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Young Choi J. The relationship between patterns of negative life experiences and clinical presentation in a psychiatric sample. J Clin Psychol 2024; 80:559-575. [PMID: 38111170 DOI: 10.1002/jclp.23631] [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: 05/08/2022] [Revised: 10/18/2023] [Accepted: 11/20/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND Attempts have been made to classify the patterns of polytraumatization using a person-centered approach. However, most studies have only focused on maltreatment and interpersonal trauma and have been unable to examine various clinical symptoms. OBJECTIVES This study aimed to explore patterns of negative life experiences, including maltreatment, lifetime trauma, and recent stressful life events, and compare diverse dimensions of the clinical manifestations among the subtypes in a clinical sample. METHOD We investigated childhood maltreatment, lifetime trauma, and recent stressful events using a self-report method in 1410 psychiatric patients; we classified the patterns of lifelong negative life experiences using latent profile analysis (LPA). We used the rates of psychiatric diagnosis, the Beck Depression Inventory, the Impact of Event Scale-Revised (IES-R-K), and the Multiphasic Minnesota Personality Inventory-2-Restructured Form to compare various symptom dimensions among the derived subtypes. RESULTS LPA indicated a four-class solution: mild, recent stress, maltreatment, and multiple adversity group. The multiple adversity group experiencing both lifetime trauma and recent stressful life events, in addition to maltreatment, including sexual abuse, had a high rate of severe mental illness and more symptom dimensions of thought and behavior problems. However, the rates of depressive disorders and emotional/internalizing symptoms were not more than those in the other two groups (recent stress and maltreatment groups) experiencing moderate levels of lifetime trauma. There was no significant difference between the recent stress and maltreatment groups for most symptom dimensions. CONCLUSIONS The findings indicate that distinct symptom profiles may be associated with the pattern of negative experiences, suggesting that negative experiences need multidimensional investigation in clinical settings.
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Affiliation(s)
- Ji Young Choi
- Department of Child Studies, Inha University, Incheon, South Korea
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2
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Wang W, Wang X, Duan G. Non-suicidal self-injury and suicidal ideation among Chinese college students of childhood emotional abuse: associations with rumination, experiential avoidance, and depression. Front Psychiatry 2023; 14:1232884. [PMID: 37588028 PMCID: PMC10427149 DOI: 10.3389/fpsyt.2023.1232884] [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: 06/01/2023] [Accepted: 07/18/2023] [Indexed: 08/18/2023] Open
Abstract
Background Prior studies have proved the relationships between childhood emotional abuse (CEA) histories and suicidal thoughts or behaviors in adulthood, however, how emotion regulation strategies work as the mediating mechanism is necessary to be investigated. This study aimed to further verify the impacts of rumination, experiential avoidance (EA) and depression on the associations between CEA and non-suicidal self-injury (NSSI) and suicidal ideation (SI) on a sample of Chinese college students. Methods The Childhood Emotional Abuse Questionnaire, the Non-Suicidal Self-Injury Questionnaire, the Symptom Checklist, the Ruminative Response Scale, the Acceptance and Action Questionnaire-II and the Zung Self-Rating Depression Scale were completed by 1,317 college students. Results The rates of NSSI and SI of students with CEA experiences were 31.70 and 7.90% respectively, both higher than those without such experiences. The mediating roles of rumination, EA and depression between CEA and NSSI and SI were significant (p < 0.01). Conclusion The current study shed light on the linking roles of rumination, EA and depression in the relations between CEA and NSSI and SI. It is suggested that developing adaptive emotion-regulating strategies may be helpful to the intervention of suicidal thoughts or behaviors among individuals with CEA experiences.
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Affiliation(s)
- Wan Wang
- Department of Child Development and Behavior, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xi Wang
- College of Computer Science and Electronic Engineering, Hunan University, Changsha, China
| | - Guiqin Duan
- Department of Child Development and Behavior, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Strelchuk D, Hammerton G, Wiles N, Croft J, Turner K, Heron J, Zammit S. PTSD as a mediator of the relationship between trauma and psychotic experiences. Psychol Med 2022; 52:2722-2730. [PMID: 33315002 PMCID: PMC9647519 DOI: 10.1017/s0033291720004821] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 10/29/2020] [Accepted: 11/16/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Traumatic experiences are associated with a higher risk of psychotic illnesses, but little is known about potentially modifiable mechanisms underlying this relationship. This study aims to examine whether post-traumatic stress disorder (PTSD) symptoms mediate the relationship between trauma and psychotic experiences (PEs). METHODS We used data from the Avon Longitudinal Study of Parents and Children to examine whether: PTSD symptoms mediate the relationships between (a) childhood trauma and adolescent PEs (study of adolescent PEs; n = 2952), and (b) childhood/adolescent trauma and PEs in early adulthood (study of adult PEs; n = 2492). We examined associations between variables using logistic regression, and mediation using the parametric g-computation formula. RESULTS Exposure to trauma was associated with increased odds of PEs (adolescent PEs: ORadjusted 1.48, 95% CI 1.23-1.78; adult PEs: ORadjusted 1.57, 95% CI 1.25-1.98) and PTSD symptoms (adolescent PTSD: ORadjusted 1.59, 95% CI 1.31-1.93; adult PTSD: ORadjusted 1.50, 95% CI 1.36-1.65). The association between PTSD symptoms and PE was stronger in adolescence (ORadjusted 4.63, 95% CI 2.34-9.17) than in adulthood (ORadjusted 1.62, 95% CI 0.80-3.25). There was some evidence that PTSD symptoms mediated the relationship between childhood trauma and adolescent PEs (proportion mediated 14%), though evidence of mediation was weaker for adult PEs (proportion mediated 8%). CONCLUSIONS These findings are consistent with the hypothesis that PTSD symptoms partly mediate the association between trauma exposure and PEs. Targeting PTSD symptoms might help prevent the onset of psychotic outcomes.
