Childhood physical abuse and emotional neglect are specifically associated with adult mental disorders

Recent life events and adverse childhood experiences in predicting antenatal depression and anxiety: cross-sectional study

BACKGROUND

Antenatal depression and anxiety are associated with preterm labour, low birth weight, and postpartum depression, and can impact the emotional and mental development of the child. Both adverse childhood experiences and recent stressful events are linked to negative health outcomes. However, certain events may be more impactful than others.

OBJECTIVE

This study aims to investigate the most important types of adverse childhood events and recent stressors that may help in identifying pregnant women in most need of psychological support.

METHODS

This observational study examines data from the FamilieTrivsel trial, in which women between 6 and 10 weeks gestation were recruited by general practitioners. All participants were asked to complete questionnaires. Mental health was assessed with the Hospital Anxiety and Depression Score (HADS). Potential contributory risk factors were identified using the Recent Life Events Questionnaire and the Adverse Childhood Experiences questionnaire. The relative importance of the various types of events was analysed in a dominance analysis, and the direction of their association was determined by a multivariable linear regression analysis.

RESULTS

Of specific recent life events, serious problems with a friend, divorce, racial harassment, unemployment, financial difficulties, and moving house had the strongest associations with poor mental health, along with childhood experience of mental illness in the household. Growing up with an experience of physical neglect and parental divorce were, paradoxically, associated with lower HADS scores.

CONCLUSIONS

Recent stressful life events have a stronger association with postnatal mental health than adverse childhood events, implying that it might be useful for clinicians providing routine antenatal care to gather information on recent stressors.

Do coping strategies mediate the effects of childhood adversities and traumata on clinical high-risk of psychosis, depression, and social phobia? A cross-sectional study on patients of an early detection service

BACKGROUND

Childhood adversities and traumata (CAT) increase the risk for various mental disorders, including the clinical high-risk of psychosis (CHR-P) state and its main comorbidities, i.e., depression, and social phobia. However, these relations are likely mediated by personal coping behaviors. This cross-sectional study investigates the relationships between the main CAT domains, coping, CHR-P, depression, and social phobia.

METHODS

Using path analyses, we analyzed data of 736 patients (mean age 24 years, 67% male) who presented at an early detection service between 2002 and 2013, answered questionnaires on CAT, coping, depressiveness, and social phobia, and underwent clinical examination for CHR-P according to the recommendations of the Guidance project of the European Psychiatric Association.

RESULTS

All path models (total sample, males and females) showed good to excellent fit to the data. In all models, higher scores on maladaptive coping mediated the negative effect of emotional abuse on mental health outcomes. Additionally, in the total sample and males, lower scores on adaptive coping mediated the negative effect of emotional abuse and neglect, and physical neglect was associated with lower scores on adaptive coping that, in turn, were linked to depression and social phobia but not CHR-P. Overall, effects of maladaptive coping were higher than those of adaptive coping, although adaptive coping was more diversely associated with CAT. Furthermore, the interrelated depression and social phobia were more widely explained by the models than CHR-P, which was not significantly associated with them.

CONCLUSIONS

Our findings underscore the complex interplay of the CAT domains and their relevant mediators with mental health outcomes that likely reflect underlying sex-specific psychological, social, cultural and neurobiological mechanisms. Supporting a broader view on CAT than the traditional focus on sexual abuse, results indicate an important role of emotional abuse that, descriptively, is most strongly mediated by maladaptive coping strategies on mental health outcomes. A detailed understanding of the effects of CAT will in future help to develop a multi-dimensional, holistic and sex-specific approach to the treatment of patients who have experienced CAT.

TRIAL REGISTRATION

The study was registered in the German Clinical Trial Register ( https://drks.de/ ) as DRKS00024469 at 02/24/2021.

Consequences of Early Maternal Deprivation on Neuroinflammation and Mitochondrial Dynamics in the Central Nervous System of Male and Female Rats

Early life stress (ELS) is associated with an increased risk for neuropsychiatric disorders, and both neuroinflammation and mitochondrial dysfunction seem to be central to mental health. Herein, using an animal model of ELS, a single episode of maternal deprivation (MD, 24 h on pnd 9) extensively documented to elicit behavioural anomalies in male and female Wistar rats, we investigated its consequences in terms of neuroinflammation and mitochondrial dynamics in the prefrontal cortex (PFC) and the hippocampal formation (HCF). MD differentially affected the brain content of cytokines: MD induced a transient increase in pro-inflammatory cytokines (IL-1β and IL-6) in the PFC, as well as in the levels of the anti-inflammatory cytokine IL-10 in the HCF. MD also induced a significant decrease mitochondria citrate synthase activity, but MD did not exert significant changes in mitochondria Complex IV activity, revealing a generalized decrease in mitochondrial density without any change in mitochondrial respiration. In the present study, we demonstrate that MD induces neuroinflammatory processes in specific brain regions. Additional research is needed to better understand the temporal pattern of such changes, their impact on the developing brain, and their participation in the already well-known behavioural consequences of MD.

Parental marital status and anxiety symptoms in adolescents: the mediating effect of childhood maltreatment

Although previous studies have established the association between parental marital status and mental health problems in adolescents, however, the adverse effects of incomplete family settings and childhood maltreatment on adolescent anxiety symptoms have not been fully investigated. Moreover, whether childhood maltreatment can mediate the relationship between parental marital status and anxiety symptoms remains unclear. A population-based cross-sectional study was performed among 35,573 adolescents in elementary schools across 17 provinces in China. And childhood maltreatment, resilience, and anxiety symptoms were assessed among adolescents, respectively. The parental marital status was self-reported as having two married biological parents, divorced parents, stepparents, and single-parent. We found that the rates of anxiety symptoms among adolescents were 35.1% in intact families, 48.8% in divorced families, 49% in stepparent families, and 48% in single-parent families. Divorced parents (aOR = 1.191, 95% CI [1.060-1.337]) was an independent risk factor for adolescents' anxiety symptom while having stepparents and single-parent were not. In addition, emotional abuse (aOR = 1.300, 95% CI [1.285-1.316]), sexual abuse (aOR = 1.088, 95% CI [1.063-1.114]), and physical neglect (aOR = 1.019, 95% CI [1.007-1.031]) were all independent risk factors for anxiety symptoms in adolescents, while physical abuse and emotional neglect were not. The negative impacts of divorced and remarried parents on adolescent anxiety symptoms were mediated by childhood maltreatment partially (64.9% and 72.2%), while childhood maltreatment completely mediated the adverse impacts of single-parent on adolescent anxiety symptoms. Childhood maltreatment intervention strategies could be necessary for anxiety symptoms of adolescents in divorced/stepparent/single-parent families.

Differential associations of adverse childhood experiences and mental health outcomes in U.S. military veterans

Adverse childhood experiences (ACEs) are robustly associated with adverse mental health outcomes across the lifespan. Military veterans may be particularly vulnerable to adverse mental health effects of ACEs given their potentially higher prevalence of childhood traumas and compounding effects of military service-related traumas. To date, however, scarce research has examined the differential impact of individual ACEs on mental health outcomes in population-based samples of veterans. To address this gap, we analyzed data from the National Health and Resilience in Veterans Study (NHRVS), which surveyed a nationally representative sample of 4069 U.S. veterans, to examine the association between specific ACEs and major depressive, generalized anxiety, and posttraumatic stress disorders, and suicidal thoughts and behaviors. Results of multivariable logistic regression analyses revealed that emotional neglect and sexual abuse were most consistently associated with these outcomes, even after adjustment for the number of ACEs endorsed. Collectively, results of this study underscore the importance of assessing for specific ACEs-most notably childhood emotional neglect and sexual abuse-and treating these potentially unresolved childhood traumas in veterans.

