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van Rensburg DJ, Womersley JS, Martin L, Seedat S, Hemmings SMJ. Differential microRNA expression in adolescent anxiety proneness. Eur J Neurosci 2024; 60:5680-5693. [PMID: 39189635 DOI: 10.1111/ejn.16523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 07/29/2024] [Accepted: 08/14/2024] [Indexed: 08/28/2024]
Abstract
Biological mechanisms underlying anxiety proneness (AP), the tendency to react fearfully to stressors due to the belief that experiencing anxiety has harmful consequences, remain unclear. Epigenetic mechanisms, such as microRNAs (small, non-coding RNAs 19-20 nucleotides long), may be contributory. This study investigated AP-associated differences in microRNA expression among South African adolescents with variable exposure to childhood trauma (CT). AP was assessed using a composite score reflecting trait anxiety and anxiety sensitivity, while CT exposure was assessed with the Childhood Trauma Questionnaire. High-quality total RNA (n = 88) extracted from whole blood underwent microRNA-sequencing. Differential microRNA expression analysis was conducted with DESeq2 in R, messenger RNA target prediction analysis was performed using TargetScan and DIANA-microT, and the DIANA mirPATH tool was used for KEGG pathway analysis. The majority of participants were female (75.86%) with an average age of 15 (±1.19) years. MicroRNA expression analysis identified upregulation of hsa-miR-28-5p and downregulation of hsa-miR-502-3p and hsa-miR-500a-3p in high-AP individuals, irrespective of CT. Four KEGG pathways, each with ≥10% of their constituent genes predicted to be targets of the differentially expressed microRNAs, were identified and were enriched for genes involved in calcineurin and glutamate signalling. These findings suggest that epigenetically mediated effects on neuronal function contribute to the molecular aetiology of AP.
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Affiliation(s)
- Danièlle Jansen van Rensburg
- Division of Molecular Biology and Human Genetics, Department of Biomedical Science, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town, South Africa
| | - Jacqueline Samantha Womersley
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Stellenbosch University/South African Medical Research Council Genomics of Brain Disorders Extramural Research Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Lindi Martin
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Stellenbosch University/South African Medical Research Council Genomics of Brain Disorders Extramural Research Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Sian Megan Joanna Hemmings
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Stellenbosch University/South African Medical Research Council Genomics of Brain Disorders Extramural Research Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Van Landeghem C, Jakobson LS. Isolating unique variance in mental health outcomes attributable to personality variables and childhood emotional abuse. Front Psychol 2024; 15:1330483. [PMID: 38318082 PMCID: PMC10838979 DOI: 10.3389/fpsyg.2024.1330483] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 01/08/2024] [Indexed: 02/07/2024] Open
Abstract
Introduction University students are at high risk for anxiety and depression. Our main objective was to tease apart variance in symptom severity that was uniquely attributable to four associated variables that are frequently confounded: exposure to childhood emotional abuse, alexithymia, sensory processing sensitivity (SPS), and anxiety sensitivity (AS). Methods University students (N = 410) completed an online survey designed to measure our four key study variables along with several other potentially relevant variables including sex, physical activity levels, and perceived COVID-19 impacts. Results Over half of the participants reported moderate to extremely severe symptoms of anxiety and depression. Females reported stronger signs of SPS and AS and were more likely than males to have increased their moderate/vigorous exercise since the pandemic began. After controlling for the other variables, the best predictors of perceived COVID-19 impacts were SPS, childhood emotional abuse, and current levels of physical activity. Whereas all three personality variables and childhood emotional abuse emerged as significant predictors of both depression and anxiety, neither COVID-19 impacts nor physical activity levels accounted for unique variance in either model. Unexpectedly, male sex emerged as an additional risk factor for depression, raising the possibility that males experience unique stressors and societal pressures that increase their risk of depression. Discussion These findings help to clarify the links between childhood emotional abuse, personality traits implicated in emotional awareness and self-regulation, and mental health. They may have important implications for the development and implementation of individualized treatments for common mental disorders.
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Affiliation(s)
| | - Lorna S. Jakobson
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
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3
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Azarmehr R, Reck AJ, Zhang L, Oshri A. COVID-19-related stress exacerbates the effect of child maltreatment on negative affect via increased identity confusion during adolescence. J Adolesc 2024; 96:18-30. [PMID: 37718632 PMCID: PMC10843095 DOI: 10.1002/jad.12249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 08/30/2023] [Accepted: 09/05/2023] [Indexed: 09/19/2023]
Abstract
INTRODUCTION Exposure to childhood maltreatment may undermine the crucial developmental task of identity formation in adolescence, placing them at risk for developing negative affect. The current study investigated whether COVID-19-related stress intensified the indirect link between child maltreatment and adolescents' negative affect through identity confusion. METHOD Using multidimensional assessments of child maltreatment (threat vs. deprivation), the study included a sample of 124 adolescents (Mage = 12.89, SD = 0.79; 52% female) assessed before (January 2018 to March 2020) and during the pandemic (May to October 2020) in Georgia, United States. The majority of the participants were European American (78.8%), followed by African American (11.5%), Hispanic (3.8%), Asian/Pacific Islander (1.0%), and other (4.8%). We used structural equation modeling to test (a) the mediating role of identity confusion in the link between childhood maltreatment and negative affect and (b) whether COVID-19-related stress moderated these indirect effects. Simple slopes and Johnson-Neyman plots were generated to probe regions of significant interaction effects. RESULTS Threat and deprivation predicted an increase in adolescent identity confusion. Additionally, childhood threat and deprivation were indirectly linked to adolescents' negative affect through increased levels of identity confusion. COVID-19-related stress significantly exacerbated the link between identity confusion and negative affect. CONCLUSION Identity confusion is a mechanism underlying the link between child maltreatment and the development of negative affect in adolescence. Our results inform prevention and intervention programs that aim to reduce negative affect among adolescents who experience threatening and depriving rearing environments.
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Affiliation(s)
- Rabeeh Azarmehr
- Department of Human Development and Family Science, University of Georgia, Dawson Hall, 305 Sanford Drive, Athens, GA, 30602, United States
- Youth Development Institute, University of Georgia, Room 208, 105 Foster Road (Pound Hall), Athens, GA, 30606, United States
| | - Ava J. Reck
- Department of Human Development and Family Science, University of Georgia, Dawson Hall, 305 Sanford Drive, Athens, GA, 30602, United States
- Youth Development Institute, University of Georgia, Room 208, 105 Foster Road (Pound Hall), Athens, GA, 30606, United States
| | - Linhao Zhang
- Department of Human Development and Family Science, University of Georgia, Dawson Hall, 305 Sanford Drive, Athens, GA, 30602, United States
- Youth Development Institute, University of Georgia, Room 208, 105 Foster Road (Pound Hall), Athens, GA, 30606, United States
| | - Assaf Oshri
- Department of Human Development and Family Science, University of Georgia, Dawson Hall, 305 Sanford Drive, Athens, GA, 30602, United States
- Youth Development Institute, University of Georgia, Room 208, 105 Foster Road (Pound Hall), Athens, GA, 30606, United States
- Integrated Life Sciences, Behavioral and Cognitive Neuroscience, University of Georgia, Athens, GA, United States
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Delgado-Sanchez A, Brown C, Charalambous C, Sivan M, Jones A. Trauma in childhood is associated with greater pain catastrophizing but not anxiety sensitivity: a cross-sectional study. Pain Rep 2023; 8:e1083. [PMID: 37388407 PMCID: PMC10306427 DOI: 10.1097/pr9.0000000000001083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 03/01/2023] [Accepted: 04/10/2023] [Indexed: 07/01/2023] Open
Abstract
Introduction Adverse life experiences have been identified as a possible vulnerability factor for chronic pain. This association could result from the effect of trauma on the psychological state of individuals. Previous studies found childhood trauma to be associated with pain catastrophizing and anxiety sensitivity, both of which have been associated with an increased risk of chronic pain. However, it is unknown whether trauma in adulthood affects these variables and whether the effect on pain catastrophizing is independent of confounds such as depression and anxiety. Objectives To test the effect of childhood and adulthood trauma on pain catastrophizing and anxiety sensitivity whilst controlling for depression and anxiety. Methods In the current study, we conducted an online survey in the United Kingdom in a chronic pain sample (N = 138; 123 women; age range 19-78). We analysed whether there is an association between different types of trauma (both in childhood and through the lifespan), pain catastrophizing, and anxiety sensitivity while controlling for anxiety and depression. Results We found that childhood trauma (particularly emotional abuse) significantly predicts pain catastrophizing, even when controlling for depression and anxiety, whereas it did not have a significant effect on anxiety sensitivity. Trauma through the lifespan (not childhood) did not have a significant effect on anxiety sensitivity nor did it have a significant effect on pain catastrophizing. Conclusions Our results show that the life stage in which trauma occurs is key in its psychological effects on patients with chronic pain. Furthermore, it shows that trauma affects some psychological variables but not others.
