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Ke J, Wu J, Zhao W, Wang Y, Zhang Z, Tong Q, Guo Z, Wen Y, Li N, Yu F, Xie S, Zhu C, Wang K, Zhang L. Childhood maltreatment and engaging in NSSI for automatic-negative reinforcement: The mediating role of alexithymia and moderating role of help-seeking attitudes. J Affect Disord 2024; 350:295-303. [PMID: 38211755 DOI: 10.1016/j.jad.2024.01.068] [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: 08/31/2023] [Revised: 12/21/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024]
Abstract
BACKGROUND There is evidence indicating that childhood maltreatment is linked to the occurrence of non-suicidal self-injury (NSSI). Nevertheless, the association between childhood maltreatment and the automatic-negative reinforcement aspect of NSSI remains understudied. Chapman's (2006) experiential avoidance model posits that the main factor in sustaining NSSI is negative reinforcement, specifically through the avoidance or escape from distressful emotional experiences. The current study examines a conceptual framework based on this theory and the available literature that explores the potential mediation role of alexithymia in the relation between childhood maltreatment and the automatic-negative reinforcement of NSSI. Additionally, this study investigates how this process may be influenced by individuals' attitudes toward seeking professional help. METHODS 3657 adolescents (1616 females) completed questionnaires regarding childhood maltreatment, alexithymia, help-seeking attitudes, the NSSI, and its functions. RESULTS The findings of the study exposed a positive link between childhood maltreatment and the automatic-negative reinforcement of NSSI, with the mediating role of alexithymia. Interestingly, it was unexpected to discover that individuals with high help-seeking attitudes experienced an intensification of the relationship between childhood maltreatment and both alexithymia and the automatic-negative reinforcement of NSSI. LIMITATION The study's cross-sectional design hindered the inference of causality. CONCLUSION The present study demonstrated that it is crucial to consider the impact of both alexithymia and help-seeking attitudes in adolescents who have experienced maltreatment. These findings hold implications for preventive interventions that target the reduction of NSSI behaviors driven by automatic-negative reinforcement.
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Affiliation(s)
- Jing Ke
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Jiayi Wu
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Weixiang Zhao
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Yuebing Wang
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Ze Zhang
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Qing Tong
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Zixuan Guo
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Yan Wen
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Nan Li
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China; Department of Neurology, The First Affiliated Hospital of Anhui Medical University, The School of Mental Health and Psychological Sciences, Hefei, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China; Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Affective Computing & Advanced Intelligent Machine, Hefei, China
| | - Fengqiong Yu
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Sisi Xie
- Anhui Mental Health Center, Hefei, China
| | - Chunyan Zhu
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Kai Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, The School of Mental Health and Psychological Sciences, Hefei, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China; Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Anhui Medical University, Hefei, China.
| | - Lei Zhang
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China; Research Center for Translational Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China; Key Laboratory of Philosophy and Social Science of Anhui Province on Adolescent Mental Health and Crisis Intelligence Intervention, Hefei, China.
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Di Trani M, Metallo C, Renzi A, Mariani R, Rosabianca A, Tomasini A, Celano A. Childhood traumatic events, alexithymia and perceived stress in patients with rheumatoid arthritis during the COVID-19 pandemic. PSYCHOL HEALTH MED 2023; 28:2169-2181. [PMID: 37386736 DOI: 10.1080/13548506.2023.2229243] [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: 12/27/2022] [Accepted: 06/20/2023] [Indexed: 07/01/2023]
Abstract
Rheumatoid arthritis (RA) is a chronic inflammatory disease, causing joint-swelling and pain. International literature highlights that patients with RA are more likely to report high levels of alexithymia, adverse childhood events (ACEs) and stress, but studies investigating the association between these dimensions are lacking. The general aim of the present study is to investigate the association between alexithymia, ACEs, and stress in RA patients and to highlight possible predictors of greater perceived stress. One hundred and thirty-seven female patients with RA (mean age = 50.74; SD = 10.01) participated in an online survey between April and May 2021. Participants completed a questionnaire for the collection of sociodemographic and clinical information, the 20-item Toronto Alexithymia Scale, the Adverse Childhood Events questionnaire and the 10-item Perceived Stress Scale. The correlational analysis highlighted several significant associations between the dimensions evaluated. Regression analyses showed that alexithymia, ACEs and the perceived health status have a predictive effect on the perceived stress of RA patients. More specifically, the role of difficulty in identifying feelings, and the physical and emotional neglect, has been highlighted. ACEs and high levels of alexithymia are common in RA clinical populations and seem to affect the wellbeing of these patients. The use of a biopsychosocial approach to RA treatment appears essential in achieving a better quality of life and illness control in this specific clinical population.
