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Rameckers SA, van Emmerik AAP, Grasman RPPP, Arntz A. Non-fear emotions in changes in posttraumatic stress disorder symptoms during treatment. J Behav Ther Exp Psychiatry 2024; 84:101954. [PMID: 38479086 DOI: 10.1016/j.jbtep.2024.101954] [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: 06/03/2022] [Revised: 12/31/2023] [Accepted: 02/19/2024] [Indexed: 05/15/2024]
Abstract
BACKGROUND AND OBJECTIVES Posttraumatic stress disorder (PTSD) is not only associated with fear but also with other emotions. The present study aimed to examine if changes in shame, guilt, anger, and disgust predicted changes in PTSD symptoms during treatment, while also testing if PTSD symptoms, in turn, predicted changes in these emotions. METHODS Participants (N = 155) with childhood-related PTSD received a maximum of 12 sessions of eye movement desensitization and reprocessing or imagery rescripting. The data was analyzed using Granger causality models across 12 treatment sessions and 6 assessment sessions (up until one year after the start of treatment). Differences between the two treatments were explored. RESULTS Across treatment sessions, shame, and disgust showed a reciprocal relationship with PTSD symptoms, while changes in guilt preceded PTSD symptoms. Across assessments, anger was reciprocally related to PTSD, suggesting that anger might play a more important role in the longer term. LIMITATIONS The individual emotion items were not yet validated, and the CAPS was not administered at all assessments. CONCLUSIONS These findings partly differ from earlier studies that suggested a unidirectional relationship in which changes in emotions preceded changes in PTSD symptoms during treatment. This is in line with the idea that non-fear emotions do play an important role in the treatment of PTSD and constitute an important focus of treatment and further research.
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Affiliation(s)
- Sophie A Rameckers
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, the Netherlands.
| | | | - Raoul P P P Grasman
- Department of Psychological Methods, University of Amsterdam, Amsterdam, the Netherlands
| | - Arnoud Arntz
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, the Netherlands
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2
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Blair M, Tweedlie L, Minnis H, Cronin I, Turner F. Online therapy with families - what can families tell us about how to do this well? A qualitative study assessing families' experience of remote Dyadic Developmental Psychotherapy compared to face-to-face therapy. PLoS One 2024; 19:e0301640. [PMID: 38626223 PMCID: PMC11020366 DOI: 10.1371/journal.pone.0301640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 03/19/2024] [Indexed: 04/18/2024] Open
Abstract
Dyadic Developmental Psychotherapy (DDP) is a family-based therapy for adopted children aiming to achieve secure attachment between the child and parent. Due to restrictions under the COVID-19 pandemic, delivery of DDP transitioned from face-to-face to online methods. This study aimed to explore families experience of online DDP compared to face-to-face DDP, looking at the advantages and disadvantages of remote delivery methods and the implications this has on future service delivery for clinicians. Semi-structured interviews with 6 families were conducted online. Analysis of transcripts using Interpretative Phenomenological Analysis (IPA) revealed four superordinate themes: environment and child engagement, non-verbal communication, travel and familiarity with remote interactions. Parents recognised the influence the physical and online environment had on their child's engagement levels, however, varied in their experience and hence preference of delivery method. All families emphasised the importance of non-verbal communication within DDP sessions and majority highlighted this may be lost online. For families who travelled to face-to-face DDP, car journeys provided a unique opportunity to decompress and reflect after sessions. For families where travel is unfeasible, online DDP was a lifeline, demonstrating the ability of remote therapy to widen access to specialist healthcare. Familiarity with online work emerged as a strong indicator of positive attitudes towards remote DDP, especially if the previous experience is positive and the child is confident using technology. Overall, families differed greatly in their experience of remote and face-to-face DDP indicating a new approach must be undertaken with each family beginning therapy, ensuring it is unique and individual to their needs.
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Affiliation(s)
- Monica Blair
- College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Leigh Tweedlie
- College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Helen Minnis
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Irene Cronin
- Academic Child and Mental Health Services, University of Glasgow, Glasgow, United Kingdom
| | - Fiona Turner
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, United Kingdom
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3
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Sajadian M, Younesi SJ, Jafari P, Azkhosh M, Yarandi RB, Kordbagheri M. Shame, fear of compassion, self-criticism, and self-reassurance mediate the effect of early life events on emotional disorders among male prisoners: A structural equation modeling analysis. Acta Psychol (Amst) 2024; 242:104116. [PMID: 38113609 DOI: 10.1016/j.actpsy.2023.104116] [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] [Received: 10/06/2023] [Revised: 12/13/2023] [Accepted: 12/13/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Early negative experiences in childhood are potent predictors of criminal behavior in youth and adulthood. This study aimed to identify the mediation effects of Shame, Fear of Compassion, Self-criticism, and Self-reassurance on the effect of Early Life Events on Emotional Disorders. METHOD This cross-sectional study was conducted among 368 male prisoners (Mean age: 33.26 ± 8.41 years) with convenient sampling method, from Ilam, Iran. A set of self-reported instruments were used for data collection. The ultimate model was constructed using structural equation modeling after confirming the construct validity of the measures via confirmatory factor analysis. RESULTS Shame, fear of compassion, self-criticism, and self-reassurance significantly mediated the relationship between Early Life Events and emotional disorders. The mediating effect accounted for 77 % of the total effect in the mediating model. According to Pearson's correlation, a positive and significant relationship existed between early life events and self-criticism, shame, fear of compassion and emotional disorders (P < .001). In conclusion, the presented model has an appropriate and acceptable fit, as evidenced by the results of the chi-square test (χ2 = 48.067, p < .001) and other relevant fit indices. However, self-reassurance's mediating role was insignificant (P > .05). CONCLUSIONS The present results showed that shame, fear of compassion, and self-criticism are important mediators in the relationship between early life events and emotional disorders among male prisoners. So, it is necessary to develop related protocols to increase the mental health of prisoners.
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Affiliation(s)
- Maryam Sajadian
- Department of Counselling, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Seyed Jalal Younesi
- Department of Counselling, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Parvin Jafari
- Department of Counselling, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Manouchehr Azkhosh
- Department of Counselling, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Razieh Bidhendi Yarandi
- Epidemiology and Biostatistics Department, University of social welfare and rehabilitation sciences, Tehran, Iran
| | - Mohammadreza Kordbagheri
- Department of Statistics, Faculty of Mathematical Sciences, Shahid Beheshti University, Tehran, Iran
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4
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Köhler-Dauner F, Dalhof Gulde M, Hart L, Ziegenhain U, Fegert JM. The negative association of the SARS-CoV-2 pandemic with the health of mother and child considering maternal childhood maltreatment. BMC Psychol 2023; 11:292. [PMID: 37759267 PMCID: PMC10523770 DOI: 10.1186/s40359-023-01327-8] [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] [Received: 02/21/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Social distancing strategies during the SARS-CoV-2 pandemic have left families facing a variety of different constraints. Especially in this stressful time, children need a stable parental home to prevent developmental consequences. Additional risk factors such as maternal childhood maltreatment (CM) may affect mother's psychosomatic health and children's physical well-being in this period. OBJECTIVE It was aimed to analyze the associations between maternal CM, mother's mental health, and children's physical complaints during the SARS-CoV-2-pandemic. METHOD Mothers of a well-documented birth cohort from a longitudinal study were included in this study. Psychosomatic health was assessed with the PHQ-D and children's physical health with the GBB-KJ during the pandemic. N = 159 mothers completed the online survey. To describe the maternal CM, data from a longitudinal survey were used. RESULTS The calculation of three mediation analyses demonstrate that maternal depression symptoms (c-path: β = 0.10, p = .02; c'-path: β = 0.07, p = .13), somatic symptoms (c-path: β = 0.10, p = .02; c'-path: β = 0.07, p = .13) and psychosomatic symptoms (c-path: β = 0.10, p = .02; c'-path: β = 0.06, p = .19) fully mediate the relationship between CM and children's physical health complaints. CONCLUSIONS Maternal CM experiences seem to be one relevant risk factor during the pandemic and seem to influence the way in which parents deal with stressful situations and increase the risk for depressive symptoms. The present results highlight the importance to provide individually adjusted assistance to help the families to get through the pandemic.
