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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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Xia X, Tang J, Peng Y, Liu Y, Chen Y, Yuan M, Yu R, Hou X, Fu Y. Brain alterations in adolescents with first-episode depression who have experienced adverse events: evidence from resting-state functional magnetic resonance imaging. Front Psychiatry 2024; 15:1358770. [PMID: 38654725 PMCID: PMC11036546 DOI: 10.3389/fpsyt.2024.1358770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 03/18/2024] [Indexed: 04/26/2024] Open
Abstract
Introduction Adverse life events constitute primary risk factors for major depressive disorder (MDD), influencing brain function and structure. Adolescents, with their brains undergoing continuous development, are particularly susceptible to enduring impacts of adverse events. Methods We investigated differences and correlations among childhood trauma, negative life events, and alterations of brain function in adolescents with first-episode MDD. The study included 23 patients with MDD and 19 healthy controls, aged 10-19 years. All participants underwent resting-state functional magnetic resonance imaging and were assessed using the beck depression inventory, childhood trauma questionnaire, and adolescent self-rating life events checklist. Results Compared with healthy controls, participants with first-episode MDD were more likely to have experienced emotional abuse, physical neglect, interpersonal relationship problems, and learning stress (all p' < 0.05). These adverse life events were significantly correlated with alterations in brain functions (all p < 0.05). Discussion This study contributes novel evidence on the underlying process between adverse life events, brain function, and depression, emphasizing the significant neurophysiological impact of environmental factors.
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Affiliation(s)
- Xiaodi Xia
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jinxiang Tang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yadong Peng
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ying Liu
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yingying Chen
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Meng Yuan
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Renqiang Yu
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiao Hou
- Department of Clinical Medicine, Chongqing Medical and Pharmaceutical College, Chongqing, China
| | - Yixiao Fu
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Wamser RA, Walker HE, Sager J. Physical Health Outcomes of Trauma Exposure Across the Lifespan. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:12025-12045. [PMID: 37565310 DOI: 10.1177/08862605231190670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
Trauma exposure and posttraumatic stress symptoms (PTSS) are established risk factors for poorer physical health. Prior work has focused on childhood adversities and PTSS in relation to physical health conditions, but trauma exposure over the lifespan has been overlooked. Further, the associations between trauma and PTSS and other physical health markers, such as diet and exercise, are less clear. Very little is known regarding how different trauma types (i.e., interpersonal, non-interpersonal), may be tied to aspects of physical health. To expand this area of research, this study aimed to: (a) examine the links between cumulative trauma and PTSS, and body mass index (BMI), diet, and exercise; and (b) investigate the relations between interpersonal and non-interpersonal trauma and these three health indices, while controlling for PTSS. Participants were 493 Midwestern University students (Mage = 23.87, standard deviation [SD] = 6.90, range = 18-63; 79.3% female; 57.4% White). Cumulative trauma corresponded with higher BMIs and less exercise use (B = 0.10; B = -0.09), while PTSS were unrelated. Conversely, PTSS were tied to greater consumption of added sugars (B = 0.11), and cumulative trauma was not linked with diet. Interpersonal and non-interpersonal traumas were not tied to BMI or exercise, although interpersonal trauma and PTSS were linked with greater sugar intake and non-interpersonal trauma was associated with fruit and vegetable consumption. Trauma exposure and PTSS may have complicated and distinct associations with physical health indices, such as BMI, diet, and exercise, and additional research is needed to further parse out these relations.
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Lin ERH, Roeckner AR, Fani N, Merrill N, Gillespie CF, Ely TD, Bradley B, Michopoulos V, Powers A, Jovanovic T, Stevens JS. Association between dimensions of trauma-related psychopathology and asthma in trauma-exposed women. Front Behav Neurosci 2023; 17:1268877. [PMID: 38025383 PMCID: PMC10648896 DOI: 10.3389/fnbeh.2023.1268877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 09/22/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Exposure to traumatic events and stressful life experiences are associated with a wide range of adverse mental and physical health outcomes. Studies have found post-traumatic stress disorder (PTSD), depression, and anxiety sensitivity occurrence to be common in addition to inflammatory diseases like asthma, especially in women. Moreover, overlapping neurobiological mechanisms have been linked to both PTSD and asthma. Methods In the current study, n = 508 women reported on presence of lifetime asthma diagnosis and symptoms of trauma-related psychopathology including PTSD and depression. A separate group of female participants (n = 64) reported on asthma, PTSD, depression and anxiety sensitivity, and underwent functional MRI scans during a fearful faces task, and their anterior insula responses were analyzed. Results Overall, PTSD and depression severity were significantly higher in those with asthma versus those without asthma. There was a positive association between anterior insula response to social threat cues and depression symptoms only among individuals without a lifetime presence of asthma. Discussion These findings provide continued evidence on the interactions between stress, neural mechanisms involved in interoception and salience detection, and trauma-related psychopathology.
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Affiliation(s)
- Esther R.-H. Lin
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Alyssa R. Roeckner
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Negar Fani
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Natalie Merrill
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Charles F. Gillespie
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Timothy D. Ely
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Bekh Bradley
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
- Atlanta VA Health Care System, Atlanta, GA, United States
| | - Vasiliki Michopoulos
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Abigail Powers
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Tanja Jovanovic
- Wayne State University School of Medicine, Detroit, MI, United States
| | - Jennifer S. Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
- Atlanta VA Health Care System, Atlanta, GA, United States
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Torres-McGehee TM, Emerson DM, Flanscha-Jacobson A, Uriegas NA, Moore EM, Smith AB. Energy Availability, Mental Health, and Sleep Patterns of Athletic Trainers. J Athl Train 2023; 58:788-795. [PMID: 36913639 PMCID: PMC11215732 DOI: 10.4085/1062-6050-0547.22] [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: 03/14/2023]
Abstract
CONTEXT Engaging in exercise and appropriate nutritional intake improves mental health by reducing anxiety, depression, and sleep disturbances. However, few researchers have examined energy availability (EA), mental health, and sleep patterns in athletic trainers (ATs). OBJECTIVE To examine ATs' EA, mental health risk (ie, depression, anxiety), and sleep disturbances by sex (male, female), job status (part time [PT AT], full time [FT AT]), and occupational setting (college or university, high school, or nontraditional). DESIGN Cross-sectional study. SETTING Free living in occupational settings. PATIENTS OR OTHER PARTICIPANTS A total of 47 ATs (male PT ATs = 12, male FT ATs = 12; female PT ATs = 11, female FT ATs = 12) in the southeastern United States. MAIN OUTCOME MEASURE(S) Anthropometric measurements consisted of age, height, weight, and body composition. Energy availability was measured through energy intake and exercise energy expenditure. We used surveys to assess the depression risk, anxiety (state or trait) risk, and sleep quality. RESULTS Thirty-nine ATs engaged in exercise, and 8 did not exercise. Overall, 61.5% (n = 24/39) reported low EA (LEA); 14.9% (n = 7/47) displayed a risk for depression; 25.5% (n = 12/47) indicated a high risk for state anxiety; 25.5% (n = 12/47) were at high risk for trait anxiety, and 89.4% (n = 42/47) described sleep disturbances. No differences were found by sex and job status for LEA, depression risk, state or trait anxiety, or sleep disturbances. Those ATs not engaged in exercise had a greater risk for depression (risk ratio [RR] = 1.950), state anxiety (RR = 2.438), trait anxiety (RR = 1.625), and sleep disturbances (RR = 1.147), whereas ATs with LEA had an RR of 0.156 for depression, 0.375 for state anxiety, 0.500 for trait anxiety, and 1.146 for sleep disturbances. CONCLUSIONS Although most ATs engaged in exercise, their dietary intake was inadequate, they were at increased risk for depression and anxiety, and they experienced sleep disturbances. Those who did not exercise were at an increased risk for depression and anxiety. Energy availability, mental health, and sleep affect overall quality of life and can affect ATs' ability to provide optimal health care.
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Tang Y, He W. Depression and academic engagement among college students: the role of sense of security and psychological impact of COVID-19. Front Public Health 2023; 11:1230142. [PMID: 37601170 PMCID: PMC10436546 DOI: 10.3389/fpubh.2023.1230142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 07/24/2023] [Indexed: 08/22/2023] Open
Abstract
Background The negative consequences of depression in college students have garnered global attention, especially in relation to academic achievement during the COVID-19 pandemic, which need critical assessment. Aim This study investigated whether a sense of security mediated the relationship between depression and academic engagement among college students during the pandemic and whether the moderating psychological impact of COVID-19 has a moderating effect on this relationship. Methods In this cross-sectional study, we recruited 466 college students from 30 provincial-level administrative regions in China via the Internet and used established scales to measure depression, academic engagement, a sense of security, and the psychological impact of COVID-19. The mediating and moderating effects were tested using the bootstrap method. Results Depression was found to negatively influence academic engagement, with a sense of security partially mediating this relationship. Moreover, the psychological impact of COVID-19 was shown to have a moderating effect on this mediating process. Conclusion This study could aid in crafting pertinent strategies to mitigate the adverse effects of depression on learning amid unexpected public health crises and foster better mental health among college students.
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Affiliation(s)
| | - Weiguang He
- College of Social Sciences, Shenzhen University, Shenzhen, China
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Liu Y, Peng W, Cao M, Zhang S, Peng J, Zhou Z. Cyberchondria and Chinese Adolescent Mental Health in the Age of COVID-19 Pandemic. CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2023. [PMID: 37406285 DOI: 10.1089/cyber.2022.0319] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
One of the far-reaching impacts of the COVID-19 pandemic is that it has become the fertile soil of cyberchondria. Adolescents' mental health was severely hit by this by-product of the COVID-19 pandemic both due to the direct effects and its indirect effects on security. This study investigated whether and how cyberchondria was associated with Chinese adolescents' mental health (i.e., well-being and depressive symptoms). Based on a large Internet sample (N = 1,108, 67.5 percent female, Mage = 16.78 years), cyberchondria, psychological insecurity, mental health, and a series of covariates were assessed. Preliminary analyses were conducted in SPSS Statistics software and main analyses were conducted in Mplus. Path analyses indicated that (a) cyberchondria was negatively associated with well-being (b = -0.12, p = 0.001) and positively associated with depressive symptoms (b = 0.17, p < 0.001); (b) psychological insecurity could fully mediate the association between cyberchondria and mental health (indirect effect well-being = -0.15, 95% confidence interval [CI -0.19 to -0.12] and indirect effect depressive symptoms = 0.15, 95% CI [0.12 to 0.19]); (c) the two dimensions (social insecurity and uncertainty) of psychological insecurity could play the mediating role in the associations between cyberchondria and mental health, uniquely and parallelly; and (d) these results did not vary by gender. This study suggests that cyberchondria may arouse individuals' psychological insecurity about interpersonal interaction and the development of events, which ultimately decreases their well-being and increases the risk of depressive symptoms. These findings facilitate the establishment and implementation of relevant prevention and intervention programs.
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Affiliation(s)
- Yuxiao Liu
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan, China
- School of Psychology, Central China Normal University, Wuhan, China
| | - Wenya Peng
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Min Cao
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan, China
- School of Psychology, Central China Normal University, Wuhan, China
| | - Shujing Zhang
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan, China
- School of Psychology, Central China Normal University, Wuhan, China
| | - Ji Peng
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan, China
- School of Psychology, Central China Normal University, Wuhan, China
| | - Zongkui Zhou
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan, China
- School of Psychology, Central China Normal University, Wuhan, China
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Oyekunle V, Tomita A, Gibbs A. High levels of poor mental health among young men in urban informal settlements in South Africa: a community-based study of social determinants. PSYCHOL HEALTH MED 2023; 28:2606-2620. [PMID: 35699350 DOI: 10.1080/13548506.2022.2088816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 06/07/2022] [Indexed: 10/18/2022]
Abstract
Informal settlements (high population density areas at the outskirts of urban areas characterized by lack basic amenities) in South Africa are consequences of apartheid regime's discriminatory migrant labour and spatial policy and continue to grow. Living in informal settlements accompanies a mire of social/health challenges that threatens upward mobility, but few studies exist that document drivers of mental health challenges in these settings. We investigated the prevalence and social determinants of poor mental health for young men in informal settlements adjacent to one of the largest cities that is at the heart of HIV endemic in South Africa. This study involved a cross-sectional study with cluster sampling design of 674 young men aged 18-30 years residing in eThekwini informal settlement communities. We assessed the prevalence, and social determinants, of significant depressive (i.e., depression) and post-traumatic stress (i.e., PTS) symptoms using logistic regression. Given the complex survey design of the study, all analyses were adjusted for clustering. The prevalence of depression and PTS in the sample was 46.8% and 14.4% respectively. Results of the multivariable analyses indicated that severe food insecurity (aOR = 2.98, 95% CI:1.70-5.22), crime perpetration (aOR = 1.51, 95% CI:1.05-3.80), severe adverse childhood event (aOR = 2.00, 95% CI: 1.05-3.80), traumatic event exposures (aOR = 2.43, 95% CI:1.56-3.80) and problematic alcohol use (aOR = 1.73, 95% CI:1.20-2.49) were significantly associated with depression. While incomplete secondary education (aOR = 0.45, 95% CI:0.22-0.92), moderate food insecurity (aOR = 2.51, 95% CI:1.04-6.06), traumatic event exposures (aOR = 2.19, 95% CI:1.32-3.64) and problematic alcohol use (aOR = 2.15, 95% CI: 1.24-3.73) were significantly associated with PTS. Our study highlights the exceedingly high levels of poor mental health among young men in informal settlements, with depression and PTS being driven by economic/social conditions. Multilevel interventions that address the individual, interpersonal, and social variables that contribute to poor mental health are needed.
