The indirect effect from childhood maltreatment to PTSD symptoms via thought suppression and cognitive reappraisal

Navigating the battlefield within: Exploring the interplay of political armed conflict, mental health, and emotion regulation

The study explored the intricate relationship between political armed conflict, mental health outcomes, and emotion regulation strategies, focusing on cognitive reappraisal and emotion suppression. Drawing on extensive literature, we examined the impact of the Israel-Hamas war on mental health, particularly post-traumatic stress symptoms (PTSS) and anxiety. Using data from a nationally representative sample of 517 Israeli adults surveyed four weeks after the October 7 war began, we conducted path analysis to examine the direct and indirect effects of conflict exposure on mental health outcomes mediated by emotion regulation. Cognitive reappraisal was positively associated with well-being, while emotion suppression was linked to higher levels of PTSS and anxiety and lower levels of well-being. Subjective exposure to war events was associated with higher levels of anxiety and PTSS, and cognitive reappraisal served as a protective factor for overall well-being. We also observed ethnicity, age, and gender differences in exposure levels and mental health outcomes. Emotion regulation emerges as a crucial factor in navigating the psychological challenges posed by war exposure, with cognitive reappraisal associated with positive mental health outcomes and emotion suppression linked to adverse effects.

The association between child maltreatment, cognitive reappraisal, negative coping styles, and non-suicidal self-injury in adolescents with major depressive disorder

BACKGROUND

Non-suicidal self-injury (NSSI) is a significant public health concern among adolescents with major depressive disorders (MDD). Although previous research has linked child maltreatment (CM) to NSSI, the precise mechanisms remain unclear. This study aims to investigate the association between CM, cognitive reappraisal (CR), negative coping styles (NC) and NSSI in adolescents with MDD, from the perspectives of both Latent Variable Theory and the Network Theory of Mental Disorder.

METHODS

A sample of 651 adolescents with MDD was recruited from January to December 2023. Data on CM, CR, NC, and NSSI were collected through paper-based self-reported questionnaires. Data analysis primarily involved structural equation modeling and network analysis.

RESULTS

The reporting rate of NSSI among adolescents with MDD was 48.2%. CM showed a significant positive correlation with NSSI. NSSI was affected by CM through three paths: the mediating role of CR, the mediating role of NC, and the chain mediating role of both CR and NC. Emotional abuse (EA) was the central node, while NSSI, EA, and "The urge to cry quietly when faced with troubles"(NC10) were the key bridge nodes.

CONCLUSIONS

This study is the first to use both structural equation modeling and network analysis to explore the explore the relationship between CM, CR, NC, and NSSI in adolescents with MDD, providing a theoretical basis for future early prevention and targeted interventions for adolescents with MDD.

Childhood abuse v. neglect and risk for major psychiatric disorders

BACKGROUND

Childhood maltreatment (CM) is a strong risk factor for psychiatric disorders but serves in its current definitions as an umbrella for various fundamentally different childhood experiences. As first step toward a more refined analysis of the impact of CM, our objective is to revisit the relation of abuse and neglect, major subtypes of CM, with symptoms across disorders.

METHODS

Three longitudinal studies of major depressive disorder (MDD, N = 1240), bipolar disorder (BD, N = 1339), and schizophrenia (SCZ, N = 577), each including controls (N = 881), were analyzed. Multivariate regression models were used to examine the relation between exposure to abuse, neglect, or their combination to the odds for MDD, BD, SCZ, and symptoms across disorders. Bidirectional Mendelian randomization (MR) was used to probe causality, using genetic instruments of abuse and neglect derived from UK Biobank data (N = 143 473).

RESULTS

Abuse was the stronger risk factor for SCZ (OR 3.51, 95% CI 2.17-5.67) and neglect for BD (OR 2.69, 95% CI 2.09-3.46). Combined CM was related to increased risk exceeding additive effects of abuse and neglect for MDD (RERI = 1.4) and BD (RERI = 1.1). Across disorders, abuse was associated with hallucinations (OR 2.16, 95% CI 1.55-3.01) and suicide attempts (OR 2.16, 95% CI 1.55-3.01) whereas neglect was associated with agitation (OR 1.24, 95% CI 1.02-1.51) and reduced need for sleep (OR 1.64, 95% CI 1.08-2.48). MR analyses were consistent with a bidirectional causal effect of abuse with SCZ (IVWforward = 0.13, 95% CI 0.01-0.24).

