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Zhao Q, Paschali M, Dehoney J, Baker FC, de Zambotti M, De Bellis MD, Goldston DB, Nooner KB, Clark DB, Luna B, Nagel BJ, Brown SA, Tapert SF, Eberson S, Thompson WK, Pfefferbaum A, Sullivan EV, Pohl KM. Identifying high school risk factors that forecast heavy drinking onset in understudied young adults. Dev Cogn Neurosci 2024; 68:101413. [PMID: 38943839 PMCID: PMC11261404 DOI: 10.1016/j.dcn.2024.101413] [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: 11/02/2023] [Revised: 06/12/2024] [Accepted: 06/20/2024] [Indexed: 07/01/2024] Open
Abstract
Heavy alcohol drinking is a major, preventable problem that adversely impacts the physical and mental health of US young adults. Studies seeking drinking risk factors typically focus on young adults who enrolled in 4-year residential college programs (4YCP) even though most high school graduates join the workforce, military, or community colleges. We examined 106 of these understudied young adults (USYA) and 453 4YCPs from the National Consortium on Alcohol and NeuroDevelopment in Adolescence (NCANDA) by longitudinally following their drinking patterns for 8 years from adolescence to young adulthood. All participants were no-to-low drinkers during high school. Whereas 4YCP individuals were more likely to initiate heavy drinking during college years, USYA participants did so later. Using mental health metrics recorded during high school, machine learning forecasted individual-level risk for initiating heavy drinking after leaving high school. The risk factors differed between demographically matched USYA and 4YCP individuals and between sexes. Predictors for USYA drinkers were sexual abuse, physical abuse for girls, and extraversion for boys, whereas 4YCP drinkers were predicted by the ability to recognize facial emotion and, for boys, greater openness. Thus, alcohol prevention programs need to give special consideration to those joining the workforce, military, or community colleges, who make up the majority of this age group.
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Affiliation(s)
- Qingyu Zhao
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | | | - Joseph Dehoney
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | | | - Michael D De Bellis
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - David B Goldston
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Kate B Nooner
- Department of Psychology, University of North Carolina Wilmington, Wilmington, NC, USA
| | - Duncan B Clark
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Beatriz Luna
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Bonnie J Nagel
- Departments of Psychiatry and Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, USA
| | - Sandra A Brown
- Department of Psychology, University of California San Diego, La Jolla, CA, USA; Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Susan F Tapert
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Sonja Eberson
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | | | - Adolf Pfefferbaum
- Center for Health Sciences, SRI International, Menlo Park, CA, USA; Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Edith V Sullivan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Kilian M Pohl
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA.
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Leri J, Cisler JM, Dodd CG, Clark SL, Taylor L, Theodorou A, Belford A, Liberzon I, Rathouz PJ, Newport DJ, Devargas C, Wagner K, Nemeroff CB. The role of recurrent trauma on post-traumatic stress disorder symptoms and substance use among trauma exposed youth. Psychiatry Res 2024; 338:115980. [PMID: 38833935 DOI: 10.1016/j.psychres.2024.115980] [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: 01/16/2024] [Revised: 05/17/2024] [Accepted: 05/25/2024] [Indexed: 06/06/2024]
Abstract
Comorbidity between post-traumatic stress disorder (PTSD) and substance use disorder may be explained by a prospective trauma risk conferred by both conditions. The current study modeled concurrent and prospective associations of trauma, PTSD symptoms, and substance use (SU) behavior among trauma exposed youth (ages 8-20). Clinical interviews assessed trauma exposure, PTSD symptom severity, and SU behavior at baseline and at six- and 12-month follow up study visits (N = 2,069). Structural equation models assessed the associations of trauma, PTSD symptoms, and SU behavior. Lifetime trauma was associated with more severe PTSD symptoms and SU behaviors, whereas trauma exposure during the study was only associated with PTSD symptoms. PTSD symptom severity was prospectively associated with trauma exposure. PTSD symptom severity and SU behavior at follow-up study visits were prospectively associated. These results highlight the dynamic interplay between trauma, PTSD symptoms, and SU behavior during youth, a developmental period during which complex psychiatric presentations can have longstanding consequences for health.
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Affiliation(s)
- John Leri
- Department of Psychiatry and Behavioral Sciences, The University of Texas at Austin Dell Medical School, 1601 Trinity Street, Austin, TX 78712, United States.
| | - Josh M Cisler
- Department of Psychiatry and Behavioral Sciences, The University of Texas at Austin Dell Medical School, 1601 Trinity Street, Austin, TX 78712, United States
| | - Cody G Dodd
- Department of Psychiatry and Behavioral Sciences, The University of Texas Medical Branch, United States
| | - Shaunna L Clark
- Department of Psychiatry & Behavioral Sciences, Texas A&M University, United States
| | - Leslie Taylor
- Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, United States
| | - Arrian Theodorou
- The University of North Texas Health Science Center, United States
| | - Anissa Belford
- Department of Psychiatry and Behavioral Sciences, The University of Texas at San Antonio, United States
| | - Israel Liberzon
- Department of Psychiatry & Behavioral Sciences, Texas A&M University, United States
| | - Paul J Rathouz
- Department of Population Health, The University of Texas at Austin Dell Medical School, United States
| | - D Jeffrey Newport
- Department of Psychiatry and Behavioral Sciences, The University of Texas at Austin Dell Medical School, 1601 Trinity Street, Austin, TX 78712, United States; Department of Women's Health, The University of Texas at Austin Dell Medical School, United States
| | - Cecilia Devargas
- Department of Psychiatry, Texas Tech University Health Sciences Center El Paso, United States
| | - Karen Wagner
- Department of Psychiatry and Behavioral Sciences, The University of Texas Medical Branch, United States
| | - Charles B Nemeroff
- Department of Psychiatry and Behavioral Sciences, The University of Texas at Austin Dell Medical School, 1601 Trinity Street, Austin, TX 78712, United States
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Baumann-Larsen M, Storheim K, Stangeland H, Zwart JA, Wentzel-Larsen T, Skurtveit S, Dyb G, Stensland SØ. Childhood trauma and the use of opioids and other prescription analgesics in adolescence and young adulthood: The HUNT Study. Pain 2024; 165:1317-1326. [PMID: 38126936 PMCID: PMC11090031 DOI: 10.1097/j.pain.0000000000003131] [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: 09/19/2023] [Revised: 11/04/2023] [Accepted: 11/07/2023] [Indexed: 12/23/2023]
Abstract
ABSTRACT Opioid and nonopioid analgesics are commonly prescribed to young people to alleviate pain. Even short-term prescriptions increase the risk of persistent use and future misuse of potent analgesics, such as opioids. Childhood trauma exposure has been found to be related to pain conditions and to using more prescription analgesics. This large, prospective cohort study aimed to investigate the association of a broad range of childhood trauma exposures with prescription rates for opioid and nonopioid analgesics in adolescence and young adulthood. Self-reported data on childhood trauma exposures from adolescents (aged 13-19 years) who participated in the Young-HUNT3 Study (2006-2008, n = 8199) were linked to data from the Norwegian Prescription Database (NorPD, 2004-2021). We found that exposure to childhood trauma was consistently associated with higher prescription rates for opioids throughout adolescence and young adulthood. The highest incidence rate ratio (IRR) in adolescence was observed for sexual abuse (IRR 1.63, confidence interval [CI] 1.19-2.23). In young adulthood, the highest IRR was observed for physical violence (2.66, CI 2.27-3.12). The same overall pattern was observed for nonopioid analgesics. The more frequent prescriptions of opioid and nonopioid analgesics to participants exposed to childhood trauma suggests a higher symptom load of pain causing them to seek professional help with pain relief. Receiving potent analgesics is not without risk, and the likelihood of misuse may be elevated among trauma-exposed individuals. A trauma-informed approach to pain could be vital for guiding clinicians to the most effective and least harmful treatment for each patient.
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Affiliation(s)
- Monica Baumann-Larsen
- Division of Clinical Neuroscience, Department of Research and Innovation, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Kjersti Storheim
- Division of Clinical Neuroscience, Department of Research and Innovation, Oslo University Hospital, Oslo, Norway
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Helle Stangeland
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - John-Anker Zwart
- Division of Clinical Neuroscience, Department of Research and Innovation, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Tore Wentzel-Larsen
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
- Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | - Svetlana Skurtveit
- Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
| | - Grete Dyb
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Synne Øien Stensland
- Division of Clinical Neuroscience, Department of Research and Innovation, Oslo University Hospital, Oslo, Norway
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
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Bhuptani PH, Zhang Y, Danzey L, Bali A, Langdon K, Orchowski LM. Interpersonal trauma, shame, and substance use: A systematic review. Drug Alcohol Depend 2024; 258:111253. [PMID: 38552599 PMCID: PMC11090047 DOI: 10.1016/j.drugalcdep.2024.111253] [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: 11/20/2023] [Revised: 02/21/2024] [Accepted: 02/24/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND Interpersonal trauma is a risk factor for a wide array of adverse mental health outcomes, including substance use. Research has begun investigating the role of shame in the intersection between substance use and interpersonal trauma. The current systematic review summarizes the existing literature documenting the relation among shame, substance use, and interpersonal trauma. METHOD Articles were collected using a Boolean search strategy of terms related to interpersonal trauma, substance use, and shame across six databases. Independent search and screening by three researchers led to a final review of 27 articles, 15 of which were qualitative studies. RESULTS Findings highlight robust associations among shame, interpersonal violence, and substance use across varied samples. Findings emphasize that increased shame is associated with greater substance use among survivors of interpersonal violence and elevated shame and greater interpersonal violence are present among individuals who use substances given the high prevalence rates. Burgeoning research suggests that shame mediates the relationship between interpersonal violence and substance use. CONCLUSION Results from our review suggest that shame may be an important treatment target for individuals presenting with substance use and a history of interpersonal violence. Future studies, with longitudinal designs, are needed to parse out the temporal relation among shame, substance use, and interpersonal violence.
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Affiliation(s)
- Prachi H Bhuptani
- Rhode Island Hospital, Providence, RI, USA; Brown University, Providence, RI, USA.
| | | | - Lauren Danzey
- Rhode Island Hospital, Providence, RI, USA; Brown University, Providence, RI, USA
| | - Aanandita Bali
- Rhode Island Hospital, Providence, RI, USA; Brown University, Providence, RI, USA
| | - Kirsten Langdon
- Rhode Island Hospital, Providence, RI, USA; Brown University, Providence, RI, USA
| | - Lindsay M Orchowski
- Rhode Island Hospital, Providence, RI, USA; Brown University, Providence, RI, USA
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Srivastava AV, Brown R, Newport DJ, Rousseau JF, Wagner KD, Guzick A, Devargas C, Claassen C, Ugalde IT, Garrett A, Gushanas K, Liberzon I, Cisler JM, Nemeroff CB. The role of resilience in the development of depression, anxiety, and post-traumatic stress disorder after trauma in children and adolescents. Psychiatry Res 2024; 334:115772. [PMID: 38442477 DOI: 10.1016/j.psychres.2024.115772] [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: 07/25/2023] [Revised: 01/30/2024] [Accepted: 02/02/2024] [Indexed: 03/07/2024]
Abstract
This investigation, conducted within the Texas Childhood Trauma Research Network, investigated the prospective relationships between resiliency and emergent internalizing symptoms among trauma-exposed youth. The cohort encompassed 1262 youth, aged 8-20, from twelve health-related institutions across Texas, who completed assessments at baseline and one- and six-month follow-ups for resiliency, symptoms of depression, generalized anxiety, posttraumatic stress disorder (PTSD), and other demographic and clinical characteristics. At baseline, greater resilience was positively associated with older age, male (vs female) sex assigned at birth, and history of mental health treatment. Unadjusted for covariates, higher baseline resilience was associated with greater prospective depression and PTSD symptoms but not anxiety symptoms. Upon adjusting for demographic and clinical factors, higher baseline resilience was no longer associated with depression, PTSD, or anxiety symptoms. Our analyses demonstrate that the predictive value of resilience on psychopathology is relatively small compared to more readily observable clinical and demographic factors. These data suggest a relatively minor prospective role of resilience in protecting against internalizing symptoms among trauma-exposed youth and highlight the importance of controlling for relevant youth characteristics when investigating a protective effect of resilience on internalizing symptoms.
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Affiliation(s)
- Arjun V Srivastava
- Department of Psychiatry and Behavioral Sciences, University of Texas at Austin Dell Medical School, Health Discovery Building, 1601 Trinity Blvd, Austin, TX 78701, USA
| | - Ryan Brown
- Department of Psychiatry and Behavioral Sciences, University of Texas at Austin Dell Medical School, Health Discovery Building, 1601 Trinity Blvd, Austin, TX 78701, USA
| | - D Jeffrey Newport
- Department of Psychiatry and Behavioral Sciences, University of Texas at Austin Dell Medical School, Health Discovery Building, 1601 Trinity Blvd, Austin, TX 78701, USA; Department of Women's Health, University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - Justin F Rousseau
- Department of Population Health, University of Texas at Austin Dell Medical School, Austin, TX, USA; Department of Neurology, University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - Karen D Wagner
- Department of Psychiatry and Behavioral Sciences, University of Texas Medical Branch, Galveston, TX, USA
| | - Andrew Guzick
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Cecilia Devargas
- Department of Psychiatry, Texas Tech University Health Sciences Center - El Paso Paul L. Foster School of Medicine, El Paso, TX, USA
| | - Cynthia Claassen
- Department of Psychiatry, JPS Health Network / University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Irma T Ugalde
- Department of Emergency Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Amy Garrett
- Department of Psychiatry, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
| | - Kim Gushanas
- Department of Psychiatry and Behavioral Sciences, University of Texas Medical Branch, Galveston, TX, USA
| | - Israel Liberzon
- Department of Psychiatry and Behavioral Sciences, Texas A&M University School of Medicine, Bryan, TX, USA
| | - Josh M Cisler
- Department of Psychiatry and Behavioral Sciences, University of Texas at Austin Dell Medical School, Health Discovery Building, 1601 Trinity Blvd, Austin, TX 78701, USA.
| | - Charles B Nemeroff
- Department of Psychiatry and Behavioral Sciences, University of Texas at Austin Dell Medical School, Health Discovery Building, 1601 Trinity Blvd, Austin, TX 78701, USA
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Saxena A, Hartman CA, Blatt SD, Fremont WP, Glatt SJ, Faraone SV, Zhang-James Y. Reward Functioning in General and Specific Psychopathology in Children and Adults. J Atten Disord 2024; 28:77-88. [PMID: 37864336 DOI: 10.1177/10870547231201867] [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] [Indexed: 10/22/2023]
Abstract
OBJECTIVE Problems with reward processing have been implicated in multiple psychiatric disorders, but psychiatric comorbidities are common and their specificity to individual psychopathologies is unknown. Here, we evaluate the association between reward functioning and general or specific psychopathologies. METHOD 1,213 adults and their1,531 children (ages 6-12) completed various measures of the Positive Valence System domain from the Research Domain Criteria (RDoC). Psychopathology was assessed using the Child Behavior Checklist for children and the Adult Self Report for parents. RESULTS One general factor identified via principal factors factor analysis explained most variance in psychopathology in both groups. Measures of reward were associated with the general factor and most specific psychopathologies. Certain reward constructs were associated solely with specific psychopathologies but not general psychopathology. However, some prior associations between reward and psychopathology did not hold following removal of comorbidity. CONCLUSION Reward dysfunction is significantly associated with both general and specific psychopathologies.