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Affiliation(s)
- Michela Di Trani
- Department of Dynamic and Clinical Psychology and Health Studies, of "Sapienza", University of Rome, Rome, Italy
| | - Carla Metallo
- Department of Dynamic and Clinical Psychology and Health Studies, of "Sapienza", University of Rome, Rome, Italy
| | - Alessia Renzi
- Department of Dynamic and Clinical Psychology and Health Studies, of "Sapienza", University of Rome, Rome, Italy
| | - Rachele Mariani
- Department of Dynamic and Clinical Psychology and Health Studies, of "Sapienza", University of Rome, Rome, Italy
| | - Alessandra Rosabianca
- National Association of People with Rheumatological and Rare Diseases, Apmarr Aps, Lecce, Italy
| | - Andrea Tomasini
- National Association of People with Rheumatological and Rare Diseases, Apmarr Aps, Lecce, Italy
| | - Antonella Celano
- National Association of People with Rheumatological and Rare Diseases, Apmarr Aps, Lecce, Italy
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Alexithymia and psychosomatic diseases in adolescents: primary headaches. ACTA BIOMEDICA SCIENTIFICA 2023. [DOI: 10.29413/abs.2023-8.1.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
Background. Alexithymia is traditionally regarded as a factor which influences the development of psychosomatic diseases and contribute to a more severe and prolonged course of somatic diseases the high level of alexithymia indicates the deficit in cognitive processes associated with awareness, exteriorization and regulation of feelings and emotions. In recent years, a lot of research has been conducted on the comorbidity of alexithymia and psychosomatic diseases in adults, but there are very few studies in relation to children and adolescents.The aim. To analyze psychosomatic diseases associated with the high level of alexithymia in adolescents, to study the correspondence of alexithymia and central sensitization (CS) in adolescents with primary headaches (migraine and tension-type headache).Methods. The diagnosis of headache was based on the criteria for the International Classification of Headache, 3rd edition. The study group included 84 adolescents, average age – 14 [13; 16] (51 females, 33 males). CS was assessed using the Russian version of “Central Sensitization Inventory” (2020) for adolescents. Alexithymia was assessed using the Russian version of “Alexithymia questionnaire for children” (2019). Headache intensity was measured using the Visual Analogue Scale. There were also assessed the number of months and days per month with headaches; duration of night sleep; age of phrasal speech start.Results and discussion. The results showed the direct correlation between levels of alexithymia and central sensitization (rS = 0.49; p = 0.00001), the number of days with headaches per month and central sensitization severity (rS = 0.24; p = 0.027). There was no significant correlation between alexithymia severity and headaches duration (rS= 0.06; p = 0.5), no reliable results on the correspondence of alexithymia severity, age of phrasal speech start and nocturnal sleep.Conclusion. A high level of alexithymia is observed in adolescents with various somatic diseases. Primary headaches are associated with a high level of alexithymia and the severity of central sensitization. Pediatricians and neurologists should be advised to assess the level of alexithymia and central sensitization in adolescents with headaches.
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Li X, Wang X, Sun L, Hu Y, Xia L, Wang S, Guo C, Shi Y, Yuan X, Zhang K, Liu H. Associations between childhood maltreatment and suicidal ideation in depressed adolescents: The mediating effect of alexithymia and insomnia. CHILD ABUSE & NEGLECT 2023; 135:105990. [PMID: 36527985 DOI: 10.1016/j.chiabu.2022.105990] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 10/31/2022] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND People with depression appear to experience higher levels of childhood maltreatment (CM) and suicidal behaviour. However, no studies have discussed the factors through which CM influences suicidal ideation (SI) in adolescents with depression. The present study examined the effects of alexithymia and insomnia on the relationship between CM and SI in a population of Chinese adolescents with depression. METHODS A total of 262 adolescents with depression (198 females) completed the Childhood Trauma Questionnaire-Short Form, the Toronto Alexithymia Scale-20, the Insomnia Severity Index, and the Positive and Negative Suicide Ideation. RESULTS With the exception of sexual abuse (SA), four types of CM were associated with SI in depressed individuals. The highest incidence was found for physical neglect (PN) (65.27 %). Alexithymia and insomnia were both positively associated with SI. Externally oriented thinking (EOT) and insomnia had significant mediating effects on the relationship between emotional abuse (EA) and SI. EOT and insomnia also had significant mediating effects on the relationship between physical neglect (PN) and SI. LIMITATIONS The major limitations of this study include the impacts of cross-sectional studies and recall bias on the results. CONCLUSIONS Alexithymia and insomnia have an impact on SI in adolescents with depression who have experienced CM. Therefore, we should be aware of the impact of alexithymia and insomnia on depression patients. Rates of suicide among adolescents with depression should be reduced by identifying targeted measures.
