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Reichl C, Schär S, Lerch S, Hedinger N, Brunner R, Koenig J, Kaess M. Two-year course of non-suicidal self-injury in an adolescent clinical cohort: The role of childhood adversity in interaction with cortisol secretion. Psychoneuroendocrinology 2024; 167:107093. [PMID: 38889567 DOI: 10.1016/j.psyneuen.2024.107093] [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: 01/27/2024] [Revised: 04/28/2024] [Accepted: 06/05/2024] [Indexed: 06/20/2024]
Abstract
AIM Non-suicidal self-injury (NSSI) is a highly prevalent phenomenon during adolescence. Nonetheless, research on predictors of the clinical course of NSSI over time is still scarce. The present study aimed at investigating the impact of adverse childhood experiences (ACE) and hypothalamus-pituitary-adrenal (HPA) axis functioning on the longitudinal course of NSSI. METHODS In a sample of n = 51 help-seeking adolescents engaging in NSSI, diurnal cortisol secretion (CAR, cortisol awakening response; DSL, diurnal slope), hair cortisol concentrations and ACE were assessed at baseline. Clinical outcome was defined by change in the frequency of NSSI in the past 6 months measured 12 and 24 months after the baseline assessments. Mixed-effects linear regression models were used to test for effects of ACE and HPA axis functioning on the course of NSSI. RESULTS ACE and HPA axis functioning did not show main but interaction effects in the prediction of NSSI frequency over time: Adolescents with a low severity of ACE and either an increased CAR or a flattened DSL showed a steep decline of NSSI frequency in the first year followed by a subsequent increase of NSSI frequency in the second year. CONCLUSIONS Our findings could be interpreted in the sense of high diurnal cortisol concentrations in the absence of ACE being favorable for clinical improvement on the short-term but bearing a risk of allostatic load and subsequent increase of NSSI frequency. In contrast, adolescents with severe ACE may benefit from elevated cortisol concentrations leading to slower but lasting decreases of NSSI frequency.
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Affiliation(s)
- Corinna Reichl
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Selina Schär
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Stefan Lerch
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Nicole Hedinger
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Romuald Brunner
- Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Germany
| | - Julian Koenig
- Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Cologne, Germany
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland; Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Germany.
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Lyons-Ruth K, Chasson M, Khoury J, Ahtam B. Reconsidering the nature of threat in infancy: Integrating animal and human studies on neurobiological effects of infant stress. Neurosci Biobehav Rev 2024; 163:105746. [PMID: 38838878 DOI: 10.1016/j.neubiorev.2024.105746] [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: 03/14/2024] [Revised: 05/25/2024] [Accepted: 06/01/2024] [Indexed: 06/07/2024]
Abstract
Early life stress has been associated with elevated risk for later psychopathology. One mechanism that may contribute to such long-term risk is alterations in amygdala development, a brain region critical to stress responsivity. Yet effects of stress on the amygdala during human infancy, a period of particularly rapid brain development, remain largely unstudied. In order to model how early stressors may affect infant amygdala development, several discrepancies across the existing literatures on early life stress among rodents and early threat versus deprivation among older human children and adults need to be reconciled. We briefly review the key findings of each of these literatures. We then consider them in light of emerging findings from studies of human infants regarding relations among maternal caregiving, infant cortisol response, and infant amygdala volume. Finally, we advance a developmental salience model of how early threat may impact the rapidly developing infant brain, a model with the potential to integrate across these divergent literatures. Future work to assess the value of this model is also proposed.
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Affiliation(s)
- Karlen Lyons-Ruth
- Department of Psychiatry, Cambridge Hospital, Harvard Medical School, 1493 Cambridge St, Cambridge, MA 02468, USA.
| | - Miriam Chasson
- Department of Psychiatry, Cambridge Hospital, Harvard Medical School, 1493 Cambridge St, Cambridge, MA 02468, USA.
| | - Jennifer Khoury
- Department of Psychiatry, Cambridge Hospital, Harvard Medical School, 1493 Cambridge St, Cambridge, MA 02468, USA.
| | - Banu Ahtam
- Fetal-Neonatal Neuroimaging & Developmental Science Center, Division of Newborn Medicine, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, USA.
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3
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Hall H, Papp V, Fitzgerald M. Childhood sexual abuse and IL6 mediated by change in BMI over an 18-year period: A growth curve model. CHILD ABUSE & NEGLECT 2024; 154:106914. [PMID: 38986306 DOI: 10.1016/j.chiabu.2024.106914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 06/10/2024] [Accepted: 06/17/2024] [Indexed: 07/12/2024]
Abstract
BACKGROUND Childhood sexual abuse can increase both body weight and inflammation later in life. Higher weight or faster changes in weight, as measured by changes in body mass index (BMI), may mediate the relationship between childhood sexual abuse and inflammation, however, most studies to date have used a cross-sectional design limiting causal inferences. OBJECTIVE The current study aimed to investigate the interrelationships between childhood sexual abuse, BMI, and C-reactive protein (CRP) and interleukin-6 (IL6). PARTICIPANTS AND SETTING Data from 461 adults who participated in the Midlife in the United States (MIDUS) study were utilized. METHODS Growth curve modeling was used to test initial levels of BMI and changes of BMI over an 18-year period as mediators linking childhood sexual abuse to CRP and IL6. RESULTS Sexual abuse was not significantly associated with the initial level of BMI; however, sexual abuse was associated with the slope of BMI (b = 0.072, p = .006). BMI intercept (b = 0.080, p = .001) and slope (b = 0.240, p = .002) predicted IL6 values whereas the slope of BMI (b = 0.398, p = .033) but not intercept predicted CRP values. The indirect effect from sexual abuse to IL6 through BMI slope was significant (b = 0.017, 95 % [CI.001, 0.033]) while the indirect effect from sexual abuse to CRP through BMI slope was not significant (b = 0.028, 95 % [CI -0.004, 0.061]). CONCLUSION Childhood sexual abuse was indirectly associated with IL6 through rates of change in BMI over time.
