Childhood trauma and depression in alcoholics: relationship to hostility

The investigation of the mediating role of coping trategies on the relationship between childhood traumas, depression and alcohol use disorder in university students

The aim of this study is to investigate the mediating effect of coping strategies on the relationship among childhood traumas, depression, and alcohol use disorder in university students. The participants of this study consisted of 735 (209 males and 526 females) university students. Participants completed measures of depressive symptoms, childhood traumas, problematic alcohol consumption, and coping strategies as well as a sociodemographic information form. According to results, coping strategies fully mediated the relationship between childhood traumas and alcohol use disorder, and partially mediated the relationship between childhood traumas and depression.

Mediators of the Association Between Childhood Emotional Maltreatment and Young Adult Men's Life Satisfaction

Childhood emotional maltreatment has been linked to a wide range of deleterious physical and psychological adult health outcomes. The present study extends past research by examining the effects of childhood emotional maltreatment on young adult men's life satisfaction through its effects on hostility and perceptions of social relationships. Participants were 423 single men who completed two interviews 1 year apart. As hypothesized, the association between self-reported childhood emotional maltreatment and adult life satisfaction was mediated through general hostility, rejection sensitivity in romantic relationships, and perceptions of male friends' social support. These findings suggest that interventions which address distorted perceptions of romantic partners and friends might reduce the negative impact of childhood emotional maltreatment.

The many wounds of war: The association of service-related and clinical characteristics with problems with the law in Iraq and Afghanistan veterans

Previous research has demonstrated that veterans with posttraumatic stress disorder (PTSD) are at higher risk for aggression, hostility, and anger, potentially leading to problems with the law or disciplinary action while in the military. There have been calls for increased consideration of the unique aspects of the judicial system in legal matters with veterans involved. The bulk of the research so far has considered the link between PTSD, traumatic brain injury (TBI), and combat exposure, but little is known about the potential role of chronic pain and Military Sexual Trauma (MST) in a veteran's experience of anger, aggression, and discipline while in the military and legal concerns. The present study used retrospective cross-sectional health screening data in a sample of 1250 Iraq and Afghanistan veterans to examine the associations of demographic, service-related, and clinical characteristics with self-reported legal problems. A total of 440 veterans (34.6%) endorsed having experienced some type of problems with the law. Independent logistic regression analyses demonstrated that those who screened positive for PTSD, MST, TBI, and clinical levels of pain were more likely to report legal problems; only the associations with positive PTSD (p=0.001) and MST (p=0.007) screens remained significant in multivariate regression analyses. The findings underscore the need for a thorough psychological evaluation when veterans are involved in the legal system with a special emphasis on factors prevalent to Iraq and Afghanistan veterans.

Role of FKBP5 in emotion processing: results on amygdala activity, connectivity and volume

Accumulating evidence suggests a role of FKBP5, a co-chaperone regulating the glucocorticoid receptor sensitivity, in the etiology of depression and anxiety disorders. Based on recent findings of altered amygdala activity following childhood adversity, the present study aimed at clarifying the impact of genetic variation in FKBP5 on threat-related neural activity and coupling as well as morphometric alterations in stress-sensitive brain systems. Functional magnetic resonance imaging during an emotional face-matching task was performed in 153 healthy young adults (66 males) from a high-risk community sample followed since birth. Voxel-based morphometry was applied to study structural alterations and DNA was genotyped for FKBP5 rs1360780. Childhood adversity was measured using retrospective self-report (Childhood Trauma Questionnaire) and by a standardized parent interview assessing childhood family adversity. Depression was assessed by the Beck Depression Inventory. There was a main effect of FKBP5 on the left amygdala, with T homozygotes showing the highest activity, largest volume and increased coupling with the left hippocampus and the orbitofrontal cortex (OFC). Moreover, amygdala-OFC coupling proved to be associated with depression in this genotype. In addition, our results support previous evidence of a gene-environment interaction on right amygdala activity with respect to retrospective assessment of childhood adversity, but clarify that this does not generalize to the prospective assessment. These findings indicated that activity in T homozygotes increased with the level of adversity, whereas the opposite pattern emerged in C homozygotes, with CT individuals being intermediate. The present results point to a functional involvement of FKBP5 in intermediate phenotypes associated with emotional processing, suggesting a possible mechanism for this gene in conferring susceptibility to stress-related disorders.

