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Myllyaho T, Siira V, Wahlberg KE, Hakko H, Taka-Eilola T, Läksy K, Tikkanen V, Roisko R, Niemelä M, Räsänen S. Associations of Duration of Preadoption Out-of-home Care, Genetic Risk for Schizophrenia Spectrum Disorders and Adoptive Family Functioning with Later Psychiatric Disorders of Adoptees. Child Psychiatry Hum Dev 2024; 55:350-360. [PMID: 35962879 PMCID: PMC10891258 DOI: 10.1007/s10578-022-01411-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/02/2022] [Indexed: 11/03/2022]
Abstract
The objective was to examine the impacts of duration of preadoption out-of-home care and adoptive family functioning on later psychiatric morbidity of adoptees with high (HR) and low (LR) genetic risk for schizophrenia spectrum disorders. The study uses nationwide data from the Finnish Adoptive Family Study of Schizophrenia. The study population in this substudy consisted of 43 h adoptees and 128 LR adoptees. Of these adoptees, 90 had spent 0-6 months and 81 over 6 months in preadoption out-of-home care. The family functioning of adoptive families was assessed based on Global Family Ratings and psychiatric disorders on DSM-III-R criteria. The results showed that among the adoptees with over 6 months in preadoption out-of-home care, the likelihood for psychiatric disorders was significantly increased in HR adoptees compared to LR adoptees. In adoptees with 6 months or less in preadoption out-of-home care, an increased likelihood for psychiatric disorders was found among those living in adoptive families with dysfunctional processes. These findings indicate that especially for HR children, a well-functioning early caregiving environment is crucial in terms of subsequent mental wellbeing. The results emphasize that when adoption is necessary, early placement and well-functioning adoptive family environment are beneficial to children.
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Affiliation(s)
- Toni Myllyaho
- Unit of Clinical Neuroscience, Psychiatry, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland.
| | - Virva Siira
- Faculty of Education, University of Oulu, P.O. Box 2000, 90014, Oulu, Finland
| | - Karl-Erik Wahlberg
- Unit of Clinical Neuroscience, Psychiatry, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
| | - Helinä Hakko
- Department of Psychiatry, Oulu University Hospital, P.O. Box 26, 90014, Oulu, Finland
| | - Tiina Taka-Eilola
- Unit of Clinical Neuroscience, Psychiatry, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
- Department of Psychiatry, Basic Health Care District of Kallio, Oulu, Finland
| | - Kristian Läksy
- Unit of Clinical Neuroscience, Psychiatry, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
| | - Ville Tikkanen
- Unit of Clinical Neuroscience, Psychiatry, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
| | - Riikka Roisko
- Department of Psychiatry, Oulu University Hospital, P.O. Box 26, 90014, Oulu, Finland
| | - Mika Niemelä
- Department of Psychiatry, Oulu University Hospital, P.O. Box 26, 90014, Oulu, Finland
- Faculty of Medicine, Center for Life Course Health Research, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
| | - Sami Räsänen
- Department of Psychiatry, Oulu University Hospital, P.O. Box 26, 90014, Oulu, Finland
- Faculty of Medicine, Research Unit of Clinical Neuroscience, Psychiatry, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
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Band-Winterstein T, Shulyaev K, Eisikovits Z. Is lifetime abuse forgivable in old age? J Elder Abuse Negl 2024; 36:198-225. [PMID: 38379201 DOI: 10.1080/08946566.2024.2319785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
Old age is characterized by reflection and a retrospective examination of the multiple meanings of various life experiences, including lifelong abuse. Forgiveness is found to have a salutary effect, especially for older adults. To understand the place and role of forgiveness in the reflective process during aging, we performed a secondary analysis of in-depth, semi-structured interviews (N = 78) with older women survivors of abuse. Inductive thematic analysis was based on concepts developed deductively from the literature review. The findings include three main themes: (1) The dimensions of forgiving: The victim as subject; (2) Being forgiven: Between lost forgiveness and hope; and (3) Self-forgiveness and the aging self. Despite the known salutary effect of forgiveness, we must consider that this is not a universally desirable process. We included the dimension of forgiveness in the study of abuse throughout the older person's life course and identified further complexities in addition to the "forgiveness"/"unforgiveness."