CONCLUSIONS

Childhood abuse and neglect are associated with different risks to psychiatric symptoms and disorders. Unraveling the origin of these differences may advance understanding of disease etiology and ultimately facilitate development of improved personalized treatment strategies.

Moving out of your mind and into your body: Yoga buffers the effects of childhood maltreatment on PTSD symptoms

Objective: Childhood maltreatment has been consistently linked to posttraumatic stress disorder (PTSD) symptoms among college students and yoga may buffer the effects. The current study examined the frequency of college student's yoga practice over the past year as a moderator of childhood maltreatment and PTSD symptoms in the past 30 days. Participants: A sample of 177 college students from a southern university. Methods: Participants competed an online survey in exchange for extra credit or entry into a gift card raffle. Results: Moderation analysis indicated that a more frequent yoga practice buffered the relationship between maltreatment and PTSD symptoms. Conclusion: Clinicians working with college students with a history of maltreatment are encouraged to make referrals to yoga classes. Universities are encouraged to adopt trauma-sensitive yoga programs.

A 1-year longitudinal study on experiencing workplace cyberbullying, affective well-being and work engagement of teachers: The mediating effect of cognitive reappraisal

Research on experiencing workplace cyberbullying (WCB) and its underlying mechanisms that impact the well-being of teachers is scarce. We propose that cognitive reappraisal, which is a useful and adaptive emotion-regulation strategy for reinterpreting emotion-eliciting situations, is a mediator explaining the inverse relationships between experiencing WCB and well-being. A three-wave longitudinal survey (baseline, T1; 3 months, T2; and 1 year, T3) was conducted with a sample of 444 primary and secondary schoolteachers in Hong Kong, China. Exposure to WCB, cognitive reappraisal, affective well-being and work engagement of participants was assessed. In line with the hypotheses, results showed that cognitive reappraisal mediated the associations between WCB and well-being. WCB at T1 was negatively associated with cognitive reappraisal at T2, which in turn was positively associated with positive affect and work engagement and negatively associated with negative affect at T3. Findings suggest that the intrusive nature of WCB renders its victims emotionally exhausted and helpless, thus negatively impacting the process to reinterpret the situation in a positive light, resulting in undesirable consequences. This study has illuminated WCB's inhibitory mechanism and its long-term detrimental impact. Practical implications are discussed.

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

BACKGROUND

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

METHODS

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

RESULTS

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

LIMITATIONS

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

CONCLUSIONS

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

Regional superficial amygdala resting-state functional connectivity in adults infers childhood maltreatment severity

Background

Childhood maltreatment (CM) is a potential risk factor for some neuropsychiatric disorders in adulthood (e.g. depression and anxiety) and alters trajectories of brain development. Accumulating evidence suggests that functional connectivity of the limbic system, especially the amygdala, is highly associated with childhood maltreatment, although not all studies have found this. These inconsistent results may be due to differential alterations of amygdala resting-state functional connectivity (rsFC) following childhood maltreatment.

Objective

Our aim was to investigate the relationship between the rsFC of amygdala subregions and CM severity, as well as to develop a stable rsFC-based model for inferring the severity of CM.

Methods

In this study, we employed the Childhood Trauma Questionnaire (CTQ) to assess CM severity in each individual. We explored the relationship between the rsFC of amygdala subregions (i.e. centromedial -CMA, basolateral -BLA, superficial-SFA amygdala) and CM experience in a discovery dataset of n = 110 healthy Chinese participants by linear multiple regression analysis. Subsequent dimensional and categorical approach were performed to elucidate the relationship between rsFCs and CM severity and CM subtypes, respectively. A support vector regression model was then conducted to validate the associations between rsFCs and total CTQ scores. Moreover, we also verified the model into another independent replication dataset (n = 38).

Results

Our findings suggested that childhood maltreatment was negatively associated with rsFC between the right superficial amygdala and perigenual anterior cingulate cortex (pgACC)/postcentral gyrus (PCG) but not the other two amygdala subregions. Moreover, SFA-pgACC coupling was more associated with physical neglect whereas the SFA-PCG was more related to emotional neglect. In addition, supervised machine learning confirmed that using these two rsFCs as predictors could stably estimate continuous maltreatment severity in both discovery and replication datasets.

Conclusion

The current study supports that the rsFCs of superficial amygdala are related to childhood maltreatment and which may be a potential biomarker for the effects of childhood maltreatment-related psychiatric disorders (i.e. depression and anxiety).