The interplay of childhood trauma, oxytocin, and impulsivity in predicting the onset of methamphetamine use

BACKGROUND

Childhood trauma is associated with substance use disorders, including methamphetamine use disorder (MUD). Oxytocin, involved in social bonding, stress regulation, and reward processing, may influence addiction vulnerability and impulsivity in individuals with a history of childhood trauma.

OBJECTIVE

To investigate the relationships among childhood trauma, oxytocin levels, impulsivity, and the age of first methamphetamine use in individuals with MUD.

PARTICIPANTS AND SETTING

The study included 298 male participants (148 individuals with MUD and 150 healthy controls) from both probation offices and psychiatric clinics.

METHODS

Childhood trauma was assessed using the Childhood Trauma Questionnaire-Short Form (CTQ-SF), impulsivity with the Barratt Impulsiveness Scale-11 (BIS-11), and plasma oxytocin levels were obtained.

RESULTS

Individuals with MUD exhibited higher levels of childhood trauma, impulsivity, and lower plasma oxytocin levels compared to healthy controls. Childhood trauma was associated with a younger age of first methamphetamine use, higher impulsivity, and lower oxytocin levels among individuals with MUD. Plasma oxytocin levels partially mediated the relationship between childhood trauma and both the age of first methamphetamine use and impulsivity. Serial mediation analysis demonstrated that oxytocin levels and impulsivity sequentially mediated the relationship between childhood trauma and the age of first methamphetamine use.

CONCLUSIONS

The findings reveal the complex interplay among childhood trauma, oxytocin, impulsivity, and methamphetamine use, emphasizing the importance of considering these factors in prevention and intervention strategies for MUD. Future research should explore oxytocin and impulsivity-focused interventions to mitigate the effects of childhood trauma and reduce MUD development risk.

Adverse childhood experiences and psychological functioning among women with schizophrenia or bipolar disorder: population-based study

BACKGROUND

Adverse childhood experiences (ACEs) are well-known risk factors for schizophrenia and bipolar disorder.

AIMS

The aim was to study the associations between specific ACEs and psychological functioning in women with schizophrenia or bipolar disorder.

METHOD

Among 29 367 women (mean age 44 years) from the Icelandic Stress-And-Gene-Analysis (SAGA) study, 534 (1.8%, mean age 40) reported having been diagnosed with schizophrenia or bipolar disorder, which were combined to 'severe mental disorders'. Participants reported on 13 types of ACEs, childhood deprivation and psychological functioning (defined as coping ability and current symptoms of depression, anxiety and sleep disturbances). Adjusted Poisson regression calculated prevalence ratios (PRs) between ACEs and severe mental disorders. Linear regression assessed the association between ACEs and psychological functioning among women with a severe mental disorder.

RESULTS

Women with a severe mental disorder reported more ACEs (mean 4.57, s.d. = 2.82) than women without (mean 2.51, s.d. = 2.34) in a dose-dependent manner (fully-adjusted PR = 1.23 per ACE, 95% CI 1.20-1.27). After mutual adjustment for other ACEs, emotional abuse, sexual abuse, mental illness of a household member, emotional neglect, bullying and collective violence were associated with severe mental disorders. Among women with severe mental disorders, a higher number of ACEs was associated with increased symptom burden of depression (β = 2.79, 95% CI = 1.19-4.38) and anxiety (β = 2.04, 95% CI = 0.99-3.09) including poorer sleep quality (β = 0.83, 95% CI = 0.07-1.59). Findings were similar for schizophrenia and bipolar disorder separately.

CONCLUSION

Women with schizophrenia or bipolar disorder show a strong history of ACEs, which may interfere with their psychological functioning and, therefore, need to be addressed as part of their treatment, for example, with trauma-focused psychotherapy.

The Impact of Childhood Psychological Maltreatment on Mental Health Outcomes in Adulthood: A Systematic Review and Meta-Analysis

Childhood emotional abuse (CEA) and childhood emotional neglect (CEN) are the least well-studied forms of childhood maltreatment due to challenges in their definition and in detection. However, the available evidence suggests associations with multiple adulthood mental health problems in clinical and non-clinical populations. This systematic review and meta-analysis (PROSPERO registration number CRD42020197833) explored the associations between CEA and CEN and a range of adulthood mental health problems based on systematic searches of eight databases. In total, 79 English and 11 Chinese studies met our inclusion criteria. Results suggested that CEA and CEN had positive associations with various adulthood mental health problems (d = 0.02-1.84), including depression, anxiety, substance abuse, suicidal ideation or attempts, personality disorders, eating disorders, and other psychological symptoms in the general population and across different geographic regions. Furthermore, findings suggested that compared with the non-clinical population, individuals in clinical populations were more likely to have experienced emotional abuse and neglect during childhood. The review highlights the need for more research on emotional abuse and emotional neglect. Furthermore, future research should include more populations from non-western countries and non-college populations. They further underline the importance of addressing issues related to CEA/CEN experiences in the prevention and treatment of mental health issues in adulthood.

Childhood maltreatment and suicide risk: The mediating role of self-compassion, mentalization, depression

BACKGROUND

Childhood maltreatment (CM) is a well-established risk factor for depression and increased suicide risk. This study aimed to investigate the distinctive mechanisms of individual types of CM on young adult suicide risk, by exploring the potential mediating role of mentalization, self-compassion, and depression.

METHODS

A total of 4873 adults completed a survey screening for experiences of CM, self-compassion, mentalization, depression, and suicide risk.

RESULTS

The path analysis revealed significant direct effects of mentalization, self-compassion, and depression on suicide risk. Moreover, mentalization, self-compassion, and depression mediated the relationship between emotional abuse/neglect and suicide risk, whereas physical neglect contributed to suicide risk only through mentalization and depression. Furthermore, sexual abuse had a significant direct effect on suicide risk, whereas physical abuse did not show any direct or indirect effects.

LIMITATIONS

The cross-sectional design of the study limits its ability to establish causality, and the risk of recall bias in reporting physical or sexual abuse cannot be ignored.

CONCLUSIONS

This study represents the first identification of disturbances in self-compassion, mentalization, and depression that mediate the relationship between various types of CM and suicide risk in young adults. Our findings suggest substantive differences in the impact of emotional CM compared to other forms of CM. Enhancing self-compassion and mentalization abilities could be valuable intervention strategies for individuals with a history of emotional CM. Addressing factors that hinder the recall of relevant subjective experiences of physical and sexual abuse is also critical.

Effects of early-life stress on probabilistic reversal learning and response perseverance in young adults

Early life stress (ELS), including experiences with abuse and neglect, are related to several negative health outcomes in adulthood. One area that has received attention is the increased rate of substance abuse disorder in individuals who had experienced ELS. Given the critical role habitual behavior in the development of substance abuse, ELS may affect the trajectory of neural development such that habitual responding is more dominant than in individuals who did not experience ELS. Here, we examine learning of a probabilistic classification task (the Weather Prediction Task) in healthy young adults who reported significant ELS and those that did not. This task can be learned in a declarative, model-based manner, or in a more habitual, stimulus-response manner. Participants learned to choose the outcome (sun or rain) that was probabilistically associated with each cue combination through reinforcement on each trial. After 100 trials, the probabilities were reversed, and we conceptualized habitual behavior as perseverating responses based on the old probabilities. We also collected information about subjective socio-economic status (sSES), anxiety, depression, and substance use from participants. Using multiple regression, we found that our measure of habitual responding was correlated with reported alcohol use, suggesting that our measure of habit has validity for health behaviors. Furthermore, we found that some forms of early life stress led to greater response perseverance after contingencies were reversed. Overall, the results suggest that childhood adversity may contribute to the development of habit.