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Affiliation(s)
- Ariane Delgado-Sanchez
- Human Pain Research Group, Division of Human Communication, Development, and Hearing, University of Manchester, Manchester, United Kingdom
| | - Christopher Brown
- Human Pain Research Group, Division of Human Communication, Development, and Hearing, University of Manchester, Manchester, United Kingdom
- Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Christiana Charalambous
- Human Pain Research Group, Division of Human Communication, Development, and Hearing, University of Manchester, Manchester, United Kingdom
- Department of Mathematics, The University of Manchester, Manchester, United Kingdom
| | - Manoj Sivan
- Human Pain Research Group, Division of Human Communication, Development, and Hearing, University of Manchester, Manchester, United Kingdom
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom
| | - Anthony Jones
- Human Pain Research Group, Division of Human Communication, Development, and Hearing, University of Manchester, Manchester, United Kingdom
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The Role of Anxiety Sensitivity in the Association Between Childhood Maltreatment and Sleep Disturbance Among Adults in Psychiatric Inpatient Treatment. J Nerv Ment Dis 2023; 211:306-313. [PMID: 36801864 DOI: 10.1097/nmd.0000000000001621] [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: 02/19/2023]
Abstract
The present investigation examined associations of childhood maltreatment, anxiety sensitivity (AS), and sleep disturbance among a diverse sample of adults in psychiatric inpatient treatment. We hypothesized that childhood maltreatment would be indirectly associated with greater sleep disturbance through elevated AS. Exploratory analyses examined the indirect effect models with three AS subscales (i.e., physical, cognitive, and social concerns) as parallel mediators. A sample of adults in acute-care psychiatric inpatient treatment (N = 88; 62.5% male; Mage = 33.32 years, SD = 11.07; 45.5% White) completed a series of self-report measures. After accounting for theoretically relevant covariates, childhood maltreatment was indirectly associated with sleep disturbance through AS. Parallel mediation analyses revealed that no individual subscale of AS significantly accounted for this association. These findings suggest that heightened levels of AS may explain the association between childhood maltreatment and sleep disturbance among adults in psychiatric inpatient treatment. Interventions targeting AS can be brief and efficacious and have the potential to improve clinical outcomes among psychiatric populations.
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Sfendla A, Bador K, Paganelli M, Kerekes N. Swedish High School Students' Drug and Alcohol Use Habits throughout 2020. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16928. [PMID: 36554808 PMCID: PMC9779023 DOI: 10.3390/ijerph192416928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/26/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
This study describes gender-specific patterns in alcohol and drug use among Swedish high school students throughout 2020 and questions the current cutoffs for identifying addiction in this population. From September 2020 to February 2021, 1590 Swedish upper secondary high school students (mean age 17.15 years, age range 15-19 years, 39.6% male, and 60.4% female) completed the anonymous, electronic survey of the Mental and Somatic Health without borders study. The respondents reported their substance use habits during the previous 12 months using the Drug Use Disorders Identification Test (DUDIT) and Alcohol Use Disorders Identification Test (AUDIT). They also answered questions about changes in their alcohol and illegal drug use habits after the COVID-19 outbreak. No gender differences were detected in the prevalence and degree of alcohol use. Compared to female adolescents, significantly more male adolescents used drugs (and to a significantly higher degree, although with a small effect size). Substance use problems peaked in females at age 17 and in males at age 18. The COVID-19 outbreak affected alcohol consumption and illegal drug use in male and female adolescents similarly. For both genders, of those who used illegal drugs, over 40% reported increased use after the outbreak. Our results reinforce previous suggestions of the narrowing of gender differences in Swedish adolescents' risk behaviors and challenge the previously validated gender-specific cutoffs for the AUDIT and DUDIT. An improved understanding of the impacts of gender diversity and evolving gender roles and norms on behaviors and mental health is warranted.
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Affiliation(s)
- Anis Sfendla
- Higher Institute of Nursing Professions and Health Techniques, Errachidia 52000, Morocco
- Department of Biology, Faculty of Sciences, Abdelmalek Essaâdi University, Tetouan 93000, Morocco
- Center for Holistic Psychiatry Research (CHoPy), 431 60 Mölndal, Sweden
| | - Kourosh Bador
- Center for Holistic Psychiatry Research (CHoPy), 431 60 Mölndal, Sweden
- AGERA KBT, 411 38 Gothenburg, Sweden
| | - Michela Paganelli
- Center for Holistic Psychiatry Research (CHoPy), 431 60 Mölndal, Sweden
| | - Nóra Kerekes
- Center for Holistic Psychiatry Research (CHoPy), 431 60 Mölndal, Sweden
- Department of Health Sciences, University West, 461 86 Trollhättan, Sweden
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7
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Womersley JS, Roeh S, Martin L, Ahmed-Leitao F, Sauer S, Rex-Haffner M, Hemmings SMJ, Binder EB, Seedat S. FKBP5 intron 7 methylation is associated with higher anxiety proneness and smaller right thalamus volume in adolescents. Brain Struct Funct 2022; 227:2809-2820. [PMID: 36197505 DOI: 10.1007/s00429-022-02577-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 09/23/2022] [Indexed: 11/28/2022]
Abstract
Dysregulation of stress response systems may mediate the detrimental effects of childhood trauma (CT) on mental health. FKBP5 regulates glucocorticoid receptor sensitivity and exerts pleiotropic effects on intracellular signaling, neurobiology and behavior. We investigated whether CT, alone and in combination with rs1360780 genotype, is associated with altered FKBP5 methylation and whether CT-associated methylation profiles are associated with anxiety proneness (AP) and structural brain volumes. Ninety-four adolescents completed the Childhood Trauma Questionnaire, and a composite AP score was generated from the Childhood Anxiety Sensitivity Index and the State-Trait Anxiety Inventory-Trait measure. Mean methylation values for 12 regulatory regions and 25 individual CpG sites were determined using high-accuracy measurement via targeted bisulfite sequencing. FKBP5 rs1360780 genotype and structural MRI data were available for a subset of participants (n = 71 and n = 75, respectively). Regression models revealed an inverse association between methylation of three intron 7 CpG sites (35558438, 35558566 and 35558710) and right thalamus volume. CpG35558438 methylation was positively associated with AP scores. Our data indicate that an intron 7 methylation profile, consistent with lower FKBP5 expression and elevated high sensitivity glucocorticoid receptor levels, is associated with higher AP and smaller right thalamus volume. Research into the mechanisms underlying the intron 7 methylation-thalamus volume relationship, and whether it confers increased risk for long-term psychopathology by altering the regulatory threshold of stress responding, is required.
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Affiliation(s)
- Jacqueline S Womersley
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa. .,South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa. .,Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany.
| | - Simone Roeh
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Lindi Martin
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Fatima Ahmed-Leitao
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Susann Sauer
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Monika Rex-Haffner
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Sian M J Hemmings
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Elisabeth B Binder
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany.,Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,South African Research Chairs Initiative (SARChI) in PTSD, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
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8
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Sevenoaks T, Fouche JP, Phillips N, Heany S, Myer L, Zar HJ, Stein DJ, Hoare J. Childhood Trauma and Mental Health in the Cape Town Adolescent Antiretroviral Cohort. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:353-363. [PMID: 35600517 PMCID: PMC9120333 DOI: 10.1007/s40653-021-00362-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/05/2021] [Indexed: 06/03/2023]
Abstract
This study aimed to assess the association of childhood trauma, stressful life events and HIV stigma with mental health in South African adolescents from the Cape Town Adolescent Antiretroviral Cohort (CTAAC). The Childhood Trauma Questionnaire, Life Events Questionnaire and the HIV Stigma Scale for South African Adolescents Living with HIV was used to assess childhood trauma, stressful life events and stigma in adolescents living with perinatally acquired HIV and healthy controls enrolled in the CTAAC. These measures were associated with mental health outcomes including the Beck-Youth Inventories, Child Behaviour Checklist, Columbian Impairment Scale, Childrens Motivation Scale, Conners Scale for Attention Deficit Hyperactivity Disorder using Pearson correlations and self-reported alcohol use, using Spearman-rank correlation. 63.7% of adolescents reported at least one childhood trauma on the CTQ. Significant associations were reported between CTQ measures and Beck-Youth Inventories. Emotional abuse was associated with anxiety, anger, depression and disruptive behaviour. Emotional neglect was associated with poor self-concept and disruptive behaviour. LEQ total score was significantly associated with Beck-Youth Inventories including anxiety, depression, anger and disruptive behaviour scales. HIV stigma was significantly associated with Beck-Youth Inventories including depression, anger and disruptive behaviour. Childhood trauma, stressful life events and HIV stigma in South African adolescents are associated with anxiety, depression, anger, disruptive-behaviour and poor self-concept. This study highlights the importance of enquiring about exposure to a variety of traumas, particularly those commonly experienced by South African adolescents. In addition, it is important to understand the impact of trauma exposure on each individuals mental health and functioning.