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Affiliation(s)
- Tova Band-Winterstein
- The Minerva Centre on Intersectionality in Aging (MCIA), Faculty of Social Welfare and Health Studies, University of Haifa, Haifa, Israel
| | - Ksenya Shulyaev
- The Minerva Centre on Intersectionality in Aging (MCIA), Faculty of Social Welfare and Health Studies, University of Haifa, Haifa, Israel
- Center of Research & Study of Aging (CRCA), Faculty of Social Welfare and Health Studies, University of Haifa, Haifa, Israel
| | - Zvi Eisikovits
- The Minerva Centre on Intersectionality in Aging (MCIA), Faculty of Social Welfare and Health Studies, University of Haifa, Haifa, Israel
- Centre for the Study of Society, Faculty of Social Welfare and Health Studies, University of Haifa, Haifa, Israel
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Wang Y, Chen X, Zhou K, Zhang H. A Meta-Analysis of the Effects of Childhood Maltreatment on Elderly Depression. TRAUMA, VIOLENCE & ABUSE 2023; 24:1593-1607. [PMID: 35232293 DOI: 10.1177/15248380211073838] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Background: The present study aimed to synthesize the effects of five types of child maltreatment (physical abuse, emotional abuse, sexual abuse, physical neglect and emotional neglect) on late-life depression.Method: Four English-language databases (Web of Science, PsycINFO and PsycARTICLES, PubMed, and Cochrane Library) and three Chinese databases (China National Knowledge Infrastructure, Wanfang Database, and Weipu Database) were systematically reviewed, and data related to the association between child maltreatment and late-life depression were extracted. Ten studies involving 30,308 older adults were included, and the effect sizes were pooled using random-effect models.Findings: Except for sexual abuse, four types of child maltreatment were found to be positively associated with late-life depression. Physical abuse, emotional abuse and physical neglect were associated with elderly depression (PA: OR = 1.73, 95% CI = 1.55-1.95, p < .001; EA: OR = 1.92, 95% CI = 1.73-2.12, p < .001; PN: OR = 2.05, 95% CI = 1.15-3.67, p < .01) at a small level, and emotional neglect was associated with elderly depression (OR = 3.25, 95% CI = 1.43-7.39, p < .001) at an approximately moderate level. Gender moderated the relationship between physical neglect, emotional neglect, and late-life depression.Conclusion: Our findings highlight the significance of child maltreatment in the development of late-life depression, and underscore the need for future research and practice to explore potential ways to address late-life depression among older adults who suffered child maltreatment.
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Affiliation(s)
- Yang Wang
- Department of Social Work and Social Policy, Renmin University of China, Beijing, China
| | - Xiaoxuan Chen
- Department of Social Work and Social Policy, Renmin University of China, Beijing, China
| | - Ke Zhou
- Department of Social Work and Social Policy, Renmin University of China, Beijing, China
| | - Huiping Zhang
- Department of Social Work and Social Policy, Renmin University of China, Beijing, China
- Center for Studies of Sociological Theory and Method, Renmin University of China, Beijing, China
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GÖKDAĞ C, KIZILTEPE R. Risk Factors in Depression and Anxiety Disorders from the Framework of Developmental Psychopathology. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2023. [DOI: 10.18863/pgy.1118163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
Depression and anxiety disorders are among the most prevalent psychiatric disorders that negatively affect individuals’ life in many ways. Understanding how these highly comorbid emotional disorders develop and persist might guide prevention, intervention, and treatment studies. Some common vulnerability factors underlie depression and anxiety disorders. Developmental psychopathology deals with these vulnerabilities and risk factors from a lifetime perspective. The aim of this review is to present the risk factors associated with depression and anxiety from the perspective of developmental psychopathology. For this purpose, we discussed genetic and biological factors, temperament, negative childhood experiences, family and peer relationships, and some cognitive and emotional factors as risk factors. Also, we discussed how these risk factors lead to depression and anxiety disorders. This review emphasizes that some common transdiagnostic risk factors underlie emotional disorders and highlights the importance of a developmental psychopathology perspective to understand the developmental pathways of depression and anxiety disorders.