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Affiliation(s)
- Victoria Oyekunle
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Andrew Tomita
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- Research Innovation and Sequencing Platform (KRISP), College of Health Sciences, University of KwaZulu-NatalKwaZulu-Natal, Durban, South Africa
| | - Andrew Gibbs
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa
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Li T, Mao Z, Zhao L, Sun Y, Wang C, Bo Q. Childhood trauma and its influence on the clinical features of bipolar disorder. CHILD ABUSE & NEGLECT 2023; 141:106203. [PMID: 37088009 DOI: 10.1016/j.chiabu.2023.106203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 04/03/2023] [Accepted: 04/16/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Childhood trauma is an environmental risk factor for bipolar disorder (BD), But its influence on the clinical features of BD has not been examined sufficiently. OBJECTIVE We compared the childhood trauma between patients with BD and healthy controls (HCs) and determined how childhood trauma impacts clinical features, such as severity, mood episodes, and disease duration. PARTICIPANTS AND SETTING The study population comprised patients with BD (in a state of euthymia or depression, n = 90) and HCs (n = 94). METHODS The Structured Clinical Interview for DSM-IV Axis I Disorders was used to diagnose BD and ascertain its clinical features. The Childhood Trauma Questionnaire (CTQ) was used to assess childhood trauma. RESULTS The total CTQ score and scores for the CTQ subscales emotional abuse, sexual abuse, emotional neglect, and physical neglect, significantly differed between the BD and HC groups. Emotional abuse was correlated with higher Hamilton Anxiety Rating Scale (HARS) score and more frequent mood episodes; emotional neglect was correlated with higher HARS score, longer disease duration, and more mood episodes; and total CTQ score was positively correlated with HARS score, disease duration, and mood episodes. Regression analysis showed that emotional neglect significantly predicted HARS score, Hamilton Depression Rating Scale score, and disease duration in the BD group (P < 0.05). CONCLUSIONS Patients with BD have more serious childhood trauma. General childhood trauma, emotional abuse, and emotional neglect negatively affect the clinical features of BD.
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Affiliation(s)
- Tian Li
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China
| | - Zhen Mao
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China
| | - Lei Zhao
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China
| | - Yue Sun
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China
| | - Chuanyue Wang
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China
| | - Qijing Bo
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China.
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Rohr JC, Bourassa KA, Thompson DS, Fowler JC, Frueh BC, Weinstein BL, Petrosino J, Madan A. History of childhood physical abuse is associated with gut microbiota diversity among adult psychiatric inpatients. J Affect Disord 2023; 331:50-56. [PMID: 36933668 DOI: 10.1016/j.jad.2023.03.023] [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: 12/05/2022] [Revised: 03/03/2023] [Accepted: 03/11/2023] [Indexed: 03/20/2023]
Abstract
BACKGROUND Traumatic life events are associated with the development of psychiatric and chronic medical illnesses. This exploratory study examined the relationship between traumatic life events and the gut microbiota among adult psychiatric inpatients. METHODS 105 adult psychiatric inpatients provided clinical data and a single fecal sample shortly after admission. A modified version of the Stressful Life Events Screening Questionnaire was used to quantify history of traumatic life events. 16S rRNA gene sequencing was used to analyze the gut microbial community. RESULTS Gut microbiota diversity was not associated with overall trauma score or any of the three trauma factor scores. Upon item-level analysis, history of childhood physical abuse was uniquely associated with beta diversity. Linear Discriminant Analysis Effect Size (LefSe) analyses revealed that childhood physical abuse was associated with abundance of distinct bacterial taxa associated with inflammation. LIMITATIONS This study did not account for dietary differences, though diet was highly restricted as all participants were psychiatric inpatients. Absolute variance accounted for by the taxa was small though practically meaningful. The study was not powered for full subgroup analysis based on race and ethnicity. CONCLUSIONS This study is among the first to demonstrate a relationship between childhood physical abuse and gut microbiota composition among adult psychiatric patients. These findings suggest that early childhood adverse events may have long-conferred systemic consequences. Future efforts may target the gut microbiota for the prevention and/or treatment of psychiatric and medical risk associated with traumatic life events.
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Affiliation(s)
- Jessica C Rohr
- Department of Psychiatry & Behavioral Health, Houston Methodist, Houston, TX, USA.
| | - Katelynn A Bourassa
- Department of Psychiatry & Behavioral Health, Houston Methodist, Houston, TX, USA
| | - Dominique S Thompson
- Department of Psychiatry & Behavioral Health, Houston Methodist, Houston, TX, USA; Department of Molecular Virology & Microbiology, Alkek Center for Metagenomics and Microbiome Research, Baylor College of Medicine, Houston, TX, USA
| | - J Christopher Fowler
- Department of Psychiatry & Behavioral Health, Houston Methodist, Houston, TX, USA; Houston Methodist Academic Institute, Houston, TX, USA; Department of Psychiatry, Weill Cornell Medical College, New York, NY, USA
| | | | - Benjamin L Weinstein
- Department of Psychiatry & Behavioral Health, Houston Methodist, Houston, TX, USA
| | - Joseph Petrosino
- Department of Molecular Virology & Microbiology, Alkek Center for Metagenomics and Microbiome Research, Baylor College of Medicine, Houston, TX, USA
| | - Alok Madan
- Department of Psychiatry & Behavioral Health, Houston Methodist, Houston, TX, USA; Houston Methodist Academic Institute, Houston, TX, USA; Department of Psychiatry, Weill Cornell Medical College, New York, NY, USA
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Differential co-expression networks of the gut microbiota are associated with depression and anxiety treatment resistance among psychiatric inpatients. Prog Neuropsychopharmacol Biol Psychiatry 2023; 120:110638. [PMID: 36122838 DOI: 10.1016/j.pnpbp.2022.110638] [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: 03/07/2022] [Revised: 09/07/2022] [Accepted: 09/09/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Comorbid anxiety and depression are common and are associated with greater disease burden than either alone. Our recent efforts have identified an association between gut microbiota dysfunction and severity of anxiety and depression. In this follow-up, we applied Differential Co-Expression Analysis (DiffCoEx) to identify potential gut microbiota biomarker(s) candidates of treatment resistance among psychiatric inpatients. METHODS In a sample of convenience, 100 psychiatric inpatients provided clinical data at admission and discharge; fecal samples were collected early during the hospitalization. Whole genome shotgun sequencing methods were used to process samples. DiffCoEx was used to identify clusters of microbial features significantly different based on treatment resistance status. Once overlapping features were identified, a knowledge-mining tool was used to review the literature using a list of microbial species/pathways and a select number of medical subject headlines (MeSH) terms relevant for depression, anxiety, and brain-gut-axis dysregulation. Network analysis used overlapping features to identify microbial interactions that could impact treatment resistance. RESULTS DiffCoEx analyzed 10,403 bacterial features: 43/44 microbial features associated with depression treatment resistance overlapped with 43/114 microbial features associated with anxiety treatment resistance. Network analysis resulted in 8 biological interactions between 16 bacterial species. Clostridium perfringens evidenced the highest connection strength (0.95). Erysipelotrichaceae bacterium 6_1_45 has been most widely examined, is associated with inflammation and dysbiosis, but has not been associated with depression or anxiety. CONCLUSION DiffCoEx potentially identified gut bacteria biomarker candidates of depression and anxiety treatment-resistance. Future efforts in psychiatric microbiology should examine the mechanistic relationship of identified pro-inflammatory species, potentially contributing to a biomarker-based algorithm for treatment resistance.
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Chiu CD, Chou LS, Hsieh YC, Lin CH, Li DJ. Erroneous Thought in Inpatients with Major Depressive Disorder: The Role of Psychological Trauma During Childhood and Adulthood. Neuropsychiatr Dis Treat 2023; 19:337-348. [PMID: 36778532 PMCID: PMC9910196 DOI: 10.2147/ndt.s396451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 01/27/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The pathogenic role of trauma in psychotic-like experiences has yet to be clarified. The aim of this study was to investigate the role of childhood and adulthood trauma on erroneous thoughts among patients with major depressive disorder. MATERIALS AND METHODS Inpatients with major depressive disorder (MDD) and healthy controls (HCs) were enrolled, and paper-and-pencil questionnaires were applied. Clinical rating and self-reported scales were used to measure levels of depression, dissociation, psychological trauma, parental maltreatment, and erroneous thoughts. Pearson's correlation analysis was conducted to explore potentially significant associations between erroneous thoughts and other independent variables, and standardized regression coefficients of hierarchical regression analysis were used to predict the significant relationships between erroneous thoughts and adulthood or childhood trauma. RESULTS A total of 99 participants were included into the analysis, of whom 59 were patients with MDD and 40 were HCs. After treatment, the patients with MDD showed significantly higher levels of depression, childhood maltreatment, interpersonal trauma and erroneous thoughts than the HCs. After estimating and verifying correlations with hierarchical regression among the patients with MDD, a link between adulthood betrayal trauma and higher level of conviction along with the number of erroneous thoughts was found. However, no significant association was identified between childhood trauma and erroneous thought. The concurrent level of depression significantly predicted a higher level of being preoccupied, along with the number of erroneous thoughts. CONCLUSION The current study fills a gap in the literature by showing a link between adulthood trauma and erroneous thoughts in non-psychotic patients. Further studies with well-controlled comparisons and prospective cohort with longer follow-up are warranted to extend the applicability and generalizability of the current study.
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Affiliation(s)
- Chui-De Chiu
- Department of Psychology, Clinical and Health Psychology Centre, and Centre for Cognition and Brain Studies, the Chinese University of Hong Kong, Sha Tin City, Hong Kong
| | - Li-Shiu Chou
- Department of Adult Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan
| | - Yung-Chi Hsieh
- Department of Adult Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan
| | - Ching-Hua Lin
- Department of Adult Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan
| | - Dian-Jeng Li
- Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan.,Department of Nursing, Meiho University, Pingtung, Taiwan
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13
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Watters ER, Aloe AM, Wojciak AS. Examining the Associations Between Childhood Trauma, Resilience, and Depression: A Multivariate Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2023; 24:231-244. [PMID: 34313169 DOI: 10.1177/15248380211029397] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
TOPIC OF REVIEW Childhood trauma has been associated with increased depression; however, resilience has been found to reduce this association. METHOD OF REVIEW Present analyses were based on multivariate meta-analytical techniques, an extension of univariate meta-analysis. All computations were performed using the metafor package and the metaRmat package from R. Bivariate associations (r) between trauma, resilience, and depression were utilized as the pooled effect sizes. CRITERIA FOR INCLUSION Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, articles were coded based on the following inclusion criteria: (a) sample participants had a history of childhood trauma; (b) studies included one of the four instruments of trait resilience; (c) studies included measures of individual outcomes of depression; (d) studies were published in peer-reviewed journals, dissertations, book chapters since 2009, or provided by leading scholars who had yet to publish their data; (e) all manuscripts were written in English; and (f) studies included the Pearson Product Moment Correlation Coefficient (r) for the effect size. CRITERIA FOR REVIEW We systematically coded for the following items for each study: year of publication, type of report, peer-reviewed, funding, sampling strategy, sample size, gender, mean age, country of study, measure of resilience, measure depression, and measure of childhood trauma. MAJOR FINDINGS The pooled correlations indicate that trauma, resilience, and depression are significantly associated. There were no significant differences in symptoms of depression for high versus low reports of resilience for individuals with a history of trauma. Year of publication was a significant moderator for the associations between trauma, resilience, and depression. Resilience significantly mediated the association between trauma and depression.