Parental emotional neglect and academic procrastination: the mediating role of future self-continuity and ego depletion

The purpose of this study was to explore the effect of parental emotional neglect on the academic procrastination of late adolescents and further analyze the mediating role of future self-continuity and ego depletion. This study included 609 college students, 344 males and 265 females, ranging in age from 17 to 21 years (M = 18.39, SD = 0.82), who responded to four questionnaires measuring parental emotional neglect, academic procrastination, future self-continuity, and ego depletion, respectively. The results showed that future self-continuity and ego depletion mediated the association between parental emotional neglect and late adolescents' academic procrastination in a serial pattern. Perceived higher levels of parental emotional neglect correlated with lower future self-continuity and higher ego depletion in these late adolescents, leading to higher levels of academic procrastination.

Factors Associated with High-Risk Substance Use in Persons Receiving Psychiatric Treatment for a Primary Trauma- and Stressor-Related Disorder Diagnosis

OBJECTIVE

Although mental health disorders and high-risk substance use frequently co-occur, they are typically investigated independently. Clinical trials focused on treatment for individuals with trauma- and stressor-related disorders often exclude individuals with high-risk substance use. Little is also known about the role of gender in the relationship between trauma- and stressor-related disorders and high-risk substance use. We examined the relationship between trauma- and stressor-related disorders, high-risk substance use, and gender.

METHODS

Using the Mental Health Client-Level Data dataset, we examined 15,772 adults receiving treatment in psychiatric hospitals in the United States from 2013 to 2019.

RESULTS

A logistic regression model showed that for men, relative to women, having multiple mental health diagnoses and having a serious mental illness or serious emotional disturbance was associated with greater odds of high-risk substance use.

CONCLUSIONS

This study underscores the value of comprehensive gender-centered treatment for people with trauma- and stressor-related disorders engaging in high-risk substance use.

The influence of childhood emotional neglect experience on brain dynamic functional connectivity in young adults

Background: Childhood emotional neglect (CEN) confers a great risk for developing multiple psychiatric disorders; however, the neural basis for this association remains unknown. Using a dynamic functional connectivity approach, this study aimed to examine the effects of CEN experience on functional brain networks in young adults.Method: In total, 21 healthy young adults with CEN experience and 26 without childhood trauma experience were recruited. The childhood trauma experience was assessed using the childhood trauma questionnaire (CTQ), and eligible participants underwent resting-state functional MRI. Sliding windows and k-means clustering were used to identify temporal features of large-scale functional connectivity states (frequency, mean dwell time, and transition numbers).Result: Dynamic analysis revealed two separate connection states: state 1 was more frequent and characterized by extensive weak connections between the brain regions. State 2 was relatively infrequent and characterized by extensive strong connections between the brain regions. Compared to the control group, the CEN group had a longer mean dwell time in state 1 and significantly decreased transition numbers between states 1 and 2.Conclusion: The CEN experience affects the temporal properties of young adults' functional brain connectivity. Young adults with CEN experience tend to be stable in state 1 (extensive weak connections between the brain regions), reducing transitions between states, and reflecting impaired metastability or functional network flexibility.

Childhood family environment predicting psychotic disorders over a 37-year follow-up - A general population cohort study

BACKGROUND

Childhood adverse effects and traumatic experiences increase the risk for several psychiatric disorders. We now investigated whether prospectively assessed childhood family environment per se contributes to increased risk for psychotic disorders in adulthood, and whether these family patterns are also relevant in the development of affective disorders.

METHODS

We used the Young Finns Data (n = 3502). Childhood family environment was assessed in 1980/1983 with previously constructed risk scores: (1) disadvantageous emotional family atmosphere (parenting practices, parents' life satisfaction, parents' mental disorder, parents' alcohol intoxication), (2) adverse socioeconomic environment (overcrowded apartment, home income, parent's employment, occupational status, educational level), and (3) stress-prone life events (home movement, school change, parental divorce, death, or hospitalization, and child's hospitalization). Psychiatric diagnoses (ICD-10 classification) over the lifespan were collected up to 2017 from the national registry of hospital care. Non-affective psychotic disorder and affective disorder groups were formed.

RESULTS

Frequent stress-prone life events predicted higher likelihood of non-affective psychotic disorders (OR = 2.401, p = 0.001). Adverse socioeconomic environment or emotional family atmosphere did not predict psychotic disorders. Only disadvantageous emotional family atmosphere predicted modestly higher likelihood of affective disorders (OR = 1.583, p = 0.013).

CONCLUSIONS

Our results suggest that childhood family environment and atmosphere patterns as such contribute to the risk for developing adulthood mental disorders with relative disorder specificity. The results emphasize the importance of both individual and public health preventive initiatives, including family support interventions.

Childhood trauma, peer victimization, and non-suicidal self-injury among Chinese adolescents: a latent variable mediation analysis

BACKGROUND

Childhood and peer experiences can influence adolescents' perceptions of interpersonal relationships, which can, in turn, influence their emotional states and behavior patterns. Non-suicidal self-injury (NSSI) is now a common problem behavior among adolescents. The present study examined the role of childhood trauma and peer victimization in adolescents' NSSI.

METHODS

A cross-sectional survey was conducted among 1783 adolescents (1464 girls and 318 boys) in the psychiatric outpatient clinics or wards of 14 psychiatric hospitals or general hospitals in nine provinces in China. Data were collected using the Multidimensional Peer Victimization Scale (MPVS), Short-form Childhood Trauma Questionnaire(CTQ-SF), and Functional Assessment of Self-Mutilation (FASM). Structural equation modeling (SEM) with latent variables was used to demonstrate the mediating role of peer victimization in the association between childhoodtrauma and NSSI.

RESULTS

The SEM analysis demonstrated that peer victimization plays a partial mediating role in the relationship between childhood trauma and NSSI. In addition, several covariates (such as age, gender, education level, and place of residence) effectively regulated the relationship between peer victimization and NSSI.

CONCLUSION

In future studies of NSSI among Chinese adolescents, attention should be paid to the roles of childhood trauma and peer bullying; there is a temporal sequence between these two variables and, to some extent, childhood trauma can have an impact on bullying during adolescence which, in turn, influences NSSI behavior.

Emotional neglect and parents' adverse childhood events

INTRODUCTION

Emotional neglect means that the child's emotional and developmental needs are not fulfilled by the parents or other caregivers. Adverse childhood events (ACEs) are a risk factor for mental health problems and impaired parenting skills. The objective here was to examine whether parents' ACEs increase the child's risk of experiencing emotional neglect.

METHODS

The participants in the present study were members of the Northern Finland Birth Cohort 1986 (NFBC1986). Emotional neglect experiences were measured in 190 members of this cohort by means of the Trauma and Distress Scale (TADS), and ACEs in both parents were measured with a specific questionnaire. A linear regression model was used to examine the association between parents' ACEs and the children's emotional neglect scores.

RESULTS

The children's mean emotional neglect score was 8.11 on a scale from 5 to 25. There was no significant difference between males (mean 8.01) and females (mean 8.19). Only father's ACEs were associated with child's emotional neglect score. In the linear regression model, the children's emotional neglect scores increased by 0.3 points for father's ACE.