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Affiliation(s)
| | - Catharina A Hartman
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University Medical Center Groningen, University of Groningen, The Netherlands
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Hua LL, Lee J, Rahmandar MH, Sigel EJ. Suicide and Suicide Risk in Adolescents. Pediatrics 2024; 153:e2023064800. [PMID: 38073403 DOI: 10.1542/peds.2023-064800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/25/2023] [Indexed: 01/02/2024] Open
Abstract
Suicide is the second leading cause of death for 10- to 24-year-olds in the United States and is a global public health issue, with a recent declaration of a National State of Emergency in Children's Mental Health by the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry, and Children's Hospital Association. This clinical report is an update to the previous American Academy of Pediatrics clinical report, "Suicide and Suicide Attempts in Adolescents." Because pediatricians and pediatric health care providers are at the front line of care for adolescents amid a child and adolescent mental health crisis, and because of the chronic and severe shortage of mental health specialists, it is important that pediatric health care providers become facile with recognizing risk factors associated with suicidality and at-risk populations, screening and further assessment of suicidality as indicated, and evidence-based interventions for patients with suicidal ideation and associated behaviors. Suicide risk can be mitigated by appropriate screening, bolstering of protective factors, indicated treatment, community resources, and referrals to mental health providers when available.
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Affiliation(s)
- Liwei L Hua
- Division of Integrated Behavioral Health, South Bend Clinic, South Bend, Indiana
| | - Janet Lee
- Department of Pediatrics, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - Maria H Rahmandar
- Potocsnak Family Division of Adolescent & Young Adult Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, and Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Eric J Sigel
- Department of Pediatrics, University of Colorado School of Medicine, Section of Adolescent Medicine, Children's Hospital Colorado, Aurora, Colorado
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A systematic literature review of the relationship between parenting responses and child post-traumatic stress symptoms. Eur J Psychotraumatol 2023; 14:2156053. [PMID: 37052099 PMCID: PMC9788707 DOI: 10.1080/20008066.2022.2156053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: Parents are a key source of support for children exposed to single-incident/acute traumas and can thereby play a potentially significant role in children's post-trauma psychological adjustment. However, the evidence base examining parental responses to child trauma and child posttraumatic stress symptoms (PTSS) has yielded mixed findings.Objective: We conducted a systematic review examining domains of parental responding in relation to child PTSS outcomes.Method: Studies were included if they (1) assessed children (6-19 years) exposed to a potentially traumatic event, (2) assessed parental responses to a child's trauma, and (3) quantitatively assessed the relationship between parental responses and child PTSS outcomes. A systematic search of three databases (APAPsycNet, PTSDpubs, and Web of Science) yielded 27 manuscripts.Results: Parental overprotection, trauma communication, avoidance of trauma discussion and of trauma reminders, and distraction were consistently related to child PTSS. There was more limited evidence of a role for trauma-related appraisals, harsh parenting, and positive parenting in influencing child outcomes. Significant limitations to the evidence base were identified, including limited longitudinal evidence, single informant bias and small effect sizes.Conclusion: We conclude that key domains of parental responses could be potential intervention targets, but further research must validate the relationship between these parental responses and child PTSS outcomes.
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Crum KI, Aloi J, Blair KS, Bashford-Largo J, Bajaj S, Zhang R, Hwang S, Schwartz A, Elowsky J, Filbey FM, Dobbertin M, Blair RJ. Latent profiles of substance use, early life stress, and attention/externalizing problems and their association with neural correlates of reinforcement learning in adolescents. Psychol Med 2023; 53:7358-7367. [PMID: 37144406 PMCID: PMC10625649 DOI: 10.1017/s0033291723000971] [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] [Indexed: 05/06/2023]
Abstract
BACKGROUND Adolescent substance use, externalizing and attention problems, and early life stress (ELS) commonly co-occur. These psychopathologies show overlapping neural dysfunction in the form of reduced recruitment of reward processing neuro-circuitries. However, it is unclear to what extent these psychopathologies show common v. different neural dysfunctions as a function of symptom profiles, as no studies have directly compared neural dysfunctions associated with each of these psychopathologies to each other. METHODS In study 1, a latent profile analysis (LPA) was conducted in a sample of 266 adolescents (aged 13-18, 41.7% female, 58.3% male) from a residential youth care facility and the surrounding community to investigate substance use, externalizing and attention problems, and ELS psychopathologies and their co-presentation. In study 2, we examined a subsample of 174 participants who completed the Passive Avoidance learning task during functional magnetic resonance imaging to examine differential and/or common reward processing neuro-circuitry dysfunctions associated with symptom profiles based on these co-presentations. RESULTS In study 1, LPA identified profiles of substance use plus rule-breaking behaviors, attention-deficit hyperactivity disorder, and ELS. In study 2, the substance use/rule-breaking profile was associated with reduced recruitment of reward processing and attentional neuro-circuitries during the Passive Avoidance task (p < 0.05, corrected for multiple comparisons). CONCLUSIONS Findings indicate that there is reduced responsivity of striato-cortical regions when receiving outcomes on an instrumental learning task within a profile of adolescents with substance use and rule-breaking behaviors. Mitigating reward processing dysfunction specifically may represent a potential intervention target for substance-use psychopathologies accompanied by rule-breaking behaviors.
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Affiliation(s)
- Kathleen I Crum
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
- Division of Neuroimaging, Department of Neuroscience, Medical University of South Carolina, Charleston, SC, USA
| | - Joseph Aloi
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Karina S Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Johannah Bashford-Largo
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Sahil Bajaj
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Ru Zhang
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Soonjo Hwang
- Department of Psychiatry, University of Nebraska Medical Center, Omaha, NE, USA
| | - Amanda Schwartz
- Department of Psychology, University of North Dakota, Grand Forks, ND, USA
| | - Jaimie Elowsky
- Department of Psychology, University of Nebraska - Lincoln, Lincoln, NE, USA
| | - Francesca M Filbey
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA
| | - Matthew Dobbertin
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - R James Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
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10
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Clark SL, Dodd CG, Taylor L, Stewart S, Yang N, Shahidullah JD, Guzick AG, Richmond R, Aksan N, Rathouz PJ, Rousseau JF, Newport DJ, Wagner KD, Nemeroff CB. Characterizing patterns of substance use in trauma exposed youth. J Psychiatr Res 2023; 167:1-9. [PMID: 37778242 DOI: 10.1016/j.jpsychires.2023.09.020] [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: 06/06/2023] [Revised: 08/17/2023] [Accepted: 09/21/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVE Previous work investigating the impact of childhood trauma on substance use and co-occurring psychiatric disorders has primarily been conducted in adults or on specific trauma types. This limits understanding of traumas impact in childhood and how different types of traumas play a role. We sought to characterize substance use in a sample of trauma-exposed youth in the context of psychiatric comorbidities. METHOD 1152 youth from the Texas Childhood Trauma Research Network (TX-CTRN) that were exposed to at least one trauma meeting DSM-5 Criterion A were assessed for current substance use and psychiatric diagnoses. Latent class analysis was used to identify patterns of substance use. To characterize these patterns, we examined if demographics, number of trauma types experienced, or childhood psychiatric disorders predicted class membership. RESULTS We identified four primary patterns of substance use: Non-use (66.1%), predominantly alcohol use (19.7%), predominantly cannabis use (4.5%), and polysubstance use (9.7%). Compared to the non-users, polysubstance users tended to be older, Non-Hispanic White, have experienced more types of trauma. They were also more likely to have fulfilled diagnostic criteria for suicidality and ADHD. Comparisons among the substance using classes were more nuanced. CONCLUSION The findings highlight the need for universal assessments of trauma, substance misuse, and mental health symptoms in youth as the presence or absence of their co-occurrence has implications for treatment.
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Affiliation(s)
| | - Cody G Dodd
- University of Texas Medical Branch, United States
| | - Leslie Taylor
- University of Texas Health Science Center, United States
| | | | | | | | | | - Robyn Richmond
- Texas Tech University Health Sciences Center, United States
| | - Nazan Aksan
- University of Texas at Austin, United States
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11
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Li D, Wang D, Ren H, Tian Y, Chen J, Zhu R, Li Y, Wang L, Zhang XY. Association between rumination and drug craving in Chinese male methamphetamine use disorder patients with childhood trauma. CHILD ABUSE & NEGLECT 2023; 144:106357. [PMID: 37459735 DOI: 10.1016/j.chiabu.2023.106357] [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: 03/13/2023] [Revised: 05/18/2023] [Accepted: 07/12/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND In China, males make up the majority of methamphetamine (MA) dependent individuals and the majority of treatment seekers. Childhood trauma (CT) and rumination are associated with an increased risk of MA use. However, the association between CT, rumination, and drug craving remains largely unknown. OBJECTIVE The present study aims to explore the association between rumination and drug craving in methamphetamine use disorder (MAUD) patients with CT. PARTICIPANTS AND SETTING This study recruited 404 male participants with MAUD from a male drug rehabilitation center in Southwest China. METHODS Patients with CT were identified by the short form of Childhood Trauma Questionnaire (CTQ-SF). Rumination and drug craving were assessed by the Ruminative Responses Scale (RRS) and the Obsessive Compulsive Drug Use Scale (OCDUS), respectively. RESULTS 188 patients (46.5 %) experienced CT. Patients who had experienced CT showed significantly higher RRS symptom rumination score and OCDUS total score than those who had not. In patients with CT, RRS total and all subscale scores were positively associated with OCDUS interference of drug. Furthermore, the RRS brooding (β = 0.34, p < 0.001) and total scores (β = 0.38, p < 0.001) were determined to be separate contributors to the OCDUS total score in patients with CT. CONCLUSIONS Our study suggests that CT is common in male MAUD patients, and those who have suffered CT may exhibit higher levels of rumination and drug craving. Moreover, CT may play an influential role in the association between rumination and drug craving in patients with MAUD.
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Affiliation(s)
- Deyang Li
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Dongmei Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
| | - Hengqin Ren
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yang Tian
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Jiajing Chen
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Rongrong Zhu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yuqing Li
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Li Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xiang-Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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12
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Dell'Aquila A, Berle D. Predictors of alcohol and substance use among people with post-traumatic stress disorder (PTSD): findings from the NESARC-III study. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1509-1522. [PMID: 37133523 PMCID: PMC10460312 DOI: 10.1007/s00127-023-02472-6] [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: 01/14/2023] [Accepted: 03/30/2023] [Indexed: 05/04/2023]
Abstract
PURPOSE The self-medication hypothesis suggests people may develop Alcohol Use Disorder (AUD) or Non-Alcohol Substance Use Disorder (NA-SUD) following PTSD as a maladaptive way of coping with PTSD symptoms. Given that an accumulation of trauma experiences and interpersonal trauma increase the likelihood and severity of PTSD, we sought to determine whether the number and type of traumas additionally predict AUD and NA-SUD following PTSD. METHODS We analysed data from 36,309 adult participants in the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III) study (M = 45.63 years, SD = 17.53, 56.3% female) who were administered semi-structured diagnostic interviews of trauma exposure and PTSD, AUD and NA-SUD symptoms. RESULTS Individuals with PTSD were more likely to have an AUD or NA-SUD than those without PTSD. Endorsement of a greater number of traumas was associated with greater odds of having PTSD, AUD, or NA-SUD. Experience of interpersonal trauma was related to greater odds of having PTSD and subsequent AUD or NA-SUD than not experiencing interpersonal trauma. Multiple experiences of interpersonal trauma compared to one interpersonal trauma exposure also increased the odds of having PTSD followed by AUD or NA-SUD. CONCLUSIONS Interpersonal trauma and multiple experiences of interpersonal trauma may result in individuals turning to alcohol and substances as a way to alleviate intolerable PTSD symptomology, aligning with the self-medication hypothesis. Our findings highlight the importance of ensuring services and support for interpersonal trauma survivors and for those who have experienced multiple traumas given their increased for unfavourable outcomes.
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Affiliation(s)
- Adriana Dell'Aquila
- Graduate School of Health, University of Technology Sydney, Sydney, Australia
| | - David Berle
- Graduate School of Health, University of Technology Sydney, Sydney, Australia.
- School of Medicine and Psychology, Australian National University, Canberra, Australia.