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Affiliation(s)
- Elizabeth R Watters
- Department of Psychological and Quantitative Foundations, University of Iowa, IA, USA
| | - Ariel M Aloe
- Department of Psychological and Quantitative Foundations, University of Iowa, IA, USA
| | - Armeda S Wojciak
- Department of Family Social Sciences, University of Minnesota, MN, USA
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14
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Recollection of childhood trauma changes according to the shift in individual attachment rather than psychiatric diagnosis. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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15
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Maharaj R, Tineo K, Flores-Ortega M, Cordova DA, Iskhakova A, Linn R, Nikulina V. The association between COVID-19-related stressors and mental health outcomes for survivors of past interpersonal and non-interpersonal trauma. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2022; 6:100300. [PMID: 37520402 PMCID: PMC9547392 DOI: 10.1016/j.ejtd.2022.100300] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 09/18/2022] [Accepted: 10/07/2022] [Indexed: 11/07/2022]
Abstract
The mental health difficulties of trauma survivors during the COVID-19 pandemic have been under-reported. This study explored the moderating role of trauma history and trauma type (interpersonal and non-interpersonal) in the association between COVID-19-related stressors and depression, anxiety, and stress. A sample of n = 321 participants ages 19 to 71 (M = 36.63, SD = 10.36) was recruited from across the United States through MTurk. Participants reported the number of COVID-19-related stressors, trauma history and psychological symptoms. Hierarchical multiple regression analyses, controlling for age, race, ethnicity, gender, education, and income levels, were used to determine (a) whether COVID-19-related stressors are associated with adverse mental health outcomes; (b) whether trauma history and (c) trauma type moderated this association. Results revealed significant interactions; for those with a trauma history, exposure to COVID-19-related stressors was associated with higher levels of depression (β = .21, p < .05) and anxiety (β = .19, p < .05). For those with a history of interpersonal trauma specifically, COVID-19-related stressors were associated with depression (β = .16, p < .05) more so than for those without a trauma history. These findings highlight the vulnerability of trauma survivors to the unprecedented COVID-19-related stress.
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Affiliation(s)
- Reena Maharaj
- Department of Psychology, Queens College, City University of New York, United States
| | - Katherine Tineo
- Department of Psychology, Queens College, City University of New York, United States
| | - Marisol Flores-Ortega
- Department of Psychology, Queens College, City University of New York, United States
| | - Diego A Cordova
- Department of Psychology, Queens College, City University of New York, United States
| | - Alexandra Iskhakova
- Department of Psychology, Queens College, City University of New York, United States
| | - Rose Linn
- Department of Psychology, Queens College, City University of New York, United States
| | - Valentina Nikulina
- Department of Psychology, Queens College, City University of New York, United States
- The Graduate Center, City University of New York, United States
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16
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Dewar C, Heggs DA, Davies J. Exploring the Relationship Between Domestic Violence Perpetration and Suicidal Behavior in Male Prisoners. Arch Suicide Res 2022; 26:1831-1846. [PMID: 34162317 DOI: 10.1080/13811118.2021.1939207] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study is the first to explore the relationship between domestic violence perpetration and suicidal behavior in prisoners in England and Wales. The nature of this relationship is unclear, however, understanding and reducing suicide in prisons is a critical issue for frontline staff and policy makers. Eight participants with a history of suicide attempts and domestic violence perpetration were interviewed. Five key themes were identified through thematic analysis; "Trauma, victimization and life struggles," "Relationship ideals versus relationship reality", "Explaining domestic violence", "The impact of prison" and "Suicide as a coping strategy". This study shows that the relationship between domestic violence and suicide risk in prisoners may be better understood through a pathway of experiences rather than individual risk factors. Further research is needed to test the replicability of this pathway in other samples.
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17
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Yang MJ, Sawhney V, McHugh RK, Leyro TM. Examination of the indirect effect of childhood emotional trauma on internalizing symptoms through distress intolerance. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:1347-1353. [PMID: 32877634 DOI: 10.1080/07448481.2020.1810053] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 07/01/2020] [Accepted: 07/24/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES Extant studies document a prospective link between early childhood trauma and internalizing symptoms, such as anxiety and depression. Less is known regarding specific cognitive-affective mechanisms. The current study sought to examine distress intolerance (DI) as a mechanism that may explain the relation between early childhood emotional abuse and internalizing symptoms. PARTICIPANTS AND METHODS Participants (N = 230; 54.3% women; mean age = 19.72, SD = 2.28) completed multiple self-report indices of early childhood emotional abuse, DI, and internalizing symptom indices. Using structural equation modeling, a series of mediation models was run to examine the indirect effect of childhood emotional abuse on latent and specific internalizing symptom indices through a latent index of subjective DI. RESULTS Childhood emotional abuse was significantly associated with internalizing symptoms through DI (effect size range = .083-.227, medium to large). CONCLUSIONS The results provide preliminary evidence for DI as a mechanism of interest in the relation between early childhood emotional abuse and internalizing symptoms.
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Affiliation(s)
- Min-Jeong Yang
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| | - Vyom Sawhney
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| | - R Kathryn McHugh
- Division of Alcohol and Drug Abuse, Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont, Massachusetts, USA
| | - Teresa M Leyro
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
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18
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Wrobel AL, Russell SE, Jayasinghe A, Lotfaliany M, Turner A, Dean OM, Cotton SM, Diaz‐Byrd C, Yocum AK, Duval ER, Ehrlich TJ, Marshall DF, Berk M, McInnis MG. Attachment insecurity partially mediates the relationship between childhood trauma and depression severity in bipolar disorder. Acta Psychiatr Scand 2022; 145:591-603. [PMID: 35243610 PMCID: PMC9314952 DOI: 10.1111/acps.13419] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/23/2022] [Accepted: 02/26/2022] [Indexed: 12/17/2022]
Abstract
BACKGROUND Childhood trauma is associated with greater depression severity among individuals with bipolar disorder. However, the mechanisms that explain the link between childhood trauma and depression severity in bipolar disorder remain poorly understood. The mediational role of attachment insecurity in childhood and adulthood was assessed in the current study. METHODS Participants with bipolar disorder (N = 143) completed measures of childhood trauma (Childhood Trauma Questionnaire), attachment insecurity (Experiences in Close Relationships Scale) and depression severity (Hamilton Depression Rating Scale) as part of the Prechter Longitudinal Study of Bipolar Disorder. A sequential mediation model was tested using path analysis: the direct and indirect effects of childhood trauma on depression severity with attachment insecurity (attachment anxiety and avoidance) in childhood (mother and father) and adulthood (partner) as mediators were estimated. RESULTS The final path model demonstrated an excellent fit to the data (comparative fit index = 0.996; root mean square error of approximation = 0.021 [90% confidence interval = 0.000-0.073]). Supporting the hypothesised sequential mediation model, maternal attachment anxiety in childhood and romantic attachment avoidance in adulthood partially mediated the relationship between childhood trauma and depression severity; this effect accounted for 12% of the total effect of childhood trauma on depression severity. CONCLUSION Attachment insecurity in childhood and adulthood form part of the complex mechanism informing why people with bipolar disorder who have a history of childhood trauma experience greater depression severity. Addressing attachment insecurity represents a valuable psychotherapeutic treatment target for bipolar disorder.
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Affiliation(s)
- Anna L. Wrobel
- IMPACT – The Institute for Mental and Physical Health and Clinical TranslationSchool of MedicineDeakin UniversityGeelongVictoriaAustralia
- OrygenParkvilleVictoriaAustralia
| | - Samantha E. Russell
- IMPACT – The Institute for Mental and Physical Health and Clinical TranslationSchool of MedicineDeakin UniversityGeelongVictoriaAustralia
| | - Anuradhi Jayasinghe
- OrygenParkvilleVictoriaAustralia
- School of PsychologyDeakin UniversityGeelongVictoriaAustralia
| | - Mojtaba Lotfaliany
- IMPACT – The Institute for Mental and Physical Health and Clinical TranslationSchool of MedicineDeakin UniversityGeelongVictoriaAustralia
| | - Alyna Turner
- IMPACT – The Institute for Mental and Physical Health and Clinical TranslationSchool of MedicineDeakin UniversityGeelongVictoriaAustralia
- School of Medicine and Public HealthUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Olivia M. Dean
- IMPACT – The Institute for Mental and Physical Health and Clinical TranslationSchool of MedicineDeakin UniversityGeelongVictoriaAustralia
- Florey Institute for Neuroscience and Mental HealthUniversity of MelbourneMelbourneVictoriaAustralia
| | - Sue M. Cotton
- OrygenParkvilleVictoriaAustralia
- Centre for Youth Mental HealthUniversity of MelbourneParkvilleVictoriaAustralia
| | - Claudia Diaz‐Byrd
- Department of PsychiatryUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | - Anastasia K. Yocum
- Department of PsychiatryUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | - Elizabeth R. Duval
- Department of PsychiatryUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | - Tobin J. Ehrlich
- Department of PsychiatryUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | - David F. Marshall
- Department of PsychiatryUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | - Michael Berk
- IMPACT – The Institute for Mental and Physical Health and Clinical TranslationSchool of MedicineDeakin UniversityGeelongVictoriaAustralia
- OrygenParkvilleVictoriaAustralia
- Florey Institute for Neuroscience and Mental HealthUniversity of MelbourneMelbourneVictoriaAustralia
- Centre for Youth Mental HealthUniversity of MelbourneParkvilleVictoriaAustralia
- Department of PsychiatryRoyal Melbourne HospitalUniversity of MelbourneParkvilleVictoriaAustralia
| | - Melvin G. McInnis
- Department of PsychiatryUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
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Chen Y, Cheung S, Huang CC. Intimate Partner Violence During Pregnancy: Effects of Maternal Depression Symptoms and Parenting on Teen Depression Symptoms. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP7034-NP7056. [PMID: 33096950 DOI: 10.1177/0886260520967754] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Past studies have indicated that mothers who are victims of intimate partner violence (IPV) have a greater risk of developing depression symptoms. Furthermore, existing literature provides evidence that children's mental health can be affected by their mother's mental health well past infancy and early childhood. Given this, children of IPV victims are particularly at risk of developing depression symptoms. Guided by trauma theory, the ecobiodevelopmental (EBD) framework, and social learning theory, this study investigates the long-term relationship between maternal IPV victimization during pregnancy and teen depression symptoms. This study utilizes longitudinal data from the Fragile Families and Child Wellbeing Study to examine the relationship between IPV during pregnancy and maternal depression symptoms at early childhood, as well as the mechanism by which maternal depression symptoms affect child depression symptoms in the adolescent stage of development. The findings indicate that mothers who were victims of IPV during pregnancy were more likely to have depression symptoms when children turned 3 and that maternal depression symptoms could directly predict children's depression symptoms at age 15. Meanwhile, maternal depression symptoms could indirectly increase adolescent depression symptoms via physical punishment at age 5 and bullying victimization at age 9. While extensive evidence has shown that IPV during pregnancy has detrimental effects on mothers and children, our study adds to the literature that such detriments can last as long as a decade. Given that depression symptoms can be detrimental to later development, the findings call for universal and comprehensive IPV screening tools and swift service referrals for pregnant women who are experiencing IPV. At the same time, trauma-informed parenting education for women, along with school- and community-based interventions for children, may also mitigate these harmful associations.