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Affiliation(s)
- Xiaoyue Li
- Department of Psychiatry, Fourth People's Hospital in Wuhu, Wuhu 241002, China; Department of Psychiatry, Chaohu Hospital, Anhui Medical University, Hefei 238000, China
| | - Xixin Wang
- Taizhou Central Hospital (Taizhou University Hospital), Taizhou 318000, China
| | - Liang Sun
- Department of Psychiatry, Chaohu Hospital, Anhui Medical University, Hefei 238000, China; Fuyang Third People's Hospital, Fuyang 236000, China
| | - Yu Hu
- Department of Psychiatry, Chaohu Hospital, Anhui Medical University, Hefei 238000, China
| | - Lei Xia
- Department of Psychiatry, Chaohu Hospital, Anhui Medical University, Hefei 238000, China
| | - Song Wang
- Department of Psychiatry, Chaohu Hospital, Anhui Medical University, Hefei 238000, China; School of Mental Health and Psychological Sciences, Anhui Medical University, China
| | - Chunyan Guo
- Department of Psychiatry, Chaohu Hospital, Anhui Medical University, Hefei 238000, China
| | - Yudong Shi
- Department of Psychiatry, Chaohu Hospital, Anhui Medical University, Hefei 238000, China; School of Mental Health and Psychological Sciences, Anhui Medical University, China
| | - Xiaoping Yuan
- Department of Psychiatry, Chaohu Hospital, Anhui Medical University, Hefei 238000, China; School of Mental Health and Psychological Sciences, Anhui Medical University, China
| | - Kai Zhang
- Department of Psychiatry, Chaohu Hospital, Anhui Medical University, Hefei 238000, China; School of Mental Health and Psychological Sciences, Anhui Medical University, China.
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital, Anhui Medical University, Hefei 238000, China; School of Mental Health and Psychological Sciences, Anhui Medical University, China.
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Wu J. Exploring the process of harsh parenting on online aggressive behaviour: The mediating role of trait anger. JOURNAL OF PSYCHOLOGY IN AFRICA 2022. [DOI: 10.1080/14330237.2022.2121035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Jingli Wu
- Mental Health Education Center, Xinxiang Vocational and Technical College, Henan, China
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Chasson M, Taubman-Ben-Ari O. The Maternal Disintegrative Responses Scale (MDRS) and its associations with attachment orientation and childhood trauma. CHILD ABUSE & NEGLECT 2022; 131:105693. [PMID: 35689990 DOI: 10.1016/j.chiabu.2022.105693] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 03/20/2022] [Accepted: 06/02/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The Maternal Disintegrative Responses Scale (MDRS), which examines intrusive thoughts and dissociative experiences among mothers in the postpartum period, has recently been developed and initially validated. OBJECTIVE In this series of two studies, we sought to further examine the validity and psychometric properties of the MDRS by confirming its factor structure and investigating its associations with insecure attachment and childhood trauma. PARTICIPANTS AND SETTING Two convenience samples were recruited through social media. Participants in Study 1 consisted of 249 women aged 19 to 43 (M = 30.10, SD = 4.90) whose infants were up to 12 months old. Participants in Study 2 consisted of 637 women aged 20 to 46 (M = 31.43, SD = 4.81) whose infants were up to 16 weeks old. METHOD The participants completed a set of self-report questionnaires. In Study 1 we assessed trait anxiety, attachment orientation, the MDRS, and a background inventory. In Study 2 we assessed psychological distress, childhood trauma, the MDRS, and a background inventory. RESULTS In both studies, the factor structure of the MDRS was confirmed. In addition, insecure attachment and childhood trauma were both related to the MDRS factors, above and beyond the woman's background characteristics and current level of anxiety or distress. CONCLUSIONS The studies indicate the value of the MDRS as a promising, valid, and theory-based questionnaire for mothers following childbirth.
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Fung HW, Chien WT, Ling HWH, Ross CA, Lam SKK. The mediating role of post-traumatic stress disorder symptoms in the relationship between childhood adversities and depressive symptoms in two samples. CHILD ABUSE & NEGLECT 2022; 131:105707. [PMID: 35714440 DOI: 10.1016/j.chiabu.2022.105707] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 05/31/2022] [Accepted: 06/07/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Childhood adversities have been increasingly recognized as a significant risk factor for depression. However, the underlying mediating mechanism between childhood adversities and depression requires further investigation. The literature shows that childhood adversities are also closely associated with post-traumatic stress disorder (PTSD) symptoms and that PTSD symptoms can predict depressive symptoms. It remains unexplored whether PTSD symptoms can act as a mediator between childhood adversities and depression. OBJECTIVES The primary goal of this study was to examine whether PTSD symptoms would mediate the relationship between childhood adversities and depressive symptoms. PARTICIPANTS AND SETTING We examined in a convenience sample of Hong Kong adults aged 18 or above (N = 418) whether PTSD symptoms would mediate the relationship between childhood adversities and depressive symptoms. We then examined and compared the results with those in another convenience sample of Chinese-speaking young adults (mainly from Taiwan and Hong Kong) aged between 18 and 24 (N = 205). Participants in both samples completed online surveys that included measures of childhood adversities, PTSD symptoms and depressive symptoms. RESULTS Childhood adversities were significantly associated with depressive symptoms; and this relationship was mediated by PTSD symptoms in both samples. CONCLUSION This study is one of very few studies demonstrating that PTSD symptoms mediate the relationship between childhood adversities and depressive symptoms. Our findings suggest that addressing unresolved PTSD symptoms for adults with childhood adversities may help in preventing or treating depressive symptoms. Therefore, PTSD symptoms should be taken into account in the prevention and management of depression.
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Affiliation(s)
- Hong Wang Fung
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong; The Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Henry Wai-Hang Ling
- The Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Colin A Ross
- The Colin A. Ross Institute for Psychological Trauma, Richardson, TX, United States
| | - Stanley Kam Ki Lam
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
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