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Yu Y, Cui X, Du J, Wilson A, Xu S, Wang Y. Linear and curvilinear association of pain tolerance and social anxiety symptoms among youth with different subgroups of childhood trauma. J Affect Disord 2024; 354:491-499. [PMID: 38508458 DOI: 10.1016/j.jad.2024.03.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 03/05/2024] [Accepted: 03/14/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Social anxiety is a common symptom that occurs after exposure to childhood trauma (CT), and pain tolerance is a protective factor against social anxiety in generic populations with CT. However, few studies have investigated whether and how this association varies across different CT subgroups. Thus, this study aimed to investigate (1) the effects of pain tolerance on social anxiety symptoms among youth with different subgroups of CT; (2) the nonlinear relationship between pain tolerance and social anxiety symptoms among different CT categories. METHODS In this study, 15,682 college or university students with experiences of CT were identified in a large sample and divided into five CT subgroups. Linear and quadratic regression models were conducted to explore the association between pain tolerance and social anxiety symptoms among youth with different CT subgroups. RESULTS The results of model revealed a linear relationship between pain tolerance and social anxiety symptoms among youth with most CT subgroups. Notably, an inverted U-shaped curve was found between pain tolerance and social anxiety symptoms in youth with emotional abuse. Social anxiety symptoms increased gradually with pain tolerance scores between 0 and 16, and then sharply decreased when scores reached above 16. LIMITATIONS Limited by self-report measurements, the results of this study focused only on perceived pain tolerance and ignored behavioral pain tolerance. CONCLUSION These findings highlight the importance of assessing pain tolerance thresholds in youth with emotional abuse and improving pain tolerance to prevent social anxiety symptoms in youth with different subgroups of CT.
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Affiliation(s)
- Yi Yu
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China; and School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Xin Cui
- Department of Psychology, Faculty of Arts and Sciences, Beijing Normal University, Zhuhai, China; Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Jinmei Du
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China; and School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Amanda Wilson
- Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, United Kingdom
| | - Shicun Xu
- Northeast Asian Research Center, Jilin University, Changchun, China
| | - Yuanyuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China; and School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.
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Tapia G, Teysseyre J, Bréhonnet R, Baud A, Gauvreau G, Gray M, Oprescu F. Childhood trauma and alcohol misuse in college students: The moderating role of minimization. CHILD ABUSE & NEGLECT 2024; 152:106749. [PMID: 38581770 DOI: 10.1016/j.chiabu.2024.106749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/16/2024] [Accepted: 03/11/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND History of childhood trauma as a risk factor for alcohol misuse in early adulthood is very well documented. Given the associations between childhood trauma and alcohol misuse, more work is needed to understand the factors that influence this relationship. OBJECTIVE The purpose of this study was to examine the relationship between childhood trauma, minimization of such events and alcohol misuse in a French college student sample. PARTICIPANTS AND SETTING A convenience sampling method was used to recruit students from several colleges located in Western France. The data set included 1180 records with complete responses. METHODS This study employed a cross-sectional online survey. Data collection instruments included the Childhood Trauma Questionnaire Short-Form (CTQ-SF) and the Alcohol Use Disorders Identification Test (AUDIT). RESULTS The strength of the association between CTQ score and AUDIT total score was increased by minimization score (β = 0.122, p = .07). This result suggests that under-reporting childhood trauma experiences tends to increase the impact of such events on alcohol misuse. CONCLUSION These findings suggest that a tendency to minimize threatening childhood events may specifically be related to increased risk of greater alcohol misuse among college students. Therefore, it may be important for clinician to assess minimization of early events in students with a history of childhood trauma.
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Affiliation(s)
| | | | - Rémi Bréhonnet
- Groupe Excelia La Rochelle, 17024 La Rochelle Cedex 1, France
| | - Alexandra Baud
- Groupe Excelia La Rochelle, 17024 La Rochelle Cedex 1, France
| | | | - Marion Gray
- Faculty of Health, Engineering and Sciences, University of Southern Queensland, Ipswich, Australia
| | - Florin Oprescu
- Cluster for Health Improvement, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Maroochydore, Australia
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Musella KE, DiFonte MC, Michel R, Stamates A, Flannery-Schroeder E. Emotion regulation as a mediator in the relationship between childhood maltreatment and symptoms of social anxiety among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-8. [PMID: 38466343 DOI: 10.1080/07448481.2024.2325926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 02/22/2024] [Indexed: 03/13/2024]
Abstract
OBJECTIVE The current study explored emotion regulation strategies (ie, suppression, cognitive reappraisal, experiential avoidance) as mediators in the relationship between childhood maltreatment and social anxiety. PARTICIPANTS One hundred and ninety-three undergraduate students (Mage = 19.5 years; 83.9% female) were recruited from a public university in the northeastern United States. METHODS Participants completed measures assessing childhood maltreatment, emotion regulation strategies, and social anxiety. RESULTS Structural equation modeling was used to examine the mediation paths. Childhood maltreatment was negatively associated with cognitive reappraisal and experiential avoidance, and positively associated with suppression. Higher suppression was associated with higher social anxiety, and higher experiential avoidance was associated with lower social anxiety. The association between childhood maltreatment and symptoms of social anxiety was mediated by suppression and experiential avoidance, but not cognitive reappraisal. All other paths were nonsignificant. CONCLUSIONS Findings suggest that treatments for childhood maltreatment should aim to bolster experiential avoidance and minimize suppression to address social anxiety symptoms.
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Affiliation(s)
- Katharine E Musella
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Maria C DiFonte
- Anxiety Disorders Center, Institute of Living, Hartford, Connecticut, USA
| | - Rebecca Michel
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Amy Stamates
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
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Abeditehrani H, Dijk C, Dehghani Neyshabouri M, Arntz A. Effectiveness of cognitive behavioral group therapy, psychodrama, and their integration for treatment of social anxiety disorder: A randomized controlled trial. J Behav Ther Exp Psychiatry 2024; 82:101908. [PMID: 37690886 DOI: 10.1016/j.jbtep.2023.101908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 05/23/2023] [Accepted: 08/26/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND AND OBJECTIVES Although cognitive behavioral group therapy (CBGT) is an effective treatment for social anxiety disorder, many socially anxious patients are still symptomatic after treatment. A possible improvement for CBGT could come from the more experiential group psychotherapy, psychodrama (PD). The integration of CBGT and PD (labeled CBPT) might offer an even more effective treatment than CBGT or PD alone. With the present study, we investigated first whether three kinds of group therapy (CBGT, PD, and CBPT) are superior to a waitlist (WL). Second, we investigated whether CBPT is more effective than CBGT or PD alone. METHODS One hundred and forty-four social anxiety patients were randomly assigned to three active conditions or a WL. After wait, WL-participants were randomized over the active treatment conditions. RESULTS The results of a multilevel analysis showed that all treatments were superior to WL in reducing social anxiety complaints. Only CBGT and CBPT differed significantly from WL in reducing fear of negative evaluations. There were no significant differences between active conditions in any of the variables after treatment and after six-month follow up, neither were there significant differences in treatment dropout. LIMITATIONS First there is the lack of a long-term follow-up. Second, because of loss of participants, we did not reach the planned numbers in the active treatment groups in comparison to WL. Moreover, this study was not designed as a non-inferiority or equivalence trial. CONCLUSIONS Although the integrative CBPT showed good results, it was not more effective than the other treatments.
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Affiliation(s)
- Hanieh Abeditehrani
- University of Amsterdam, Department of Clinical Psychology, Amsterdam, the Netherlands.
| | - Corine Dijk
- University of Amsterdam, Department of Clinical Psychology, Amsterdam, the Netherlands
| | | | - Arnoud Arntz
- University of Amsterdam, Department of Clinical Psychology, Amsterdam, the Netherlands
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Melamed DM, Botting J, Lofthouse K, Pass L, Meiser-Stedman R. The Relationship Between Negative Self-Concept, Trauma, and Maltreatment in Children and Adolescents: A Meta-Analysis. Clin Child Fam Psychol Rev 2024; 27:220-234. [PMID: 38386241 PMCID: PMC10920440 DOI: 10.1007/s10567-024-00472-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2024] [Indexed: 02/23/2024]
Abstract
Experiencing trauma in childhood is a global public health issue linked to worse physical and mental health outcomes, including Post-Traumatic Stress Disorder (PTSD). Self-concept is a transdiagnostic concept linked to various psychopathologies and understanding its unique relationship to trauma is important. This meta-analysis aimed to understand the size of the effect between trauma and maltreatment and self-concept in children and adolescents. The current meta-analysis searched PubMed, PILOTS, PsycINFO, and Web of Science databases. Inclusion criteria involved studies with defined trauma exposure, valid measures of self-concept, and participants' mean age under 18 years old. One-hundred-and-thirty-four studies were included in the meta-analysis (N = 255,334). A random-effects meta-analysis was performed. A small negative relationship was observed between trauma exposure and self-concept (r = - 0.20, 95% CI - 0.22, - 0.18). This relationship was significantly moderated by some variables (type and nature of trauma exposure) but not others (participant gender, type of self-concept measure, quality of studies, country economic status). A small relationship between trauma exposure and negative self-concept in children and adolescents was detected, with repeated trauma exposure and type of trauma exposure moderating this relationship. This provides important directions for clinical practice around providing support for those exposed or most vulnerable to experiencing trauma.
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Affiliation(s)
- Daniela M Melamed
- Department of Clinical Psychology and Psychological Therapies, University of East Anglia, Norwich Research Park, Norwich, Norfolk, NR4 7TJ, UK
| | - Jessica Botting
- Department of Clinical Psychology and Psychological Therapies, University of East Anglia, Norwich Research Park, Norwich, Norfolk, NR4 7TJ, UK
| | - Katie Lofthouse
- Department of Clinical Psychology and Psychological Therapies, University of East Anglia, Norwich Research Park, Norwich, Norfolk, NR4 7TJ, UK
| | - Laura Pass
- Department of Clinical Psychology and Psychological Therapies, University of East Anglia, Norwich Research Park, Norwich, Norfolk, NR4 7TJ, UK
| | - Richard Meiser-Stedman
- Department of Clinical Psychology and Psychological Therapies, University of East Anglia, Norwich Research Park, Norwich, Norfolk, NR4 7TJ, UK.
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Jin Y, Xu S, Shao Z, Luo X, Wang Y, Yu Y, Wang Y. Discovery of depression-associated factors among childhood trauma victims from a large sample size: Using machine learning and network analysis. J Affect Disord 2024; 345:300-310. [PMID: 37865343 DOI: 10.1016/j.jad.2023.10.101] [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: 04/04/2023] [Revised: 09/25/2023] [Accepted: 10/15/2023] [Indexed: 10/23/2023]
Abstract
BACKGROUND Experiences of childhood trauma (CT) would lead to serious mental problems, especially depression. Therefore, it becomes crucial to identify influential factors related to depression and explore their associations. The objectives were to 1) identify critical depression-related factors using the extreme gradient boosting (XGBoost) method from a large-scale survey data; 2) explore associations between these factors for targeted interventions and treatments. METHODS A large-scale epidemiological study covering 63 universities was conducted in Jilin Province, China. The XGBoost model was trained and tested to classify young adults with CT experiences who had or did not have depression (N = 27,671). The essential factors were selected by SHapley Additive exPlanations (SHAP) value. Multiple logistic regression analyses were conducted for validation. The associations between these depression-related factors were further explored using network analysis. RESULTS The XGBoost model selected the top 10 features associated with depression with satisfactory performance (AUC = 0.91; sensitivity = 0.88 and specificity = 0.76). These factors significantly differed between depression and non-depression groups (p < 0.001). There are strong positive associations between anxiety and obsessive-compulsive disorder (OCD), anxiety and post-traumatic stress disorder (PTSD), social anxiety disorder (SAD) and appearance anxiety, and negative associations between sleep quality and anxiety, sleep quality and PTSD among CT participants with depression. LIMITATIONS The cross-sectional design cannot draw causality, and biases in self-report measurements cannot be ignored. CONCLUSIONS XGBoost model and network analysis were useful methods for discovering and understanding depression-related factors in this epidemiological study. Moreover, these essential factors could offer insights into future interventions and treatments for depressed young adults with CT experiences.
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Affiliation(s)
- Yu Jin
- College of Education for the Future, Beijing Normal University, Beijing, China
| | - Shicun Xu
- Northeast Asian Research Center, Jilin University, Changchun, China; Department of Population, Resources and Environment, Northeast Asian Studies College, Jilin University, Changchun, China; China Center for Aging Studies and Social-Economic Development, Jilin University, Changchun, China
| | - Zhixian Shao
- School of Statistics, Beijing Normal University, Beijing, China
| | - Xianyu Luo
- College of Education for the Future, Beijing Normal University, Beijing, China
| | - Yinzhe Wang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Yi Yu
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Yuanyuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.
