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Emery CR. Intergenerational mental health effects of traumatic victimization in Nepal: A 3-D theory study. Soc Sci Med 2024; 352:117020. [PMID: 38838530 DOI: 10.1016/j.socscimed.2024.117020] [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: 01/04/2024] [Revised: 04/18/2024] [Accepted: 05/24/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND Intergenerational transmission of trauma is a major focus of international research. Epigenetic, complex-trauma, and intergenerational abuse pattern transmission theoretical explanations all have existing empirical support. Three-D theory argues that in addition to trauma victimization severity, victimization invasiveness and exploitativeness have important independent effects. Moreover, 3-D theory claims that a positive 3-way interaction occurs between trauma victimization invasiveness, exploitativeness, and severity. This study examines the 3-D hypotheses in the context of intergenerational trauma effects on adolescent depression symptoms and suicidal ideation in generation two. Three-D theory may play a particularly important role in intergenerational trauma effects for female victims in the context of conservative South Asian sex role norms. OBJECTIVE Test for main effects, two-way, and three-way interaction effects of invasiveness, exploitativeness, and severity of traumatic victimization on intergenerational transmission to adolescent depression and suicidal ideation in generation two. Pathways from maternal depression and borderline personality symptoms as well as physical and sexual abuse and neglect of the adolescent child were also tested. PARTICIPANTS and setting. Participants were a nationally representative, random, multi-stage cluster sample of 1089 Nepali mothers and their 15-17 year old adolescent children. METHODS Regression models with adjustments for clustering within municipality were used to test the hypotheses. RESULTS One in four Nepali adolescents had considered suicide; more than half had high depression scores. A three-way interaction effect between maternal trauma invasiveness, exploitativeness, and severity was positively associated with adolescent depression symptoms. A two-way interaction effect between exploitativeness and severity of maternal trauma was positively associated with adolescent suicidal ideation. Maternal depression, BPD symptoms, and very severe physical abuse of the adolescent were also associated with adolescent depression symptoms. CONCLUSION Further research is needed to measure and investigate invasiveness, exploitativeness, and severity of traumatic victimization as they bear on intergenerational transmission of trauma. Examination of intergenerational transmission of self-concept as a potential vector is recommended.
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Mohammadi Z, Dehghani M, Fathali Lavasani F, Farahani H, Ashouri A. A network analysis of ICD-11 Complex PTSD, emotional processing, and dissociative experiences in the context of psychological trauma at different developmental stages. Front Psychiatry 2024; 15:1372620. [PMID: 38532985 PMCID: PMC10963615 DOI: 10.3389/fpsyt.2024.1372620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 02/27/2024] [Indexed: 03/28/2024] Open
Abstract
Objective Traumatic experiences are a significant risk factor for psychological disturbances, including disorders such as complex posttraumatic stress disorder, emotion-processing problems, and trauma-related dissociative experiences. The present investigation examined the coexistence of these symptoms using a network analysis model. Method This study included a sample of 406 people referred to comprehensive health centers in Tehran from September to December 2023 with psychopathological syndromes. Variables were assessed using The International Trauma Questionnaire, International Measurement of Exposure to Traumatic Event checklist, Baker Emotional Processing Questionnaire, and Dissociative Experiences. A regularized partial correlation network and Glasso algorithm, in combination with Extended Bayesian information criteria, were applied to estimate the network structure. Results Signs of unprocessed emotions and disturbance in self-organization symptoms were the most important symptoms in the symptom network, forming strong connections with other nodes. Thereby, these two symptoms can be regarded as the most important clinical manifestations in the symptom network following traumatic experiences. Three distinct symptom communities were identified: the community of traumatic experiences (childhood, adolescence, adulthood), the community of dissociative experiences (amnesia, depersonalization/derealization, and absorption), and the community of emotional processing (suppression, unpleasant emotional experience, Signs of unprocessed emotions, avoidance, and emotional control, posttraumatic stress disorder symptoms and disturbance in self-organization symptoms). The strongest edges observed were between childhood trauma-adolescence trauma (0.473) in the community of traumatic experiences, between amnesia and depersonalization/derealization (0.644) in the community of dissociative experiences, and between disturbance in self-organization symptoms and unprocessed emotions (0.324) in the community of emotional processing, indicating the recurrent occurrence of these symptoms. Conclusion In this study, disturbance in self-organization symptoms was identified as the central psychopathologic symptom in individuals experiencing traumas at different developmental stages. It seems that adolescent trauma and not childhood trauma plays a more decisive role in the symptoms that a person manifests after traumatic experiences. Also, posttraumatic stress disorder symptoms and disturbance in self-organization symptoms were recognized in the cluster of emotional processing symptoms and can have substantial roles in prioritizing therapeutic measures.