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Affiliation(s)
- Daniela Strelchuk
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Gemma Hammerton
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Nicola Wiles
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Jazz Croft
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Katrina Turner
- NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jonathan Heron
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Stanley Zammit
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK
- Division of Psychological Medicine and Clinical Neuroscience, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
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Wolde A, Dessalegn N. Posttraumatic Stress Disorder, Suicidal Behavior, Substance Use, and Sexual Victimization Among Adolescent Girls Aged 10-19 Years Living Under Ethnic-Based Civil War in Ethiopia. Neuropsychiatr Dis Treat 2022; 18:2239-2250. [PMID: 36254143 PMCID: PMC9569158 DOI: 10.2147/ndt.s381461] [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: 07/07/2022] [Accepted: 10/01/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is a chronic, impairing mental disorder that develops after exposure to a traumatic event. Despite many factors putting adolescent girls at risk of PTSD, little is known about the prevalence and how adolescent girls cope with the PTSD burden. So, this study aimed to investigate the prevalence of PTSD and associated factors among adolescent girls in three selected towns in Southwest Ethiopia. METHODS A community-based cross-sectional study was conducted among 397 adolescent girls from May 27 to July 27, 2021. The participants were selected by a systematic random sampling method. PTSD and substance use disorder were assessed by DSM V criteria for mental disorders. The data was entered into Epi Data Manager Version 4.0.2 before being exported to SPSS Version 25 for analysis. A logistic regression model was used, and variables with a p-value less than 0.05 in the final fitting model were stated as independent predictors of PTSD. RESULTS The prevalence of PTSD among the adolescent girls was 22%, and about three in four (72.7%) of the adolescent girls developed PTSD after exposure to sexual violence. Furthermore, PTSD was associated with Khat use disorder (AOR, 95% CI: 2.79 (1.47-5.30), alcohol use disorder (AOR, 95% CI: 5.27 (2.21-12.60), and suicidal behavior (AOR, 95% CI: 2.12 (1.20-3.74)). CONCLUSION The prevalence of PTSD was high among adolescent girls, and suicidal ideation or attempt, khat use disorder, and alcohol use disorder were risk factors for PTSD. Therefore, early screening for PTSD and comorbid risk factors among this particular age group and managing accordingly is warranted.
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Affiliation(s)
- Asrat Wolde
- Department of Psychiatry, School of Medicine, Mizan Tepi University, Mizan Aman, Ethiopia
| | - Nigatu Dessalegn
- Department of Pediatric Health Nursing, Mizan Tepi University, Mizan Aman, Ethiopia
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Lee J, Kim H, Chang SM, Hong JP, Lee DW, Hahm BJ, Cho SJ, Park JI, Jeon HJ, Seong SJ, Park JE, Kim BS. The Association of Childhood Maltreatment with Adulthood Mental Disorders and Suicidality in Korea: a Nationwide Community Study. J Korean Med Sci 2021; 36:e240. [PMID: 34581520 PMCID: PMC8476936 DOI: 10.3346/jkms.2021.36.e240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 08/02/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Although childhood maltreatment is a known risk factor for adulthood mental health, the impact of different types of childhood maltreatment on mental disorders is not yet clear. This study explored the association of each type of childhood maltreatment with adulthood mental disorders and suicidality in South Korea. METHODS A total of 5,102 individuals from the general populations over the age of 18 responded to the Korean version of the Composite International Diagnostic Interview and questions about childhood maltreatment (emotional neglect, psychological abuse, physical abuse, and sexual abuse). To evaluate the odds ratio for mental disorders and suicidality associated with each type of childhood maltreatment, we used logistic regression analysis. RESULTS About 17.0% of the respondents reported having experienced a type of maltreatment in childhood. According to the type, 9.4% reported physical abuse, 9.3% reported emotional neglect, 7.9% reported psychological abuse, and 3.8% reported sexual abuse. Exposure to each type of childhood maltreatment was associated with most types of mental disorders after adjusting for sociodemographic factors. Each type of childhood maltreatment victim was associated with suicidality (suicidal ideations, suicide plans, and suicide attempts). Dose-response patterns for suicide attempts were observed in all types of victims. Moreover, the respondents who experienced frequent childhood emotional neglect were 14 times more likely to have attempted suicide. CONCLUSION Childhood maltreatment was associated with mental health in adulthood. The findings show the need for early detection and intervention of victims of childhood maltreatment to minimize its negative impact on adult mental health.
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Affiliation(s)
- Jimin Lee
- Department of Psychiatry, Kyungpook National University Hospital, Daegu, Korea
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hyerim Kim
- Department of Psychiatry, Kyungpook National University Hospital, Daegu, Korea
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Sung Man Chang
- Department of Psychiatry, Kyungpook National University Hospital, Daegu, Korea
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jin Pyo Hong
- Department of Psychiatry, School of Medicine, Sungkyunkwan University, Seoul, Korea
| | - Dong-Woo Lee
- Department of Psychiatry, Inje University College of Medicine, Seoul, Korea
| | - Bong-Jin Hahm
- Department of Psychiatry and Behavioral Sciences, Seoul National University College of Medicine, Seoul, Korea
| | - Seong-Jin Cho
- Department of Psychiatry, Gachon Medical School, Incheon, Korea
| | - Jong-Ik Park
- Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Hong Jin Jeon
- Department of Psychiatry, School of Medicine, Sungkyunkwan University, Seoul, Korea
| | - Su Jeong Seong
- Department of Psychiatry, Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Jee Eun Park
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Byung-Soo Kim
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Korea
- Department of Psychiatry, Kyungpook National University Chilgok Hospital, Daegu, Korea.