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Affiliation(s)
- Tatum Sevenoaks
- Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Outpatient Building, H-Floor Research Offices, Circle Groote Schuur Hospital, Observatory, Cape Town, 7925 South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Jean-Paul Fouche
- Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Outpatient Building, H-Floor Research Offices, Circle Groote Schuur Hospital, Observatory, Cape Town, 7925 South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Nicole Phillips
- Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Outpatient Building, H-Floor Research Offices, Circle Groote Schuur Hospital, Observatory, Cape Town, 7925 South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Sarah Heany
- Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Outpatient Building, H-Floor Research Offices, Circle Groote Schuur Hospital, Observatory, Cape Town, 7925 South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Landon Myer
- Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Heather J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
- SA MRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Dan J Stein
- Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Outpatient Building, H-Floor Research Offices, Circle Groote Schuur Hospital, Observatory, Cape Town, 7925 South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- SA MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Jacqueline Hoare
- Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Outpatient Building, H-Floor Research Offices, Circle Groote Schuur Hospital, Observatory, Cape Town, 7925 South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
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Zhang L, Cui Z, Sasser J, Carvalho C, Oshri A. Family stress during the pandemic worsens the effect of adverse parenting on adolescent sleep quality. CHILD ABUSE & NEGLECT 2022; 123:105390. [PMID: 34794017 PMCID: PMC8714683 DOI: 10.1016/j.chiabu.2021.105390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 10/28/2021] [Accepted: 11/01/2021] [Indexed: 05/05/2023]
Abstract
BACKGROUND Adverse parenting is consistently associated with increased sleep problems among adolescents. Shelter-in-Place restrictions and the uncertainty linked to the Covid-19 pandemic have introduced new stressors on parents and families, adding to the risk for youth's sleep problems. OBJECTIVE Using multidimensional assessments of child maltreatment (CM; threat vs. deprivation), the present study examined whether parent-report and child-report of Covid-19 related stress potentiated the effect of CM on sleep problems among boys and girls. PARTICIPANTS AND SETTING The study focused on a sample of 124 dyads of adolescents (Mage = 12.89, SD = 0.79; 52% female) and their primary caregivers (93% mothers) assessed before and during the pandemic (May to October 2020). METHOD Data were obtained from both youth and their parents. Structural equation modeling (SEM) was used to test all study hypotheses. Simple slopes and Johnson-Neyman plots were generated to probe significant interaction effects. RESULTS Deprivation, but not threat, directly predicted increased sleep problems among boys during the pandemic. Additionally, elevation in Covid-19 stress (both parent and child report) intensified the link between CM (threat and deprivation) and sleep problems among boys. CONCLUSION Our findings inform prevention and intervention efforts that aim to reduce sleep problems among boys during stressful contexts, such as the Covid-19 pandemic.
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Affiliation(s)
- Linhao Zhang
- Department of Human Development and Family Science, University of Georgia, Dawson Hall, 305 Sanford Drive, Athens, GA 30602, United States; Youth Development Institute, University of Georgia, Room 208, 105 Foster Road (Pound Hall), Athens, GA 30606, United States.
| | - Zehua Cui
- Department of Human Development and Family Science, University of Georgia, Dawson Hall, 305 Sanford Drive, Athens, GA 30602, United States; Youth Development Institute, University of Georgia, Room 208, 105 Foster Road (Pound Hall), Athens, GA 30606, United States.
| | - Jeri Sasser
- Department of Psychology, Arizona State University, Tempe, AZ 85281, United States.
| | - Cory Carvalho
- Department of Human Development and Family Science, University of Georgia, Dawson Hall, 305 Sanford Drive, Athens, GA 30602, United States; Youth Development Institute, University of Georgia, Room 208, 105 Foster Road (Pound Hall), Athens, GA 30606, United States.
| | - Assaf Oshri
- Department of Human Development and Family Science, University of Georgia, Dawson Hall, 305 Sanford Drive, Athens, GA 30602, United States; Department of Psychology, Arizona State University, Tempe, AZ 85281, United States; Integrated Life Sciences, Behavioral and Cognitive Neuroscience, University of Georgia, Athens, GA, United States.
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10
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Basedow LA, Kuitunen-Paul S, Eichler A, Roessner V, Golub Y. Diagnostic Accuracy of the Drug Use Disorder Identification Test and Its Short Form, the DUDIT-C, in German Adolescent Psychiatric Patients. Front Psychol 2021; 12:678819. [PMID: 34149570 PMCID: PMC8212997 DOI: 10.3389/fpsyg.2021.678819] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 05/10/2021] [Indexed: 01/07/2023] Open
Abstract
Background A common screening instrument for substance use disorders (SUDs) is the Drug Use Disorders Identification Test (DUDIT) which includes a short form regarding only drug consumption (DUDIT-C). We aim to assess if a German version of the DUDIT, adapted for adolescents, is a suitable screening instrument in a sample of adolescent psychiatric patients. Methods N = 124 (54 female) German adolescent (M = 15.6 + 1.5 years) psychiatric patients completed the DUDIT and received a diagnostic interview (MINI-KID) assessing DSM-5 SUD criteria. A confirmatory factor analysis (CFA), receiver operating characteristic (ROC) curves, the area under the curve (AUC), and Youden’s Index were calculated. Results A two-factor model of the DUDIT shows the best model fit (CFI = 0.995, SRMR = 0.055, RMSEA = 0.059, WRMR = 0.603). The DUDIT as well as the DUDIT-C show high diagnostic accuracy, with AUC = 0.95 and AUC = 0.88, respectively. For the DUDIT a cut-off value of 8.5 was optimal (sensitivity = 0.93, specificity = 0.91, J = 0.84), while for the DUDIT-C the optimal cut-off value was at 1.5 (sensitivity = 0.86, specificity = 0.84, J = 0.70). Conclusion This is the first psychometric evaluation of the DUDIT in German, adolescent psychiatric outpatients, using the DSM-5 diagnostic criteria. The DUDIT as well as the DUDIT-C are well suited for use in this population. Since in our sample only few patients presented with a mild or moderate SUD, our results need to be replicated in a sample of adolescents with mild SUD.
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Affiliation(s)
- Lukas A Basedow
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Sören Kuitunen-Paul
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Anna Eichler
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Yulia Golub
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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11
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Lee S, Kim B. Cognitive and Emotional Processes and Life Satisfaction of Korean Adults With Childhood Abuse Experience According to the Level of Emotional Expressiveness. Psychol Rep 2021; 125:1957-1976. [PMID: 33940975 DOI: 10.1177/00332941211012622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study evaluates a hypothesized model describing the cognitive and emotional processes of childhood abuse and its influence on life satisfaction and explores the moderating effect of emotional expressivity in Korean young adults. The mediating roles of early maladaptive schema and state anxiety are explored, and the level of life satisfaction is compared according to the emotional expressivity level. A total of 550 young adults completed self-reported questionnaires, including Childhood Trauma Questionnaire (CTQ-SF), Young Schema Questionnaire (YSQ-SF), State-Trait Anxiety Inventory (STAI-Y), Satisfaction With Life Scale (SWLS), and Emotional Expressivity Scale (EES). The mediating roles of early maladaptive schema and state anxiety between childhood abuse and life satisfaction are confirmed. In the low emotional expressivity group, the double-mediation effect of early maladaptive schema and state anxiety is confirmed, whereas for the high emotional expressivity group, the mediating roles of each early maladaptive schema and state anxiety are confirmed, as well as the double-mediation effect. Moreover, the high emotional expressivity group showed higher life satisfaction. The study results imply that even though expressing emotions does not result in immediate mood elevation, but eventually leads to higher life satisfaction. The implications, limitations, and suggestions are discussed.
