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Rogerson O, O'Connor RC, O'Connor DB. The effects of childhood trauma on stress-related vulnerability factors and indicators of suicide risk: An ecological momentary assessment study. J Affect Disord 2024; 352:479-489. [PMID: 38342320 DOI: 10.1016/j.jad.2024.02.029] [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: 05/04/2023] [Revised: 02/01/2024] [Accepted: 02/08/2024] [Indexed: 02/13/2024]
Abstract
BACKGROUND Childhood trauma is experienced by approximately one third of young people in the United Kingdom and has been shown to confer an increased risk for mental health difficulties in adulthood. Understanding the associations between these factors before negative health outcomes manifest in adulthood is imperative to help inform the development of interventions. The aims of this study were two-fold; first, to investigate the effects of childhood trauma on daily stress-related vulnerability factors over a period of 7 days and to test whether any observed relationships were moderated by protective or risk factors. Second, to explore the indirect effects of childhood trauma on reasons for living, optimism, daily suicide ideation, defeat and entrapment through the daily stress-related vulnerability factors. METHODS 212 participants were recruited to an ecological momentary assessment study to complete three diaries per day for a 7-day period. Participants completed daily measures of stress, hassles, executive functioning, impulsivity, sleep quality (stress-related vulnerability factors) as well as measures of reasons for living, optimism, daily thoughts of suicide, defeat and entrapment. The Childhood Trauma Questionnaire was also completed at baseline. RESULTS Analyses found that childhood trauma was significantly associated with higher scores on the daily stress-related vulnerability factors and positively related to each of the daily indicators of suicide risk. The study also uncovered key pathways whereby trauma had indirect effects on reasons for living, optimism, daily thoughts of suicide, defeat and entrapment through executive functioning, impulsivity, sleep quality and stress. LIMITATIONS The measures of executive function and sleep were self-reported and future research ought to replicate the current findings using more objective methods. DISCUSSION The findings from this study highlight the complexity of childhood trauma and its damaging effects on stress-related vulnerability factors and poorer mental health outcomes. Greater understanding of pathways by which trauma may impact later health outcomes is essential for development of interventions.
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Affiliation(s)
| | - Rory C O'Connor
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
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2
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Zhang Y, Li S, Li R, Rong F, Yu W, Zhang Z, Wan Y. Effects of social-ecological risk factors and resilience on the relationship between metabolic metrics and mental health among young adults. Psychiatry Res 2024; 337:115909. [PMID: 38703563 DOI: 10.1016/j.psychres.2024.115909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 04/04/2024] [Accepted: 04/07/2024] [Indexed: 05/06/2024]
Abstract
The correlation between metabolic metrics and mental health remains underexplored, with few in-depth studies examining whether this association exists among college students and whether it might be moderated by socio-ecological risk factors (SERFs) and mediated by resilience. A follow-up study design investigated the association between baseline metabolic metrics, SERFs and resilience and mental health. A multivariable linear regression model using the PROCESS method established the relationship of SERFs, resilience and metabolic metrics with mental health. Participants were 794 adolescents (mean age: 18.64 [±0.90] years). In multivariable linear regression, the high-level SERFs (β = 0.124), resilience (β = -0.042), LCI (β = 0.072), and RFM (β = 0.145) were associated with higher depression symptoms, while CVH (β = 0.602), TyG (β = 0.295), TyG-BMI (β = 0.004), and RC (β = -0.041) were not. An association was also observed between SERFs, resilience, RFM and anxiety. Resilience mediated the relationship between metabolic metrics and depression and anxiety, and SERFs moderated this relationship, demonstrating the relationship between resilience, metabolic metrics, SERFs and mental health. By revealing the potential sociological mechanism underlying the relationship between metabolic metrics and adolescents' mental health, this study provides a theoretical basis for further exploration of the biological foundations of mental health.