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Affiliation(s)
- Zahra Mohammadi
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Mahmood Dehghani
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Fahimeh Fathali Lavasani
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | | | - Ahmad Ashouri
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
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Harris J, Loth E, Sethna V. Tracing the paths: a systematic review of mediators of complex trauma and complex post-traumatic stress disorder. Front Psychiatry 2024; 15:1331256. [PMID: 38510809 PMCID: PMC10951104 DOI: 10.3389/fpsyt.2024.1331256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/20/2024] [Indexed: 03/22/2024] Open
Abstract
Complex trauma is associated with complex-posttraumatic stress disorder (CPTSD). While dissociative processes, developmental factors and systemic factors are implicated in the development of CPTSD, there are no existing systematic reviews examining the underlying pathways linking complex trauma and CPTSD. This study aims to systematically review evidence of mediating factors linking complex trauma exposure in childhood (birth to eighteen years of age) and subsequent development of CPTSD (via self-reports and diagnostic assessments). All clinical, at-risk and community-sampled articles on three online databases (PsycINFO, MedLine and Embase) were systematically searched, along with grey literature from ProQuest. Fifteen articles were eligible for inclusion according to pre-determined eligibility criteria and a search strategy. Five categories of mediating processes were identified: 1) dissociative processes; 2) relationship with self; 3) emotional developmental processes; 4) social developmental processes; and 5) systemic and contextual factors. Further research is required to examine the extent to which targeting these mediators may act as mechanisms for change in supporting individuals to heal from complex trauma. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022346152.
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Affiliation(s)
- Joseph Harris
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, England, United Kingdom
| | - Eva Loth
- Department of Forensic and Neurodevelopmental Science, School of Academic Psychiatry, King’s College London, London, England, United Kingdom
| | - Vaheshta Sethna
- Department of Social, Genetic & Developmental Psychiatry Centre, School of Mental Health & Psychological Sciences, King’s College London, London, England, United Kingdom
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Hamer R, Bestel N, Mackelprang JL. Dissociative Symptoms in Complex Posttraumatic Stress Disorder: A Systematic Review. J Trauma Dissociation 2024; 25:232-247. [PMID: 38112306 DOI: 10.1080/15299732.2023.2293785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 07/07/2023] [Indexed: 12/21/2023]
Abstract
The 11th revision of the International Classification of Diseases (ICD-11) introduced Complex Posttraumatic Stress Disorder (CPTSD) as a sibling disorder to PTSD. Dissociative symptoms have been implicated in the severity of ICD-11 CPTSD; however, no reviews have investigated how dissociation has been measured in studies investigating CPTSD, nor the relationship between CPTSD and dissociation. This systematic review aimed to identify measures used to assess dissociative symptoms in studies that have assessed CPTSD according to ICD-11 criteria and to synthesize the relationship between these constructs. PsycINFO, PubMed, Scopus and Web of Science were searched on March 31, 2021. Seventeen articles met inclusion criteria. CPTSD was most frequently measured by a version of the International Trauma Questionnaire. Twelve measures were used to assess for dissociative symptoms, the most common being the Dissociative Symptoms Scale and the Dissociative Experiences Scale. The relationship between CPTSD and dissociative symptoms was moderate-to-strong, but inconsistently reported. Further research is needed to determine the most appropriate measure(s) of dissociation in CPTSD.
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Affiliation(s)
- Ruby Hamer
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Australia
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Australia
| | | | - Jessica L Mackelprang
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Australia
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Borrelli G, Lamberti Zanardi A, Scognamiglio C, Cinquegrana V, Perrella R. The relationship between childhood interpersonal and non-interpersonal trauma and autobiographical memory: a systematic review. Front Psychol 2024; 15:1328835. [PMID: 38298520 PMCID: PMC10827865 DOI: 10.3389/fpsyg.2024.1328835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 01/04/2024] [Indexed: 02/02/2024] Open
Abstract
Childhood trauma can have negative effects on several domains of mental functioning, including Autobiographical Memory (AM). Conflicting results emerge in the scientific literature regarding the effects of childhood trauma on AM. In this review, we explored the relationship between the childhood trauma and AM, classifying childhood trauma as interpersonal, non-interpersonal and overall (interpersonal and non-interpersonal). We carried out a systematic literature review, following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA statement). From searching the PubMed, Scopus, and Web of Science databases, we identified 48 studies conducted from 2014 to 2023, which were included when they: (a) were written in English, (b) investigated the relationship between AM and childhood trauma, (c) included a sample of children, adolescents, or adults who had experienced childhood interpersonal and/or non-interpersonal trauma. Of the 48 eligible studies, 29 referred to trauma of an interpersonal nature, 12 to trauma of a non-interpersonal nature, and 7 to overall trauma. Regarding the relationship between childhood trauma and AM, 24 studies found a negative relationship between childhood interpersonal trauma and AM; among the articles on non-interpersonal trauma, 10 studies found no relevant relationship; in the studies on overall trauma, 4 articles found negative relationship between overall trauma and AM. The literature explored in our systematic review supports the prevalence of a negative relationship between interpersonal childhood trauma and AM. This relationship is present regardless of psychiatric disorders (e.g., Depression, Post Traumatic Stress Disorder, and Personality Disorders), and in the presence of the latter, AM results even more fragmented. Future research should use more accurate methodologies in identifying and classifying childhood trauma in order to more precisely determine its effect on AM.