Person-environment transactions: personality traits moderate and mediate the effects of child sexual victimization on psychopathology

Personality, environmental adversity and psychopathology are related, and different models have been proposed to explain their interaction. The theory of person-environment transactions may elucidate the role of personality in these interactions beyond traditional conceptualizations. To our knowledge, hardly any studies have explored the relationships between the Five Factor Model, child sexual victimization and general psychopathology. We hypothesized (1) that neuroticism and conscientiousness will moderate the effect of sexual victimization on psychopathology and (2) that neuroticism will mediate the relationship between sexual victimization and psychopathology. Our findings partially support these hypotheses. Neuroticism, conscientiousness and sexual victimization have a direct effect on psychopathology, whereas extraversion, openness to experience and agreeableness do not. With regard to interactive effects, conscientiousness, but not neuroticism, moderates the effect of sexual victimization on psychopathology, and neuroticism does mediate the aforementioned effect. No other interactions were found with regard to extraversion, agreeableness or openness to experience. To our knowledge, the present study represents the first global test of person-environment transactions with regard to psychopathology and sexual victimization within the framework of the Five Factor Model.

Stress and development of depression and heavy drinking in adulthood: moderating effects of childhood trauma

PURPOSE

Studies suggest that childhood trauma is linked to both depression and heavy drinking in adulthood, and may create a lifelong vulnerability to stress. Few studies have explored the effects of stress sensitization on the development of depression or heavy drinking among those who have experienced traumatic childhood events. This study aimed to determine the effect of childhood trauma on the odds of experiencing depression or heavy drinking in the face of an adult life stressor, using a large population-based Canadian cohort.

METHODS

A total of 3,930 participants were included from the National Population Health Survey. The associations among childhood trauma, recent stress and depression/heavy drinking from 1994/1995 to 2008/2009 were explored using logistic regression, as were interactions between childhood trauma and recent stress. A generalized linear mixed model was used to determine the effects of childhood trauma and stressful events on depression/heavy drinking. Analyses were stratified by sex.

RESULTS

Childhood trauma significantly increased the odds of becoming depressed (following 1 event: OR = 1.66; 95%CI 1.01, 2.71; 2+ events, OR = 3.89; 95%CI 2.44, 6.22) and drinking heavily (2+ events: OR = 1.79; 95%CI 1.03, 3.13). Recent stressful events were associated with depression, but not heavy drinking. While most interaction terms were not significant, in 2004/2005 the association between recent stress and depression was stronger in those who reported childhood trauma compared to those with no childhood trauma.

CONCLUSIONS

Childhood trauma increases risk for both depression and heavy drinking. Trauma may moderate the effect of stress on depression; the relationship among trauma, stress and heavy drinking is less clear.

Impact of multiple types of childhood trauma exposure on risk of psychiatric comorbidity among alcoholic inpatients

BACKGROUND

This study examined the prevalence of single- and multiple-type childhood trauma exposure (CTE) among alcoholic patients undergoing inpatient detoxification and treatment. The relationships between various types of CTE and lifetime psychiatric comorbidities and suicide attempts were also explored.

METHODS

A total of 196 alcoholic inpatients were assessed by Structured Clinical Interview for DSM-IV Axis I Disorders and Childhood Trauma Questionnaire (CTQ) for CTE history.

RESULTS

The overall prevalence of CTE in the entire sample was high (55.1%). Specifically, the prevalence of emotional abuse was 21.4%, physical abuse 31.1%, sexual abuse 24.0%, emotional neglect 20.4%, and physical neglect 19.9%. Regarding multiple types of CTE, 31.7 and 18.9% reported at least 2 and at least 3 CTE types, respectively. Strikingly, among those with at least 1 positive CTQ category, more than half reported 2 or more CTE types. A history of emotional abuse increased the risk of mood disorder, in particular major depressive disorder, as well as posttraumatic stress disorder (PTSD). Physical abuse contributed to the prediction of suicide attempts, while sexual abuse was associated with a diagnosis of anxiety disorder, PTSD, and multiple comobidities (e.g., anxiety and mood disorder). The number of reported CTE types or the total score of the CTQ predicted an increased risk of having single or multiple psychiatric comorbidities as well as suicide attempts.