Association between Exposure to Domestic Violence during Childhood and Depressive Symptoms in Middle and Older Age: A Longitudinal Analysis in China

Exposure to domestic violence (EDV) is a constant threat to social stability and global solidarity and may be associated with an increased risk of depression in later life. This study assessed the association between EDV during childhood and depressive symptoms in middle and older age. A total of 10,521 respondents obtained from the China Health and Retirement Longitudinal Study were enrolled in our analysis. Depressive symptoms were measured using the 10-item form of the Center for Epidemiological Studies Depression (CES-D) scale, and EDV included parental conflict and corporal punishment. A random-effects linear regression was used to assess associations. The results showed positive relationships between "not very often" (β = 0.862; 95% CI:0.512 to 1.211; p < 0.001), "sometimes" (β = 1.692; 95% CI:1.227 to 2.158; p < 0.001) and "often" (β = 2.143; 95% CI:1.299 to 2.987; p < 0.001) in parental conflict and the CES-D scores, compared with that of those reported "never" in parental conflict. Similarly, positive relationships between "sometimes" (β = 0.389; 95% CI:0.091 to 0.687; p = 0.011) and "often" (β = 1.892; 95% CI:1.372 to 2.413; p < 0.001) in corporal punishment and the CES-D scores were observed. EDV is associated with an increased risk of depression in later life. Future research could develop interventions that target EDV and explore the mechanisms in China to further decrease lifetime depression risk and improve the population's mental health.

Psychological maltreatment and depression symptoms among Chinese adolescents: A multiple mediation model

BACKGROUND

Adolescents are at risk of depression, and recent studies also found a high prevalence of depression among Chinese adolescents. Therefore, it is necessary to explore the risk and protective factors of depression among Chinese adolescents.

OBJECTIVE

This study examined the direct effect of psychological maltreatment on depression symptoms in adolescents and the mediating roles of emotion regulation and social support in their relationship.

METHOD

Data were collected from Chinese senior high school students (N = 687, 36.5 % males and 63.5 % females, M_age = 16.44 years, SD = 0.78) who completed the measures of psychological maltreatment, depression symptoms, perceived social support, and emotion regulation strategies, including cognitive reappraisal and expressive suppression.

RESULTS

The results indicated that: (a) psychological maltreatment was positively correlated with depression symptoms; (b) the two emotion regulation strategies and perceived social support partially mediated the link between psychological maltreatment and depression symptoms separately; (c) the two emotion regulation strategies and perceived social support partially mediated the link between psychological maltreatment and depression symptoms in a sequential pattern.

CONCLUSION

Psychological maltreatment was positively associated with depression symptoms in adolescents. Emotion regulation and perceived social support both significantly mediated the relationship between psychological maltreatment and depression symptoms.

Childhood maltreatment and impulsivity in offenders: Examining the mediating roles of self-compassion and cognitive reappraisal

BACKGROUND

The higher impulsivity of offenders in prison is a challenge for prison intervention. Childhood maltreatment, one of the factors closely related to the generation and development of impulsivity, is also prevalent in offenders. Therefore, it is critical to investigate the underlying paths that generate impulsivity in offenders who have experienced childhood abuse.

OBJECTIVE

Targeting positive protective factors, this study aimed to probe the mediating roles of self-compassion and cognitive reappraisal in the relationship between childhood maltreatment and impulsivity in offenders.

METHODS

The participants included 2643 offenders, 1534 males and 1109 females. Each participant completed the appropriate questionnaires to measure childhood maltreatment, impulsivity, self-compassion, and cognitive reappraisal. The PROCESS macro was used to perform the mediation analysis and hypothesis testing.

RESULTS

The findings showed that childhood maltreatment indirectly affected offenders' impulsivity through self-compassion and cognitive reappraisal, and the mediating effect of self-compassion was stronger than that of cognitive reappraisal. Further analyses found that sexual abuse indirectly affected impulsivity through self-compassion, and the remaining types of childhood maltreatment were associated with impulsivity in indirect pathways through self-compassion and cognitive reappraisal.

CONCLUSIONS

The results suggest that reinforcing practical training in self-compassion and cognitive reappraisal, especially the former, might facilitate the reduction of impulsive symptoms among offenders with backgrounds of childhood maltreatment.