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13
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Farmer RF, Seeley JR, Kosty DB, Gau JM. Deconstructing the heterogeneity of alcohol use disorder: lifetime comorbid non-alcohol substance use disorder as a distinct behavioral phenotype? Psychol Med 2023; 53:4962-4976. [PMID: 35781344 DOI: 10.1017/s0033291722001921] [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] [Indexed: 11/05/2022]
Abstract
BACKGROUND Alcohol use disorder (AUD) is an etiologically and clinically heterogeneous condition. Accumulating evidence suggests that persons with lifetime histories of comorbid AUD and non-alcohol substance use disorder (DRUG) constitute an important subgroup of AUD. This study evaluated the distinctiveness of the comorbid AUD/DRUG behavioral phenotype in a community sample with respect to risk factors, AUD course features, and outcome variables assessed at age 30. Contrast groups included persons with histories of AUD only, DRUG only, and neither AUD nor DRUG. METHODS This research utilized a prospective study design with an age-based cohort (n = 732). Participants completed four comprehensive diagnostic evaluations during the high-risk periods of adolescence, emerging adulthood, and young adulthood. RESULTS The comorbid AUD/DRUG group was distinguished from the AUD only group by risk factors, AUD course features, and outcomes. Group differences in outcomes were also explained by overall substance use disorder (SUD) severity. Persons with AUD/DRUG comorbidity were indistinguishable from those with DRUG only histories with respect to risk factors and outcomes but demonstrated greater overall SUD severity. Persons with AUD only were indistinguishable from those with neither AUD nor DRUG histories in risk factor endorsements and were mostly similar in outcomes. CONCLUSIONS Findings collectively suggest that young adults with histories of AUD only and those with comorbid AUD/DRUG are drawn from dissimilar populations. Similarities between the AUD only group with those absent AUD or DRUG histories are likely related to the former group's developmentally limited AUD course accompanied by relatively few or short-lived alcohol-related problems.
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Affiliation(s)
- Richard F Farmer
- Oregon Research Institute, 1776 Millrace Drive, Eugene, OR 97403, USA
| | - John R Seeley
- Oregon Research Institute, 1776 Millrace Drive, Eugene, OR 97403, USA
- College of Education, University of Oregon, 901 East 18th Ave., Eugene, OR 97403, USA
| | - Derek B Kosty
- Oregon Research Institute, 1776 Millrace Drive, Eugene, OR 97403, USA
- College of Education, University of Oregon, 901 East 18th Ave., Eugene, OR 97403, USA
| | - Jeff M Gau
- Oregon Research Institute, 1776 Millrace Drive, Eugene, OR 97403, USA
- College of Education, University of Oregon, 901 East 18th Ave., Eugene, OR 97403, USA
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14
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Burkhart K, Agarwal N, Kim S, Neudecker M, Ievers-Landis CE. A Scoping Review of Trauma-Informed Pediatric Interventions in Response to Natural and Biologic Disasters. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1017. [PMID: 37371249 DOI: 10.3390/children10061017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 05/23/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023]
Abstract
A scoping review was performed of trauma-informed psychological interventions to treat anxiety, depression, and posttraumatic stress symptoms in youth in response to natural/biologic disasters. The specific aims were to identify psychosocial interventions used in response to natural/biologic disasters, report the interventions' effectiveness, describe limitations, and provide treatment recommendations and future directions. Of the 45 studies extracted, 28 were on natural disasters and 17 on biologic disasters with the majority related to the COVID-19 pandemic. The most commonly implemented interventions were Cognitive Behavioral Therapy (CBT), Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), and eye movement desensitization and reprocessing (EMDR). The UCLA Posttraumatic Stress Disorder Reaction Index (UCLA PTSD-RI) and the Strengths and Difficulties Questionnaire (SDQ) were the most frequently used measures. Methodological rigor was varied, with 60% randomized, controlled trials. Overall, there was a significant decrease in posttraumatic stress symptoms, distress, anxiety, and depression regardless of whether the participant received CBT, TF-CBT, or EMDR. Generally, there was not a significant decrease in anxiety and depression with yoga, cognitive fear-reduction, emotion-based drawing, and community health education. Recommendations for future directions include larger-scale studies with group and on-line interventions that include younger children with moderation analyses by gender and race/ethnicity.
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Affiliation(s)
- Kimberly Burkhart
- Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, 10524 Euclid Ave., Cleveland, OH 44106, USA
| | - Neel Agarwal
- Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106, USA
| | - Sehyun Kim
- Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106, USA
| | - Mandy Neudecker
- Rainbow Babies and Children's Hospital, 1100 Euclid Ave., Cleveland, OH 44106, USA
| | - Carolyn E Ievers-Landis
- Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, 10524 Euclid Ave., Cleveland, OH 44106, USA
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15
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Haahr-Pedersen I, Vallières F, Hansen M, Aldamman K, Schmidt-Rasmussen V, Bramsen RH, Spitz P, Hyland P. Evidence of a traumatic stress dimension of psychopathology among at-risk children living in Denmark. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04381-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
AbstractThe Hierarchical Taxonomy of Psychopathology (HiTOP) is a quantitative model of psychopathology. HiTOP proposes that trauma-related distress is a facet of Internalizing psychopathology, but recent evidence with young people suggests that it may reflect a unique dimension of psychopathology. This study assessed the latent structure of child and adolescent psychopathology to determine whether there is evidence of a unique ‘Traumatic Stress’ dimension, and how dimensions of psychopathology are associated with specific types of childhood adversity and trauma, and suicidal ideation and self-injurious behavior. Participants were children and adolescents aged 1–17 years (N = 1,800) who were in contact with the Danish child protection system due to suspected child abuse. Confirmatory factor analysis was used to determine the optimal latent structure of psychopathology, and structural equation modelling was used to determine how the dimensions of psychopathology were associated with different forms of trauma and adversity and suicidality/self-harm. The best fitting model included three factors of Internalizing, Externalizing, and Traumatic Stress. The Traumatic Stress dimensions was associated with older age, living outside of the family home, parental mental illness, higher levels of parental conflict, and the presence of domestic violence in the child’s home. The Traumatic Stress dimension was not associated with suicidality/self-harm. This study provides additional evidence of a distinct dimension of Traumatic Stress among young people. Further studies are needed to determine if these findings are replicable, particularly in older participants.
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16
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Norton EO, Hailemeskel R, Bravo AJ, Pilatti A, Kaimner D, Conway CC, Mezquita L, Hogarth L. Childhood Traumatic Experiences and Negative Alcohol-Related Consequences in Adulthood: A Cross-Cultural Examination of Distress Tolerance and Drinking to Cope. Subst Use Misuse 2023; 58:804-811. [PMID: 36935590 PMCID: PMC10124750 DOI: 10.1080/10826084.2023.2188563] [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] [Indexed: 03/21/2023]
Abstract
Background: Prior research has established that Adverse Childhood Experiences (ACEs) predict harmful alcohol use outcomes. However, underlying mechanisms that could explain these associations are less clear. The present study examined if ACEs are indirectly related to alcohol negative consequences through their associations with distress tolerance and drinking to cope. Method: A sample of 3,763 (71.9% female) college students who drink alcohol from seven countries (U.S., Argentina, Canada, Uruguay, Spain, South Africa, and England) completed online surveys. Path analysis was performed within the whole sample testing the serial unique associations between ACEs→distress tolerance→drinking to cope→negative alcohol-related consequences. Multi-group analysis was performed to determine if the proposed pathways were invariant across gender and countries. Results: Both distress tolerance and drinking to cope uniquely accounted for the relationship between ACEs and negative alcohol-related consequences. Additionally, a significant double-mediation effect was found illustrating that a higher endorsement of ACEs was associated with lower distress tolerance, which in turn was associated with higher drinking to cope, which in turn was associated with more negative alcohol-related consequences. These effects were invariant across countries and gender groups. Conclusions: These findings provide support for the relevance of distress tolerance and coping motives as potential factors in linking ACEs to problematic alcohol use across nations. Our data are consistent with the idea that intervening on distress tolerance and drinking motives could mitigate downstream alcohol-related consequences related to ACEs in college student populations around the world.
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Affiliation(s)
| | | | | | - Angelina Pilatti
- Universidad Nacional de Córdoba, Facultad de Psicología, Instituto de Investigaciones Psicológicas, IIPsi, CONICET. Córdoba, Argentina
| | - Debra Kaimner
- Department of Psychology, University of Cape Town, South Africa
| | | | - Laura Mezquita
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castelló de la Plana, Castellón, Spain
| | - Lee Hogarth
- School of Psychology, University of Exeter, United Kingdom
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17
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Bassir Nia A, Weleff J, Fogelman N, Nourbakhsh S, Sinha R. Regular cannabis use is associated with history of childhood and lifetime trauma in a non-clinical community sample. J Psychiatr Res 2023; 159:159-164. [PMID: 36736285 PMCID: PMC10024801 DOI: 10.1016/j.jpsychires.2023.01.036] [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: 10/06/2022] [Revised: 01/19/2023] [Accepted: 01/26/2023] [Indexed: 01/29/2023]
Abstract
Higher rate of substance use, including cannabis, has been reported in individuals with a history of childhood trauma, but less is known about the association between cannabis use with lifetime history of trauma and chronic stress, and potential gender differences in this association. This study systematically examined this association in a cross-sectional study of 841 individuals recruited between 2007 and 2012 from the community in New Haven, Connecticut. The Cumulative Adversity Index (CAI) was used to measure cumulative lifetime major life events, life trauma, and recent life events and chronic stress. Childhood Trauma Questionnaire (CTQ) was used to measure childhood trauma. Current and regular use of drugs were assessed using self-report questionnaires and objectively verified with urine drug testing. Higher rates of childhood trauma as well as lifetime trauma, and major life events were found in cannabis users, compared to non-users. The association between cannabis use with childhood trauma (total CTQ scores) was significant after controlling for age, gender, ethnicity and regular use of alcohol or cocaine. In logistic regression analysis, cannabis use had a significant positive association with major life events and lifetime trauma, but not with chronic stress, controlling for confounding factors including age, gender, ethnicity, and regular use of alcohol and cocaine. When analyzed separately, only in women the association between cannabis use and childhood trauma was significant. These associations point to further assessment of the impact of these gender differences on neurobiology of stress and cannabis misuse risk.
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Affiliation(s)
- Anahita Bassir Nia
- Department of Psychiatry, Yale University School of Medicine, United States
| | - Jeremy Weleff
- Department of Psychiatry, Yale University School of Medicine, United States; Department of Psychiatry and Psychology, Cleveland Clinic, United States.
| | - Nia Fogelman
- Department of Psychiatry, Yale University School of Medicine, United States
| | - Sormeh Nourbakhsh
- Department of Psychiatry, Yale University School of Medicine, United States
| | - Rajita Sinha
- Department of Psychiatry, Yale University School of Medicine, United States
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18
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Heradstveit O, Hysing M, Breivik K, Skogen JC, Askeland KG. Negative Life Events, Protective Factors, and Substance-Related Problems: A Study of Resilience in Adolescence. Subst Use Misuse 2023; 58:471-480. [PMID: 36710631 DOI: 10.1080/10826084.2022.2161319] [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: 01/31/2023]
Abstract
BACKGROUND There is compelling evidence for an association between negative life events (NLE) and substance-related problems (SRP) during adolescence. The literature is, however, still limited with regards to protective factors for SRP among adolescents exposed to NLE. METHODS A large population-based survey including 9,611 Norwegian adolescents aged 16 to 19 years, comprised the dataset of this study. The main explanatory variable was NLE. The main outcome variable was SRP, assessed by the CRAFFT scale. Potential protective factors were measured with five subscales from the Resilience Scale for Adolescents (READ) questionnaire. The potential protective factors and sex were explored as moderators for the associations between NLE and SRP. RESULTS NLE were strongly associated with SRP. Four out of five potential protective factors (i.e., Goal Orientation, Self-confidence, Family Cohesion, and Social Support) showed evidence of a protective-stabilizing effect. Even if they had protective effect across all levels of exposure to NLE, these effects were even stronger for adolescents with high exposure. For Family Cohesion a protective-stabilizing effect was only evident for boys, while a direct protective effect was found for girls. Finally, Social Competence was the only factor that did not show any evidence of promoting resilience toward SRP. CONCLUSIONS NLE had a strong relation with SRP in this study. Protective factors buffered against SRP for all adolescents - but particularly so for adolescents who had high exposure to NLE. These findings highlight the need for preventive efforts to strengthen protective factors that may promote resilience among adolescents at risk for SRP.
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Affiliation(s)
- Ove Heradstveit
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway.,Center for Alcohol & Drug Research, Stavanger University Hospital, Stavanger, Norway
| | - Mari Hysing
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway.,Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Kyrre Breivik
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
| | - Jens Christoffer Skogen
- Center for Alcohol & Drug Research, Stavanger University Hospital, Stavanger, Norway.,Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway
| | - Kristin Gärtner Askeland
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
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19
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Marchand K, Liu G, Mallia E, Ow N, Glowacki K, Hastings KG, Mathias S, Sutherland JM, Barbic S. Impact of the COVID-19 pandemic on alcohol or drug use symptoms and service need among youth: a cross-sectional sample from British Columbia, Canada. Subst Abuse Treat Prev Policy 2022; 17:82. [PMID: 36550587 PMCID: PMC9774070 DOI: 10.1186/s13011-022-00508-9] [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: 09/22/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Concerns about youth alcohol and drug use have risen since the declaration of the global COVID-19 pandemic due to the pandemic's impact on known risk and protective factors for substance use. However, the pandemic's immediate and long-term impact on youths' substance use patterns has been less clear. Thus, this study sought to determine how the COVID-19 pandemic impacted alcohol or drug use and its risk and protective factors among youth accessing integrated youth services. METHODS We conducted a repeated cross-sectional study of patient-reported outcomes data collected between May 2018 and February 2022 among youth (n = 6022) ages 10-24 accessing a provincial network of integrated youth services in Canada. The main exposure of interest was the COVID-19 pandemic (March 2020 - February 2022) compared with a pre-pandemic period (May 2018 - February 2020). As measured by the Global Appraisal of Individual Needs - Short Screener, outcomes included the average number of past month alcohol or drug use symptoms and past month likelihood of service need for alcohol/drug use (moderate/high vs. low need). Interrupted time series (ITS) examined change in average monthly alcohol/drug use symptoms between the pre- and pandemic periods. Stratified multivariable logistic regression investigated how the pandemic modified the effects of established risk/protective factors on likelihood of alcohol/drug use service need. RESULTS Fifty-percent of youth met the criteria for moderate/high likelihood of alcohol/drug use service need, with the odds being 2.39 times (95% confidence interval = 2.04, 2.80) greater during the pandemic compared to the pre-pandemic period. Results from the ITS indicated significant immediate effects of the pandemic on monthly substance use symptoms (p = 0.01). Significant risk/protective factors for service need included exposure to violence, engagement in meaningful activities, and self-rated physical and mental health; and the direction of their effects remained consistent across pandemic and pre-pandemic periods. CONCLUSIONS This study demonstrated that the COVID-19 pandemic corresponded with increased alcohol or drug use among youth accessing integrated services. This signals an urgent need for increased clinical capacity in existing youth services and policies that can respond to risk/protective factors for substance use earlier.