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Akın A, Goth K, Seiffge-Krenke I, Obbarius A, Winter SM, Sarrar L. Operationalized Psychodynamic Diagnostic of Adolescents in Light of the New ICD-11 Model of Personality Functioning: Personality Structure, Psychodynamic Conflicts, and Mental Health Problems. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1095. [PMID: 37508592 PMCID: PMC10378630 DOI: 10.3390/children10071095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/18/2023] [Accepted: 06/20/2023] [Indexed: 07/30/2023]
Abstract
The International Classification of Diseases and Related Health Problems, 11th Revision introduced a fully dimensional approach to personality disorders which conceptionally converges with the long-standing psychodynamic understanding of psychopathology through underlying intra- and interpersonal impairments. In this study, the diagnostic contributions of the two psychodynamic concepts of personality structure and psychodynamic conflicts were investigated through the comparison of self-report data of 189 adolescents with mental health problems and 321 mentally healthy controls. The study results reveal that adolescents with mental health problems show significantly higher impairments in all four domains of personality structure and significantly higher levels of several psychodynamic conflicts. Further, adolescents with different mental health problems significantly differ regarding the impairments in the personality structure domains and several levels of psychodynamic conflicts. While higher structural impairments are shown in adolescents with eating and anxiety disorders, higher levels of the passive self-worth conflict persist in adolescents with depressive disorders, and higher levels of the passive identity conflict are affecting adolescents with eating disorders. The findings suggest that a standardized diagnostic assessment of personality structure and psychodynamic conflicts in adolescent patients could contribute to a deeper understanding of mental health problems and appropriate treatment planning through the detection of underlying intra- and interpersonal impairments.
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Affiliation(s)
- Aslı Akın
- Unit for Psychosomatic Medicine, Institute of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité-Medical Heart Center of Charité and German Heart Institute Berlin, 13353 Berlin, Germany
- Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Kirstin Goth
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics Basel, 4002 Basel, Switzerland
- Department of Child and Adolescent Psychiatry, University Clinics Saarland, 66421 Homburg, Germany
| | | | - Alexander Obbarius
- Department of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, 12200 Berlin, Germany
| | - Sibylle M Winter
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany
| | - Lea Sarrar
- Department of Psychology, Faculty of Sciences, MSB Medical School Berlin, 14197 Berlin, Germany
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Stalias-Mantzikos ME, Barahmand U, Aguero K, Peters L, Shamsina N. Early maladaptive schemas in misophonia. CLIN PSYCHOL-UK 2023. [DOI: 10.1080/13284207.2023.2171786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2023]
Affiliation(s)
- Maria E. Stalias-Mantzikos
- Department of Psychology, City University of New York, Queens College, New York, NY, USA
- Westchester Community College, SUNY, New York, NY, USA
| | - Usha Barahmand
- Department of Psychology, City University of New York, Queens College, New York, NY, USA
| | - Kerry Aguero
- Department of Psychology, City University of New York, Queens College, New York, NY, USA
| | - Laurisa Peters
- Department of Psychology, City University of New York, Queens College, New York, NY, USA
| | - Naila Shamsina
- Department of Psychology, City University of New York, Queens College, New York, NY, USA
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7
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Zhang K, Sun J, Zhang Q, Zhang J, He L, Wang Z, Hu L. The association between childhood trauma and pain symptoms in depressed adults: The moderating role of anxious attachment. Clin Psychol Psychother 2023. [PMID: 36630316 DOI: 10.1002/cpp.2824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 11/09/2022] [Accepted: 01/09/2023] [Indexed: 01/12/2023]
Abstract
Studies have previously demonstrated that anxious attachment shapes the association between childhood traumatic experiences and somatic pain; however, it remains unclear how this relationship is influenced by anxious attachment in patients with depression. This study investigated how anxious attachment influences the relationship between childhood traumatic experiences and pain symptoms in depressed patients from a social psychological perspective. A total of 139 adult patients with depression participated in this study; the level of depression was assessed by a psychiatric professional. Childhood trauma, pain symptoms, and attachment dimensions were tested by various questionnaires. The moderating role of anxious attachment in the trauma-pain association was examined using the PROCESS Model 1. Our findings showed that in depressed patients, childhood maltreatment had a significant positive impact on the severity of pain ratings. Moreover, anxious attachment influenced the relationship between childhood trauma and pain symptoms. Our study indicated that anxious attachment is not necessarily a negative outcome for depressed patients; moderate levels of anxious attachment alleviate childhood trauma-related pain symptoms in individuals with highly traumatic experiences. Understanding the traumatic experiences and attachment styles of depressed patients with pain complaints can help to develop intervention strategies.