How do physical and emotional abuse affect depression and problematic behaviors in adolescents? The roles of emotional regulation and anger

BACKGROUND

Rates of physical and emotional abuse are high among Chinese adolescents and elicit distinct psychopathologies. However, it remains unclear whether physical and emotional abuse relate to depression and behavior problems similarly or differently. In addition, few studies have examined if they share underlying mechanisms in adolescents.

OBJECTIVE

This study used longitudinal data to examine the mechanisms underlying the effect of physical and emotional abuse on depression and problematic behaviors through emotional regulation and anger in Chinese adolescents.

PARTICIPANTS AND SETTINGS

Participants were 1689 adolescents (with age ranging from 12 to 17 years) from junior and senior high schools in Zhejiang Province, China.

METHODS

Participants completed a childhood trauma questionnaire and an emotion regulation strategies questionnaire at time 1 (T1), and they completed an anger scale, a depression scale, and a problematic behaviors questionnaire one year later (T2). Structural equation modeling was used to examine the research hypotheses.

RESULTS

Physical abuse had direct positive effects on problematic behaviors but not on depression. However, emotional abuse had direct effects on depression and problematic behaviors, and indirect effects on both psychopathologies through expressive suppression and anger.

CONCLUSIONS

Physical and emotional abuse had distinct effects and influencing mechanisms on adolescents' externalizing and internalizing problems. Compared with physical abuse, emotional abuse elicited more harms and subsequent psychopathologies.

Roles of Family Stress, Maltreatment, and Affect Regulation Difficulties on Adolescent Mental Health During COVID-19

This study examines the indirect effects of affect dysregulation and suppression on the associations between family stress from confinement, maltreatment, and adolescent mental health during COVID-19. We examined both adolescent and caregiver perspectives to yield a more well-rounded understanding of these associations than afforded in previous research. Using both adolescent (N = 809, Mage = 15.66) and caregiver (N = 578) samples, family stress from confinement, exposure to physical and psychological maltreatment, affect dysregulation and suppression, and youth internalizing and externalizing symptoms were measured in the summer of 2020, following three months of stay-at-home orders due to COVID-19. Affect dysregulation partially accounted for the associations between family stress from confinement and psychological maltreatment on both internalizing and externalizing symptoms for youth and caregiver report. Suppression partially accounted for the associations between family stress and maltreatment on internalizing and externalizing symptoms in the youth sample, but only for internalizing symptoms in the caregiver sample. Understanding family predictors of adolescents' mental health concerns and their underlying mechanisms, affect dysregulation and suppression, can inform mental health interventions during and following the COVID-19 pandemic.

Model of Post-traumatic Growth in Newly Traumatized vs. Retraumatized Adolescents

Background: In our analysis of adolescents affected by the 2016 Fort McMurray wildfire, we observed many negative mental health effects in individuals with a prior history of psychological trauma. Elevated rates of depression and markers of post-traumatic stress disorder (PTSD) were observed, consistent with the hypothesis that prior trauma may reduce sensitivity thresholds for later psychopathology (stress sensitization). Surprisingly, levels of anxiety did not differ based on prior trauma history, nor were retraumatized individuals at increased risk for recent (past month) suicidal ideation. These results are more suggestive of inoculation by prior trauma than stress sensitization. This led us to consider whether individuals with a prior trauma history showed evidence of Post-Traumatic Growth (PTG), a condition in which the experience of a previous trauma leads to areas of sparing or even improvement. Method: To investigate this issue, we generated a structural equation model (SEM) exploring the role of anxiety in previously traumatized (n = 295) and wildfire trauma alone (n = 740) groups. Specifically, models were estimated to explore the relationship between hopelessness, anxiety, PTSD symptoms, self-efficacy and potential protective factors such as friend and family support in both groups. The model was tested using a cross-sectional sample of affected youth, comparing effects between the two groups. Results: While both models produced relatively good fit, differences in the effects and chi-squared values led us to conclude that the groups are subject to different causal specifications in a number of areas, although details warrant caution pending additional investigation. Discussion: We found that adolescents with a prior trauma history appear to have a more realistic appraisal of potential difficulties associated with traumatic events, and seem less reactive to potentially unsettling PTSD symptoms. They also seemed less prone to overconfidence as they got older, an effect seen in the adolescents without a history of trauma. Our findings provide preliminary evidence that the construct of anxiety may work differently in newly traumatized and retraumatized individuals, particularly in the context of mass trauma events.