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Affiliation(s)
- Kirsten Marchand
- Foundry, 915-1045 Howe Street, Vancouver, BC V6Z 2A9 Canada ,grid.17091.3e0000 0001 2288 9830Faculty of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC V6T 1Z3 Canada ,grid.17091.3e0000 0001 2288 9830Department of Occupational Science and Occupational Therapy, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC V6T 1Z3 Canada ,grid.498725.5Centre for Health Evaluation & Outcome Sciences, 588-1081 Burrard Street, Vancouver, BC V6Z 1Y6 Canada
| | - Guiping Liu
- grid.17091.3e0000 0001 2288 9830Centre for Health Services and Policy Research, 201- 2206 East Mall, Vancouver, BC V6T 1Z3 Canada
| | - Emilie Mallia
- Foundry, 915-1045 Howe Street, Vancouver, BC V6Z 2A9 Canada
| | - Nikki Ow
- Foundry, 915-1045 Howe Street, Vancouver, BC V6Z 2A9 Canada ,grid.17091.3e0000 0001 2288 9830Faculty of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC V6T 1Z3 Canada ,grid.17091.3e0000 0001 2288 9830Department of Occupational Science and Occupational Therapy, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC V6T 1Z3 Canada ,grid.498725.5Centre for Health Evaluation & Outcome Sciences, 588-1081 Burrard Street, Vancouver, BC V6Z 1Y6 Canada
| | - Krista Glowacki
- Foundry, 915-1045 Howe Street, Vancouver, BC V6Z 2A9 Canada ,grid.17091.3e0000 0001 2288 9830Faculty of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC V6T 1Z3 Canada ,grid.17091.3e0000 0001 2288 9830Department of Occupational Science and Occupational Therapy, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC V6T 1Z3 Canada ,grid.498725.5Centre for Health Evaluation & Outcome Sciences, 588-1081 Burrard Street, Vancouver, BC V6Z 1Y6 Canada
| | - Katherine G. Hastings
- Foundry, 915-1045 Howe Street, Vancouver, BC V6Z 2A9 Canada ,grid.17091.3e0000 0001 2288 9830Faculty of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC V6T 1Z3 Canada ,grid.17091.3e0000 0001 2288 9830School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3 Canada
| | - Steve Mathias
- Foundry, 915-1045 Howe Street, Vancouver, BC V6Z 2A9 Canada ,grid.17091.3e0000 0001 2288 9830Faculty of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC V6T 1Z3 Canada ,grid.498725.5Centre for Health Evaluation & Outcome Sciences, 588-1081 Burrard Street, Vancouver, BC V6Z 1Y6 Canada ,grid.17091.3e0000 0001 2288 9830Department of Psychiatry, University of British Columbia, 2255 Wesbrook Mall, Vancouver, BC V6T 2A1 Canada
| | - Jason M. Sutherland
- grid.17091.3e0000 0001 2288 9830Faculty of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC V6T 1Z3 Canada ,grid.498725.5Centre for Health Evaluation & Outcome Sciences, 588-1081 Burrard Street, Vancouver, BC V6Z 1Y6 Canada ,grid.17091.3e0000 0001 2288 9830Centre for Health Services and Policy Research, 201- 2206 East Mall, Vancouver, BC V6T 1Z3 Canada ,grid.17091.3e0000 0001 2288 9830School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3 Canada
| | - Skye Barbic
- Foundry, 915-1045 Howe Street, Vancouver, BC V6Z 2A9 Canada ,grid.17091.3e0000 0001 2288 9830Faculty of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC V6T 1Z3 Canada ,grid.17091.3e0000 0001 2288 9830Department of Occupational Science and Occupational Therapy, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC V6T 1Z3 Canada ,grid.498725.5Centre for Health Evaluation & Outcome Sciences, 588-1081 Burrard Street, Vancouver, BC V6Z 1Y6 Canada
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20
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Johnson ME, Rigg KK, Vroom EB, Akbari Z, Bristol SC. Racial/Ethnic Differences in the Effects of Adverse Childhood Experiences on Substance Misuse among Justice-Involved Children. Subst Use Misuse 2022; 58:54-65. [PMID: 36469650 PMCID: PMC9975643 DOI: 10.1080/10826084.2022.2148477] [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] [Indexed: 12/12/2022]
Abstract
Background: Adverse childhood experiences (ACEs) are linked to substance use (SU) and substance use disorders (SUD). However, this relationship has yet to be tested among justice-involved children (JIC), and it is unclear if racial/ethnic differences exist. This study aimed to determine: (1) whether ACEs are associated with increased risk of SU and SUD among JIC; and (2) if the effects of ACEs on SU and SUD are moderated by race/ethnicity. Methods: Bivariate and multivariate logistic regression analyses were employed to examine a statewide dataset of 79,960 JIC from the Florida Department of Juvenile Justice. Marginal odds were estimated to examine how race moderates the relationship between ACEs and SU and SUD. Results: Results showed higher ACEs scores were linked to SU and SUD. Black JIC were 2.46 times more likely, and Latinx JIC were 1.40 times more likely to report SU than white JIC. Specifically, Black and Latinx JIC with a higher average ACEs score were more likely to report SU but less likely to have ever been diagnosed with a SUD when compared to white JIC with equivalent ACEs. Conclusions: Study results highlight the need to develop trauma-informed and culturally appropriate interventions for SU and SUD among JIC.
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Affiliation(s)
- Micah E. Johnson
- Substance Misuse and Addiction Research Traineeship (SMART), Department of Mental Health Law and Policy, College of Behavioral and Community Sciences, University of South Florida, Tampa, Florida, USA
| | - Khary K. Rigg
- Department of Mental Health Law and Policy, College of Behavioral and Community Sciences, University of South Florida, Tampa, Florida, USA
| | - Enya B. Vroom
- Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Zahra Akbari
- Department of Economics, Martha and Spencer Love School of Business, Elon University, Elon, North Carolina, USA
| | - Skye C. Bristol
- Substance Misuse and Addiction Research Traineeship (SMART), Department of Mental Health Law and Policy, College of Behavioral and Community Sciences, University of South Florida, Tampa, Florida, USA
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21
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Campisi SC, Ataullahjan A, Baxter JAB, Szatmari P, Bhutta ZA. Mental health interventions in adolescence. Curr Opin Psychol 2022; 48:101492. [PMID: 36347181 DOI: 10.1016/j.copsyc.2022.101492] [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: 05/04/2022] [Revised: 09/23/2022] [Accepted: 10/06/2022] [Indexed: 01/28/2023]
Abstract
Adolescent mental health (MH) disorders with striking prominence include anxiety, self-harm and depression. The current review aims to highlight high-quality reviews of novel interventions, mainly Cochrane reviews, and/or quality meta-analyses published between 2019 and 2022 on three adolescent mental health challenges. Recent evidence about the effectiveness of psychosocial interventions is encouraging. However, the shift to virtual treatment methods during the pandemic was supported by a relatively thin body of research. Future research and policy in child and youth MH must address the consequences of the pandemic or comparable disruptions on adolescent MH, as well as mitigation strategies. An emphasis on integrated digital, community and school platforms for mental health within child and adolescent health services would benefit from a greater focus on early recognition and prevention.
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Affiliation(s)
- Susan C Campisi
- Department of Psychiatry, Hospital for Sick Children, 555 University Avenue, Burton Wing, Toronto, ON M5G 1X8, Canada
| | - Anushka Ataullahjan
- Centre for Global Child Health, Hospital for Sick Children; 686 Bay Street, 11th Floor, Suite 11.9805, Toronto, ON, M5G 0A4. Canada
| | - Jo-Anna B Baxter
- Centre for Global Child Health, Hospital for Sick Children; 686 Bay Street, 11th Floor, Suite 11.9805, Toronto, ON, M5G 0A4. Canada
| | - Peter Szatmari
- Department of Psychiatry, Hospital for Sick Children, 555 University Avenue, Burton Wing, Toronto, ON M5G 1X8, Canada; Cundill Centre for Child and Youth Depression, Centre for Addiction, and Mental Health, 80 Workman Way, Toronto, ON - M6J 1H4. Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, 250 College Street, 8th Floor, Toronto, Ontario M5T 1R8. Canada
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, Hospital for Sick Children; 686 Bay Street, 11th Floor, Suite 11.9805, Toronto, ON, M5G 0A4. Canada; Centre of Excellence in Women, and Child Health, Aga Khan University, Stadium Road, PO Box 3500, Karachi, Pakistan. 74800.
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22
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Hinckley JD, Danielson CK. Elucidating the Neurobiologic Etiology of Comorbid PTSD and Substance Use Disorders. Brain Sci 2022; 12:brainsci12091166. [PMID: 36138902 PMCID: PMC9496654 DOI: 10.3390/brainsci12091166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/23/2022] [Accepted: 08/29/2022] [Indexed: 11/26/2022] Open
Abstract
Early childhood maltreatment and other traumatic event experiences ("trauma") are common among youth, including those with substance use problems including substance use disorders (SUD). Particularly, interpersonal violence is associated with high rates of comorbidity between posttraumatic stress disorder (PTSD) and SUD, and these comorbid disorders exhibit high levels of overlapping symptomatology. Theoretical models proposed to explain the bidirectional relationship between PTSD and SUD include the self-medication hypothesis and susceptibility hypothesis. In this article, we explore neurobiologic changes associated with trauma, PTSD, and SUD that underly dysregulated stress response. Examining lessons learned from recent translational and clinical research, we propose that further elucidating the neurobiologic etiology of comorbid PTSD and SUD will require a collaborative, interdisciplinary approach, including the integration of preclinical and clinical studies, exploration of biologic markers in clinical studies, and accumulation of larger studies and longitudinal studies with the power to study PTSD and SUD. Such research can transform the field and ultimately reduce high rates and costly impairment of co-occurring PTSD and SUD across the lifespan.
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Affiliation(s)
- Jesse D. Hinckley
- Division of Addiction Science, Treatment & Prevention, Department of Psychiatry, University of Colorado School of Medicine, 1890 N Revere Court, MS-F570, Aurora, CO 80045, USA
- Correspondence:
| | - Carla Kmett Danielson
- National Crime Victims Research & Treatment Center, Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, 67 President Street, MSC 861, Charleston, SC 29425, USA
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23
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Cruz D, Lichten M, Berg K, George P. Developmental trauma: Conceptual framework, associated risks and comorbidities, and evaluation and treatment. Front Psychiatry 2022; 13:800687. [PMID: 35935425 PMCID: PMC9352895 DOI: 10.3389/fpsyt.2022.800687] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 06/27/2022] [Indexed: 11/17/2022] Open
Abstract
Children exposed to adverse childhood experiences (ACEs) and pervasive interpersonal traumas may go on to develop PTSD and, in most cases, will further undergo a significant shift in their developmental trajectory. This paper examines contemporary research on Developmental Trauma (DT), which is inextricably linked to disruptions in social cognition, physiological and behavioral regulation, and parent-child attachments. Developmental trauma associated with early experiences of abuse or neglect leads to multi-faceted and longstanding consequences and underscores critical periods of development, complex stress-mediated adaptations, and multilevel, trans-theoretical influences in the diagnostic formulation and treatment of traumatized children, adolescents, and adults. Psychological and medical correlates of Developmental Trauma Disorder are considered, and directions for future research are discussed.
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Affiliation(s)
- Daniel Cruz
- Hackensack Meridian Health Mountainside Medical Center, Montclair, NJ, United States
| | | | - Kevin Berg
- Hackensack Meridian Health Mountainside Medical Center, Montclair, NJ, United States
| | - Preethi George
- Hackensack Meridian Health Mountainside Medical Center, Montclair, NJ, United States
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24
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Hoffmann JP, Jones MS. Cumulative Stressors and Adolescent Substance Use: A Review of 21st-Century Literature. TRAUMA, VIOLENCE & ABUSE 2022; 23:891-905. [PMID: 33345723 DOI: 10.1177/1524838020979674] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The aim of this review is to assess empirical studies from the last 2 decades that have examined the association between cumulative stressors and adolescent substance use. Cumulative stressors were measured in these studies with adverse childhood experiences or adolescent stressful life events inventories. The 109 articles meeting the eligibility criteria that emerged from the review demonstrated a consistent, yet modest, association between cumulative stressors and adolescent substance use. Of note, several studies found that the associations were moderated or mediated by genetic factors related to cortisol regulation, intrapersonal factors such as low self-control, or interpersonal factors such as peer substance use. The review's findings thus suggest that efforts to reduce the effects of cumulative stressors on substance use could gainfully identify and target these risk moderators and mediators.