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Affiliation(s)
- Yi Zhang
- Department of Endocrinology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Department of Maternal, Child and Adolescent Health, School of public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Shuqin Li
- Department of Maternal, Child and Adolescent Health, School of public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Ruoyu Li
- Department of Maternal, Child and Adolescent Health, School of public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Fan Rong
- Department of Maternal, Child and Adolescent Health, School of public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Weiqiang Yu
- Department of Maternal, Child and Adolescent Health, School of public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Zhisu Zhang
- General Hospital of Huainan Eastern Hospital Group, Huainan 232063, China.
| | - Yuhui Wan
- Department of Maternal, Child and Adolescent Health, School of public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China.
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3
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Benham G, Charak R, Cano-Gonzalez I, Mena Teran J, Kenemore J. Recent Stressful Life Events and Perceived Stress as Serial Mediators of the Association between Adverse Childhood Events and Insomnia. Behav Med 2024:1-12. [PMID: 38634227 DOI: 10.1080/08964289.2024.2335175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 03/19/2024] [Indexed: 04/19/2024]
Abstract
Insomnia is common in college students and linked to poorer mental and physical health. There is growing evidence that adverse childhood experiences (ACEs) may contribute to insomnia in adulthood. However, beyond the need for additional replication of these findings, there is a need to identify underlying mechanisms that plausibly connect the two experiences. Based on a serial mediation model, the current study examined the role of two theoretically informed mediators: recent stressful life events and perceived stress. A cross-sectional survey of 2,218 college students at a large university in the southwestern United States was conducted between August 2020 and December 2021. The sample was predominantly Hispanic (96%) and female (73%), with a mean age of 20.7 years. Standardized measures of adverse childhood experiences, recent stressful life events, perceived stress, and insomnia were administered to participants online. Almost 20% of participants reported having experienced four or more adverse childhood experiences and 63% met the threshold for insomnia. Reporting four or more ACEs was associated with significantly greater insomnia severity, and this relationship was serially mediated by both recent stressful life events and perceived stress. However, recent stressful life events appeared to be the most powerful mediator. The results of the current study indicate that recent exposure to stressful life events serves as a plausible mechanism linking early adversity during childhood to adult insomnia and could therefore serve as a potential target for intervention. The findings suggest that students would benefit from university-wide efforts to reduce the number and/or intensity of common stressors.
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Affiliation(s)
- Grant Benham
- Department of Psychological Science, The University of Texas Rio Grande Valley
| | - Ruby Charak
- Department of Psychological Science, The University of Texas Rio Grande Valley
| | - Ines Cano-Gonzalez
- Department of Psychological Science, The University of Texas Rio Grande Valley
| | - Joceline Mena Teran
- Department of Psychological Science, The University of Texas Rio Grande Valley
| | - Jordan Kenemore
- Department of Psychological Science, The University of Texas Rio Grande Valley
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4
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Tyler KA, Ray CM. PTSD Symptoms Among College Students: Linkages with Familial Risk, Borderline Personality, and Sexual Assault. JOURNAL OF CHILD SEXUAL ABUSE 2024; 33:127-145. [PMID: 38456682 PMCID: PMC11003306 DOI: 10.1080/10538712.2024.2326543] [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] [Received: 04/11/2023] [Accepted: 02/27/2024] [Indexed: 03/09/2024]
Abstract
College students have high rates of post-traumatic stress disorder (PTSD) symptoms as well as high rates of sexual assault. What is less clear, however, is whether different sexual assault types (e.g. coercive, physically forced, and incapacitation) are associated with greater PTSD symptoms. Moreover, understanding early familial and mental health histories of college students is important for explaining PTSD symptoms. As such, we use a social stress framework to examine the relationships between early familial risk (i.e. child abuse, perceived maternal rejection), borderline personality (BP) symptoms, and three sexual assault types with PTSD symptoms among college students. A total of 783 undergraduate students (65.4% female) completed paper and pencil surveys in fall 2019 and spring 2020 at a large public university. Results revealed that females were more likely to experience child sexual abuse and all three forms of sexual assault, while males experienced higher rates of child physical abuse. OLS regression results showed positive associations between child sexual abuse, perceived maternal rejection, BP symptoms and all three types of sexual assault with PTSD symptoms. Females also experienced more PTSD symptoms compared to males. Findings have implications for targeted interventions to improve mental health outcomes.
