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Miller AP, Agrawal A. Genetic Contributions to Reported Childhood Maltreatment: What It Means and How It Could Mean More. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2023; 3:587-589. [PMID: 37881533 PMCID: PMC10593938 DOI: 10.1016/j.bpsgos.2023.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 10/27/2023] Open
Affiliation(s)
- Alex P. Miller
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
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Senberg A, Schmucker M, Oster A, Zumbach J. Parental personality disorder and child maltreatment: A systematic review and meta-analysis. CHILD ABUSE & NEGLECT 2023; 140:106148. [PMID: 37060689 DOI: 10.1016/j.chiabu.2023.106148] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 02/20/2023] [Accepted: 03/15/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND Parental pathology may affect parenting capacity and is deemed a risk factor for child maltreatment. Especially parental personality disorder (PD) can significantly burden the relationship and interaction between parents and their children. OBJECTIVE This meta-analytic review aims to summarize and quantify the influence of parental PD on the occurrence / the risk of child maltreatment. PARTICIPANTS AND SETTING Studies had to meet the following inclusion criteria: They had to analyze a sample of parents with a diagnosed PD and the occurrence / risk of maltreating their children. To be included in the narrative synthesis and/or meta-analysis, they had to be case-control, cross-sectional, or longitudinal studies. Literature research was conducted in the databases Web of Science, Psychinfo, and Google Scholar up to January 2023. METHODS First, studies were analyzed on a narrative level, and eligible studies for the meta-analysis were identified. Studies were grouped according to the diagnosed PDs. Five different groups were included: borderline PD, antisocial PD, narcissistic PD, nondifferentiated PDs, and Cluster B PDs. Three different random-effects meta-analyses were computed (borderline PD, antisocial PD, Cluster B PDs). Meta-analyses were controlled for publication bias and different covariates (e.g., study quality, sample size). RESULTS After screening 41 full texts, 17 studies were included in the narrative synthesis, out of which 14 samples from 11 studies were included in the meta-analysis. Analysis of borderline PD showed an association with the occurrence / risk of child maltreatment (OR = 8.08; 95 % CI [2.51, 25.93]). However, after taking into account possible publication bias, this association was no longer significant. We found a significant and stable association between antisocial PD and the occurrence of / risk of child maltreatment (OR = 4.92; 95 % CI [3.26, 7.43]). Analysis of Cluster B PDs (antisocial, borderline, histrionic, narcissistic) revealed a significant overall association (OR = 4.23; 95 % CI [2.75, 6.5]), indicating that the presence of Cluster B PDs in parents significantly increases the occurrence of / the risk of child maltreatment. CONCLUSIONS Analyses indicated a significant association between of Cluster B PDs, and specifically between antisocial and borderline PD, with the occurrence of / the risk of child maltreatment. However, methodological limitations have to be taken into account, because results for borderline PD were no longer significant after controlling for possible publication bias. Moreover, the number of studies included was rather small, and results showed a substantial amount of heterogeneity. OTHER This work was not supported by any funding.
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Affiliation(s)
- Asne Senberg
- Department of Forensic Psychology, Psychologische Hochschule Berlin, Am Koellnischen Park 2, 10179 Berlin, Germany.
| | - Martin Schmucker
- Institute of Psychology, Friedrich-Alexander University Erlangen-Nürnberg, Nägelsbachstraße 49b, 91052 Erlangen, Germany.
| | - Anna Oster
- Department of Forensic Psychology, Psychologische Hochschule Berlin, Am Koellnischen Park 2, 10179 Berlin, Germany.
| | - Jelena Zumbach
- Department of Forensic Psychology, Psychologische Hochschule Berlin, Am Koellnischen Park 2, 10179 Berlin, Germany.
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Wilson K, Van Doorn G, Dye J. Vulnerable dark traits mediate the association between childhood adversity and suicidal ideation. PERSONALITY AND INDIVIDUAL DIFFERENCES 2023. [DOI: 10.1016/j.paid.2022.111959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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South SC, Boudreaux MJ, Oltmanns TF. Childhood Maltreatment, Personality Pathology, and Intimate Partner Aggression. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP23107-NP23130. [PMID: 35649532 DOI: 10.1177/08862605221076164] [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: 06/15/2023]
Abstract
The goal of the current study was to examine the early childhood roots of adult personality pathology and intimate partner aggression in later life. Childhood maltreatment is associated with perpetration of intimate partner aggression (IPA) in adulthood, although the effect is generally only small to moderate in size. Childhood maltreatment is also linked with the Diagnostic and Statistical Manual of Mental Disorders (DSM) personality disorders (PDs) in adulthood, which in turn are correlated with IPA in adult romantic relationships. This suggests that one pathway by which childhood maltreatment leads to adult IPA is through maladaptive personality patterns. In the current analyses, data from 495 older, racially diverse adults and their romantic partners recruited from the St. Louis Personality and Aging Network (SPAN) study were used to examine whether childhood maltreatment may impact adult IPA through adult personality pathology. Findings from structural equation modeling demonstrated that for most of the 10 DSM-5 PD (Section II) constructs, there was a significant indirect effect from childhood maltreatment to IPA in later life through a latent variable of personality pathology. Our findings confirm that IPA does occur among romantic partners in later life, that it is robustly associated with personality pathology traits in later life, and that personality pathology in later life may have its roots in early neglect and maltreatment.