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7
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Li Q, Zhang X, Yang X, Pan N, He M, Suo X, Li X, Gong Q, Wang S. Pre-COVID resting-state brain activity in the fusiform gyrus prospectively predicts social anxiety alterations during the pandemic. J Affect Disord 2024; 344:380-388. [PMID: 37838273 DOI: 10.1016/j.jad.2023.10.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 09/24/2023] [Accepted: 10/09/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND Social anxiety (SA) has been linked to the coronavirus disease 2019 (COVID-19) pandemic, but the neurobiopsychological mechanisms underlying this relationship remain unclear. This study aimed to elucidate the neurofunctional markers for COVID-induced SA development and the potential role of COVID-related posttraumatic stress symptoms (PTSS) in the brain-SA alterations link. METHODS Before the COVID-19 pandemic (T1), 100 general college students underwent resting-state magnetic resonance imaging and behavioral tests. During the period of community-level outbreaks (T2), these students were re-contacted to undergo follow-up behavioral assessments. RESULTS Whole-brain correlation and prediction analyses found that pre-pandemic spontaneous neural activity (measured by fractional amplitude of low-frequency fluctuations) in the right fusiform gyrus (FG) was positively correlated to SA alterations (T2 - T1). Mediation analyses revealed that COVID-specific PTSS mediated the effects of right FG on SA alterations. LIMITATIONS The results should be interpreted carefully because only one-session neuroimaging data in a sample of normal adults were included. CONCLUSIONS The results provide evidence for neurofunctional markers of COVID-induced SA and may help develop targeted brain-based interventions that reduce SA.
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Affiliation(s)
- Qingyuan Li
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China; Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xun Zhang
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Xun Yang
- School of Public Affairs, Chongqing University, Chongqing, China
| | - Nanfang Pan
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Min He
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Xueling Suo
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Xiao Li
- Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qiyong Gong
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China; Department of Radiology, West China Xiamen Hospital of Sichuan University, Xiamen, China.
| | - Song Wang
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China.
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Benzi IMA, Carone N, Parolin L, Martin-Gagnon G, Ensink K, Fontana A. Different epistemic stances for different traumatic experiences: implications for mentalization. RESEARCH IN PSYCHOTHERAPY (MILANO) 2023; 26:708. [PMID: 38156583 PMCID: PMC10772857 DOI: 10.4081/ripppo.2023.708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 11/04/2023] [Indexed: 12/30/2023]
Abstract
Traumatic experiences may impair reflective functioning (RF), making it difficult for individuals to understand their own and others' mental states. Epistemic trust (ET), which enables evaluating social information as reliable and relevant, may vary in association with RF. In this study, we explored the implications of different ET stances (i.e., trust, mistrust, and credulity) in the relation between different childhood traumatic experiences (i.e., emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect) and different types of RF impairments (uncertainty and certainty about mental states). A non-clinical community sample of 496 cisgender emerging adults (mage = 24.91, standard deviation = 2.66, 71.85% assigned female at birth, 63.63% heterosexual) reported on their childhood traumatic experiences, ET, and RF. We used structural equation models to examine direct and indirect associations. The results showed significant indirect effects between emotional abuse and uncertainty about mental states through credibility. We also observed significant indirect effects between emotional abuse and certainty about mental states through mistrust and credibility. The findings suggest that a lack of discrimination when evaluating knowledge from others (i.e., credulity) might promote increased uncertainty in RF when emerging adults have experienced emotional abuse in their childhood. Conversely, a tendency to view all information sources as unreliable or ill-intentioned (i.e., mistrust) may foster greater certainty in RF as a protective mechanism against an unreliable and potentially harmful world when combined with childhood emotional abuse. The implications for clinical practice and intervention are discussed.
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Affiliation(s)
| | - Nicola Carone
- Department of Brain and Behavioral Sciences, University of Pavia.
| | - Laura Parolin
- Department of Psychology, University of Milano-Bicocca, Milan.
| | | | - Karin Ensink
- Department of Psychology, Laval University, Quebec.
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Li Q, Zhang X, Yang X, Pan N, Li X, Kemp GJ, Wang S, Gong Q. Pre-COVID brain network topology prospectively predicts social anxiety alterations during the COVID-19 pandemic. Neurobiol Stress 2023; 27:100578. [PMID: 37842018 PMCID: PMC10570707 DOI: 10.1016/j.ynstr.2023.100578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/12/2023] [Accepted: 09/30/2023] [Indexed: 10/17/2023] Open
Abstract
Background Social anxiety (SA) is a negative emotional response that can lead to mental health issues, which some have experienced during the coronavirus disease 2019 (COVID-19) pandemic. Little attention has been given to the neurobiological mechanisms underlying inter-individual differences in SA alterations related to COVID-19. This study aims to identify neurofunctional markers of COVID-specific SA development. Methods 110 healthy participants underwent resting-state magnetic resonance imaging and behavioral tests before the pandemic (T1, October 2019 to January 2020) and completed follow-up behavioral measurements during the pandemic (T2, February to May 2020). We constructed individual functional networks and used graph theoretical analysis to estimate their global and nodal topological properties, then used Pearson correlation and partial least squares correlations examine their associations with COVID-specific SA alterations. Results In terms of global network parameters, SA alterations (T2-T1) were negatively related to pre-pandemic brain small-worldness and normalized clustering coefficient. In terms of nodal network parameters, SA alterations were positively linked to a pronounced degree centrality pattern, encompassing both the high-level cognitive networks (dorsal attention network, cingulo-opercular task control network, default mode network, memory retrieval network, fronto-parietal task control network, and subcortical network) and low-level perceptual networks (sensory/somatomotor network, auditory network, and visual network). These findings were robust after controlling for pre-pandemic general anxiety, other stressful life events, and family socioeconomic status, as well as by treating SA alterations as categorical variables. Conclusions The individual functional network associated with SA alterations showed a disrupted topological organization with a more random state, which may shed light on the neurobiological basis of COVID-related SA changes at the network level.
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Affiliation(s)
- Qingyuan Li
- Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, 610041, China
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China
- Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Xun Zhang
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, 610041, China
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China
- Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Xun Yang
- School of Public Affairs, Chongqing University, Chongqing, 400044, China
| | - Nanfang Pan
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, 610041, China
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China
- Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Xiao Li
- Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Graham J. Kemp
- Liverpool Magnetic Resonance Imaging Centre (LiMRIC) and Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, L69 3BX, UK
| | - Song Wang
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, 610041, China
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China
- Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Qiyong Gong
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, 610041, China
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China
- Department of Radiology, West China Xiamen Hospital of Sichuan University, Xiamen, 361000, China
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10
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Trent ES, Viana AG, Raines EM, Busch HEC, Silva K, Storch EA, Zvolensky MJ. Childhood exposure to parental threatening behaviors and anxiety in emerging adulthood: Indirect effects of perceived stress. J Clin Psychol 2023; 79:1984-2008. [PMID: 36971223 PMCID: PMC10440255 DOI: 10.1002/jclp.23516] [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: 04/27/2022] [Revised: 03/03/2023] [Accepted: 03/14/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND Although childhood exposure to parental threatening behaviors is associated with elevated anxiety in emerging adulthood, the underlying mechanisms remain unexplored. Perceived stress-a subjective experience comprised of feelings of helplessness (being unable to cope or exert control) and poor self-efficacy (confidence in one's ability to manage stressors)-is one candidate mechanism. The present investigation examined the underlying role of perceived stress in the association between childhood exposure to parental threatening behaviors and anxiety symptom severity in a sample of emerging adults. METHODS Participants (N = 855; Mage = 18.75 years, SD = 1.05, range 18-24; 70.8% female) were recruited from a large state university and administered a battery of self-report questionnaires assessing constructs of interest. RESULTS Structural equation modeling (SEM) analyses indicated that only greater childhood exposure to maternal threatening behaviors was directly associated with greater feelings of helplessness and lower self-efficacy. Furthermore, only childhood exposure to maternal threatening behaviors was indirectly associated with anxiety severity through greater feelings of helplessness and lower self-efficacy. In contrast, childhood exposure to paternal threatening behaviors was neither directly nor indirectly associated with anxiety severity. LIMITATIONS Limitations include a cross-sectional design, use of self-report measures, and a nonclinical sample. Replicating these findings in a clinical sample and testing the hypothesized model in a longitudinal design is necessary. CONCLUSIONS Findings underscore the need for intervention efforts that screen for and target perceived stress in emerging adults exposed to negative maternal parenting behaviors.
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Affiliation(s)
- Erika S. Trent
- Department of Psychology, University of Houston, Houston, TX
| | - Andres G. Viana
- Department of Psychology, University of Houston, Houston, TX
- Texas Institute of Measurement, Evaluation, & Statistics, University of Houston, Houston, TX
| | | | | | - Karina Silva
- Department of Psychology, University of Houston, Houston, TX
| | - Eric A. Storch
- Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX
| | - Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, TX
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX
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Hovmand OR, Reinholt N, Dichmann K, Borisov R, Arnfred S. Social phobia and evasiveness: trial protocol for a randomized controlled feasibility and superiority trial of the effect of Modified Collaborative Assessment vs. standard assessment on patients' readiness for psychotherapy (CO-ASSM-RCT). Pilot Feasibility Stud 2023; 9:102. [PMID: 37340450 DOI: 10.1186/s40814-023-01332-z] [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: 10/21/2021] [Accepted: 05/26/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Evasive personality disorder (AvPD) and social phobia (SP) have substantial costs for patients and their families and great economic costs to the society. While psychotherapy can be an efficacious treatment, many patients drop out during treatment. Increased knowledge on how to decrease dropout from psychotherapy is warranted, including how to increase a patient's readiness for psychotherapy. METHODS We describe a randomized controlled feasibility and superiority trial of 42 individuals with a clinical diagnosis of either SP or AvPD, who are to initiate psychotherapeutic treatment in Danish outpatient mental health services. They will be randomized in a 1:1 ratio to either assessment-as-usual and receive no further assessment or to a Modified Collaborative Assessment (MCA) provided as a pre-treatment intervention before psychotherapy initiation. MCA will include a battery of psychological tests designed to thoroughly assess the patients' psychopathology. The tests are administered in collaboration with the patient, including detailed oral and written feedback. We hypothesize that the intervention is feasible regarding patient's acceptance and adherence. We further hypothesize that patients randomized to MCA will reach higher levels of readiness for psychotherapy as assessed with the University of Rhode Island Change Assessment Scale (URICA). DISCUSSION This protocol assesses the feasibility, efficacy, acceptability, and safety of an intervention aimed at changing the readiness for participation in psychotherapy of patients with SP and AvPD. Results from this feasibility study could guide the development of future large-scale trials of MCA and procedures for MCA treatment fidelity assessment. TRIAL REGISTRATION NCT2021001.
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Affiliation(s)
- Oliver Rumle Hovmand
- Department of Clinical Medicine, Faculty of Health, University of Copenhagen, Copenhagen, Denmark.
- Psychiatric Research Unit, Region Zealand Mental Health Service, Fælledvej 6, 4200, Slagelse, Denmark.
| | - Nina Reinholt
- Psychiatric Research Unit, Region Zealand Mental Health Service, Fælledvej 6, 4200, Slagelse, Denmark
| | - Kirstine Dichmann
- Department of Clinical Medicine, Faculty of Health, University of Copenhagen, Copenhagen, Denmark
- Research Unit for Psychotherapy and Psychopathology, Region Zealand Mental Health Service, Fælledvej 6, 4200, Slagelse, Denmark
- Department of Forensic Psychiatry, Region Zealand Mental Health Service, Slagelse, Denmark
| | - Radoslav Borisov
- Psychiatry South, Region Zealand Mental Health Service, Ramsherred 1, 1. Sal, 4700, Naestved, Denmark
| | - Sidse Arnfred
- Department of Clinical Medicine, Faculty of Health, University of Copenhagen, Copenhagen, Denmark
- Psychiatric Research Unit, Region Zealand Mental Health Service, Fælledvej 6, 4200, Slagelse, Denmark
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12
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Liu J, Deng J, Zhang H, Tang X. The relationship between child maltreatment and social anxiety: A meta-analysis. J Affect Disord 2023; 329:157-167. [PMID: 36841306 DOI: 10.1016/j.jad.2023.02.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/16/2023] [Accepted: 02/18/2023] [Indexed: 02/26/2023]
Abstract
BACKGROUND Globally, child maltreatment has become a serious problem, affecting individuals' physical and mental health. This meta-analysis aimed to explore the association between child maltreatment and social anxiety. METHODS MEDLINE, PsycINFO, EMBASE, Scopus, and Web of Science were searched for articles published by October 2021. Newcastle-Ottawa Quality Assessment Scale (NOS) was used to evaluate the quality of studies. Maltreatment type, sample setting, age, country and measurement instruments were analyzed as moderators. RESULTS Twenty-nine studies met the inclusion criteria. Child maltreatment was positively correlated with social anxiety (r = 0.201, 95 % CI [0.171, 0.230]). The moderating effect of maltreatment subtypes was significant whether divided into three types (Qb = 12.152, p = .002), or five types (Qb = 11.574, p = .021). Specifically, emotional maltreatment (r = 0.251, 95 % CI [0.201, 0.298]) had a stronger relationship with social anxiety than physical (r = 0.138, 95 % CI [0.085, 0.191]; Qb = 9.312, p = .002) and sexual maltreatment (r = 0.153, 95 % CI [0.108, 0.197]; Qb = 9.197, p = .002). However, there was no significant difference in the effect size between physical and sexual maltreatment (Qb = 0.096, p = .757). Other variables (age, sample setting and country) were not significant moderators. LIMITATIONS Only twenty-nine studies were included, and there was high heterogeneity among the studies, the interpretation of the results should be cautious. CONCLUSIONS This meta-analysis confirmed the relationship between child maltreatment and social anxiety, especially highlight the harmfulness of emotional maltreatment.