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Affiliation(s)
- Yafan Chen
- Rutgers University School of Social Work, New Brunswick, NJ, USA
| | - Shannon Cheung
- Rutgers University School of Social Work, New Brunswick, NJ, USA
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20
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Murphy R, Kettner H, Zeifman R, Giribaldi B, Kartner L, Martell J, Read T, Murphy-Beiner A, Baker-Jones M, Nutt D, Erritzoe D, Watts R, Carhart-Harris R. Therapeutic Alliance and Rapport Modulate Responses to Psilocybin Assisted Therapy for Depression. Front Pharmacol 2022; 12:788155. [PMID: 35431912 PMCID: PMC9009076 DOI: 10.3389/fphar.2021.788155] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 12/07/2021] [Indexed: 01/30/2023] Open
Abstract
Background: Across psychotherapeutic frameworks, the strength of the therapeutic alliance has been found to correlate with treatment outcomes; however, its role has never been formally assessed in a trial of psychedelic-assisted therapy. We aimed to investigate the relationships between therapeutic alliance and rapport, the quality of the acute psychedelic experience and treatment outcomes. Methods: This 2-arm double-blind randomized controlled trial compared escitalopram with psychedelic-assisted therapy for moderate-severe depressive disorder (N = 59). This analysis focused on the psilocybin condition (n = 30), who received two oral doses of 25 mg psilocybin, 3-weeks apart, with psychological preparation, in-session support, and integration therapy. A new psychedelic therapy model, called “Accept-Connect-Embody” (ACE), was developed in this trial. The primary outcome was depression severity 6 weeks post treatment (Quick Inventory of Depressive Symptomatology, QIDS-SR-16). Path analyses tested the hypothesis that therapeutic alliance (Scale To Assess the Therapeutic Relationship Patient Version, STAR-P) would predict depression outcomes via its influence on the acute psychedelic experience, specifically emotional-breakthrough (EBI) and mystical-type experiences (MEQ). The same analysis was performed on the escitalopram arm to test specificity. Results: The strength of therapeutic alliance predicted pre-session rapport, greater emotional-breakthrough and mystical-type experience (maximum EBI and MEQ scores across the two psilocybin sessions) and final QIDS scores (β = −0.22, R2 = 0.42 for EBIMax; β = −0.19, R2 = 0.32 for MEQMax). Exploratory path models revealed that final depression outcomes were more strongly affected by emotional breakthrough during the first, and mystical experience during the second session. Emotional breakthrough, but not mystical experience, during the first session had a positive effect on therapeutic alliance ahead of the second session (β = 0.79, p < 0.0001). Therapeutic alliance ahead of the second session had a direct impact on final depression scores, not mediated by the acute experience, with a weaker alliance ahead of the second psilocybin session predicting higher absolute depression scores at endpoint (β = −0.49, p < 0.001) Discussion: Future research could consider therapist training and characteristics; specific participant factors, e.g., attachment style or interpersonal trauma, which may underlie the quality of the therapeutic relationship, the psychedelic experience and clinical outcomes; and consider how therapeutic approaches might adapt in cases of weaker therapeutic alliance. Clinical Trial Registration: This trial is registered at http://clinicaltrials.gov, identifier (NCT03429075).
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Affiliation(s)
- Roberta Murphy
- Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, Faculty of Medicine, London, United Kingdom
- Medical Psychotherapy, South West London and St. Georges NHS Trust, London, United Kingdom
- *Correspondence: Roberta Murphy,
| | - Hannes Kettner
- Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, Faculty of Medicine, London, United Kingdom
| | - Rick Zeifman
- Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, Faculty of Medicine, London, United Kingdom
- Department of Psychology, Ryerson University, Toronto, ON, Canada
| | - Bruna Giribaldi
- Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, Faculty of Medicine, London, United Kingdom
| | - Laura Kartner
- Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, Faculty of Medicine, London, United Kingdom
| | - Jonny Martell
- Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, Faculty of Medicine, London, United Kingdom
- Medical Psychotherapy and General Adult Psychiatry, Devon Partnership NHS Trust, Exeter, United Kingdom
| | - Tim Read
- Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, Faculty of Medicine, London, United Kingdom
| | - Ashleigh Murphy-Beiner
- Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, Faculty of Medicine, London, United Kingdom
- Department of Psychology, Royal Holloway University, Surrey, United Kingdom
| | - Michelle Baker-Jones
- Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, Faculty of Medicine, London, United Kingdom
| | - David Nutt
- Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, Faculty of Medicine, London, United Kingdom
| | - David Erritzoe
- Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, Faculty of Medicine, London, United Kingdom
| | - Rosalind Watts
- Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, Faculty of Medicine, London, United Kingdom
| | - Robin Carhart-Harris
- Department of Brain Sciences, Centre for Psychedelic Research, Imperial College London, Faculty of Medicine, London, United Kingdom
- Psychedelics Division Neuroscape, Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
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Prevalence of children witnessed violence in a pediatric emergency department. Eur J Pediatr 2022; 181:2695-2703. [PMID: 35441247 PMCID: PMC9018099 DOI: 10.1007/s00431-022-04474-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 03/03/2022] [Accepted: 04/10/2022] [Indexed: 11/03/2022]
Abstract
UNLABELLED Witnessed violence is a form of child abuse with detrimental effects on child wellbeing and development, whose recognition relies on the assessment of their mother exposure to intimate partner violence (IPV). The aim of this study was to assess the frequency of witnessed violence in a population of children attending a pediatric emergency department (ED) in Italy, by searching for IPV in their mother, and to define the characteristics of the mother-child dyads. An observational cross-sectional study was conducted from February 2020 to January 2021. Participating mothers were provided a questionnaire, which included the Woman Abuse Screening Tool (WAST) and additional questions about their baseline data and health. Descriptive analysis was reported as frequency and percentage for the categorical variables and median and interquartile range (IQR) for quantitative variables. Mothers and children screened positive and negative for IPV and witnessed violence, respectively, were compared by the chi-square test or the exact Fisher test for categorical variables, and by the Wilcoxon-Mann-Whitney test for continuous variables. Out of 212 participating mothers, ninety-three (43.9%) displayed a positive WAST. Mothers tested positive were mainly Italian (71%, p 0.003), had a lower level of education (median age at school dropout 19, p 0.0002), and a higher frequency of unemployment (p 0.001) and poor personal health status (8.6%, p 0.001). The children of mothers tested positive showed a higher occurrence of abnormal psychological-emotional state (38.7%, p 0.002) and sleep disturbances (26.9%, p 0.04). CONCLUSION IPV was common in a population of mothers seeking care for their children in a pediatric ED. WHAT IS KNOWN • Witnessed violence is a form of child abuse, usually inferred by their mothers' exposure to IPV. The latter is suffered by one in three women worldwide. WHAT IS NEW • This study shows a 43.9% prevalence of IPV among mothers attending an Italian pediatric ED. • Positive mother-child dyads displayed a higher frequency of poor mothers' health status and children's abnormal emotional state and sleep disturbances.
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22
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Thompson DS, Fowler JC, Bradshaw MR, Frueh BC, Weinstein BL, Petrosino J, Hadden JK, Madan A. Is the gut microbiota associated with suicidality? Non-significant finding among a large cohort of psychiatrically hospitalized individuals with serious mental illness. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Ciocca G, Pelligrini F, Mollaioli D, Limoncin E, Sansone A, Colonnello E, Jannini EA, Fontanesi L. Hypersexual behavior and attachment styles in a non-clinical sample: The mediation role of depression and post-traumatic stress symptoms. J Affect Disord 2021; 293:399-405. [PMID: 34246948 DOI: 10.1016/j.jad.2021.06.064] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 06/24/2021] [Accepted: 06/27/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Hypersexuality is a complex behavioral dysfunction concerning the excess of sexual activities. In this study, we aim to investigate the role of attachment styles, post-traumatic and depression symptoms in hypersexual behavior. METHODS We recruited through an online platform a snowball convenience sample of 1025 subjects (females: n=731; 71.3%; males: 294; 28.7%; age: 29.62±10.90) and we administered them a sociodemographic questionnaire, with a psychometric protocol composed by the Hypersexual Behavior Inventory (HBI) to assess hypersexuality, the Relationship Questionnaire (RQ) for the attachment styles, the International Trauma Questionnaire (ITQ) to evaluate the trauma and Patient Health Questionnaire (PHQ) for depression. RESULTS We found a significant and predictive impact of preoccupied and fearful attachment styles on hypersexual behavior (β=.116; p<.0001 and β=.121p<.0001, respectively). The categorical analysis of RQ confirmed also statistically significant differences between secure attachment style with fearful and preoccupied ones in terms of HBI levels (secure=30.01±10.79; preoccupied=35.50±14.46; fearful=36.57±13.50). Moreover, we found that depression symptoms and the total score of ITQ also resulted predictive for hypersexuality (β=.323; p<.0001 and β=.063; p<.04). However, in our model, depression and post-traumatic symptoms played a mediation role between insecure attachment and hypersexual behavior. CONCLUSION This study found a fundamental role of insecure attachment styles, post-traumatic and depression symptoms in the development of problematic sexuality. Hypersexual behavior is related in a causal manner with an insecure attachment style, fearful and preoccupied attachment, particularly. Nevertheless, the traumatic core of personality together with depression symptoms could play a mediation role towards the hypersexual behavior.
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Affiliation(s)
- Giacomo Ciocca
- Department of Dynamic and Clinical Psychology, and Health Studies, "Sapienza" University of Rome, Rome, Italy.
| | - Fabiana Pelligrini
- Department of Dynamic and Clinical Psychology, and Health Studies, "Sapienza" University of Rome, Rome, Italy
| | - Daniele Mollaioli
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Erika Limoncin
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Andrea Sansone
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Elena Colonnello
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Emmanuele A Jannini
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Lilybeth Fontanesi
- Department of Psychological, Health, and Territorial Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
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Le TL, Geist R, Bearss E, Maunder RG. Childhood adversity and attachment anxiety predict adult symptom severity and health anxiety. CHILD ABUSE & NEGLECT 2021; 120:105216. [PMID: 34303992 DOI: 10.1016/j.chiabu.2021.105216] [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: 01/05/2021] [Revised: 06/29/2021] [Accepted: 07/09/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Childhood adversity is associated with somatization, including physical symptom burden and health anxiety. Attachment theory offers a developmental framework to understand adult somatization, as attachment phenomena are theoretically and empirically related to physiological regulation, affect regulation, and childhood adversity, all of which are relevant to somatization. OBJECTIVE The purpose of this study was to identify the pathways by which childhood adversity and attachment insecurity influence physical symptom burden and health anxiety in adults. PARTICIPANTS AND SETTING Three hundred and fifty-one family medicine patients from a teaching hospital in Toronto, Canada. METHODS A cross-sectional survey study was conducted to assess adverse childhood experiences, attachment insecurity, health anxiety and physical symptom severity in primary care patients. Path Analysis using structural equation modeling (AMOS V.26, IBM, 2019) was used to test the model in which childhood adversity, attachment anxiety, attachment avoidance, symptom severity interact to influence health anxiety. RESULTS The majority of the participants were white (66%), had completed post-secondary education (68%), and reported themselves to be in very good to excellent health (62%). Childhood adversity, attachment anxiety, attachment avoidance, health anxiety and symptom severity are all significantly correlated (ranges of rs = 0.29 to 0.63). Childhood adversity has a significant indirect effect on health anxiety with attachment anxiety and symptom severity as serial mediators (βindirect = 0.237, p = .001 and βdirect = 0.065, p = .244). CONCLUSIONS Overall, this model extends our understanding of the processes underlying adult somatization. Findings support that childhood adversity and attachment anxiety are predictors of symptom severity and health anxiety.
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Affiliation(s)
- Thao Lan Le
- Department of Psychiatry, Sinai Health System, 600 University Avenue, Toronto, Ontario, Canada.
| | - Rose Geist
- Department of Psychiatry, The Hospital for Sick Children, 555 University Ave, Toronto, ON, Canada
| | - Erin Bearss
- Mount Sinai Academic Family Health Team, Sinai Health System, 60 Murray St, Toronto, Ontario, Canada
| | - Robert G Maunder
- Department of Psychiatry, Sinai Health System, 600 University Avenue, Toronto, Ontario, Canada
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Dargis M, Mitchell-Somoza A. Challenges Associated with Parenting While Incarcerated: A Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9927. [PMID: 34574849 PMCID: PMC8469117 DOI: 10.3390/ijerph18189927] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/07/2021] [Accepted: 09/08/2021] [Indexed: 01/24/2023]
Abstract
Of the 2.5 million people who are incarcerated in the United States, over half are parents. While it is well-established that incarceration has a detrimental impact on the children of incarcerated parents, less is known regarding the psychological impact of incarceration on parents themselves. The present review summarizes existing literature on the impact of incarceration on parents retrieved via online databases. Published articles were classified according to their overall themes and summarized. Pertinent studies include the psychological and emotional consequences of incarceration on parents, the experience of parenting while incarcerated, including barriers to parenting, the utility of parenting program interventions during periods of incarceration, and how these results differ for mothers and fathers. While the existing evidence introduces these issues, there is a need for additional research on the impact of incarceration on parents. These areas for future research as well as clinical implications are discussed.