CONCLUSIONS

We observed high rates of a broad range of CTE types and a trend for CTE-specific enhancement of risk for various psychiatric outcomes among alcoholic inpatients. Of note, a dose-response relationship between number of CTE types and risk of psychiatric comorbidities as well as suicide attempts was found. We suggest a wide range of CTE should be included when exploring the effects of CTE or developing prevention and treatment strategies among alcoholic subjects.

Family-related adverse childhood experiences as risk factors for psychiatric disorders in Nigeria

BACKGROUND

Adverse childhood experiences have been associated with a variety of mental health problems in adult life.

AIMS

To examine whether this reported link between childhood experiences and mental health disorders in adult life applies in a Sub-Saharan African setting where cultural and family attributes may be different.

METHOD

A multistage random sampling was used in the Nigerian Survey of Mental Health and Well-Being (NSMHW) to select respondents for face-to-face interviews. Assessments of family-related adverse childhood experiences and lifetime mental health disorders were conducted with the Composite International Diagnostic Interview (CIDI 3.0).

RESULTS

Almost half of the respondents had experienced an adverse childhood experience within the context of the family before they were 16 years of age. Associations between adverse childhood experiences and adult mental health disorders were few and were attenuated when clustering of adverse childhood experience and disorder comorbidities were accounted for. There was an elevated likelihood of adult substance use disorders among individuals who had experienced family violence and neglect or abuse. Parental psychopathology was associated with a significantly increased risk for developing mood disorders.

CONCLUSIONS

Adverse childhood experiences reflecting violence in the family, parental criminality and parental mental illness and substance misuse were more likely to have significant mental health consequences in adulthood.

Risk factors for suicide attempts among alcohol dependent patients

Suicidal behavior is a common and important problem among alcohol dependent patients. The study was designed to examine risk factors for attempting suicide in 499 alcohol dependent patients. Those who had attempted suicide (N = 198) were more likely to be female, report a family history of suicidal behavior, report more childhood trauma, report greater levels of aggressive behavior, began heavy drinking earlier, and were more likely to have received antidepressant medication. Logistic regression analysis showed that gender, family history, and childhood sexual abuse history made significant and independent contributions to the risk of a suicide attempt. Thus, developmental, personality, family history, social, and comorbidity risk factors may differentiate alcohol dependent patients who have attempted suicide from those who have not.

Trait aggression and hostility in recovered alcoholics

There is a long-recognized association between alcohol consumption and aggressive behavior. This study was designed to examine aggression in a group of socially well-adapted recovered alcoholics (RA). The question addressed was whether the treatment, together with long-term abstinence from alcohol, could reduce aggression and hostility in RA. A group of male RA (n = 64), who did not meet the DSM-IV criteria for any psychiatric or personality disorder, were recruited to the study from aftercare groups. According to data from their group therapists, they were reliably abstinent for at least 3 years and socially well adapted. The study participants representing the control group (n = 69), diagnosed as being 'reliable nonalcoholics' (NA) by the Munich Alcoholism Test, were recruited from general practice. Data were derived from an in-house questionnaire on general characteristics of both groups, and aggressive and hostility traits were assessed using the Buss-Durkee Hostility Inventory (BDHI). The univariate and multivariate between-groups design was used for data analysis. Taking into account the BDHI dimensions of aggression and hostility, the difference between RA and NA groups was statistically significant [Wilks' lambda (8, 125) = 0.769; p = 0.00004]. There were statistically significant differences in the BDHI scales for indirect aggression, irritability, negativism, suspicion, resentment, and guilt. Both RA and Na groups did not differ significantly in variables that assessed physical and verbal aggression. After a 3-year abstinence, subjects from the RA group displayed signs of hostility and covert aggression.

Symptoms of traumatic stress and substance use in a non-clinical sample of young adults

The link between symptoms of traumatic stress and substance abuse is well established in the literature, but the specific features of trauma that contribute to substance abuse remain elusive and have not been studied in non-clinical samples. The current study assessed the relationship between traumatic symptoms and alcohol use in a sample of Midwestern college students. Using multiple regression analysis, traumatic stress symptoms, overall, accounted for 55% of the variance in use of alcohol. Most importantly, dissociative behavior, intrusive thoughts, as well as low levels of tension reduction behaviors uniquely contributed to the self-reported use of alcohol. We discuss the importance of educating college-aged students about this relationship as a preventative measure to alcohol and other drug use/abuse.