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Bourgeois C, Lecomte T, McDuff P, Daigneault I. Mental health disorders as cooccuring and predictive factors of psychotic disorders in sexually abused children. CHILD ABUSE & NEGLECT 2021; 111:104819. [PMID: 33261843 DOI: 10.1016/j.chiabu.2020.104819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 10/10/2020] [Accepted: 11/09/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Little is known about the factors associated with psychosis in sexually abused children. Many factors have been associated with both sexual abuse and psychosis, and some mental health disorders have been identified as implied in the relationship between childhood trauma and psychosis. OBJECTIVES This study aims to identify factors cooccurring with psychotic disorders in sexually abused youth and to determine which predict the development of psychosis in this population. PARTICIPANTS AND SETTING Children with a corroborated report of sexual abuse (n = 882) at a Child Protection Agency (CPA) between 2000 and 2010 and whose health data could be retrieved from public health databases were selected for this study. METHODS A prospective matched-cohort design was used, with administrative databases from a CPA and a public health system. Logistic regressions were performed to determine which mental health diagnoses were associated with, and which predicted, psychotic disorders. RESULTS Logistic regressions revealed that personality disorders were significantly associated with psychotic disorders whereas substance misuse disorders and intellectual disability significantly predicted psychotic disorders. CONCLUSIONS Psychotic disorders and personality disorders appear concomitantly in sexually abused youth. Having received a substance misuse disorder diagnosis increases the risk of developing a psychotic disorder in sexually abused youth. Health professionals should be aware of those risk factors to help reduce the severity of youth sexual abuse consequences and, ultimately, prevent psychosis.
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Affiliation(s)
- Catherine Bourgeois
- Université de Montréal, Department of Psychology, 90 avenue Vincent d'Indy, Montreal, Quebec, H2V 2S9, Canada.
| | - Tania Lecomte
- Université de Montréal, Department of Psychology, 90 avenue Vincent d'Indy, Montreal, Quebec, H2V 2S9, Canada
| | - Pierre McDuff
- Université de Montréal, Department of Psychology, 90 avenue Vincent d'Indy, Montreal, Quebec, H2V 2S9, Canada
| | - Isabelle Daigneault
- Université de Montréal, Department of Psychology, 90 avenue Vincent d'Indy, Montreal, Quebec, H2V 2S9, Canada
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Alameda L, Rodriguez V, Carr E, Aas M, Trotta G, Marino P, Vorontsova N, Herane-Vives A, Gadelrab R, Spinazzola E, Di Forti M, Morgan C, Murray RM. A systematic review on mediators between adversity and psychosis: potential targets for treatment. Psychol Med 2020; 50:1966-1976. [PMID: 32744193 DOI: 10.1017/s0033291720002421] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Various psychological and biological pathways have been proposed as mediators between childhood adversity (CA) and psychosis. A systematic review of the evidence in this domain is needed. Our aim is to systematically review the evidence on psychological and biological mediators between CA and psychosis across the psychosis spectrum. This review followed PRISMA guidelines. Articles published between 1979 and July 2019 were identified through a literature search in OVID (PsychINFO, Medline and Embase) and Cochrane Libraries. The evidence by each analysis and each study is presented by group of mediator categories found. The percentage of total effect mediated was calculated. Forty-eight studies were included, 21 in clinical samples and 27 in the general population (GP) with a total of 82 352 subjects from GP and 3189 from clinical studies. The quality of studies was judged as 'fair'. Our results showed (i) solid evidence of mediation between CA and psychosis by negative cognitive schemas about the self, the world and others (NS); by dissociation and other post-traumatic stress disorder symptoms; and through an affective pathway in GP but not in subjects with disorder; (iii) lack of studies exploring biological mediators. We found evidence suggesting that various overlapping and not competing pathways involving post-traumatic and mood symptoms, as well as negative cognitions contribute partially to the link between CA and psychosis. Experiences of CA, along with relevant mediators should be routinely assessed in patients with psychosis. Evidence testing efficacy of interventions targeting such mediators through cognitive behavioural approaches and/or pharmacological means is needed in future.
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Affiliation(s)
- Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program, Lausanne University Hospital (CHUV), CH-1008Lausanne, Switzerland
- Department of Psychiatry, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Spain
- Instituto de Investigacion Sanitaria de Sevilla, IBiS, Spain
| | - Victoria Rodriguez
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ewan Carr
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Monica Aas
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Giulia Trotta
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Paolo Marino
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Natasha Vorontsova
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Andrés Herane-Vives
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Departamento de Clínicas, Facultad de Medicina, Universidad Católica del Norte, Coquimbo, Chile
| | - Romayne Gadelrab
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Edoardo Spinazzola
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Marta Di Forti
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Craig Morgan
- ESRC Centre for Society and Mental Health, King's College London, UK
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Childhood sexual abuse as a potential predictor of psychotic like experiences in Tunisian college students. Psychiatry Res 2019; 275:181-188. [PMID: 30925305 DOI: 10.1016/j.psychres.2019.03.034] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 03/19/2019] [Accepted: 03/19/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Current research has shown that experiencing childhood trauma may predispose individuals for psychosis and expression of Psychotic like experiences (PLEs). We aimed to examine the prevalence and characteristics of PLEs and depressive and negative experiences in a sample of Tunisian college students, and to evaluate the impact of childhood traumas in the occurrence and severity of these experiences at the time of the survey. METHOD A total of 482 college students (63.7% female; aged 18-32) participated in a cross-sectional survey. The Positive Subscale of Community Assessment of Psychotic Experiences (CAPE) was used to measure PLEs. The Childhood Trauma Questionnaire was used to assess childhood trauma and neglect. RESULTS 53.5% (n = 258) of the students reported at least one positive PLE 'nearly always', and 40.9% (n = 197) reported at least one negative PLE with this frequency. After controlling for demographic variables (gender, age) and psychosocial factors (drug use, depression, anxiety and stress), sexual abuse significantly contributed to PLEs. CONCLUSION There is a need for further cross-cultural research regarding the phenotypal expression of PLEs and its associated variables. Child sexual abuse victims should receive systematic and complete psychological screening during their adolescence/ early adulthood including, among others, PLEs and psychotic symptoms.