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Affiliation(s)
- Monika Dargis
- Department of Psychiatry, Weill Cornell Medical College, New York, NY 10065, USA
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Wang D, Jiang Q, Yang Z, Choi JK. The longitudinal influences of adverse childhood experiences and positive childhood experiences at family, school, and neighborhood on adolescent depression and anxiety. J Affect Disord 2021; 292:542-551. [PMID: 34147966 DOI: 10.1016/j.jad.2021.05.108] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 03/19/2021] [Accepted: 05/30/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Adolescent depression and anxiety are major mental health concerns. Adverse childhood experiences (ACEs) are risk factors for depression and anxiety in adolescence and positive childhood experiences at home, school, and neighborhood are protective factors. Few studies, however, have compared the longitudinal effects of these two sets of contextual risk and protective factors on depression and anxiety among adolescents by framing them together. METHODS This study used data on a subsample of 3426 socioeconomically disadvantaged adolescents collected at their birth, ages one, three, five, nine, and fifteen. Logistic regression was used to examine the longitudinal effects of ACEs, focusing on childhood maltreatment and family dysfunctions, and positive childhood experiences with family, school, and neighborhood on the risks of depression and anxiety. Adolescents' characteristics and their families' socioeconomic status were adjusted. RESULTS In the two ACEs subcategories, childhood maltreatment exposures increased the risks only for later anxiety; family dysfunction increased the risks for both later depression and anxiety. In the three contexts, positive childhood experiences at family and school protected at-risk adolescents against both mental health concerns, whereas neighborhood collective efficacy protected adolescents only against depression. LIMITATIONS Resilience was examined as an outcome only; it can also be examined as a process. Neither teachers' nor grandparents' supports were included. CONCLUSIONS ACEs maltreatment and family dysfunction are two different risk dimensions for adolescent depression and anxiety. Positive childhood experiences at family are the strongest protective factors for children exposed to ACEs, followed by these in school and neighborhood. Early interventions building positive relationships may benefit adolescent mental health.
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Affiliation(s)
- Dan Wang
- Department of Child, Youth, and Family Studies, University of Nebraska-Lincoln, Lincoln, Nebraska.
| | - Qingyu Jiang
- Department of Child, Youth, and Family Studies, University of Nebraska-Lincoln, Lincoln, Nebraska
| | - Zhenqiao Yang
- Department of Child, Youth, and Family Studies, University of Nebraska-Lincoln, Lincoln, Nebraska
| | - Jeong-Kyun Choi
- Department of Child, Youth, and Family Studies, University of Nebraska-Lincoln, Lincoln, Nebraska
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Moore KE, Siebert S, Brown G, Felton J, Johnson JE. Stressful life events among incarcerated women and men: Association with depression, loneliness, hopelessness, and suicidality. HEALTH & JUSTICE 2021; 9:22. [PMID: 34427798 PMCID: PMC8386053 DOI: 10.1186/s40352-021-00140-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 06/11/2021] [Indexed: 05/13/2023]
Abstract
BACKGROUND Justice-involved populations report a higher than average number of pre-incarceration stressful life events. However, few studies have described stressful life events which occur during incarceration, explored gender differences in these events, or evaluated the effect of these events on well-being. METHOD This study draws from a sample of male and female adults incarcerated in 6 prison facilities across two states (n = 160) to identify the number and type of stressful life events they experienced during incarceration, gender differences in stressful events, and the relationship between stressful life events and markers of well-being (i.e., depression, hopelessness, loneliness, suicidality). We also examined whether perceived social support would buffer the relationship between stressful events and well-being outcomes. RESULTS Participants on average reported experiencing 4 stressful life events during their current incarceration, the most common being relocation to another cell and being made fun of/insulted by someone in the prison. There were few gender differences in types of events experienced. Regression analyses showed that stressful life events were associated with more loneliness, as well as suicidality, but only when participants had low perceived social support. CONCLUSIONS Stressful life events, and drawing on social support networks to cope with stress, should be addressed in the context of correctional treatments to reduce suicide risk during incarceration.
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Affiliation(s)
- Kelly E Moore
- Department of Psychology, East Tennessee State University, 420 Rogers-Stout Hall, P.O. Box 70649, Johnson City, TN, 37614, USA.
| | - Shania Siebert
- Department of Psychology, East Tennessee State University, 420 Rogers-Stout Hall, P.O. Box 70649, Johnson City, TN, 37614, USA
| | - Garrett Brown
- College of Human Medicine, Michigan State University, Flint, USA
| | - Julia Felton
- College of Human Medicine, Michigan State University, Flint, USA
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Hatton-Bowers H, Lombardi CM, Kemp B, Decker KB, Virmani EA, Brophy-Herb HE, Vallotton CD. Risks and resources for college students' mental health: ACEs, attachment, and mindfulness. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021:1-12. [PMID: 34242546 DOI: 10.1080/07448481.2021.1942007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 03/24/2021] [Accepted: 06/08/2021] [Indexed: 06/13/2023]
Abstract
To examine associations between risks and resources in predicting college students' depressive symptoms at the beginning of one semester and change over the semester. Participants: Participants were undergraduate students taking human development courses at one of 11 universities in the U.S. (N = 854). Methods: Survey data were collected at the beginning and end of the semester. Results: Experiencing more direct abusive or neglectful adverse childhood experiences (ACEs), and attachment preoccupation were associated with higher depressive symptoms at the beginning of the semester. Conversely, greater mindful awareness and attachment security were associated with lower initial depressive symptoms. Experiences of ACEs were associated with increases in depressive symptoms, as were higher levels of attachment dismissiveness. Greater mindful acceptance was associated with decreases in depressive symptoms. In most analyses, resources did not moderate the associations between ACEs and depressive symptoms. Conclusions: Results may inform instructors and counselors in supporting students' well-being.
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Affiliation(s)
- Holly Hatton-Bowers
- Child, Youth, and Family Studies, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | | | - Blakelee Kemp
- Sociology, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Kalli B Decker
- Health & Human Development, Montana State University, Bozeman, Montana, USA
| | - Elita Amini Virmani
- Early Childhood Studies, Sonoma State University, Rohnert Park, California, USA
| | - Holly E Brophy-Herb
- Human Development & Family Studies, Michigan State University, East Lansing, Michigan, USA
| | - Claire D Vallotton
- Human Development & Family Studies, Michigan State University, East Lansing, Michigan, USA
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Schleider JL, Woerner J, Overstreet C, Amstadter AB, Sartor CE. Interpersonal Trauma Exposure and Depression in Young Adults: Considering the Role of World Assumptions. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:6596-6620. [PMID: 30574826 PMCID: PMC7359202 DOI: 10.1177/0886260518819879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
The transition to young adulthood confers heightened risk for depression, and exposure to interpersonal trauma (IPT) can magnify this risk. However, not all IPT-exposed young adults develop depressive symptoms, and not all young adults with depressive symptoms report past IPT, suggesting a need to identify moderators of the IPT-depression link. This study investigated whether four different world assumptions-core beliefs about the nature of the world-moderated the association between IPT exposure and depressive symptoms in college students (N = 1,084, M age = 19.5, 74.1% female). Participants self-reported IPT exposure, depressive symptoms, and world assumptions via an online survey. We predicted that the IPT-depressive symptom association would be weaker among young adults with more positive assumptions about the safety of the world, trustworthiness of people, predictability of people, and controllability of events, versus those with more negative world assumptions in these domains. Hierarchical regression results supported this prediction with respect to one world assumption type: more positive beliefs about the world's safety significantly attenuated the relation between past IPT exposure and present depressive symptoms, ΔF(1, 1061) = 9.54, ΔR2 = 0.01, p = .002. The IPT-depressive symptom link was over 3 times as strong for young adults with weak "world-is-safe" assumptions, versus those with strong "world-is-safe" assumptions. No other world assumption types emerged as moderators. Lay theories of the world's safety may represent a basic, survival-oriented belief with implications for depressive symptoms following safety threats, such as IPT. Addressing "world-is-safe" assumptions may enhance depression prevention efforts for IPT-exposed young adults.
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Cho S, Bulger M. Social Support and Depressive Symptoms among Trauma-Impacted Older Adults. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2021; 18:371-378. [PMID: 33491588 DOI: 10.1080/26408066.2020.1866729] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose: The present study investigates the association between social support and depressive symptomatology among older adults who have been impacted by trauma. Previous studies have not sufficiently explored this topic to date.Method: The current study analyzed public-use data from the 2012 Health and Retirement Study (N = 4,195), focusing specifically on community-dwelling older adults (> 50). They had at least one traumatic event in their lifetime.Results: This study found that higher levels of social support were significantly associated with lower levels of depressive symptoms after controlling for life satisfaction, age, gender, race, ethnicity, and education..Discussion and Conclusion: The recent emergence of trauma-informed research has consistently emphasized the importance of social interaction for mental health. The current study shows that social support can reduce depressive symptoms of those who have experienced trauma.
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Affiliation(s)
- Seungjong Cho
- Department of Sociology, Anthropology, and Social Work, Texas Tech University Lubbock, TX, USA
| | - Morgan Bulger
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, USA
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Ashfield E, Chan C, Lee D. Building 'a compassionate armour': The journey to develop strength and self-compassion in a group treatment for complex post-traumatic stress disorder. Psychol Psychother 2021; 94 Suppl 2:286-303. [PMID: 32306537 DOI: 10.1111/papt.12275] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 02/14/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Complex post-traumatic stress disorder (PTSD) is associated with severe difficulties in emotional regulation, interpersonal relationships, and shame. For individuals with these difficulties, exposure-based treatment for PTSD symptoms is less effective and can even be harmful. This study aimed to investigate the mechanisms of change at an individual and group level for individuals completing treatment for complex PTSD. DESIGN Constructivist grounded theory was used to develop an explanatory theoretical model of the change process. METHODS Semi-structured interviews were conducted with 11 women with a diagnosis of complex PTSD who had completed the group treatment. RESULTS The theoretical model captured change as an ongoing journey, which continued after treatment finished. Participants identified three essential aspects of the group that brought about change. The first was the group itself, in which valued relationships were formed. Additionally, participants described two key mechanisms - developing a comprehensive understanding of themselves and their difficulties, and experiencing their emotions and compassion from others. CONCLUSIONS The key mechanisms of change were the relationships formed within the group and the need for a deeper understanding of the self in order to reduce shame and prepare for exposure-based treatment. Further support is provided for a phase-based approach to complex PTSD treatment. Psychoeducation alone, however, was not sufficient, and it was also crucial that participants could safely access their emotions and experience compassion from others in order for change to come about. PRACTITIONER POINTS Important aspects of treatment for complex PTSD are emphasised to inform professional practice. In particular, the role of relationships is altering self-perceptions through group therapy. Other key elements included participants building an understanding of themselves and their difficulties through psychoeducation, developing compassion for others and themselves, and safely accessing their emotions. This study also builds upon the body of evidence for the benefits of phase-based treatment which addresses shame and emotional regulation prior to exposure therapy.
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Affiliation(s)
- Emily Ashfield
- Wokingham Community Mental Health Team, Berkshire Healthcare Foundation Trust, UK
| | - Carmen Chan
- Horizon (Supporting Young People and Families Affected by Sexual Harm), Oxford Health NHS Foundation Trust, UK
| | - Deborah Lee
- Berkshire Traumatic Stress Service, Berkshire Healthcare Foundation Trust, UK
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Psychological outcomes for young adults after disastrous events: A mixed-methods scoping review. Soc Sci Med 2021; 276:113851. [PMID: 33812159 DOI: 10.1016/j.socscimed.2021.113851] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 02/03/2021] [Accepted: 03/13/2021] [Indexed: 12/13/2022]
Abstract
RATIONALE Young adulthood (18 to 34) is a time of transitional change where individuals can be highly susceptible to mental health concerns. Despite similar vulnerabilities to their adolescent counterparts, the psychological outcomes for young adults following disasters are not well understood. OBJECTIVE This scoping review aimed to explore the literature on the psychological outcomes for young adults after disaster events. METHODS A systematic search of the literature was conducted in seven electronic databases, including PsycINFO, Medline, CINAHL, PILOTS, EMBASE, Scopus, and ProQuest dissertations and theses global. In total, 91 reports from 15 countries were included. RESULTS Findings suggested that young adults experience a range of psychological consequences after disasters, including posttraumatic stress symptoms, depression, anxiety, and other psychological outcomes, such as general/non-specific psychological distress. Pre-disaster, peri-disaster, and post-disaster factors were also found to influence the degree of psychological outcomes experienced by young adults, including prior psychological functioning and disaster exposure, among a host of other factors. CONCLUSION Future research is recommended to better understand young adults' psychological outcomes, experiences, and service needs following disasters.