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Affiliation(s)
- Sinhye Lee
- Department of Psychology, The Catholic University of Korea, Bucheon, South Korea
| | - Boyoung Kim
- Department of Psychology, The Catholic University of Korea, Bucheon, South Korea
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Womersley JS, Martin L, van der Merwe L, Seedat S, Hemmings SMJ. Genetic variation in neuropeptide Y interacts with childhood trauma to influence anxiety sensitivity. ANXIETY STRESS AND COPING 2021; 34:450-464. [PMID: 33491492 DOI: 10.1080/10615806.2021.1876225] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND OBJECTIVES Anxiety sensitivity (AS) refers to a fear of the negative implications of anxiety, and arises due to gene-environment interactions. We investigated whether genetic variation in two neuropeptides implicated in the stress response, neuropeptide Y (NPY) and pituitary adenylate cyclase-activating polypeptide receptor 1, interacted with childhood trauma (CT) to influence AS. DESIGN AND METHODS This cross-sectional study examined the CT x genetic variant effects on AS in 951 adolescents who self-identified as Xhosa or South African Colored (SAC) ethnicity. RESULTS In Xhosa females, the NPY rs5573 A allele and rs3037354 deletion variant were associated with increased (p = 0.035) and decreased (p = 0.034) AS, respectively. The interaction of CT and the NPY rs5574 A allele increased AS in SAC female participants (p = 0.043). The rs3037354 deletion variant protected against AS with increased CT in SAC male participants (p = 0.011). CONCLUSIONS The NPY rs5574 A allele and rs3037354 deletion variant interact with CT to act as risk and protective factors, respectively, for AS in an ethnicity- and sex- differentiated manner. Our results reaffirm the role of NPY and gene-environment interactions in anxiety-related behaviors and reinforce the need for psychiatric genetics studies in diverse populations.
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Affiliation(s)
- Jacqueline Samantha Womersley
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,South African Medical Research Council / Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Lindi Martin
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Lize van der Merwe
- Department of Statistics and Population Studies, University of the Western Cape, Cape Town, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,South African Medical Research Council / Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Sian Megan Joanna Hemmings
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,South African Medical Research Council / Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa
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13
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Short NA, Lechner M, Bell K, Black J, Buchanan J, Ho J, Reed G, Corzine A, Riviello R, Martin SL, Liberzon I, Rauch S, McLean SA. Anxiety Sensitivity Prospectively Predicts Increased Acute Posttraumatic Stress and Related Symptoms After Sexual Assault. J Trauma Stress 2020; 33:1111-1120. [PMID: 33179292 PMCID: PMC7726025 DOI: 10.1002/jts.22613] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 08/07/2020] [Accepted: 08/18/2020] [Indexed: 11/09/2022]
Abstract
Anxiety sensitivity is a potential risk factor for posttraumatic stress symptoms (PTSS) and has been hypothesized to contribute to PTSS development. However, few prospective studies have evaluated whether anxiety sensitivity predicts PTSS. In a subsample of 48 women sexual assault survivors enrolled as part of a larger prospective observational study, elevated anxiety sensitivity measured via a brief assessment 1 week after experiencing a sexual assault was concurrently associated with PTSS at 1 week and prospectively predicted PTSS 6 weeks after the event, with small-to-medium effect sizes, η2 p = .10, even after covarying for trauma history. Heightened anxiety sensitivity at 1-week postevent also interacted with time to predict anxiety and depression both before and after sexual assault, with medium-to-large effect sizes, ηp 2 = .21- .24. This is consistent with research linking anxiety sensitivity to PTSS, but this was the first prospective study of which we are aware to demonstrate that anxiety sensitivity in the acute posttrauma period predicts PTSS among women who have recently experienced sexual assault. Future research should use the full Anxiety Sensitivity Index to replicate findings in a larger sample and explore whether targeting anxiety sensitivity could mitigate the development of PTSS in this vulnerable population.
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Affiliation(s)
- Nicole A. Short
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Megan Lechner
- UC Health Memorial Hospital, Colorado Springs, Colorado, USA
| | - Kathy Bell
- Tulsa Forensic Nursing, Tulsa, Oklahoma, USA
| | | | | | - Jeffrey Ho
- Hennepin Healthcare, Minneapolis, Minnesota, USA
| | | | | | - Ralph Riviello
- University of Texas Health–San Antonio, San Antonio, Texas, USA
| | - Sandra L. Martin
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Israel Liberzon
- College of Medicine, Department of Psychiatry, Texas A&M University, Bryan, Texas, USA
| | - Sheila Rauch
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia, USA
| | - Samuel A. McLean
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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14
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Malesza M, Kaczmarek MC. Predictors of anxiety during the COVID-19 pandemic in Poland. PERSONALITY AND INDIVIDUAL DIFFERENCES 2020; 170:110419. [PMID: 33052156 PMCID: PMC7545237 DOI: 10.1016/j.paid.2020.110419] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 09/15/2020] [Accepted: 09/27/2020] [Indexed: 11/03/2022]
Abstract
A coronavirus pandemic hit the world and Poland was no exception. The present research sought to investigate different factors associated with coronavirus-related anxiety during the COVID-19 outbreak in Poland. More specifically, COVID-19-related risk perceptions, beliefs, precautionary actions, information sources, and anxiety level were studied on general population (N = 1069) in Poland between March 29th and April 17th 2020. Multiple regression was used to examine the significant predictions of anxiety. Data revealed that anxiety in response to the COVID-19 was common in the sample. Major predictors of higher anxiety related to the pandemic outbreak included demographic factors, like being female, being older, being married or cohabiting, and having children. Additionally, greater anxiety was reported among people who reported chronic illnesses and generally worse health condition. From COVID-19 related factors, higher frequency of recommended protective behaviors, greater perceived risk of infection, greater likelihood of contacting COVID-19 during the current outbreak, greater amounts of information about COVID-19 received from various sources, and very little or lack of belief that degree of catching COVID-19 depends on one's own behavior predicted greater anxiety among individuals.
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Affiliation(s)
- Marta Malesza
- Faculty of Psychology, University of Economics and Human Sciences in Warsaw, Poland
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15
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Mall S, Platt JM, Temmingh H, Musenge E, Campbell M, Susser E, Stein DJ. The relationship between childhood trauma and schizophrenia in the Genomics of Schizophrenia in the Xhosa people (SAX) study in South Africa. Psychol Med 2020; 50:1570-1577. [PMID: 31387660 PMCID: PMC7053504 DOI: 10.1017/s0033291719001703] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Evidence from high-income countries suggests that childhood trauma is associated with schizophrenia. Studies of childhood trauma and schizophrenia in low and middle income (LMIC) countries are limited. This study examined the prevalence of childhood traumatic experiences among cases and controls and the relationship between specific and cumulative childhood traumatic experiences and schizophrenia in a sample in South Africa. METHODS Data were from the Genomics of Schizophrenia in the South African Xhosa people study. Cases with schizophrenia and matched controls were recruited from provincial hospitals and clinics in the Western and Eastern Cape regions in South Africa. Childhood traumatic experiences were measured using the Childhood Trauma Questionnaire (CTQ). Adjusted logistic regression models estimated associations between individual and cumulative childhood traumatic experiences and schizophrenia. RESULTS Traumatic experiences were more prevalent among cases than controls. The odds of schizophrenia were 2.44 times higher among those who experienced any trauma than those who reported no traumatic experiences (95% CI 1.77-3.37). The odds of schizophrenia were elevated among those who experienced physical/emotional abuse (OR 1.59, CI 1.28-1.97), neglect (OR 1.39, CI 1.16-1.68), and sexual abuse (OR 1.22, CI 1.03-1.45) compared to those who did not. Cumulative physical/emotional abuse and neglect experiences increased the odds of schizophrenia as a dose-response relationship. CONCLUSION Childhood trauma is common in this population. Among many other benefits, interventions to prevent childhood trauma may contribute to a decreasing occurrence of schizophrenia.