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Les traumatismes de l’enfance chez les sujets à ultra haut risque de psychose. Presse Med 2019; 48:243-249. [DOI: 10.1016/j.lpm.2018.11.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 09/19/2018] [Accepted: 11/27/2018] [Indexed: 12/16/2022] Open
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10
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Psychological mediators of the association between childhood adversities and psychosis: A systematic review. Clin Psychol Rev 2018; 65:175-196. [DOI: 10.1016/j.cpr.2018.05.009] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 05/27/2018] [Accepted: 05/31/2018] [Indexed: 01/03/2023]
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Schiavone FL, McKinnon MC, Lanius RA. Psychotic-Like Symptoms and the Temporal Lobe in Trauma-Related Disorders: Diagnosis, Treatment, and Assessment of Potential Malingering. CHRONIC STRESS 2018; 2:2470547018797046. [PMID: 32440584 PMCID: PMC7219949 DOI: 10.1177/2470547018797046] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 07/30/2018] [Indexed: 11/17/2022]
Abstract
Objective To overview the phenomenology, etiology, assessment, and treatment of psychotic-like symptoms in trauma-related disorders focusing on the proposed role of temporal lobe dysfunction. Method We describe the literature pertaining to (i) psychotic-like symptoms and temporal lobe dysfunction in trauma-related disorders and (ii) psychological testing profiles in trauma-related disorders. We define trauma-related disorders as borderline personality disorder, post-traumatic stress disorder, and the dissociative disorders. Our search terms were dissociative disorders, temporal lobe, trauma, post-traumatic stress disorder, borderline personality disorder, psychosis, and malingering. Results Trauma-related psychotic-like symptoms are common and can differ in phenomenology from primary psychotic symptoms. Hallucinations consist of auditory and nonauditory content that may or may not relate to traumatic content. Child voices are highly suggestive of complex dissociative disorders. Critically, not only do these symptoms resemble those seen in temporal lobe epilepsy, but the temporal lobe is implicated in trauma-related disorders, thus providing a plausible neurobiological explanation. Despite such evidence, these symptoms are frequently considered atypical and misdiagnosed. Indeed, common structured psychological assessment tools categorize these symptoms as possible indicators of invalid testing profiles. Conclusion Psychotic-like symptoms are common in trauma-related disorders, may be related to temporal lobe dysfunction, and are frequently misinterpreted. This may lead to ineffective treatment and inappropriate determinations of malingering in the forensic system.
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Affiliation(s)
| | - Margaret C McKinnon
- Mood Disorders Program, St. Joseph's Healthcare, Hamilton, Ontario, Canada.,Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, Ontario, Canada.,Homewood Research Institute, Guelph, Ontario, Canada
| | - Ruth A Lanius
- Department of Psychiatry, University of Western Ontario, London, Ontario, Canada.,Department of Neuroscience, University of Western Ontario, London, Ontario, Canada
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12
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Psychotic disorders in sexually abused youth: A prospective matched-cohort study. Schizophr Res 2018; 199:123-127. [PMID: 29548761 DOI: 10.1016/j.schres.2018.03.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 02/14/2018] [Accepted: 03/12/2018] [Indexed: 11/20/2022]
Abstract
Child sexual abuse has been identified as a potential risk factor for developing a psychotic disorder. However, little is known about the prevalence of psychotic disorders in youth who were sexually abused during adolescence and young adulthood. Gender differences also remain unclear. This study used administrative databases from a Child Protection Agency and a public health care system. It aimed to investigate the prevalence of psychotic disorders in sexually abused youth between the first substantiated report of sexual abuse and the beginning of adulthood. A second objective was to assess gender differences. Administrative health data for 882 sexually abused youth were compared with 882 matched controls from the general population over a 13-year period using conditional generalized linear mixed models. Stratified analyses by gender (group comparison) and group (gender comparison) were also performed. Sexually abused youth were 10 times more at risk of receiving a diagnosis of psychotic disorder than youth from the general population. There was no gender difference in the prevalence of psychotic disorders among sexually abused youth. These results highlight the importance of targeted prevention of psychotic disorders among sexually abused youth. Future studies should investigate risk factors and developmental trajectories of psychotic disorders in this population.
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Abstract
AIMS War and conflict are known to adversely affect mental health, although their effects on risk symptoms for psychosis development in youth in various parts of the world are unclear. The Rwandan genocide of 1994 and Civil War had widespread effects on the population. Despite this, there has been no significant research on psychosis risk in Rwanda. Our goal in the present study was to investigate the potential effects of genocide and war in two ways: by comparing Rwandan youth born before and after the genocide; and by comparing Rwandan and Kenyan adolescents of similar age. METHODS A total of 2255 Rwandan students and 2800 Kenyan students were administered the Washington Early Recognition Center Affectivity and Psychosis (WERCAP) Screen. Prevalence, frequency and functional impairment related to affective and psychosis-risk symptoms were compared across groups using univariate and multivariate statistics. RESULTS Rwandan students born before the end of the genocide and war in 1994 experienced higher psychotic and affective symptom load (p's < 0.001) with more functional impairment compared with younger Rwandans. 5.35% of older Rwandan students met threshold for clinical high-risk of psychosis by the WERCAP Screen compared with 3.19% of younger Rwandans (χ 2 = 5.36; p = 0.02). Symptom severity comparisons showed significant (p < 0.001) group effects between Rwandan and Kenyan secondary school students on affective and psychotic symptom domains with Rwandans having higher symptom burden compared with Kenyans. Rwandan female students also had higher rates of psychotic symptoms compared with their male counterparts - a unique finding not observed in the Kenyan sample. CONCLUSIONS These results suggest extreme conflict and disruption to country from genocide and war can influence the presence and severity of psychopathology in youth decades after initial traumatic events.