Clinical correlates of childhood abuse and neglect in substance dependents

The aim of this study was to evaluate the prevalence of childhood abuse and neglect (CAN) in Turkish substance dependents and to investigate the relationship between CAN with axis I disorders, personality disorders and severity of depression and anxiety symptoms. Among 132 substance dependents, 56.1% met dichotomous criteria for some form of CAN. Current age was lower, whereas rate of suicide attempt, self-destructive behavior, divorce of parents, major depression, posttraumatic stress disorder (PTSD), lifetime specific phobia and personality disorders were higher in patients with history of CAN. Severity of depression and anxiety symptoms were also higher in group with CAN and number of abuse type was correlated with depression and anxiety scores. Lifetime major depression, lifetime PTSD, suicide attempt, self-destructive behavior and divorce of parents predicted CAN. The high rate of CAN found among Turkish substance dependents suggests that special attention must be given to identify CAN in this group. Findings of this study showed that there is a relationship between history of CAN and some axis I disorders, personality disorders and severity of depression and anxiety symptoms.

Cognitive mediation of childhood maltreatment and adult depression in recent crime victims

Childhood maltreatment has been linked to adult depressive disorders. However, few studies have examined mechanisms through which childhood maltreatment may contribute to adult depression. Thus, we examined the role of one potential mechanism of this relationship, maladaptive cognitions, in a recently traumatized sample. Participants were adult women who had been recently raped (n = 133) or physically assaulted (n = 73). We examined whether maladaptive self-and other-cognitions mediated relationships between childhood sexual, physical, and emotional abuse and current depression. Relationships between childhood sexual abuse and both current depression symptoms and diagnosis were mediated by maladaptive cognitions about self. Relationships between both childhood sexual abuse and childhood physical abuse and adult depressive symptoms were mediated by maladaptive cognitions about others.

Adverse childhood experiences and the risk of depressive disorders in adulthood

BACKGROUND

Research examining the association between childhood abuse and depressive disorders has frequently assessed abuse categorically, thus not permitting discernment of the cumulative impact of multiple types of abuse. As previous research has documented that adverse childhood experiences (ACEs) are highly interrelated, we examined the association between the number of such experiences (ACE score) and the risk of depressive disorders.

METHODS

Retrospective cohort study of 9460 adult health maintenance organization members in a primary care clinic in San Diego, CA who completed a survey addressing a variety of health-related concerns, which included standardized assessments of lifetime and recent depressive disorders, childhood abuse and household dysfunction.

RESULTS

Lifetime prevalence of depressive disorders was 23%. Childhood emotional abuse increased risk for lifetime depressive disorders, with adjusted odds ratios (ORs) of 2.7 [95% confidence interval (CI), 2.3-3.2] in women and 2.5 (95% CI, 1.9-3.2) in men. We found a strong, dose-response relationship between the ACE score and the probability of lifetime and recent depressive disorders (P<0.0001). This relationship was attenuated slightly when a history of growing up with a mentally ill household member was included in the model, but remained significant (P<0.001).

CONCLUSIONS

The number of ACEs has a graded relationship to both lifetime and recent depressive disorders. These results suggest that exposure to ACEs is associated with increased risk of depressive disorders up to decades after their occurrence. Early recognition of childhood abuse and appropriate intervention may thus play an important role in the prevention of depressive disorders throughout the life span.

Psychiatric Comorbidity in Treatment-Seeking Alcoholics: The Role of Childhood Trauma and Perceived Parental Dysfunction

BACKGROUND

This study among treatment-seeking alcoholics examined the relationship between childhood abuse (sexual abuse only [CSA], physical abuse only [CPA], or dual abuse [CDA]) and the presence of comorbid affective disorders, anxiety disorders, and suicide attempts, controlling for the potential confounding effects of other childhood adversities (early parental loss, witnessing domestic violence, parental alcoholism, and/or dysfunction) and adult assault histories.

METHOD

We assessed 155 (33 females, 122 males) treatment-seeking alcoholics using the European Addiction Severity Index, the Structured Trauma Interview, and the Composite International Diagnostic Interview.