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Affiliation(s)
- Jiaqi Liu
- Department of Psychology, Renmin University of China, Beijing, China
| | - Jiaqi Deng
- Department of Psychology, Renmin University of China, Beijing, China
| | - Huiping Zhang
- Department of Social Work and Social Policy, Renmin University of China, Beijing, China
| | - Xinfeng Tang
- Department of Psychology, Renmin University of China, Beijing, China; Laboratory of Department of Psychology, Renmin University of China, Beijing, China; Interdisciplinary Platform of Philosophy and Cognitive Science, Renmin University of China, Beijing, China.
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Edelmann S, Wiegand A, Hentrich T, Pasche S, Schulze-Hentrich JM, Munk MHJ, Fallgatter AJ, Kreifelts B, Nieratschker V. Blood transcriptome analysis suggests an indirect molecular association of early life adversities and adult social anxiety disorder by immune-related signal transduction. Front Psychiatry 2023; 14:1125553. [PMID: 37181876 PMCID: PMC10168183 DOI: 10.3389/fpsyt.2023.1125553] [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: 12/16/2022] [Accepted: 03/29/2023] [Indexed: 05/16/2023] Open
Abstract
Social anxiety disorder (SAD) is a psychiatric disorder characterized by severe fear in social situations and avoidance of these. Multiple genetic as well as environmental factors contribute to the etiopathology of SAD. One of the main risk factors for SAD is stress, especially during early periods of life (early life adversity; ELA). ELA leads to structural and regulatory alterations contributing to disease vulnerability. This includes the dysregulation of the immune response. However, the molecular link between ELA and the risk for SAD in adulthood remains largely unclear. Evidence is emerging that long-lasting changes of gene expression patterns play an important role in the biological mechanisms linking ELA and SAD. Therefore, we conducted a transcriptome study of SAD and ELA performing RNA sequencing in peripheral blood samples. Analyzing differential gene expression between individuals suffering from SAD with high or low levels of ELA and healthy individuals with high or low levels of ELA, 13 significantly differentially expressed genes (DEGs) were identified with respect to SAD while no significant differences in expression were identified with respect to ELA. The most significantly expressed gene was MAPK3 (p = 0.003) being upregulated in the SAD group compared to control individuals. In contrary, weighted gene co-expression network analysis (WGCNA) identified only modules significantly associated with ELA (p ≤ 0.05), not with SAD. Furthermore, analyzing interaction networks of the genes from the ELA-associated modules and the SAD-related MAPK3 revealed complex interactions of those genes. Gene functional enrichment analyses indicate a role of signal transduction pathways as well as inflammatory responses supporting an involvement of the immune system in the association of ELA and SAD. In conclusion, we did not identify a direct molecular link between ELA and adult SAD by transcriptional changes. However, our data indicate an indirect association of ELA and SAD mediated by the interaction of genes involved in immune-related signal transduction.
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Affiliation(s)
- Susanne Edelmann
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tuebingen Center for Mental Health (TüCMH), Eberhard Karls University of Tuebingen, Tuebingen, Germany
| | - Ariane Wiegand
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tuebingen Center for Mental Health (TüCMH), Eberhard Karls University of Tuebingen, Tuebingen, Germany
- Max Planck Fellow Group Precision Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Thomas Hentrich
- Institute for Medical Genetics and Applied Genomics, Eberhard Karls University of Tuebingen, Tuebingen, Germany
- Department of Genetics and Epigenetics, Faculty NT, Saarland University, Saarbrücken, Germany
| | - Sarah Pasche
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tuebingen Center for Mental Health (TüCMH), Eberhard Karls University of Tuebingen, Tuebingen, Germany
| | - Julia Maria Schulze-Hentrich
- Institute for Medical Genetics and Applied Genomics, Eberhard Karls University of Tuebingen, Tuebingen, Germany
- Department of Genetics and Epigenetics, Faculty NT, Saarland University, Saarbrücken, Germany
| | - Matthias H. J. Munk
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tuebingen Center for Mental Health (TüCMH), Eberhard Karls University of Tuebingen, Tuebingen, Germany
| | - Andreas J. Fallgatter
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tuebingen Center for Mental Health (TüCMH), Eberhard Karls University of Tuebingen, Tuebingen, Germany
| | - Benjamin Kreifelts
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tuebingen Center for Mental Health (TüCMH), Eberhard Karls University of Tuebingen, Tuebingen, Germany
| | - Vanessa Nieratschker
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tuebingen Center for Mental Health (TüCMH), Eberhard Karls University of Tuebingen, Tuebingen, Germany
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14
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Hou S, Twayigira M, Luo X, Song L, Cui X, Xie Q, Shen Y, Yang F, Yuan X. The relationship between emotional neglect and non-suicidal self-injury among middle school students in China: the mediating role of social anxiety symptoms and insomnia. BMC Psychiatry 2023; 23:248. [PMID: 37055779 PMCID: PMC10100180 DOI: 10.1186/s12888-023-04735-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 03/30/2023] [Indexed: 04/15/2023] Open
Abstract
BACKGROUND: Non-suicidal self-injury (NSSI) is a vital public concern around the world, and it often starts in adolescence. Emotional neglect (EN) has been considered a distal risk factor for NSSI, but the effects of social anxiety symptoms (SA) and insomnia on this relationship have remained unclear. This study aimed to investigate the potential pathways from EN to NSSI, examining the role of SA and insomnia in this association. METHODS One thousand three hundred thirty seven Chinese middle school students (Mage = 13.040, SD = 0.981, 50.2% males) in China were enrolled in this cross-sectional study. Participants completed the Emotional Neglect sub-scale of Childhood Trauma Questionnaire (CTQ-SF), the Social Anxiety Scale for Adolescent (SAS-A), Athens Insomnia Scale (AIS) and non-suicidal self-injury assessment. Structural equation modelling (SEM) was used to test the possible mediation model among these variables. RESULTS 231(17.3%) students reported NSSI history during last year and 322 (24.1%) participants reported experiences of EN. Students who experienced EN have higher rates of NSSI compared to students without EN history (29.2% vs 13.5%). EN, SA, insomnia and NSSI were positively related to each other. Furthermore, both SA and insomnia played a mediating role in the relationship between EN and NSSI, the series mediating effect of SA and insomnia on this association was also significant after controlling for demographics. Indirect effects accounted for 58.26% of the total effects (EN → NSSI). CONCLUSIONS Our study revealed that EN was associated with NSSI, SA and insomnia play indirect roles in the association between EN and NSSI. The findings of our research may have implications for clinicians, families, and schools in their efforts to lower the risk of NSSI in adolescents.
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Affiliation(s)
- Shiyi Hou
- Department of Clinical Psychology, Central South University, The Third Xiangya Hospital, Changsha, 410013, Hunan, China
| | - Mireille Twayigira
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Xuerong Luo
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Lintong Song
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Xilong Cui
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Qiuxiang Xie
- Department of General Practice, Central South University, The Third Xiangya Hospital, Changsha, 410013, Hunan, China
| | - Yanmei Shen
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Feilong Yang
- Department of Clinical Psychology, Central South University, The Third Xiangya Hospital, Changsha, 410013, Hunan, China
| | - Xiuhong Yuan
- Department of Clinical Psychology, Central South University, The Third Xiangya Hospital, Changsha, 410013, Hunan, China.
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15
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Lucherini Angeletti L, Scalabrini A, Ricca V, Northoff G. Topography of the Anxious Self: Abnormal Rest-Task Modulation in Social Anxiety Disorder. Neuroscientist 2023; 29:221-244. [PMID: 34282680 DOI: 10.1177/10738584211030497] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Social anxiety disorder (SAD) is characterized by social anxiety/fear, self-attention, and interoception. Functional magnetic resonance imaging studies demonstrate increased activity during symptom-sensitive tasks in regions of the default-mode network (DMN), amygdala (AMG), and salience network (SN). What is the source of this task-unspecific symptom-sensitive hyperactivity in DMN? We address this question by probing SAD resting state (rs) changes in DMN including their relation to other regions as possible source of task-unspecific hyperactivity in the same regions. Our findings show the following: (1) rs-hypoconnectivity within-DMN regions; (2) rs-hyperconnectivity between DMN and AMG/SN; (3) task-evoked hyperactivity in the abnormal rs-regions of DMN and AMG/SN during different symptom-sensitive tasks; (4) negative relationship of rest and task changes in especially anterior DMN regions as their rs-hypoconnectivity is accompanied by task-unspecific hyperactivity; (5) abnormal top-down/bottom-up modulation between anterior DMN regions and AMG during rest and task. Findings demonstrate that rs-hypoconnectivity among DMN regions is negatively related to task-unspecific hyperactivity in DMN and AMG/SN. We propose a model of "Topography of the Anxious Self" in SAD (TAS-SAD). Abnormal DMN-AMG/SN topography during rest, as trait feature of an "unstable social self", is abnormally aggravated during SAD-sensitive situations resulting in task-related hyperactivity in the same regions with an "anxious self" as state feature.
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Affiliation(s)
| | - Andrea Scalabrini
- Department of Psychological Health and Territorial Sciences (DiSPuTer), G. d'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Valdo Ricca
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Georg Northoff
- Mental Health Centre, Zhejiang University School of Medicine, Hangzhou, China.,Centre for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, China.,The Royal's Institute of Mental Health Research & University of Ottawa, Ottawa, Ontario, Canada.,Centre for Neural Dynamics, Faculty of Medicine, Brain and Mind Research Institute, University of Ottawa, Ottawa, Ontario, Canada
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16
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Early life stress, depression and epigenetics. VITAMINS AND HORMONES 2023; 122:307-337. [PMID: 36863799 DOI: 10.1016/bs.vh.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Different factors are essential in increasing the vulnerability to psychiatric disorders, such as genetics. Among these factors, early life stress (ELS), including sexual, physical, emotional abuse, and emotional and physical neglect, enhances the odds of having menial conditions throughout life. Exhaustive research has shown that ELS leads to physiological changes, such as alteration in the HPA axis. During the most critical development period (childhood and adolescence), these changes increase the risk of having child-onset psychiatric disorders. Furthermore, research has suggested a relationship between early life stress and depression, particularly more prolonged episodes of depression with treatment-resistant outcomes. Molecular studies indicate that, in general, the hereditary character of psychiatric disorders is polygenic, multifactorial and highly complex, with innumerable low-effect genetic variants interacting with each other. However, whether there are independent effects among subtypes of ELS remains unclear. This article provides an overview of the interplay of epigenetics, the HPA axis, early life stress and the development of depression. Advances in our knowledge of epigenetics in the context of early life stress and depression provide a new understanding of the genetic influence on psychopathology. Furthermore, they could lead to identifying new targets for clinical intervention.
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17
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Nieser KJ, Stowe ZN, Newport DJ, Coker JL, Cochran AL. Detection of differential depressive symptom patterns in a cohort of perinatal women: an exploratory factor analysis using a robust statistics approach. EClinicalMedicine 2023; 57:101830. [PMID: 36798754 PMCID: PMC9925853 DOI: 10.1016/j.eclinm.2023.101830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 12/10/2022] [Accepted: 01/05/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Postpartum depression can take many forms. Different symptom patterns could have divergent implications for how we screen, diagnose, and treat postpartum depression. We sought to utilise a recently developed robust estimation algorithm to automatically identify differential patterns in depressive symptoms and subsequently characterise the individuals who exhibit different patterns. METHODS Depressive symptom data (N = 548) were collected from women with neuropsychiatric illnesses at two U.S. urban sites participating in a longitudinal observational study of stress across the perinatal period. Data were collected from Emory University between 1994 and 2012 and from the University of Arkansas for Medical Sciences between 2012 and 2017. We conducted an exploratory factor analysis of Beck Depression Inventory (BDI) items using a robust expectation-maximization algorithm, rather than a conventional expectation-maximization algorithm. This recently developed method enabled automatic detection of differential symptom patterns. We described differences in symptom patterns and conducted unadjusted and adjusted analyses of associations of symptom patterns with demographics and psychiatric histories. FINDINGS 53 (9.7%) participants were identified by the algorithm as having a different pattern of reported symptoms compared to other participants. This group had more severe symptoms across all items-especially items related to thoughts of self-harm and self-judgement-and differed in how their symptoms related to underlying psychological constructs. History of social anxiety disorder (OR: 4.0; 95% CI [1.9, 8.1]) and history of childhood trauma (for each 5-point increase, OR: 1.2; 95% CI [1.1, 1.3]) were significantly associated with this differential pattern after adjustment for other covariates. INTERPRETATION Social anxiety disorder and childhood trauma are associated with differential patterns of severe postpartum depressive symptoms, which might warrant tailored strategies for screening, diagnosis, and treatment to address these comorbid conditions. FUNDING There are no funding sources to declare.