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Affiliation(s)
- Franziska Köhler-Dauner
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, Steinhövelstraße 5, 89075, Ulm, Germany.
| | - Manuela Dalhof Gulde
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, Steinhövelstraße 5, 89075, Ulm, Germany
| | - Lara Hart
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, Steinhövelstraße 5, 89075, Ulm, Germany
| | - Ute Ziegenhain
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, Steinhövelstraße 5, 89075, Ulm, Germany
| | - Jörg M Fegert
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, Steinhövelstraße 5, 89075, Ulm, Germany
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5
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Ye B, Wang Q, Zhang Y, Yang Q. Adverse childhood experiences and depressive symptoms among adolescents during the COVID-19 pandemic: mediating roles of poor sleep quality and psychological inflexibility. PSYCHOL HEALTH MED 2023; 28:2095-2107. [PMID: 36922371 DOI: 10.1080/13548506.2023.2190986] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 03/09/2023] [Indexed: 03/18/2023]
Abstract
Previous studies have found that adverse childhood experiences can lead to depressive symptoms. But the underlying mechanisms have not been determined. Guided by the 3-P model of insomnia and acceptance and commitment therapy, this study examined the mediating role of poor sleep quality and psychological inflexibility in the relationship between adverse childhood experiences and depressive symptoms during the COVID-19 pandemic. A total of 996 senior high school students in China (Mage = 16.57 years; SD = 1.03) completed the self-report measures of adverse childhood experiences, depressive symptoms, poor sleep quality, and psychological inflexibility. Multiple mediation analysis revealed that adverse childhood experiences were related to depressive symptoms through poor sleep quality and psychological inflexibility, serially. These findings point to potential targets in the prevention of and intervention in adolescent depressive symptoms.
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Affiliation(s)
- Baojuan Ye
- Center of Mental Health Education and Research, School of Psychology, Jiangxi Normal University, Nanchang, China
| | - Qipeng Wang
- Center of Mental Health Education and Research, School of Psychology, Jiangxi Normal University, Nanchang, China
| | - Yanzhen Zhang
- Brain Game Center, Department of Psychology, University of California, Riverside, CA, USA
- Computer Science Department, Irvine Valley College, 5500 Irvine Center Dr, Irvine, CA, USA
| | - Qiang Yang
- School of Education, Jiangxi Normal University, Nanchang, China
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6
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Marici M, Clipa O, Runcan R, Pîrghie L. Is Rejection, Parental Abandonment or Neglect a Trigger for Higher Perceived Shame and Guilt in Adolescents? Healthcare (Basel) 2023; 11:1724. [PMID: 37372842 DOI: 10.3390/healthcare11121724] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/07/2023] [Accepted: 06/11/2023] [Indexed: 06/29/2023] Open
Abstract
Theories of development point out that childhood experiences are relevant across the lifespan, and that the parent-child relationship is essential for a child's physical and psychological wellbeing. The aim of this study is to investigate whether parental abandonment influences self-conscious emotions such as guilt and shame. This quasi-experiment included 230 adolescents and teenagers (M = 17.1, SD = 1.82), and data were collected via a self-reported questionnaire administered online. We used the Guilt Inventory, the Experience of Shame Scale, the Childhood Trauma Questionnaire, and the Parental Acceptance/Rejection Questionnaire. Results indicated that the child's environment was significantly associated with feelings of shame. Abuse is associated with both guilt and shame, while paternal rejection is associated with guilt. The environment in which children and teenagers develop is associated with how they perceive themselves in relation to others. This study underlines the importance of considering child development conditions and the paramount importance of social work assistance for abandoned children and teenagers.
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Affiliation(s)
- Marius Marici
- Faculty of Educational Sciences, Stefan cel Mare University, 720229 Suceava, Romania
| | - Otilia Clipa
- Faculty of Educational Sciences, Stefan cel Mare University, 720229 Suceava, Romania
| | - Remus Runcan
- Faculty of Educational Sciences, Psychology and Social Work, Aurel Vlaicu University of Arad, 310032 Arad, Romania
| | - Loredana Pîrghie
- Faculty of Educational Sciences, Stefan cel Mare University, 720229 Suceava, Romania
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7
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Kealy D, Laverdière O, Cox DW, Hewitt PL. Childhood emotional neglect and depressive and anxiety symptoms among mental health outpatients: the mediating roles of narcissistic vulnerability and shame. J Ment Health 2023; 32:24-32. [PMID: 33084445 DOI: 10.1080/09638237.2020.1836557] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Theorized to stem from experiences of childhood emotional neglect, narcissistic vulnerability has been identified as contributing to expressions of psychiatric distress such as depressive and anxiety symptoms, particularly due to shame-proneness. AIMS To investigate narcissistic vulnerability and shame as mediators between perceived childhood emotional neglect and depressive and generalized anxiety symptoms among psychiatric outpatients. METHODS Adults (N = 137) attending community mental health services completed self-report measures at intake. Mediation analyses tested the indirect effect of perceived emotional neglect on depressive and generalized anxiety symptom severity through narcissistic vulnerability; shame was added to subsequent models to examine narcissistic vulnerability and shame as sequential mediators. RESULTS Perceived emotional neglect was significantly associated with narcissistic vulnerability, which in turn was linked with depressive and generalized anxiety symptoms as separate dependent variables. Indirect effects were significant in each model, indicating narcissistic vulnerability as a significant mediator. With the inclusion of shame, narcissistic vulnerability and shame were significant as sequential mediators. CONCLUSION Narcissistic vulnerability and shame may operate as mechanisms in conferring affective symptom severity from perceived childhood emotional neglect. Narcissistic vulnerability and susceptibility to shame may thus be important treatment targets when addressing psychological distress in the context of childhood adversity.
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Affiliation(s)
- David Kealy
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Olivier Laverdière
- Département de Psychologie, Université de Sherbrooke, Sherbrooke, Canada
| | - Daniel W Cox
- Counselling Psychology Program, University of British Columbia, Vancouver, Canada
| | - Paul L Hewitt
- Department of Psychology, University of British Columbia, Vancouver, Canada
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8
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Understanding the Relationship Between Social Stressors, Trauma, and Somatic Symptoms Among Latina Immigrant Women. J Racial Ethn Health Disparities 2023; 10:387-394. [PMID: 35257311 PMCID: PMC9448827 DOI: 10.1007/s40615-022-01230-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 12/21/2021] [Accepted: 01/04/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Latina immigrant women are at increased risk for poor mental health. Little is known about factors associated with somatic symptoms, the physical manifestation of distress, in this population. This study examined associations between social stressors, trauma, and somatic symptoms. METHODS This study used survey data from a community-based sample of Latina immigrant women (n = 154). We determined the frequency of somatic symptoms and used linear regressions to estimate associations of stressors and trauma with physical symptoms. RESULTS Most participants reported mild or moderate levels of somatic symptom severity. In univariate models, all social stressors and trauma types were significantly associated with higher levels of somatic symptoms. A multivariate model suggested perceived stress was associated with increased somatic symptoms after accounting for other stressors and trauma. DISCUSSION Future research should examine whether stress and trauma lead to higher levels of somatic symptoms among Latina immigrants.