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Affiliation(s)
- Haley Hall
- Oklahoma State University, 230 Nancy Randolph Davis Building, Stillwater, OK, 74074, United States of America.
| | - Viktoria Papp
- Oklahoma State University, 230 Nancy Randolph Davis Building, Stillwater, OK, 74074, United States of America.
| | - Michael Fitzgerald
- Oklahoma State University, 230 Nancy Randolph Davis Building, Stillwater, OK, 74074, United States of America.
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4
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Rossi E, Cassioli E, Dani C, Marchesoni G, Monteleone AM, Wonderlich SA, Ricca V, Castellini G. The maltreated eco-phenotype of eating disorders: A new diagnostic specifier? A systematic review of the evidence and comprehensive description. Neurosci Biobehav Rev 2024; 160:105619. [PMID: 38462152 DOI: 10.1016/j.neubiorev.2024.105619] [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: 12/17/2023] [Revised: 03/01/2024] [Accepted: 03/06/2024] [Indexed: 03/12/2024]
Abstract
This systematic review aimed to summarize the evidence on the existence of a distinct phenotypic expression of Eating Disorders (EDs) associated with childhood maltreatment (CM), the so-called maltreated eco-phenotype of EDs. PRISMA standards were followed. Articles providing data about the characteristics of individuals with an ED reporting CM were included. Relevant results were extracted and summarized. A quality assessment was performed. A total of 1207 records were identified and screened, and 97 articles published between 1994 and 2023 were included. Findings revealed distinct biological and clinical features in patients with EDs reporting CM, including neuroanatomical changes, altered stress responses, ghrelin levels, inflammation markers, and gut microbiota composition. Clinically, CM correlated with severer eating behaviors, higher psychiatric comorbidity, impulsivity, emotional dysregulation, and risky behaviors. Additionally, CM was associated with poorer treatment outcomes, especially in general psychopathology and psychiatric comorbidities. This review highlighted the need to move towards an etiologically informed nosography, recognizing CM not merely as a risk factor, but also as an etiologic agent shaping different eco-phenotypic variants of EDs.
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Affiliation(s)
- Eleonora Rossi
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Emanuele Cassioli
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Cristiano Dani
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Giorgia Marchesoni
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | | | | | - Valdo Ricca
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Giovanni Castellini
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy.
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Vaillancourt-Morel MP, Bussières ÈL, Nolin MC, Daspe MÈ. Partner Effects of Childhood Maltreatment: A Systematic Review and Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2024; 25:1150-1167. [PMID: 37209135 PMCID: PMC10913306 DOI: 10.1177/15248380231173427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Although several studies have shown that childhood maltreatment (CM) is associated with a host of negative consequences including romantic relationship difficulties for victims in adulthood, most overlooked the potential effects on the romantic partner. This systematic review and meta-analysis aims to comprehensively synthesize the literature on the association between a person's CM and their partner's individual and couple outcomes. We searched PubMed, PsycNET, Medline, CINAHL, and Eric using search strings related to CM and partner. We identified 3,238 articles after removal of duplicates; 28 studies met the inclusion criteria and relied on independent sample. The studies reported associations between a person's CM and a wide breadth of partner's negative couple outcomes (e.g., communication, sexuality) as well as intra-individual psychological difficulties (e.g., psychological distress, emotion, and stress reactivity). Meta-analytic results showed significant, but trivial to small associations between a person's CM and their partner's lower relationship satisfaction (r = -.09, 95% CI [-.14, -.04]), higher intimate partner violence (r = .08, [.05, .12]), and higher psychological distress (r = .11, [.06, .16]). These associations were similar for women and men and did not differ as a function of sample's mean age, proportion of cultural diversity, and publication year. These findings suggest that a person's CM is related to their partner's outcomes including to the partner's intra-individual outcomes. Prevention and intervention strategies should acknowledge that a person's CM may also affect their romantic partner, considering the couple as a reciprocal system, and offer victims' romantic partners specific services.
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Amedick G, Krylova M, Mayer K, Izyurov I, Herrmann L, Martens L, Kasties V, Heller J, Li M, van der Meer J, Croy I, Engert V, Walter M, Colic L. Association among childhood adversity and susceptibility to interference during varying salience: two studies in healthy males. Sci Rep 2024; 14:7050. [PMID: 38528096 DOI: 10.1038/s41598-024-57025-x] [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: 06/06/2023] [Accepted: 03/12/2024] [Indexed: 03/27/2024] Open
Abstract
Childhood adversity, a prevalent experience, is related to a higher risk for externalizing and internalizing psychopathology. Alterations in the development of cognitive processes, for example in the attention-interference domain may link childhood adversity and psychopathology. Interfering stimuli can vary in their salience, i.e. ability to capture attentional focus, and valence. However, it is not known if interference by salience or valence is associated with self-reported adversity. In two independent study samples of healthy men (Study 1: n = 44; mean age [standard deviation (SD)] = 25.9 [3.4] years; Study 2: n = 37; 43.5 [9.7] years) we used the attention modulation task (AMT) that probed interference by two attention-modulating conditions, salience and valence separately across repeated target stimuli. The AMT measures the effects of visual distractors (pictures) on the performance of auditory discrimination tasks (target stimuli). We hypothesized that participants reporting higher levels of childhood adversity, measured with the childhood trauma questionnaire, would show sustained interference in trials with lower salience. Due to conflicting reports on the valence-modulation, we tested the valence condition in an exploratory manner. Linear mixed models revealed an interaction between reported childhood adversity and the salience condition across tone presentations in both study samples (Sample 1: p = .03; Sample 2: p = .04), while there were no effects for the valence condition across both studies. Our study suggests that higher self-reported childhood adversity is related to faster processing of target cues during high salience, but slower during low salience conditions. These results hint to the mechanisms linking childhood adversity and psychopathological symptoms in the attentional domain.