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Bürgin D, Boonmann C, Schmeck K, Schmid M, Tripp P, Nishimi K, O’Donovan A. Compounding Stress: Childhood Adversity as a Risk Factor for Adulthood Trauma Exposure in the Health and Retirement Study. J Trauma Stress 2021; 34:124-136. [PMID: 33200440 PMCID: PMC7887022 DOI: 10.1002/jts.22617] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 08/10/2020] [Accepted: 09/07/2020] [Indexed: 12/21/2022]
Abstract
Childhood adversity (CA) and adulthood traumatic experiences (ATEs) are common and unequally distributed in the general population. Early stressors may beget later stressors and alter life-course trajectories of stressor exposure. Gender differences exist regarding the risk of specific stressors. However, few studies have examined the associations between specific types of CA and ATEs. Using a large-scale sample of older adults, we aimed to (a) determine if specific or cumulative CA increased the risk for specific or cumulative ATEs and (b) examine whether these associations were moderated by gender. In a sample from the U.S. Health and Retirement Study (N = 15,717; Mage = 67.57 years, SD = 10.54), cross-sectional Poisson and logistic regression models were fitted to assess the specific and cumulative associations between CA and ATEs. Overall, cumulative CA was associated with a larger risk ratio of ATEs, adjusted for covariates: aRRRs = 1.28, 1.63, and 1.97 for 1, 2, and 3-4 adverse events in childhood, respectively. Cumulative CA was particularly strongly associated with adulthood physical attacks, aOR = 5.66, and having a substance-abusing spouse or child, aOR = 4.00. Childhood physical abuse was the strongest independent risk factor for cumulative ATEs, aRRR = 1.49, and most strongly associated with adulthood physical attacks, aOR = 3.41. Gender moderated the association between cumulative CA and cumulative ATEs, with slightly stronger associations between cumulative CA and ATEs for women than men. Given that CA and ATEs perpetuate health disparities worldwide, reducing their incidence and effects should be major priorities for public health.
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Affiliation(s)
- David Bürgin
- Child and Adolescent Psychiatric Research Department, University Psychiatric Hospitals, University of Basel, Basel, Switzerland
- Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, USA
- Mental Health Service, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
| | - Cyril Boonmann
- Child and Adolescent Psychiatric Research Department, University Psychiatric Hospitals, University of Basel, Basel, Switzerland
| | - Klaus Schmeck
- Child and Adolescent Psychiatric Research Department, University Psychiatric Hospitals, University of Basel, Basel, Switzerland
| | - Marc Schmid
- Child and Adolescent Psychiatric Research Department, University Psychiatric Hospitals, University of Basel, Basel, Switzerland
| | - Paige Tripp
- Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, USA
- Mental Health Service, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
| | - Kristen Nishimi
- Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, USA
- Mental Health Service, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
| | - Aoife O’Donovan
- Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, USA
- Mental Health Service, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
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Orme W, Kapoor S, Frueh BC, Allen JG, Fowler JC, Madan A. Attachment Style Mediates the Relationship between Trauma and Somatic Distress among Individuals with Serious Mental Illness. Psychiatry 2021; 84:150-164. [PMID: 34293279 DOI: 10.1080/00332747.2021.1930427] [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: 10/20/2022]
Abstract
Objective: Individuals with mental illnesses severe enough to require psychiatric hospitalization often have significant trauma histories, have developed maladaptive attachment styles, and experience comorbid somatic distress. Gaining an understanding about the interaction of such factors may lead to prioritizing interventions that target factors that mediate the relationship between trauma and adverse somatic distress. Prior research has examined various mediation models, but results have been mixed and conducted only on outpatient samples.Method: Participants (47.7% female) in a large sample (N = 2702) with a mean age of 34.62 (SD = 14.7) were enrolled in a specialist inpatient program and completed self-report measures pertaining to demographics, attachment insecurity, lifetime trauma exposure, and somatic distress within 72 hours of admission. The dimensions of attachment insecurity (i.e., attachment anxiety and attachment avoidance) were tested as parallel mediators in the relationship between lifetime trauma exposure and somatic distress.Results: The mediation analyses revealed that attachment anxiety and avoidance partially mediated the relationship between lifetime trauma exposure and somatic distress.Conclusions: These results are the first to date to implicate both attachment anxiety and avoidance as mediators between trauma exposure and somatic distress in a high acuity sample. Although the results do not imply causality, they do call attention to social-cognitive factors related to somatic distress and highlight the importance of considering attachment styles as a possible contributor to comorbid physical symptoms in patients with trauma exposure.
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Leo D, Izadikhah Z, Fein EC, Forooshani SA. The Effect of Trauma on Religious Beliefs: A Structured Literature Review and Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2021; 22:161-175. [PMID: 30862254 DOI: 10.1177/1524838019834076] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Empirical research has shown that religious beliefs support people recovering from traumatic experiences. However, there is relatively little research on the inversion of this dynamic, the way that trauma changes a person's religious beliefs. The authors of this article conducted a structured literature review and meta-analysis of published quantitative and qualitative literature related to the effects of interpersonal trauma on religious beliefs in adults. Their aims were to determine whether religious beliefs act as cognitive schemas, to support or reject the "shattered assumptions" hypothesis, and to assess whether post-traumatic stress disorder (PTSD) symptoms have an additive effect on changing beliefs. METHOD Five academic databases were searched using permutations of the key words: Religion, Trauma, and Posttraumatic Stress Disorder (PTSD). The resulting references were compared to predetermined inclusion/exclusion criteria, and the reference lists of these papers were also searched for additional matches. Included papers were then subjected to a meta-analysis. RESULTS Five quantitative, two qualitative, and two mixed-methodologies papers were matched. Aggravated analyzes confirmed the hypothesized effect (r = .19, p < .05). CONCLUSIONS The reviewed literature suggests that most people do not change their religious beliefs after a trauma but significant changes occur for a smaller proportion of people-either increasing or decreasing their religious beliefs. These effects are greatest for people who develop PTSD. This review supports the shattered assumptions hypothesis of Janoff-Bulman, explains the cognitive mechanisms of change, and proposes a model for the additive effects of PTSD.
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Affiliation(s)
- Darius Leo
- School of Psychology and Counselling, 7932University of Southern Queensland, Ipswich, Queensland, Australia
| | - Zahra Izadikhah
- School of Psychology and Counselling, 7932University of Southern Queensland, Ipswich, Queensland, Australia
| | - Erich C Fein
- School of Psychology and Counselling, 7932University of Southern Queensland, Ipswich, Queensland, Australia
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Bürgin D, Kind N, Schröder M, Clemens V, Fegert JM, Eckert A, Buchheim A, O'Donovan A, Boonmann C, Schmid M. The Stress of Caring-Resilience and HPA-Axis Activity in Hair Samples of Youth Residential Caregivers. Front Psychiatry 2020; 11:556486. [PMID: 33408649 PMCID: PMC7779549 DOI: 10.3389/fpsyt.2020.556486] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 11/30/2020] [Indexed: 11/26/2022] Open
Abstract
Background: Professional caregivers in youth residential care institutions experience frequent verbal and physical aggression as well as multiple stressors as part of their everyday work, leading to high levels of burnout and staff turnover. Resilience might buffer against psychophysiological stress response and therefore be crucial for well-being in professional caregivers. Objectives: We aimed to investigate if measures related to resilience [sense of coherence (SoC), self-efficacy and self-care] and attachment security of caregivers were cross-sectionally associated with stress markers in hair samples [cortisol and dehydroepiandrosterone (DHEA)]. Method: Participants (n = 134; 64.2% women) reported on individual resilience measures and provided hair samples for cortisol and DHEA assays. Attachment was assessed in a subsample using the Adult Attachment Projective Picture System (AAP, n = 69). Linear regression models were fitted to estimate the association between resilience measures and the Cortisol:DHEA ratio, cortisol and DHEA, controlling for gender and age. Results: SoC was associated with a lower Cortisol:DHEA ratio (β = -0.36, p < 0.001), driven by a positive association between SoC and DHEA levels (β = 0.28, p = 0.002). Self-care was also associated with lower Cortisol:DHEA ratios (β = -0.24, p = 0.005), due to self-care being associated with higher DHEA (β = 0.21, p = 0.016). HPA-axis measures were not associated with self-efficacy nor with attachment patterns in a subsample. Conclusions: Our findings imply that youth residential care institutions might benefit from programs focusing on enhancing SoC and self-care practices. Fostering a meaningful, comprehensible and manageable professional climate in caregiving environments and implementing self-care in routine practices might enhance not only well-being but also physical health of professional caregivers and in this way buffer adverse health effects of chronic stressors.
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Affiliation(s)
- David Bürgin
- Child and Adolescent Psychiatric Research Department, University Psychiatric Hospitals, University of Basel, Basel, Switzerland
| | - Nina Kind
- Child and Adolescent Psychiatric Research Department, University Psychiatric Hospitals, University of Basel, Basel, Switzerland
| | - Martin Schröder
- Child and Adolescent Psychiatric Research Department, University Psychiatric Hospitals, University of Basel, Basel, Switzerland
| | - Vera Clemens
- Department for Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Jörg M. Fegert
- Department for Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Anne Eckert
- Neurobiological Laboratory for Brain Aging and Mental Health, Transfaculty Research Platform, University of Basel, Basel, Switzerland
| | - Anna Buchheim
- Institute of Psychology, University Innsbruck, Innsbruck, Austria
| | - Aoife O'Donovan
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, CA, United States
- Mental Health Services, San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States
| | - Cyril Boonmann
- Child and Adolescent Psychiatric Research Department, University Psychiatric Hospitals, University of Basel, Basel, Switzerland
| | - Marc Schmid
- Child and Adolescent Psychiatric Research Department, University Psychiatric Hospitals, University of Basel, Basel, Switzerland
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Food Addiction and Tobacco Use Disorder: Common Liability and Shared Mechanisms. Nutrients 2020; 12:nu12123834. [PMID: 33334010 PMCID: PMC7765398 DOI: 10.3390/nu12123834] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/04/2020] [Accepted: 12/10/2020] [Indexed: 02/07/2023] Open
Abstract
As food addiction is being more commonly recognized within the scientific community, parallels can be drawn between it and other addictive substance use disorders, including tobacco use disorder. Given that both unhealthy diets and smoking are leading risk factors for disability and death, a greater understanding of how food addiction and tobacco use disorder overlap with one another is necessary. This narrative review aimed to highlight literature that investigated prevalence, biology, psychology, and treatment options of food addiction and tobacco use disorder. Published studies up to August 2020 and written in English were included. Using a biopsychosocial lens, each disorder was assessed together and separately, as there is emerging evidence that the two disorders can develop concurrently or sequentially within individuals. Commonalities include but are not limited to the dopaminergic neurocircuitry, gut microbiota, childhood adversity, and attachment insecurity. In addition, the authors conducted a feasibility study with the purpose of examining the association between food addiction symptoms and tobacco use disorder among individuals seeking tobacco use disorder treatment. To inform future treatment approaches, more research is necessary to identify and understand the overlap between the two disorders.
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Wang P, Lei L, Yu G, Li B. Social Networking Sites Addiction and Materialism Among Chinese Adolescents: A Moderated Mediation Model Involving Depression and Need to Belong. Front Psychol 2020; 11:581274. [PMID: 33363495 PMCID: PMC7753116 DOI: 10.3389/fpsyg.2020.581274] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 11/09/2020] [Indexed: 01/09/2023] Open
Abstract
Recent research indicates that social networking site (SNS) addiction is positively associated with materialism. However, little attention has been paid to the potential mechanisms in this relationship. This study tested the mediating role of depression and the moderating role of need to belong (NTB) in the relationships between SNS addiction and adolescents’ materialism. This research model was tested among 733 adolescents in China (mean age = 16.79 years, SD = 0.91). The findings indicated that both SNS addiction and NTB were positively related to adolescents’ materialism. Mediation analyses showed that depression mediated the association between SNS addiction and adolescents’ materialism. Moderated mediation indicated that the effect of SNS addiction on materialism and the effect of SNS addiction on depression were exacerbated by NTB. This study can advance our understanding of how SNS could contribute to adolescents’ materialism in this digital society.