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Affiliation(s)
- Kenneth J. Nieser
- Department of Population Health Sciences, University of Wisconsin–Madison, United States
| | - Zachary N. Stowe
- Department of Psychiatry, University of Wisconsin–Madison, United States
| | - D. Jeffrey Newport
- Department of Psychiatry & Behavioral Sciences, University of Texas at Austin Dell Medical School, United States
- Department of Women's Health, University of Texas at Austin Dell Medical School, United States
| | - Jessica L. Coker
- Department of Psychiatry, University of Arkansas for Medical Sciences, United States
- Department of Obstetrics & Gynecology, University of Arkansas for Medical Sciences, United States
| | - Amy L. Cochran
- Department of Population Health Sciences, University of Wisconsin–Madison, United States
- Department of Mathematics, University of Wisconsin–Madison, United States
- Corresponding author. Department of Population Health Sciences, University of Wisconsin–Madison, 610 Walnut Street, Madison, WI, 53726, United States.
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18
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Impact of Teachers' Post-Traumatic Stress Due to Violence Victimization: Moderated Mediation Effect of Living a Calling. Behav Sci (Basel) 2023; 13:bs13020139. [PMID: 36829368 PMCID: PMC9952778 DOI: 10.3390/bs13020139] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/02/2023] [Accepted: 02/05/2023] [Indexed: 02/10/2023] Open
Abstract
Based on the Affective Events Theory, Work as a Calling Theory, and related studies, this research examined the moderated mediating effects of Living a Calling and the mediating effect of social interaction anxiety and psychological burnout on the relationships between post-traumatic stress disorder symptoms consequent to violence victimization, self-destructive behaviors, and turnover intention. Data from 420 Korean elementary and secondary school teachers were analyzed using the moderated mediation model. The analysis revealed that post-traumatic stress disorder caused by violence victimization positively affected self-destructive behavior and turnover intention through the sequential mediation of social interaction anxiety and psychological burnout. Further, Living a Calling moderated the indirect effect of violence victimization; the stronger the Living-a-Calling experience, the greater the indirect effect of violence victimization on turnover intention. Additionally, when the sense of Living a Calling was low, post-traumatic stress disorder caused by violence did not significantly affect turnover intention through social interaction anxiety, but contrary to expectations, the stronger the sense of Living a Calling, the more positive the mediating effect of social interaction anxiety. Therapeutic interventions in teachers' work environment, improvements, and suggestions for future research are discussed.
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Grummitt LR, Kelly EV, Barrett EL, Lawler S, Prior K, Stapinski LA, Newton NC. Associations of childhood emotional and physical neglect with mental health and substance use in young adults. Aust N Z J Psychiatry 2022; 56:365-375. [PMID: 34250829 DOI: 10.1177/00048674211025691] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Childhood neglect is a risk factor for subsequent mental health problems. However, research on the unique contribution of emotional and physical subtypes of neglect is lacking. Importantly, if emotional and physical neglect have different impacts on mental health, they must be examined separately to understand how to prevent and treat their effects. OBJECTIVE This study aimed to examine associations of emotional and physical neglect with depression, anxiety, stress, alcohol and drug use in 18- to 20-year-olds. METHODS Participants (N = 569, mean age = 18.9, 70% female) responded in an online survey to questions on childhood emotional and physical neglect, childhood abuse, symptoms of depression, anxiety and stress, and alcohol and drug use and problems. Procedures were approved by the University of Sydney Human Ethics Committee. Hierarchical linear regressions were performed, controlling for socio-demographic characteristics and other adverse childhood experiences. RESULTS Combined neglect was associated with depression (B = 2.895, p < 0.001), anxiety (B = 1.572, p = 0.003) and stress (B = 1.781, p = 0.001). However, a second model entering emotional and physical neglect as separate exposures revealed emotional neglect was driving this association with depression (B = 2.884, p < 0.001), anxiety (B = 1.627, p = 0.001) and stress (B = 1.776, p = 0.001), and that physical neglect was not associated with any outcome. Neither emotional nor physical neglect were associated with alcohol or drug use. CONCLUSION Emotional neglect is a risk factor for mental health problems in early adulthood. Research that combines emotional and physical neglect into a single exposure may be obscuring relationships with mental health. Mental health prevention and treatment must screen for, and address, emotional neglect.
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Affiliation(s)
- Lucinda Rachel Grummitt
- NHMRC Centre of Research Excellence PREMISE, The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Erin Veronica Kelly
- NHMRC Centre of Research Excellence PREMISE, The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Emma Louise Barrett
- NHMRC Centre of Research Excellence PREMISE, The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Siobhan Lawler
- NHMRC Centre of Research Excellence PREMISE, The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Katrina Prior
- NHMRC Centre of Research Excellence PREMISE, The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Lexine A Stapinski
- NHMRC Centre of Research Excellence PREMISE, The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Nicola Clare Newton
- NHMRC Centre of Research Excellence PREMISE, The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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Babad S, Zwilling A, Carson K, Fairchild V, Nikulina V. Childhood Environmental Instability and Social-Emotional Outcomes in Emerging Adults. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP3875-NP3904. [PMID: 32854580 PMCID: PMC8041097 DOI: 10.1177/0886260520948147] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Adverse childhood experiences (ACEs) can negatively affect social-emotional functioning. The association between individual and cumulative ACEs and social-emotional domains of self-esteem, loneliness, and negotiation in intimate partner relationships has not been explored in low-risk emerging adults, a gap this study aims to fill. An online survey was administered to undergraduate emerging adults, ages 18 to 25 years (Mage = 19.73, SD = 1.83; N = 436; 20.60% Hispanic; 63.80% female). The ACEs Survey, Child Abuse Potential Inventory, and Conflict Tactics Scale-2nd Edition were used. Three multivariate ordinary least squares regressions were run, each including predictors significant in bivariate analyses and outcomes of self-esteem, loneliness, and negotiation for each regression. Emotional abuse, B = -.20, p < .01; emotional neglect, B = -.21, p < .001; and substance using family member, B = -.12, p < .05, were negatively associated with self-esteem; emotional neglect, B = .11, p < .01, and cumulative ACEs, B = .16, p < .01, were positively associated with loneliness; and incarcerated family member was positively associated with negotiation, B = .12, p < .05. Overall, these findings suggest that individual ACEs associated with environmental instability (e.g., emotional abuse) are strong predictors of social-emotional outcomes, relative to ACEs associated with more direct physical harm (e.g., sexual abuse).
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Affiliation(s)
- S. Babad
- Queens College, City University of New York
- The Graduate Center, City University of New York
- Corresponding Author: Sara Babad, M.A., Doctoral Candidate, The Graduate Center & Queens College, City University of New York, Psychology Department, 65-30 Kissena Blvd, Science Building A344, Queens, NY 11367-1597, Phone: 516-578-5698,
| | - A. Zwilling
- Queens College, City University of New York
- The Graduate Center, City University of New York
| | - K.W. Carson
- Queens College, City University of New York
- The Graduate Center, City University of New York
| | - V. Fairchild
- Queens College, City University of New York
- The Graduate Center, City University of New York
| | - V. Nikulina
- Queens College, City University of New York
- The Graduate Center, City University of New York
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Social anxiety disorder with comorbid major depression - why fearful attachment style is relevant. J Psychiatr Res 2022; 147:283-290. [PMID: 35114512 DOI: 10.1016/j.jpsychires.2022.01.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 12/17/2021] [Accepted: 01/09/2022] [Indexed: 11/22/2022]
Abstract
Individuals with social anxiety disorder (SAD) often suffer from comorbid major depressive disorder (MDD), which goes along with increased clinical and functional impairment. There has been little research on underlying differences regarding childhood adversities and attachment styles between individuals with SAD with and without comorbid MDD. In the present study, the consecutive sample comprised 612 SCID-diagnosed participants. Of these, n = 472 (62.3% women, 40.7 ± 13.8 years) showed SAD and comorbid MDD (SAD-MDD group) and n = 140 (47.9% women, 43.7 ± 14.7 years) showed just SAD (SAD group). The two groups were compared regarding SAD symptom severity (Social Phobia Inventory; SPIN), childhood adversities (Adverse Childhood Experience Questionnaire; ACE) and attachment styles (Attachment Style Questionnaire, ASQ). The SAD-MDD group reported significantly more severe SAD symptoms (p = .002, d = 0.30), more childhood adversities (p < .001, d = 0.35) and a higher level of fearful attachment style (p < .001, d = 0.30). Group significantly moderated the association between fearful attachment style and SAD symptom severity (β = .292, p < .05) but not between preoccupied attachment style and SAD symptom severity (β = -.184, p = .124; R2adj = .168, p < .05). Fearful attachment style mediated the association between childhood adversities and SAD symptom severity in the SAD-MDD group. Our study could identify a specific significance of fearful attachment style for the association between negative childhood experiences and social anxiety symptoms in SAD-MDD. Findings have specific implications for the therapeutic relationship.
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22
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Chung ML, Forstner AJ, Mücke M, Geiser F, Schumacher J, Conrad R. Predictors of suicidal ideation in social anxiety disorder - evidence for the validity of the Interpersonal Theory of Suicide. J Affect Disord 2022; 298:400-407. [PMID: 34767858 DOI: 10.1016/j.jad.2021.11.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 11/04/2021] [Accepted: 11/07/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND This study aims to identify covariates of suicidal ideation (SI) in a large sample of individuals diagnosed with social anxiety disorder (SAD). METHODS In a cross-sectional design, 305 individuals (38.4 ± 14.1 years, 59% female) with SAD were assessed by the Social Phobia Inventory, Beck Depression Inventory, Adverse Childhood Experience Questionnaire, State Trait Anger Expression Inventory, Beck Scale for Suicidal Ideation and the Interpersonal Needs Questionnaire. RESULTS SAD individuals with SI (n = 142, 46.6%) reported higher SAD and depression symptoms, more adverse childhood experiences (ACE), higher state anger (SA), perceived burdensomeness (PB) and higher thwarted belongingness (TB) compared to SAD individuals without SI (n = 163, 53.4%). In binary logistic regression, PB (odds ratio (OR) = 1.11, 95% confidence interval (CI) = 1.06-1.15), TB (OR = 1.05, 95% CI = 1.02-1.07), SA (OR = 1.07, 95% CI = 1.01-1.13) and ACE (OR = 1.18, 95% CI = 1.03-1.35) emerged as significant covariates of acute SI (Nagelkerke's R2 = 0.39). Receiver operating characteristic (ROC) curves showcased the following areas under the curve (AUC): PB (AUC = 0.78), TB (AUC = 0.76), SA (AUC = 0.62) and ACE (AUC = 0.62). Multinomial logistic regression (no SI = ref.) showcased similar results for passive and active SI (n = 42), with SA reaching significance only for active SI. The Youden index identified appropriate cut-off values for PB, TB, SA and ACEQ by maximizing sensitivity and specificity. LIMITATIONS Cross-sectional design and self-reporting measures limit generalization. CONCLUSION Our findings confirm the validity of the Interpersonal Theory of Suicide concerning SI in SAD. PB and TB with SA and ACE may support the valid assessment of SI in therapeutic settings.
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Affiliation(s)
- Man-Long Chung
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Venusberg Campus 1, Bonn 53127, Germany
| | - Andreas J Forstner
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany; Institute of Neuroscience and Medicine (INM-1), Research Center Jülich, Germany; Centre for Human Genetics, University of Marburg, Marburg, Germany
| | - Martin Mücke
- Center for Rare Diseases Bonn (ZSEB), University Hospital Bonn, Venusberg Campus 1, Bonn 53127, Germany
| | - Franziska Geiser
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Venusberg Campus 1, Bonn 53127, Germany
| | | | - Rupert Conrad
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Venusberg Campus 1, Bonn 53127, Germany.
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Saul MA, He X, Black S, Charles F. A Two-Person Neuroscience Approach for Social Anxiety: A Paradigm With Interbrain Synchrony and Neurofeedback. Front Psychol 2022; 12:568921. [PMID: 35095625 PMCID: PMC8796854 DOI: 10.3389/fpsyg.2021.568921] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 12/06/2021] [Indexed: 12/11/2022] Open
Abstract
Social anxiety disorder has been widely recognised as one of the most commonly diagnosed mental disorders. Individuals with social anxiety disorder experience difficulties during social interactions that are essential in the regular functioning of daily routines; perpetually motivating research into the aetiology, maintenance and treatment methods. Traditionally, social and clinical neuroscience studies incorporated protocols testing one participant at a time. However, it has been recently suggested that such protocols are unable to directly assess social interaction performance, which can be revealed by testing multiple individuals simultaneously. The principle of two-person neuroscience highlights the interpersonal aspect of social interactions that observes behaviour and brain activity from both (or all) constituents of the interaction, rather than analysing on an individual level or an individual observation of a social situation. Therefore, two-person neuroscience could be a promising direction for assessment and intervention of the social anxiety disorder. In this paper, we propose a novel paradigm which integrates two-person neuroscience in a neurofeedback protocol. Neurofeedback and interbrain synchrony, a branch of two-person neuroscience, are discussed in their own capacities for their relationship with social anxiety disorder and relevance to the paradigm. The newly proposed paradigm sets out to assess the social interaction performance using interbrain synchrony between interacting individuals, and to employ a multi-user neurofeedback protocol for intervention of the social anxiety.