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9
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Jacobsen SA, Bibby BM, Frostholm L, Petersen MW, Ørnbøl E, Schovsbo SU, Dantoft TM, Carstensen TBW. Development and Validation of the Weighted Index for Childhood Adverse Conditions (WICAC). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192013251. [PMID: 36293829 PMCID: PMC9602749 DOI: 10.3390/ijerph192013251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/30/2022] [Accepted: 10/09/2022] [Indexed: 05/17/2023]
Abstract
BACKGROUND Adverse experiences in childhood are a major public health concern, promoting social inequality in health through biopsychosocial mechanisms. So far, no known measures comprehend the complexity and variations of severity of adverse events. This study aims to develop and validate a new index: the Weighted Index for Childhood Adverse Conditions (WICAC). METHODS The population consists of 7493 randomly invited men and women aged 18-72 years. Data were collected in 2012-2015 as part of the Danish Study of Functional Disorders (DanFunD). Content and construct validation of the WICAC was performed with the hypothesis testing of multiple biopsychosocial outcomes: cardiovascular disease, cancer, poor health, back pain, BMI, obesity, anxiety, depression, low vitality, subjective social status, lower education, smoking, and alcohol consumption. Data were analysed with binominal and linear regression models with risk ratios (RR) and mean differences (MD). RESULTS Content validation is fitting for WICAC. The strongest associations observed were for most severe adversity: Poor Health RR = 2.16 (1.19-2.91), Anxiety RR = 3.32 (2.32-4.74), Heavy Drinking RR = 4.09 (1.85-9.04), and Subjective Social Status MD = -0.481 (-0.721-(-0.241)). Similar results were found for the remaining outcomes. Discriminative validation was undecided. CONCLUSIONS WICAC is an adequate instrument for measuring cumulative adverse life events in childhood and adolescence for research purposes.
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Affiliation(s)
- Sofie A. Jacobsen
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Palle Juul-Jensen Boulevard 11, 8200 Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Palle Juul-Jensen Boulevard 11, 8200 Aarhus, Denmark
- Correspondence:
| | - Bo M. Bibby
- Department of Public Health, Biostatistics, Aarhus University, Bartholins Allé 2, 8000 Aarhus, Denmark
| | - Lisbeth Frostholm
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Palle Juul-Jensen Boulevard 11, 8200 Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Palle Juul-Jensen Boulevard 11, 8200 Aarhus, Denmark
| | - Marie W. Petersen
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Palle Juul-Jensen Boulevard 11, 8200 Aarhus, Denmark
| | - Eva Ørnbøl
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Palle Juul-Jensen Boulevard 11, 8200 Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Palle Juul-Jensen Boulevard 11, 8200 Aarhus, Denmark
| | - Signe U. Schovsbo
- Center for Clinical Research and Disease Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, 2400 Copenhagen, Denmark
| | - Thomas M. Dantoft
- Center for Clinical Research and Disease Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, 2400 Copenhagen, Denmark
| | - Tina B. W. Carstensen
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Palle Juul-Jensen Boulevard 11, 8200 Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Palle Juul-Jensen Boulevard 11, 8200 Aarhus, Denmark
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10
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Mauritz M, Goossens P, Jongedijk R, Vermeulen H, van Gaal B. Investigating the Efficacy and Experiences With Narrative Exposure Therapy in Severe Mentally Ill Patients With Comorbid Post-traumatic Stress Disorder Receiving Flexible Assertive Community Treatment: A Mixed Methods Study. Front Psychiatry 2022; 13:804491. [PMID: 35573345 PMCID: PMC9095974 DOI: 10.3389/fpsyt.2022.804491] [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: 10/29/2021] [Accepted: 03/08/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patients with severe mental illness with repeated interpersonal trauma and post-traumatic stress disorder (PTSD) have a negative illness progression. Traumas are often not treated because of their vulnerability. Narrative exposure therapy (NET) is an effective trauma therapy. It is unknown whether NET is effective and tolerable in these patients receiving community mental healthcare. OBJECTIVES The objectives of this study are (1) to gain insights into patients' experiences before, during, and after NET concerning changes in PTSD, dissociative and severe mental ill symptoms, care needs (CAN), quality of life, and global functioning; (2) to identify factors that influence diagnostic changes after NET as compared to patients' experiences. These insights will help to decide whether NET should be incorporated in usual care for these patients. DESIGN A mixed methods convergent design consists of a grounded theory approach with thematic analysis followed by a merged analysis, comparing quantitative, and qualitative data for each participant and by means of a joint matrix. PARTICIPANTS Adult psychiatric outpatients (age, 21-65) with post-traumatic stress disorder (PTSD) related to repeated interpersonal trauma were indicted for the study. METHODS Baseline demographics and clinical characteristics were assessed. Qualitative data were collected 3 months after NET using individual semi-structured in-depth interviews. The merged analysis compared quantitative and qualitative results for each participant. RESULTS Twenty-three outpatients (female, 82%) with a mean age of 49.9 years (SD 9.8) participated in the study. Participants experienced NET as intensive, and most of them tolerated it well. Afterward, eighteen participants perceived less symptoms. Mixed analysis showed substantial congruency between quantitative scores and participants' perceptions of PTSD, dissociative symptoms, and CAN (Cohen's kappa > 0.4). Remission of PTSD was associated with sufficient experienced support. CONCLUSION Outpatients with severe mental illness underwent intensive NET, and most of them tolerate it well. This therapy is clearly efficacious in this group. CLINICAL TRIAL REGISTRATION [www.ClinicalTrials.gov], identifier [NL5608 (NTR5714)].
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Affiliation(s)
- Maria Mauritz
- GGNet Center for Mental Health Care, Warnsveld, Netherlands.,Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, Netherlands
| | - Peter Goossens
- Dimence Group, Center for Mental Health Care, SCBS Bipolar Disorders, Deventer, Netherlands.,Department of Public Health, Faculty of Medicine and Health Sciences, University Center for Nursing and Midwifery, Ghent University, Ghent, Belgium
| | - Ruud Jongedijk
- ARQ Centrum'45, Oegstgeest, Netherlands.,ARQ National Psychotrauma Centre, Diemen, Netherlands
| | - Hester Vermeulen
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, Netherlands.,School of Health Studies, HAN University of Applied Sciences, Nijmegen, Netherlands
| | - Betsie van Gaal
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, Netherlands.,School of Health Studies, HAN University of Applied Sciences, Nijmegen, Netherlands
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11
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Wu X, Zhu Y, Wu Z, Huang J, Cao L, Wang Y, Su Y, Liu H, Fang M, Yao Z, Wang Z, Wang F, Wang Y, Peng D, Chen J, Fang Y. Identifying the Subtypes of Major Depressive Disorder Based on Somatic Symptoms: A Longitudinal Study Using Latent Profile Analysis. Front Psychiatry 2022; 13:759334. [PMID: 35903631 PMCID: PMC9314656 DOI: 10.3389/fpsyt.2022.759334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 06/06/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Two-thirds of major depressive disorder (MDD) patients initially present with somatic symptoms, yet no study has used approaches based on somatic symptoms to subtype MDD. This study aimed to classify MDD via somatic symptoms and tracked the prognosis of each subtype. METHODS Data were obtained from the study of Algorithm Guided Treatment Strategies for Major Depressive Disorder (AGTs-MDD). We recruited 395 subjects who received monotherapy of mirtazapine or escitalopram and conducted 2-, 4-, 6-, 8-, and 12-week follow-up assessments (n = 311, 278, 251, 199, and 178, respectively). Latent profile analysis (LPA) was performed on somatic symptom items of the depression and somatic symptoms scale (DSSS). Generalized linear mixed models (GLMM) were used to study the longitudinal prognosis of the subtypes classed by LPA. Primary outcome measures were the Hamilton Depression Rating Scale (HAMD), HAMD score reduction rate, as well as somatic and depressive items of DSSS. RESULTS Three subtypes of MDD were found, namely, depression with mild somatic symptoms (68.9%), depression with moderate somatic symptoms (19.2%), and depression with severe somatic symptoms (11.9%). Scores of HAMD (F = 3.175, p = 0.001), somatic (F = 23.594, p < 0.001), and depressive (F = 4.163, p < 0.001) DSSS items throughout the 12-week follow-up showed statistical difference among the three subtypes. The moderate group displayed a higher HAMD-17 score and a lower reduction rate at the 6th week, and more severe depressive symptoms both at the 4th and 6th weeks. CONCLUSION The results indicate that somatic symptoms should be emphasized in patients with MDD, and more attention is needed for those with moderate somatic symptoms, which may be relevant to a worse prognosis.