CONCLUSIONS

Our findings suggest that father's ACEs may increase the child's risk of experiencing emotional neglect. It seems that childhood adversities are transferred from parents to children, but larger samples would be needed to confirm these findings.

The truth project paper one-how did victims and survivors experience participation? Addressing epistemic relational inequality in the field of child sexual abuse

The last 30 years has seen an exponential increase in Historical Institutional Abuse Inquiries. One feature of these has been to place adult survivor voices at the center of Inquiry work, meaning that child abuse victims and survivors are engaging with Inquiries, sharing their experiences, with this participation often presented as empowering and healing. This initiative challenges long held beliefs that child sexual abuse survivors are unreliable witnesses, which has led to epistemic injustice and a hermeneutical lacunae in survivor testimony. However to date there has been limited research on what survivors say about their experiences of participation. The Truth Project was one area of work of the Independent Inquiry into Child Sexual Abuse in England and Wales. It invited survivors of Child Sexual Abuse to share their experiences including the impacts of abuse and their recommendations for change. The Truth Project concluded in 2021 and heard from more than 6,000 victims of child sexual abuse. The evaluation of the Trauma Informed Approach designed to support survivors through their engagement with the project was a mixed methods, two phase methodology. A total of 66 survey responses were received. Follow-up interviews were conducted with seven survey respondents. The Trauma Informed Approach was found to be predominantly helpful in attending to victim needs and minimizing harm. However, a small number of participants reported harmful effects post-session. The positive impacts reported about taking part in the Truth Project as a one-off engagement challenges beliefs that survivors of child sexual abuse cannot safely talk about their experiences. It also provides evidence of the central role survivors should have in designing services for trauma victims. This study contributes to the epistemic justice literature which emphasizes the central role of relational ethics in the politics of knowing, and the importance of developing a testimonial sensibility when listening to marginalized groups.

Childhood abuse and association with adult depressive symptoms among people with cardiovascular disease

Background

To study the association between the total/different types of childhood abuse and adult depressive symptoms in people with cardiovascular disease (CVD).

Methods

The subjects were people with CVD who continuously participated in the China Health and Retirement Longitudinal Study (CHARLS) life history survey and the 2018 wave of the CHARLS national baseline Survey. Multi-level logistic regression models were used to analyze the relationship between emotional neglect, physical neglect, physical abuse and adult depressive symptoms.

Results

A total of 4,823 respondents were included in this study. The incidence of childhood abuse (existed emotional neglect, physical neglect or physical abuse) was 43.58% among people over 45 years old with CVD, which was higher than that of the general population (36.62%, p < 0.05). Adjusted model showed that overall childhood abuse was associated with adult depressive symptoms (OR = 1.230, 95%CI:1.094-1.383). Among different types of childhood abuse, only physical abuse was associated with depressive symptoms in adulthood (OR = 1.345, 95%CI:1.184-1.528).

Conclusion

Compared with that of the general population, the incidence of childhood abuse in CVD population is higher. Physical abuse in childhood increased the risk of depressive symptoms in adulthood. It suggested that the occurrence of depressive symptoms was the result of related factors in the whole life course. In order to prevent the depressive symptoms, childhood abuse also needs to be considered. It is very important to identify and prevent the continuation of childhood abuse in time.

Intergenerational effects of childhood maltreatment: The relationships among parental childhood emotional neglect, emotional expressiveness and children's problem behaviors

BACKGROUND

Childhood maltreatment has a severe impact on both the health and parenting styles of abused individuals in adulthood, and it even has a negative impact on the offspring of abused individuals. Although studies have confirmed the intergenerational effects of childhood maltreatment, relatively few have emphasized emotional neglect and its mechanism of intergenerational effects. Additionally, few studies have examined the unique role of fathers and how mothers and fathers interact with one another.

OBJECTIVE

The current study aimed to employ the actor-partner interdependence mediation model to investigate the relationship between parental childhood emotional neglect and children's problem behaviors, as well as whether parents' positive and negative emotional expressiveness plays a mediating role.

METHODS, PARTICIPANTS, AND SETTING

In total, 397 dyads of mothers and fathers of children aged 6-9 were recruited and reported their childhood emotional neglect experience and emotional expressiveness, and mothers also rated their children's problem behaviors.

RESULTS

The findings revealed that (a) maternal childhood emotional neglect was associated solely with mothers' own negative emotional expressiveness, followed by their children's problem behavior and (b) paternal childhood emotional neglect showed no effect on children's problem behavior through fathers' own or their spouses' positive and negative emotional expressiveness.

CONCLUSIONS

The findings of this study suggest that childhood emotional neglect has intergenerational effects and that mothers' parenting behaviors are relatively important in preventing adverse effects on their children.

The relationship between child maltreatment and social anxiety: A meta-analysis

BACKGROUND

Globally, child maltreatment has become a serious problem, affecting individuals' physical and mental health. This meta-analysis aimed to explore the association between child maltreatment and social anxiety.

METHODS

MEDLINE, PsycINFO, EMBASE, Scopus, and Web of Science were searched for articles published by October 2021. Newcastle-Ottawa Quality Assessment Scale (NOS) was used to evaluate the quality of studies. Maltreatment type, sample setting, age, country and measurement instruments were analyzed as moderators.

RESULTS

Twenty-nine studies met the inclusion criteria. Child maltreatment was positively correlated with social anxiety (r = 0.201, 95 % CI [0.171, 0.230]). The moderating effect of maltreatment subtypes was significant whether divided into three types (Q_b = 12.152, p = .002), or five types (Q_b = 11.574, p = .021). Specifically, emotional maltreatment (r = 0.251, 95 % CI [0.201, 0.298]) had a stronger relationship with social anxiety than physical (r = 0.138, 95 % CI [0.085, 0.191]; Q_b = 9.312, p = .002) and sexual maltreatment (r = 0.153, 95 % CI [0.108, 0.197]; Q_b = 9.197, p = .002). However, there was no significant difference in the effect size between physical and sexual maltreatment (Q_b = 0.096, p = .757). Other variables (age, sample setting and country) were not significant moderators.

LIMITATIONS

Only twenty-nine studies were included, and there was high heterogeneity among the studies, the interpretation of the results should be cautious.

CONCLUSIONS

This meta-analysis confirmed the relationship between child maltreatment and social anxiety, especially highlight the harmfulness of emotional maltreatment.

Latent profiles of childhood psychological maltreatment and their links to adult mental health in China and the UK

BACKGROUND

Though links between childhood maltreatment and mental health have been established, little known about how specific types of childhood maltreatment tend to cluster and how the resulting patterns of exposure impact mental health outcomes.

METHOD

The current study used latent profile analyses in Chinese (N = 544) and UK (N = 589) samples to identify childhood psychological maltreatment profiles (i.e., profiles of psychological abuse, psychological neglect, and psychological non-support) in different country contexts, and their associations with a range of mental health (i.e., depression, anxiety, anger, physical aggression, verbal aggression, and hostility), and broader well-being (i.e., self-esteem) outcomes. Unadjusted as well as analyses adjusted for adverse childhood experiences (ACEs) were conducted.

RESULTS

Four profiles were identified in both samples, but their nature differed between the Chinese sample ("Psychological Non-support", "Low-Maltreated", "High-Maltreated", and "Severe-Maltreated") and the UK sample ("Low-Maltreated", "Moderate-Maltreated", "High-Maltreated", and "Severe-Maltreated"). Individuals in the "Psychological Non-support" in China and "Low-Maltreated" class in the UK displayed better mental health outcomes-lower levels of depression, anxiety, and aggression, and higher self-esteem. In contrast, individuals in the "Severe-Maltreated" profiles in both the Chinese and UK samples displayed poorer mental health outcomes-higher depression, anxiety, and aggression, and lower self-esteem. Interventions and prevention efforts are needed for individuals categorized in profiles affected by psychological maltreatment.