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Affiliation(s)
- Giovanni Borrelli
- Department of Human Sciences, Guglielmo Marconi University, Rome, Italy
| | | | | | - Vincenza Cinquegrana
- Department of Psychology, University of Study of Campania “Luigi Vanvitelli”, Caserta, Italy
| | - Raffaella Perrella
- Department of Psychology, University of Study of Campania “Luigi Vanvitelli”, Caserta, Italy
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Bachem R, Levin Y, Yuval K, Langer NK, Solomon Z, Bernstein A. Complex posttraumatic stress disorder in intergenerational trauma transmission among Eritrean asylum-seeking mother-child dyads. Eur J Psychotraumatol 2024; 15:2300588. [PMID: 38190253 PMCID: PMC10776052 DOI: 10.1080/20008066.2023.2300588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 12/21/2023] [Indexed: 01/10/2024] Open
Abstract
Background: Traumatic stress among forcibly displaced people has a variety of adverse consequences beyond individual mental health, including implications for poor socioemotional developmental outcomes for their children post-displacement.Objective: This study explored the intergenerational transmission of maternal ICD-11 Complex Posttraumatic Stress Disorder (CPTSD) and depression among asylum-seeking mothers for their children's internalizing and externalizing difficulties.Method: Participants were 127 trauma-affected Eritrean mothers of preschool-aged children in Israel. The severity of child difficulties was compared between mothers with probable ICD-11 CPTSD (94.5% comorbid depression), ICD-11 PTSD (48.5% comorbid depression), unimorbid depression, and healthy mothers, using multivariate analyses of variance, while controlling for children's direct exposure to adverse life experiences.Results: Probable ICD-11 CPTSD and PTSD were present in 23.6% and 26.0% of mothers, respectively. Relative to maternal PTSD, CPTSD was significantly and strongly associated with elevated child internalizing symptoms (d = 2.44) and marginally significantly, although strongly, associated with child externalizing symptoms (d = 1.30). Post-hoc exploratory analyses documented that, relative to maternal PTSD and depression, CPTSD and depression comorbidity was marginally significantly but strongly associated with child internalizing (SMD = .67), but not externalizing symptoms (SMD = .35).Conclusions: Findings implicate maternal CPTSD and comorbid depression in child socio-emotional development and inform clinical assessment, prevention, and intervention to attenuate poor development among children in unstable post-displacement settings.
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Affiliation(s)
- Rahel Bachem
- Psychopathology and Clinical Intervention, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Yafit Levin
- School of Social Work, Ariel University, Ariel, Israel
| | - Kim Yuval
- Observing Minds Lab, Department of Psychology, School of Psychological Sciences, University of Haifa, Haifa, Israel
| | - Nora Korin Langer
- Bob Shapell School of Social Work, Tel-Aviv University, Tel-Aviv, Israel
| | - Zahava Solomon
- Bob Shapell School of Social Work, Tel-Aviv University, Tel-Aviv, Israel
- the I-Core Research Center for Mass Trauma, Tel-Aviv, Israel
| | - Amit Bernstein
- Observing Minds Lab, Department of Psychology, School of Psychological Sciences, University of Haifa, Haifa, Israel
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Fung HW, Chien WT, Lam SKK, Ross CA. The Relationship Between Dissociation and Complex Post-Traumatic Stress Disorder: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2023; 24:2966-2982. [PMID: 36062904 DOI: 10.1177/15248380221120835] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Complex post-traumatic stress disorder (CPTSD) has recently been recognized as an official psychiatric diagnosis in ICD-11, after years of research and advocacy in the field. It has been suggested that dissociative symptoms are a major feature of CPTSD. This scoping review aimed to summarize the existing knowledge base on the relationship between dissociation and CPTSD, and to identify relevant research gaps. We searched the two largest and most widely used academic databases (i.e., the Web of Science and Scopus databases) and the ProQuest database and identified original studies published in English relevant to our research questions, namely: (1) Would CPTSD be associated with dissociative symptoms? 2) How common are dissociative symptoms among people with CPTSD? (3) What are the correlates of dissociative symptoms among people with CPTSD? In all, 26 studies were included. We found 10 studies which reported that people with CPTSD scored significantly higher on a dissociation measure than those without CPTSD, and 11 studies reported a positive correlation between CPTSD symptoms and psychoform/somatoform dissociation scores. While very few studies reported the prevalence and correlates of dissociative symptoms among people with CPTSD, there may be a considerable subgroup of people with CPTSD who have clinically significant levels of dissociative symptoms (e.g., 28.6-76.9%). Dissociation may also be associated with other comorbidities (e.g., DSM-IV Axis II features, shame, somatic symptoms) in people with CPTSD. We recommend that more studies are needed to investigate the prevalence of dissociative symptoms among people with CPTSD and examine how these symptoms are associated with other comorbid conditions and clinical needs in this vulnerable group.
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Affiliation(s)
- Hong Wang Fung
- Department of Social Work, Hong Kong Baptist University, Hong Kong
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Stanley Kam Ki Lam
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Colin A Ross
- The Colin A. Ross Institute for Psychological Trauma, Richardson, Texas, USA
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Knefel M, Karatzias T, Spinazzola J, Shevlin M, Ford JD. The relationship of posttraumatic stress disorder and developmental trauma disorder with childhood psychopathology: A network analysis. J Anxiety Disord 2023; 99:102766. [PMID: 37690357 DOI: 10.1016/j.janxdis.2023.102766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/25/2023] [Accepted: 09/03/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVE Potentially traumatic experiences are a major risk factor for mental disorders in children and adolescents. Posttraumatic psychopathology includes trauma-specific disorders such as posttraumatic stress disorder (PTSD) as well as other psychiatric disorders. Developmental Trauma Disorder (DTD) has been proposed as a developmentally sensitive diagnosis. We aimed to further illuminate the co-occurrence of psychiatric conditions with DTD and PTSD. METHOD In a convenience sample of families of 507 children and adolescents (mean age = 12.11 years old, SD = 2.92; 48.5% female), we assessed DTD, PTSD, and screened for psychiatric disorders. We estimated network models including DTD, PTSD and ten psychiatric conditions. RESULTS We found that DTD and PTSD share both common and differential comorbidity features on disorder-, domain-, and symptom-level. The differential comorbidity patterns of the DTD and PTSD domains placed DTD close to both externalizing and internalizing psychopathology while PTSD was primarily linked to internalizing conditions. CONCLUSIONS Our study provides evidence for the complex clinical presentation of posttraumatic psychopathology over and above PTSD in children. DTD and PTSD provide useful and distinct diagnostic categories for children who are also experiencing internalizing conditions, and DTD may be especially relevant for children who are experiencing externalizing psychopathology.