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Affiliation(s)
- Sumaya Mall
- Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jonathan M. Platt
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
| | - Henk Temmingh
- Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Eustasius Musenge
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Megan Campbell
- Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Ezra Susser
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
- New York State Psychiatric Institute, New York, USA
| | - Dan J. Stein
- Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- SU/UCT Medical Research Council Unit on Risk & Resilience in Mental Disorders, South Africa
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16
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Viljoen M, Benecke RM, Martin L, Adams RCM, Seedat S, Smith C. Anxiety: An overlooked confounder in the characterisation of chronic stress-related conditions? PLoS One 2020; 15:e0230053. [PMID: 32298279 PMCID: PMC7162495 DOI: 10.1371/journal.pone.0230053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Accepted: 02/20/2020] [Indexed: 12/25/2022] Open
Abstract
Although anxiety disorders are among the most prevalent of psychiatric disorders, childhood trauma-related studies seldom consider anxiety proneness as distinct aetiological contributor. We aimed to distinguish between trauma- and anxiety-associated physiological profiles. South African adolescent volunteers were categorised for trauma exposure (CTQ, mean score 39±11) and anxiety proneness (AP)(CASI, mean score 37±7, STAI-T, mean score 41±8). Circulating hormone and leukocyte glucocorticoid receptor levels, as well as leukocyte functional capacity, were assessed. AP was associated with lower DHEAs (P<0.05) and higher leukocyte GR expression (P<0.05). DHEAs was also negatively correlated with anxiety sensitivity (CASI, P<0.05). In conclusion, AP may have more predictive power than trauma in terms of health profile. Increased glucocorticoid sensitivity previously reported after trauma, may be a unique function of anxiety and not trauma exposure per se. DHEAs concentration was identified as potentially useful marker for monitoring progressive changes in HPA-axis sensitivity and correlated with psychological measures of anxiety.
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Affiliation(s)
- Monet Viljoen
- Department of Physiological Sciences, Science Faculty, Stellenbosch University, Stellenbosch, South Africa
| | - Rohan M. Benecke
- Department of Physiological Sciences, Science Faculty, Stellenbosch University, Stellenbosch, South Africa
| | - Lindi Martin
- Department of Psychiatry, Faculty of Health Sciences, Stellenbosch University, Bellville, Cape Town, South Africa
| | - Rozanne C. M. Adams
- Department of Physiological Sciences, Science Faculty, Stellenbosch University, Stellenbosch, South Africa
- Flow Cytometry and Imaging Unit, Central Analytical Facility, Stellenbosch University, Stellenbosch, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Health Sciences, Stellenbosch University, Bellville, Cape Town, South Africa
| | - Carine Smith
- Department of Physiological Sciences, Science Faculty, Stellenbosch University, Stellenbosch, South Africa
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17
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Honeycutt JA, Demaestri C, Peterzell S, Silveri MM, Cai X, Kulkarni P, Cunningham MG, Ferris CF, Brenhouse HC. Altered corticolimbic connectivity reveals sex-specific adolescent outcomes in a rat model of early life adversity. eLife 2020; 9:52651. [PMID: 31958061 PMCID: PMC7010412 DOI: 10.7554/elife.52651] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 01/17/2020] [Indexed: 12/11/2022] Open
Abstract
Exposure to early-life adversity (ELA) increases the risk for psychopathologies associated with amygdala-prefrontal cortex (PFC) circuits. While sex differences in vulnerability have been identified with a clear need for individualized intervention strategies, the neurobiological substrates of ELA-attributable differences remain unknown due to a paucity of translational investigations taking both development and sex into account. Male and female rats exposed to maternal separation ELA were analyzed with anterograde tracing from basolateral amygdala (BLA) to PFC to identify sex-specific innervation trajectories through juvenility (PD28) and adolescence (PD38;PD48). Resting-state functional connectivity (rsFC) was assessed longitudinally (PD28;PD48) in a separate cohort. All measures were related to anxiety-like behavior. ELA-exposed rats showed precocial maturation of BLA-PFC innervation, with females affected earlier than males. ELA also disrupted maturation of female rsFC, with enduring relationships between rsFC and anxiety-like behavior. This study is the first providing both anatomical and functional evidence for sex- and experience-dependent corticolimbic development. Having a traumatic childhood increases the risk a person will develop anxiety disorders later in life. Early life adversity affects men and women differently, but scientists do not yet know why. Learning more could help scientists develop better ways to prevent or treat anxiety disorders in men and women who experienced childhood trauma. Anxiety occurs when threat-detecting brain circuits turn on. These circuits begin working in infancy, and during childhood and adolescence, experiences shape the brain to hone the body’s responses to perceived threats. Two areas of the brain that are important hubs for anxiety-related brain circuits include the basolateral amygdala (BLA) and the prefrontal cortex (PFC). Now, Honeycutt et al. show that rats that experience early life adversity develop stronger connections between the BLA and PFC, and these changes occur earlier in female rats. In the experiments, one group of rats was repeatedly separated from their mothers and littermates (an early life trauma), while a second group was not. Honeycutt et al. examined the connections between the BLA and PFC in the two groups at three different time periods during their development: the juvenile stage, early adolescence, and late adolescence. The experiments showed stronger connections between the BLA and PFC begin to appear earlier in juvenile traumatized female rats. But these changes did not appear in their male counterparts until adolescence. Lastly, the rats that developed these strengthened BLA-PFC connections also behaved more anxiously later in life. This may mean that the ideal timing for interventions may be different for males and females. More work is needed to see if these results translate to humans and then to find the best times and methods to help people who experienced childhood trauma.
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Affiliation(s)
- Jennifer A Honeycutt
- Developmental Neuropsychobiology Laboratory, Department of Psychology, Northeastern University, Boston, United States
| | - Camila Demaestri
- Developmental Neuropsychobiology Laboratory, Department of Psychology, Northeastern University, Boston, United States
| | - Shayna Peterzell
- Developmental Neuropsychobiology Laboratory, Department of Psychology, Northeastern University, Boston, United States
| | - Marisa M Silveri
- Neurodevelopmental Laboratory on Addictions and Mental Health, McLean Hospital, Belmont, United States.,Department of Psychiatry, Harvard Medical School, Boston, United States
| | - Xuezhu Cai
- Center for Translational Neuroimaging, Department of Psychology, Northeastern University, Boston, United States
| | - Praveen Kulkarni
- Center for Translational Neuroimaging, Department of Psychology, Northeastern University, Boston, United States
| | - Miles G Cunningham
- Laboratory for Neural Reconstruction, Department of Psychiatry, McLean Hospital, Belmont, United States
| | - Craig F Ferris
- Center for Translational Neuroimaging, Department of Psychology, Northeastern University, Boston, United States
| | - Heather C Brenhouse
- Developmental Neuropsychobiology Laboratory, Department of Psychology, Northeastern University, Boston, United States
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18
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Nöthling J, Suliman S, Martin L, Simmons C, Seedat S. Differences in Abuse, Neglect, and Exposure to Community Violence in Adolescents With and Without PTSD and Depression. JOURNAL OF INTERPERSONAL VIOLENCE 2019; 34:4357-4383. [PMID: 27777370 DOI: 10.1177/0886260516674944] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
South African adolescents are exposed to high levels of violence and trauma, including community violence, abuse, and neglect. Violence and trauma are associated with negative mental health outcomes, including posttraumatic stress disorder (PTSD) and depression. Demographic characteristics, additional exposure to trauma, community violence, and types of childhood abuse and neglect may place adolescents at greater risk of developing PTSD. This study aimed to first assess the weighted contribution of demographic factors, trauma load, community violence, and types of abuse and neglect in predicting PTSD symptom severity. Second, we aimed to determine group differences in demographic factors, trauma load, community violence, and types of abuse and neglect among participants with no disorder, PTSD only, PTSD and depression, and depression only. Participants were 215 adolescents identified with emotional and/or behavioral problems and referred to an adolescent trauma clinic from schools in the Western Cape region of South Africa. Clinical assessments were undertaken to assess community violence exposure; physical, sexual, and emotional abuse; physical and emotional neglect; and a clinical diagnosis of PTSD and comorbidity. Trauma-exposed adolescents with PTSD and depression reported significantly higher levels of emotional abuse and community violence exposure in comparison with trauma-exposed adolescents without a disorder. Emotional abuse, community violence exposure, and female gender were significant predictors of PTSD in regression analysis. These findings underscore the contribution of different types of trauma in the development of PTSD. Interventions focused on preventing trauma, PTSD, and depression should be multifaceted and be targeted at various levels, for example, individual/interpersonal level (reduce abuse in the household and immediate environment) and community/societal level (reduce crime rates in communities and strengthen conviction policies). Traumatized youth should routinely be screened for a history of abuse and particularly exposure to community violence, given their strong association with PTSD.