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Affiliation(s)
- Greta Amedick
- Department of Psychiatry and Psychotherapy, University Tübingen, Tübingen, Germany
| | - Marina Krylova
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Philosophenweg 3, 07743, Jena, Germany
- Department of Radiology, Institute of Diagnostic and Interventional Radiology, Jena University Hospital, Jena, Germany
| | - Kathrin Mayer
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Philosophenweg 3, 07743, Jena, Germany
| | - Igor Izyurov
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Philosophenweg 3, 07743, Jena, Germany
| | - Luisa Herrmann
- Department of Psychiatry and Psychotherapy, University Tübingen, Tübingen, Germany
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Philosophenweg 3, 07743, Jena, Germany
| | - Louise Martens
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany
| | - Vanessa Kasties
- Department of Psychiatry and Psychotherapy, University Tübingen, Tübingen, Germany
| | - Johanna Heller
- Department of Psychiatry and Psychotherapy, University Tübingen, Tübingen, Germany
- Institute of Clinical Psychology, Center for Mental Health, Hospital Stuttgart, Stuttgart, Germany
| | - Meng Li
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Philosophenweg 3, 07743, Jena, Germany
| | - Johan van der Meer
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
- Amsterdam UMC, Department of Radiology and Nuclear Medicine, Amsterdam, The Netherlands
| | - Ilona Croy
- Institute for Psychology, Friedrich Schiller University, Jena, Germany
- German Center for Mental Health, partner site Halle-Jena-Magdeburg, Jena, Germany
| | - Veronika Engert
- German Center for Mental Health, partner site Halle-Jena-Magdeburg, Jena, Germany
- Institute of Psychosocial Medicine, Psychotherapy and Psychooncology, Jena University Hospital, Jena, Germany
| | - Martin Walter
- Department of Psychiatry and Psychotherapy, University Tübingen, Tübingen, Germany
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Philosophenweg 3, 07743, Jena, Germany
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany
- German Center for Mental Health, partner site Halle-Jena-Magdeburg, Jena, Germany
- Leibniz Institute for Neurobiology, Magdeburg, Germany
- Center for Behavioral Brain Sciences, Magdeburg, Germany
| | - Lejla Colic
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Philosophenweg 3, 07743, Jena, Germany.
- German Center for Mental Health, partner site Halle-Jena-Magdeburg, Jena, Germany.
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Bérubé A, Pearson J, Blais C, Forget H. Stress and emotion recognition predict the relationship between a history of maltreatment and sensitive parenting behaviors: A moderated-moderation. Dev Psychopathol 2024:1-11. [PMID: 38173233 DOI: 10.1017/s095457942300158x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Our study proposes to examine how stress and emotion recognition interact with a history of maltreatment to influence sensitive parenting behaviors. A sample of 58 mothers and their children aged between 2 and 5 years old were recruited. Parents' history of maltreatment was measured using the Child Trauma Questionnaire. An emotion recognition task was performed. Mothers identified the dominant emotion in morphed facial emotion expressions in children. Mothers and children interacted for 15 minutes. Salivary cortisol levels of mothers were collected before and after the interaction. Maternal sensitive behaviors were coded during the interaction using the Coding Interactive Behavior scheme. Results indicate that the severity of childhood maltreatment is related to less sensitive behaviors for mothers with average to good abilities in emotion recognition and lower to average increases in cortisol levels following an interaction with their children. For mothers with higher cortisol levels, there is no association between a history of maltreatment and sensitive behaviors, indicating that higher stress reactivity could act as a protective factor. Our study highlights the complex interaction between individual characteristics and environmental factors when it comes to parenting. These results argue for targeted interventions that address personal trauma.
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Affiliation(s)
- Annie Bérubé
- Université du Québec en Outaouais, Gatineau, QC, Canada
- Centre de recherche universitaire pour les jeunes enfants et leur famille, Trois-Rivieres, QC, Canada
| | - Jessica Pearson
- Centre de recherche universitaire pour les jeunes enfants et leur famille, Trois-Rivieres, QC, Canada
- Université du Québec à Trois-Rivières, Trois-Rivieres, QC, Canada
| | | | - Hélène Forget
- Université du Québec en Outaouais, Gatineau, QC, Canada
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Igboanugo S, O'Connor C, Zitoun OA, Ramezan R, Mielke JG. A systematic review of hair cortisol in healthy adults measured using immunoassays: Methodological considerations and proposed reference values for research. Psychophysiology 2024; 61:e14474. [PMID: 37950380 DOI: 10.1111/psyp.14474] [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: 07/28/2022] [Revised: 10/11/2023] [Accepted: 10/11/2023] [Indexed: 11/12/2023]
Abstract
Hair cortisol concentration (HCC) has shown remarkable promise as a stable, non-invasive measure of systemic cortisol; however, despite methodological advances, the value that would typically be seen in healthy adults has not been established. Therefore, we sought to review the relevant literature to determine a reference value for HCC in healthy (i.e., non-clinical) adults. To this end, we conducted a systematic review of the PubMed, Scopus, and CINAHL databases for studies that measured healthy adult HCC using immunoassay methods, given that these are the most widely accessible analytical tools. To be eligible, studies were required to have been published in English, to have provided relevant descriptive statistics (i.e., means and standard deviations), and to have used a healthy adult human sample. We found 17 studies that met our inclusion criteria; the reports involved 1348 participants with a mean age of about 38 years. Since we identified a large amount of between-study heterogeneity, we completed a random-effect meta-regression analysis and found that test kit vendor was the only significant variable of the model. As a result, when using methodologies from traditional finite mixture distributions to determine reference values for mean and elevated HCC in individual healthy adults, we calculated these estimates for each of the major test kit vendors. Future work will need to determine whether our estimated reference values need to be modified, and these efforts will be greatly assisted by studies that account for potential moderating factors, such as age, sex, and ethnicity.