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Affiliation(s)
- John P Hoffmann
- Department of Sociology, Brigham Young University, Provo, UT, USA
| | - Melissa S Jones
- Department of Sociology, Brigham Young University, Provo, UT, USA
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25
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Orengo-Aguayo R, Dueweke AR, Nicasio A, de Arellano MA, Rivera S, Cohen JA, Mannarino AP, Stewart RW. Trauma-focused cognitive behavioral therapy with Puerto Rican youth in a post-disaster context: Tailoring, implementation, and program evaluation outcomes. CHILD ABUSE & NEGLECT 2022; 129:105671. [PMID: 35580399 DOI: 10.1016/j.chiabu.2022.105671] [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: 10/23/2021] [Revised: 03/23/2022] [Accepted: 05/08/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) has not yet been systematically evaluated in the Caribbean context, particularly with Hispanic youth exposed to multiple disasters. The objective of this project was twofold: 1) to train mental health providers in Puerto Rico in TF-CBT as part of a clinical implementation project within the largest managed behavioral health organization (MBHO) on the island, and 2) to conduct a program evaluation to determine the feasibility of implementation and the effectiveness of the treatment. METHOD Fifteen psychologists were trained in TF-CBT. These psychologists then provided TF-CBT to 56 children and adolescents, ages 5-18, in community-based mental health clinics and one primary care clinic with a co-located psychologist in Puerto Rico. The mean number of traumatic events reported by youth referred for TF-CBT was 4.11. RESULTS Thirty-six out of 56 children enrolled in the project (64.3%) successfully completed all components of TF-CBT. Results demonstrated large effect sizes for reduction in youth-reported posttraumatic stress symptoms (PTSS) (Cohen's d = 1.32), depressive symptoms (Cohen's d = 1.32), and anxiety symptoms (Cohen's d = 1.18). CONCLUSIONS These results suggest that it was feasible to train providers in TF-CBT, that providers were able to deliver TF-CBT in community-based settings both in person and via telehealth (due to the COVID-19 pandemic), and that TF-CBT was an effective treatment option to address trauma-related concerns for youth in Puerto Rico in a post-disaster context. This project is an important first step in the dissemination and implementation of evidence-based trauma-focused treatment for Hispanic youth and disaster-affected youth in the Caribbean.
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Affiliation(s)
| | | | | | | | - Susana Rivera
- Serving Children and Adults in Need (SCAN) Inc., United States of America
| | | | | | - Regan W Stewart
- Medical University of South Carolina, United States of America
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26
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Hoover LV, Yu HP, Duval ER, Gearhardt AN. Childhood trauma and food addiction: The role of emotion regulation difficulties and gender differences. Appetite 2022; 177:106137. [PMID: 35738482 DOI: 10.1016/j.appet.2022.106137] [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: 03/18/2022] [Revised: 06/09/2022] [Accepted: 06/11/2022] [Indexed: 11/02/2022]
Abstract
OBJECTIVE Childhood trauma has been associated with substance use disorders (SUDs), but less research has investigated its association with food addiction (i.e., compulsive intake of highly processed foods containing refined carbohydrates and/or added fat). Existing research on childhood trauma and food addiction has focused primarily on women from restricted samples. Further, emotion dysregulation difficulties are implicated in both childhood trauma and food addiction, but research has not explored whether it may play a mediating role. METHOD Thus, the current study utilizes a sample of 310 participants recruited from Amazon Mechanical Turk (mean age = 41.3 years old, 47.4% men, 78.7% white) to investigate the mediating role of emotion dysregulation in the association between childhood trauma and food addiction. We also conducted exploratory analyses to investigate for gender differences in these associations. Gender-stratified correlational matrixes were conducted to investigate association between childhood trauma, food addiction, and emotional dysregulation. Moderated mediation models and multilevel regressions were also conducted to identify the role of gender in the association between childhood trauma, food addiction, and emotion dysregulation. RESULTS Emotion dysregulation was found to partially mediate the associations between food addiction and childhood trauma and gender was found to moderate associations between childhood trauma and emotion dysregulation, as well as childhood trauma and food addiction. Both moderating pathways were significantly stronger for men compared to women. DISCUSSION Results suggests that emotion dysregulation may be one important mediator in the association between childhood trauma and food addiction, particularly for men. The identification of other potential mechanisms contributing to the association between childhood trauma and food addiction and the use of longitudinal measurement strategies will be important in future research.
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Affiliation(s)
- Lindzey V Hoover
- Department of Psychology, University of Michigan, Ann Arbor, USA.
| | - Hayley P Yu
- Department of Psychology, University of Michigan, Ann Arbor, USA
| | - Elizabeth R Duval
- Department of Psychology, University of Michigan, Ann Arbor, USA; Department of Psychiatry, University of Michigan, Ann Arbor, USA
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27
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Yüksel BC, Mortan Sevi O. Substance use-related factors and psychosocial characteristics among Turkish adults with early- and late-onset substance use disorder. J Ethn Subst Abuse 2022; 23:128-149. [PMID: 35678296 DOI: 10.1080/15332640.2022.2075514] [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] [Indexed: 10/18/2022]
Abstract
The onset of substance use is a strong predictor of substance use disorders and related problems. This study examined the differences between early- and late-onset substance use in personality and substance use characteristics, traumatic experiences, and social support with a sample of 100 Turkish adults with substance use disorders. Early onset (<18 years) was associated with more traumatic experiences, increased risk of developing posttraumatic stress disorder (PTSD), and higher levels of depressive symptoms compared to late onset (≥18 years). Also, depressive symptoms, living, and working status were predictors of substance use onset. The study addresses the groups at risk of initiating substance use.
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28
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The Interaction Effect of Parental Rejection and Oxytocin Receptor Gene Polymorphism on Depression: A Cross-Cultural Study in Non-Clinical Samples. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095566. [PMID: 35564961 PMCID: PMC9105151 DOI: 10.3390/ijerph19095566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/28/2022] [Accepted: 04/29/2022] [Indexed: 12/10/2022]
Abstract
Parental rejection has been consistently empirically implicated in a wide array of developmental, behavioural and psychological problems worldwide. However, the interaction effect between parental rejection in childhood and the oxytocin receptor genotype on psychological adjustment has yet to be investigated. The present study aimed to investigate gene–environment interaction effects between parental rejection (maternal and paternal) and oxytocin receptor (OXTR) gene polymorphisms (rs53576 and rs2254298) on depressive symptoms in adults in different cultural contexts. Adults from Italy and Japan (N = 133, age = 18–27 years, females = 68) were preliminarily genotyped and then completed the Parental Acceptance-Rejection Questionnaire for mothers and fathers and the Beck Depression Inventory. Hierarchical multiple regression analysis showed that paternal rejection was related to self-reported depression and that the effect of parental rejection was moderated by OXTR gene polymorphisms and nationality. Among Italians, OXTR rs2254298 A-carriers showed resilience to negative early parental care, whereas among Japanese, OXTR rs53576 non-A-carriers showed resistance to negative early paternal care. These findings align with expected relations between perceived acceptance–rejection and an individual’s psychological adjustment, as proposed by interpersonal acceptance–rejection theory, and indicate the need for future studies adopting a multicultural and multilevel approach to better understand how the effects of parental rejection extend into adulthood.
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29
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Hyland P, Karatzias T, Ford JD, Fox R, Spinazzola J. The Latent Structure of Child and Adolescent Psychopathology and its Association with Different Forms of Trauma and Suicidality and Self-Harm : LATENT STRUCTURE OF PSYCHOPATHOLOGY. Res Child Adolesc Psychopathol 2022; 50:1501-1513. [PMID: 35476235 PMCID: PMC9616783 DOI: 10.1007/s10802-022-00925-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2022] [Indexed: 11/24/2022]
Abstract
The Hierarchical Taxonomy of Psychopathology (HiTOP) is a multidimensional and hierarchical model of the latent structure of psychopathology. While HiTOP has received much support in child/adolescent community samples, fewer studies have assessed this model in clinical samples of children/adolescents. Here, we modelled the latent structure of 45 symptoms of psychopathology from a clinical sample of children/adolescents and assessed how dimensions of psychopathology were related to specific forms of trauma and suicidality/self-harm. Clinician-derived assessments were obtained from 507 people aged 7-18 years. Confirmatory factor analysis was used to determine the optimal fitting model, and structural equation modelling was used to estimate associations with trauma exposure and suicidality/self-harm. The best fitting model(s) included five first-order factors reflecting Fear, Distress, Externalizing, Thought Disorder, and Traumatic Stress, with a higher-order general factor (p) accounting for the covariation between these factors. Unique associations were identified between specific forms of trauma and each dimension of psychopathology. p was strongly associated with suicidality/self-harm, and of the first-order factors, Distress was most strongly associated with suicidality/self-harm. Findings support the predictions of HiTOP that the latent structure of child/adolescent psychopathology can be effectively described by a multidimensional and hierarchal model. Moreover, we found tentative evidence for a unique dimension of Traumatic Stress psychopathology. Our findings also highlight the unique associations between specific forms of early life trauma and specific dimensions of psychopathology, and the importance of Distress related psychopathology for suicidality/self-harm in children and adolescents.
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Affiliation(s)
- Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland.
| | - Thanos Karatzias
- Department of Psychology, Edinburgh Napier University, Edinburgh, Scotland
| | - Julian D Ford
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Robert Fox
- School of Business, National College of Ireland, Dublin, Ireland
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30
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Trapp NT, Martyna MR, Siddiqi SH, Bajestan SN. The Neuropsychiatric Approach to the Assessment of Patients in Neurology. Semin Neurol 2022; 42:88-106. [PMID: 35477181 PMCID: PMC9177704 DOI: 10.1055/s-0042-1745741] [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] [Indexed: 10/18/2022]
Abstract
Neuropsychiatry is a clinical neuroscience specialty focused on the evaluation and treatment of patients who present with symptoms at the intersection of neurology and psychiatry. Neuropsychiatrists assess and manage the cognitive, affective, behavioral, and perceptual manifestations of disorders of the central nervous system. Although fellowship training in behavioral neurology-neuropsychiatry exists in the United States and several other countries internationally, the need for neuropsychiatric expertise greatly outweighs the number of specialists in practice or training. This article serves as a primer for both neurologists and psychiatrists seeking to improve or refresh their knowledge of the neuropsychiatric assessment, including detailing aspects of the history-taking, physical exam, psychometric testing, and associated diagnostic work-up. In doing so, we urge the next generation of neurologists and psychiatrists to take on both the opportunity and challenge to work at the intersection of both clinical neuroscience specialties using an integrated neuropsychiatric perspective.
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Affiliation(s)
- Nicholas T. Trapp
- Stanford University Department of Psychiatry and Behavioral Sciences, Stanford, CA, USA
- University of Iowa Department of Psychiatry, Iowa City, IA, USA
| | - Michael R. Martyna
- Stanford University Department of Psychiatry and Behavioral Sciences, Stanford, CA, USA
- University of Alberta Department of Psychiatry, Edmonton, AB, CAN
| | - Shan H. Siddiqi
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Sepideh N. Bajestan
- Stanford University Department of Psychiatry and Behavioral Sciences, Stanford, CA, USA
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31
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Mirkazemi R, Ranjbar M, Hamelmann C, Omidmorad A, Hajebi A. Developing a tool to measure substance use and the associated factors among children. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2022.2047803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Roksana Mirkazemi
- Founder and Managing Director of Farzanegan Nik Andish Institute for the Development of Knowledge and Technology, Tehran, Iran
| | - Mansour Ranjbar
- National Professional Officer, NCD and Mental Health Unit Head, World Health Organization Country Office, Tehran, Iran
| | | | - Afsaneh Omidmorad
- National Consultant, World Health Organization Country Office, Tehran, Iran
| | - Ahmad Hajebi
- Research Center for Addiction and Risky Behaviors (ReCARB), Psychiatric Department, Iran University of Medical Sciences, Tehran, Iran
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32
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Brammer WA, Conn BM, Iverson E, Lankenau SE, Dodson C, Wong CF. Coping Motives Mediate the Association of Trauma History with Problematic Cannabis Use in Young Adult Medical Cannabis Patients and Non-Patient Cannabis Users. Subst Use Misuse 2022; 57:684-697. [PMID: 35193442 PMCID: PMC11148629 DOI: 10.1080/10826084.2022.2026970] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Background: Despite evidence of the contribution of childhood trauma to the development of problematic cannabis use, its mediating pathways are largely unknown. Given the link between cannabis motives with trauma and problematic cannabis use, motives of use may represent a construct through which trauma impacts problematic cannabis use. Methods: A sample of 339 medical cannabis patient and non-patient young adult users from the Los Angeles area were sampled at baseline and one year later. The current study examined the impact of childhood trauma on problematic use through a variety of cannabis use motives. Results: Controlling for age, socioeconomic status, perceived stress, and baseline problematic use, endorsing the use of cannabis to cope with distress at baseline uniquely mediated the associations between different childhood trauma types (e.g., physical abuse, neglect, sexual trauma) and problematic use one year later. Experience of any childhood trauma was positively associated with coping motives, whereas emotional and physical abuse were positively associated with pain motives, and sexual abuse was positively associated with sleep motives. Using cannabis for coping and increasing attention/focus were also positively associated with higher problematic use, whereas using cannabis for sleep was inversely associated with problematic use one year later. Conclusions: The motives of coping with distress and inattention may represent intermediate constructs through which trauma leads to later problematic cannabis use. Results highlight the need to clarify the pathways between health and non-health-oriented motives and cannabis use over time.