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Affiliation(s)
| | - Colleen M. Ray
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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5
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Barclay N, Kelley KA, Brausch AM, Muehlenkamp JJ, Nadorff MR. Changes in the suicide risk behaviors of American college students over time: An analysis of three universities. Suicide Life Threat Behav 2023; 53:764-775. [PMID: 37515442 DOI: 10.1111/sltb.12981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 06/06/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023]
Abstract
INTRODUCTION Suicide-related behaviors are prevalent among college students, and several mental health problems associated with increased suicide risk have increased over time. Furthermore, notable cultural events (e.g., political changes, COVID-19) have occurred in the past decade, which likely impact trends in suicide-related behaviors. The current study examined how the prevalence of nonsuicidal self-injury (NSSI), suicidal ideation (SI), and suicide attempts has changed from 2012 to 2022 across three different universities. METHOD Archival datasets from multiple years of college student survey data were compiled, and different measures of NSSI, SI, and suicide attempts were dichotomized to assess prevalence. Chi-square goodness-of-fit tests were used to identify changes in suicide-related behaviors across time. RESULTS Results indicated significant increases in the prevalence of most behaviors across each university, with most increases occurring after 2018. Despite sharing a general trend of increased suicide-related behaviors, each university differed considerably in their respective trends between various timepoints, suggesting that unique factors may differentially contribute to growing risk among college students. CONCLUSION Overall, the current study identifies increasing trends in suicide-related behaviors over the past decade and highlights the value of investigating these behaviors at the university level.
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Affiliation(s)
- Nathan Barclay
- Department of Psychology, Mississippi State University, Starkville, Mississippi, USA
| | - Karen A Kelley
- Department of Psychology, Mississippi State University, Starkville, Mississippi, USA
| | - Amy M Brausch
- Department of Psychological Sciences, Western Kentucky University, Bowling Green, Kentucky, USA
| | - Jennifer J Muehlenkamp
- Department of Psychology, University of Wisconsin-Eau Claire, Eau Claire, Wisconsin, USA
| | - Michael R Nadorff
- Department of Psychology, Mississippi State University, Starkville, Mississippi, USA
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Limowski AR, DeJesus CR, Ward-Ciesielski EF, McDermott MJ. Emotion dysregulation, help-seeking attitudes, and posttraumatic stress disorder symptoms: A structural equation model. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:871-878. [PMID: 34242125 DOI: 10.1080/07448481.2021.1909039] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Objective: Most college students have experienced an adverse event in their lifetime, yet help-seeking rates remain low. This study seeks to understand psychological factors that might contribute to delays in treatment initiation among trauma-affected students. Participants: Our sample consisted of 531 undergraduate students of which 27% scored above the clinical cutoff for PTSD using the PTSD Checklist for DSM-5 (PCL-5). Methods: This cross-sectional study explored relationships among help-seeking attitudes, emotion dysregulation, and PTSD symptoms using structural equation modeling. Results: Findings demonstrated that individuals with more severe emotion dysregulation had more severe PTSD symptoms and held more negative attitudes toward seeking help. Conclusions: Individuals who are the most in need of treatment hold attitudes that may impede help-seeking. We discuss clinical implications and ways college counseling centers can maximize outreach and programming efforts to increase treatment initiation and engagement.