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Affiliation(s)
| | | | - Lindi Martin
- Stellenbosch University, Cape Town, South Africa
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19
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Francis SE, Noël VA, Ryan SL. A Systematic Review of the Factor Structure of Anxiety Sensitivity Among Children: Current Status and Recommendations for Future Directions. CHILD & YOUTH CARE FORUM 2019. [DOI: 10.1007/s10566-019-09502-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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20
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Becker KR, Keshishian AC, Liebman RE, Coniglio KA, Wang SB, Franko DL, Eddy KT, Thomas JJ. Impact of expanded diagnostic criteria for avoidant/restrictive food intake disorder on clinical comparisons with anorexia nervosa. Int J Eat Disord 2019; 52:230-238. [PMID: 30578644 PMCID: PMC7191972 DOI: 10.1002/eat.22988] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 11/09/2018] [Accepted: 11/13/2018] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Avoidant/restrictive food intake disorder (ARFID) and anorexia nervosa (AN) are restrictive eating disorders. There is a proposal before the American Psychiatric Association to broaden the current DSM-5 criteria for ARFID, which currently require dietary intake that is inadequate to support energy or nutritional needs. We compared the clinical presentations of ARFID and AN in an outpatient sample to determine how a more inclusive definition of ARFID, heterogeneous for age and weight status, is distinct from AN. METHODS As part of standard care, 138 individuals with AN or ARFID completed an online assessment battery and agreed to include their responses in research. RESULTS Individuals with ARFID were younger, reported earlier age of onset, and had higher percent median BMI (%mBMI) than those with AN (all ps < .001). Individuals with ARFID scored lower on measures of eating pathology, depression, anxiety, and clinical impairment (all ps < .05), but did not differ from those with AN on restrictive eating (p = .52), and scored higher on food neophobia (p < .001). DISCUSSION Allowing psychosocial impairment to be sufficient for an ARFID diagnosis resulted in a clinical picture of ARFID such that %mBMI was higher (and in the normal range) compared with AN. Differences in gender distribution, age, and age of onset remained consistent with previous research. Both groups reported similar levels of dietary restriction, although ARFID can be distinguished by relatively higher levels of food neophobia. Currently available measures of eating pathology may capture certain ARFID symptoms, but highlight the need for measures of impairment relative to ARFID.
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Affiliation(s)
- Kendra R. Becker
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Ani C. Keshishian
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital
| | - Rachel E. Liebman
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | | | - Shirley B. Wang
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital,Department of Psychology, Harvard University, Boston, Massachusetts
| | - Debra L. Franko
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital,Northeastern University, Boston, Massachusetts
| | - Kamryn T. Eddy
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Jennifer J. Thomas
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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21
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The effects of childhood maltreatment and anxiety proneness on neuropsychological test performance in non-clinical older adolescents. J Affect Disord 2019; 243:133-144. [PMID: 30243193 DOI: 10.1016/j.jad.2018.09.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 07/30/2018] [Accepted: 09/09/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND The effect of childhood maltreatment (CM) on neuropsychological performance is well established, but the effect of anxiety proneness (AP) on such performance has been underexplored. We assessed the predictive ability of CM and AP, and their interaction, in non-clinical adolescents, for a range of previously documented neuropsychological deficits. METHODS Multiple linear regression models were used to assess the unique and combined influences of CM and AP on neuropsychological performance in 104 non-clinical adolescents, who underwent both neuropsychiatric and neuropsychological assessment. RESULTS The interaction of CM and AP was associated with poorer performance in executive functioning skills, processing speed, and estimated IQ. CM and AP were uniquely associated with verbal working memory performance, while verbal and visual memory performance and learning, and visuo-spatial ability, were not associated with either CM, AP or the interaction of CM and AP. LIMITATIONS The use of self-report measures to determine participants' levels of CM, AP, and depression. The CTQ-SF, a retrospective self-report measure, may have introduced recall bias. The neuropsychological evaluation was not conducted in the Xhosa language, the first language of most African participants. Most instruments utilized have not been validated in a South African adolescent sample. The impact of important moderator variables (e.g., age of onset of maltreatment) was not assessed. CONCLUSIONS Increased levels of CM and AP may be risk markers for poor performance in several key neuropsychological domains. Our findings underscore the importance of assessing the impact of both CM and anxiety-related temperamental traits on neuropsychological performance.
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22
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Hogarth L, Martin L, Seedat S. Relationship between childhood abuse and substance misuse problems is mediated by substance use coping motives, in school attending South African adolescents. Drug Alcohol Depend 2019; 194:69-74. [PMID: 30412899 PMCID: PMC6327152 DOI: 10.1016/j.drugalcdep.2018.10.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 10/17/2018] [Accepted: 10/17/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND In adults, it has been shown that the relationship between childhood abuse and substance misuse problems is mediated by the belief that substance use helps cope with negative affective states. By contrast, in adolescents, it is unknown whether drug use coping motives play this same mediating role. METHODS Secondary analysis of 1149 school attending adolescents in Cape Town, South Africa (average age = 16.24 years, range = 13-23; 60% female). Questionnaire measures obtained during a single test session (among a larger battery) assessed childhood trauma (CTQ), alcohol (AUDIT) and drug problems (DUDIT), and coping orientation (A-COPE) which contained three items assessing drug use to cope with negative affect. RESULTS The three types of childhood abuse measured by the CTQ - emotional, physical and sexual - were positively associated with greater alcohol/drug problems, and drug use coping motives. Drug use coping motives mediated the relationships between childhood abuse types and alcohol/drug problems, and these mediational pathways remained significant when gender and other subscales of the A-COPE were included as covariates. CONCLUSIONS These data are preliminary insofar as drug use coping motives were assessed with a non-validated subscale of the A-COPE. Nevertheless, drug use to cope with negative affect mediated the relationship between all three types of childhood abuse (emotional, physical, sexual) and alcohol/drug problems in school attending adolescents. The implication is that drug prevention programs for this risk group should seek to mitigate drug use coping motives.
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Affiliation(s)
- Lee Hogarth
- School of Psychology, University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG, UK.
| | - Lindi Martin
- Department of Psychiatry, Stellenbosch University, Private Bag X1, Matieland, 7602, Stellenbosch, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, Private Bag X1, Matieland, 7602, Stellenbosch, South Africa
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23
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Vujanovic AA, Farris SG, Bartlett BA, Lyons RC, Haller M, Colvonen PJ, Norman SB. Anxiety sensitivity in the association between posttraumatic stress and substance use disorders: A systematic review. Clin Psychol Rev 2018; 62:37-55. [PMID: 29778929 DOI: 10.1016/j.cpr.2018.05.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 05/08/2018] [Accepted: 05/09/2018] [Indexed: 11/19/2022]
Abstract
Posttraumatic stress disorder (PTSD) and substance use disorders (SUD) are complex psychiatric conditions that commonly co-occur. No evidence-based, "gold standard" treatments for PTSD/SUD comorbidity are currently available. Thus, it is imperative to better understand cognitive-affective mechanisms, targetable via cognitive-behavioral intervention (i.e., malleable), that may be related to both disorders in order to improve the theory and treatment of PTSD/SUD. Anxiety sensitivity is a malleable cognitive-affective factor with relevance to both PTSD and SUD. This systematic review focused on the published literature on anxiety sensitivity and trauma/PTSD and substance use/SUD from 1966 - May 1, 2018, and includes a total of 35 manuscripts. The state of the literature, limitations, and future research directions are discussed.