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Affiliation(s)
- Somkene Igboanugo
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Claire O'Connor
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Osama A Zitoun
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Reza Ramezan
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada
| | - John G Mielke
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
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9
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Schindler-Gmelch L, Capito K, Steudte-Schmiedgen S, Kirschbaum C, Berking M. Hair Cortisol Research in Posttraumatic Stress Disorder - 10 Years of Insights and Open Questions. A Systematic Review. Curr Neuropharmacol 2024; 22:1697-1719. [PMID: 37550910 DOI: 10.2174/1570159x21666230807112425] [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: 10/27/2022] [Revised: 01/05/2023] [Accepted: 01/13/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Cortisol is one of the most extensively studied biomarkers in the context of trauma/posttraumatic stress disorder (PTSD). For more than a decade, hair cortisol concentrations (HCC) have been measured in this context, leading to a two-staged dysregulation model. Specifically, an elevated secretion during/immediately after trauma exposure eventually reverts to hyposecretion with increasing time since trauma exposure has been postulated. OBJECTIVE The aim of our systematic review was to re-evaluate the two-staged secretion model with regard to the accumulated diagnostic, prognostic, and intervention-related evidence of HCC in lifetime trauma exposure and PTSD. Further, we provide an overview of open questions, particularly with respect to reporting standards and quality criteria. METHOD A systematic literature search yielded 5,046 records, of which 31 studies were included. RESULTS For recent/ongoing (traumatic) stress, the predictions of cortisol hypersecretion could be largely confirmed. However, for the assumed hyposecretion temporally more distal to trauma exposure, the results are more ambiguous. As most studies did not report holistic overviews of trauma history and confounding influences, this may largely be attributable to methodological limitations. Data on the prognostic and intervention-related benefits of HCC remain sparse. CONCLUSION Over the last decade, important insights could be gained about long-term cortisol secretion patterns following lifetime trauma exposure and PTSD. This systematic review integrates these insights into an updated secretion model for trauma/PTSD. We conclude with recommendations for improving HCC research in the context of trauma/PTSD in order to answer the remaining open questions.
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Affiliation(s)
- Lena Schindler-Gmelch
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Klara Capito
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Susann Steudte-Schmiedgen
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | | | - Matthias Berking
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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10
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Wiglesworth A, Butts J, Carosella KA, Mirza S, Papke V, Bendezú JJ, Klimes-Dougan B, Cullen KR. Stress system concordance as a predictor of longitudinal patterns of resilience in adolescence. Dev Psychopathol 2023; 35:2384-2401. [PMID: 37434505 PMCID: PMC10784418 DOI: 10.1017/s0954579423000731] [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] [Indexed: 07/13/2023]
Abstract
Resilience promotes positive adaptation to challenges and may facilitate recovery for adolescents experiencing psychopathology. This work examined concordance across the experience, expression, and physiological response to stress as a protective factor that may predict longitudinal patterns of psychopathology and well-being that mark resilience. Adolescents aged 14-17 at recruitment (oversampled for histories of non-suicidal self-injury; NSSI) were part of a three-wave (T1, T2, T3) longitudinal study. Multi-trajectory modeling produced four distinct profiles of stress experience, expression, and physiology at T1 (High-High-High, Low-Low-Low, High-Low-Moderate, and High-High-Low, respectively). Linear mixed-effect regressions modeled whether the profiles predicted depressive symptoms, suicide ideation, NSSI engagement, positive affect, satisfaction with life, and self-worth over time. Broadly, concordant stress response profiles (Low-Low-Low, High-High-High) were associated with resilient-like patterns of psychopathology and well-being over time. Adolescents with a concordant High-High-High stress response profile showed a trend of greater reduction in depressive symptoms (B = 0.71, p = 0.052), as well as increased global self-worth (B = -0.88, p = 0.055), from T2 to T3 compared to the discordant High-High-Low profile. Concordance across multi-level stress responses may be protective and promote future resilience, whereas blunted physiological responses in the presence of high perceived and expressed stress may indicate poorer outcomes over time.
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Affiliation(s)
| | - Jessica Butts
- Public Health, Division of Biostatistics, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | | | - Salahudeen Mirza
- Psychology, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Victoria Papke
- Psychology, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | | | | | - Kathryn R Cullen
- Psychiatry and Behavioral Sciences, University of Minnesota Twin Cities, Minneapolis, MN, USA
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11
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Llorens M, Barba M, Torralbas-Ortega J, Nadal R, Armario A, Gagliano H, Urraca L, Pujol S, Montalvo I, Gracia R, Polo D, González-Riesco L, Matalí JL, Palao D, Pàmias M, Labad J. Relationship between hair cortisol concentrations and cognitive functioning in adolescents with ADHD. Eur J Psychotraumatol 2023; 14:2281752. [PMID: 38154075 PMCID: PMC10990442 DOI: 10.1080/20008066.2023.2281752] [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: 05/22/2023] [Accepted: 10/03/2023] [Indexed: 12/30/2023] Open
Abstract
Background: Our study aimed to explore whether the hair cortisol concentration (HCC), a measure of long-term cortisol output, is associated with poorer cognitive functioning in adolescents with attention deficit and hyperactivity disorder (ADHD). We further aimed to test the potential moderating effects of sex and childhood maltreatment.Methods: In this cross-sectional study, fifty-three adolescents with ADHD were studied. The ADHD Rating Scale (ADHD-RS) and Childhood Trauma Questionnaire (CTQ) were administered. Seven cognitive tasks from the Cambridge Neuropsychological Test Automated Battery (CANTAB) were administered, and two cognitive factors (attention and memory and executive functioning) were identified by confirmatory factor analysis. A 3-cm hair sample from the posterior vertex region of the head was obtained. HCCs were determined by a high-sensitivity enzyme immunoassay kit. Multiple linear regression analyses were used to explore the association between HCCs and either cognitive performance or ADHD severity while adjusting for sex, childhood maltreatment and the ADHD-RS total score.Results: Sex moderated the relationship between HCCs and attention/memory confirmatory factor analysis (CFA) scores, with better performance in boys with higher HCCs. HCCs were not associated with executive functioning or ADHD symptoms. Childhood maltreatment was associated with inattention symptoms in adolescents with ADHD.Conclusions: Our study suggests that HCCs are positively associated with attention and memory performance in adolescents with ADHD, with a moderating effect of sex (the relationship is strongest in boys).