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Affiliation(s)
- Anne R Limowski
- Department of Psychology, Hofstra University, Hempstead, NY, USA
| | | | - Erin F Ward-Ciesielski
- Department of Psychology, Hofstra University, Hempstead, NY, USA
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Michael J McDermott
- Department of Psychology, University of Louisiana at Lafayette, Lafayette, LA, USA
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7
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Feiler T, Vanacore S, Dolbier C. Relationships Among Adverse and Benevolent Childhood Experiences, Emotion Dysregulation, and Psychopathology Symptoms. ADVERSITY AND RESILIENCE SCIENCE 2023; 4:1-17. [PMID: 37361560 PMCID: PMC10063933 DOI: 10.1007/s42844-023-00094-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/07/2023] [Indexed: 04/03/2023]
Abstract
This cross-sectional study sought to examine adverse childhood experiences (ACEs), benevolent childhood experiences (BCEs), and emotion dysregulation as they relate to psychopathology symptoms (posttraumatic stress disorder [PTSD], anxiety, depression) in university students in emerging adulthood. Students at a United States university (N = 1,498) completed an online survey during the fall 2021 and spring 2022 semesters. Measures include the Adverse Childhood Experiences Questionnaire, Benevolent Childhood Experiences Scale, Difficulties in Emotion Regulation Scale-Short Form, PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders 5th edition, Patient Health Questionnaire 8, and Generalized Anxiety Disorder 7 Scale. ACEs significantly related to greater symptoms and positive screens for PTSD, depression, and anxiety. BCEs significantly related to fewer symptoms and positive screens for PTSD, depression, and anxiety. Emotion dysregulation was a significant mediator of relationships between ACEs and all symptom types (direct and indirect effects were both significant, supporting partial mediation). Emotion dysregulation was a significant partial mediator of relationships between BCEs and all symptom types (direct and indirect effects were both significant, supporting partial mediation). Results showed significant small moderation effects of BCEs on the relationships of ACEs-emotion dysregulation, ACEs-depression symptoms, ACEs-anxiety symptoms, and emotion dysregulation-PTSD symptoms. Implications for colleges and universities are discussed.
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Affiliation(s)
- Tatum Feiler
- Department of Psychology, East Carolina University, Greenville, NC USA
| | - Sarah Vanacore
- Department of Psychology, East Carolina University, Greenville, NC USA
| | - Christyn Dolbier
- Department of Psychology, East Carolina University, Greenville, NC USA
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Offerman ECP, Asselman MW, Bolling F, Helmond P, Stams GJJM, Lindauer RJL. Prevalence of Adverse Childhood Experiences in Students with Emotional and Behavioral Disorders in Special Education Schools from a Multi-Informant Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063411. [PMID: 35329097 PMCID: PMC8948877 DOI: 10.3390/ijerph19063411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/20/2022] [Accepted: 03/08/2022] [Indexed: 02/05/2023]
Abstract
Adverse childhood experiences (ACEs) are associated with an increased risk of developing severe emotional and behavioral problems; however, little research is published on ACEs for students with emotional and behavioral disorders (EBD) in special education (SE) schools. We therefore systematically explored the prevalence, type and timing of ACEs in these students from five urban SE schools in the Netherlands (Mage = 11.58 years; 85.1% boys) from a multi-informant perspective, using students’ self-reports (n = 169), parent reports (n = 95) and school files (n = 172). Almost all students experienced at least one ACE (96.4% self-reports, 89.5% parent reports, 95.4% school files), and more than half experienced four or more ACEs (74.5% self-reports, 62.7% parent reports, 59.9% school files). A large majority of students experienced maltreatment, which often co-occurred with household challenges and community stressors. Additionally, 45.9% of the students experienced their first ACE before the age of 4. Students with EBD in SE who live in poverty or in single-parent households were more likely to report multiple ACEs. Knowledge of the prevalence of ACEs may help understand the severe problems and poor long-term outcomes of students with EBD in SE.
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Affiliation(s)
- Evelyne C. P. Offerman
- Orion, Special Education, Bijlmerdreef 1289-2, 1103 TV Amsterdam, The Netherlands; (M.W.A.); (F.B.)
- Correspondence: ; Tel.: +31-65374496
| | - Michiel W. Asselman
- Orion, Special Education, Bijlmerdreef 1289-2, 1103 TV Amsterdam, The Netherlands; (M.W.A.); (F.B.)
| | - Floor Bolling
- Orion, Special Education, Bijlmerdreef 1289-2, 1103 TV Amsterdam, The Netherlands; (M.W.A.); (F.B.)
| | - Petra Helmond
- Levvel, Academic Center for Child and Adolescent Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands; (P.H.); (R.J.L.L.)
| | - Geert-Jan J. M. Stams
- Department of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS Amsterdam, The Netherlands;
| | - Ramón J. L. Lindauer
- Levvel, Academic Center for Child and Adolescent Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands; (P.H.); (R.J.L.L.)