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Affiliation(s)
- Matthias Knefel
- Faculty of Psychology, University of Vienna, Vienna, Austria; Department of Internal Medicine, Landesklinikum Baden , Baden bei Wien, Austria.
| | - Thanos Karatzias
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, UK; Rivers Centre for Traumatic Stress, NHS Lothian, Edinburgh, UK
| | | | - Mark Shevlin
- Ulster University, School of Psychology, Coleraine, UK
| | - Julian D Ford
- University of Connecticut School of Medicine, Farmington, CT, USA
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9
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Marques-Feixa L, Moya-Higueras J, Romero S, Santamarina-Pérez P, Martín-Gonzalez NS, Mas A, Rapado-Castro M, Blasco-Fontecilla H, Zorrilla I, Forner-Puntonet M, Anglada E, Ramírez M, Mayoral M, Muñoz MJ, Fañanás L, Palma-Gudiel H, Castro-Quintas Á, Monteserín JL, Marín-Vila M, Lobato MJ, Martín M, Méndez I, Gadea S, Vidal J, Guillen H, Piazza F, Fàbregas A, Rios G. Complex post-traumatic stress disorder (CPTSD) of ICD-11 in youths with childhood maltreatment: Associations with age of exposure and clinical outcomes. J Affect Disord 2023; 332:92-104. [PMID: 37004905 DOI: 10.1016/j.jad.2023.03.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 03/18/2023] [Accepted: 03/27/2023] [Indexed: 04/04/2023]
Abstract
BACKGROUND Exposure to childhood maltreatment (CM) increases the risk of psychiatric morbidity in youths. The new Complex Post-Traumatic Stress Disorder (CPTSD) diagnosis captures the heterogeneity and complexity of clinical outcomes observed in youths exposed to CM. This study explores CPTSD symptomatology and its association with clinical outcomes, considering the impact of CM subtypes and age of exposure. METHODS Exposure to CM and clinical outcomes were evaluated in 187 youths aged 7-17 (116 with psychiatric disorder; 71 healthy controls) following the Tools for Assessing the Severity of Situations in which Children are Vulnerable (TASSCV) structured interview criteria. CPTSD symptomatology was explored by confirmatory factor analysis, considering four subdomains: post-traumatic stress symptoms, emotion dysregulation, negative self-concept and interpersonal problems. RESULTS Youths exposed to CM (with or without psychiatric disorders) showed greater internalizing, externalizing and other symptomatology, worse premorbid adjustment and poorer overall functioning. Youth with psychiatric disorder and exposed to CM reported more CPTSD symptomatology, psychiatric comorbidity and polypharmacy and earlier onset of cannabis use. Different subtypes of CM and the developmental stage of exposure differentially impact CPTSD subdomains. LIMITATIONS Small percentage of resilient youths was studied. It was not possible to explore specific interactions between diagnostic categories and CM. Direct inference cannot be assumed. CONCLUSIONS Gathering information on type and age of exposure to CM is clinically useful to understand the complexity of psychiatric symptoms observed in youths. Inclusion of the CPTSD diagnosis should increase the implementation of early specific interventions, improving youths' functioning and reducing the severity of clinical outcomes.
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Affiliation(s)
- Laia Marques-Feixa
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Biomedicine Institute of the University of Barcelona (IBUB), Barcelona, Spain; Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, ISCIII, Spain
| | - Jorge Moya-Higueras
- Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, ISCIII, Spain; Department of Psychology, Faculty of Education, Psychology and Social Work, University of Lleida, Spain
| | - Soledad Romero
- Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, ISCIII, Spain; Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neuroscience, Hospital Clínic Barcelona, Barcelona, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
| | - Pilar Santamarina-Pérez
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neuroscience, Hospital Clínic Barcelona, Barcelona, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Nerea San Martín-Gonzalez
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Biomedicine Institute of the University of Barcelona (IBUB), Barcelona, Spain
| | - Ariadna Mas
- Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Marta Rapado-Castro
- Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, ISCIII, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, Madrid, Spain; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne & Melbourne Health, Victoria, Australia
| | - Hilario Blasco-Fontecilla
- Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, ISCIII, Spain; Department of Psychiatry, Puerta de Hierro University Hospital-Majadahonda, ITA Mental Health, Madrid, Spain
| | - Iñaki Zorrilla
- Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, ISCIII, Spain; Hospital Santiago Apostol, Department of Psychiatry, Vitoria-Gasteiz, Spain
| | - Mireia Forner-Puntonet
- Department of Mental Health, Hospital Universitari Vall d'Hebron. Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | | | - Maite Ramírez
- Day Hospital for Adolescents OSI Barrualde-Galdakao, Child and Adolescent Mental Health, Galdakao, Spain
| | - María Mayoral
- Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, ISCIII, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, Madrid, Spain
| | - María José Muñoz
- Hospital Benito Menni, Adolescent Crisis Unit, Sant Boi de Llobregat, Spain
| | - Lourdes Fañanás
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Biomedicine Institute of the University of Barcelona (IBUB), Barcelona, Spain; Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, ISCIII, Spain.