CONCLUSION

This study highlights the importance of using targeted intervention or prevention to prevent psychological maltreatment, as well as improve mental health outcomes in individuals who have experienced psychological maltreatment.

Childhood emotional neglect and depressive and anxiety symptoms among mental health outpatients: the mediating roles of narcissistic vulnerability and shame

BACKGROUND

Theorized to stem from experiences of childhood emotional neglect, narcissistic vulnerability has been identified as contributing to expressions of psychiatric distress such as depressive and anxiety symptoms, particularly due to shame-proneness.

AIMS

To investigate narcissistic vulnerability and shame as mediators between perceived childhood emotional neglect and depressive and generalized anxiety symptoms among psychiatric outpatients.

METHODS

Adults (N = 137) attending community mental health services completed self-report measures at intake. Mediation analyses tested the indirect effect of perceived emotional neglect on depressive and generalized anxiety symptom severity through narcissistic vulnerability; shame was added to subsequent models to examine narcissistic vulnerability and shame as sequential mediators.

RESULTS

Perceived emotional neglect was significantly associated with narcissistic vulnerability, which in turn was linked with depressive and generalized anxiety symptoms as separate dependent variables. Indirect effects were significant in each model, indicating narcissistic vulnerability as a significant mediator. With the inclusion of shame, narcissistic vulnerability and shame were significant as sequential mediators.

CONCLUSION

Narcissistic vulnerability and shame may operate as mechanisms in conferring affective symptom severity from perceived childhood emotional neglect. Narcissistic vulnerability and susceptibility to shame may thus be important treatment targets when addressing psychological distress in the context of childhood adversity.

The influence of childhood emotional neglect on emotional face processing in young adults

Childhood emotional neglect (CEN) refers to a failure to meet the basic emotional needs of a child, which can seriously impact interpersonal communication and psychological health in young adults. Emotional face processing is critical in interpersonal communication; however, whether CEN affects this processing in young adults has not been investigated. Therefore, the current study aimed to explore the effects of CEN on emotional face processing in young adults. Using the Child Trauma Questionnaire, an online survey was conducted with 5010 students from four universities in Tianjin, China. After online interviews and diagnosis by professional doctors, we obtained 20 participants with CEN (CEN group) and 20 without CEN (control group). None of the participants had any mental diseases. A 2 × 4 mixed design was used to investigate the differences in accuracy and response time when identifying the valence of the emotional faces. Compared to the control group, the CEN group identified the valence of all emotional faces more slowly, but there was no significant difference between the two groups in terms of accuracy. CEN caused delayed emotional face processing in young adults, which may be related to unresponsive, unavailable, and limited emotional interaction patterns between parents and their children.

Childhood neglect is associated with low affect and high stress in habitual alcohol drinkers

OBJECTIVE

Adverse childhood experiences, ranging from childhood trauma to neglect or mistreatment, show associations with alcohol dependence in adulthood. Alcohol researchers have not yet clearly demonstrated the potential impact of childhood maltreatment on everyday drinking in alcohol consumers who do not have an alcohol use disorder (AUD). This study examined whether a history of childhood neglect results in differential ratings of stress, affect, and desire to drink, during typical alcohol consumption in moderate to heavy drinkers without an AUD.

METHODS

The parent study from which these analyses were generated recruited overall healthy, albeit moderate to heavy alcohol users who fell above National Institute on Alcohol Abuse and Alcoholism (NIAAA) classifications for low-risk drinking. Childhood Trauma Questionnaire (CTQ) responses were collected, and real-time surveys were collected in participants' natural environments approximately every three hours between 9 a.m. and 9 p.m. using iPhones equipped with a study-created application probing stress, affect, and desire for alcohol, while participants followed their typical drinking routine (3 days) and during a brief period of imposed abstinence (3 days).

RESULTS

Thirty-six participants averaging 41 years of age and consuming an average of 17 (±5) drinks per week participated in this study. CTQ responses showed low prevalence of childhood abuse, but moderate to high emotional (M = 17.39, SD = 6.77) and physical neglect (M = 11.11, SD = 3.31) scores. Multilevel modeling revealed significantly higher stress and lower affect ratings among participants reporting higher physical neglect. Alcohol consumption was significantly associated with decreased stress, and increased affect and desire for alcohol. A significant interaction showed that as childhood physical neglect ratings increased, the benefits observed following drinking (of decreased stress, and increased affect and desire for alcohol) were reduced.

CONCLUSIONS

These results suggest that moderate to heavy healthy daily drinkers with histories of greater childhood physical neglect experience poorer mood and higher stress on a daily basis, with smaller improvement experienced from drinking alcohol. Among moderate to heavy daily drinkers without an AUD, those with greater childhood physical neglect experience poorer mood and higher stress on a daily basis, and have smaller improvements in stress, affect and desire while/following drinking alcohol than those with less childhood physical neglect.

Tensions in the therapeutic relationship: emotional labour in the response to child abuse and neglect in primary healthcare

Background

Child abuse and neglect (child abuse) is a prevalent public health issue linked to survivors experiencing a higher risk of health issues such as obesity, heart disease and major depression. Given the significant impact of child abuse on health, general practitioners (GPs) and primary care nurses (nurses) are well-placed to respond to child abuse. However, research shows that responding to child abuse is difficult for health practitioners, especially the act of reporting child abuse. The present study aimed to understand how GPs and nurses experience the response to child abuse in primary healthcare.

Methods

This study employed qualitative methods. Twenty-six in-depth individual and group interviews were conducted with 30 GPs and nurses. The interviews were audio recorded with consent, transcribed verbatim and thematically analysed.

Results

The participants were mostly metropolitan-based female GPs. Participants were sampled from two settings: private general practice and community health; and Doctors in Secondary Schools, a program that places GPs and nurses in high schools. Thematic analysis generated four themes: blowing trust out of the water; riding the reaction wave; opening a hornet’s nest; and battling emotions. Participants felt that, in considering child abuse, they were betraying the trust of the therapeutic relationship and thus, had to manage their patients’ reactions to preserve the therapeutic relationship. They used strategies that created shifts in perception in both themselves and their patients to help maintain the therapeutic relationship. Participants often felt that they had to compromise their professional code of ethics to fulfil their mandatory reporting obligations. Thus, they experienced internal emotional battles when responding which led to some experiencing burnout or vicarious trauma and others resilience. This complex interplay of relationship and emotional management was placed in the context of emotional labour theory. We contend that our participants undertook emotional labour across three levels: internal, organisational and systemic.

Conclusions

We conclude that the emotional labour exerted in the response to child abuse can be diminished by: developing strategies for therapeutic relationship management; undertaking an internal, organisational and systemic values assessment; and facilitating communication between health professionals and the child protection system.

Personality functioning and the pathogenic effect of childhood maltreatment in a high-risk sample

BACKGROUND

While the psychopathological sequalae of childhood maltreatment are widely acknowledged, less is known about the underlying pathways by which childhood maltreatment might lead to an increased risk for mental health problems. Recent studies indicated that impaired personality functioning might mediate this relationship. The aim of the present paper was to extend the current literature by investigating the mediating effect of impaired personality functioning between different types of childhood maltreatment and self-reported mental health problems in a high-risk sample.