- Department of Child and Adolescent Psychiatry, Amsterdam University Medical Centre, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands
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Kalmakis KA, Kent NM, Alhowaymel F, Chiodo LM. Perceived stress, fatigue symptoms, and posttraumatic stress disorder symptoms among young adult college students. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2022; 35:60-67. [PMID: 34561938 PMCID: PMC8813883 DOI: 10.1111/jcap.12352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 09/10/2021] [Accepted: 09/12/2021] [Indexed: 02/03/2023]
Abstract
PROBLEM University students experience stress and fatigue often affecting their health, academic success, and social adjustment. Many also have histories of childhood trauma that may result in posttraumatic stress symptoms. The purpose of this study was to determine the associations between perceptions of stress, symptoms of fatigue, and symptoms of posttraumatic stress disorder (PTSD) among university students, many of whom report childhood adversity. METHODS Sixty-nine students from one university campus participated in this study. A cross-sectional design was used to gather data across six self-report measures. FINDINGS Childhood adversity was associated with PTSD symptoms and acute stress, and PTSD symptoms were related to all three measures of fatigue. PTSD symptoms mediated the relationship between stress and fatigue, but not other fatigue domains. CONCLUSIONS The implications of an association between PTSD, stress, and fatigue are relevant to students' health and academic success. It is important to note that even subclinical levels of PTSD impact fatigue.
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Affiliation(s)
- Karen, A. Kalmakis
- University of Massachusetts Amherst, 651 North Pleasant Street, Amherst, MA 01003
| | - Nicole, M. Kent
- University of Massachusetts Amherst, 651 North Pleasant Street, Amherst, MA 01003
| | - Fahad Alhowaymel
- College of Applied Medical Sciences, Shaqra University, Shaqra, Saudi Arabia
| | - Lisa, M. Chiodo
- University of Massachusetts Amherst, 651 North Pleasant Street, Amherst, MA 01003
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Clark CS, Aboueissa AEM. Nursing students' adverse childhood experience scores: a national survey. Int J Nurs Educ Scholarsh 2021; 18:ijnes-2021-0013. [PMID: 34963206 DOI: 10.1515/ijnes-2021-0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 12/08/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To determine the adverse childhood experience scores (ACES) of nursing students in the United States. METHODS Utilized the standardized Family Health History Questionnaire to determine the ACES of a national sample of nursing students. Simple descriptive statistics were used to analyze the findings. RESULTS Nursing students ACES indicate that they enter academia with a much higher baseline of childhood trauma versus the general population. Over 40% of nursing students surveyed had an ACES of 4 or more versus the national average of 12.5-13.3% of the general population having an ACES of 4 or more. CONCLUSIONS This data provides support for Conti-O'Hare's theory of nurses as wounded healer. Nursing faculty should consider nursing students to be members of a vulnerable population and revise curricula to support nursing students stress resileince.