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Affiliation(s)
- Whitney A Brammer
- Division of Adolescent and Young Adult Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Bridgid M Conn
- Division of Adolescent and Young Adult Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA
- Keck School of Medicine, Department of Pediatrics, University of Southern California, Los Angeles, California, USA
| | - Ellen Iverson
- Division of Adolescent and Young Adult Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA
- Keck School of Medicine, Department of Pediatrics, University of Southern California, Los Angeles, California, USA
| | - Stephen E Lankenau
- Dornsife School of Public Health, Department of Community Health and Prevention, Drexel University, Philadelphia, Pennsylvania, USA
| | - Chaka Dodson
- Division of Adolescent and Young Adult Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Carolyn F Wong
- Division of Adolescent and Young Adult Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA
- Keck School of Medicine, Department of Pediatrics, University of Southern California, Los Angeles, California, USA
- Division of Research on Children, Youth, & Families, Children's Hospital Los Angeles, Los Angeles, California, USA
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33
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Panagou C, MacBeth A. Deconstructing pathways to resilience: A systematic review of associations between psychosocial mechanisms and transdiagnostic adult mental health outcomes in the context of adverse childhood experiences. Clin Psychol Psychother 2022; 29:1626-1654. [PMID: 35266603 PMCID: PMC9790303 DOI: 10.1002/cpp.2732] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 03/02/2022] [Accepted: 03/07/2022] [Indexed: 12/30/2022]
Abstract
Adverse childhood experiences (ACEs) are identified with increased risk of adult mental health difficulties and negative impacts on well-being. However, there is a need to go beyond simple associations and identify candidate mechanisms underpinning the ACEs-mental health relationship. Further methodological heterogeneity points to issues around the operationalization of ACEs and the importance of modelling data using robust research designs. The aim of the current review was to synthesize studies that utilized formal mediation and/or moderation analyses to explore psychological and social variables on the pathway between clearly defined ACEs (as measured by the ACE questionnaire and Childhood Trauma Questionnaire [CTQ]) and common mental health outcomes (depressive, anxiety and post-traumatic stress disorder [PTSD] symptoms) across community samples aged over 18. A total of 31 papers were retrieved for critical appraisal. The majority of the studies explored factors mediating/moderating the link between child adversity and depression and less on anxiety and trauma. Most mechanisms were tested in only single studies, limiting the consistency of evidence. Evidence indicated that the mechanisms underlying associations between ACEs and adult mental health are likely to reflect multiple intervening variables. Further, there are substantial methodological limitations in the extant literature including the proliferation of causal inferences from cross-sectional designs and both measurement and conceptual issues in operationalizing adversity. Consistent transdiagnostic mechanisms relevant to common mental health problems were identified, including perceived social support, emotion regulation and negative cognitive appraisals/beliefs. Further research using longitudinal design is required to delineate the potential contribution of the identified mechanisms.
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Affiliation(s)
- Corinna Panagou
- School of Health in Social ScienceUniversity of EdinburghEdinburghEH8 9AGUK
| | - Angus MacBeth
- School of Health in Social ScienceUniversity of EdinburghEdinburghEH8 9AGUK
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34
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Neural Underpinnings of Social Stress in Substance Use Disorders. Curr Top Behav Neurosci 2022; 54:483-515. [PMID: 34971448 DOI: 10.1007/7854_2021_272] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Drug addiction is a complex brain disorder that is characterized by craving, withdrawal, and relapse, which can be perpetuated by social stress. Stemming from an acute life event, chronic stress, or trauma in a social context, social stress has a major role in the initiation and trajectory of substance use. Preclinical literature shows that early life stress exposure and social isolation facilitate and enhance drug self-administration. Epidemiological evidence links childhood adversity to increased risk for drug use and demonstrates that cumulative stress experiences are predictive of substance use severity in a dose-dependent manner. Stress and drug use induce overlapping brain alterations leading to downregulation or deficits in brain reward circuitry, thereby resulting in greater sensitization to the rewarding properties of drugs. Though stress in the context of addiction has been studied at the neural level, a gap in our understanding of the neural underpinnings of social stress in humans remains. METHODS We conducted a systematic review of in vivo structural and functional neuroimaging studies to evaluate the neural processes associated with social stress in individuals with substance use disorder. Results were considered in relation to participants' history of social stress and with regard to the effects of social stress induced during the neuroimaging paradigm. RESULTS An exhaustive search yielded 21 studies that matched inclusion criteria. Social stress induces broad structural and functional neural effects in individuals with substance use disorder throughout their lifespan and across drug classes. A few patterns emerged across studies: (1) many of the brain regions altered in individuals who were exposed to chronic social stress and during acute stress induction have been implicated in addiction networks (including the prefrontal cortex, insula, hippocampus, and amygdala); (2) individuals with childhood maltreatment and substance use history had decreased gray matter or activation in regions of executive functioning (including the medial prefrontal cortex, orbitofrontal cortex, anterior cingulate cortex), the hippocampal complex, and the supplementary motor area; and (3) during stress-induction paradigms, activation in the anterior cingulate cortex, caudate, and amygdala was most commonly observed. CONCLUSIONS/IMPLICATIONS A distinct overlap is shown between social stress-related circuitry and addiction circuitry, particularly in brain regions implicated in drug-seeking, craving, and relapse. Given the few studies that have thoroughly investigated social stress, the evidence accumulated to date needs to be replicated and extended, particularly using research designs and methods that disentangle the effects of substance use from social stress. Future clinical studies can leverage this information to evaluate the impact of exposure to trauma or adverse life events within substance use research. Expanding knowledge in this emerging field could help clarify neural mechanisms underlying addiction risk and progression to guide causal-experimental inquiry and novel prevention and treatment strategies.
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35
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Connors EH, Prout J, Vivrette R, Padden J, Lever N. Trauma-Focused Cognitive Behavioral Therapy in 13 Urban Public Schools: Mixed Methods Results of Barriers, Facilitators, and Implementation Outcomes. SCHOOL MENTAL HEALTH 2021; 13:772-790. [PMID: 34925633 DOI: 10.1007/s12310-021-09445-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Trauma-focused cognitive behavioral therapy (TF-CBT) is an evidence-based intervention to treat Post-traumatic Stress Disorder among youth ages 3-18 years. In this pilot study, 31 clinicians in 13 urban public schools received TF-CBT training to improve access to a high-quality trauma treatment for youth in need. A mixed methods design was used to assess implementation barriers, facilitators and outcomes to examine initial feasibility, acceptability, and appropriateness of TF-CBT delivered in school settings. Although 70% of clinicians reported confidence in the evidence-base of TF-CBT and its potential to support their students who have a very high prevalence of lifetime trauma exposure, implementation practice outcomes suggest a wide range of TF-CBT use (Range = 0 to 11 students enrolled per clinician, Mean = 1.4 students) with 23 clinicians implementing the TF-CBT model with at least one case. Results point to the potential value of training school mental health clinicians in TF-CBT based on its compatibility with student needs. Yet, by connecting focus group results to top-rated barriers and facilitators, we identify several adjustments that should be made to improve intervention-setting fit in future studies. Specifically, school setting-specific intervention adaptations, school-tailored implementation support and thoughtful consideration of school-based clinicians' roles and responsibilities are needed to enhance future implementation success.
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Affiliation(s)
- E H Connors
- Department of Psychiatry, Yale University, 389 Whitney Avenue, Office 106, New Haven, CT 06511, USA.,National Center for School Mental Health, Division of Child and Adolescent Psychiatry, University of Maryland School of Medicine, 737 West Lombard Street, 4 Floor, Baltimore, MD, 21201, USA
| | - J Prout
- National Center for School Mental Health, Division of Child and Adolescent Psychiatry, University of Maryland School of Medicine, 737 West Lombard Street, 4 Floor, Baltimore, MD, 21201, USA
| | - R Vivrette
- National Center for School Mental Health, Division of Child and Adolescent Psychiatry, University of Maryland School of Medicine, 737 West Lombard Street, 4 Floor, Baltimore, MD, 21201, USA.,Child Trends, 7315 Wisconsin Avenue Suite 1200, Bethesda, MD, 20814, USA
| | - J Padden
- Advanced Studies, Leadership and Policy, School of Education & Urban Studies, Morgan State University, 1700 East Cold Spring Lane, Baltimore, MD 21251, USA
| | - N Lever
- National Center for School Mental Health, Division of Child and Adolescent Psychiatry, University of Maryland School of Medicine, 737 West Lombard Street, 4 Floor, Baltimore, MD, 21201, USA
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Rojas-Jara C, Polanco-Carrasco R, Caycho-Rodríguez T, Acuña-Espinoza R, González-Serrano C, Roa-Méndez P, Rojas-Román A, Sepúlveda-López MA. Experiencias adversas en la infancia y el uso de drogas en la adolescencia y adultez: un análisis de la evidencia. UNIVERSITAS PSYCHOLOGICA 2021. [DOI: 10.11144/javeriana.upsy20.eaiu] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
El objetivo de este estudio es la revisión de la evidencia actual sobre la relación entre la vivencia de experiencias adversas en la infancia y el posterior uso de drogas en la adolescencia y adultez, y sus características. La metodología utilizada fue una revisión sistemática de publicaciones científicas, entre el periodo 2013-2017, disponibles en la base de datos Scopus sobre experiencias adversas en la infancia y el uso de drogas en la adolescencia y adultez que arrojó un total de 69 publicaciones incluidas en el estudio. Las experiencias adversas en la infancia presentan una elevada relación con el uso y/o abuso de drogas en la adolescencia y adultez. El consumo de drogas en adolescentes y adultos expuestos a experiencias traumáticas en la infancia se da principalmente en hombres. Las drogas mayormente usadas son alcohol, tabaco, cannabis y fármacos no recetados y, en menor medida, opioides, cocaína y anfetaminas. Las drogas, en este sentido, cumplen el rol de barrera química para distanciar el dolor emocional que deriva del recuerdo de las experiencias traumáticas y su intensa carga psíquica. Se requieren acciones de promoción del buen trato en la infancia, así como el abordaje terapéutico temprano de niños expuestos a experiencias traumáticas.
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Paquin V, Muckle G, Bolanis D, Courtemanche Y, Castellanos-Ryan N, Boivin M, Tremblay R, Côté S, Geoffroy MC. Longitudinal Trajectories of Food Insecurity in Childhood and Their Associations With Mental Health and Functioning in Adolescence. JAMA Netw Open 2021; 4:e2140085. [PMID: 34928352 PMCID: PMC8689386 DOI: 10.1001/jamanetworkopen.2021.40085] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
IMPORTANCE Household food insecurity has been associated with mental health problems in children independently of family income and other confounders. It is unclear whether food insecurity during childhood is also associated with mental health and functioning during adolescence. OBJECTIVE To evaluate longitudinal trajectories of household food insecurity during the first 13 years of life, characteristics associated with these trajectories, and the associations of the trajectories with externalizing, internalizing, substance use, and social adjustment problems at 15 years of age. DESIGN, SETTING, AND PARTICIPANTS This cohort study included participants from the Québec Longitudinal Study of Child Development, a cohort of 2120 children born in Québec, Canada, in 1997 and 1998 and followed up annually or biannually from 5 months to 15 years of age (1998-2013). Data were analyzed from November 2020 to October 2021. EXPOSURES When children were aged 1.5, 4, 8, 10, 12, and 13 years, mothers reported whether a family member experienced hunger because the family had run out of food or money to buy food in the past 12 months. MAIN OUTCOMES AND MEASURES Group-based trajectory modeling was used to identify differential exposure to food insecurity from 1.5 to 13 years according to logit functions of age. At 15 years of age, adolescents completed validated questionnaires assessing externalizing, internalizing, substance use, and social adjustment problems. Associations between trajectories of food insecurity and outcomes were assessed using linear regressions. RESULTS A total of 2032 individuals were included in the analyses of trajectories of food insecurity (1026 [50.5%] male) and 1441 in the analysis of the association with outcomes at 15 years of age (752 [52.2%] female). Two trajectories of food insecurity were identified between 1.5 and 13 years of age: high risk (73 children [3.6%]) and low risk (1959 children [96.4%]). At 5 months, the high-risk and low-risk groups differed in household characteristics including income insufficiency (58 [80.6%] vs 405 [21.0%]), single parenthood (21 [29.2%] vs 135 [6.9%]), and parental history of depression (mothers: 30 [43.5%] vs 411 [21.7%]; fathers: 12 [32.4%] vs 209 [13.5%]). The high-risk trajectory from 1.5 to 13 years of age was associated with cannabis use (β, 0.47; 95% CI, 0.12-0.81), peer bullying (β, 0.43; 95% CI, 0.08-0.77), and dropout potential (β, 0.38; 95% CI, 0.03-0.68) at 15 years of age after adjustment for sex, household income insufficiency, and parental mental health. CONCLUSIONS AND RELEVANCE In this cohort study, few children experienced a persistent high risk of food insecurity, which was associated with psychosocial problems later in adolescence after adjustment for confounders including low income. Early identification of risk for food insecurity may guide the delivery of tailored interventions to improve functioning in adolescence.
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Affiliation(s)
- Vincent Paquin
- McGill Group for Suicide Studies, Department of Psychiatry, Douglas Mental Health University Institute, Montreal, Québec, Canada
| | - Gina Muckle
- School of Psychology, Laval University, Québec City, Québec, Canada
- Centre Hospitalier Universitaire de Québec, Laval University Research Center, Québec City, Québec, Canada
| | - Despina Bolanis
- McGill Group for Suicide Studies, Department of Psychiatry, Douglas Mental Health University Institute, Montreal, Québec, Canada
- Department of Educational and Counselling Psychology, McGill University, Montreal, Québec, Canada
| | - Yohann Courtemanche
- Centre Hospitalier Universitaire de Québec, Laval University Research Center, Québec City, Québec, Canada
| | - Natalie Castellanos-Ryan
- Department of Psychology, University of Montreal, Montreal, Québec, Canada
- Centre Hospitalier Universitaire Sainte-Justine Research Centre, Montreal, Québec, Canada
| | - Michel Boivin
- School of Psychology, Laval University, Québec City, Québec, Canada
| | - Richard Tremblay
- Department of Psychology, University of Montreal, Montreal, Québec, Canada
- Centre Hospitalier Universitaire Sainte-Justine Research Centre, Montreal, Québec, Canada
| | - Sylvana Côté
- Centre Hospitalier Universitaire Sainte-Justine Research Centre, Montreal, Québec, Canada
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Québec, Canada
- INSERM 1219 Bordeaux Population Health, Bordeaux, France
| | - Marie-Claude Geoffroy
- McGill Group for Suicide Studies, Department of Psychiatry, Douglas Mental Health University Institute, Montreal, Québec, Canada
- Department of Educational and Counselling Psychology, McGill University, Montreal, Québec, Canada
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Mantovani N, Smith J. A retrospective study examining the adverse effect of childhood abuse among adult psychiatric service users in Britain. Int J Ment Health Nurs 2021; 30:1093-1105. [PMID: 34515389 DOI: 10.1111/inm.12860] [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: 10/23/2020] [Revised: 02/01/2021] [Accepted: 02/25/2021] [Indexed: 11/30/2022]
Abstract
The long-term effects of childhood abuse have been well studied though the effects of abuse of specific types in adult psychiatric service users are less known. This study aimed to assess the association between childhood abuse and the development of harmful social and behavioural outcomes among adult psychiatric service users. Adult psychiatric service users were accessed from secondary mental health services in South London. A retrospective analysis was conducted of a randomly selected sample of 342 mental health records. Chi-square tests and logistic regression models were used to examine associations between childhood abuse - sexual abuse, physical abuse and psychological/emotional abuse - and health and behavioural outcomes. This study identified that 109 (31.8%) psychiatric service users had some history of childhood abuse and more often presented with high-risk or severe behaviours. Sexual abuse in childhood was linked with social isolation related to loss of friends (odds ratio (OR) = 2.68, P < 0.01), risky behaviours such as binge drinking (OR = 2.15, P < 0.05) and self-harming (OR = 2.86, P < 0.01), while childhood physical abuse was associated with drug abuse in adulthood (OR = 1.88, P < 0.05). Revictimization (adult domestic violence) also impacted on service users' quality of life in terms of loss of housing (OR = 2.21, P < 0.05) and loss of friends/family contact (OR = 2.73, P < 0.01). These findings suggest childhood abuse may play an important role in shaping risk and vulnerability for mental health problems across a lifespan. In acute mental health services, the incorporation of a trauma-informed nursing care model is necessary to generate a shift in culture in the delivery of care.