METHODS

Overall, 173 young adults (mean age = of 26.61 years; SD = 3.27) with a history of residential child welfare and juvenile justice placements in Switzerland were included in the current study. The Childhood Trauma Questionnaire (CTQ-SF), Semi-structured Interview for Personality Functioning DSM-5 (STiP-5.1) and the self-report questionnaires of the Achenbach System of Empirically Based Assessment scales (ASEBA) were used. Mediation analyses were conducted through structural equation modeling.

RESULTS

Overall, 76.3% (N = 132) participants indicated at least one type of childhood maltreatment, with emotional neglect being most commonly reported (60.7%). A total of 30.6% (N = 53) participants self-reported mental health problems. Emotional abuse (r = 0.34; p < .001) and neglect (r = 0.28; p < .001) were found to be most strongly associated with mental health problems. In addition, impaired personality functioning was fond to be a significant mediator for overall childhood maltreatment (β = 0.089; p = 0.008) and emotional neglect (β = 0.077; p = 0.016). Finally, impaired self-functioning was found to be a significant mediator when both self-functioning and interpersonal functioning were included as potential mediators in the relationship between overall childhood maltreatment (β1 = 0.177, p1 = 0.007) and emotional neglect (β1 = 0.173, p1 = 0.003).

CONCLUSION

Emotional neglect may be particularly important in the context of childhood maltreatment, personality functioning, and mental health problems and, therefore, should not be overlooked next to the more "obvious" forms of childhood maltreatment. Combining interventions designed for personality functioning with trauma-informed practices in standard mental health services might counteract the psychopathological outcomes of maltreated children and adolescents.

Disentangling the impact of childhood abuse and neglect on depressive affect in adulthood: A machine learning approach in a general population sample

BACKGROUND

Different types of childhood maltreatment (CM) are key risk factors for psychopathology. Specifically, there is evidence for a unique role of emotional abuse in affective psychopathology in children and youth; however, its predictive power for depressive symptomatology in adulthood is still unknown. Additionally, emotional abuse encompasses several facets, but the strength of their individual contribution to depressive affect has not been examined.

METHOD

Here, we used a machine learning (ML) approach based on Random Forests to assess the performance of domain scores and individual items from the Childhood Trauma Questionnaire (CTQ) in predicting self-reported levels of depressive affect in an adult general population sample. Models were generated in a training sample (N = 769) and validated in an independent test sample (N = 466). Using state-of-the-art methods from interpretable ML, we identified the most predictive domains and facets of CM for adult depressive affect.

RESULTS

Models based on individual CM items explained more variance in the independent test sample than models based on CM domain scores (R² = 7.6 % vs. 6.4 %). Emotional abuse, particularly its more subjective components such as reactions to and appraisal of the abuse, emerged as the strongest predictors of adult depressive affect.

LIMITATIONS

Assessment of CM was retrospective and lacked information on timing and duration. Moreover, reported rates of CM and depressive affect were comparatively low.

CONCLUSIONS

Our findings corroborate the strong role of subjective experience in CM-related psychopathology across the lifespan that necessitates greater attention in research, policy, and clinical practice.

Smartphone addiction and cross-cultural adjustment among overseas Chinese students: The role of emotion regulation beliefs and strategies

Background

Few studies have focused on the cross-cultural adjustment of Chinese students studying in Belarus with the size of this group increasing in recent years. The current study aimed to map the process of cross-cultural adjustment onto various factors including childhood emotional neglect, emotion regulation beliefs, emotional regulation strategies, and smartphone addiction in the international students. Emotional regulation strategy and emotion regulation beliefs could perform as key parts in adapting into overseas life from social learning perspective. Furthermore, smartphone addiction could precipitate a failed adjustment process.

Materials and methods

A total of 356 Chinese students in Belarus completed a self-administered questionnaire including the Chinese versions of the 12-item general health questionnaire (GHQ-12), sociocultural adaptation scale, mobile phone addiction tendency scale for college students, emotion regulation questionnaire, emotion and regulation beliefs scale, and childhood trauma questionnaire-short form. Correlation analysis, regression analysis and T-tests were used to explore the relationship between the variables. Structural equation modeling was carried out to test the hypotheses for association.

Results

Emotion regulation beliefs of international students mediated the effect of childhood emotional neglect on cross-cultural adjustment through expression suppression and smartphone addiction. While, in another chain mediation model, childhood emotional neglect affected cross-cultural adjustment only through emotion regulation beliefs and smartphone addiction. Cognitive appraisal independently influenced adjustment through smartphone addiction.

Limitations

Limitations include its cross-sectional design and self-reported survey methodology. In the future, we can combine experimental manipulations to explore the mechanisms by which various emotion beliefs act on smartphone addiction and cross-cultural adjustment in different situations.

Conclusion

This study displays the correlation between emotion regulation beliefs to smartphone addiction and cross-cultural adjustment, as well as the harmful effects of childhood emotional neglect; these components should be further addressed in future studies.

The Association Between Polyvictimization in Childhood and Intimate Partner Violence and Child Abuse in Adulthood

The main purpose of this study was to examine the association of family polyvictimization in childhood with the victimization or perpetration of spousal abuse and the perpetration of child abuse in adulthood. While associations between maltreatment in childhood and subsequent perpetration or victimization in adulthood are well documented, their association with polyvictimization in childhood (i.e., experiencing multiple types of victimization) has received less attention. This research aims to empirically investigate 1) whether early experiences of family polyvictimization are predictive of subsequent experience or spousal abuse or perpetration of child abuse and 2) whether there are gender differences in those associations. Through conducting Chi-square analysis and logistic regression analysis with South Korea's National Domestic Violence Survey 2019, the study found significant empirical evidence that polyvictimization is predictive of perpetration or experience of spousal abuse and perpetration of child abuse. Particularly, adults who experienced polyvictimization in childhood were more likely to perpetrate child abuse regardless of the type of abuse (p < .001). Polyvictimization in childhood was also significantly associated with perpetration and victimization of spousal abuse (p < .001). In regard to gender differences, this study found that males were more likely to be polyvictimized by family in childhood (15.11%) than females (10.23%), and polyvictimization was found to increase the likelihood of females being revictimized in adulthood. More attention should be paid to victimization by multiple types of violence within the family and its influence on intergenerational transmission of violence.

Associations of childhood emotional and physical neglect with mental health and substance use in young adults

BACKGROUND

Childhood neglect is a risk factor for subsequent mental health problems. However, research on the unique contribution of emotional and physical subtypes of neglect is lacking. Importantly, if emotional and physical neglect have different impacts on mental health, they must be examined separately to understand how to prevent and treat their effects.

OBJECTIVE

This study aimed to examine associations of emotional and physical neglect with depression, anxiety, stress, alcohol and drug use in 18- to 20-year-olds.

METHODS

Participants (N = 569, mean age = 18.9, 70% female) responded in an online survey to questions on childhood emotional and physical neglect, childhood abuse, symptoms of depression, anxiety and stress, and alcohol and drug use and problems. Procedures were approved by the University of Sydney Human Ethics Committee. Hierarchical linear regressions were performed, controlling for socio-demographic characteristics and other adverse childhood experiences.

RESULTS

Combined neglect was associated with depression (B = 2.895, p < 0.001), anxiety (B = 1.572, p = 0.003) and stress (B = 1.781, p = 0.001). However, a second model entering emotional and physical neglect as separate exposures revealed emotional neglect was driving this association with depression (B = 2.884, p < 0.001), anxiety (B = 1.627, p = 0.001) and stress (B = 1.776, p = 0.001), and that physical neglect was not associated with any outcome. Neither emotional nor physical neglect were associated with alcohol or drug use.