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Affiliation(s)
- Xiaohui Wu
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuncheng Zhu
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhiguo Wu
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jia Huang
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lan Cao
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yun Wang
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yousong Su
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hongmei Liu
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Zhijian Yao
- Nanjing Medical University Affiliated Brain Hospital, Nanjing, China
| | - Zuowei Wang
- Department of Psychiatry, Hongkou District Mental Health Center of Shanghai, Shanghai, China
| | - Fan Wang
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yong Wang
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Daihui Peng
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Chen
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yiru Fang
- Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai, China.,Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
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12
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Boring BL, Walsh KT, Nanavaty N, Mathur VA. Shame Mediates the Relationship Between Pain Invalidation and Depression. Front Psychol 2021; 12:743584. [PMID: 34925146 PMCID: PMC8677820 DOI: 10.3389/fpsyg.2021.743584] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 11/11/2021] [Indexed: 11/13/2022] Open
Abstract
The experience of pain is subjective, yet many people have their pain invalidated or not believed. Pain invalidation is associated with poor mental health, including depression and lower well-being. Qualitative investigations of invalidating experiences identify themes of depression, but also social withdrawal, self-criticism, and lower self-worth, all of which are core components of shame. Despite this, no studies have quantitatively assessed the interrelationship between pain invalidation, shame, and depression. To explore this relationship, participants recounted the frequency of experienced pain invalidation from family, friends, and medical professionals, as well as their feelings of internalized shame and depressive symptoms. As shame has been shown to be a precursor for depression, we further explored the role of shame as a mediator between pain invalidation and depressive symptoms. All sources of pain invalidation were positively associated with shame and depressive symptoms, and shame fully mediated the relationship between each source of pain invalidation and depression. Relative to other sources, pain invalidation from family was most closely tied to shame and depression. Overall, findings indicate that one mechanism by which pain invalidation may facilitate depression is via the experience of shame. Future research may explore shame as a potential upstream precursor to depression in the context of pain. Findings provide more insight into the harmful influence of pain invalidation on mental health and highlight the impact of interpersonal treatment on the experiences of people in pain.
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Affiliation(s)
- Brandon L Boring
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States
| | - Kaitlyn T Walsh
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States
| | - Namrata Nanavaty
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States
| | - Vani A Mathur
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States.,Texas A&M Institute for Neuroscience, College Station, TX, United States
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13
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Luk JW, Bond AE, Gabrielli J, LaCroix JM, Perera KU, Lee-Tauler SY, Goldston DB, Soumoff A, Ghahramanlou-Holloway M. A latent class analysis of physical, emotional, and sexual abuse history among suicidal inpatients. J Psychiatr Res 2021; 142:9-16. [PMID: 34311282 DOI: 10.1016/j.jpsychires.2021.07.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 06/23/2021] [Accepted: 07/05/2021] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Physical, emotional, and sexual abuse are subtypes of childhood abuse that may persist into adulthood. This study applied latent class analysis to describe the pattern of co-occurrence of these three abuse subtypes during childhood and adulthood and examined latent class differences in psychosocial characteristics and three types of suicide attempt history (aborted, interrupted, and actual). METHODS Data were drawn from a high-risk sample of 115 military service members and adult beneficiaries who were psychiatrically hospitalized following a suicide-related crisis. RESULTS Three latent classes were identified: Multiple and Persistent Abuse (Class One: 29.6%), Childhood Physical and Persistent Emotional Abuse (Class Two: 27.0%), and Minimal Abuse (Class Three: 43.5%). Females were more likely than males to report a history of Multiple and Persistent Abuse. After controlling for gender, the Multiple and Persistent Abuse Class had higher scores of depressive symptoms and hazardous drinking, poorer sleep quality, and increased social stress than the Minimal Abuse Class. Moreover, the Multiple and Persistent Abuse Class was associated with increased likelihood of lifetime interrupted suicide attempt (Odds Ratio [OR] = 3.81, 95% CI = 1.20, 12.07) and actual suicide attempt (OR = 3.65, 95% CI = 1.23, 10.85), and had the greatest number of total actual suicide attempt (1.82 times on average). CONCLUSION Co-occurrence of multiple subtypes of abuse across development is associated with higher psychosocial risk and history of suicide attempt. The assessment of specific subtypes of abuse and their timing may inform case conceptualization and the management of suicide risk among psychiatric inpatients.
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Affiliation(s)
- Jeremy W Luk
- National Institute on Alcohol Abuse and Alcoholism, Office of the Clinical Director, Building 10 - CRC, Room 1-5340, Bethesda, MD, 20892, USA
| | - Allison E Bond
- The University of Southern Mississippi, Department of Psychology, 118 College Dr., Hattiesburg, MS, 39406, USA
| | - Joy Gabrielli
- University of Florida, Department of Clinical and Health Psychology, 1225 Center Dr., Rm. 3130, Gainesville, FL, 32610-0165, USA
| | - Jessica M LaCroix
- Uniformed Services University of the Health Sciences, Department of Medical and Clinical Psychology, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Kanchana U Perera
- Uniformed Services University of the Health Sciences, Department of Medical and Clinical Psychology, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Su Yeon Lee-Tauler
- Uniformed Services University of the Health Sciences, Department of Medical and Clinical Psychology, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - David B Goldston
- Duke University School of Medicine, Box 3527 Med Ctr, Durham, NC, 27710, USA
| | - Alyssa Soumoff
- Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD, 20889, USA
| | - Marjan Ghahramanlou-Holloway
- Uniformed Services University of the Health Sciences, Department of Medical and Clinical Psychology, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
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14
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Piontek K, Wiesmann U, Apfelbacher C, Völzke H, Grabe HJ. The association of childhood maltreatment, somatization and health-related quality of life in adult age: Results from a population-based cohort study. CHILD ABUSE & NEGLECT 2021; 120:105226. [PMID: 34352685 DOI: 10.1016/j.chiabu.2021.105226] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 06/04/2021] [Accepted: 07/22/2021] [Indexed: 05/23/2023]
Abstract
BACKGROUND Population-based data regarding the relationship between childhood maltreatment (CM), somatization and health-related quality of life (HRQoL) in adults are limited. OBJECTIVE To investigate the association of CM history (emotional and physical abuse and neglect, sexual abuse) with somatization and with physical and mental HRQoL in adults. PARTICIPANTS AND SETTING Data from 2305 participants from the population-based Study of Health in Pomerania were analyzed (aged 20 to 80 years). METHODS We applied the Childhood Trauma Questionnaire. Somatoform disorders were diagnosed according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) in a clinical interview. Using a self-administered questionnaire, we assessed the number of somatic symptoms and physical and mental HRQoL. RESULTS Sexual abuse was related to the diagnosis of a somatoform disorder (odds ratio [OR] 1.87; 95% confidence interval [CI] 1.29, 2.69). Emotional abuse and physical neglect were associated with the number of somatic symptoms (B = 0.93; 95% CI 0.42, 1.45 and B = 0.50; 95% CI 0.17, 1.83, respectively). Sexual abuse and physical neglect were related to lower physical HRQoL (B = -1.87; 95% CI -3.17, -0.57 and B = -1.26; 95% CI -2.02, -0.49, respectively), and emotional abuse was associated with lower mental HRQoL (B = -2.83; 95% CI -4.03, -1.62). CONCLUSIONS A history of CM, in particular sexual abuse, emotional abuse and physical neglect, is a risk factor for somatization and impaired HRQoL in adults. Individuals with somatic symptoms are an important target group for CM screening. Addressing HRQoL might be significant in psychotherapy for individuals with CM experience.