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Affiliation(s)
- Marta Llorens
- Department of Child and Adolescent Mental Health, Hospital Sant Joan de Déu, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Maria Barba
- Department of Mental Health, Parc Taulí Hospital Universitari, Sabadell, Spain
| | - Jordi Torralbas-Ortega
- Nursing Care Research Group, Sant Pau Biomedical Research Institute (IIB SANTPAU). Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Roser Nadal
- Institut de Neurociències, Translational Neuroscience Research Unit I3PT-INc-UAB, Sabadell, Spain
- Psicobiology Unit, Faculty of Psychology, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Antonio Armario
- Institut de Neurociències, Translational Neuroscience Research Unit I3PT-INc-UAB, Sabadell, Spain
- Psicobiology Unit, Faculty of Psychology, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Animal Physiology Unit (Department of Cellular Biology, Physiology and Immunology), Faculty of Biosciences, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Humberto Gagliano
- Animal Physiology Unit (Department of Cellular Biology, Physiology and Immunology), Faculty of Biosciences, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Lara Urraca
- Department of Mental Health, Parc Taulí Hospital Universitari, Sabadell, Spain
| | - Susana Pujol
- Department of Mental Health, Parc Taulí Hospital Universitari, Sabadell, Spain
| | - Itziar Montalvo
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Department of Mental Health, Parc Taulí Hospital Universitari, Sabadell, Spain
- Institut de Neurociències, Translational Neuroscience Research Unit I3PT-INc-UAB, Sabadell, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d’Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain
| | - Rebeca Gracia
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Department of Mental Health, Parc Taulí Hospital Universitari, Sabadell, Spain
| | - Diana Polo
- Department of Child and Adolescent Mental Health, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Laura González-Riesco
- Department of Child and Adolescent Mental Health, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Josep Lluís Matalí
- Department of Child and Adolescent Mental Health, Hospital Sant Joan de Déu, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Diego Palao
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Department of Mental Health, Parc Taulí Hospital Universitari, Sabadell, Spain
- Institut de Neurociències, Translational Neuroscience Research Unit I3PT-INc-UAB, Sabadell, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d’Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain
| | - Montserrat Pàmias
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Department of Mental Health, Parc Taulí Hospital Universitari, Sabadell, Spain
- Institut de Neurociències, Translational Neuroscience Research Unit I3PT-INc-UAB, Sabadell, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d’Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain
| | - Javier Labad
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Institut de Neurociències, Translational Neuroscience Research Unit I3PT-INc-UAB, Sabadell, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d’Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain
- Department of Mental Health, Consorci Sanitari del Maresme, Mataró, Spain
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12
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Yamashita M, Matsubayashi S. A case of central adrenocortical insufficiency with alexithymia and alexisomia. Acta Psychol (Amst) 2023; 240:104030. [PMID: 37734245 DOI: 10.1016/j.actpsy.2023.104030] [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: 06/24/2023] [Revised: 09/07/2023] [Accepted: 09/08/2023] [Indexed: 09/23/2023] Open
Abstract
The patient was a 27-year-old woman. Following physical examination for unconscious hypoglycemia, the patient was diagnosed with central adrenocortical insufficiency. She also had alexithymia and alexisomia. Alexisomia is the inability to recognize or describe bodily sensations. Alexithymia is the difficulty of expressing one's feelings adequately. Alexisomia can be described as impaired interoceptive awareness. She had been maltreated and emotionally abused by her parents; thus, her upbringing may have influenced the development of alexithymia and alexisomia. In addition, her upbringing may have influenced the reduced hypothalamus-pituitary-adrenal axis activity. Her failure to perceive hypoglycemic symptoms as hypoglycemia was thought to have been influenced by her alexisomia. Interestingly, her alexisomia improved with steroid replacement therapy; however, the underlying mechanism remains unclear. However, exogenous steroids can also affect interoception. The patient was diagnosed with central adrenocortical insufficiency, an endocrine disorder, suggesting that psychosomatic factors may have been related to the patient's growth history.
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Affiliation(s)
- Makoto Yamashita
- Department of Psychosomatic Medicine, Endocrinology and Diabetes Mellitus, Fukuoka Tokushukai Hospital, Japan.
| | - Sunao Matsubayashi
- Department of Psychosomatic Medicine, Endocrinology and Diabetes Mellitus, Fukuoka Tokushukai Hospital, Japan
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13
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Simon L, Admon R. From childhood adversity to latent stress vulnerability in adulthood: the mediating roles of sleep disturbances and HPA axis dysfunction. Neuropsychopharmacology 2023; 48:1425-1435. [PMID: 37391592 PMCID: PMC10425434 DOI: 10.1038/s41386-023-01638-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/29/2023] [Accepted: 06/16/2023] [Indexed: 07/02/2023]
Abstract
Childhood adversity is a prominent predisposing risk factor for latent stress vulnerability, expressed as an elevated likelihood of developing stress-related psychopathology upon subsequent exposure to trauma in adulthood. Sleep disturbances have emerged as one of the most pronounced maladaptive behavioral outcomes of childhood adversity and are also a highly prevalent core feature of stress-related psychopathology, including post-traumatic stress disorder (PTSD). After reviewing the extensive literature supporting these claims, the current review addresses the notion that childhood adversity-induced sleep disturbances may play a causal role in elevating individuals' stress vulnerability in adulthood. Corroborating this, sleep disturbances that predate adult trauma exposure have been associated with an increased likelihood of developing stress-related psychopathology post-exposure. Furthermore, novel empirical evidence suggests that sleep disturbances, including irregularity of the sleep-wake cycle, mediate the link between childhood adversity and stress vulnerability in adulthood. We also discuss cognitive and behavioral mechanisms through which such a cascade may evolve, highlighting the putative role of impaired memory consolidation and fear extinction. Next, we present evidence to support the contribution of the hypothalamic-pituitary-adrenal (HPA) axis to these associations, stemming from its critical role in stress and sleep regulatory pathways. Childhood adversity may yield bi-directional effects within the HPA stress and sleep axes in which sleep disturbances and HPA axis dysfunction reinforce each other, leading to elevated stress vulnerability. To conclude, we postulate a conceptual path model from childhood adversity to latent stress vulnerability in adulthood and discuss the potential clinical implications of these notions, while highlighting directions for future research.