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Choi JY, Park SH. Childhood Maltreatment as Predictor of Pathological Personality Traits Using PSY-5 in an Adult Psychiatric Sample. J Pers Disord 2018; 32:1-16. [PMID: 28263090 DOI: 10.1521/pedi_2017_31_282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Extant literature indicates that childhood maltreatment is significantly associated with personality disorders. With the recent call for a more dimensional approach to understanding personality and pathological personality traits, the aim of the present study was to examine whether the experience of childhood maltreatment is associated with pathological personality traits as measured by the Personality Psychopathology Five (PSY-5). We analyzed data from 557 adult psychiatric patients with diverse psychiatric diagnoses, including mood disorders, schizophrenia spectrum disorders, and anxiety disorders. Hierarchical multiple regression analyses were conducted to determine the degree to which childhood maltreatment explained the five trait dimensions after controlling for demographic variables, presence of psychotic symptoms, and degree of depressive symptoms. Childhood maltreatment significantly predicted all of the five trait dimensions of the PSY-5. This suggests that childhood maltreatment may negatively affect the development of an adaptive adjustment system, thereby potentially contributing to the emergence of pathological personality traits.
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Affiliation(s)
- Ji Young Choi
- Department of Psychiatry, Sanggye Paik Hospital, Inje University, Seoul, Republic of Korea
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Seo J, Choi JY. Social defeat as a mediator of the relationship between childhood trauma and paranoid ideation. Psychiatry Res 2018; 260:48-52. [PMID: 29172098 DOI: 10.1016/j.psychres.2017.11.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 10/20/2017] [Accepted: 11/08/2017] [Indexed: 11/25/2022]
Abstract
Social defeat, the subjective experience of viewing oneself as a failure or social outsider, is associated with various psychiatric disorders. Recent studies suggest that social defeat may play an important role in the development of psychotic disorders. This study examined the role of social defeat in the relationship between childhood trauma and paranoid ideation, a symptom of psychosis, in non-psychotic mental disorders. Psychiatric patients (N = 199) completed the Korean version of the Childhood Trauma Questionnaire, the Korean version of the Defeat Scale, and Restructured Clinical Scale 6 (Ideas of Persecution) of the Korean version of the Minnesota Multiphasic Personality Inventory-2. A partial correlation analysis revealed that childhood trauma was significantly related to social defeat and paranoid ideation after controlling for age and gender. Structural equation modeling confirmed that the relationship between childhood trauma and paranoid ideation was partially mediated by social defeat. Thus, social defeat is a possible psychological mechanism underlying the association between childhood trauma and paranoia.
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Affiliation(s)
- Jihyeon Seo
- Department of Psychiatry, Sanggye Paik Hospital, Inje University, 1342, Dongil-ro, Nowon-gu, Seoul, Republic of Korea
| | - Ji Young Choi
- Department of Psychiatry, Sanggye Paik Hospital, Inje University, 1342, Dongil-ro, Nowon-gu, Seoul, Republic of Korea.
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Abstract
Cognitive deficits in Posttraumatic Stress Disorder (PTSD) and dissociative symptoms suggest there may be an underlying and persistent problem with temporal processing in PTSD, but this question has not been systematically examined. We investigated the ability of a group of PTSD participants in estimating the duration of supra-second visual stimuli relative to healthy controls. The data of 59 participants with PTSD and 62 healthy controls, collected from the BRID database, have been examined. Overall, our results indicate that PTSD patients overestimate the duration of the displayed stimuli. Moreover, we found that PTSD are more variable in the time estimation compared to the control group. Finally, we found evidence that working memory and attention impairments were associated with time overestimation in PTSD. The finding of time overestimation in PTSD accords with previous reports of time overestimation during stressful experiences associated with fear and arousal, but extends findings to suggest it remains in chronic PTSD populations processing non-emotional stimuli. The evidence of time overestimation in PTSD suggests the potential relevance of this factor as a cognitive marker in assessing the neuropsychological profile of this clinical population.
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Choi JY. Posttraumatic stress symptoms and dissociation between childhood trauma and two different types of psychosis-like experience. CHILD ABUSE & NEGLECT 2017; 72:404-410. [PMID: 28917190 DOI: 10.1016/j.chiabu.2017.08.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 07/19/2017] [Accepted: 08/19/2017] [Indexed: 06/07/2023]
Abstract
This study examined the roles of posttraumatic stress (PTS) symptoms and dissociation in the relationship between childhood trauma and two different types of psychosis-like experience, including persecutory ideation and aberrant experience, in non-psychotic psychiatric patients. From August 2015 to August 2016, among psychiatric out patients seeking treatment at the Department of Psychiatry at a major teaching medical hospital in Seoul, Korea, 169 patients who had never been diagnosed with a psychotic disorder, including schizophrenia spectrum disorder, bipolar disorder, and/or depressive disorder with psychotic features, completed the Korean Childhood Trauma Questionnaire, the Korean version of the Impact of Event Scale-Revised, the modified Korean version of the Peritraumatic Dissociation Experiences Questionnaire, and the Korean Minnesota Multiphasic Personality Inventory-2 (MMPI-2). The RC 6 (Ideas of Persecution) and RC 8 (Aberrant Experiences) of the restructured scales of the MMPI-2 were used as a measure of persecutory ideation and aberrant experience. Structural equation modeling analyses confirmed a partial mediation model in which PTS symptoms partially mediated the relationship between childhood trauma and persecutory ideation, and dissociation partially mediated the relationship between childhood trauma and aberrant experience. This implies that there are distinct mechanisms depending on the type of psychosis-like experience in relation to childhood trauma.