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Affiliation(s)
- Katharina Piontek
- Institute of Social Medicine and Health Systems Research, Medical Faculty Magdeburg, Magdeburg, Germany.
| | - Ulrich Wiesmann
- Institute for Medical Psychology, University Medicine Greifswald, Greifswald, Germany
| | - Christian Apfelbacher
- Institute of Social Medicine and Health Systems Research, Medical Faculty Magdeburg, Magdeburg, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Hans Jörgen Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
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15
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Moreno-Manso JM, García-Baamonde MªE, Guerrero-Barona E, Godoy-Merino MªJ, Guerrero-Molina M, Barbosa-Torres C. Executive Processes and Emotional and Behavioural Problems in Youths Under Protective Measures. Front Psychol 2021; 12:716489. [PMID: 34489820 PMCID: PMC8417520 DOI: 10.3389/fpsyg.2021.716489] [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: 06/01/2021] [Accepted: 07/28/2021] [Indexed: 12/03/2022] Open
Abstract
This research studies the executive processes of youths under protective measures between 13 and 18years of age, as well as the emotional problems they have and the presence of behavioural problems, such as difficulties to control and direct attention, to control one’s own behaviour and inhibit inadequate or ineffective responses (hyperactivity-impulsiveness) and problems related to emotional regulation. In addition, we study the presence of significant differences according to the sex of the youths. We also analyse to what extent the difficulties in the executive processes are related to and can predict the emotional and behavioural problems. The instruments used were Stroop’s Colour and Word Test (Stroop), the Paths Test (TESen), and the System of Evaluation for Children and Adolescents (SENA). The results indicated that the youths had difficulties in such executive processes as execution, speed, and accuracy in carrying out tasks. Furthermore, they had emotion problems, amongst which the symptoms of anxiety are worthy of note; whilst attention deficit, hyperactivity-impulsiveness, and problems related to emotional regulation could also be observed. The data indicated greater difficulties in the executive processes for males than for females. There was a greater emotional symptomatology in the females, whilst there were greater deficits in attention and hyperactivity/impulsiveness in the males. Similarly, the deficits in the executive processes were related to and predicted emotional and behavioural problems. This research suggests the design of a structured programme focused on systematic training in real, daily situations, recommending the use of restorative techniques to work on the affected cognitive skills and techniques aimed at improving the youths’ emotion regulation.
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16
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The treatment of somatic symptoms in childhood abuse-related PTSD: Do we need a modular approach? J Psychiatr Res 2021; 141:223-225. [PMID: 34246977 DOI: 10.1016/j.jpsychires.2021.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/24/2021] [Accepted: 07/04/2021] [Indexed: 11/21/2022]
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17
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Troya MI, Cully G, Leahy D, Cassidy E, Sadath A, Nicholson S, Ramos Costa AP, Alberdi-Páramo Í, Jeffers A, Shiely F, Arensman E. Investigating the relationship between childhood sexual abuse, self-harm repetition and suicidal intent: mixed-methods study. BJPsych Open 2021; 7:e125. [PMID: 34236021 PMCID: PMC8281309 DOI: 10.1192/bjo.2021.962] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Research into the association between childhood sexual abuse (CSA) and self-harm repetition is limited. AIMS We aimed to examine the association between self-harm repetition, mental health conditions, suicidal intent and CSA experiences among people who frequently self-harm. METHOD A mixed-methods study was conducted including consecutive patients aged ≥18 years, with five or more self-harm presentations, in three Irish hospitals. Information was extracted from psychiatric records and patients were invited to participate in a semi-structured interview. Data was collected and analysed with a mixed-methods, convergent parallel design. In tandem, the association between CSA and self-harm repetition, suicidal intent and mental health conditions was examined with logistic regression models and independent sample t-test, with psychiatric records data. Thematic analysis was conducted with interview data, to explore CSA experiences and self-harm repetition. RESULTS Between March 2016 and July 2019, information was obtained on 188 consecutive participants, with 36 participants completing an interview. CSA was recorded in 42% of the total sample and 72.2% of those interviewed. CSA was positively associated with self-harm repetition (odds ratio 6.26, 95% CI 3.94-9.94, P = 0.00). Three themes emerged when exploring participants' CSA experiences: CSA as a precipitating factor for self-harm, secrecy of CSA accentuating shame, and loss experiences linked to CSA and self-harm. CONCLUSIONS CSA was frequently reported among people who frequently self-harm, and associated with self-harm repetition. Identification of patients at risk of repetition is key for suicide prevention. This is an at-risk group with particular characteristics that must be considered; comprehensive patient histories can help inform and tailor treatment pathways.
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Affiliation(s)
- Maria Isabela Troya
- School of Public Health, College of Medicine and Health, University College Cork, Ireland; and National Suicide Research Foundation, University College Cork, Ireland
| | - Grace Cully
- School of Public Health, College of Medicine and Health, University College Cork, Ireland; and National Suicide Research Foundation, University College Cork, Ireland
| | - Dorothy Leahy
- School of Public Health, College of Medicine and Health, University College Cork, Ireland; and National Suicide Research Foundation, University College Cork, Ireland
| | - Eugene Cassidy
- Cork University Hospital Group, Liaison Psychiatry Service, Ireland
| | - Anvar Sadath
- School of Public Health, College of Medicine and Health, University College Cork, Ireland; and National Suicide Research Foundation, University College Cork, Ireland
| | - Sarah Nicholson
- School of Public Health, College of Medicine and Health, University College Cork, Ireland; and National Suicide Research Foundation, University College Cork, Ireland
| | - Ana Paula Ramos Costa
- School of Public Health, College of Medicine and Health, University College Cork, Ireland; and National Suicide Research Foundation, University College Cork, Ireland
| | - Íñigo Alberdi-Páramo
- Instituto de Psiquiatría y Salud Mental, Hospital Clínico San Carlos, Spain; and Departamento de Medicina Legal, Psiquiatría y Patología, Universidad Complutense de Madrid, Spain
| | - Anne Jeffers
- National Clinical Programme for the Assessment and Management of Patients presenting to the Emergency Department following Self-Harm, Office of the National Clinical Advisor and Group Lead - Mental Health, Dr. Steeven's Hospital, Ireland
| | - Frances Shiely
- School of Public Health, College of Medicine and Health, University College Cork, Ireland
| | - Ella Arensman
- School of Public Health, College of Medicine and Health, University College Cork, Ireland; National Suicide Research Foundation, University College Cork, Ireland; and Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Australia
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18
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Kealy D, Rice SM, Chartier GB, Cox DW. Investigating Attachment Insecurity and Somatosensory Amplification, and the Mediating Role of Interpersonal Problems. EUROPEAN JOURNAL OF HEALTH PSYCHOLOGY 2021. [DOI: 10.1027/2512-8442/a000078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Background: Somatosensory amplification involves perceptual sensitivity to and cognitive-affective interpretation of bodily sensations and external stimuli, contributing to heightened experiences of somatic symptoms. However, little is known about somatosensory amplification in relation to vulnerabilities such as attachment insecurity. Aims: The present study investigated the link between attachment insecurity and somatosensory amplification, including the mediating role of dysfunctional interpersonal behaviors. Method: A sample of 245 adult community members completed the Somatosensory Amplification Scale, Generalized Anxiety Disorder Scale, and abbreviated versions of the Experiences in Close Relationships scale and Inventory of Interpersonal Problems. Correlational and regression analyses were used to examine relations among study variables, including a hypothesized parallel mediation model. Results: Somatosensory amplification was significantly associated with attachment anxiety, but not attachment avoidance. Regression analyses, controlling for general anxiety symptoms and gender, found that interpersonal sensitivity (but not aggression or ambivalence) mediated the link between attachment anxiety and somatosensory amplification. Limitations: Study limitations include the use of cross-sectional data and a non-clinical sample. Conclusion: The findings indicate that somatosensory amplification may be related to individuals’ attachment anxiety, through the mediating effect of interpersonal sensitivity problems.