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Adverse Childhood Experiences and Neurocognition in Borderline Personality Disorder: A Call-to-Action Perspective Review. Harv Rev Psychiatry 2022; 30:248-260. [PMID: 35849742 DOI: 10.1097/hrp.0000000000000344] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Adverse childhood experiences (ACEs) contribute to the development of personality traits leading to adult borderline personality disorder (BPD). Neurocognitive changes could partly mediate the association between ACEs and BPD. We discuss how exposure to ACEs could induce alterations in neurocognition, which, in turn, would contribute to the development of BPD. We conducted a review of MEDLINE articles through 2021, documenting a link between ACEs, neurocognitive impairments, and BPD, and also focusing on the pairwise associations. ACEs appear to have a strong impact on neurocognition and are a predictive factor for BPD. Maltreated, abused, and emotionally invalidated children are more likely to present BPD traits. Neurocognitive impairments in adults exposed to ACEs and in patients with BPD arise from similar brain alterations in the amygdala, hippocampus, and prefrontal cortex. These impairments seem to be linked with clinical dimensions of BPD: increased impulsivity to altered inhibitory control; dissociative experiences to nonspecific autobiographical memory; and emotionally biased facial recognition to unstable interpersonal relationships. This perspective review highlights the contributory role of neurocognition in the association between ACEs and BPD. Additional research is needed, however, on the interconnections among ACEs, neurocognition, and BPD. Future studies could also focus on developing tools to assess early adversity in BPD specifically and on psychotherapeutic approaches to promptly remedy neurocognitive impairments.
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McClendon J, Chang K, J Boudreaux M, Oltmanns TF, Bogdan R. Black-White racial health disparities in inflammation and physical health: Cumulative stress, social isolation, and health behaviors. Psychoneuroendocrinology 2021; 131:105251. [PMID: 34153589 DOI: 10.1016/j.psyneuen.2021.105251] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 03/16/2021] [Accepted: 04/29/2021] [Indexed: 11/18/2022]
Abstract
Black Americans have vastly increased odds and earlier onsets of stress- and age-related disease compared to White Americans. However, what contributes to these racial health disparities remains poorly understood. Using a sample of 1577 older adults (32.7% Black; ages 55-65 at baseline), we examined whether stress, health behaviors, social isolation, and inflammation are associated with racial disparities in self-reported physical health. A latent cumulative stress factor and unique stress-domain specific factors were modeled by applying bifactor confirmatory analysis to assessments across the lifespan (i.e., childhood maltreatment, trauma exposure, discrimination, stressful life events, and indices of socioeconomic status). Physical health, health behavior, and social isolation were assessed using self-report. Interleukin-6 (IL-6) and C-reactive protein (CRP) were assayed from morning fasting serum samples; a z-scored inflammation index was formed across these 2 cytokines. A parallel serial mediational model tested whether race (i.e., Black/White) is indirectly associated with health through the following 3 independent pathways: (1) cumulative stress to preventative health behaviors (e.g., healthy eating) to inflammation, (2) cumulative stress to risky health behaviors (e.g., substance use) to inflammation; and (3) cumulative stress to social isolation to inflammation. There were significant indirect effects between race and self-reported physical health through cumulative stress, preventative health behaviors, and inflammation (B = -0.02, 95% CI: -0.05, -0.01). Specifically, Black Americans were exposed to greater cumulative stress, which was associated with reduced engagement in preventative health behaviors, which was, in turn, associated with greater inflammation and reduced physical health. A unique SES factor also indirectly linked race to physical health through preventative health behaviors. Cumulative stress exposure and unique aspects of socioeconomic status are indirectly associated with Black-White racial health disparities through behavioral (i.e., preventative health behavior) and biological (i.e., inflammation) factors. Culturally responsive evidence-based interventions that enhance engagement in preventative health behaviors are needed to directly confront health disparities. Ultimately, large scale anti-racist public policies that reduce cumulative stress burden (e.g., a living wage, universal healthcare) may best attenuate racial health disparities.