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Affiliation(s)
- Carey S Clark
- Nursing, Pacific College of Oriental Medicine - New York Campus, Denmark, ME, USA
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11
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Schulte EM, Bach C, Berkowitz RI, Latner JD, Pearl RL. Adverse Childhood Experiences and Weight Stigma: Co-Occurrence and Associations with Psychological Well-Being. STIGMA AND HEALTH 2021; 6:408-418. [PMID: 34926807 PMCID: PMC8675894 DOI: 10.1037/sah0000341] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Prior research has demonstrated that individuals with a higher body weight (i.e., obesity) have a relatively high incidence of adverse childhood experiences (ACEs) (e.g., abuse, neglect). Individuals with obesity are also susceptible to experiencing and internalizing weight stigma. Negative physical and mental health consequences have been associated with both ACEs and weight stigma, yet the interplay between these factors has not been explored. The current study examined ACEs in a sample of 105 treatment-seeking adults with obesity who all reported having experienced and internalized weight stigma (90.5% women, 70.5% non-Hispanic White, mean age=49.1 years). The study aimed to 1) provide a descriptive overview of rates of ACEs in this unique sample of adults with potentially high psychological vulnerability and 2) assess associations between ACEs, weight stigma, and psychological well-being. Over three-fourths of participants (76.2%) reported experiencing at least one ACE. The total number of ACEs was significantly associated with more frequent experiences of and greater distress about weight stigma during childhood, as well as higher current perceived stress. Experiencing weight stigma for the first time in childhood was also associated with more reported ACEs. ACEs of abuse were associated with more lifetime reported experiences of weight stigma and greater internalization, use of eating as a strategy to cope with weight stigma, and higher perceived stress. These findings have implications for early identification of and tailored interventions for individuals who have experienced adverse events and weight stigma at a young age.
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Affiliation(s)
- Erica M. Schulte
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA USA
| | - Caroline Bach
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA USA
| | - Robert I. Berkowitz
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA USA
- Department of Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, PA USA
| | - Janet D. Latner
- Department of Psychology, University of Hawaii at Manoa, Honolulu, HI USA
| | - Rebecca L. Pearl
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA USA
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL USA
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12
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Ghinea D, Fuchs A, Parzer P, Koenig J, Resch F, Kaess M. Psychosocial functioning in adolescents with non-suicidal self-injury: the roles of childhood maltreatment, borderline personality disorder and depression. Borderline Personal Disord Emot Dysregul 2021; 8:21. [PMID: 34193286 PMCID: PMC8246665 DOI: 10.1186/s40479-021-00161-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 05/31/2021] [Indexed: 03/07/2023] Open
Abstract
BACKGROUND There is a lack of studies examining psychosocial functioning in patients with non-suicidal self-injury (NSSI), especially in adolescents, and rates of impaired functioning in existing literature vary considerably. These variations may be attributable to further risk factors that influence psychosocial functioning. Thus, the aim of the study was to examine whether adolescent NSSI patients with childhood maltreatment (CM), a known risk factor for lower psychosocial functioning, may differ from adolescent NSSI patients without CM, and whether these differences may be explained by the severity of comorbid disorders. Specifically, we examined whether severity of borderline personality disorder (BPD), depression and posttraumatic stress disorder may explain differences in psychosocial functioning in NSSI patients with and without CM. METHODS Data of 368 adolescents with NSSI disorder from an outpatient clinic were analyzed using structural equation modeling. Clinicans' rating of the Global Assessment of Functioning Scale (GAF) was collected, in addition to clinical interviews. RESULTS Results indicate that GAF scores were lower among NSSI patients with CM and that the difference in psychosocial functioning between these groups was explained by BPD and depression severity. CONCLUSIONS Psychosocial functioning in NSSI patients varies depending on whether they have experienced CM or not. Specifically, these differences seem to be attributable to higher BPD and depression severity in adolescent NSSI patients with CM. Clinicians should ensure to assess CM and focus on BPD and depression severity in this population. Treatment of BPD and depression may notably reduce psychosocial impairment in NSSI patients with CM.