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Affiliation(s)
- Ji Young Choi
- Department of Psychiatry, Sanggye Paik Hospital, Inje University, 1342, Dongilro, Nowon-gu, Seoul, Republic of Korea.
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Choi BS, Kim JI, Kim BN, Kim B. Comorbidities and correlates of conduct disorder among male juvenile detainees in South Korea. Child Adolesc Psychiatry Ment Health 2017; 11:44. [PMID: 28924450 PMCID: PMC5599892 DOI: 10.1186/s13034-017-0182-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 07/31/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to examine the rate and distribution of comorbidities, severity of childhood maltreatment, and clinical characteristics of adolescents with conduct disorder detained in a juvenile detention center in South Korea. METHODS In total, 173 juvenile detainees were recruited. We analyzed the distribution of psychiatric disorders among the sample and compared the rate of comorbidities between groups with and without conduct disorder. We compared the two groups in terms of demographic and clinical characteristics, as well as severity of childhood maltreatment and psychiatric problems, using the Young Self Report (YSR) scale. RESULTS A total of 95 (55%) of the detainees were diagnosed with conduct disorder, and 93 (96.9%) of them had at least one comorbid axis I psychiatric disorder. Detainees with conduct disorder had a higher number of comorbid psychiatric disorders; a higher rate of violent crime perpetration; had suffered more physical, emotional, and sexual abuse; and showed higher total YSR scores and externalizing behavior, somatic complaints, rule-breaking behavior, and aggressive behavior YSR subscale scores. CONCLUSIONS Conduct disorder is a common psychiatric disorder among juvenile detainees in South Korea, who tend to commit more violent crimes and show more psychopathology than detainees who do not have conduct disorder. These findings highlight the importance of diagnosing and intervening in conduct disorder within the juvenile detention system.
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Affiliation(s)
- Bum-Sung Choi
- Department of Psychiatry, Medical Research Institute, Pusan National University Yangsan Hospital, 20 Geumo-ro, Yangsan, Mulgeum-eup 50612 Republic of Korea
| | - Johanna Inhyang Kim
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, 101 Daehak-no, Chongno-gu, Seoul, 03080 Republic of Korea
| | - Bung-Nyun Kim
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, 101 Daehak-no, Chongno-gu, Seoul, 03080 Republic of Korea
| | - Bongseog Kim
- Department of Psychiatry, Sanggye Paik Hospital, Inje University College of Medicine, 1342 Dong-il Street, Seoul, 01757 Republic of Korea
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Sun M, Zhang W, Guo R, Hu A, Li Y, Mwansisya TE, Zhou L, Liu C, Chen X, Tao H, Huang X, Xue Z, Chiu HFK, Liu Z. Psychotic-like experiences and correlation with childhood trauma and other socio-demographic factors: A cross-sectional survey in adolescence and early adulthood in China. Psychiatry Res 2017; 255:272-277. [PMID: 28595150 DOI: 10.1016/j.psychres.2017.03.059] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 03/08/2017] [Accepted: 03/21/2017] [Indexed: 10/19/2022]
Abstract
Psychotic-like experiences (PLEs) in adolescence are found to be risk factors for later mental disorders. Previous research has also found that childhood trauma has a positive correlation with mental health problems. However, few studies have focused on the relationship between them, especially in adolescence and early adulthood. A total of 9122 students (age between 10 and 23.3) were surveyed and assessed with the positive and depressive subscales of the Community Assessment of Psychic Experiences and the Trauma History Questionnaire. A total of 20.7% students experienced frequent PLEs, 17.5% had frequent delusional experiences, and 7.6% had frequent hallucinatory experiences. Only a small portion of this sample experienced frequent PLEs, associated with more types of PLEs, more distress, and more depressive experiences. Several socio-demographic factors were associated with frequent PLEs in this sample, which could be further examined in future prevention studies. Students with frequent PLEs experienced significantly higher impact from trauma events, both at the time of the events and in the present, indicating a possible reciprocal effect between childhood trauma and PLEs. The impact of childhood trauma played an important role in the relationship between childhood trauma and PLEs.
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Affiliation(s)
- Meng Sun
- Department of Psychiatry, the Second Xiangya Hospital of Central South University, China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, Changsha, Hunan 410011, China
| | - Wen Zhang
- Department of Psychiatry, the Second Xiangya Hospital of Central South University, China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, Changsha, Hunan 410011, China
| | - Rui Guo
- Department of Psychiatry, the Second Xiangya Hospital of Central South University, China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, Changsha, Hunan 410011, China
| | - Aimin Hu
- Department of Psychiatry, the Second Xiangya Hospital of Central South University, China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, Changsha, Hunan 410011, China
| | - Yihui Li
- Department of Psychology, Gannan Medical University, Ganzhou, China
| | | | - Li Zhou
- Department of Psychiatry, the Second Xiangya Hospital of Central South University, China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, Changsha, Hunan 410011, China
| | - Chang Liu
- Department of Psychiatry, the Second Xiangya Hospital of Central South University, China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, Changsha, Hunan 410011, China
| | - Xudong Chen
- Department of Psychiatry, the Second Xiangya Hospital of Central South University, China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, Changsha, Hunan 410011, China
| | - Haojuan Tao
- Department of Psychiatry, the Second Xiangya Hospital of Central South University, China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, Changsha, Hunan 410011, China
| | - Xiaojun Huang
- Department of Psychiatry, the Second Xiangya Hospital of Central South University, China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, Changsha, Hunan 410011, China
| | - Zhimin Xue
- Department of Psychiatry, the Second Xiangya Hospital of Central South University, China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, Changsha, Hunan 410011, China
| | - Helen F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Zhening Liu
- Department of Psychiatry, the Second Xiangya Hospital of Central South University, China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, Changsha, Hunan 410011, China.