| | - Helena Palma-Gudiel
- Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, ISCIII, Spain; College of Public Health and Health Professions, Department of Epidemiology, University of Florida, United States of America
| | - Águeda Castro-Quintas
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Biomedicine Institute of the University of Barcelona (IBUB), Barcelona, Spain; Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, ISCIII, Spain
| | - José Luís Monteserín
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Biomedicine Institute of the University of Barcelona (IBUB), Barcelona, Spain; Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, ISCIII, Spain
| | - María Marín-Vila
- Department of Psychiatry, Puerta de Hierro University Hospital-Majadahonda, ITA Mental Health, Madrid, Spain
| | - María José Lobato
- Department of Psychiatry, Puerta de Hierro University Hospital-Majadahonda, ITA Mental Health, Madrid, Spain
| | - María Martín
- Hospital Benito Menni, Adolescent Crisis Unit, Sant Boi de Llobregat, Spain
| | - Iria Méndez
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neuroscience, Hospital Clínic Barcelona, Barcelona, Spain
| | - Silvia Gadea
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, Madrid, Spain
| | - Jorge Vidal
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, Madrid, Spain
| | - Hugo Guillen
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neuroscience, Hospital Clínic Barcelona, Barcelona, Spain
| | - Flavia Piazza
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neuroscience, Hospital Clínic Barcelona, Barcelona, Spain
| | - Anna Fàbregas
- Department of Pediatrics, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - Giulana Rios
- Social Work Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
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Simon P, Blanchet A. Interaction microanalysis of foster care research using THEME. Front Psychol 2022; 13:956259. [PMID: 36329728 PMCID: PMC9623253 DOI: 10.3389/fpsyg.2022.956259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 10/04/2022] [Indexed: 11/16/2022] Open
Abstract
Environmental stress is a key element to the understanding of the psychopathology of children in foster care. Such children often present a wide range of symptoms from anxiety to depression, including abnormal behaviors in their interactions with adults that can be related to experience suffered in their family of origin (e.g., abandonment, abuse, etc.). Foster care should provide a safe environment, both to protect children from abuse and to help them build a well-adjusted developmental trajectory. The relationships with the family of origin may also be maintained. How do children in foster care behave in relation to caregivers given the differences between the families they grow up in? This study focuses on three adult-child relationships: those with a foster carer, a mother and a father. Each adult-child interaction was recorded several times in a day-to-day environment. On each occasion the instruction was given to behave naturally while interacting with a child. No additional material was supplied. Our observations concern the verbal and non-verbal comportment of a 4-year-old foster child named Julia when entering the study, with her caregivers. Once the principal elements had been coded (behaviors, verbalizations), a sequential behavioral patterns analysis was performed using the THEME© program. For this purpose, a 2-min interaction was chosen from the third video of an event which appeared particularly representative of the relationship between Julia and her different caregivers. According to whom Julia was with, the results reveal very different interactive processes. We observe, for example, that with the foster carer the interaction patterns were primarily focused on play objects, whereas they involved more collaborative activity with the father and distraction/avoidance behaviors with the mother. The study identifies the use of disengaging and self-exciting behaviors in all types of interaction. Those emotion regulation strategies are particularly developed during parent–child sessions, showing pathological processes of relationship.
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Hemady CL, Speyer LG, Kwok J, Meinck F, Melendez-Torres G, Fry D, Auyeung B, Murray AL. Using network analysis to illuminate the intergenerational transmission of adversity. Eur J Psychotraumatol 2022; 13:2101347. [PMID: 36016844 PMCID: PMC9397447 DOI: 10.1080/20008198.2022.2101347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 07/01/2022] [Accepted: 07/01/2022] [Indexed: 11/03/2022] Open
Abstract
Objective: The effects of maternal exposure to adverse childhood experiences (ACEs) may be transmitted to subsequent generations through various biopsychosocial mechanisms. However, studies tend to focus on exploring one or two focal pathways with less attention paid to links between different pathways. Using a network approach, this paper explores a range of core prenatal risk factors that may link maternal ACEs to infant preterm birth (PTB) and low birthweight (LBW). Methods: We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC) (n = 8379) to estimate two mixed graphical network models: Model 1 was constructed using adverse infant outcomes, biopsychosocial and environmental risk factors, forms of ACEs, and sociodemographic factors. In Model 2, ACEs were combined to represent a threshold ACEs score (≥4). Network indices (i.e., shortest path and bridge expected influence [1-step & 2-step]) were estimated to determine the shortest pathway from ACEs to infant outcomes, and to identify the risk factors that are vital in activating other risk factors and adverse outcomes. Results: Network analyses estimated a mutually reinforcing web of childhood and prenatal risk factors, with each risk connected to at least two other risks. Bridge influence indices suggested that childhood physical and sexual abuse and multiple ACEs were highly interconnected to others risks. Overall, risky health behaviours during pregnancy (i.e., smoking & illicit drug use) were identified as 'active' risk factors capable of affecting (directly and indirectly) other risk factors and contributing to the persistent activation of the global risk network. These risks may be considered priority candidate targets for interventions to disrupt intergenerational risk transmission. Our study demonstrates the promise of network analysis as an approach for illuminating the intergenerational transmission of adversity in its full complexity. HIGHLIGHTS We took a network approach to assessing links between ACEs and birth outcomes.ACEs, other prenatal risk factors, and birth outcomes had complex inter-connectionsHealth behaviours in pregnancy were indicated as optimal intervention targets.