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Affiliation(s)
- Marcia A. Saul
- Faculty of Media and Communication, Centre for Digital Entertainment, Bournemouth University, Poole, United Kingdom
| | - Xun He
- Department of Psychology, Faculty of Science and Technology, Bournemouth University, Poole, United Kingdom
- *Correspondence: Xun He
| | - Stuart Black
- Applied Neuroscience Solutions Ltd., Frimley Green, United Kingdom
| | - Fred Charles
- Department of Creative Technology, Faculty of Science and Technology, Bournemouth University, Poole, United Kingdom
- Fred Charles
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24
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Ju N, Yang X, Ma X, Wang B, Fu L, Hu Y, Luo D, Xiao X, Zheng W, Xu H, Fang Y, Chan PSF, Xu Z, Chen P, He J, Zhu H, Tang H, Huang D, Hong Z, Xiao F, Sun F, Hao Y, Cai L, Yang J, Ye S, Chen YQ, Yuan J, Wang Z, Zou H. Hospitalization, interpersonal and personal factors of social anxiety among COVID-19 survivors at the six-month follow-up after hospital treatment: the minority stress model. Eur J Psychotraumatol 2022; 13:2019980. [PMID: 35111284 PMCID: PMC8803063 DOI: 10.1080/20008198.2021.2019980] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND As a highly infectious disease with human-to-human transmission characteristics, COVID-19 has caused panic in the general public. Those who have recovered from COVID-19 may experience discrimination and internalized stigma. They may be more likely to worry about social interaction and develop social anxiety. OBJECTIVES This study investigated the associations among hospitalization factors, social/interpersonal factors, personal factors, and social anxiety to reveal the mechanism of social anxiety in COVID-19 survivors. METHODS A cross-sectional, multicenter telephone survey was conducted from July to September 2020 in five Chinese cities (i.e. Wuhan, Nanning, Shenzhen, Zhuhai, and Dongguan); adult COVID-19 survivors were recruited 6 months after they were discharged from the hospital. Linear regressions and path analysis based on the minority stress model were conducted to test the relationships among hospitalization, social/interpersonal factors, personal factors, and social anxiety. RESULTS The response rate was 74.5% (N = 199, 55.3% females). Linear regression analyses showed that various hospitalization, social/interpersonal, and personal factors were statistically significantly associated with social anxiety. Path analysis showed that the proposed model fit the data well (χ2(df) = 3.196(3), p = .362, CFI = .999, NNFI = .996, RMSEA = .018). Internalized stigma fully mediated the association between perceived discrimination/social support and social anxiety, while it partially mediated the association between perceived affiliate stigma and social anxiety. CONCLUSIONS The results suggest that social/interpersonal and personal factors have a stronger association with social anxiety than hospitalization factors and highlight the importance of internalized stigma in understanding the mechanisms of these relationships. Clinical psychologists can refer to these modifiable psychosocial factors to develop efficient interventions for mental health promotion.
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Affiliation(s)
- Niu Ju
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Xue Yang
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xiaojun Ma
- Guangdong Provincial People's Hospital, Guangzhou, China
| | - Bingyi Wang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Leiwen Fu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Yuqing Hu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Dan Luo
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Xin Xiao
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China.,Center for Optometry and Visual Science, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Weiran Zheng
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Hui Xu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Yuan Fang
- Department of Early Childhood Education, The Education University of Hong Kong, Hong Kong SAR, China
| | - Paul Shing Fong Chan
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Zhijie Xu
- The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Ping Chen
- The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Jiaoling He
- The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Hongqiong Zhu
- The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Huiwen Tang
- The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Dixi Huang
- The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Zhongsi Hong
- The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Fei Xiao
- The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | | | - Yanrong Hao
- Department of Scientific Research, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Lianying Cai
- Department of Education, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Jianrong Yang
- Department of Hepatobiliary, Pancreas and Spleen Surgery, the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Shupei Ye
- Department of Emergency, SSL Central Hospital of Dongguan City, Dongguan, China
| | - Yao-Qing Chen
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Jianhui Yuan
- Shenzhen Nanshan District Center for Disease Control and Prevention, Shenzhen, China
| | - Zixin Wang
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Huachun Zou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China.,School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shenzhen Center for Disease Control and Prevention, Shenzhen, China.,Kirby Institute, University of New South Wales, Sydney, Australia
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25
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Li X, Tu L, Jiang X. Childhood maltreatment affects depression and anxiety: The mediating role of benign envy and malicious envy. Front Psychiatry 2022; 13:924795. [PMID: 36465291 PMCID: PMC9709293 DOI: 10.3389/fpsyt.2022.924795] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 10/20/2022] [Indexed: 11/18/2022] Open
Abstract
The influence of childhood maltreatment on depression and anxiety has been reported in many studies, and the mechanism of this influence has been described from different perspectives. However, few research has explored the influence of child maltreatment on depression and anxiety from the perspective of benign/malicious envy. Given that, based on social comparison theory, this study explored the mediating effect of benign envy/malicious envy on child maltreatment, depression, and anxiety. The sample of this study consisted of 2,691 Chinese adolescents. The results showed that benign and malicious envy both played a significant role in mediating the relation between childhood maltreatment and depression and anxiety. Interestingly, we found that there were different mechanisms of benign and malicious envy in this relationship, namely, malicious envy promoted the effects of childhood maltreatment on depression and anxiety, whereas benign envy inhibited the effects of childhood maltreatment on depression and anxiety. These findings not only reveal the different mechanisms between the two socially comparable emotions of benign/malicious envy in the early adverse environment and depression and anxiety, but also provide a specific reference for individuals to regulate the depression and anxiety caused by childhood maltreatment and envy.
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Affiliation(s)
- Xiaojun Li
- School of Teacher Education, Nanjing Xiaozhuang University, Nanjing, China
| | - Linping Tu
- School of Educational Science, Hunan Normal University, Changsha, China
| | - Xinsheng Jiang
- School of Educational Science, Hunan Normal University, Changsha, China
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26
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Wiegand A, Munk MHJ, Drohm S, Fallgatter AJ, MacIsaac JL, Kobor MS, Nieratschker V, Kreifelts B. Neural correlates of attentional control in social anxiety disorder: the impact of early-life adversity and DNA methylation. J Psychiatry Neurosci 2021; 46:E663-E674. [PMID: 34916236 PMCID: PMC8687622 DOI: 10.1503/jpn.210064] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 08/10/2021] [Accepted: 10/10/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Social anxiety disorder is characterized by intense fear and avoidance of social interactions and scrutiny by others. Although alterations in attentional control seem to play a central role in the psychopathology of social anxiety disorder, the neural underpinnings in prefrontal brain regions have not yet been fully clarified. METHODS The present study used functional MRI in participants (age 18-50 yr) with social anxiety disorder (n = 42, 31 female) and without (n = 58, 33 female). It investigated the interrelation of the effects of social anxiety disorder and early-life adversity (a main environmental risk factor of social anxiety disorder) on brain activity during an attentional control task. We applied DNA methylation analysis to determine whether epigenetic modulation in the gene encoding the glucocorticoid receptor, NR3C1, might play a mediating role in this process. RESULTS We identified 2 brain regions in the left and medial prefrontal cortex that exhibited an interaction effect of social anxiety disorder and early-life adversity. In participants with low levels of early-life adversity, neural activity in response to disorder-related stimuli was increased in association with social anxiety disorder. In participants with high levels of early-life adversity, neural activity was increased only in participants without social anxiety disorder. NR3C1 DNA methylation partly mediated the effect of social anxiety disorder on brain activity as a function of early-life adversity. LIMITATIONS The absence of behavioural correlates associated with social anxiety disorder limited functional interpretation of the results. CONCLUSION These findings demonstrate that the neurobiological processes that underlie social anxiety disorder might be fundamentally different depending on experiences of early-life adversity. Long-lasting effects of early-life adversity might be encoded in NR3C1 DNA methylation and entail alterations in social anxiety disorder-related activity patterns in the neural network of attentional control.
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Affiliation(s)
- Ariane Wiegand
- From the Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health, Eberhard Karls University of Tübingen, Tübingen, Germany (Wiegand, Munk, Drohm, Fallgatter, Nieratschker, Kreifelts); the International Max Planck Research School for Cognitive and Systems Neuroscience, University of Tübingen, Tübingen, Germany (Wiegand); the Department of Biology, Technische Universität Darmstadt, Darmstadt, Germany (Munk); the Department of Medical Genetics, University of British Columbia-BC Children's Hospital Research Institute, Vancouver, BC (MacIsaac, Kobor); and the Werner Reichardt Centre for Integrative Neuroscience, Tübingen, Germany (Nieratschker)
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27
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Carlton CN, Garcia KM, Sullivan-Toole H, Stanton K, McDonnell CG, Richey JA. From childhood maltreatment to adult inflammation: Evidence for the mediational status of social anxiety and low positive affect. Brain Behav Immun Health 2021; 18:100366. [PMID: 34704081 PMCID: PMC8526764 DOI: 10.1016/j.bbih.2021.100366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 10/04/2021] [Accepted: 10/08/2021] [Indexed: 01/02/2023] Open
Abstract
Prior work has established a robust association between childhood maltreatment and systemic inflammatory activation later in life; however, the mechanisms involved in this process remain incompletely understood. The purpose of this investigation was to examine potential mechanistic roles for social anxiety (SA) symptoms and low positive affect (PA) in the path from childhood maltreatment to elevations in circulating interleukin (IL)-6, a common biomarker of inflammatory activation. In addition, building on prior work establishing linkages between mindful awareness and reductions in systemic inflammation, we examined the potential role of trait mindfulness as a moderator of the relationships among childhood maltreatment, SA, low PA, and IL-6. A serial mediation model utilizing a large epidemiologic dataset (final N = 527) supported our central hypothesis that the direct effect of childhood maltreatment on IL-6 was fully serially statistically mediated by SA symptoms and low PA (but not high negative affect). Additionally, results indicated that individuals falling in the upper versus lower quartiles of SA symptoms demonstrated significantly elevated concentrations of IL-6, a finding that has not been previously reported. Trait mindfulness moderated the association between low PA and IL-6, to the exclusion of any paths related to negative affect. Additionally, results indicated that the effect of child maltreatment on IL-6 bypasses SA to indirectly impact IL-6 via negative affect. Overall, we conclude that childhood maltreatment and SA symptoms have a significant influence on IL-6, albeit indirectly via low PA, and the influence of PA on IL-6 may be uniquely susceptible to influence by individual differences in mindfulness.
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Affiliation(s)
| | | | - Holly Sullivan-Toole
- Virginia Tech, Department of Psychology, USA
- Temple University, Department of Psychology, USA
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28
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Swee MB, Hudson CC, Heimberg RG. Examining the relationship between shame and social anxiety disorder: A systematic review. Clin Psychol Rev 2021; 90:102088. [PMID: 34598054 DOI: 10.1016/j.cpr.2021.102088] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 07/21/2021] [Accepted: 09/17/2021] [Indexed: 11/28/2022]
Abstract
This paper is the first systematic review of the literature on the relationship between shame and social anxiety (SA). We reviewed a total of 60 peer-reviewed empirical articles that met criteria for inclusion. We begin by summarizing literature investigating the empirical association between shame and SA and review literature on whether this association is impacted by cultural or diagnostic differences. Next, we briefly describe the updated version of Rapee and Heimberg's (1997) cognitive-behavioral model of social anxiety disorder (SAD; Heimberg, Brozovich, & Rapee, 2014) and propose how shame may interact with five processes described therein: environmental experiences, observations/images of the self, perceived negative evaluation by others, post-event cognitive processes, and behavioral manifestations of SA. We review the current literature on shame and SA as it relates to each of these domains. Thereafter, we discuss existing research on the role of shame in the treatment of SAD and the implications of the research discussed in this review. Finally, we conclude with a discussion of some key limitations in the existing literature and areas for future research.
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Affiliation(s)
- Michaela B Swee
- Department of Psychology, Temple University, 1701 North 13(th) Street, Philadelphia, PA 19122, United States.
| | - Chloe C Hudson
- Department of Psychology, Queen's University, 62 Arch Street, Humphrey Hall, Kingston, ON K7L 3N6, Canada.
| | - Richard G Heimberg
- Department of Psychology, Temple University, 1701 North 13(th) Street, Philadelphia, PA 19122, United States.