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Affiliation(s)
- Nadia Mantovani
- St George's University London, Population Health Research Institute, London, UK
| | - Jared Smith
- St George's University London, Population Health Research Institute, London, UK
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Stewart RW, Orengo-Aguayo R, Villalobos BT, Nicasio AV, Dueweke AR, Alto M, Cohen JA, Mannarino AP, de Arellano MA. Implementation of an Evidence-Based Psychotherapy for Trauma-Exposed Children in a Lower-Middle Income Country: the Use of Trauma-Focused Cognitive Behavioral Therapy in El Salvador. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2021; 14:433-441. [PMID: 34471458 PMCID: PMC8357881 DOI: 10.1007/s40653-020-00327-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/25/2020] [Indexed: 06/13/2023]
Abstract
Central American youth are at a high risk for experiencing trauma and related psychosocial problems. Despite this, few studies of evidence-based trauma-focused interventions with this population exist. The objective of this project was twofold: 1) to train providers in El Salvador in Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) as part of a clinical implementation project within a non-governmental organization, and 2) to conduct program evaluation to determine the feasibility of implementation and the effectiveness of the treatment. Fifteen Salvadoran psychologists were trained in TF-CBT who then provided TF-CBT to 121 children and adolescents ages 3-18 in community-based locations. The mean number of traumas reported by youth was 4.39. Results demonstrated large effect sizes for reduction in youth-reported trauma symptoms (Cohen's d = 2.04), depressive symptoms (Cohen's d = 1.68), and anxiety symptoms (Cohen's d = 1.67). Our program evaluation results suggest that it was feasible to train providers in TF-CBT, that providers were in turn able to deliver TF-CBT in community-based settings, and that TF-CBT was an effective treatment option to address trauma-related concerns for youth in El Salvador. This project is an important first step in the dissemination and implementation of evidence-based trauma-focused treatment for youth in Latin American countries.
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Affiliation(s)
- Regan W Stewart
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President St MSC 861, Charleston, SC 29425 USA
| | - Rosaura Orengo-Aguayo
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President St MSC 861, Charleston, SC 29425 USA
| | - Bianca T Villalobos
- Department of Psychological Sciences, University of Texas Rio Grande Valley, Brownsville, TX USA
| | - Andel V Nicasio
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President St MSC 861, Charleston, SC 29425 USA
| | - Aubrey R Dueweke
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President St MSC 861, Charleston, SC 29425 USA
| | - Michelle Alto
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President St MSC 861, Charleston, SC 29425 USA
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD USA
| | | | | | - Michael A de Arellano
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President St MSC 861, Charleston, SC 29425 USA
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Lapshina N, Stewart SL. Traumatic life events, polyvictimization, and externalizing symptoms in children with IDD and mental health problems. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 116:104028. [PMID: 34339937 DOI: 10.1016/j.ridd.2021.104028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 05/22/2021] [Accepted: 07/07/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND AND AIMS This study aims to examine the rates of potentially traumatic events (PTEs) and polyvictimization, as well as interrelationships among PTE types in children and youth with intellectual developmental disorder (IDD) and co-occurring mental health issues. It also examines the association between polyvictimization (experiencing three or more PTEs) and externalizing symptoms, controlling for IDD severity, sex and age. METHOD The study utilized archival data collected from 2012 to 2020 by trained assessors (e.g., nurses, social workers, psychologists) at intake into clinical mental health services in the Province of Ontario, Canada. The sample included 502 children and youth (age range: 4-18 years) who were assessed using the interRAI Child and Youth Mental Health and Developmental Disability (ChYMH-DD) instrument. Using this standardized assessment, trained clinicians reported on children's demographics, traumatic life events, and externalizing symptoms (proactive and reactive aggression) among other physical and mental health indicators. RESULTS 64.74 % of the children had experienced at least one type of PTE, whereas 33.06 % experienced lifetime polyvictimization. Most of the PTE types were positively correlated, with the strongest associations between physical, emotional abuse, witnessing domestic violence, and parental addiction. In a multivariate model, experiences of three or more PTEs (vs. none), mild or moderate IDD (vs. severe/profound), male sex (vs. female) were associated with greater externalizing symptoms. There was a quadratic relationship between age and externalizing symptoms. CONCLUSION The project advances knowledge on trauma and polyvictimization patterns and their association with IDD severity and externalizing symptoms in this population. Trauma-informed services should be tailored to the specific needs of these children.
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Childhood physical abuse and subsequent violent victimization among people who use illegal drugs in Vancouver, Canada. PLoS One 2021; 16:e0255875. [PMID: 34383806 PMCID: PMC8360372 DOI: 10.1371/journal.pone.0255875] [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: 10/28/2020] [Accepted: 07/26/2021] [Indexed: 11/19/2022] Open
Abstract
Background Violent victimization is common among people who use illegal drugs (PWUD) and is a source of significant health-related harm. However, little attention has been paid to how antecedent childhood trauma among PWUD may contribute to the risk of victimization in adulthood. Objective This study sought to examine the relationship between childhood physical abuse and victimization by physical assault among adult PWUD. Participants and setting Data were derived from three prospective cohorts of PWUD in Vancouver, Canada between 2005 and 2018. Methods Childhood physical abuse was assessed using the Childhood Trauma Questionnaire. Generalized linear mixed modeling was used to estimate the relationship between childhood physical abuse and subsequent violent victimization, after adjustment for potential confounders. Results Among 2960 PWUD, including 1018 (34.39%) female participants, 1030 (34.8%) participants reported a history of moderate to severe childhood physical abuse, and 949 (32.06%) participants reported recent violent victimization at baseline. In a multivariate analysis, childhood physical abuse (Adjusted Odds Ratio [AOR] = 1.34, 95% confidence interval [CI]: 1.23–1.46) remained independently associated with violent victimization after adjustment for potential confounders. Conclusions This study found a high prevalence of childhood physical abuse and that this was associated with a higher risk of subsequent violent victimization among PWUD in this setting. Greater support for PWUD with a history of childhood physical abuse is needed to decrease existing vulnerability to violence, including screening for and treatment of childhood trauma and related violence prevention.
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Berfield JB, Goncharenko S, Forkus SR, Contractor AA, Weiss NH. The differential relation of trauma types with negative and positive emotion dysregulation. ANXIETY STRESS AND COPING 2021; 35:425-439. [PMID: 34369816 DOI: 10.1080/10615806.2021.1964072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Background and Objectives: Research provides robust support for an association between traumatic exposure and emotion dysregulation. Less understood is the relation of emotion dysregulation stemming from positive emotions to traumatic exposure, or the extent to which negative and positive emotion dysregulation may be uniquely related to specific trauma types.Design and Methods: The present study explored the associations between negative and positive emotion dysregulation and specific trauma types in a community sample of 433 adults (M age = 43.81, 68.4% women).Results: Results highlighted three main findings: (1) negative and positive emotion dysregulation were significantly higher among individuals with vs. without exposure to six and nine specific trauma types, respectively; (2) negative and positive emotion dysregulation were significantly and positively related to total number of specific traumatic events; and (3) negative emotion dysregulation was significantly higher among individuals with Victimization Traumas in the overall sample as well as the no-PTSD and no-MDD subsamples, and positive emotion dysregulation was significantly lower among individuals with Accidental/Injury Traumas and Victimization Traumas in the PTSD subsample.Conclusions: Results underscore the relative and unique roles of negative and positive emotion dysregulation in trauma types; these findings may inform future research.
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Affiliation(s)
- Jillian B Berfield
- Department of Psychology, University of Missouri-St. Louis, St. Louis, MO, USA
| | | | - Shannon R Forkus
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | | | - Nicole H Weiss
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
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Robinson WL, Whipple CR, Jason LA, Flack CE. African American adolescent suicidal ideation and behavior: The role of racism and prevention. JOURNAL OF COMMUNITY PSYCHOLOGY 2021; 49:1282-1295. [PMID: 33675671 PMCID: PMC8222079 DOI: 10.1002/jcop.22543] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 02/15/2021] [Accepted: 02/16/2021] [Indexed: 05/14/2023]
Abstract
Suicide is one of the most devastating, yet preventable, health disparities for African American adolescents. African American adolescent suicidal ideation and behavior may have different manifestations and risk factors relative to those of adolescents from other ethnic backgrounds that impact prevention efforts. For example, in addition to more common manifestations of suicidal ideation and behavior, African American youth may engage in violent or high-risk behaviors, use more lethal means, or report ideation at lower depression levels. The Adapted-Coping with Stress Course (A-CWS), an adaptation of Gregory Clarke and colleagues' Coping with Stress Course, was developed to address the cultural nuances of African American adolescents. The A-CWS is a 15-session cognitive-behavioral, group-based preventive intervention that aims to enhance adaptive coping skills and reduce suicidal ideation, by incorporating strategies that counter stressors associated with systemic racism that burden African American adolescents. This study evaluated the feasibility and acceptability of the A-CWS intervention, using a sample of predominantly African American ninth-grade students. Results indicated that the adolescents were very favorable and receptive to the A-CWS intervention and that the intervention could be conducted feasibly. The A-CWS intervention serves as a model to advance culturally-grounded, evidence-based preventive intervention, for an underserved sector of adolescents.
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Affiliation(s)
| | | | - Leonard A Jason
- Department of Psychology, DePaul University, Chicago, Illinois, USA
| | - Caleb E Flack
- Department of Psychology, DePaul University, Chicago, Illinois, USA
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The association between type of trauma, level of exposure and addiction. Addict Behav 2021; 118:106889. [PMID: 33735776 DOI: 10.1016/j.addbeh.2021.106889] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 02/04/2021] [Accepted: 02/22/2021] [Indexed: 01/09/2023]
Abstract
Exposure to trauma is considered a risk factor for the development of addictive disorders. Currently, there is a knowledge gap concerning specific links between types and levels of exposure to traumatic events and addiction.In this study we explored the associations between interpersonal trauma and risk of addictive behaviors, stratified by type of trauma (physical, weapon, sexual assault, and combat) and level of exposure (direct/indirect), focusing on a wide range of substances and behaviors. Data from an online representative sample of 4025 respondents were collected, including the Life Events Checklist (LEC-5), substance use disorders and behavioral addictions metrics, and sociodemographic data. Substantial differences were found between specific types of trauma and risk of addiction. Among those exposed to sexual assault, the risk of alcohol use disorder was found to 15.4%, 95%CI[14.4-16.4%], compared to 12.1%,95%CI[11.3-12.8] among those exposed to combat-related trauma. Both direct and indirect exposure to trauma were found to be significantly related with risk of addiction. While direct exposure was most highly associated with addictions across several types of trauma, in the case of combat-related trauma, indirect exposure was more highly associated with alcohol and pornography addiction (14.5%,95%CI[13.2-15.8%] and 10.0%, 95%CI[6.3-15.0%], respectively) compared to direct exposure (10.7%,95%CI[9.9-11.6%] and 7.4%, 95%CI[4.7-11.6%], respectively). Our findings emphasize the strong association between all types of trauma and the risk of several specific substance and behavioral addictions. Specifically, the role of indirect exposure to trauma is highlighted.
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Chaiyachati BH, Gur RE. Effect of child abuse and neglect on schizophrenia and other psychotic disorders. Pharmacol Biochem Behav 2021; 206:173195. [PMID: 33961909 PMCID: PMC10961915 DOI: 10.1016/j.pbb.2021.173195] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/20/2021] [Accepted: 04/29/2021] [Indexed: 12/25/2022]
Abstract
Childhood experiences impact long-term physical and behavioral health outcomes including potential risk for schizophrenia and psychosis. Negative experiences, such as child abuse and neglect, have been specifically associated with risk for schizophrenia and psychosis. This review provides a brief overview of child abuse and neglect, including its position within the larger field of trauma and adversity and its long term consequences. The link to schizophrenia is then explored. Principles of treatment and outcomes for schizophrenia with antecedent child abuse and neglect are then reviewed. Finally, next steps and points of prevention are highlighted.