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Affiliation(s)
- Chad Lance Hemady
- School of Social and Political Science, University of Edinburgh, Edinburgh, UK
| | - Lydia Gabriela Speyer
- Department of Psychology, University of Cambridge, Cambridge, UK
- Department of Psychology, School of Philosophy, Psychology & Language Sciences, University of Edinburgh, Edinburgh, UK
| | - Janell Kwok
- Department of Psychology, School of Philosophy, Psychology & Language Sciences, University of Edinburgh, Edinburgh, UK
| | - Franziska Meinck
- School of Social and Political Science, University of Edinburgh, Edinburgh, UK
- OPTENTIA, Faculty of Health Sciences, North-West University, Vanderbijlpark, South Africa
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Deborah Fry
- Moray House School of Education and Sport, University of Edinburgh, Edinburgh, UK
| | - Bonnie Auyeung
- Department of Psychology, School of Philosophy, Psychology & Language Sciences, University of Edinburgh, Edinburgh, UK
- Department of Psychiatry, Autism Research Centre, University of Cambridge, Cambridge, UK
| | - Aja Louise Murray
- Department of Psychology, School of Philosophy, Psychology & Language Sciences, University of Edinburgh, Edinburgh, UK
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12
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de Ruiter C, Burghart M, De Silva R, Griesbeck Garcia S, Mian U, Walshe E, Zouharova V. A meta-analysis of childhood maltreatment in relation to psychopathic traits. PLoS One 2022; 17:e0272704. [PMID: 35947555 PMCID: PMC9365173 DOI: 10.1371/journal.pone.0272704] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 07/25/2022] [Indexed: 12/03/2022] Open
Abstract
Psychopathy is a personality disorder characterized by a mix of traits belonging to four facets: affective (e.g., callous/lack of empathy), interpersonal (e.g., grandiosity), behavioral instability (e.g., impulsivity, poor behavioral controls), and social deviance (e.g., juvenile delinquency, criminal versatility). Several scholars have argued that early childhood maltreatment impacts the development of psychopathy, although views regarding its role in the four facets differ. We conducted a meta-analysis including 47 studies comprising a total of 389 effect sizes and 12,737 participants, to investigate the association between psychopathy and four types of child maltreatment: physical abuse, emotional abuse, neglect, and sexual abuse. We found support for a moderate link between overall psychopathy and childhood physical abuse, emotional abuse, and neglect, as well as overall childhood maltreatment. The link between psychopathy and childhood sexual abuse was small, but still statistically significant. These associations were stronger for the behavioral and antisocial facets than for the affective and interpersonal facets of psychopathy, but nearly all associations were statistically significant. Our findings are consistent with recently developed theories on the role of complex trauma in the development of severe personality disorders. Trauma-focused preventive and therapeutic interventions can provide further tests of the trauma-psychopathy hypothesis.
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Affiliation(s)
- Corine de Ruiter
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
- * E-mail:
| | - Matthias Burghart
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
- Department of Clinical Psychology, University of Konstanz, Konstanz, Germany
| | - Raneesha De Silva
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Sara Griesbeck Garcia
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Ushna Mian
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Eoin Walshe
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Veronika Zouharova
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
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13
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Redican E, Hyland P, Cloitre M, McBride O, Karatzias T, Murphy J, Bunting L, Shevlin M. Prevalence and predictors of ICD-11 posttraumatic stress disorder and complex PTSD in young people. Acta Psychiatr Scand 2022; 146:110-125. [PMID: 35503737 PMCID: PMC9540630 DOI: 10.1111/acps.13442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 04/26/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The prevalence, construct validity, risk factors and psychopathological correlates associated with ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) as measured by the International Trauma Questionnaire for Children and Adolescents (ITQ-CA) were assessed in a sample of young people from Northern Ireland. METHOD Participants were trauma-exposed 11-19-year-olds (N = 507) who participated in the Northern Ireland Youth Wellbeing Prevalence Survey (YWS-NI, 2020). Factor mixture modelling (FMM) was used to test the latent structure of the ITQ-CA. Risk-factors and psychopathological correlates associated with latent class membership, and ICD-11diagnostic status, were also investigated. RESULTS More participants met the ITQ-CA criteria for CPTSD (3.4%, n = 44) than PTSD (1.5%, n = 19). A second-order FMM comprising a 'partial-PTSD class', a 'CPTSD class', a 'DSO class' and a 'low symptom endorsement class' was the best-fitting model. Younger age and cumulative trauma were risk factors for all trauma classes. Female gender and two or more violent traumas were significant predictors of the 'PTSD' and 'CPTSD' classes, while single sexual trauma was a significant predictor of the 'DSO' and 'CPTSD' classes. Two or more sexual traumas was a unique predictor of 'CPTSD class', while two or more vicarious traumas was a unique predictor of 'DSO class'. The 'CPTSD' class displayed the most notable comorbidity. CONCLUSIONS Findings indicate that CPTSD may be more prevalent than PTSD in children and young people. Support for the ICD-11 conceptualisation of CPTSD as representing a unique diagnostic construct was supported using FMM, with findings indicating trauma symptom class-specific risk profiles.