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29
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Barnes GL, Garety PA, Emsley R, Jameel L, Hardy A. Is there an association between caregiver antipathy and psychosis? A systematic review. Psychol Psychother 2021; 94:798-821. [PMID: 33595172 DOI: 10.1111/papt.12328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 01/22/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Existing reviews of trauma and psychosis have identified associations between childhood emotional abuse (CEA) and psychosis. However, conceptual issues relating to assessment of CEA limit the conclusions that can be drawn from the literature. The aim of this review was to identify and evaluate studies reporting an association between childhood experiences of caregiver antipathy (i.e. criticism, hostility, coldness, or rejection from a parental figure experienced prior to age 17 years) and psychosis symptoms/diagnosis. METHODS Five databases were systematically searched for articles published until May 2020. Studies were evaluated against inclusion/exclusion criteria, and a narrative synthesis of findings was completed. Study quality was assessed by two independent raters. RESULTS Fourteen studies comprised of 1,848 participants met inclusion criteria. Twelve of these studies found significant associations between caregiver antipathy and psychosis, and two did not. There was evidence that adults with schizophrenia-spectrum diagnoses report more severe caregiver antipathy in childhood than non-clinical controls and that caregiver antipathy severity is positively correlated with psychosis symptom severity. Most studies received weak or moderate quality ratings and all used cross-sectional or case-control designs which showed associations, rather than causal relationships, between childhood caregiver antipathy and later psychosis. CONCLUSIONS Future research would benefit from more rigorous and valid assessment of CEA, use of multivariate methods to account for possible patterns of co-occurrence, and longitudinal study designs to make more robust causal claims. The findings may have important implications for the delivery of psychological care for people with psychosis who report adverse caregiving experiences. PRACTITIONER POINTS People with schizophrenia-spectrum diagnoses may report more severe caregiver antipathy in childhood than non-clinical controls. Caregiver antipathy severity appears to be positively correlated with psychosis symptom severity in clinical and non-clinical populations. Clinicians should consider the possible impact of caregiver antipathy on psychosis symptoms, their content and distress maintenance. Clinicians should also recognise the potential impact of adverse caregiving experiences on therapeutic relationships, patterns of help-seeking and service engagement. Best practice in clinical services would be to adopt individual, formulation-based approaches within trauma-informed models of care.
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Affiliation(s)
- Georgina L Barnes
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, UK.,South London & Maudsley NHS Trust, Maudsley Hospital, London, UK
| | - Philippa A Garety
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, UK.,South London & Maudsley NHS Trust, Maudsley Hospital, London, UK
| | - Richard Emsley
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Leila Jameel
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, UK.,South London & Maudsley NHS Trust, Maudsley Hospital, London, UK
| | - Amy Hardy
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, UK.,South London & Maudsley NHS Trust, Maudsley Hospital, London, UK
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The hidden burden of social anxiety disorder in U.S. military veterans: Results from the National Health and Resilience in Veterans Study. J Affect Disord 2021; 291:9-14. [PMID: 34022553 DOI: 10.1016/j.jad.2021.04.088] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 02/08/2021] [Accepted: 04/25/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Social anxiety disorder (SAD) is a chronic and disabling psychiatric disorder associated with low levels of help-seeking. To date, however, scarce research has examined the epidemiology of SAD in veterans. This study examined the prevalence, comorbidities and incremental burden of SAD in relation to suicidality and functioning in a representative sample of U.S. military veterans. METHODS A nationally representative sample of 3,157 U.S. veterans completed a web survey containing measures of SAD symptoms, trauma history, psychiatric history and functioning. Multivariable analyses were conducted to examine associations between SAD and psychiatric comorbidities, suicidality and functioning. RESULTS A total 9.5% (n = 272) of the sample screened positive for lifetime SAD. Veterans with SAD were more likely than those without SAD to be younger, female, single, racial/ethnic minorities and to have experienced childhood abuse. They also had substantially elevated rates of comorbid psychiatric disorders, particularly lifetime major depression (odds ratio [OR]=5.8) and posttraumatic stress disorder (OR=3.1), as well as current suicidal ideation (OR=3.3). Veterans with SAD scored lower on measures of functioning, particularly social, emotional and mental health functioning (d's=0.21-0.34). LIMITATIONS Data were collected cross-sectionally using self-report. CONCLUSIONS SAD in U.S. veterans is prevalent and associated with psychiatric comorbidities, functional impairment and a more than 3-fold greater risk for suicidal ideation . Given that SAD is associated with low treatment seeking and engagement, it may be undetected and undertreated relative to other psychiatric morbidities. These results underscore the importance of screening, monitoring and treating SAD in this population along with other prevalent mental disorders.
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31
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Increased attention allocation to socially threatening faces in social anxiety disorder: A replication study. J Affect Disord 2021; 290:169-177. [PMID: 34000570 PMCID: PMC8217243 DOI: 10.1016/j.jad.2021.04.063] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 02/16/2021] [Accepted: 04/23/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Threat-related attention bias has been implicated in the etiology and maintenance of social anxiety disorder (SAD), with attentional research increasingly using eye-tracking methodology to overcome the poor psychometric properties of response-time-based tasks and measures. Yet, extant eye-tracking research in social anxiety has mostly failed to report on psychometrics and attempts to replicate past results are rare. Therefore, we attempted to replicate a previously published eye-tracking study of gaze patterns in socially anxious and nonanxious participants as they viewed social threatening and neutral faces, while also exploring the psychometric properties of the attentional measures used. METHODS Gaze was monitored as participants freely viewed 60 different matrices comprised of eight socially-threatening and eight neutral faces, presented for 6000 ms each. Gaze patterns directed at threat and neutral areas of interest (AOIs) were compared by group. Internal consistency and test-retest reliability were also evaluated. RESULTS Relative to healthy controls, socially anxious patients dwelled significantly longer on threat faces, replicating prior findings with the same task. Internal consistency of total dwell time on threat and neutral AOIs was high, and two-week test-retest reliability was acceptable. LIMITATIONS Test-retest reliability was only examined for the control group, which had a small sample size. CONCLUSION Increased dwell time on socially threatening stimuli is a reliable, stable, and generalizable measure of attentional bias in adults with social anxiety.
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Ji H, Lü W. Childhood abuse and social anxiety symptoms among young adults: Moderating role of respiratory sinus arrhythmia suppression to social stress. CHILD ABUSE & NEGLECT 2021; 117:105118. [PMID: 34020292 DOI: 10.1016/j.chiabu.2021.105118] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 04/02/2021] [Accepted: 05/06/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Childhood abuse (CA) has been considered as an environmental risk factor for the development of social anxiety symptoms. Respiratory sinus arrhythmia (RSA) is a biomarker that has been found to interact with environmental stressors to affect psychopathological symptoms. However, little is known whether RSA moderates the relationship between CA and social anxiety symptoms. OBJECTIVE The current study aimed to examine the relationships between CA and two forms of social anxiety symptoms including social performance anxiety symptoms (SPAS) and social interaction anxiety symptoms (SIAS), and the moderating role of baseline RSA and/or RSA suppression to a social-evaluative stress in these links. PARTICIPANTS AND SETTING A total of 157 Chinese undergraduate students (Mage = 18.96, SD = 0.85, 85 % females) participated in this study. METHOD Participants completed the short form of Childhood Trauma Questionnaire, Social Phobia Scale and Social Interaction Anxiety Scale to assess CA, SPAS and SIAS, and then underwent a social stress protocol (a public speech task) during which their baseline RSA and stress induced RSA were obtained. RESULTS CA was positively correlated with SPAS but was not correlated with SIAS. RSA suppression to social stress moderated the associations between CA and two forms of social anxiety symptoms, such that CA was positively associated with SPAS and SIAS among individuals with blunted RSA suppression, but not among those with greater RSA suppression. CONCLUSIONS Greater social stress RSA suppression as a better physiological regulation marker might ameliorate the negative effect of CA on social anxiety symptoms.
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Affiliation(s)
- Huayu Ji
- Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, Shaanxi Key Research Center for Children Mental and Behavior Health, School of Psychology, Shaanxi Normal University, China
| | - Wei Lü
- Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, Shaanxi Key Research Center for Children Mental and Behavior Health, School of Psychology, Shaanxi Normal University, China.
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Abstract
The purpose of the current article is to explore familial factors that influence the development of social anxiety disorder (SAD) in children and adolescents, including parenting, sibling relationships, and family environment. A multitude of interrelated genetic and familial factors have been found to cause and maintain SAD in children and adolescents. There are many challenges in diagnosing and treating the disorder. Knowledge and awareness of familial factors provide insight on targeted treatments that prevent or ameliorate SAD. [Journal of Psychosocial Nursing and Mental Health Services, 59(7), 23-34.].
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Kim HJ, Kim JE, Lee SH. Functional Impairment in Patients with Panic Disorder. Psychiatry Investig 2021; 18:434-442. [PMID: 33979948 PMCID: PMC8169331 DOI: 10.30773/pi.2020.0425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 02/20/2021] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE Anxiety and depression and sociodemographic factors such as age, gender, education level, income, and marital status among people with panic disorder (PD) are associated with functional impairment in the areas of work, social, and family. Although both PD-specific scales such as the Panic Disorder Severity Scale (PDSS) and Anxiety Sensitivity Inventory-Revised (ASI-R) and early trauma have been investigated, their relationship with functional impairment in PD patients has not been clarified. METHODS This study included 267 PD patients. The PDSS, Beck Depression Inventory (BDI), ASI-R, and Early Trauma Inventory were used. Pearson's correlation and multiple linear regression analyses were performed. The Sheehan Disability Scale (SDS) was administered to assess the functional impairment level in PD patients. RESULTS Our findings showed that high levels of PDSS, BDI, and ASI-R were significantly correlated with the functional impairment among PD patients. Multiple regression analyses showed that PDSS, BDI, and ASI-R can predict the functional impairment levels, and PDSS and ASI-R were significantly associated with lost and underproductive days in PD patients. CONCLUSION Panic-specific symptoms, depression, and AS are associated with functional impairment level in PD patients. Elevated symptom severity can play a role by affecting productivity and daily responsibilities in PD patients.
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Affiliation(s)
- Hyun-Ju Kim
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Ji Eun Kim
- Graduate School of Social Welfare, Yonsei University, Seoul, Republic of Korea
| | - Sang-Hyuk Lee
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea.,Department of Clinical Pharmacology and Therapeutics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
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Effectiveness of group psychodrama on aggression and social anxiety of children with attention-deficit/hyperactivity disorder: A randomized clinical trial. ARTS IN PSYCHOTHERAPY 2021. [DOI: 10.1016/j.aip.2021.101756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Merkin AG, Akinfieva SS, Martyushev-Poklad AV, Beloskurskaya OP, Dinov EN, Ostrovsky SL, Komarov AN, Zakharova OY, Kazhin VA, Nikiforov IA, Glover M. Anxiety: phenomenology, epidemiology, and risk factors during the novel coronavirus SARS-CoV-2 (COVID-19) pandemic. NEUROLOGY, NEUROPSYCHIATRY, PSYCHOSOMATICS 2021. [DOI: 10.14412/2074-2711-2021-1-107-112] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The COVID-19 coronavirus pandemic in 2020 led to significant negative social consequences associated inter alia with adverse effects on mental health. One of the most common mental illness is anxiety disorders, the rise in which is characteristic of social upheaval periods. This paper analyzes the problem of anxiety, reviews information on the epidemiology of anxiety, on the factors and mechanisms of its development. It unveils the association of anxiety with addictive disorders, lifestyle factors, and traumatic childhood experience and highlights the problem of increased anxiety in the context of the novel coronavirus COVID-19 pandemics in Russia.
