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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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Naveed S, Saboor S, Zeshan M. An Overview of Attachment Patterns: Psychology, Neurobiology, and Clinical Implications. J Psychosoc Nurs Ment Health Serv 2020; 58:18-22. [PMID: 32744643 DOI: 10.3928/02793695-20200717-01] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Attachment is an emotional bond that connects children to their caregivers. The psychology of attachment suggests that children with a stronger relationship with their primary caregivers are considered secure in their attachment patterns, whereas children with a strained relationship with their early caregivers and who had felt rejected in their childhood are considered insecure. The quality of the nurturing environment in the early stages of life of children and the relationship of parents themselves (e.g., divorce, conflict) contribute significantly to shaping a child's attachment behaviors. The neurobiology of attachment patterns includes the (a) hypothalamus, which mediates stress hormones; (b) amygdala, which controls stronger emotions such as fear; and (c) prefrontal cortex, which is responsible for emotional regulation. These areas of the brain play a vital role in children's socioemotional development. The current article reviews four attachment patterns: insecure avoidant (type A), secure (type B), insecure ambivalent/resistant (type C), and disorganized (an extreme form of insecure attachment), and explores the implications of attachment patterns on the mental health of children. [Journal of Psychosocial Nursing and Mental Health Services, 58(8), 18-22.].
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Singh R, Rothstein R, Ricci K, Visintainer P, Shenberger J, Attwood E, Friedmann P. Partnering with parents to improve outcomes for substance exposed newborns-a pilot program. J Perinatol 2020; 40:1041-1049. [PMID: 32203180 DOI: 10.1038/s41372-020-0662-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 03/02/2020] [Accepted: 03/11/2020] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Assess impact of parental involvement in care provision for term substance exposed newborns (SENs). STUDY DESIGN Prospective observational cohort study included mothers with opioid use disorder and their SENs over 4 year study period. Maternal-Infant dyads enrolled in EMPOWER and rooming-in (RI) programs were included and received care 24/7 in a private room until newborn's discharge. Outcomes were compared for dyads participating in EMPOWER/RI with historical controls. RESULTS Ninety of 156 historical SENs were RI eligible, while 49 of 108 SENs born during RI period had mothers enrolled in EMPOWER. EMPOWER/RI SENs had lower rates for and duration of pharmacotherapy, shorter neonatal intensive care unit (NICU) and hospital lengths of stay. EMPOWER/RI increased initiation and continuation of breastfeeding at discharge. CONCLUSIONS Parental participation was associated with a decrease in initiation and duration of pharmacotherapy, NICU admission, length of stay and hospital charges while increasing breastfeeding initiation and continuation at discharge.
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Affiliation(s)
- Rachana Singh
- Baystate Medical Center, Springfield, MA, USA. .,University of Massachusetts Medical School-Baystate, Springfield, MA, USA.
| | - Rachel Rothstein
- Baystate Medical Center, Springfield, MA, USA.,Penn State College of Medicine, Hershey, PA, USA
| | - Karen Ricci
- Baystate Medical Center, Springfield, MA, USA
| | - Paul Visintainer
- University of Massachusetts Medical School-Baystate, Springfield, MA, USA.,Office of Research, UMMS-Baystate, Springfield, MA, USA
| | - Jeffrey Shenberger
- Baystate Medical Center, Springfield, MA, USA.,Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Eilean Attwood
- Baystate Medical Center, Springfield, MA, USA.,University of Massachusetts Medical School-Baystate, Springfield, MA, USA
| | - Peter Friedmann
- Baystate Medical Center, Springfield, MA, USA.,Office of Research, UMMS-Baystate, Springfield, MA, USA
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Wang W, Wang L, Xu H, Cao C, Liu P, Luo S, Duan Q, Ellenbroek B, Zhang X. Characteristics of pro- and anti-inflammatory cytokines alteration in PTSD patients exposed to a deadly earthquake. J Affect Disord 2019; 248:52-58. [PMID: 30711869 DOI: 10.1016/j.jad.2019.01.029] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 01/03/2019] [Accepted: 01/19/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Many studies have shown that the disturbance of pro-inflammatory and/or anti-inflammatory cytokines is involved in the modulation of traumatic stress and related psychiatric disorders, typically posttraumatic stress disorder (PTSD). However, the specific immune alterations associated with PTSD symptoms are still unclear. The present study compared levels of pro- and anti-inflammatory cytokines between PTSD and non-PTSD controls, and investigated the relationships of immune changes with PTSD symptomatology. METHODS In this study, 51 earthquake-exposed PTSD patients and 136 earthquake-exposed healthy controls were recruited. We assessed trauma exposure, PTSD and depression severity, and quantified a panel of pro- inflammatory cytokines, including interleukin (IL)-1β, IL-2, IL-6, IL-8, tumor necrosis factor alpha (TNF-α), interferon ϒ (IFNϒ), and anti-inflammatory cytokines, including IL-4, IL-10 and IL-13 with enzyme-linked immunosorbent assays. Additionally, total pro-inflammatory cytokines score and total anti-inflammatory cytokines score were calculated to reflect the status of two balance system. RESULTS Behavioral data showed that the PTSD group had greater severity of depression, as well as total symptoms and every symptom cluster in the seven-factor model of PTSD compared to the non-PTSD control group. Immune data showed that PTSD subjects had higher levels of IL-1β and TNFα, as well as total pro-inflammatory cytokine scores compared to controls, suggesting an increase of inflammatory activity in PTSD. In all subjects, the IL-1β levels were correlated with PCL scores, after controlling for covariates, including age, education, marital status and gender, trauma exposure severity and depression. LIMITATIONS The current study did not include a non-traumatized healthy control group, and PTSD was assessed using a self-reported measure. CONCLUSIONS Thus, by including a control group comprised entirely of earthquake-exposed individuals as means to discriminate specific alterations of cytokine levels in PTSD, these findings suggest that the increased inflammatory cytokines, especially IL-1β, may play a role in the pathophysiology of PTSD.