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Affiliation(s)
- Enya Redican
- School of PsychologyUlster UniversityColeraineUK
| | - Philip Hyland
- Department of PsychologyMaynooth UniversityMaynoothIreland
| | - Marylene Cloitre
- National Center for PTSDVerterans Affairs Palo Alto Health Care SystemPalo AltoCaliforniaUSA
| | - Orla McBride
- School of PsychologyUlster UniversityColeraineUK
| | - Thanos Karatzias
- School of Health and Social CareEdinburgh Napier UniversityEdinburghUK
| | - Jamie Murphy
- School of PsychologyUlster UniversityColeraineUK
| | - Lisa Bunting
- School of Social Sciences, Education and Social WorkQueen's UniversityBelfastUK
| | - Mark Shevlin
- School of PsychologyUlster UniversityColeraineUK
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14
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Cruz D, Lichten M, Berg K, George P. Developmental trauma: Conceptual framework, associated risks and comorbidities, and evaluation and treatment. Front Psychiatry 2022; 13:800687. [PMID: 35935425 PMCID: PMC9352895 DOI: 10.3389/fpsyt.2022.800687] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 06/27/2022] [Indexed: 11/17/2022] Open
Abstract
Children exposed to adverse childhood experiences (ACEs) and pervasive interpersonal traumas may go on to develop PTSD and, in most cases, will further undergo a significant shift in their developmental trajectory. This paper examines contemporary research on Developmental Trauma (DT), which is inextricably linked to disruptions in social cognition, physiological and behavioral regulation, and parent-child attachments. Developmental trauma associated with early experiences of abuse or neglect leads to multi-faceted and longstanding consequences and underscores critical periods of development, complex stress-mediated adaptations, and multilevel, trans-theoretical influences in the diagnostic formulation and treatment of traumatized children, adolescents, and adults. Psychological and medical correlates of Developmental Trauma Disorder are considered, and directions for future research are discussed.
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Affiliation(s)
- Daniel Cruz
- Hackensack Meridian Health Mountainside Medical Center, Montclair, NJ, United States
| | | | - Kevin Berg
- Hackensack Meridian Health Mountainside Medical Center, Montclair, NJ, United States
| | - Preethi George
- Hackensack Meridian Health Mountainside Medical Center, Montclair, NJ, United States
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15
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Maercker A, Cloitre M, Bachem R, Schlumpf YR, Khoury B, Hitchcock C, Bohus M. Complex post-traumatic stress disorder. Lancet 2022; 400:60-72. [PMID: 35780794 DOI: 10.1016/s0140-6736(22)00821-2] [Citation(s) in RCA: 69] [Impact Index Per Article: 34.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 04/19/2022] [Accepted: 04/27/2022] [Indexed: 12/21/2022]
Abstract
Complex post-traumatic stress disorder (complex PTSD) is a severe mental disorder that emerges in response to traumatic life events. Complex PTSD is characterised by three core post-traumatic symptom clusters, along with chronic and pervasive disturbances in emotion regulation, identity, and relationships. Complex PTSD has been adopted as a new diagnosis in the ICD-11. Individuals with complex PTSD typically have sustained or multiple exposures to trauma, such as childhood abuse and domestic or community violence. The disorder has a 1-8% population prevalence and up to 50% prevalence in mental health facilities. Progress in diagnostics, assessment, and differentiation from post-traumatic stress disorder and borderline personality disorder is reported, along with assessment and treatment of children and adolescents. Studies recommend multicomponent therapies starting with a focus on safety, psychoeducation, and patient-provider collaboration, and treatment components that include self-regulatory strategies and trauma-focused interventions.
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Affiliation(s)
- Andreas Maercker
- Division of Psychopathology and Clinical Intervention, University of Zurich, Zurich, Switzerland.
| | - Marylene Cloitre
- National Center for PTSD Division of Dissemination and Training and Department of Psychiatry and Behavioural Sciences, Stanford University, CA, USA
| | - Rahel Bachem
- Division of Psychopathology and Clinical Intervention, University of Zurich, Zurich, Switzerland
| | | | | | - Caitlin Hitchcock
- MRC Cognition and Brain Science Unit, University of Cambridge, Cambridge, UK; Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Martin Bohus
- Heidelberg University, Heidelberg Germany and Ruhr University, Bochum, Germany
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16
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Pfluger V, Rohner SL, Eising CM, Maercker A, Thoma MV. Internalizing Mental Health Disorders and Emotion Regulation: A Comparative and Mediational Study of Older Adults With and Without a History of Complex Trauma Exposure. Front Psychol 2022; 13:820345. [PMID: 35814079 PMCID: PMC9260226 DOI: 10.3389/fpsyg.2022.820345] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 05/17/2022] [Indexed: 12/04/2022] Open
Abstract
Individuals with complex trauma exposure (CTE) in early life (i.e., childhood/adolescence) are at heightened risk for developing problems in various domains of functioning. As such, CTE has repeatedly been linked to internalizing mental health disorders, such as depression and anxiety, as well as emotion dysregulation across the lifespan. While these correlates of CTE are comparatively well studied up to middle adulthood, they are insufficiently studied in older adulthood. Therefore, this study aimed to (a) compare Swiss older adults with and without a CTE history regarding current and lifetime internalizing mental health disorders and emotion regulation strategies; and (b) to examine the potential mediating role of emotion regulation in the mental health disparities between these groups. A total of N = 257 participants (age = 49-95 years; 46.3% female) were assessed in a retrospective, cross-sectional study, using two face-to-face interviews. The CTE group (n = 161; M age = 69.66 years, 48.4% female) presented with significantly more current and lifetime internalizing mental health disorders than the non-affected (nCTE) group (n = 96; M age = 72.49 years, 42.7% female). The CTE group showed significantly higher emotion suppression and lower emotion reappraisal compared to the nCTE group. Mediation analysis revealed that the two emotion regulation strategies were significant mediators between CTE history and internalizing mental health disorders. Findings emphasize the relevance of emotion (dys-)regulation in understanding mental health disparities in older age and deciding about treatment strategies. Research and practice should pay more attention to the needs of this high-risk group of older individuals.