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Affiliation(s)
- A. G. Merkin
- Federal Research and Clinical Center of Specialized Types of Medical Care and Medical Technologies, Federal Biomedical Agency of Russia; Centre for Precise Psychiatry and Neurosciences
| | - S. S. Akinfieva
- Doverie (Trust) National Center for Social Support and Rehabilitation Technologies
| | | | | | - E. N. Dinov
- Peoples' Friendship University of Russia (RUDN University)
| | | | - A. N. Komarov
- Doverie (Trust) National Center for Social Support and Rehabilitation Technologies
| | - O. Yu. Zakharova
- Russian Presidential Academy of National Economy and Public Administration
| | | | - I. A. Nikiforov
- Federal Research and Clinical Center of Specialized Types of Medical Care and Medical Technologies, Federal Biomedical Agency of Russia
| | - M. Glover
- Centre of Research Excellence: Indigenous Sovereignty & Smoking
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Petrović-Lazić M, Ilić-Savić I. Prevalence, etiology and treatment of psychogenic aphonia in children: A case report. PRAXIS MEDICA 2021. [DOI: 10.5937/pramed2104007p] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Introduction. Emotions are one of the most important psychological processes, with a decisive influence on a person's voice. Faced with the great challenges and changes that primary and secondary socialization agents impose in the process of growing up, children consequently experience a spectrum of various unpleasant feelings: anxiety, fear, anger, frustration and sadness. Due to the fast-paced lifestyle, it often happens that the child ignores unpleasant feelings, which further worsens the condition in which he finds himself. Among other conditions, psychogenic aphonia in children has become more frequent in recent years. The current case report aims to determine the frequency of psychogenic aphonia in children, to identify the most common causes that lead to psychogenic aphonia and highlight the methods of vocal treatment that give the best results during rehabilitation. Case report. The current paper presents the results collected in a two-year period at the Clinic for Ear, Throat and Nose of the Clinical Hospital Center "Zvezdara". In the period from March 2017 to May 2019, psychogenic aphonia was diagnosed in 31 patients, which is an evident increase compared to the previous ten-year period in which psychogenic aphonia was diagnosed in 38 younger patients. Analyzing heteroanamnestic data obtained from parents, the most common answer about the cause of psychogenic aphonia is dissatisfaction with school success. After successful diagnostics by an otorhinolaryngologist, psychiatrist and vocal pathologist, in the process of rehabilitation of psychogenic aphonia, methods of digital manipulation of the larynx, methods of restoring the voice with cough reflex and methods of turning out the feedback system were applied. In this particular case, the method of digital manipulation of the larynx gave the best results. Conclusion. Optimal evaluation of patients with voice disorders requires the joint efforts of experts from different disciplines. Having in mind the tendency of recurrence of psychogenic aphonia, these findings suggest that the integration of the interventions of a vocal pathologist and a psychiatrist could give effective results in the process of rehabilitation voice.
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Marx BP, Thompson-Hollands J, Lee DJ, Resick PA, Sloan DM. Estimated Intelligence Moderates Cognitive Processing Therapy Outcome for Posttraumatic Stress Symptoms. Behav Ther 2021; 52:162-169. [PMID: 33483114 PMCID: PMC8439555 DOI: 10.1016/j.beth.2020.03.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 03/26/2020] [Accepted: 03/27/2020] [Indexed: 11/25/2022]
Abstract
Although patient intelligence may be an important determinant of the degree to which individuals may comprehend, comply with, and ultimately benefit from trauma-focused treatment, no prior studies have examined the impact of patient intelligence on benefit from psychotherapies for PTSD. We investigated the degree to which educational achievement, often used as a proxy for intelligence, and estimated full scale intelligence quotient (FSIQ) scores themselves moderated treatment outcomes for two effective psychotherapies for PTSD: Cognitive Processing Therapy (CPT) and Written Exposure Therapy (WET). Participants, 126 treatment-seeking adults with PTSD (52% male; mean age = 43.9, SD = 14.6), were equally randomized to CPT and WET; PTSD symptom severity was measured at baseline and 6-, 12-, 24-, 36-, and 60-weeks following the first treatment session. Multilevel models revealed that participants with higher FSIQ scores experienced significantly greater PTSD symptom reduction through the 24-week assessment in CPT but not WET; this effect did not persist through the 60-week assessment. Educational achievement did not moderate symptom change through either 24- or 60-weeks. Individuals with higher FSIQ who are treated with CPT may experience greater symptom improvement in the early stages of recovery.
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Affiliation(s)
| | | | | | | | - Denise M Sloan
- National Center for PTSD at VA Boston Healthcare System; Boston University School of Medicine
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De castella K, Goldin P, Jazaieri H, Ziv M, Heimberg RG, Gross JJ. Emotion beliefs in social anxiety disorder: Associations with stress, anxiety, and well‐being. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2020. [DOI: 10.1111/ajpy.12053] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Krista De castella
- Research School of Psychology, Australian National University, Canberra, Australian Capital Territory, Australia,
- Clinically Applied Affective Neuroscience Laboratory (CAAN), Department of Psychology, Stanford University, Stanford, California, USA,
| | - Philippe Goldin
- Clinically Applied Affective Neuroscience Laboratory (CAAN), Department of Psychology, Stanford University, Stanford, California, USA,
| | - Hooria Jazaieri
- Clinically Applied Affective Neuroscience Laboratory (CAAN), Department of Psychology, Stanford University, Stanford, California, USA,
| | - Michal Ziv
- Clinically Applied Affective Neuroscience Laboratory (CAAN), Department of Psychology, Stanford University, Stanford, California, USA,
| | - Richard G. Heimberg
- Adult Anxiety Clinic of Temple (AACT), Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA,
| | - James J. Gross
- Clinically Applied Affective Neuroscience Laboratory (CAAN), Department of Psychology, Stanford University, Stanford, California, USA,
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Introducing the Early Trauma Inventory Self Report - Short Form and its Qualitative and Quantitative Validation for the Slovenian General Population. Zdr Varst 2020; 59:245-255. [PMID: 33133281 PMCID: PMC7583426 DOI: 10.2478/sjph-2020-0031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 09/16/2020] [Indexed: 11/20/2022] Open
Abstract
Introduction Traumatic experience in childhood or adolescence has a significant impact on the development of chronic mental and physical conditions in adulthood. Thus, it is very important for health professionals, especially primary care physicians to have an inventory in order to detect early trauma for planning appropriate treatment, such as the Early Trauma Inventory (ETI). The aim of this paper is to test the psychometric properties of the Slovenian translation of the short, self-rated version (ETISR-SF), and to further validate the instrument. Methods The research was done in two parts – qualitative and quantitative. In the qualitative part, a questionnaire was translated and culturally adapted using the Delphi method. For the quantitative part, 51 patients with substance use disorders hospitalized at the Centre for the Treatment of Drug Addictions were recruited, along with 133 controls. The psychometric properties of the questionnaire were checked. Internal consistency was calculated using Cronbach’s alpha, test-retest reliability was examined graphically using a Bland-Altman plot. Discriminant validity between groups was gauged using the independent samples t-test. Results Consensus in the Delphi study was reached in the second round. Cronbach’s alpha varied between 0.60 - 0.85. Of the four domains, physical abuse had the lowest Cronbach’s alpha. The test-retest reliability is high for all domains, with correlation coefficients ranging from 0.82 to 0.96. The non-clinical sample differed significantly from the clinical sample. Conclusion The Slovenian translation of ETISR-SF is a satisfactory instrument for the evaluation of trauma before the age of 18.
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Shahar B. New Developments in Emotion-Focused Therapy for Social Anxiety Disorder. J Clin Med 2020; 9:E2918. [PMID: 32927706 PMCID: PMC7565910 DOI: 10.3390/jcm9092918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 08/23/2020] [Accepted: 09/07/2020] [Indexed: 11/30/2022] Open
Abstract
Social anxiety disorder (SAD) is a highly complex, chronic, disabling and costly anxiety disorder. Although cognitive-behavioral therapy (CBT) is effective for many patients, many others do not respond to CBT or remain considerably symptomatic at the end of treatment. Pharmacological effects are also modest. More empirically-supported treatment options are needed in order to increase patient access to effective treatment. Emotion-focused therapy (EFT) shows great promise in treating SAD effectively and is particularly suitable for treating SAD because pervasive emotional avoidance, difficulties with emotional differentiation, and high levels of self-criticism, which are central psychopathological processes in SAD, are also primary therapeutic targets in EFT. EFT is based on the assumption that the most efficient way to change a maladaptive emotion is not through reason or skill learning, but through the activation of other, more adaptive emotions. EFT aims to access shame-based emotional memories that underlie SAD, and transform them by exposing them to new adaptive emotional experiences, such as empowering assertive anger, grief, and self-compassion. In this paper, the core features of EFT for SAD are presented, as well as the EFT view of dysfunction in SAD and EFT change processes. Research findings regarding the effectiveness of EFT for SAD are presented together with initial findings regarding mechanisms of change occurring during treatment.
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Affiliation(s)
- Ben Shahar
- The Paul Baerwald School of Social Work and Social Welfare, Hebrew University, Jerusalem 91905, Israel
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42
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Womersley JS, Hemmings SMJ, Ziegler C, Gutridge A, Ahmed-Leitao F, Rosenstein D, Domschke K, Seedat S. Childhood emotional neglect and oxytocin receptor variants: Association with limbic brain volumes. World J Biol Psychiatry 2020; 21:513-528. [PMID: 30806136 DOI: 10.1080/15622975.2019.1584331] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: Childhood emotional neglect (EN) is a predictor for the development of affective disorders. Oxytocin (OXT) may mediate the interplay between EN and changes in stress biological systems, brain development, and mental health outcomes. We investigated, in a cross-sectional study, the associations between EN, (epi)genetic variation in the OXT receptor (OXTR) gene, and amygdalar and hippocampal volumes, two brain regions implicated in emotional processing.Methods: We recruited 63 Caucasian South African adults (35 women) with and without social anxiety disorder. Childhood EN was assessed using the Childhood Trauma Questionnaire. rs53576 and rs2254298 genotypes, as well as methylation status, was determined using DNA purified from whole blood. Bilateral amygdalar and hippocampal volumes were determined by structural magnetic resonance imaging. The relationships between these variables were investigated using linear regression.Results: The interaction of the rs2254298 A risk allele and EN was nominally associated with reduced left hippocampal volume. The rs2254298 A risk allele was independently associated with reduced bilateral amygdalar volumes. We found no association between EN, OXTR methylation and amygdalar or hippocampal volumes. The rs53576 GG risk genotype was, however, associated with decreased OXTR methylation.Conclusions: The rs2254298 A allele may increase susceptibility to the structural brain effects of EN.
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Affiliation(s)
- Jacqueline Samantha Womersley
- Department of Psychiatry, Faculty of Medicine and Health Sciences, University of Stellenbosch, Tygerberg, 7505, South Africa
| | - Sian Megan Joanna Hemmings
- Department of Psychiatry, Faculty of Medicine and Health Sciences, University of Stellenbosch, Tygerberg, 7505, South Africa
| | - Christiane Ziegler
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, 70104, Freiburg, Germany
| | - Ashley Gutridge
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, University of Stellenbosch, Tygerberg, 7505, South Africa
| | - Fatima Ahmed-Leitao
- Department of Psychiatry, Faculty of Medicine and Health Sciences, University of Stellenbosch, Tygerberg, 7505, South Africa
| | - David Rosenstein
- Department of Psychiatry, Faculty of Medicine and Health Sciences, University of Stellenbosch, Tygerberg, 7505, South Africa
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, 70104, Freiburg, Germany
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, University of Stellenbosch, Tygerberg, 7505, South Africa
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Annor FB, Gilbert LK, Davila EP, Massetti GM, Kress H, Onotu D, Ogbanufe O. Emotional violence in childhood and health conditions, risk-taking behaviors, and violence perpetration among young adults in Nigeria. CHILD ABUSE & NEGLECT 2020; 106:104510. [PMID: 32447142 PMCID: PMC8299818 DOI: 10.1016/j.chiabu.2020.104510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 03/12/2020] [Accepted: 04/18/2020] [Indexed: 05/11/2023]
Abstract
BACKGROUND Globally, over 1 billion children are victims of violence against children annually. Studies examining the health consequences of childhood violence have mostly focused on childhood physical violence (PV) and sexual violence (SV). Recent evidence suggests that childhood emotional violence (EV) may also be deleterious to the health and wellbeing of victims. OBJECTIVE This study examines the independent association between EV and some health conditions, risk taking behaviors, and violence perpetration among Nigerian young adults ages 18-24 years. PARTICIPANTS AND SETTING Data from 2014 Nigeria Violence Against Children Survey (n = 4,203), a nationally representative cross-sectional survey of individuals ages 13-24 were used. METHODS Childhood EV was defined as EV victimization before age 18 perpetrated by a parent, adult caregiver or other adult relative. Logistic regression analyses assessed the association between EV in childhood and mental distress in the past 30 days, ever self-harm behaviors and history of sexually transmitted infections; risk behaviors such as having multiple sex partners in the past 12 months; and ever violence perpetration. RESULTS After controlling for study covariates, EV in childhood was associated with mental distress in both males and females, and self-harm behaviors in females; excessive alcohol use and infrequent condom use in males, and multiple sexual partners in females; and PV perpetration in males and SV perpetration in females. CONCLUSION EV in childhood is associated with some health conditions, risk taking behaviors, and violence perpetration. Implementing programs that address all forms of violence in childhood, including EV may benefit children.
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Affiliation(s)
- Francis B Annor
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States.
| | - Leah K Gilbert
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Evelyn P Davila
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Greta M Massetti
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Howard Kress
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Dennis Onotu
- Division of Global HIV and TB, Center for Global Health, Centers for Disease Control and Prevention, Abuja, Nigeria
| | - Obinna Ogbanufe
- Division of Global HIV and TB, Center for Global Health, Centers for Disease Control and Prevention, Abuja, Nigeria
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Integrating cognitive behavioral group therapy and psychodrama for social anxiety disorder: An intervention description and an uncontrolled pilot trial. CLINICAL PSYCHOLOGY IN EUROPE 2020; 2:e2693. [DOI: 10.32872/cpe.v2i1.2693] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 11/16/2019] [Indexed: 01/04/2023] Open
Abstract
Background
Cognitive behavioral therapy (CBT) is generally considered to be the most effective psychological treatment for social anxiety disorder (SAD). Nevertheless, many patients with SAD are still symptomatic after treatment. The present pilot study aimed to examine integrating CBT, with a focus on cognitive and behavioral techniques, and psychodrama, which focuses more on experiential techniques into a combined treatment (CBPT) for social anxious patients in a group format. This new intervention for SAD is described session-by-session.