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Affiliation(s)
- David Kealy
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Simon M. Rice
- Orygen, Parkville, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Australia
| | | | - Daniel W. Cox
- Counselling Psychology Program, University of British Columbia, Vancouver, BC, Canada
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19
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Heshmati R, Azmoodeh S, Caltabiano ML. Pathway Linking Different Types of Childhood Trauma to Somatic Symptoms in a Subclinical Sample of Female College Students: The Mediating Role of Experiential Avoidance. J Nerv Ment Dis 2021; 209:497-504. [PMID: 34170858 DOI: 10.1097/nmd.0000000000001323] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT Research has shown that women are more prone to childhood trauma and this state is associated with somatic symptoms. Also, people who have been exposed to traumatic experiences use experiential avoidance to reduce negative emotions. However, the mediating role of experiential avoidance in the relationship between childhood trauma and somatic symptoms is not clear, so, the present study investigated whether the relationships among different types of childhood trauma and somatic symptoms could be explained by experiential avoidance in female college students. In a cross-sectional study, 251 Iranian female college students with somatic symptoms were recruited from the University of Tabriz. Participants completed self-report scales, including the Persian version of Child Abuse Self-Reported Scale, Acceptance and Action Questionnaire-II (AAQ-II), and the Patient-health questionnaire (PHQ-15). A path analysis was used to empirically explore the relationships. Structural equation modeling analyses confirmed a partial mediation model. Study participants who had a higher level of emotional trauma reported higher levels of somatic symptoms. Emotional and neglect trauma showed significant positive relations with experiential avoidance. Bootstrapping results showed that experiential avoidance partially mediated the relationship between emotional trauma and somatic symptoms. Moreover, the association between neglect and somatic symptoms was fully mediated by experiential avoidance. These findings suggest that experiential avoidance might be one mechanism explaining how adverse emotional and neglect experiences influence somatic symptoms. Interventions addressing experiential avoidance through methods such as emotion-focused therapy and mindfulness are discussed as potential future directions for treating somatic symptoms in females who experienced emotional and neglect trauma.
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Affiliation(s)
- Rasoul Heshmati
- Department of Psychology, Faculty of Education and Psychology, University of Tabriz, Tabriz
| | - Shahin Azmoodeh
- Department of Psychology, Faculty of Literature and Humanities, Urmia University, Urmia, Iran
| | - Marie L Caltabiano
- College of Healthcare Sciences, Division of Tropical Health & Medicine, James Cook University, Queensland, Australia
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20
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O’Bree B, Walton CC, Bendall S, Wilson M, Valentine L, McEnery C, D’Alfonso S, Alvarez-Jimenez M, Rice S. Perceived Helpfulness of a Moderated Online Social Therapy Network for Young People Experiencing Social Anxiety. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18062796. [PMID: 33801893 PMCID: PMC7999473 DOI: 10.3390/ijerph18062796] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/05/2021] [Accepted: 03/08/2021] [Indexed: 11/16/2022]
Abstract
There is a growing need for more effective delivery of digital mental health interventions, particularly for individuals experiencing difficulty accessing or engaging with traditional face-to-face therapy. Young people with social anxiety, and young males with social anxiety in particular need interventions sensitized to their needs. While digital interventions for mental health have proliferated, increasing their accessibility and utility, the data on acceptability and effectiveness of these interventions, however, indicates a need for improvement. The current study sought to utilise qualitative data from semi-structured interviews with 70 participants (male n = 33; age range = 14-25 years, mean age = 19.8) from a single-group pilot study of a novel intervention for young people with social anxiety (Entourage), using a content analysis approach. Results indicated that participants spoke about five main categories: connection, anxiety management, appeal, disengagement and system improvement. No overt gender differences were found in the appeal or perceived helpfulness of the Entourage platform. The current study provides valuable information and suggestions to guide future improvement of digital interventions for young people, particularly those experiencing social anxiety.
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Affiliation(s)
- Bridget O’Bree
- School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, Victoria 3065, Australia;
- Orygen, Parkville, Victoria 3052, Australia; (C.C.W.); (S.B.); (M.W.); (L.V.); (C.M.); (S.D.); (M.A.-J.)
| | - Courtney C Walton
- Orygen, Parkville, Victoria 3052, Australia; (C.C.W.); (S.B.); (M.W.); (L.V.); (C.M.); (S.D.); (M.A.-J.)
- Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria 3052, Australia
| | - Sarah Bendall
- Orygen, Parkville, Victoria 3052, Australia; (C.C.W.); (S.B.); (M.W.); (L.V.); (C.M.); (S.D.); (M.A.-J.)
- Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria 3052, Australia
| | - Michael Wilson
- Orygen, Parkville, Victoria 3052, Australia; (C.C.W.); (S.B.); (M.W.); (L.V.); (C.M.); (S.D.); (M.A.-J.)
- Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria 3052, Australia
| | - Lee Valentine
- Orygen, Parkville, Victoria 3052, Australia; (C.C.W.); (S.B.); (M.W.); (L.V.); (C.M.); (S.D.); (M.A.-J.)
- Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria 3052, Australia
| | - Carla McEnery
- Orygen, Parkville, Victoria 3052, Australia; (C.C.W.); (S.B.); (M.W.); (L.V.); (C.M.); (S.D.); (M.A.-J.)
- Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria 3052, Australia
| | - Simon D’Alfonso
- Orygen, Parkville, Victoria 3052, Australia; (C.C.W.); (S.B.); (M.W.); (L.V.); (C.M.); (S.D.); (M.A.-J.)
- School of Computing and Information Systems, University of Melbourne, Parkville, Victoria 3052, Australia
| | - Mario Alvarez-Jimenez
- Orygen, Parkville, Victoria 3052, Australia; (C.C.W.); (S.B.); (M.W.); (L.V.); (C.M.); (S.D.); (M.A.-J.)
- Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria 3052, Australia
| | - Simon Rice
- Orygen, Parkville, Victoria 3052, Australia; (C.C.W.); (S.B.); (M.W.); (L.V.); (C.M.); (S.D.); (M.A.-J.)
- Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria 3052, Australia
- Correspondence: ; Tel.: +61-03-9966-9286
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21
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Fontanesi L, Marchetti D, Limoncin E, Rossi R, Nimbi FM, Mollaioli D, Sansone A, Colonnello E, Simonelli C, Di Lorenzo G, Jannini EA, Ciocca G. Hypersexuality and Trauma: a mediation and moderation model from psychopathology to problematic sexual behavior. J Affect Disord 2021; 281:631-637. [PMID: 33229025 DOI: 10.1016/j.jad.2020.11.100] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 11/09/2020] [Accepted: 11/11/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION . Hypersexuality is a clinical condition regarding the psychopathology of sexual behavior. In this study, we aimed to investigate the role of trauma, through the post-traumatic stress-disorder (PTSD), depression, shame and guilt on the hypersexual behavior. METHODS . Through an online platform, a convenience sample of 1025 subjects was recruited (females: n=731; 71.3%; males: 294; 28.7%; age: 29.62±10.90). Recruited subjects compiled a psychometric protocol composed by the Hypersexual Behavior Inventory (HBI) to assess hypersexuality, the International Trauma Questionnaire (ITQ) for PTSD, the Patient Health Questionnaire (PHQ-9) to evaluate depression and the State Shame and Guilt Scale (SSGS) for shame and guilt. Then a mediation/moderation model was performed for the data analysis. RESULTS . There was a statistically significant direct effect of post-traumatic symptoms (ITQTotal) on hypersexual behavior (HBTotal). Furthermore, indirect effects were also statistically significant, providing support to the hypothesis that depression and guilt would be serial mediators of trauma-hypersexual behavior relations. The paths through depression and guilt have been found to be the most significant with moderate and high indirect effects on hypersexuality. Moreover, male gender, as covariate variable, is a relevant risk factor for hypersexual behavior. CONCLUSION . We found the relationship between hypersexuality and trauma describing a possible etiological pathway mainly involving depression, shame and guilt. Hypersexuality can be considered as a reactive form of a major affective psychopathology representing a tip of the iceberg hiding the real issues of a suffering personality. Clinicians and researchers should therefore consider hypersexual behavior in the light of a symptomatic manifestation of a major psychopathology involving the affective aspects of personality.
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Affiliation(s)
- Lilybeth Fontanesi
- Department of Psychological, Health and Territorial Sciences, University G. D'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Daniela Marchetti
- Department of Psychological, Health and Territorial Sciences, University G. D'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Erika Limoncin
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Rodolfo Rossi
- Chair of Psychiatry Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Filippo M Nimbi
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Daniele Mollaioli
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Andrea Sansone
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Elena Colonnello
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Chiara Simonelli
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Giorgio Di Lorenzo
- Chair of Psychiatry Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Emmanuele A Jannini
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Giacomo Ciocca
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy; Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy.