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Affiliation(s)
- Lisa Simon
- School of Psychological Sciences, University of Haifa, Haifa, Israel
| | - Roee Admon
- School of Psychological Sciences, University of Haifa, Haifa, Israel.
- The Integrated Brain and Behavior Research Center (IBBRC), University of Haifa, Haifa, Israel.
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14
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Leroux PA, Dissaux N, Le Reste JY, Bronsard G, Lavenne-Collot N. Association between Hpa Axis Functioning and Mental Health in Maltreated Children and Adolescents: A Systematic Literature Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1344. [PMID: 37628343 PMCID: PMC10453675 DOI: 10.3390/children10081344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 07/26/2023] [Accepted: 07/26/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Previous studies have demonstrated that children who experience maltreatment show a more elevated risk of psychopathological disorders than children from the general population. The HPA (hypothalamic-pituitary-adrenal) axis is not mature at birth and undergoes strong social regulation during the first years of life. Consequently, early exposure to stress could modify the usual adaptative response to stress. In stressful situations, perturbations in both cortisol response and cortisol circadian rhythm have been observed. Nevertheless, studies that have evaluated the links between child abuse, dysregulation of the HPA axis, and mental disorders have shown diverse results. Because of the variety of methods employed in the different studies, no formal comparisons have been made. In this systematic review, we have brought together these results. METHODS We conducted a systematic review of studies analyzing the correlation between child abuse, mental disorders, and HPA axis activity in patients aged between 6 and 16 years. PubMed, Scopus, Cochrane, and Google Scholar were searched using relevant keywords and inclusion/exclusion criteria (from 2000 to 2020). RESULTS Fifteen studies from the 351 identified were included. Most patients were children in the child welfare system. Children who had experienced child abuse presented with more severe mental disorders (particularly in the dimensional measure) than children who had not been abused. HPA axis activity was assessed by measuring basal cortisol for some studies and cortisol reactivity for other studies. For children experiencing child abuse, there was a possible association between abuse and a decrease in the reactivity of the HPA axis. In addition, early life stress could be associated with lower matinal cortisol. However, the association between mental disorders and cortisol secretion in maltreated children did not seem obvious. CONCLUSIONS This systematic review demonstrates that mental disorders are more frequent and severe in cases where child abuse has occurred. Moreover, children who experienced child abuse seem to present changes in the reactivity of the HPA axis. Nevertheless, the potential correlation between these changes in the reactivity of the HPA axis and mental disorders in this population needs to be evaluated in further studies.
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Affiliation(s)
- Pierre-Antoine Leroux
- Service de Psychiatrie de l’Enfant et de l’Adolescent, CHRU, 29200 Brest, France
- Faculté de Médecine, Université de Bretagne Occidentale, 29200 Brest, France
| | - Nolwenn Dissaux
- Service de Psychiatrie de l’Enfant et de l’Adolescent, CHRU, 29200 Brest, France
- Faculté de Médecine, Université de Bretagne Occidentale, 29200 Brest, France
| | | | - Guillaume Bronsard
- Service de Psychiatrie de l’Enfant et de l’Adolescent, CHRU, 29200 Brest, France
- Faculté de Médecine, Université de Bretagne Occidentale, 29200 Brest, France
- EA 7479, 29200 Brest, France
- Département de Sciences Humaines et Sociales, EA 3279 (CEReSS, AMU), 29200 Brest, France
| | - Nathalie Lavenne-Collot
- Service de Psychiatrie de l’Enfant et de l’Adolescent, CHRU, 29200 Brest, France
- Faculté de Médecine, Université de Bretagne Occidentale, 29200 Brest, France
- Laboratoire du Traitement de l’Information Médicale, Inserm U1101, 29200 Brest, France
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15
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Fares-Otero NE, De Prisco M, Oliva V, Radua J, Halligan SL, Vieta E, Martinez-Aran A. Association between childhood maltreatment and social functioning in individuals with affective disorders: A systematic review and meta-analysis. Acta Psychiatr Scand 2023. [PMID: 37105552 DOI: 10.1111/acps.13557] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 04/06/2023] [Accepted: 04/08/2023] [Indexed: 04/29/2023]
Abstract
OBJECTIVE Childhood maltreatment has been linked to impairments in social functioning and social cognition in adults with affective disorders. However, conclusions have been limited by inconsistent findings across different maltreatment subtypes and social domains. We conducted a systematic review and meta-analysis to quantify associations between childhood maltreatment (overall and subtypes - physical, emotional and/or sexual abuse, and/or physical and/or emotional neglect) and different domains of social functioning and social cognition in adults with affective disorders (bipolar disorder or major depressive disorder). We also examined effect moderators and mediators of these associations. METHODS A systematic search was performed on 12.12.2022 which identified 29 studies included in qualitative synthesis (n = 3022 individuals with affective disorders), of which 27 (n = 2957) were pooled in meta-analyses. Across studies, five social functioning and five social cognition domains were examined, of which four domains of social functioning and two domains of social cognition had sufficient data for meta-analysis (PROSPERO CRD42022288976). RESULTS Social functioning: childhood maltreatment was associated with lower global social functioning (r = -0.11 to -0.20), poorer interpersonal relations (r = -0.18 to -0.33), and with aggressive behaviour (r = 0.20-0.29) but was unrelated to vocational functioning. Emotional abuse and emotional neglect showed the largest magnitudes of effect. Social cognition: there was no meta-analytic evidence of associations between maltreatment and social cognition domains. Exploratory moderation analyses did not identify any consistent moderators. Narrative synthesis identified attachment style as possible moderator, and sensory patterns, anxiety, and depressive symptoms as possible mediators between childhood maltreatment and social outcomes. Overall, the available evidence was limited, particularly in relation to social cognition. CONCLUSIONS Adults with affective disorders are at risk of social functioning difficulties after childhood maltreatment exposure, an effect observed across multiple maltreatment subtypes, social functioning domains, and diagnoses. Addressing social functioning problems may benefit maltreated adults with both bipolar disorder and major depressive disorder.