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Kratzer L, Heinz P, Schennach R. Significant improvement of posttraumatic stress disorder and psychotic symptoms after inpatient Eye Movement Desensitization and Reprocessing treatment: A case report with 6-month follow-up. Indian J Psychiatry 2017; 59:389-390. [PMID: 29085105 PMCID: PMC5659096 DOI: 10.4103/psychiatry.indianjpsychiatry_318_16] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Leonhard Kratzer
- Department of Psychotraumatology, Clinic St. Irmingard, Osternacher Strasse 103, 83209 Prien am Chiemsee, Germany. E-mail:
| | - Peter Heinz
- Department of Psychotraumatology, Clinic St. Irmingard, Osternacher Strasse 103, 83209 Prien am Chiemsee, Germany. E-mail:
| | - Rebecca Schennach
- Schoen Clinic Roseneck, Am Roseneck 6, 83209 Prien am Chiemsee, Germany.,Department of Psychiatry, Ludwig-Maximilians-University, Nussbaumstrasse 7, 80336 Munich, Germany
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Lee MA, Song R. Childhood abuse, personality traits, and depressive symptoms in adulthood. CHILD ABUSE & NEGLECT 2017; 65:194-203. [PMID: 28189957 DOI: 10.1016/j.chiabu.2017.02.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 10/17/2016] [Accepted: 02/03/2017] [Indexed: 06/06/2023]
Abstract
This study examined associations among childhood abuse, personality traits, and depressive symptoms in adulthood, and whether and how the effects of childhood abuse on depressive symptoms are mediated by the Big Five personality traits (i.e., extraversion, conscientiousness, emotional stability, agreeableness, and openness). The data were drawn from the 2012 Korean General Social Survey, a nationally representative survey using a multistage area proportional probability sampling method. Random effects regression and the Sobel test were used. Random effects models showed that physical and emotional abuse in childhood significantly increased depressive symptoms in adulthood, even after controlling for personality traits and socio-demographic factors. The coefficients of childhood abuse slightly decreased when personality traits were controlled, suggesting that personality traits mediated the relationship between childhood abuse and depressive symptoms. Among the personality traits, extraversion and emotional stability were negatively associated with depressive symptoms whereas agreeableness was positively associated with depressive symptoms. The results of the Sobel test showed that only emotional stability significantly mediated the effects of childhood abuse on depressive symptoms. Those who were exposed to childhood abuse had lower levels of emotional stability, which, in turn, led to depressive symptoms in adulthood. The findings suggest that childhood abuse may have a long lasting effect on mental health over the life course by influencing the formation of personality traits through developmental periods.
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Affiliation(s)
- Min-Ah Lee
- Department of Sociology, Chung-Ang University, 84 Heukseok-ro, Dongjak-Gu, Seoul 06974, Republic of Korea.
| | - Rira Song
- Department of Sociology, Chung-Ang University, 84 Heukseok-ro, Dongjak-Gu, Seoul 06974, Republic of Korea.
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Misiak B, Krefft M, Bielawski T, Moustafa AA, Sąsiadek MM, Frydecka D. Toward a unified theory of childhood trauma and psychosis: A comprehensive review of epidemiological, clinical, neuropsychological and biological findings. Neurosci Biobehav Rev 2017; 75:393-406. [PMID: 28216171 DOI: 10.1016/j.neubiorev.2017.02.015] [Citation(s) in RCA: 119] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 02/09/2017] [Accepted: 02/14/2017] [Indexed: 01/05/2023]
Abstract
There is a growing body of research focused on the relationship between childhood trauma and the risk of developing psychosis. Numerous studies, including many large-scale population-based studies, controlling for possible mediating variables, provide persuasive evidence of a dose-response association and are indicative of a causal relationship. Existing evidence supports the specificity model, showing differential associations between particular adversities and clinical symptoms, with cumulative adversity causing less favorable clinical and functional outcomes in psychotic patients. To date, several psychological and biological models have been proposed to search for underlying developmental trajectories leading to the onset of psychosis, influencing psychopathological manifestation and negative functional outcomes due to a history of childhood trauma. In this article, we provide a unified review on the relationship between childhood trauma and psychosis by integrating results of epidemiological, clinical, neuropsychological and biological studies. The question whether psychosis with a positive history of childhood trauma should be considered as a new psychotic phenotype, requiring specific therapeutic interventions, warrants further investigation.
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Affiliation(s)
- Błażej Misiak
- Department of Genetics, 1 Marcinkowski Street, 50-368 Wroclaw, Poland.