Method
Five adult female patients diagnosed with social anxiety disorder participated in a twelve-session CBPT in a group format. Pretest and posttest scores of social anxiety, avoidance, spontaneity, cost and probability estimates of negative social events, depression, and quality of life were compared, as were weekly assessments of fear of negative evaluation.
Results
Results demonstrated a significant reduction of the fear of negative evaluation and social anxiety symptoms. It is noteworthy that also the scores of the probability and cost estimates decreased. However, there were no significant differences between pre and post measures in any of other measures.
Conclusion
The current study suggests that group CBPT might be an effective treatment for SAD. However, our sample size was small and this was an uncontrolled study. Therefore, it is necessary to test this intervention in a randomized controlled trial with follow-up assessments.
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Terock J, Van der Auwera S, Janowitz D, Wittfeld K, Frenzel S, Klinger-König J, Grabe HJ. Childhood trauma and adult declarative memory performance in the general population: The mediating effect of alexithymia. CHILD ABUSE & NEGLECT 2020; 101:104311. [PMID: 31877447 DOI: 10.1016/j.chiabu.2019.104311] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 10/21/2019] [Accepted: 12/02/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Previous studies suggested that childhood maltreatment is associated with altered memory performance in adulthood. Deficits in identifying and describing feelings as captured by the alexithymia construct are strongly linked with childhood trauma and may mediate the associations with memory function. OBJECTIVE To investigate the associations of childhood trauma with verbal declarative memory performance and the putative mediating role of alexithymia. METHOD Associations of the different dimensions of childhood trauma with adult declarative memory performance were tested in two large, independent general population samples comprising a total of N = 5574 participants. Moreover, we tested whether associations were mediated by alexithymia. RESULTS In both samples, childhood emotional neglect, but not abuse emerged as a negative statistical predictor of early (sample 1: β=-1.79; p < 0.001, sample 2: β=-0.26; p < 0.001) as well as delayed recall (β=-0.78; p < 0.001; β=-0.24; p < 0.05). Likewise, childhood emotional neglect was the strongest predictor for alexithymia (β = 3.2; p < 0.001; β = 3.54; p < 0.001). Finally, the association between childhood emotional neglect and early (Total Mediated Effect (TME): 13.2, CI: 0.087-0.302; TME: 20.1; CI: 0.123-0.619) as well as late recall (TME: 13.2, CI: 0.086-0.301; TME: 9; CI: -0.442-0.699) was significantly mediated by alexithymia. CONCLUSIONS Our findings suggest that childhood emotional neglect is particularly detrimental to memory functioning in adulthood. In comparison, childhood abuse was not associated with reduced declarative memory capacity. Our results contribute to explain the mechanism underlying the relation of childhood trauma and memory deficits: Finding specific associations with emotional neglect and a mediating role of alexithymia highlights the relevance of emotion processing capacities for memory functioning.
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Affiliation(s)
- Jan Terock
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, 17475 Greifswald, Germany; Department of Psychiatry and Psychotherapy, HELIOS Hanseklinikum Stralsund, Rostocker Chaussee 70, 18437 Stralsund, Germany.
| | - Sandra Van der Auwera
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, 17475 Greifswald, Germany; German Center for Neurodegenerative Diseases DZNE, Site Rostock/ Greifswald, Ellernholzstraße 1-2, 17475 Greifswald, Germany
| | - Deborah Janowitz
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, 17475 Greifswald, Germany
| | - Katharina Wittfeld
- German Center for Neurodegenerative Diseases DZNE, Site Rostock/ Greifswald, Ellernholzstraße 1-2, 17475 Greifswald, Germany
| | - Stefan Frenzel
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, 17475 Greifswald, Germany
| | - Johanna Klinger-König
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, 17475 Greifswald, Germany
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, 17475 Greifswald, Germany; German Center for Neurodegenerative Diseases DZNE, Site Rostock/ Greifswald, Ellernholzstraße 1-2, 17475 Greifswald, Germany
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Personalized Clinical Approaches to Anxiety Disorders. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1191:489-521. [DOI: 10.1007/978-981-32-9705-0_25] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Brühl A, Kley H, Grocholewski A, Neuner F, Heinrichs N. Child maltreatment, peer victimization, and social anxiety in adulthood: a cross-sectional study in a treatment-seeking sample. BMC Psychiatry 2019; 19:418. [PMID: 31882002 PMCID: PMC6935074 DOI: 10.1186/s12888-019-2400-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 12/09/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Childhood adversities, especially emotional abuse, emotional neglect, and peer victimization are considered to be crucial risk factors for social anxiety disorder (SAD). We investigated whether particular forms of retrospectively recalled childhood adversities are specifically associated with SAD in adulthood or whether we find similar links in other anxiety or depressive disorders. METHODS Prevalences of adversities assessed with the Childhood Trauma Questionnaire (CTQ) and a questionnaire of stressful social experiences (FBS) were determined in N = 1091 outpatients. Adversity severities among patients with SAD only (n = 25), specific phobia only (n = 18), and generalized anxiety disorder only (n = 19) were compared. Differences between patients with anxiety disorders only (n = 62) and depressive disorders only (n = 239) as well as between SAD with comorbid depressive disorders (n = 143) and SAD only were tested. RESULTS None of the adversity types were found to be specifically associated with SAD and severities did not differ among anxiety disorders but patients with depressive disorders reported more severe emotional abuse, physical abuse, and sexual abuse than patients with anxiety disorders. SAD patients with a comorbid depressive disorder also reported more severe adversities across all types compared to SAD only. CONCLUSION Findings indicate that particular forms of recalled childhood adversities are not specifically associated with SAD in adulthood. Previously established links with SAD may be better explained by comorbid depressive symptoms.
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Affiliation(s)
- Antonia Brühl
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Bremen, Grazer Strasse 2, 28359, Bremen, Germany. .,Department of Psychology, Institute of Clinical Psychology, Psychotherapy and Assessment, Outpatient clinic, Technische Universität Braunschweig, Humboldtstr. 33, 38106, Braunschweig, Germany.
| | - Hanna Kley
- 0000 0001 0944 9128grid.7491.bDepartment of Psychology, Clinical Psychology and Psychotherapy, Outpatient clinic, Bielefeld University, Morgenbreede 2-4, 33615 Bielefeld, Germany
| | - Anja Grocholewski
- 0000 0001 1090 0254grid.6738.aDepartment of Psychology, Institute of Clinical Psychology, Psychotherapy and Assessment, Outpatient clinic, Technische Universität Braunschweig, Humboldtstr. 33, 38106 Braunschweig, Germany
| | - Frank Neuner
- 0000 0001 0944 9128grid.7491.bDepartment of Psychology, Clinical Psychology and Psychotherapy, Outpatient clinic, Bielefeld University, Morgenbreede 2-4, 33615 Bielefeld, Germany
| | - Nina Heinrichs
- 0000 0001 2297 4381grid.7704.4Department of Psychology, Clinical Psychology and Psychotherapy, University of Bremen, Grazer Strasse 2, 28359 Bremen, Germany ,0000 0001 1090 0254grid.6738.aDepartment of Psychology, Institute of Clinical Psychology, Psychotherapy and Assessment, Outpatient clinic, Technische Universität Braunschweig, Humboldtstr. 33, 38106 Braunschweig, Germany
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Yıldız Inanıcı S, Akgün B, Karataş HÖ. Self-efficacy in abused and neglected pregnant women: attachment theory and theory of mind perspectives. AUST J FORENSIC SCI 2019. [DOI: 10.1080/00450618.2019.1695940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Sinem Yıldız Inanıcı
- Department of Medical Education, Marmara University School of Medicine, Istanbul, Turkey
| | - Büşra Akgün
- Marmara University School of Medicine 6th year students, Istanbul, Turkey
| | - Hakan Ömer Karataş
- Marmara University School of Medicine 6th year students, Istanbul, Turkey
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Ahmed-Leitao F, Rosenstein D, Marx M, Young S, Korte K, Seedat S. Posttraumatic stress disorder, social anxiety disorder and childhood trauma: Differences in hippocampal subfield volume. Psychiatry Res Neuroimaging 2019; 284:45-52. [PMID: 30684895 DOI: 10.1016/j.pscychresns.2018.12.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 12/14/2018] [Accepted: 12/29/2018] [Indexed: 12/22/2022]
Abstract
Volume-based hippocampal findings in Social Anxiety Disorder (SAD) and Posttraumatic Stress Disorder (PTSD) have been inconsistent, with very little investigation of hippocampal subfields. We assessed the effects of early childhood trauma on hippocampal subfields in participants with SAD with and without early childhood trauma and PTSD, compared to healthy controls. The sample comprised 26 participants SAD with early childhood trauma, 22 participants with SAD without early childhood trauma, 17 with PTSD secondary to early childhood trauma and 25 control participants. We used Freesurfer version 6 to determine hippocampal subfield volumes. Findings included significant reduction in right parasubiculum volume between the PTSD group secondary to early childhood trauma and the SAD group without early childhood trauma, as well as a significant reduction in left HATA (Hippocampal Amygdala Transition Area) volume between PTSD with early childhood trauma compared to controls, as well as compared to SAD with early childhood trauma. These findings did withstand correction for multiple resting using the false discovery rate. Our findings of an association of reduced volumes in the parasubiculum and HATA regions with PTSD secondary to childhood trauma are interesting. Further work should investigate whether parasubiculum and HATA regional volume reductions in PTSD are a specific effect of early childhood trauma or a specific manifestation of PTSD pathology. Further work should also be undertaken to determine if hippocampal subfield atrophy is associated with SAD in the setting of early childhood maltreatment.
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Affiliation(s)
- Fatima Ahmed-Leitao
- South African Research Chairs Initiative (SARChI) in Posttraumatic Stress Disorder, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Tygerberg 8000, South Africa.
| | - David Rosenstein
- South African Research Chairs Initiative (SARChI) in Posttraumatic Stress Disorder, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Tygerberg 8000, South Africa
| | - Melanie Marx
- South African Research Chairs Initiative (SARChI) in Posttraumatic Stress Disorder, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Tygerberg 8000, South Africa
| | - Susanne Young
- South African Research Chairs Initiative (SARChI) in Posttraumatic Stress Disorder, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Tygerberg 8000, South Africa
| | - Kristina Korte
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, United States
| | - Soraya Seedat
- South African Research Chairs Initiative (SARChI) in Posttraumatic Stress Disorder, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Tygerberg 8000, South Africa
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50
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Adams GC, Wrath AJ, Mondal P, Asmundson GJG. Depression with or without comorbid social anxiety: Is attachment the culprit? Psychiatry Res 2018; 269:86-92. [PMID: 30145307 DOI: 10.1016/j.psychres.2018.08.037] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 07/06/2018] [Accepted: 08/13/2018] [Indexed: 12/27/2022]
Abstract
Major depressive disorder (MDD) frequently co-occurs with social anxiety disorder (SAD), and their comorbidity (MDD-SAD) increases clinical severity and functional impairment. Still, the specific psychological vulnerabilities of individuals with MDD-SAD are poorly understood. Individual attachment characteristics develop early in life through interactions with primary caregivers, and tend to persist throughout life. Early trauma can worsen attachment insecurity, increasing the risk for future anxiety and depression. The purpose of this study is to examine differences in individual attachment and history of trauma in depressed individuals with or without comorbid SAD and controls. One hundred sixty-two participants were categorized into three groups based on SCID-I interview: healthy controls (HC), individuals with current MDD without SAD (MDD), and individuals with current MDD comorbid with SAD (MDD-SAD). MDD-SAD group had significantly greater attachment anxiety and attachment avoidance compared to the MDD and HC groups. MDD-SAD group had greater clinician-rated depression severity and dysfunction compared to MDD group. In summary, the study further supports the clinical risks associated with MDD-SAD and suggests that insecure attachment might represent an associated vulnerability and a possible pathway which warrants further research and clinical attention.
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Affiliation(s)
- G Camelia Adams
- Department of Psychiatry, University of Saskatchewan, Ellis Hall Room 124 Royal University Hospital 103 Hospital Drive Saskatoon, Saskatoon, Saskatchewan, S7N 0W8, Canada.
| | - Andrew J Wrath
- Department of Psychiatry, University of Saskatchewan, Ellis Hall Room 124 Royal University Hospital 103 Hospital Drive Saskatoon, Saskatoon, Saskatchewan, S7N 0W8, Canada
| | - Prosanta Mondal
- Department of Psychiatry, University of Saskatchewan, Ellis Hall Room 124 Royal University Hospital 103 Hospital Drive Saskatoon, Saskatoon, Saskatchewan, S7N 0W8, Canada
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