CONCLUSION

Emotional neglect is a risk factor for mental health problems in early adulthood. Research that combines emotional and physical neglect into a single exposure may be obscuring relationships with mental health. Mental health prevention and treatment must screen for, and address, emotional neglect.

[Responding to children's emotional and cognitive needs: Applying the cumulative model to the general population]

OBJECTIVES

Several risk factors are associated with neglectful behaviors. Yet their cumulative effect, which refers to the accumulation of risk regardless of the presence or absence of specific factors, remains unknown. This study aims to determine whether risk accumulation predicts caregivers' responses to children's emotional and cognitive needs in the general population and to examine the presence of clinical thresholds.

METHOD

A total of 1102 maternal figures of children aged 5 to 9 years old living in Quebec were questioned through a telephone survey. The response to children's emotional and cognitive needs was measured using a validated version of the Parent-Report Multidimensional Neglectful Behavior Scale. Ten individual, family and socioeconomic risk factors were combined to compute a cumulative risk index.

RESULTS

Results indicate that the cumulative index predicts the response to children's emotional and cognitive needs in the general population. This effect is observed for families exposed to at least two risk factors and it increases considerably when risk exposure reaches 5 factors.

CONCLUSIONS

This study supports the cumulative risk hypothesis, which until now had mainly been examined in vulnerable or clinical samples. It fosters a better statistical understanding of contexts compromising an optimal response to school age children's emotional and cognitive needs in the general population. This breakthrough is particularity important considering the challenges of identifying children at risk of having their needs neglected.

Adverse childhood experiences as risk factors for recurrent admissions in young psychiatric inpatients

BACKGROUND

Patients who require psychiatric inpatient treatment early in life are a particularly at-risk population. Factors such as adverse childhood experiences (ACEs) are, however, not well studied in those requiring psychiatric inpatient treatment during both childhood or adolescence and adulthood. Thus, the aim of the current study was to investigate, in young adult inpatients, the risk factors for prior admissions in Child and Adolescent Psychiatry, with a focus on ACEs.

MATERIALS AND METHODS

An explorative population-based systematic chart investigation of psychiatric inpatients aged 18-25 was conducted at the University Hospital Tulln, Austria. Data analysis was done with descriptive methods and Pearson's chi- squared-, Fisher's exact-, Mann-Whitney-U-tests and predictive logistic regression models.

RESULTS

The sample comprised 390 inpatients (51.8% female), with an average age of 20 years at first psychiatric hospital admission. Those with a former child and adolescent psychiatry inpatient treatment (10.3%) were predominantly female (77.5%). Their number of documented ACEs was increased compared to those without former child and adolescent psychiatry admissions (2 vs 1.1), with up to twice as many experiences of family dysfunction, neglect or abuse. Sexual abuse (OR: 3.0), having been an adopted or fostered child (OR: 4.5), and female sex (OR: 3.0) were identified as main risk factors. Furthermore, former child and adolescent psychiatry inpatients suffered from higher rates of psychosomatic or personality disorders, comorbidities and functional impairment, and were readmitted twice as often in young adulthood.

CONCLUSION

Young adult inpatients with reoccurring psychiatric inpatient treatments have increased rates of severe ACEs. Thus, special attention should be given to identifying ACEs, evaluating needs for psychosocial support and therapy, and meeting these needs after discharge.

Dysfunctional Attitudes Mediate the Relationship Between Childhood Emotional Neglect and Anhedonia in Young Adult Major Depression Patients

BACKGROUND

Childhood traumas are well-established risk factors for major depressive disorder (MDD). However, the relationship between childhood traumas types and MDD symptoms is unclear. The present study tested the hypothesis that childhood traumas affect specific types of anhedonia in depression and the mediating role of dysfunctional attitude.

METHODS

Within this cross-sectional study, 310 young adult patients with MDD completed the PHQ-9, CTQ-SF, DAS, and SHAPS. The statistical analyses used the Mann-Whitney U test, Spearman's rank correlation, and multiple regression analysis. Mediation analyses were tested by the structural equation model (SEM).

RESULTS

Spearman's rank correlation analysis showed positive correlations between the SHAPS, CTQ-SF, and DAS total score (p < 0.05). The EA, EN, PN, and SHAPS scores were positively correlated (p < 0.05). Among the four factors of anhedonia, social interaction and interest/pastimes were positively correlated with EA, EN, and PN (p < 0.05), the sensory experience was positively correlated with EN (p < 0.01), and diet did not correlate with childhood traumas. Stepwise regression analysis showed that dysfunctional attitude and emotional neglect were the main influencing factors of sensory experience (p < 0.001) and social interaction (p < 0.001). Dysfunctional attitude and physical neglect were the main factors influencing interest/pastimes (p < 0.001). SEM analysis found that dysfunctional mediated between childhood traumas and anhedonia.

CONCLUSIONS

The degree of anhedonia was related to dysfunctional attitudes and childhood traumas. The childhood emotional neglect experience was the most important and was related to sensory and social anhedonia. Dysfunctional attitudes played a mediating role between childhood neglect and anhedonia. Early psychotherapy targeting young adult MDD patients with childhood emotional neglect may help decrease symptoms of anhedonia.

Does childhood trauma predict schizotypal traits? A path modelling approach in a cohort of help-seeking subjects

Schizotypy constitutes a susceptibility to beneficial and deleterious schizotypal traits, ranging from coping mechanisms to schizotypal personality disorder on a psychosis continuum. Growing evidence indicates a relationship between childhood adversity and trauma and schizotypy. However, the exact influence of childhood adversity and trauma on schizotypy and its relation to sex is not sufficiently understood. Therefore, we investigated sex-adjusted connections between childhood adversity and trauma subdomains (emotional/physical/sexual abuse, emotional/physical neglect) and positive (magical ideation, perceptual aberration) as well as negative schizotypy (physical/social anhedonia). In total, 240 outpatients of the Early Detection and Intervention Centre of the University Hospital Cologne were assessed with the Trauma and Distress Scale for childhood adversity and trauma and the Wisconsin Schizotypy Scales for schizotypy. Path analyses were performed to investigate sex-adjusted correlations. The well-fitting path model of the total sample linked emotional abuse to magical ideation (p = 0.03; SE = 0.20) and emotional neglect to social anhedonia (p = 0.01; SE = 0.26). In females, physical abuse predicted magical ideation (p = 0.01; SE = 0.33), while emotional neglect forecasted physical anhedonia (p = 0.03; SE = 0.34) and social anhedonia (p = 0.03; SE = 0.32). In males, sexual abuse predicted perceptive aberration (p = 0.04; SE = 0.19) and emotional abuse forecasted magical ideation (p = 0.03; SE = 0.27). Overall, the significance of sex-specific interrelations between trauma and schizotypy were highlighted. Magical ideation and perceptive aberration occurred prominently in the absence of negative and disorganized schizotypy, thus positive schizotypy could be discussed as a beneficial expression of coping with emotional, physical and sexual abuse. Furthermore, emotional neglect should be addressed particularly to prevent deleterious negative schizotypy in females.Trial registration number (20-1243), date of registration (May 19th 2020), retrospectively registered.