| | - Maja Krefft
- Department of Psychiatry, 10 Pasteur Street, 50-367 Wroclaw, Poland
| | - Tomasz Bielawski
- Department of Psychiatry, 10 Pasteur Street, 50-367 Wroclaw, Poland
| | - Ahmed A Moustafa
- School of Social Sciences and Psychology, Marcs Institute of Brain and Behaviour, University of Western Sydney, Penrith, NSW, Australia
| | - Maria M Sąsiadek
- Department of Genetics, 1 Marcinkowski Street, 50-368 Wroclaw, Poland
| | - Dorota Frydecka
- Department of Psychiatry, 10 Pasteur Street, 50-367 Wroclaw, Poland
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Schneeberger AR, Huber CG, Seixas A, Muenzenmaier KH, Lang UE, Castille D, Larkin S, Link BG. Alcohol consumption and use of health care services in people with severe mental illness and stressful childhood experiences. J Addict Dis 2017; 36:97-104. [PMID: 28103157 DOI: 10.1080/10550887.2017.1280311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
People who suffer from severe mental illness often present with histories of abuse during childhood. Alcohol use disorders is a common co-morbidity of survivors of childhood abuse and neglect. This study analyzes the effects of stressful childhood experiences, a proxy for trauma, on the frequency of alcohol consumption and the utilization of health care services in a population of people with severe mental illness. There were 111 men (mean age: 35 years) and 72 women (mean age: 40.0 years) with severe mental illness that were recruited from psychiatric outpatient clinics in New York City. The analysis focused on lifetime prevalence of stressful childhood experiences, alcohol consumption, and utilization of health care services over time. The longitudinal data were analyzed over 12 months with a level-2 model (multilevel modeling). Out of the participants, 41.5% reported a history of more than four types of abusive experiences. There were 33.3% that had a DSM-IV diagnosis of alcohol abuse and 27.3% qualified for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis of alcohol dependence throughout their lives. Stressful childhood experiences predicted an increased frequency of alcohol consumption over time. People with histories of childhood abuse had more often been to outpatient clinics and 12-step programs, but at the same time showed lower frequency rates of psychiatrist visits and visits to outpatient clinics. Childhood abuse is prevalent in people with severe mental illness and is related to an increased alcohol consumption. Despite an increased need of health care services, affected persons might encounter more barriers to access them.
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Affiliation(s)
- Andres R Schneeberger
- a Psychiatrische Dienste Graubuenden (PDGR) , St. Moritz , Switzerland.,b Universitaere Psychiatrische Kliniken Basel, Switzerland (UPK), Universitaet Basel , Basel , Switzerland.,c Albert Einstein College of Medicine (AECOM) , Department of Psychiatry and Behavioral Sciences , Bronx , New York , USA
| | - Christian G Huber
- b Universitaere Psychiatrische Kliniken Basel, Switzerland (UPK), Universitaet Basel , Basel , Switzerland
| | - Azizi Seixas
- d Center for Healthful Behavior Change (CHBC), Department of Population Health , New York University School of Medicine , New York , New York , USA
| | - Kristina H Muenzenmaier
- c Albert Einstein College of Medicine (AECOM) , Department of Psychiatry and Behavioral Sciences , Bronx , New York , USA
| | - Undine E Lang
- b Universitaere Psychiatrische Kliniken Basel, Switzerland (UPK), Universitaet Basel , Basel , Switzerland
| | | | - Stefan Larkin
- f Bronx Provider Consumer Alliance Resource Center (BPCARC) , Bronx , New York , USA.,g Behavioral Health Education, Research and Development, LLC , Bronx , New York , USA
| | - Bruce G Link
- h Mailman School of Public Health, Columbia University , New York , New York , USA
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Kim EY, Park J, Kim B. Type of childhood maltreatment and the risk of criminal recidivism in adult probationers: a cross-sectional study. BMC Psychiatry 2016; 16:294. [PMID: 27543095 PMCID: PMC4992306 DOI: 10.1186/s12888-016-1001-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 08/12/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Childhood maltreatment is strongly associated with delinquency and the repeated crime. Specific types of childhood maltreatment have been found to have differential effects on recidivism in juvenile offenders, but studies of adult probationers have not been performed. This study investigated the relationship between having a history of childhood maltreatment and mental-health problems and the independent contribution of specific types of maltreatment and mental-health problems to the criminal recidivism of adult probationers. METHOD This study included 183 adult probationers (107 males and 76 females) with a mean age of 40.1 (SD = 11.8) years. Type of childhood maltreatment was assessed using the Childhood Trauma Questionnaire, which consists of five subscales (emotional neglect and abuse, physical neglect and abuse, and sexual abuse). Additionally, we used the Mini International Neuropsychiatric Interview to assess participants for the presence of psychiatric disorders and assessed levels of emotional dysregulation and resilience. Hierarchical logistic regression analysis was performed to determine whether the types of childhood maltreatment were independently associated with repeated crime, after adjusting for demographic factors and mental-health problems. RESULTS The overall prevalence of mental illness in the childhood maltreatment group was significantly higher than in the no childhood maltreatment group (56.1 % vs. 38.2 %, p = 0.017). The maltreated group had a higher rate of major depressive disorder, a higher level of emotional dysregulation, and a lower level of resilience than the group that was not maltreated. Recidivism was uniquely associated with physical neglect (Adjusted Odds Ratio [AOR], 2.862; 95 % Confidence Interval [95 % CI], 1.213-6.752) and the presence of at least one psychiatric disorder (AOR, 3.791; 95 % CI, 1.703-8.443). CONCLUSIONS Childhood maltreatment deserves further attention in adult probationers because it is potentially associated with higher rates of psychiatric morbidity and recidivism. In particular, physical neglect during childhood plays a critical role in repeated crime, independent of mental-health problems for high-risk adults involved with the criminal justice system. Rigorous evaluations of the relevance of childhood maltreatment in the assessment and treatment of criminal offenders are needed.
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Affiliation(s)
- Eun Young Kim
- Department of Psychiatry, Inje University Sanggye Paik Hospital, Dongil-ro 1342, Nowon-gu Seoul, 139-707 Republic of Korea
| | - Jiung Park
- Department of Psychiatry, Inje University Sanggye Paik Hospital, Dongil-ro 1342, Nowon-gu Seoul, 139-707 Republic of Korea
| | - Bongseog Kim
- Department of Psychiatry, Inje University Sanggye Paik Hospital, Dongil-ro 1342, Nowon-gu, Seoul, 139-707, Republic of Korea.
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