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Affiliation(s)
- Denisa Ghinea
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Anna Fuchs
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Peter Parzer
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Julian Koenig
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Franz Resch
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Michael Kaess
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
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13
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Christensen J, Beveridge JK, Wang M, Orr SL, Noel M, Mychasiuk R. A Pilot Study Investigating the Role of Gender in the Intergenerational Relationships between Gene Expression, Chronic Pain, and Adverse Childhood Experiences in a Clinical Sample of Youth with Chronic Pain. EPIGENOMES 2021; 5:epigenomes5020009. [PMID: 34968296 PMCID: PMC8594698 DOI: 10.3390/epigenomes5020009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/24/2021] [Accepted: 04/13/2021] [Indexed: 12/20/2022] Open
Abstract
Chronic pain is a highly prevalent and costly issue that often emerges during childhood or adolescence and persists into adulthood. Adverse childhood experiences (ACEs) increase risk for several adverse health conditions, including chronic pain. Recent evidence suggests that parental trauma (ACEs, post-traumatic stress disorder (PTSD) symptoms) confers risk of poor health outcomes in their children. Intergenerational relationships between parental trauma and child chronic pain may be mediated by epigenetic mechanisms. A clinical sample of youth with chronic pain and their parents completed psychometrically sound questionnaires assessing ACEs, PTSD symptoms, and chronic pain, and provided a saliva sample. These were used to investigate the intergenerational relationships between four epigenetic biomarkers (COMT, DRD2, GR, and SERT), trauma, and chronic pain. The results indicated that the significant biomarkers were dependent upon the gender of the child, wherein parental ACEs significantly correlated with changes in DRD2 expression in female children and altered COMT expression in the parents of male children. Additionally, the nature of the ACE (maltreatment vs. household dysfunction) was associated with the specific epigenetic changes. There may be different pathways through which parental ACEs confer risk for poor outcomes for males and females, highlighting the importance of child gender in future investigations.
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Affiliation(s)
- Jennaya Christensen
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC 3004, Australia;
| | - Jaimie K. Beveridge
- Department of Psychology, University of Calgary, Calgary, AB T2N 1N4, Canada; (J.K.B.); (M.N.)
| | - Melinda Wang
- Hotchkiss Brain Institute, Calgary, AB T2N 4N1, Canada;
- Alberta Children’s Hospital Research Institute, Calgary, AB T2N 4N1, Canada
| | - Serena L. Orr
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada;
| | - Melanie Noel
- Department of Psychology, University of Calgary, Calgary, AB T2N 1N4, Canada; (J.K.B.); (M.N.)
- Hotchkiss Brain Institute, Calgary, AB T2N 4N1, Canada;
- Alberta Children’s Hospital Research Institute, Calgary, AB T2N 4N1, Canada
| | - Richelle Mychasiuk
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC 3004, Australia;
- Department of Psychology, University of Calgary, Calgary, AB T2N 1N4, Canada; (J.K.B.); (M.N.)
- Hotchkiss Brain Institute, Calgary, AB T2N 4N1, Canada;
- Alberta Children’s Hospital Research Institute, Calgary, AB T2N 4N1, Canada
- Correspondence:
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Hedrick J, Bennett V, Carpenter J, Dercher L, Grandstaff D, Gosch K, Grier L, Meek V, Poskin M, Shotton E, Waterman J. A descriptive study of adverse childhood experiences and depression, anxiety, and stress among undergraduate nursing students. J Prof Nurs 2021; 37:291-297. [PMID: 33867083 DOI: 10.1016/j.profnurs.2021.01.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND/SIGNIFICANCE The 10-point Adverse Childhood Experiences (ACEs) score measures childhood exposure to traumatic events. An ACEs score of 4 or higher has been associated with long-term physical and mental health problems, and increased mortality. It is unclear if the rates of undergraduate nursing students experiencing ACEs is different from the general population, and what impact ACEs has on nursing students' depression, anxiety and stress. PURPOSE The purpose of this study was to assess the rate of ACEs in nursing students and to examine the relationship between ACEs and perceived depression, anxiety, and stress among undergraduate nursing students. METHODS This is a descriptive correlational study to determine Adverse Childhood Experiences (ACEs) scores and Modified Depression Anxiety and Stress Scale (DASS-21) scores for undergraduate pre-licensure students at a private mid-western college. Students' ACEs scores were correlated with DASS-21 scores and demographic data. RESULTS 409 students volunteered to participate in the study. Seventeen percent of students had high ACEs scores (≥4). Those students with high ACEs scores also scored statically significantly higher on the DASS-21 items relating to depression, anxiety, and stress. CONCLUSION/IMPLICATIONS Results from this study demonstrated that many nursing students have experienced ACEs and nursing students with ACEs scores of 4 or higher had higher rates of depression, anxiety, and stress. These findings should drive faculty in nursing programs to acknowledge the prevalence of ACEs among their nursing students and recognize that impact on the mental health of students.