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Affiliation(s)
- Viviane Pfluger
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program Dynamics of Healthy Ageing, University of Zurich, Zurich, Switzerland
| | - Shauna L. Rohner
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program Dynamics of Healthy Ageing, University of Zurich, Zurich, Switzerland
| | - Carla M. Eising
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program Dynamics of Healthy Ageing, University of Zurich, Zurich, Switzerland
| | - Andreas Maercker
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program Dynamics of Healthy Ageing, University of Zurich, Zurich, Switzerland
| | - Myriam V. Thoma
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program Dynamics of Healthy Ageing, University of Zurich, Zurich, Switzerland
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17
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Trauma exposure and factors associated with ICD-11 PTSD and complex PTSD in adolescence: a cross-cultural study in Japan and Lithuania. Epidemiol Psychiatr Sci 2022. [PMCID: PMC9281490 DOI: 10.1017/s2045796022000336] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Aims Cross-cultural studies of posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) based on ICD-11 diagnostic criteria are scarce, especially in adolescence. The study aimed to evaluate the trauma exposure, prevalence and factors associated with PTSD and CPTSD in general populations of adolescents in Lithuania and Japan. Methods The study sample comprised 1746 adolescents from Lithuania (n = 832) and Japan (n = 914), 49.8% female. The mean age of study participants was 15.52 (s.d. = 1.64), ranging from 12 to 18 years. ICD-11 posttraumatic disorders were assessed using the International Trauma Questionnaire – Child and Adolescent version (ITQ-CA). Results More than half of the adolescents in a total sample (61.5%) reported exposure to at least one traumatic event in their lifetime, 80.0% in Lithuania and 44.6% in Japan, with a higher prevalence of interpersonal trauma in Lithuania and more natural disaster exposure in Japan. The prevalence of PTSD was 5.2% (95% CI 3.8–6.9%) and 2.3% (95% CI 1.4–3.5%), CPTSD 12.3% (95% CI 10.1–14.7%) and 4.1% (95% CI 2.9–5.5%) in Lithuanian and Japanese samples, respectively. Cumulative trauma exposure, female gender, loneliness and financial difficulties in family predicted both PTSD and CPTSD in the total sample. Loneliness discriminated CPTSD v. PTSD in both Lithuanian and Japanese samples. Conclusions This cross-cultural study is among the first which reported different patterns of trauma exposure in Asian Japanese and Lithuanian adolescents in Europe. Despite differences in trauma exposure and PTSD/CPTSD prevalence, we found similar predictors in both studies, particularly the importance of cumulative trauma exposure for PTSD/CPTSD, and social interpersonal factors for the risk of CPTSD. The study supports the universality of traumatic stress reactions to adverse life experiences in adolescence across cultures and regions and highlights different levels of traumatisation of adolescents in various countries.
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18
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Zhang H, Luo Y, Davis T, Zhang L. Interactive effects of childhood maltreatment and tonic respiratory sinus arrhythmia on young adults' depressive symptoms. Psychophysiology 2021; 58:e13900. [PMID: 34287947 DOI: 10.1111/psyp.13900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 06/21/2021] [Accepted: 06/24/2021] [Indexed: 01/17/2023]
Abstract
The goal of the current study was to investigate the moderating effect of tonic respiratory sinus arrhythmia (RSA) in the relation between childhood maltreatment and depression symptoms among young adults. A total of 98 participants (70 women) aged 17-22 years completed questionnaires on childhood maltreatment and depressive symptoms. RSA data were obtained during a resting condition in the laboratory. Results indicated that childhood maltreatment interacted with tonic RSA to predict depressive symptoms, even after controlling for age and body mass index (BMI) of each participant. Specifically, higher levels of childhood maltreatment were associated with higher levels of depressive symptoms, but only among young adults who exhibited lower tonic RSA. The results indicated that the association between childhood maltreatment and depressive symptoms depends on young adults' physiological functioning/flexibility. Findings suggest that consideration of external environmental factors in combination with internal physiological factors is critical to understand young adults' mental health.
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Affiliation(s)
- Hui Zhang
- Jiangsu Key Laboratory of Mental Health and Cognitive Science, School of Psychology, Nanjing Normal University, Nanjing, China
| | - Yun Luo
- School of Education, Zhaoqing University, Zhaoqing, China
| | - Toshanna Davis
- Jiangsu Key Laboratory of Mental Health and Cognitive Science, School of Psychology, Nanjing Normal University, Nanjing, China
| | - Linlin Zhang
- School of Psychology, Capital Normal University, Beijing, China
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