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Affiliation(s)
- Natalia E Fares-Otero
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic, Institute of Neurosciences (ICN), Department of Medicine, Faculty of Medicine and Health Sciences, Universitat de Barcelona (UB), Barcelona, Catalonia, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain
| | - Michele De Prisco
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic, Institute of Neurosciences (ICN), Department of Medicine, Faculty of Medicine and Health Sciences, Universitat de Barcelona (UB), Barcelona, Catalonia, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain
| | - Vincenzo Oliva
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic, Institute of Neurosciences (ICN), Department of Medicine, Faculty of Medicine and Health Sciences, Universitat de Barcelona (UB), Barcelona, Catalonia, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Joaquim Radua
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic, Institute of Neurosciences (ICN), Department of Medicine, Faculty of Medicine and Health Sciences, Universitat de Barcelona (UB), Barcelona, Catalonia, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain
- Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Sarah L Halligan
- Department of Psychology, University of Bath, Bath, UK
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic, Institute of Neurosciences (ICN), Department of Medicine, Faculty of Medicine and Health Sciences, Universitat de Barcelona (UB), Barcelona, Catalonia, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain
| | - Anabel Martinez-Aran
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic, Institute of Neurosciences (ICN), Department of Medicine, Faculty of Medicine and Health Sciences, Universitat de Barcelona (UB), Barcelona, Catalonia, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain
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16
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Zara S, Brähler E, Sachser C, Fegert JM, Häuser W, Krakau L, Kampling H, Kruse J. Associations of different types of child maltreatment and diabetes in adulthood - the mediating effect of personality functioning: Findings from a population-based representative German sample. Ann Epidemiol 2023; 78:47-53. [PMID: 36586456 DOI: 10.1016/j.annepidem.2022.12.004] [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: 09/18/2022] [Revised: 12/05/2022] [Accepted: 12/14/2022] [Indexed: 12/30/2022]
Abstract
PURPOSE This study aimed to examine the role of personality functioning in the association between various types of child maltreatment (CM) (sexual, physical, and emotional abuse as well as physical and emotional neglect) and diabetes in adulthood. METHODS Analyses are based on representative data of the German population (N = 5,041) from 2016 to 2019. Self-report questionnaires assessed diagnosis of diabetes, child maltreatment (CTQ), personality functioning (OPD-SQS), and symptoms of depression/anxiety (PHQ-4). Odd ratios were calculated to examine the association between CM and diabetes, and mediation analyses including PHQ-4 as covariate were conducted to examine the role of personality functioning. RESULTS All CM types significantly elevated the odds of having diabetes in adulthood. Personality functioning mediated the association between abuse and diabetes (sexual: b = 0.012, 95% CI [.002, 0.022], PM = 25.0%, physical: b = 0.009, 95% CI [.001, 0.017], PM = 12.0%, and emotional: b = 0.013, 95% CI [.002, 0.024], PM = 59.8%), but not between neglect and diabetes. CONCLUSIONS CM is associated with an increased risk of diabetes, with personality functioning being a relevant mediator for CM abuse types. Hence, by focusing on CM prevention and considering impaired personality functioning in diabetes treatment, diabetes self-management and health behavior could be improved.
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Affiliation(s)
- Sandra Zara
- Department of Psychosomatic Medicine and Psychotherapy, Justus Liebig University Giessen, Gießen, Germany.
| | - Elmar Brähler
- Department Psychosomatic Medicine and Psychotherapy, Johannes Gutenberg University Mainz, Mainz, Germany; Integrated Research and Treatment Center for Adiposity Diseases, Behavioral Medicine Research Unit, University Medical Center Leipzig, Leipzig, Germany
| | - Cedric Sachser
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany
| | - Jörg M Fegert
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany
| | - Winfried Häuser
- Department of Psychosomatic Medicine and Psychotherapy, Technische Universität München, München, Germany; Department of Internal Medicine I, Klinikum Saarbrücken, Saarbrücken, Germany
| | - Lina Krakau
- Department Psychosomatic Medicine and Psychotherapy, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Hanna Kampling
- Department of Psychosomatic Medicine and Psychotherapy, Justus Liebig University Giessen, Gießen, Germany
| | - Johannes Kruse
- Department of Psychosomatic Medicine and Psychotherapy, Justus Liebig University Giessen, Gießen, Germany; Department for Psychosomatic Medicine and Psychotherapy, Medical Center of the Philipps University Marburg, Marburg, Germany
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17
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Bates RA, Militello L, Barker E, Villasanti HG, Schmeer K. Early childhood stress responses to psychosocial stressors: The state of the science. Dev Psychobiol 2022; 64:e22320. [PMID: 36282746 PMCID: PMC9543576 DOI: 10.1002/dev.22320] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 06/28/2022] [Accepted: 07/26/2022] [Indexed: 01/27/2023]
Abstract
The aim of this systematic review was to better understand whether and to what extent psychosocial stressors are associated with hypothalamic-pituitary-adrenal axis or autonomic nervous system stress responses in young children (1-6 years of age). Studies were classified by psychosocial stressors from the ecobiodevelopmental model: social and economic resources, maternal mental health, parent-child relationships, and the physical environment. Of the 2388 identified studies, 32 met full inclusion criteria, including over 9107 children. Child physiologic stress responses were measured as hair and urinary cortisol and cortisone, salivary diurnal and reactive cortisol, salivary reactive alpha-amylase, and respiratory sinus arrhythmia. There were 107 identified relations between psychosocial stressors and physiologic stress responses. Nearly two thirds of these relations suggested that children have dysregulated stress responses as either significantly blunted (n = 27) or increased (n = 37); 43 relations were not significant. Children most consistently had significantly dysregulated stress responses if they experienced postnatal maternal depression or anxiety. Some reasons for the mixed findings may be related to characteristics of the child (i.e., moderators) or stressor, how the stress response or psychosocial stressor was measured, unmeasured variables (e.g., caregiving buffering), researcher degrees of freedom, or publication bias.