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Affiliation(s)
- Barbara H Chaiyachati
- The Children's Hospital of Philadelphia, Philadelphia, PA, United States of America; The University of Pennsylvania, Lifespan Brain Institute of Penn-Medicine and CHOP, Philadelphia, PA, United States of America; The Center for Pediatric Clinical Effectiveness and Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, PA, United States of America; The Leonard Davis Institute, University of Pennsylvania, Philadelphia, PA, United States of America.
| | - Raquel E Gur
- The Children's Hospital of Philadelphia, Philadelphia, PA, United States of America; The University of Pennsylvania, Lifespan Brain Institute of Penn-Medicine and CHOP, Philadelphia, PA, United States of America
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Cohen ZP, Cosgrove KT, Akeman E, Coffey S, Teague K, Hays-Grudo J, Paulus MP, Aupperle RL, Kirlic N. The effect of a mindfulness-based stress intervention on neurobiological and symptom measures in adolescents with early life stress: a randomized feasibility study. BMC Complement Med Ther 2021; 21:123. [PMID: 33858395 PMCID: PMC8050904 DOI: 10.1186/s12906-021-03295-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 03/31/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Early life stress (ELS) has been linked to poor mental and physical health outcomes in adolescence and adulthood. Mindfulness reduces symptoms of depression and anxiety and improves cognitive and social outcomes in both youth and adults. However, little is known whether mindfulness can mitigate against the adverse neurobiological and psychological effects of ELS. This study aimed to examine the feasibility of conducting a group mindfulness intervention in adolescents with ELS and provide preliminary indication of potential effects on stress-related biomarkers and mental health symptoms. METHODS Forty adolescents were randomized to receive either eight sessions of Mindfulness-Based Stress Reduction for Teens in group format (MBSR-T; n = 21) or Treatment as Usual Control group (CTRL; n = 17). Outcomes were assessed at baseline and follow-up and included measures associated with neurobiological functioning (immune and endocrine biomarkers) and self-reported mental health (depressive) symptoms. Linear mixed effects models were used to assess the effects of group and time on these outcome measures. RESULTS Sixteen of the 21 adolescents completed the intervention, attending an average of 6.5 sessions. The model examining cortisol responses to stress induction revealed medium effects trending toward significance (Cohen's d = .56) for anticipatory cortisol levels in the MBSR-T relative to CTRL groups. No significant effects were found in models examining C-reactive protein or interleukin 6 inflammatory markers. The model examining depressive symptoms revealed a medium effect for symptom reduction (Cohen's d = .69) in the MBSR-T relative to CTRL groups. CONCLUSIONS This study demonstrated feasibility of conducting a group-based MBSR-T intervention for adolescents with ELS. There was some evidence for efficacy on a symptom level with potential subtle changes on a biological level. Future larger studies are needed to determine the efficacy of group-based mindfulness interventions in this population. TRIAL REGISTRATION Identifier # NCT03633903 , registered 16/08/2018.
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Affiliation(s)
- Zsofia P Cohen
- Laureate Institute for Brain Research, 6655 S Yale Avenue, Tulsa, OK, 74136, USA
| | - Kelly T Cosgrove
- Laureate Institute for Brain Research, 6655 S Yale Avenue, Tulsa, OK, 74136, USA
- Department of Psychology, University of Tulsa, 800 S Tucker Drive, Tulsa, OK, 74104, USA
| | - Elisabeth Akeman
- Laureate Institute for Brain Research, 6655 S Yale Avenue, Tulsa, OK, 74136, USA
| | - Sara Coffey
- Center for Health Sciences, Oklahoma State University - Tulsa, 1111 W 17th St, Tulsa, OK, 74107, USA
| | - Kent Teague
- Center for Health Sciences, Oklahoma State University - Tulsa, 1111 W 17th St, Tulsa, OK, 74107, USA
- Departments of Surgery and Psychiatry, University of Oklahoma School of Community Medicine, 4502 A 41st St, Tulsa, OK, 74135, USA
| | - Jennifer Hays-Grudo
- Center for Health Sciences, Oklahoma State University - Tulsa, 1111 W 17th St, Tulsa, OK, 74107, USA
| | - Martin P Paulus
- Laureate Institute for Brain Research, 6655 S Yale Avenue, Tulsa, OK, 74136, USA
| | - Robin L Aupperle
- Laureate Institute for Brain Research, 6655 S Yale Avenue, Tulsa, OK, 74136, USA
- Oxley College of Health Sciences, School of Community Medicine, University of Tulsa, 1215 S Boulder Ave W, Tulsa, OK, 74119, USA
| | - Namik Kirlic
- Laureate Institute for Brain Research, 6655 S Yale Avenue, Tulsa, OK, 74136, USA.
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Turner HA, Finkelhor D, Henly M. Exposure to Family and Friend Homicide in a Nationally Representative Sample of Youth. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP4413-NP4442. [PMID: 29998751 DOI: 10.1177/0886260518787200] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This study examines the lifetime prevalence and distribution of family/friend homicide exposure among children and adolescents age 2 to 17 in the United States, and assesses the impact of family/friend homicide on emotional and behavioral outcomes, while controlling for potential co-occurring factors. Data were collected by telephone about the experiences of youth in 2008, 2011, or 2014, as part of the National Surveys of Children's Exposure to Violence (NatSCEV). Analyses are based on a pooled sample (n =11,771) from these three surveys. Approximately 8% of all children and youth ages 2 to 17 were exposed to a family/friend homicide. Older adolescents, Black youth, those living in single parent and nonparent family households, those from lower socioeconomic status households, and youth living in large cities were overrepresented among youth experiencing family or friend homicide. Exposed youth were also substantially more likely to be poly-victims, experience other major adversities, and live in neighborhoods with more community disorder. Exposure to family/friend homicide was significantly related to trauma symptoms. However, when other co-occurring factors were taken into account, only family/friend homicide that occurred within the last 2 years remained significant. With respect to delinquency, only nonfamily homicide exposure remained significant with these other factors controlled. Findings suggest that family/friend homicide represents a powerful marker for a broad level of victimization risk and adversity, demonstrating that family/friend murder is often just one relatively small part of a more complicated life of adversity. Although recent exposure is certainly distressing to youth, it is the wider, co-occurring context of poly-victimization and other types of adversity that appears most impactful in the longer term.
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48
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Ford JD, Spinazzola J, van der Kolk B. Psychiatric comorbidity of developmental trauma disorder and posttraumatic Stress disorder: findings from the DTD field trial replication (DTDFT-R). Eur J Psychotraumatol 2021; 12:1929028. [PMID: 34249242 PMCID: PMC8245086 DOI: 10.1080/20008198.2021.1929028] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/29/2022] Open
Abstract
Background: Developmental Trauma Disorder (DTD) has extensive comorbidity with internalizing and externalizing disorders distinct from posttraumatic stress disorder (PTSD). Objective: To replicate findings of DTD comorbidity and to determine whether this comorbidity is distinct from, and extends beyond, comorbidities of PTSD. Method: DTD was assessed by structured interview, and probable DSM-IV psychiatric disorders were identified with KSADS-PL screening modules, in a multi-site sample of 271 children (ages 8-18 years old; 47% female) in outpatient or residential mental health treatment for multiple (M = 3.5 [SD = 2.4]) psychiatric diagnoses other than PTSD or DTD. Results: DTD (N = 74, 27%) and PTSD (N = 107, 39%) were highly comorbid and shared several DSM-IV internalizing and externalizing disorder comorbidities. Children with DTD with or without PTSD had more comorbid diagnoses (M = 5.7 and 5.2 [SD = 2.4 and 1.7], respectively) than children with PTSD but not DTD (M = 3.8[SD = 2.1]) or neither PTSD nor DTD (M = 2.1[SD = 1.9]), F[3,267] = 55.49, p < .001. Further, on a multivariate basis controlling for demographics and including all potential comorbid disorders, DTD was associated with separation anxiety disorder, depression, and oppositional defiant disorder after controlling for PTSD, while PTSD was associated only with separation anxiety disorder after controlling for DTD. Both DTD and PTSD were associated with suicidality. Conclusions: DTD is associated with psychiatric comorbidity beyond that of PTSD, and DTD warrants assessment for treatment planning with children in intensive psychiatric services.
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Affiliation(s)
- Julian D Ford
- University of Connecticut School of Medicine, Farmington, CT, USA
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49
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Mills MS, Embury CM, Klanecky AK, Khanna MM, Calhoun VD, Stephen JM, Wang YP, Wilson TW, Badura-Brack AS. Traumatic Events Are Associated with Diverse Psychological Symptoms in Typically-Developing Children. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2020; 13:381-388. [PMID: 33269038 PMCID: PMC7683694 DOI: 10.1007/s40653-019-00284-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Childhood traumatic events are significant risk factors for psychopathology according to adult retrospective research; however, few studies examine trauma exposure and psychological symptoms in pre-adolescent children. Typically-developing children, aged 9-12 years (N = 114), were recruited from the community and selected from the Developmental Chronnecto-Genomics (Dev-CoG) study examining child development. Children completed questionnaires about traumatic life events, posttraumatic stress, anxiety, depression, dissociation, anger, and internalizing and externalizing behaviors. Parents also completed internalizing and externalizing measures. The number of traumatic events significantly correlated with symptom severity across all child-report psychological measures, but surprisingly, trauma was not correlated with any parent-report scores. Follow-up analyses revealed a significant trauma effect for internalizing and externalizing behaviors according to child self-report, but not for parent-report measures. Results indicate that childhood trauma may be a non-specific risk factor for sub-clinical psychopathology in otherwise typically-developing children. Moreover, children appear to be the most appropriate reporters of their own psychological distress.
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Affiliation(s)
- Mackenzie S. Mills
- Department of Psychological Science, Creighton University, 2500 California Plaza, Omaha, NE 68178 USA
| | - Christine M. Embury
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE USA
- Center for Magnetoencephalography, UNMC, Omaha, NE USA
- Department of Psychology, University of Nebraska at Omaha, Omaha, NE USA
| | - Alicia K. Klanecky
- Department of Psychological Science, Creighton University, 2500 California Plaza, Omaha, NE 68178 USA
| | - Maya M. Khanna
- Department of Psychological Science, Creighton University, 2500 California Plaza, Omaha, NE 68178 USA
| | - Vince D. Calhoun
- Department of Neurosciences, University of New Mexico (UNM), Albuquerque, NM USA
- Department of Electrical and Computer Engineering, UNM, Albuquerque, NM USA
- Department of Computer Science, UNM, Albuquerque, NM USA
- Department of Psychiatry, UNM, Albuquerque, NM USA
- The Mind Research Network, Albuquerque, NM USA
| | - Julia M. Stephen
- Department of Electrical and Computer Engineering, UNM, Albuquerque, NM USA
- Department of Computer Science, UNM, Albuquerque, NM USA
- Department of Psychiatry, UNM, Albuquerque, NM USA
- The Mind Research Network, Albuquerque, NM USA
| | - Yu-Ping Wang
- Department of Biomedical Engineering, Tulane University, New Orleans, LA USA
| | - Tony W. Wilson
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE USA
- Center for Magnetoencephalography, UNMC, Omaha, NE USA
| | - Amy S. Badura-Brack
- Department of Psychological Science, Creighton University, 2500 California Plaza, Omaha, NE 68178 USA
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50
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Chaby LE, Sadik N, Burson NA, Lloyd S, O'Donnel K, Winters J, Conti AC, Liberzon I, Perrine SA. Repeated stress exposure in mid-adolescence attenuates behavioral, noradrenergic, and epigenetic effects of trauma-like stress in early adult male rats. Sci Rep 2020; 10:17935. [PMID: 33087769 PMCID: PMC7578655 DOI: 10.1038/s41598-020-74481-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 09/30/2020] [Indexed: 12/11/2022] Open
Abstract
Stress in adolescence can regulate vulnerability to traumatic stress in adulthood through region-specific epigenetic activity and catecholamine levels. We hypothesized that stress in adolescence would increase adult trauma vulnerability by impairing extinction-retention, a deficit in PTSD, by (1) altering class IIa histone deacetylases (HDACs), which integrate effects of stress on gene expression, and (2) enhancing norepinephrine in brain regions regulating cognitive effects of trauma. We investigated the effects of adolescent-stress on adult vulnerability to severe stress using the single-prolonged stress (SPS) model in male rats. Rats were exposed to either (1) adolescent-stress (33-35 postnatal days) then SPS (58-60 postnatal days; n = 14), or (2) no adolescent-stress and SPS (58-60 postnatal days; n = 14), or (3) unstressed conditions (n = 8). We then measured extinction-retention, norepinephrine, HDAC4, and HDAC5. As expected, SPS exposure induced an extinction-retention deficit. Adolescent-stress prior to SPS eliminated this deficit, suggesting adolescent-stress conferred resiliency to adult severe stress. Adolescent-stress also conferred region-specific resilience to norepinephrine changes. HDAC4 and HDAC5 were down-regulated following SPS, and these changes were also modulated by adolescent-stress. Regulation of HDAC levels was consistent with the pattern of cognitive effects of SPS; only animals exposed to SPS without adolescent-stress exhibited reduced HDAC4 and HDAC5 in the prelimbic cortex, hippocampus, and striatum. Thus, HDAC regulation caused by severe stress in adulthood interacts with stress history such that seemingly conflicting reports describing effects of adolescent stress on adult PTSD vulnerability may stem in part from dynamic HDAC changes following trauma that are shaped by adolescent stress history.
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MESH Headings
- Adolescent
- Adolescent Behavior/physiology
- Adolescent Behavior/psychology
- Animals
- Brain/metabolism
- Disease Models, Animal
- Epigenesis, Genetic
- Extinction, Psychological/physiology
- Histone Deacetylases/metabolism
- Humans
- Male
- Norepinephrine/metabolism
- Psychology, Adolescent
- Rats, Sprague-Dawley
- Retention, Psychology/physiology
- Stress Disorders, Post-Traumatic/etiology
- Stress Disorders, Post-Traumatic/genetics
- Stress Disorders, Post-Traumatic/metabolism
- Stress Disorders, Post-Traumatic/psychology
- Stress, Psychological
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Affiliation(s)
- Lauren E Chaby
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA.
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
| | - Nareen Sadik
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Nicole A Burson
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Scott Lloyd
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
- Research Service, John D. Dingell VA Medical Center, Detroit, MI, USA
| | - Kelly O'Donnel
- Department of Psychology, University of Colorado, Colorado Springs, CO, USA
| | - Jesse Winters
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Alana C Conti
- Research Service, John D. Dingell VA Medical Center, Detroit, MI, USA
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Israel Liberzon
- Department of Psychiatry, Texas A&M College of Medicine, Bryan, TX, USA
| | - Shane A Perrine
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
- Research Service, John D. Dingell VA Medical Center, Detroit, MI, USA
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