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Affiliation(s)
- Pengcheng Wang
- School of Education, Renmin University of China, Beijing, China
| | - Li Lei
- Institute of Psychology, Renmin University of China, Beijing, China
| | - Guoliang Yu
- Institute of Psychology, Renmin University of China, Beijing, China
| | - Biao Li
- School of Journalism and Communication, Renmin University of China, Beijing, China
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Mavrandrea P, Giovazolias T. The effect of personality on depressive symptoms: The mediating effect of adult attachment. CURRENT PSYCHOLOGY 2020. [DOI: 10.1007/s12144-020-01207-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Lynch KS, Lachman ME. The Effects of Lifetime Trauma Exposure on Cognitive Functioning in Midlife. J Trauma Stress 2020; 33:773-782. [PMID: 32516491 PMCID: PMC7572703 DOI: 10.1002/jts.22522] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 10/26/2019] [Accepted: 11/19/2019] [Indexed: 11/10/2022]
Abstract
Accumulating evidence suggests that lifetime trauma exposure is associated with adulthood cognitive functioning. However, the nature and extent of this relation have yet to be fully explored. We used multilevel modeling to examine trauma exposure and age at first trauma exposure as predictors of the level of and change in cognitive functioning over a 9-year period. Data were from the Midlife in the United States study, a national survey that began in 1995. Data regarding trauma exposure and age at first exposure were obtained from the 2004 wave, whereas cognitive data were obtained from the 2004 and 2013 waves. The analyses were conducted using data from the 2,471 participants (age range: 28-84 years) who had complete data on all variables from the 2004 wave. Lifetime trauma exposure predicted change in executive functioning (EF), B = -0.03, SE = 0.01, p = .015, 95% CI [-0.05, -0.01]; and episodic memory, B = -0.05, SE = 0.02, p = .023, 95% CI [-0.10, -0.01], such that individuals with more trauma exposure had more decline over 9 years. Age at first exposure also predicted change in EF, B = -0.002, SE = 0.00, p = .009, 95% CI [-0.004, -0.001], such that individuals who were first exposed to trauma later in life had greater EF decline than individuals whose first traumatic event occurred earlier in life. Delta pseudo- R 2 values were moderate, ΔpseudoR2 = .17-.39. These findings identify trauma exposure as a risk factor for cognitive decline in adulthood and highlight the elevated risk associated with adulthood trauma exposure.
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Affiliation(s)
- Kristin S. Lynch
- Department of Psychology Brandeis University Waltham Massachusetts USA
| | - Margie E. Lachman
- Department of Psychology Brandeis University Waltham Massachusetts USA
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Undeger I, Visser RM, Olsson A. Neural Pattern Similarity Unveils the Integration of Social Information and Aversive Learning. Cereb Cortex 2020; 30:5410-5419. [PMID: 32494810 PMCID: PMC7472208 DOI: 10.1093/cercor/bhaa122] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 04/17/2020] [Accepted: 04/21/2020] [Indexed: 12/11/2022] Open
Abstract
Attributing intentions to others' actions is important for learning to avoid their potentially harmful consequences. Here, we used functional magnetic resonance imaging multivariate pattern analysis to investigate how the brain integrates information about others' intentions with the aversive outcome of their actions. In an interactive aversive learning task, participants (n = 33) were scanned while watching two alleged coparticipants (confederates)-one making choices intentionally and the other unintentionally-leading to aversive (a mild shock) or safe (no shock) outcomes to the participant. We assessed the trial-by-trial changes in participants' neural activation patterns related to observing the coparticipants and experiencing the outcome of their choices. Participants reported a higher number of shocks, more discomfort, and more anger to shocks given by the intentional player. Intentionality enhanced responses to aversive actions in the insula, anterior cingulate cortex, inferior frontal gyrus, dorsal medial prefrontal cortex, and the anterior superior temporal sulcus. Our findings indicate that neural pattern similarities index the integration of social and threat information across the cortex.
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Affiliation(s)
- Irem Undeger
- Section for Psychology, Department of Clinical Neuroscience, Karolinska Institute, Stockholm 171 77, Sweden
| | - Renée M Visser
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, 1018 WT, The Netherlands
| | - Andreas Olsson
- Section for Psychology, Department of Clinical Neuroscience, Karolinska Institute, Stockholm 171 77, Sweden
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Struck N, Krug A, Feldmann M, Yuksel D, Stein F, Schmitt S, Meller T, Brosch K, Dannlowski U, Meinert S, Opel N, Lemke H, Waltemate L, Nenadić I, Kircher T, Brakemeier EL. Attachment and social support mediate the association between childhood maltreatment and depressive symptoms. J Affect Disord 2020; 273:310-317. [PMID: 32421618 DOI: 10.1016/j.jad.2020.04.041] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 04/06/2020] [Accepted: 04/24/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To examine attachment insecurity and low social support as potential mediators of the association between childhood maltreatment (CM) types and depression severity in patients with a lifetime history of major depressive disorders (MDD). METHOD Participants with an acute or remitted MDD (N = 580) completed questionnaires about CM (Childhood Trauma Questionnaire), attachment (Relationship Scales Questionnaire), social support (Social Support Questionnaire), and depression severity (Beck Depression Inventory). Mediation and path models with CM types as independent variables, attachment avoidance and anxiety as mediators and depression severity as dependent variable were calculated. In addition, a sequential mediation model with attachment insecurity and social support as mediators of the association between CM and depression was tested. RESULTS Attachment avoidance and anxiety partially mediated the effect of CM on depression. In the path model including the different CM types, there were significant indirect effects of emotional abuse on depression via attachment anxiety and of emotional neglect on depression via attachment avoidance. Results also supported the hypothesized sequential mediation via attachment insecurity and social support. LIMITATIONS A cross-sectional design with a retrospective self-report measure of CM was used and the developmental timing of exposure to CM was not considered. CONCLUSION Our findings suggest that the effect of emotional abuse and emotional neglect on depression is partially mediated by attachment avoidance and anxiety. Further, the results support the hypothesis of a sequential mediation via attachment insecurity and social support. Accordingly, attachment insecurity is discussed as a target of psychotherapy for patients with MDD and CM.
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Affiliation(s)
- Nele Struck
- Department of Clinical Psychology and Psychotherapy, University of Marburg, Marburg, Germany.
| | - Axel Krug
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany; Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany; Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Matthias Feldmann
- Department of Clinical Psychology and Psychotherapy, University of Marburg, Marburg, Germany
| | - Dilara Yuksel
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany; Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany; Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Simon Schmitt
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany; Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Tina Meller
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany; Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany; Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Udo Dannlowski
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Susanne Meinert
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Nils Opel
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Hannah Lemke
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Lena Waltemate
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany; Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany; Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Eva-Lotta Brakemeier
- Department of Clinical Psychology and Psychotherapy, University of Marburg, Marburg, Germany; Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany; Department of Clinical Psychology and Psychotherapy, University of Greifswald, Greifswald, Germany
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Ciocca G, Rossi R, Collazzoni A, Gorea F, Vallaj B, Stratta P, Longo L, Limoncin E, Mollaioli D, Gibertoni D, Santarnecchi E, Pacitti F, Niolu C, Siracusano A, Jannini EA, Di Lorenzo G. The impact of attachment styles and defense mechanisms on psychological distress in a non-clinical young adult sample: A path analysis. J Affect Disord 2020; 273:384-390. [PMID: 32560933 DOI: 10.1016/j.jad.2020.05.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 04/21/2020] [Accepted: 05/10/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Insecure attachment styles and immature or neurotic defense mechanisms are related to psychological distress. However, their mutual interaction in influencing psychological distress deserves further investigation. METHODS One-thousand-one-hundred-twenty-nine University students were evaluated using the Global Severity Index of Symptoms Check List 90-Revised for psychological distress, Relationship Questionnaire for attachment styles and Defense Style Questionnaire for defense mechanisms. Following exploratory analyses, a Path Analysis was performed with psychological distress as outcome. RESULTS Fearful and preoccupied attachment styles had a substantial impact on psychological distress. About 30% of their effect was mediated by Immature and Neurotic defenses, with the former having the major effect. Dismissing attachment showed no substantial effect on psychological distress. Secure Attachment and Mature Defenses had a small protective effect on psychological distress, but their inclusion in the path model did not improve overall goodness-of-fit. Attachment style and defense mechanisms accounted for nearly 25% of the variance in psychological distress. CONCLUSIONS The results showed that attachment styles and defense mechanisms have a substantial impact on psychological distress. The effect of attachment style is mediated by defense mechanisms. Individual differences in attachment style and defense mechanisms represent risk factors for psychological distress in young adults.
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Affiliation(s)
- Giacomo Ciocca
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Rodolfo Rossi
- Department of Systems Medicine, University of Rome Tor Vergata, Italy
| | - Alberto Collazzoni
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy
| | - Fiorela Gorea
- Catholic University of "Our Lady of Good Council", Tirana, Albania
| | - Blerina Vallaj
- Catholic University of "Our Lady of Good Council", Tirana, Albania
| | - Paolo Stratta
- Department of Mental Health, ASL 01 Avezzano-Sulmona-L'Aquila, Italy
| | - Lucia Longo
- Department of Systems Medicine, University of Rome Tor Vergata, Italy; Psychiatry and Clinical Psychology Unit, Fondazione Policlinico Tor Vergata, Rome, Italy
| | - Erika Limoncin
- Department of Systems Medicine, University of Rome Tor Vergata, Italy
| | - Daniele Mollaioli
- Department of Systems Medicine, University of Rome Tor Vergata, Italy
| | - Dino Gibertoni
- DIBINEM Department of Biomedical And Neuromotor Sciences, Unit of Hygiene, Public Health And Biostatistics, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Emiliano Santarnecchi
- Department of Medicine, Surgery and Neuroscience, University of Siena, Italy; Berenson-Allen Center for Non-Invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Francesca Pacitti
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy; Catholic University of "Our Lady of Good Council", Tirana, Albania
| | - Cinzia Niolu
- Department of Systems Medicine, University of Rome Tor Vergata, Italy; Psychiatry and Clinical Psychology Unit, Fondazione Policlinico Tor Vergata, Rome, Italy
| | - Alberto Siracusano
- Department of Systems Medicine, University of Rome Tor Vergata, Italy; Psychiatry and Clinical Psychology Unit, Fondazione Policlinico Tor Vergata, Rome, Italy
| | | | - Giorgio Di Lorenzo
- Department of Systems Medicine, University of Rome Tor Vergata, Italy; Psychiatry and Clinical Psychology Unit, Fondazione Policlinico Tor Vergata, Rome, Italy; IRCCS Fondazione Santa Lucia, Rome, Italy.
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Nesterko Y, Jäckle D, Friedrich M, Holzapfel L, Glaesmer H. Factors predicting symptoms of somatization, depression, anxiety, post-traumatic stress disorder, self-rated mental and physical health among recently arrived refugees in Germany. Confl Health 2020; 14:44. [PMID: 32670398 PMCID: PMC7346670 DOI: 10.1186/s13031-020-00291-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 06/30/2020] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND There is a large body of research indicating increased prevalence rates of mental disorders among refugees. However, the vast majority of the evidence available on risk factors for mental disorders among refugees focuses on post-migration stressors and was collected in surveys that were conducted months and sometimes years after the participants had resettled. OBJECTIVE In the present study, we analyze socio-demographic and flight-related characteristics as predictors for symptoms of somatization, depression, anxiety, and post-traumatic stress disorder as well as self-rated mental and physical health in recently arrived refugees (up to 4 weeks after arrival) in Germany. METHODS The study was conducted in a reception facility for asylum-seekers in Leipzig, Germany. A total of 1316 adult individuals arrived at the facility during the survey period; 502 took part in the study. The questionnaire (self-administrated) included socio-demographic and flight-related questions as well as standardized instruments for assessing PTSD (PCL-5), depression (PHQ-9), anxiety (HSCL-10) and somatization (SSS-8). Linear regression models were conducted to predict symptoms of different mental disorders as well as self-rated mental and physical health. RESULTS Lack of information about family members and subjective need for health care were found to be significantly associated with symptoms of depression, somatization, anxiety, and PTSD. Better self-rated mental health was significantly associated with partnership, childlessness, lower number of traumatic events, and having information about family left behind. No associations were found between flight-related factors and symptom burden. CONCLUSIONS The results provide initial methodologically robust insights for research and health care services, which should aid in better identifying newly arrived refugees in need of psychosocial care. Furthermore, the results might help answering the question of how to provide health care for highly vulnerable groups within refugee populations regardless their residential status.
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Affiliation(s)
- Yuriy Nesterko
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
| | - David Jäckle
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
| | - Michael Friedrich
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
| | - Laura Holzapfel
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
| | - Heide Glaesmer
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
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Tang W, Hu T, Yang L, Xu J. The role of alexithymia in the mental health problems of home-quarantined university students during the COVID-19 pandemic in China. PERSONALITY AND INDIVIDUAL DIFFERENCES 2020; 165:110131. [PMID: 32518435 PMCID: PMC7273169 DOI: 10.1016/j.paid.2020.110131] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/16/2020] [Accepted: 05/18/2020] [Indexed: 02/08/2023]
Abstract
Objective While it is well known that mental health problems are common consequences of deadly pandemics, the association with alexithymia is less clear. This study examined this association in an evaluation of home-quarantined university students during the 2019/2020 COVID-19 pandemic in China. Methods In total, 2501 home-quarantined students from six southwest Chinese universities completed the following questionnaires: the 20-item Toronto Alexithymia Scale (TAS-20), the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL—C), and the Patients Health Questionnaire-9 (PHQ-9), after which structural equation modeling (SEM) and mediation analyses were employed to extract and evaluate the possible associations. Results It was found that participants with probable depression or PTSD also reported more severe alexithymia features, such as difficulties in identifying feelings (DIF) or describing feelings (DDF). Alexithymia was also found to partially mediate the effect of number of exposures on mental health problems. Conclusion These results suggested that implementing strategies to assist young people identify and deal with their own emotions and those of others could prevent or mitigate the mental health problems associated with deadly pandemic events. However, future longitudinal studies are needed to examine the specific involvement of DIF or DDF in people with mental health problems.