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Affiliation(s)
- Anka A Vujanovic
- University of Houston, Department of Psychology, Houston, TX, USA.
| | - Samantha G Farris
- The Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI, USA; The Miriam Hospital, Centers for Behavioral and Preventative Medicine, Providence, RI, USA; Butler Hospital, Behavioral Medicine and Addictions Research Unit, Providence, RI, USA; Rutgers, The State University of New Jersey, Department of Psychology, Piscataway, NJ, USA
| | | | - Robert C Lyons
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; University of California, San Diego School of Medicine, Department of Psychiatry, San Diego, CA, USA
| | - Moira Haller
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; University of California, San Diego School of Medicine, Department of Psychiatry, San Diego, CA, USA
| | - Peter J Colvonen
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; University of California, San Diego School of Medicine, Department of Psychiatry, San Diego, CA, USA; Veterans Affairs Center of Excellence for Stress and Mental Health, San Diego, CA, USA
| | - Sonya B Norman
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; University of California, San Diego School of Medicine, Department of Psychiatry, San Diego, CA, USA; Veterans Affairs Center of Excellence for Stress and Mental Health, San Diego, CA, USA; National Center for PTSD, White River Junction, VT, USA
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24
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Holgate JY, Tarren JR, Bartlett SE. Sex Specific Alterations in α4*Nicotinic Receptor Expression in the Nucleus Accumbens. Brain Sci 2018; 8:brainsci8040070. [PMID: 29671814 PMCID: PMC5924406 DOI: 10.3390/brainsci8040070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 04/12/2018] [Accepted: 04/16/2018] [Indexed: 12/11/2022] Open
Abstract
Background: The mechanisms leading from traumatic stress to social, emotional and cognitive impairment and the development of mental illnesses are still undetermined and consequently there remains a critical need to develop therapies for preventing the adverse consequences of traumatic stress. Research indicates nicotinic acetylcholine receptors containing α4 subunits (α4*nAChRs) are both impacted by stress and capable of modulating the stress response. In this study, we investigated whether varenicline, a partial α4β2*nAChR agonist which reduces nicotine, alcohol and sucrose consumption, can reduce stress, a driving factor in substance use disorders. We also examined the effect of stress on nucleus accumbens (NAc) α4*nAChR expression. Methods: Transgenic mice with fluorescent tags attached to α4*nAChRs were administered varenicline and/or yohimbine (a pharmacological stressor) and plasma corticosterone and NAc α4*nAChR expression were measured. A separated group of mice were exposed to maternal separation (MS) during post-natal day (P) 2–14, then restraint stressed (30 min) at six weeks of age. Body weight, anxiety-like behaviours (elevated plus maze), plasma corticosterone and NAc α4*nAChR levels were measured. Results: Varenicline attenuated yohimbine-induced plasma corticosterone increases with no effect on NAc α4*nAChR expression. MS reduced unrestrained plasma corticosterone levels in both sexes. In females, MS increased body weight and NAc α4*nAChR expression, whereas, in males, MS and restraint caused a greater change in anxiety-like behaviours and plasma corticosterone levels. Restraint altered NAc α4*nAChR expression in both male and female MS mice. Conclusions: The effects of stress on NAc α4*nAChR are sex-dependent. While varenicline attenuated acute stress-induced rises in corticosterone levels, future studies are required to determine whether varenicline is effective for relieving the effects of stress.
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Affiliation(s)
- Joan Y Holgate
- Institute of Health and Medical Innovation, Queensland University of Technology, Translational Research Institute, 37 Kent St, Woolloongabba, QLD 4102, Australia.
| | - Josephine R Tarren
- Institute of Health and Medical Innovation, Queensland University of Technology, Translational Research Institute, 37 Kent St, Woolloongabba, QLD 4102, Australia.
| | - Selena E Bartlett
- Institute of Health and Medical Innovation, Queensland University of Technology, Translational Research Institute, 37 Kent St, Woolloongabba, QLD 4102, Australia.
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25
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Womersley JS, Martin LI, van der Merwe L, Seedat S, Hemmings SMJ. Hypothalamic-pituitary-adrenal axis variants and childhood trauma influence anxiety sensitivity in South African adolescents. Metab Brain Dis 2018; 33:601-613. [PMID: 29101603 DOI: 10.1007/s11011-017-0138-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 10/20/2017] [Indexed: 10/18/2022]
Abstract
Anxiety sensitivity (AS) is characterised by the fear of anxiety-related symptoms and is a risk factor for the development of anxiety-related disorders. We examined whether genetic variation in three stress response genes, CRHR1, NR3C1, and FKBP5, interact with childhood trauma (CT) to predict AS in South African adolescents. Xhosa (n = 634) and Coloured (n = 317) students completed self-report measures of AS and CT, and a total of eighteen polymorphisms within CRHR1, NR3C1, and FKBP5 were genotyped. Differences in AS based on genetic variation and CT were analysed within population and gender groups using multiple linear regression. Associations were found between AS and FKBP5 rs9296158 (p = 0.025) and rs737054 (p = 0.045) in Coloured males. Analysis of gene x CT interactions indicated that NR3C1 rs190488 CC-genotype, NR3C1 rs10482605 G-allele addition, and FKBP5 rs3800373 C-allele addition protect against AS with increasing CT in Xhosa females (p = 0.009), Xhosa males (p = 0.036) and Coloured males (p = 0.049), respectively. We identified two different protective single nucleotide polymorphism (SNP) combinations in a four-SNP CRHR1 haplotype in Coloured males. An analysis of the interaction between CT and a six-SNP FKBP5 haplotype in Coloured males revealed both protective and risk allelic combinations. Our results provide evidence for the influence of both genetic variation in CRHR1, NR3C1 and FKBP5, as well as CT x SNP interactions, on AS in South African adolescents. This study reinforces the importance of examining the influence of gene-environment (G X E) interactions within gender and population groups.
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Affiliation(s)
- Jacqueline S Womersley
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Lindi I Martin
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Lize van der Merwe
- Department of Human Genetics, Faculty of Agriculture, Stellenbosch University, Stellenbosch, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Sian M J Hemmings
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.
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26
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Martin L, Hemmings SMJ, Kidd M, Seedat S. No gene-by-environment interaction of BDNF Val66Met polymorphism and childhood maltreatment on anxiety sensitivity in a mixed race adolescent sample. Eur J Psychotraumatol 2018; 9:1472987. [PMID: 29805780 PMCID: PMC5965035 DOI: 10.1080/20008198.2018.1472987] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 04/20/2018] [Indexed: 12/22/2022] Open
Abstract
Background: Anxiety disorders in youth are attributable to multiple causal mechanisms, comprising biological vulnerabilities, such as genetics and temperament, and unfavourable environmental influences, such as childhood maltreatment (CM). Objective: A gene-environment (G x E) interaction study was conducted to determine the interactive effect of the BDNF Val66Met polymorphism and CM to increase susceptibility to anxiety sensitivity (AS) in a sample of mixed race adolescents. Method: Participants (n = 308, mean age = 15.8 years) who were all secondary school students and who completed measures for AS and CM were genotyped for the BDNF Val66Met polymorphism. Hierarchical multiple regression analysis was conducted to assess G x E influences on AS. Age and gender were included in the models as covariates as age was significantly associated with AS total score (p < .05), and females had significantly higher AS scores than males (p < .05). Results: A main effect of CM on AS was evident (p < .05), however, no main effect of BDNF genotype on AS was observed (p > .05). A non-significant G x E effect on AS was revealed (p < .05). Conclusions: Our results suggest that CM does not have a moderating role in the relationship between the BDNF Val66Met genotype and the increased risk of anxiety-related phenotypes, such as AS. Given the exploratory nature of this study, findings require replication in larger samples and adjustment for population stratification to further explore the role of BDNF Val66Met and CM on AS in mixed race adolescents.
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Affiliation(s)
- Lindi Martin
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | | | - Martin Kidd
- Department of Statistics and Actuarial Science, Stellenbosch University, Cape Town, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
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27
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Psychometric Properties of the Arabic Version of the Drug Use Disorders Identification Test (DUDIT) in Clinical, Prison Inmate, and Student Samples. Int J Behav Med 2017; 24:280-287. [PMID: 28124194 PMCID: PMC5344936 DOI: 10.1007/s12529-016-9623-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Purpose The study aimed to validate the Arabic version of the Drug Use Disorders Identification Test (DUDIT) by (1) assessing its factor structure, (2) determining structural validity, (3) evaluating item-total and inter-item correlation, and (4) assessing its predictive validity. Method The study population included 169 prison inmates, 51 patients with clinical diagnosis of substance used disorder, and 53 students (N = 273). All participants completed the self-report version of the Arabic DUDIT. After exploratory factor analysis, internal consistency of the Arabic DUDIT was determined and external validation was performed. Results Principal factor analysis showed that Arabic DUDIT exhibited only one factor, which explained 66.9% of the variance. Reliability based on Cronbach’s alpha was .95. When compared to the DSM-IV substance use disorder diagnosis in a clinical sample, DUDIT had an area under the curve (AUC) of .98, with a sensitivity of .98 and a specificity of .90. Conclusion The Arabic version of DUDIT is a valid and reliable tool for screening for drug use in Arabic-speaking countries.