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22
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Wu S, Yang T, He Y, Cui X, Luo X, Liu J. Association Between Hyperactivity Symptoms and Somatic Complaints: Mediating and Moderating Mechanisms in Childhood Trauma and Life Events Among Chinese Male Adolescents. Front Psychiatry 2021; 12:630845. [PMID: 34646169 PMCID: PMC8504436 DOI: 10.3389/fpsyt.2021.630845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 08/10/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Prior research has found that attention deficit/hyperactivity disorder (ADHD) - particularly hyperactivity symptoms - is associated with various somatic complaints. The present study further tests the relationship between hyperactivity symptoms and somatic complaints in Chinese male adolescents and explores the underlying moderating and mediating mechanisms. Methods: Our sample included 1,586 males (age = 12-16) recruited as part of an epidemiological study of child and adolescent mental disorders from April to July, 2014. Hyperactivity symptoms and somatic complaints were assessed with Achenbach's Child Behavior Checklist (CBCL), and the Childhood Trauma Questionnaire Short Form (CTQ-SF) and Adolescent Life Events Scale (ASLEC) were used to assess exposure to childhood trauma and recent life events. Results: Adolescents with hyperactivity symptoms experienced more emotional abuse, physical abuse, life events, and reported more somatic complaints symptoms (p < 0.0083 or p < 0.05). Linear regression analysis showed that hyperactivity, total childhood trauma score/emotional abuse and sexual abuse and ASLEC score significantly predicted somatic complaints (all p < 0.05). Emotional abuse and life events mediated the relationship between hyperactivity symptoms and somatic complaints. Furthermore, childhood trauma moderated the path between hyperactivity symptoms and ASLEC in the moderation mediation model for predicting somatic complaints (p < 0.05). Conclusions: Hyperactivity symptoms had a significant impact on somatic complaints among Chinese male adolescents. Furthermore, childhood trauma and life events affected the relationship between hyperactivity symptoms and somatic complaints. Interventions for somatic complaints in male adolescents with hyperactivity symptoms should thus consider history of childhood trauma and life events.
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Affiliation(s)
- Shuxian Wu
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, China National Technology Institute on Mental Disorders, Changsha, China
| | - Tingyu Yang
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, China National Technology Institute on Mental Disorders, Changsha, China
| | - Yuqiong He
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, China National Technology Institute on Mental Disorders, Changsha, China
| | - Xilong Cui
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, China National Technology Institute on Mental Disorders, Changsha, China
| | - Xuerong Luo
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, China National Technology Institute on Mental Disorders, Changsha, China
| | - Jianbo Liu
- Department of Child Psychiatry of Shenzhen Kangning Hospital, Shenzhen Mental Health Center, School of Mental Health, Shenzhen University, Shenzhen, China
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Healy CJ, Lee KA, D’Andrea W. Using Psychedelics With Therapeutic Intent Is Associated With Lower Shame and Complex Trauma Symptoms in Adults With Histories of Child Maltreatment. CHRONIC STRESS (THOUSAND OAKS, CALIF.) 2021; 5:24705470211029881. [PMID: 34291179 PMCID: PMC8278461 DOI: 10.1177/24705470211029881] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 06/16/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Child maltreatment negatively affects the formation of internal schemata of self and other during development, leading to negative adaptations in self-concept and social cognition. Clinical reports suggest the efficacy of psychedelics in treating the psychopathological sequelae of child maltreatment. Altering maladaptive schemata of self and other implicated in negative self-concept and impaired social cognition may be a central mechanism for reducing posttraumatic stress symptoms. AIMS This study aims to assess whether psychedelic use moderates the relationships between child maltreatment and self-concept, social cognition, and posttraumatic stress symptoms. METHOD An online survey was completed by 166 participants and included measures of maltreatment exposure and severity, history of intentional therapeutic psychedelic use, posttraumatic stress symptoms, internalized shame, and facial emotion recognition. RESULTS Child maltreatment significantly correlated with posttraumatic stress symptoms (r = .26 and r = .20, p < .01) and internalized shame (r = .18, p < .05). Of all maltreatment subtypes, emotional abuse and neglect most strongly correlated with complex trauma symptoms (r = .32, p < .001) and internalized shame (r = .31, p < .001). Participants with a history of intentional therapeutic psychedelic use reported significantly lower complex trauma symptoms (d = 0.33, p < .05) and internalized shame (d = 0.35, p < .05) despite similar histories of maltreatment. Differences in complex trauma symptoms (d = 0.66, p < .01) and internalized shame (d = 0.80, p < .001) were largest for participants with a history of more than 5 occasions of intentional therapeutic psychedelic use. A history of more than 5 occasions of intentional therapeutic psychedelic use significantly moderated the relationship between emotional abuse and neglect and complex trauma symptoms (p < .01). No associations were found between maltreatment or psychedelic use and facial emotion recognition. CONCLUSION These findings demonstrate that using psychedelic drugs with therapeutic intent is associated with lower levels of complex trauma symptoms and internalized shame in individuals with histories of child maltreatment. Psychedelic use may have therapeutic benefit in treating the posttraumatic sequelae of child maltreatment.
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Affiliation(s)
- C. J. Healy
- Department of Psychology, The New School for Social Research, New York, NY, USA
| | - Kellie Ann Lee
- Department of Psychology, The New School for Social Research, New York, NY, USA
| | - Wendy D’Andrea
- Department of Psychology, The New School for Social Research, New York, NY, USA
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Kealy D, Treeby MS, Rice SM, Spidel A. Shame and guilt as mediators between dispositional optimism and symptom severity among mental health outpatients. PSYCHOL HEALTH MED 2020; 27:1245-1254. [DOI: 10.1080/13548506.2020.1861313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- David Kealy
- Department of Psychiatry, The University of British Columbia, Vancouver, BC, Canada
| | - Matt S. Treeby
- School of Psychology and Public Health, LaTrobe University, Bundoora, Australia
| | - Simon M. Rice
- Orygen, Parkville, Melbourne, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Alicia Spidel
- Department of Criminology, Kwantlen Polytechnic University, Surrey, BC, Canada
- Fraser Health Authority, Surrey, BC, Canada
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25
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Drukker M, Peters JCH, Vork L, Mujagic Z, Rutten BPF, van Os J, Masclee AAM, Kruimel JW, Leue C. Network approach of mood and functional gastrointestinal symptom dynamics in relation to childhood trauma in patients with irritable bowel syndrome and comorbid panic disorder. J Psychosom Res 2020; 139:110261. [PMID: 33038815 DOI: 10.1016/j.jpsychores.2020.110261] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 09/28/2020] [Accepted: 09/28/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Irritable bowel syndrome (IBS) has a high comorbidity with mental disorders. The present paper aims to visualise the interplay between IBS and affect (anxiety and mood) in daily life. Furthermore, this interplay may be different depending on risk factors such as childhood trauma. METHODS Using momentary assessment (Experience Sampling Method), data of 24 individuals diagnosed with both IBS and panic disorder were analysed (15 non-trauma and 9 low-trauma-score patients). Networks were constructed, based on multilevel time-lagged linear regression analysis. Regression coefficients present network connections including three negative affect items (down, irritated, rushed), three positive affect items (happy, enthusiastic, cheerful), three abdominal complaints (abdominal pain, bloating, nausea) and one social item (feeling lonely). Those networks were stratified by levels of childhood trauma based on the Childhood Trauma Questionnaire. RESULTS Connections within the group of mood items and within the group of abdominal complaints were more frequent than between abdominal complaints and mood items. When data were stratified by childhood trauma, networks were different. In addition, node strengths were stronger in low-trauma than in non-trauma, although only one was significantly different (enthusiastic). Overall, there were mainly non-significant connections and a clear pattern was not visible. CONCLUSIONS A time-lagged network provides additional insight in connections between abdominal complaints and affective complaints, in patients with IBS and panic disorder, with different levels of childhood trauma. More research is needed to gain a better understanding of symptom formation and the impact of variation in context on individual symptom experiences in IBS with affective comorbidity. Baseline data of a clinical trial: NCT01551225 (http://www.clinicaltrials.gov).