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Affiliation(s)
- Wanjie Tang
- Centre for Educational and Health Psychology, Sichuan University, Chengdu, China.,Institute of Emergency Management and Post-disaster Reconstruction, Sichuan University, No. 24, South Section 1, Yihuan Road Wuhou District, 610065 Chengdu, China.,Mental Health Center, State Key Lab of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Tao Hu
- Department of Psychology, Chengdu Normal University, Chengdu, China
| | - Le Yang
- West China College of Pharmacy, Sichuan University, Chengdu, China
| | - Jiuping Xu
- Institute of Emergency Management and Post-disaster Reconstruction, Sichuan University, No. 24, South Section 1, Yihuan Road Wuhou District, 610065 Chengdu, China
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Van Assche L, Van de Ven L, Vandenbulcke M, Luyten P. Ghosts from the past? The association between childhood interpersonal trauma, attachment and anxiety and depression in late life. Aging Ment Health 2020; 24:898-905. [PMID: 30739477 DOI: 10.1080/13607863.2019.1571017] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Objectives: Research suggests that vulnerability for anxiety and depression in late life results from a complex interaction between (neuro)biological and environmental factors. In this context, there is growing evidence for the role of childhood trauma on vulnerability for both anxiety and depression throughout the course of life, mainly through its effects on attachment as a biologically based neurodevelopmental stress regulation system. Yet, the impact of childhood trauma on depression and anxiety in late life specifically remains unclear. The current study therefore aims to investigate the association between retrospectively reported childhood interpersonal trauma, attachment dimensions and levels of anxiety and depression in late life.Method: A sample of 81 community dwelling older adults completed measures of early and current adversity, attachment dimensions, and levels of anxiety and depression.Results: The occurrence and frequency of childhood trauma, but not later negative adult life events, was associated with late life anxiety and depression. Both attachment anxiety and avoidance were related to anxiety and depression. Only attachment anxiety affected the association between childhood trauma, and emotional neglect in particular, and late life anxiety and depression.Conclusion: Childhood trauma may be associated with anxiety and depression in late life. Part of this association is probably indirect, via the effect of insecure attachment and high levels of attachment anxiety in particular.
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Affiliation(s)
- Lies Van Assche
- Section of Geriatric Psychiatry, Department of Psychiatry, University Hospitals Leuven, KUL, Belgium
| | - Luc Van de Ven
- Section of Geriatric Psychiatry, Department of Psychiatry, University Hospitals Leuven, KUL, Belgium
| | - Mathieu Vandenbulcke
- Section of Geriatric Psychiatry, Department of Psychiatry, University Hospitals Leuven, KUL, Belgium
| | - Patrick Luyten
- Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium.,Research Department of Clinical Educational and Health Psychology, University College London, London, UK
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Scheer JR, Harney P, Esposito J, Woulfe JM. Self-Reported Mental and Physical Health Symptoms and Potentially Traumatic Events Among Lesbian, Gay, Bisexual, Transgender, and Queer Individuals: The Role of Shame. PSYCHOLOGY OF VIOLENCE 2020; 10:131-142. [PMID: 33062388 PMCID: PMC7556696 DOI: 10.1037/vio0000241] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals disproportionately face exposure to potentially traumatic events-adverse experiences that may have a traumatizing effect-and experience shame as a common consequence. Previous research demonstrates associations between shame and psychological and physical health issues among those with exposure to potentially traumatic events in general, with limited attention among LGBTQ individuals specifically. This study determined whether shame partially mediated the relationship between potentially traumatic events exposure and self-reported mental and physical health symptoms among LGBTQ individuals. METHOD Participants were 218 self-identified LGBTQ individuals who reported experiencing at least one potentially traumatic event (e.g., childhood sexual abuse). Online surveys assessed the type and frequency of potentially traumatic events exposure, shame, self-reported mental health (depression symptoms, posttraumatic stress disorder symptoms, and substance use), and physical health symptoms (sexual risk behavior, somatic symptoms, and chronic health conditions). RESULTS Greater potentially traumatic events exposure was associated with greater shame, and greater shame was associated with worse self-reported mental and physical health. Potentially traumatic events exposure had a direct effect on self-reported mental and physical health, and shame partially mediated this relationship. CONCLUSION Shame represents an important and modifiable factor that relates to poor health and may be amenable to change through psychosocial interventions. Given the prevalence of negative self-attribution stemming from potentially traumatic events exposure, in addition to the internalization of stigma among this population, practitioners need to uncover interventions specifically targeting shame when working with LGBTQ individuals.
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Affiliation(s)
| | | | - Jessica Esposito
- Brooklyn Campus of the Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York
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Madan A, Thompson D, Fowler JC, Ajami NJ, Salas R, Frueh BC, Bradshaw MR, Weinstein BL, Oldham JM, Petrosino JF. The gut microbiota is associated with psychiatric symptom severity and treatment outcome among individuals with serious mental illness. J Affect Disord 2020; 264:98-106. [PMID: 32056780 DOI: 10.1016/j.jad.2019.12.020] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 12/09/2019] [Accepted: 12/13/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Emerging evidence implicates the gut microbiota in central nervous system functioning via its effects on inflammation, the hypothalamic-pituitary axis, and/or neurotransmission. Our understanding of the cellular underpinnings of the brain-gut relationship is based almost exclusively on animal models with some small-scale human studies. This study examined the relationship between the gut microbiota and psychiatric symptom severity and treatment response among inpatients with serious mental illness. METHOD We collected data from adult inpatients (N = 111). Measures of diagnoses, suicide severity, trauma, depression, and anxiety were collected shortly after admission, while self-collected fecal swabs were collected early in the course of hospitalization and processed using 16S rRNA gene sequencing and whole genome shotgun sequencing methods. RESULTS Results indicate that depression and anxiety severity shortly after admission were negatively associated with bacterial richness and alpha diversity. Additional analyses revealed a number of bacterial taxa associated with depression and anxiety severity. Gut microbiota richness and alpha diversity early in the course of hospitalization was a significant predictor of depression remission at discharge. CONCLUSIONS This study is among the first to demonstrate a gut microbiota relationship with symptom severity among psychiatric inpatients as well as a relationship to remission of depression post-treatment. These findings are consistent with animal models and limited human studies as well as with the broader literature implicating inflammation in the pathophysiology of depression. These findings offer the foundation for further studies of novel therapeutic approaches to the treatment, prevention of, or recurrence of serious mental illness.
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Affiliation(s)
- A Madan
- Houston Methodist Hospital, Houston, TX, USA; Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA.
| | - D Thompson
- Alkek Center for Metagenomics and Microbiome Research, Baylor College of Medicine, Houston, TX, USA
| | - J C Fowler
- Houston Methodist Hospital, Houston, TX, USA; Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - N J Ajami
- Alkek Center for Metagenomics and Microbiome Research, Baylor College of Medicine, Houston, TX, USA
| | - R Salas
- Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; Michael E DeBakey VA Medical, Houston, TX, USA; The Menninger Clinic, Houston, TX, USA
| | - B C Frueh
- Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA; Department of Psychology, University of Hawaii, Hilo, USA
| | - M R Bradshaw
- Houston Methodist Hospital, Houston, TX, USA; Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - B L Weinstein
- Houston Methodist Hospital, Houston, TX, USA; Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - J M Oldham
- Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; The Menninger Clinic, Houston, TX, USA
| | - J F Petrosino
- Alkek Center for Metagenomics and Microbiome Research, Baylor College of Medicine, Houston, TX, USA
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Nakhid-Chatoor M. Schools and Suicide - The Importance of the Attachment Bond. CRISIS 2020; 41:1-6. [PMID: 31934796 DOI: 10.1027/0227-5910/a000640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Chen CK, Nehrig N, Chou LJ, McGowan R, Guyton AF, Mustafiz F, Bailey RW. Patient Extratherapeutic Interpersonal Problems and Response to Psychotherapy for Depression. Am J Psychother 2019; 72:101-122. [PMID: 31813229 DOI: 10.1176/appi.psychotherapy.20190005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVES This paper aimed to synthesize empirical findings of patient extratherapeutic interpersonal variables associated with individual psychotherapy treatment outcomes in adult outpatients with depression. METHODS A systematic search strategy was used to identify relevant studies. Thematic analysis was used to identify recurring themes in the findings. RESULTS Forty studies met search criteria. Three themes of patient extratherapeutic interpersonal variables were identified: capacity to engage with others, capacity to navigate relationships, and capacity to achieve intimacy, progressing from basic to advanced levels of interpersonal interaction. Interpersonal variables such as interpersonal distress and style, attachment orientation, and quality of object relations were particularly useful in predicting treatment outcomes, whereas access to social support and marital status provided mixed results, likely because they do not account for relationship quality. CONCLUSIONS Recognizing variables associated with treatment response can help clinicians identify patients at risk for nonresponse and guide efforts for adapting existing therapies and developing new ones.
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Affiliation(s)
- Cory K Chen
- Veterans Affairs (VA) New York Harbor Healthcare System, New York (Chen, Nehrig, Guyton, Mustafiz); Department of Psychiatry, New York University, New York (Chen, Nehrig); VA Long Beach Healthcare System, Long Beach, California (Chou); Department of Epidemiology & Health Promotion, New York University School of Medicine, Langone Medical Center, New York (McGowan); Department of Psychology, University of New Mexico, Albuquerque (Bailey)
| | - Nicole Nehrig
- Veterans Affairs (VA) New York Harbor Healthcare System, New York (Chen, Nehrig, Guyton, Mustafiz); Department of Psychiatry, New York University, New York (Chen, Nehrig); VA Long Beach Healthcare System, Long Beach, California (Chou); Department of Epidemiology & Health Promotion, New York University School of Medicine, Langone Medical Center, New York (McGowan); Department of Psychology, University of New Mexico, Albuquerque (Bailey)
| | - Leetyng Jennifer Chou
- Veterans Affairs (VA) New York Harbor Healthcare System, New York (Chen, Nehrig, Guyton, Mustafiz); Department of Psychiatry, New York University, New York (Chen, Nehrig); VA Long Beach Healthcare System, Long Beach, California (Chou); Department of Epidemiology & Health Promotion, New York University School of Medicine, Langone Medical Center, New York (McGowan); Department of Psychology, University of New Mexico, Albuquerque (Bailey)
| | - Richard McGowan
- Veterans Affairs (VA) New York Harbor Healthcare System, New York (Chen, Nehrig, Guyton, Mustafiz); Department of Psychiatry, New York University, New York (Chen, Nehrig); VA Long Beach Healthcare System, Long Beach, California (Chou); Department of Epidemiology & Health Promotion, New York University School of Medicine, Langone Medical Center, New York (McGowan); Department of Psychology, University of New Mexico, Albuquerque (Bailey)
| | - Angel F Guyton
- Veterans Affairs (VA) New York Harbor Healthcare System, New York (Chen, Nehrig, Guyton, Mustafiz); Department of Psychiatry, New York University, New York (Chen, Nehrig); VA Long Beach Healthcare System, Long Beach, California (Chou); Department of Epidemiology & Health Promotion, New York University School of Medicine, Langone Medical Center, New York (McGowan); Department of Psychology, University of New Mexico, Albuquerque (Bailey)
| | - Fayel Mustafiz
- Veterans Affairs (VA) New York Harbor Healthcare System, New York (Chen, Nehrig, Guyton, Mustafiz); Department of Psychiatry, New York University, New York (Chen, Nehrig); VA Long Beach Healthcare System, Long Beach, California (Chou); Department of Epidemiology & Health Promotion, New York University School of Medicine, Langone Medical Center, New York (McGowan); Department of Psychology, University of New Mexico, Albuquerque (Bailey)
| | - Robert W Bailey
- Veterans Affairs (VA) New York Harbor Healthcare System, New York (Chen, Nehrig, Guyton, Mustafiz); Department of Psychiatry, New York University, New York (Chen, Nehrig); VA Long Beach Healthcare System, Long Beach, California (Chou); Department of Epidemiology & Health Promotion, New York University School of Medicine, Langone Medical Center, New York (McGowan); Department of Psychology, University of New Mexico, Albuquerque (Bailey)
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