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Affiliation(s)
- Randi A. Bates
- College of NursingUniversity of CincinnatiCincinnatiOhioUSA
| | - Lisa Militello
- College of NursingThe Ohio State UniversityColumbusOhioUSA
| | - Erin Barker
- College of NursingUniversity of CincinnatiCincinnatiOhioUSA
| | - Hugo Gonzalez Villasanti
- Crane Center for Early Childhood Research and PolicyThe Ohio State UniversityColumbusOhioUSA,Department of Educational Studies, College of Education and Human EcologyThe Ohio State UniversityColumbusOhioUSA
| | - Kammi Schmeer
- Crane Center for Early Childhood Research and PolicyThe Ohio State UniversityColumbusOhioUSA,Department of SociologyThe Ohio State UniversityColumbusOhioUSA
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18
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Misiak B, Kowalski K, Piotrowski P, Grąźlewski T, Samochowiec J. Neurodevelopmental aspects of adverse childhood experiences in psychosis: Relevance of the allostatic load concept. Psychoneuroendocrinology 2022; 143:105850. [PMID: 35772280 DOI: 10.1016/j.psyneuen.2022.105850] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/21/2022] [Accepted: 06/21/2022] [Indexed: 11/24/2022]
Abstract
Previous studies have shown that neurodevelopmental characteristics of adverse childhood experiences (ACEs), such as their accumulation and minimal age at exposure, might moderate their impact on clinical expression of psychosis. However, it remains unknown as to whether specific neurodevelopmental characteristics of ACEs are associated with biological alterations observed in psychosis. In this study, we tested the hypothesis that younger minimal age at exposure as well as greater accumulation and severity of ACEs are associated with systemic biological dysregulations captured by the allostatic load (AL) index in patients with psychosis. The present study included 65 inpatients with psychotic disorders and 56 healthy controls (HCs). A total of 15 biomarkers were used to measure the AL index. Individuals with psychosis had significantly higher AL index as well as they reported greater accumulation and severity of ACEs compared to HCs. After adjustment for age, sex, the number of education years and the dosage of antipsychotics, greater accumulation of ACEs and younger minimal age at exposure were significantly associated with higher AL index in patients with psychosis. None of neurodevelopmental characteristics of ACEs was associated with the AL index in HCs. Our findings indicate that greater accumulation of ACEs and younger minimal age at exposure are related to biological dysregulations captured by the AL index in patients with psychosis. Future studies investigating the role of ACEs in the pathophysiology of psychosis need to consider their neurodevelopmental characteristics. It is also important to further explore timing of exposure to indicate critical developmental periods related to psychosis risk and better inform potential interventions.
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Affiliation(s)
- Błażej Misiak
- Department of Psychiatry, Division of Consultation Psychiatry and Neuroscience, Wroclaw Medical University, Wroclaw, Poland
| | - Krzysztof Kowalski
- Department of Psychiatry, Division of Consultation Psychiatry and Neuroscience, Wroclaw Medical University, Wroclaw, Poland
| | - Patryk Piotrowski
- Department of Psychiatry, Division of Consultation Psychiatry and Neuroscience, Wroclaw Medical University, Wroclaw, Poland
| | - Tomasz Grąźlewski
- Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland
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19
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Demakakos P, Steptoe A. Adverse childhood experiences and diurnal cortisol patterns in older people in England. Psychoneuroendocrinology 2022; 142:105798. [PMID: 35576878 DOI: 10.1016/j.psyneuen.2022.105798] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 05/09/2022] [Accepted: 05/09/2022] [Indexed: 11/30/2022]
Abstract
Adverse childhood experiences (ACE) are associated with HPA axis dysregulation at younger ages, but there is scarcity of evidence for this association at older ages. To add to our knowledge of the lifetime impact of ACE on HPA axis function, we examined whether ACE were associated with diurnal cortisol patterns in a national sample of 587 participants (356 women) aged 55-79 years from the English Longitudinal Study of Ageing (ELSA). We conducted descriptive analyses and estimated sex-specific robust regression models of the associations between the 8-item summary ACE score and four measurements of salivary cortisol over a 24-h cycle (upon waking, 30 min later, at 7 pm, and at bedtime) as well as the cortisol awakening response (CAR) and the diurnal cortisol slope. Our models were adjusted for age, then for childhood socioeconomic position and finally for adult socioeconomic position. In men, we found significant differences that were independent of covariates, with more ACE being associated with lower salivary cortisol levels on waking, a greater CAR, and a flatter diurnal cortisol slope. In women, we observed a graded association between ACE and increased 7 pm salivary cortisol levels. Our findings indicate that childhood adversity is related to HPA axis in older people, especially men. The chronological distance (on average >50 years) between ACE and salivary cortisol levels suggests the existence of a lifelong association between childhood adversity and HPA axis and neuroendocrine function. Notwithstanding sex differences, based on our findings we suggest that HPA axis dysregulation could be a pathway that mediates the association between ACE and chronic disease later in life.
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Affiliation(s)
- Panayotes Demakakos
- Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, London WC1E 6BT, UK,.
| | - Andrew Steptoe
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, London WC1E 6BT, UK.
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