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28
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Thurman TR, Nice J, Taylor TM, Luckett B. Mitigating depression among orphaned and vulnerable adolescents: a randomized controlled trial of interpersonal psychotherapy for groups in South Africa. Child Adolesc Ment Health 2017; 22:224-231. [PMID: 32680417 DOI: 10.1111/camh.12241] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/19/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Children and adolescents affected by HIV are at elevated risk of depression, yet research on related interventions in this population is scarce in sub-Saharan Africa. This study sought to examine the effects of interpersonal psychotherapy for groups (IPTG) on depressive symptomology among orphaned and vulnerable adolescents in South Africa. METHOD A cluster randomized controlled trial wherein adolescents ages 14-17 enrolled in community-based programming for HIV-affected and vulnerable families were randomly assigned by geographic cluster to participate in a 16-session IPTG intervention or the standard of care (n = 489). Baseline and postintervention surveys conducted with enrollees included standardized depression screening. Utilizing an intent-to-treat design, mixed effects models were performed to examine treatment effects for all participants and potential moderators including gender and baseline depression level (Clinical Trials registration: ClinicalTrials.gov NCT02386878). RESULTS While 23% of adolescents in the intervention group did not attend any IPTG sessions, average attendance was 12 out of 16 possible sessions among participants. The intervention was not associated with changes in depression symptomology. CONCLUSIONS Results underscore the importance of mitigating participation barriers prior to intervention roll-out and the need for increased evidence for psychological health interventions to mitigate depression among orphaned and vulnerable adolescents. This intervention and the study selectively targeted at-risk adolescents versus using diagnostic mental health criteria for enrollment; more research is needed to identify the potential benefits and disadvantages of these approaches.
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Affiliation(s)
- Tonya R Thurman
- Tulane International LLC, 23 Belmont Road, 7700, Cape Town, South Africa.,Tulane School of Social Work, Highly Vulnerable Children Research Center, New Orleans, LA, USA
| | - Johanna Nice
- Tulane School of Social Work, Highly Vulnerable Children Research Center, New Orleans, LA, USA
| | - Tory M Taylor
- Tulane School of Social Work, Highly Vulnerable Children Research Center, New Orleans, LA, USA.,Tulane School of Public Health, New Orleans, LA, USA
| | - Brian Luckett
- Tulane School of Social Work, Highly Vulnerable Children Research Center, New Orleans, LA, USA
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29
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Rudzinski K, McDonough P, Gartner R, Strike C. Is there room for resilience? A scoping review and critique of substance use literature and its utilization of the concept of resilience. Subst Abuse Treat Prev Policy 2017; 12:41. [PMID: 28915841 PMCID: PMC5603070 DOI: 10.1186/s13011-017-0125-2] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 08/28/2017] [Indexed: 12/15/2022] Open
Abstract
Research in the area of illicit substance use remains preoccupied with describing and analyzing the risks of people who use drugs (PWUD), however more recently there has been a drive to use a strengths-based or resilience approach as an alternative to investigating drug use. This leads us to ask: what can be known about PWUD from the point of view of resilience? The objective of this scoping review is to analyze how the concept of resilience is defined, operationalized, and applied in substance use research. Popular health, social science, psychology, and inter-disciplinary databases namely: SCOPUS, PUBMED, PsycINFO, and Sociological Abstracts were searched. Studies were selected if they used the concept of resilience and if substance use was a key variable under investigation. A total of 77 studies were identified which provided a definition of resilience, or attempted to operationalize (e.g., via scales) the concept of resilience in some manner. Data were charted and sorted using key terms and fundamental aspects of resilience. The majority of studies focus on youth and their resistance to, or engagement in, substance use. There is also a small but growing area of research that examines recovery from substance addiction as a form of resilience. Very few studies were found that thoroughly investigated resilience among PWUD. Consistently throughout the literature drug use is presented as a 'risk factor' jeopardizing one's ability to be resilient, or drug use is seen as a 'maladaptive coping strategy', purporting one's lack of resilience. Currently, substance use research provides a substantial amount of information about the internal strengths that can assist in resisting future drug use; however there is less information about the external resources that play a role, especially for adults. Though popular, outcome-based conceptualizations of resilience are often static, concealing the potential for developing resilience over time or as conditions change. Studies of resilience among PWUD predominantly concentrate on health-related behaviours, recovery-related factors or predefined harm reduction strategies. Indeed, overall, current conceptualizations of resilience are too narrow to recognize all the potential manifestations of resilience practices in the daily lives of individuals who actively use drugs.
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Affiliation(s)
- Katherine Rudzinski
- Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON M5T 3M7 Canada
| | - Peggy McDonough
- Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON M5T 3M7 Canada
| | - Rosemary Gartner
- Centre for Criminology & Sociolegal Studies, University of Toronto, 14 Queen’s Park Crescent West, Toronto, ON M5S 3K9 Canada
| | - Carol Strike
- Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON M5T 3M7 Canada
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30
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Hemmings SMJ, Martin LI, van der Merwe L, Benecke R, Domschke K, Seedat S. Serotonin transporter variants play a role in anxiety sensitivity in South African adolescents. World J Biol Psychiatry 2016; 17:66-75. [PMID: 26635248 DOI: 10.3109/15622975.2015.1102324] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Anxiety sensitivity (AS) has predictive potential for the development of anxiety disorders. We investigated the role that gene-environment (G × E) interactions, focussing on childhood trauma (CT) and selected SLC6A4 variants, play in modulating levels of AS in a South African adolescent population. METHODS All adolescents (n = 951) completed measures for AS and CT. Six SLC6A4 polymorphisms were genotyped. G × E influences on AS levels were assessed using multiple linear regression models. Relevant confounders were included in all analyses. RESULTS Xhosa (n = 634) and Coloured (n = 317) participants were analysed independently of one another. The 5-HTTLPR-rs25531 L-G haplotype associated with reduced AS among Xhosa adolescents (P = 0.010). In addition, the rs1042173 CC-genotype protected against increased levels of AS in Xhosa participants who had experienced increased levels of CT (P = 0.038). Coloured males homozygous for the S-allele had significantly increased levels of AS compared to Coloured males with at least one L-allele (P = 0.016). CONCLUSIONS This is the first study to be conducted on AS in adolescents from two ethnically diverse populations. Results indicate that the L-G haplotype confers protection against high AS levels in a Xhosa population. Furthermore, increased CT was found to protect against high levels of AS in Xhosa rs1042173 CC-carriers.
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Affiliation(s)
- Sian M J Hemmings
- a Department of Psychiatry, Faculty of Medicine and Health Sciences , Stellenbosch University , Tygerberg , South Africa
| | - Lindi I Martin
- a Department of Psychiatry, Faculty of Medicine and Health Sciences , Stellenbosch University , Tygerberg , South Africa
| | - Lize van der Merwe
- b Department of Statistics , University of the Western Cape , Bellville , South Africa
| | - Rohan Benecke
- c Department of Biomedical Sciences, Faculty of Medicine and Health Sciences , Stellenbosch University , Tygerberg , South Africa
| | - Katharina Domschke
- d Department of Psychiatry , University of Wuerzburg , Wuerzburg , Germany
| | - Soraya Seedat
- a Department of Psychiatry, Faculty of Medicine and Health Sciences , Stellenbosch University , Tygerberg , South Africa
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Hildebrand M. The Psychometric Properties of the Drug Use Disorders Identification Test (DUDIT): A Review of Recent Research. J Subst Abuse Treat 2015; 53:52-9. [PMID: 25682718 DOI: 10.1016/j.jsat.2015.01.008] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 12/15/2014] [Accepted: 01/19/2015] [Indexed: 10/24/2022]
Abstract
This article reviews the reliability (internal consistency, interrater reliability), factor structure, and validity (i.e., sensitivity and specificity) of the 11-item Drug Use Disorders Identification Test (DUDIT). An extensive literature review was conducted using the Medline, Psychinfo and PubMed databases from January 2005 to October 2014. Search terms were "Drug Use Disorders Identification Test" and "DUDIT". All articles that addressed reliability, factor structure, sensitivity and specificity of the DUDIT were examined. Publications in which the DUDIT was used as a screening tool and/or studies that used the DUDIT to compare use and abuse/dependence of drugs in participants at baseline and at follow-up but had no data on its psychometric properties, were not included. In total, 18 usable publications were identified and included in the review. In general, the DUDIT yields satisfactory measures of reliability and validity for use as a clinical or research tool. Internal consistency reliability estimates (Cronbach's α) are generally >.90. Most studies also revealed favorable sensitivity (ranging from .85 to 1.00) and specificity (ranging from .75 to .92) in a variety of populations. Results on the factor structure, however, are somewhat equivocal. Future directions for research on the DUDIT are suggested.
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