports preceding these transitions. METHODS We used inhomogeneous, continuous-time, 1Markov Chain models to model transitions in and out of PTS using data from Waves 1, 3, 4, and 5 of the National Survey of Child and Adolescent Wellbeing (NSCAW I)-a longitudinal study of children who first had contact with the child welfare system between 1999 and 2000. Our analytic sample contained 915 individuals aged 11-17 years. We analyzed data in 2020. RESULTS Youth with stronger peer relationships were less likely to transition into PTS (HR: 0.82; 95% CI [0.70-0.96]), and these individuals were also more likely to transition out of PTS (HR: 1.21; 95% CI [1.04, 1.42]). Youth with adult support were less likely to transition into PTS at any given time interval (HR: 0.37; 95% CI [0.17-0.78]), but adult support was not associated with the transition out of PTS. CONCLUSIONS Strengthening peer relationships may help at-risk children both avoid PTS altogether and recover from PTS after its onset. Promoting adult support, however, may only be most effective when attempting to prevent PTS-onset.
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Affiliation(s)
- Rebeccah L. Sokol
- School of Social Work, Wayne State University, 5447 Woodward Ave, Detroit, MI 48202, USA
| | - Jason Goldstick
- University of Michigan Injury Prevention Center, 2800 Plymouth Road, NCRC 10-G080, Ann Arbor, MI 48109
- Department of Emergency Medicine, University of Michigan School of Medicine, 1500 East Medical Center Drive, Ann Arbor, MI 48109
- Michigan Youth Violence Prevention Center, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109
| | - Marc A. Zimmerman
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA
- University of Michigan Injury Prevention Center, 2800 Plymouth Road, NCRC 10-G080, Ann Arbor, MI 48109
- Michigan Youth Violence Prevention Center, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109
| | - Maria Muzik
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Katherine L. Rosenblum
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Alison L. Miller
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA
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