Short-term functional outcome in psychotic patients: results of the Turku early psychosis study (TEPS)

BACKGROUND

Functional recovery of patients with clinical and subclinical psychosis is associated with clinical, neuropsychological and developmental factors. Less is known about how these factors predict functional outcomes in the same models. We investigated functional outcomes and their predictors in patients with first-episode psychosis (FEP) or a confirmed or nonconfirmed clinical high risk of psychosis (CHR-P vs. CHR-N).

METHODS

Altogether, 130 patients with FEP, 60 patients with CHR-P and 47 patients with CHR-N were recruited and extensively examined at baseline (T0) and 9 (T1) and 18 (T2) months later. Global Assessment of Functioning (GAF) at T0, T1 and T2 and psychotic, depression, and anxiety symptoms at T1 and T2 were assessed. Functional outcomes were predicted using multivariate repeated ANOVA.

RESULTS

During follow-up, the GAF score improved significantly in patients with FEP and CHR-P but not in patients with CHR-N. A single marital status, low basic education level, poor work situation, disorganization symptoms, perceptual deficits, and poor premorbid adjustment in patients with FEP, disorganization symptoms and poor premorbid adjustment in patients with CHR-P, and a low basic education level, poor work situation and general symptoms in patients with CHR-N predicted poor functional outcomes. Psychotic symptoms at T1 in patients with FEP and psychotic and depression symptoms at T1 and anxiety symptoms at T2 in patients with CHR-P were associated with poor functioning.

CONCLUSIONS

In patients with FEP and CHR-P, poor premorbid adjustment and disorganization symptomatology are common predictors of the functional outcome, while a low education level and poor work situation predict worse functional outcomes in patients with FEP and CHR-N. Interventions aimed at improving the ability to work and study are most important in improving the functioning of patients with clinical or subclinical psychosis.

Childhood adversities are common among trans people and associated with adult depression and suicidality

Trans people suffer from increased rates of depression and suicidality even after gender-affirming medical interventions. The present study aims to examine the prevalence of childhood adversities in patients with gender dysphoria and to analyze its impact on adult depression and suicidality. Participants meeting diagnostic criteria of Gender Dysphoria were recruited in a cross-sectional multicenter study at four German health-care centers. Childhood adversities were assessed with the Childhood Trauma Questionnaire (CTQ) and additional single items for other childhood adversities. Associations between childhood adversities and adult depression and suicidality were calculated using regression analyses. A large majority of participants reported childhood adversities, and only 7% endorsed no adversities in the CTQ. Over 30% reported severe to extreme childhood adversities. One-fourth reported parents exhibiting violent behavior while bullying by peers was experienced by 70%. These adversities were associated with an increased risk for adult depression and suicidality. Time since beginning of hormonal therapy did not show a significant influence neither on depression nor on suicidality. Childhood adversities are common and associated with adult depression and suicidality in trans people. Adequately addressing these childhood adversities and providing trauma-informed mental health care might ameliorate the mental health burden in trans people.

The Psychopathology and Neuroanatomical Markers of Depression in Early Psychosis

Depression frequently occurs in first-episode psychosis (FEP) and predicts longer-term negative outcomes. It is possible that this depression is seen primarily in a distinct subgroup, which if identified could allow targeted treatments. We hypothesize that patients with recent-onset psychosis (ROP) and comorbid depression would be identifiable by symptoms and neuroanatomical features similar to those seen in recent-onset depression (ROD). Data were extracted from the multisite PRONIA study: 154 ROP patients (FEP within 3 months of treatment onset), of whom 83 were depressed (ROP+D) and 71 who were not depressed (ROP-D), 146 ROD patients, and 265 healthy controls (HC). Analyses included a (1) principal component analysis that established the similar symptom structure of depression in ROD and ROP+D, (2) supervised machine learning (ML) classification with repeated nested cross-validation based on depressive symptoms separating ROD vs ROP+D, which achieved a balanced accuracy (BAC) of 51%, and (3) neuroanatomical ML-based classification, using regions of interest generated from ROD subjects, which identified BAC of 50% (no better than chance) for separation of ROP+D vs ROP-D. We conclude that depression at a symptom level is broadly similar with or without psychosis status in recent-onset disorders; however, this is not driven by a separable depressed subgroup in FEP. Depression may be intrinsic to early stages of psychotic disorder, and thus treating depression could produce widespread benefit.

Tipping the Scales: Factors Influencing the Decision to Report Child Maltreatment in Primary Care

Child maltreatment (CM) is an important public health issue linked to significant physical and mental health complications across the life span. Given the association between CM and health, general practitioners (GPs) and primary care nurses (PNs) are well-placed to identify and respond to this issue and are mandated to report suspected CM in many jurisdictions. Research has found that primary care doctors and nurses need support when responding to CM. This scoping review sought to answer the following question: What factors influence GPs and PNs decision to report CM when fulfilling their mandatory reporting duty? By exploring these factors, areas where support is needed were pinpointed. A systematic search was run across four databases: Medline (Ovid), PsycINFO, Embase, and CINAHL. Articles that reported on studies conducted in a location that had mandatory reporting legislation specific to CM and had a study population sampled from primary care were included in analysis. Thirty-three articles met the inclusion criteria. This review found that four principal factors influenced the decision to report CM: personal threshold of suspicion of abuse, relationship with the family, faith in the child protection system, and education and discussion. We conclude that improving the support and training to address these four areas may be beneficial for GPs and PNs in responding to CM.

Putting adversity in perspective: purpose in life moderates the link between childhood emotional abuse and neglect and adulthood depressive symptoms

Background: Childhood emotional abuse and neglect is linked with a host of adverse outcomes later in life, including depression. However, potential psychological resources that may mitigate the adverse outcomes of childhood emotional abuse and neglect are not well-understood.Aims: Drawing from the insight that having a sense of purpose can help individuals deal with setbacks and difficulties better, we propose that purpose in life can also help sufferers of childhood maltreatment cope more effectively and reduce the onset of depressive symptoms.Methods: Participants were drawn from two large, nationally representative studies comprising a total of 3664 respondents. Purpose in life, childhood emotional abuse and neglect, and depressive symptoms were measured with validated scales.Results: We found convergent evidence that purpose in life attenuates the effect of childhood emotional abuse and neglect on subsequent depressive symptoms across a range of measures of mood and depression.Conclusions: The current study highlights the important role played by purpose in life in building resilience, coping against adverse life events, and psychological well-being.

Mental health and drug use severity: the role of substance P, neuropeptide Y, self-reported childhood history of trauma, parental bonding and current resiliency

BACKGROUND

Many risk factors lead to opioid use and drug-related problems. One of the challenges to understand behavioural factors, drug problems and psychopathology is to identify biological markers that are suitable for research on broad substance abuse and dependence involving human participants.

AIMS

The study has examined the relationships between the self-reported childhood history of trauma, parental bonding, psychopathology, impulsivity, current resiliency, two neuropeptides, possible markers of behaviour and emotion regulation, and severity of drug-related problems.

METHODS

One hundred and sixty-seven individuals with a history of opioid use completed questionnaires. Serum neuropeptide Y (NPY) and substance P (SP) levels were analysed. Moderating and mediating relationships between variables were examined using structural equation modelling (SEM).

RESULTS

Antisocial features, depression, impulsivity, SP, NPY, emotional neglect and resilience are associated with severity of drug-related problems. SP is associated with antisocial personality traits.

CONCLUSIONS

The novelty of this study is the proposed possible link between biochemical markers, antisocial features and behavioural and emotional regulation. Serum NPY and SP levels have a potential to be used as a biomarker in opioid users before and in the treatment process to account for interactions between biological vulnerabilities and childhood risk factors in predicting behavioural adjustment and more severe drug-related problems.