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Affiliation(s)
- Jane Hedrick
- Saint Luke's College of Health Sciences at Rockhurst University, 624 Westport Road, Kansas City, MO 64111, USA.
| | - Vicki Bennett
- Saint Luke's College of Health Sciences at Rockhurst University, 624 Westport Road, Kansas City, MO 64111, USA.
| | | | - Lauren Dercher
- Saint Luke's College of Health Sciences at Rockhurst University, 624 Westport Road, Kansas City, MO 64111, USA.
| | - Deb Grandstaff
- Saint Luke's College of Health Sciences at Rockhurst University, 624 Westport Road, Kansas City, MO 64111, USA.
| | - Kensey Gosch
- Saint Luke's Mid America Heart Institute, Saint Luke's Hospital, 4401 Wornall Road, Kansas City, MO 64111, USA.
| | - Laura Grier
- Saint Luke's College of Health Sciences at Rockhurst University, 624 Westport Road, Kansas City, MO 64111, USA.
| | - Vicki Meek
- Saint Luke's College of Health Sciences at Rockhurst University, 624 Westport Road, Kansas City, MO 64111, USA.
| | - Mary Poskin
- Saint Luke's College of Health Sciences at Rockhurst University, 624 Westport Road, Kansas City, MO 64111, USA.
| | - Emma Shotton
- Saint Luke's College of Health Sciences at Rockhurst University, 624 Westport Road, Kansas City, MO 64111, USA.
| | - James Waterman
- Saint Luke's College of Health Sciences at Rockhurst University, 624 Westport Road, Kansas City, MO 64111, USA.
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15
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Adverse Childhood Experiences and Health Indicators in a Young Adult, College Student Sample: Differences by Gender. Int J Behav Med 2020; 27:660-667. [DOI: 10.1007/s12529-020-09913-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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16
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Chandler GE, Kalmakis KA, Chiodo L, Helling J. The Efficacy of a Resilience Intervention Among Diverse, At-Risk, College Athletes: A Mixed-Methods Study. J Am Psychiatr Nurses Assoc 2020; 26:269-281. [PMID: 31747846 DOI: 10.1177/1078390319886923] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND: Adverse childhood experiences (ACEs) have been associated with psychological and physiological disease, and risky health behaviors. A person's ability to be resilient may protect them from these negative health outcomes, as resilience has been associated with increased emotional awareness, coping, belonging, and greater likelihood of good health and well-being. AIMS: The purpose of this pilot study was to assess the efficacy of a strengths-based resilience intervention to improve access to internal and external resources that effect perceptions of stress, resilience, emotional awareness, and belonging among student-athletes. METHODS: A mixed-methods design was used to examine variables of interest between intervention and control groups. A sample of 56 college athletes completed surveys and engaged in expressive writing during a 5-week resilience intervention. RESULTS: Self-report data indicated that student-athletes in the intervention group improved decision making, lowered perceived stress, and increased resilience compared with controls. Of note, participants with ACEs showed greater increments of positive change in emotional awareness scales than participants without ACEs. Descriptions of emotion management, authentic connections, and increased ability to request support from others were identified in the qualitative data. CONCLUSIONS: A strengths-based course designed to increase resilience-offered as academic and athletic stress is mounting-provided a unique opportunity to promote student-athlete success. Participants gained skills key to victory on and off the field, including health-promoting behaviors, a sense of belonging, persistence, and the ability to negotiate external resources.
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Affiliation(s)
| | - Karen A Kalmakis
- Karen A. Kalmakis, PhD, MPH, FNP, FAANP, University of Massachusetts Amherst, MA, USA
| | - Lisa Chiodo
- Lisa Chiodo, PhD, University of Massachusetts Amherst, MA, USA
| | - Jim Helling
- Jim Helling, LICSW, University of Massachusetts Amherst, MA, USA
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