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Affiliation(s)
- Marjan Drukker
- Department of Psychiatry and Neuropsychology, School of Mental Health and NeuroScience (MHeNS), Maastricht University Medical Centre, Maastricht, the Netherlands.
| | - Jill C H Peters
- Department of Psychiatry and Neuropsychology, School of Mental Health and NeuroScience (MHeNS), Maastricht University Medical Centre, Maastricht, the Netherlands.
| | - Lisa Vork
- Division of Gastroenterology-Hepatology, Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands.
| | - Zlatan Mujagic
- Division of Gastroenterology-Hepatology, Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands.
| | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, School of Mental Health and NeuroScience (MHeNS), Maastricht University Medical Centre, Maastricht, the Netherlands.
| | - Jim van Os
- Department of Psychiatry and Neuropsychology, School of Mental Health and NeuroScience (MHeNS), Maastricht University Medical Centre, Maastricht, the Netherlands; Department of Psychiatry, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, the Netherlands; Department of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College London, London, UK
| | - Ad A M Masclee
- Division of Gastroenterology-Hepatology, Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands.
| | - Joanna W Kruimel
- Division of Gastroenterology-Hepatology, Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands.
| | - Carsten Leue
- Department of Psychiatry and Neuropsychology, School of Mental Health and NeuroScience (MHeNS), Maastricht University Medical Centre, Maastricht, the Netherlands.
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The relations between childhood maltreatment, shame, guilt, depression and suicidal ideation in inpatient adolescents. J Affect Disord 2020; 276:667-677. [PMID: 32871699 DOI: 10.1016/j.jad.2020.07.056] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 05/18/2020] [Accepted: 07/05/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Previous studies demonstrated positive relations between various forms of maltreatment and suicidal ideation in youth; however, mechanisms underlying these relationships are not well understood. We propose that the experience of maltreatment in childhood may lead to high levels of generalized guilt and shame, resulting in an increase of depressive symptoms and suicidal thoughts in adolescents. The aim of the current study was to test our model of relations between these constructs using path analysis. METHODS 112 inpatient adolescents aged 12-17 years completed the Childhood Trauma Questionnaire to measure various types of maltreatment, the Personal Feelings Questionnaire to evaluate generalized guilt and shame, the Beck Depression Inventory-II to assess depressive symptoms, and the Columbia-Suicide Severity Rating Scale to assess suicidal ideation. RESULTS Findings partly confirmed the theoretical model. Indirect positive effects of sexual and emotional abuse, as well as emotional and physical neglect on suicidal ideation via generalized self-conscious emotion and/or depression were demonstrated. In contrast to our predictions, indirect negative effects of physical abuse on suicidal thoughts via generalized guilt and shame and depression were found. LIMITATIONS Sample characterized by predominately Caucasian inpatient adolescents from financially stable and well-educated environments, over-reliance on self-report measures and the lack of a longitudinal design were main limitations of the study. CONCLUSIONS The study provides novel information on the potential mechanisms underlying the association between childhood maltreatment and suicidal ideation in adolescents. Generalized guilt and/or shame could be possible targets for interventions for victims of some forms of maltreatment to reduce depressive symptoms and suicidal ideation.
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Dunlop BW, Still S, LoParo D, Aponte-Rivera V, Johnson BN, Schneider RL, Nemeroff CB, Mayberg HS, Craighead WE. Somatic symptoms in treatment-naïve Hispanic and non-Hispanic patients with major depression. Depress Anxiety 2020; 37:156-165. [PMID: 31830355 DOI: 10.1002/da.22984] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 10/29/2019] [Accepted: 11/28/2019] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Somatic complaints are a major driver of health care costs among patients with major depressive disorder (MDD). Some epidemiologic and clinical data suggest that Hispanic and non-Hispanic Black patients with MDD endorse higher levels of somatic symptoms than non-Hispanic White patients. METHODS Somatic symptoms in 102 Hispanic, 61 non-Hispanic Black, and 156 non-Hispanic White patients with treatment-naïve MDD were evaluated using the somatic symptom subscale of the Hamilton anxiety rating scale (HAM-A). The other seven items of the HAM-A comprise the psychic anxiety subscale, which was also evaluated across ethnicities. RESULTS Hispanic patients reported significantly greater levels of somatic symptoms than non-Hispanic patients, but levels of psychic anxiety symptoms did not differ by ethnicity. Levels of somatic symptoms did not significantly differ between Black and White non-Hispanic patients. Within the Hispanic sample, somatic symptom levels were higher only among those who were evaluated in Spanish; Hispanics who spoke English showed no significant differences versus non-Hispanics. CONCLUSIONS In this medically healthy sample of patients with MDD, monolingual Spanish-speaking Hispanic patients endorsed high levels of somatic symptoms. Clinicians should be mindful that the depressive experience may manifest somatically and be judicious in determining when additional medical work-up is warranted for somatic complaints.
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Affiliation(s)
- Boadie W Dunlop
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Sarah Still
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Devon LoParo
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Vivianne Aponte-Rivera
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Benjamin N Johnson
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Rebecca L Schneider
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Charles B Nemeroff
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Helen S Mayberg
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - W Edward Craighead
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
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28
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Makriyianis HM, Adams EA, Lozano LL, Mooney TA, Morton C, Liss M. Psychological inflexibility mediates the relationship between adverse childhood experiences and mental health outcomes. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2019. [DOI: 10.1016/j.jcbs.2019.09.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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29
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Pennou A, Lecomte T, Potvin S, Khazaal Y. Mobile Intervention for Individuals With Psychosis, Dual Disorders, and Their Common Comorbidities: A Literature Review. Front Psychiatry 2019; 10:302. [PMID: 31130884 PMCID: PMC6510170 DOI: 10.3389/fpsyt.2019.00302] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 04/17/2019] [Indexed: 12/24/2022] Open
Abstract
Over 50% of people diagnosed with a severe mental illness, such as schizophrenia or bipolar disorder, will meet criteria for a substance use disorder in their lifetime. This dual disorder often starts during youth and leads to significant societal costs, including lower employability rates, more hospitalizations, and higher risk of homelessness and of suicide attempts when compared to those with a serious mental illness without substance misuse. Moreover, many individuals presenting with comorbid disorders also present with other psychological difficulties as well, such as personality disorders or anxiety and depression, also known as complex comorbid disorders. Transdiagnostic treatments that focus on core difficulties found in people with complex dual disorders, such as emotional regulation, are direly needed. Emotional regulation skills can help reduce distress related to psychotic symptoms and maintain abstinence in substance use disorders. New technologies in the field of communications have developed considerably over the past decade and have the potential to improve access to such treatments, a major problem in many health care settings. As such, this paper aims at: presenting core difficulties present in many individuals with dual disorders, reviewing the scientific literature pertaining to the use of mobile applications in mental health and addictions, and presenting the development and potential of a new application for emotional regulation for people with dual disorders.
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Affiliation(s)
- Antoine Pennou
- Schizophrenia and Psychoses Study Laboratory for Intervention and Recovery, Department of Psychology, University of Montreal, Montreal, QC, Canada
- Research Center of the Montreal Mental Health University Institute, Intervention Axis and Services & Neurobiology and Cognition, Mental Health University Institute of Montreal, Montreal, QC, Canada
| | - Tania Lecomte
- Schizophrenia and Psychoses Study Laboratory for Intervention and Recovery, Department of Psychology, University of Montreal, Montreal, QC, Canada
- Research Center of the Montreal Mental Health University Institute, Intervention Axis and Services & Neurobiology and Cognition, Mental Health University Institute of Montreal, Montreal, QC, Canada
| | - Stéphane Potvin
- Research Center of the Montreal Mental Health University Institute, Intervention Axis and Services & Neurobiology and Cognition, Mental Health University Institute of Montreal, Montreal, QC, Canada
| | - Yasser Khazaal
- Research Center of the Montreal Mental Health University Institute, Intervention Axis and Services & Neurobiology and Cognition, Mental Health University Institute of Montreal, Montreal, QC, Canada
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
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