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Affiliation(s)
- Weiwen Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Li Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China.
| | - Hang Xu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Chengqi Cao
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China; Shenzhen Key Laboratory of Affective and Social Cognitive Science, Shenzhen University, Shenzhen, 518060, China
| | - Ping Liu
- People's Hospital of Deyang City, Deyang, Sichuan, 618000, China
| | - Shu Luo
- People's Hospital of Deyang City, Deyang, Sichuan, 618000, China
| | - Qing Duan
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
| | - Bart Ellenbroek
- School of Psychology, Victoria University of Wellington, Kelburn, Wellington, 6012, New Zealand
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China
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Abstract
Attachment theory was developed by John Bowlby in the 1950s. He defined attachment as a specific neurobiological system that resulted in the infant connecting to the primary caretaker in such a way to create an inner working model of relationships that continues throughout life and affects the future mental health and physical health of the infant. Given the significance of this inner working model, there has been a tremendous amount of research done in animals as well as humans to better understand the neurobiology. In this article the neurobiology of early development will be outlined with respect to the formation of attachment. This article will review what we have begun to understand as the neurobiology of attachment and will describe how the relationship with the primary caretaker affects the infant in a way leading to neurobiological changes that later in life affect emotional responses, reward, and perception difficulties that we recognize as psychiatric illness and medical morbidity.
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Affiliation(s)
- Joanna Chambers
- Associate Professor of Clinical Psychiatry, Indiana University School of Medicine; Chair of Scientific Programs, American Academy of Psychoanalysis and Dynamic Psychiatry
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Chambers RA, Wallingford SC. On Mourning and Recovery: Integrating Stages of Grief and Change Toward a Neuroscience-Based Model of Attachment Adaptation in Addiction Treatment. Psychodyn Psychiatry 2017; 45:451-473. [PMID: 29244621 PMCID: PMC6383361 DOI: 10.1521/pdps.2017.45.4.451] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Interpersonal attachment and drug addiction share many attributes across their behavioral and neurobiological domains. Understanding the overlapping brain circuitry of attachment formation and addiction illuminates a deeper understanding of the pathogenesis of trauma-related mental illnesses and comorbid substance use disorders, and the extent to which ending an addiction is complicated by being a sort of mourning process. Attention to the process of addiction recovery-as a form of grieving-in which Kubler-Ross's stages of grief and Prochaska's stages of change are ultimately describing complementary viewpoints on a general process of neural network and attachment remodeling, could lead to more effective and integrative psychotherapy and medication strategies.
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Affiliation(s)
- R. Andrew Chambers
- Director, Addiction Psychiatry Training Program & Lab for Translational Neuroscience of Dual Diagnosis, Associate Professor, Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN
| | - Sue C. Wallingford
- Chair, Division of Transpersonal Counseling and Psychology, Associate Professor, Graduate School of Counseling & Psychology, Naropa University, Boulder, CO
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Ocklenburg S, Korte SM, Peterburs J, Wolf OT, Güntürkün O. Stress and laterality – The comparative perspective. Physiol Behav 2016; 164:321-9. [DOI: 10.1016/j.physbeh.2016.06.020] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 05/30/2016] [Accepted: 06/15/2016] [Indexed: 12/28/2022]
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Abstract
Early life trauma (ELT) comprises an array of disturbingly common distressing experiences between conception and the beginning of adulthood with numerous and significant potential long-term, even transgenerational, health consequences of great public health concern, including depression, cardiovascular disease, and other psychiatric and medical disorders, and neurobiological, psychological, and behavioral effects which are sufficiently robust to confound many types of biomedical research. The impact of ELT on a woman's health trajectory appears to vary with the specific characteristics of the ELT (e.g., type, number of different types, severity, and timing), the individual (e.g., age, genetics, epigenetics, personality, and cognitive factors), and the individual's environment (e.g., level of social support and ongoing stressors) and to be mediated to a significant extent by persistent changes in a number of biological systems, dysregulation of those governing the stress response chief among them. Growing knowledge of the risk factors and pathophysiological mechanisms by which ELT confers diathesis to various poor health outcomes and the unique treatment-response profiles of women with ELT will lead to much needed improvements in prevention, diagnostic, and therapeutic efforts, including more effective psychotherapy and pharmacotherapy approaches, hopefully making strides toward improvements in the lives of women everywhere and ending countless cycles of intergenerational trauma-associated pathology. This article attempts to broadly summarize the current state of knowledge about the long-term sequelae of ELT for women's health.
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