RESULTS

The severity of childhood abuse was associated with posttraumatic stress disorder (PTSD) and suicide attempts in females and with PTSD, social phobia, agoraphobia, and dysthymia in males. Among men, multiple logistic regression models showed that CPA and CDA were not independently associated with any of the examined comorbid disorders or with suicide attempts. However, CSA independently predicted comorbid social phobia, agoraphobia, and PTSD. For the presence of comorbid affective disorders (mainly major depression) and suicide attempts, maternal dysfunctioning was particularly important. CSA also independently contributed to the number of comorbid diagnoses. For females, small sample size precluded the use of multivariate analyses.

CONCLUSION

Childhood abuse is an important factor in understanding clinical impairment in treated alcoholics, especially regarding comorbid phobic anxiety disorders, PTSD, and suicidality. These findings underline the importance of routine assessment of childhood trauma and possible trauma-related disorders in individuals presenting to alcohol treatment services. More studies with bigger samples sizes of female alcohol-dependent patients are needed.

Characteristics of drug addicts who attempt suicide

The aim of the study was to further describe the characteristics of drug-dependent patients who attempt suicide. Thus, 449 drug-dependent patients were interviewed about whether or not they had ever attempted suicide and about their family history of suicidal behavior. Patients completed the Childhood Trauma Questionnaire and the Eysenck Personality Questionnaire, and were interviewed with the Addiction Severity Index (ASI). It was found that patients who had attempted suicide (N=175) were significantly younger than patients who had never attempted suicide (N=274). Significantly more of the patients who had attempted suicide were female; had a family history of suicide; and had a lifetime history of major depression, of having received antidepressant medication, and of alcoholism. Also, patients who had attempted suicide had significantly higher scores for childhood trauma, psychoticism, neuroticism and introversion, as well as higher ASI psychiatric composite scores. These results suggest that social, personality, family, developmental and psychiatric risk factors may predispose to suicidal behavior in drug-dependent individuals.

Trauma histories of men and women in residential drug treatment: The Scottish evidence

This article focuses on self‐reported child neglect and abuse in residential drug treatment drawing on data from clients in Scotland collected 1996‐1999. The authors' findings suggest that the prevalence of childhood abuse histories are higher in female drug users than male drug users but argues that diversity of abuse experiences in drug users negate broad treatment plans for those traumatised by such experiences.

Psychological functioning and family discord among African-American adolescent females with and without a history of childhood sexual abuse

OBJECTIVES

The aim was to examine the rate of childhood sexual abuse along with the factors (age of abuse onset, type of perpetrator, and duration of the abuse), as well as the relationship of these factors to psychological functioning among females with a history of childhood abuse. Second, to determine whether levels of psychological functioning and family discord differ among females with and without a history of childhood sexual abuse.

METHOD

A cross-sectional design was used. Two hundred and forty-nine adolescent females were recruited from a community-based health program. Two trained female interviewers administered an anonymous survey that assessed childhood sexual abuse, psychological functioning, and family environment.

RESULTS

Fifty-seven (22.9%) of those surveyed reported childhood sexual abuse, of which 44.3% were intrafamilial and 55.7% were interfamilial. Age at onset ranged from 3 years to 17 years; 62.5% reported that the sexual abuse occurred 1 to 4 times; 27.9% reported a duration ranging from 1 year to 13 years; and 9.6% reported a duration of 1 month to 7 months. Multiple regression analysis revealed that a greater duration predicted higher levels of depression and lower levels of self-esteem among females with a history of sexual abuse. Females with a history of childhood sexual abuse scored significantly lower on measures of self-esteem and mastery, and significantly higher on measures of physical and emotional abuse.

CONCLUSIONS

Results indicate that adolescent females with a history of childhood sexual abuse suffer an array of negative sequelae that include psychological and family distress.

Childhood trauma and hostility as an adult: relevance to suicidal behavior

The objective of this study is to look for a relationship between childhood trauma and hostility as an adult. Toward this end, 294 recently abstinent cocaine or opiate dependent patients were asked to complete two questionnaires: the Childhood Trauma Questionnaire (CTQ) and the Hostility and Direction of Hostility Questionnaire (HDHQ). It was found that there were significant correlations between the HDHQ total hostility score and scores on the CTQ for childhood emotional abuse, physical abuse, sexual abuse, emotional neglect and physical neglect. Thus, these results suggest the possibility that childhood trauma may be a determinant of the personality dimension of hostility as an adult.