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Affiliation(s)
- Juliette McClendon
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA; Boston University School of Medicine, Boston, MA, USA
| | | | | | | | - Ryan Bogdan
- Washington University in St. Louis, St. Louis, MO, USA.
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Schneiderman JU, Prindle J, Putnam-Hornstein E. Infant Deaths From Medical Causes After a Maltreatment Report. Pediatrics 2021; 148:peds.2020-048389. [PMID: 34426532 DOI: 10.1542/peds.2020-048389] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To examine whether postneonatal infants reported for maltreatment face a heightened risk of deaths attributable to medical causes. METHODS Birth and death records for all children born in California between 2010 and 2016 (N = 3 455 985) were linked to administrative child protection system records. Infants were prospectively followed from birth through death or age 1 year. Reports of maltreatment and foster care placement episodes were modeled as time-varying covariates; sociodemographic characteristics at birth were modeled as baseline covariates. Stratified, multivariable competing risk models were used to estimate the adjusted relative hazard of postneonatal infant death attributed to a medical cause (n = 1051). RESULTS After adjusting for baseline risk factors, and compared with infants never reported for maltreatment, the medical-related mortality risk was almost twice as great among infants reported once for maltreatment (hazard ratio: 1.77; 95% confidence interval: 1.36-2.30) and 3 times greater if there was >1 maltreatment report (hazard ratio: 3.27; 95% confidence interval: 2.48, 4.30). Among infants reported for maltreatment, periods of foster care placement reduced the risk of death by roughly half. CONCLUSION Infants reported for alleged maltreatment had a higher risk of death from medical causes, with foster care emerging as protective. Targeted support services for parents and improved communication between the child protection system and the pediatric health care community is needed, especially when infants who may be medically fragile remain at home after an allegation of abuse or neglect.
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Affiliation(s)
- Janet U Schneiderman
- Department of Nursing, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California
| | - John Prindle
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California
| | - Emily Putnam-Hornstein
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California.,School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Robin M, Douniol M, Pham-Scottez A, Gicquel L, Delvenne V, Nezelof S, Speranza M, Falissard B, Silva J, Corcos M. Specific Pathways From Adverse Experiences to BPD in Adolescence: A Criteria-Based Approach of Trauma. J Pers Disord 2021; 35:94-110. [PMID: 33999657 DOI: 10.1521/pedi_2021_35_523] [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] [Indexed: 11/20/2022]
Abstract
Within the European Research Network on BPD (EURNET-BPD; n = 85 BPD adolescents, n = 84 healthy controls, aged 13-19), this study explored the combination of three types of adversity-maltreatment, stressful life events (early separation from parents, parental suicide attempt, parental chronic disease) and parental bonding-as predictors of BPD, on a criteria-based approach. Results indicated that cumulative traumatic experiences largely characterize borderline adolescent's history; and, in the multivariate regression models, all adversity experiences were likely to contribute to BPD symptoms. The role of emotional abuse, parental suicide attempt, and a decrease in paternal level of care were particularly prominent. Moreover, adversities combinations were different for each criterion, suggesting that specific sets of traumatic experiences are leading to BPD. These findings argue for a further criteria-based exploration of trauma in borderline patients, as well as a more accurate and efficient prevention.
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Affiliation(s)
- Marion Robin
- Department of Adolescent and Young Adult Psychiatry, Institut Mutualiste Montsouris, Paris, France.,Paris Descartes University, Paris, France
| | - Marie Douniol
- Medical Psychological Center, Odysseum, EPS Erasme, Sceaux, France
| | | | - Ludovic Gicquel
- Henri Laborit Hospital Center, Poitiers, URC, University of Poitiers, France
| | - Veronique Delvenne
- Queen Fabiola Children's University Hospital, Brussels, Free University of Brussels, Belgium
| | - Sylvie Nezelof
- Department of Child and Adolescent Psychiatry, Besançon University Hospital, Franche Comte University, Besançon, France
| | - Mario Speranza
- Versailles General Hospital, Le Chesnay, France.,Paris-Saclay University, UVSQ, CESP, INSERM U1178, Team PsyDev, Paris, France
| | - Bruno Falissard
- Paris-Saclay University, UVSQ, CESP, INSERM U1178, Team PsyDev, Paris, France.,INSERMU 669, Paris, France
| | - Jerôme Silva
- Department of Adolescent and Young Adult Psychiatry, Institut Mutualiste Montsouris, Paris, France
| | - Maurice Corcos
- Department of Adolescent and Young Adult Psychiatry, Institut Mutualiste Montsouris, Paris, France.,Paris Descartes University, Paris, France
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