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Affiliation(s)
- Kai Zhang
- Department of Psychiatry, School of Clinical Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Psychology, Affiliated Hospital of Jining Medical University, Jining, China
| | - Junyuan Sun
- Department of Psychiatry, School of Mental Health, Jining Medical University, Jining, China
| | - Qunlei Zhang
- Department of Psychiatry, Shandong Mental Health Center, Shandong University, Jinan, China
| | - Jianwei Zhang
- Department of Psychiatry, Shandong Mental Health Center, Shandong University, Jinan, China
| | - Long He
- Department of Psychiatry, School of Clinical Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Ziyang Wang
- Department of Psychiatry, School of Clinical Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Lei Hu
- Department of Psychiatry, Shandong Mental Health Center, Shandong University, Jinan, China
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8
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Rajkumar RP. Comorbid depression and anxiety: Integration of insights from attachment theory and cognitive neuroscience, and their implications for research and treatment. Front Behav Neurosci 2022; 16:1104928. [PMID: 36620859 PMCID: PMC9811005 DOI: 10.3389/fnbeh.2022.1104928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022] Open
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9
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Feng P, Lin L, Wang Y, Chen L, Min J, Xie Y, Liu M, Wei S, Lin S, Yu Q. Impacts of menopause hormone therapy on mood disorders among postmenopausal women. Climacteric 2022; 25:579-585. [PMID: 36179737 DOI: 10.1080/13697137.2022.2026915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE This study aimed to explore the modulatory effects of menopause hormone therapy (MHT) on mood disorders among postmenopausal women. METHODS A cross-sectional study was conducted to recruit postmenopausal women, including patients (arranged MHT for over 3 years as the medication group) and non-MHT controls. All participants were asked to respond to the Center for Epidemiological Studies Depression Scale (CES-D) and Generalized Anxiety Disorder Screener (GAD-7) questionnaires to assess their depression and anxiety status. RESULTS A total of 230 cases from the two groups were determined based on propensity score matching analysis by matching the menopausal age and menopausal durations. We found that MHT served as a favorable modulator in the depression status of postmenopausal women. Among the four factors of the CES-D questionnaire, our data indicated that the differences between the two groups fell primarily into two aspects: depressive emotion, and somatic symptoms or retarded activities. MHT was mainly involved in improving the depression of overweight women. However, no substantial effects of MHT were observed on the regulation of anxiety. CONCLUSION Postmenopausal women, especially the overweight population, who have experienced MHT exhibited an improved depressive status but not their anxiety condition.
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Affiliation(s)
- P Feng
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - L Lin
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.,Department of Obstetrics and Gynecology, the Maternal & Child Health Hospital of Guangxi Zhuang Autonomous Region, Guangxi, China
| | - Y Wang
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - L Chen
- Division of Prevention and Community Health, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - J Min
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing, China
| | - Y Xie
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - M Liu
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - S Wei
- Department of Obstetrics and Gynecology, Fangchenggang Maternal and Child Health Care Hospital, Guangxi, China
| | - S Lin
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Q Yu
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Kovács G, van Dijke A, Leontjevas R, Enders-Slegers MJ. The Relevance of Internal Working Models of Self and Others for Equine-Assisted Psychodynamic Psychotherapy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10803. [PMID: 36078534 PMCID: PMC9518159 DOI: 10.3390/ijerph191710803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 08/25/2022] [Accepted: 08/26/2022] [Indexed: 06/15/2023]
Abstract
Attachment characteristics play a key role in mental health and in understanding mental disorders. The aim of this study was to gain insight into the role the attachment characteristics can play in treatment effects in adult patients with intrapsychic and interpersonal problems who underwent Equine-assisted Short-term Psychodynamic Psychotherapy (ESTPP). In the first part of the study, we compared the effects of ESTPP to treatment-as-usual from a previous dataset regarding psychological dysfunction. For this, an explorative experimental non-randomized pre-treatment and 1-year post-treatment design was used. A mixed model revealed a significant decline in psychological dysfunction for both conditions, with no significant difference between the two. In the second part of the study, we examined the course of ESTPP effects over the period of 1 year when controlled for attachment styles and, subsequently, for internal working models of self and others. To this end, measurements were taken at baseline, 2 months waiting time, one-week intensive module, 6 months, and one year after the start of the treatment. Mixed models accounted for repeated measures showed significant improvements in psychological dysfunction, remoralization, and depression for ESTPP patients over time. The study implies that models of self and others may be used to predict the course of effects, which is relevant in determining what works for whom. In particularly, duration and intensity of therapy and a focus on the Model of Self seem relevant for shaping a more personalized treatment. ESTPP seems beneficial for patients with low pre-treatment attachment security.
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Affiliation(s)
- Géza Kovács
- Department of Psychology, Open University of the Netherlands, 6419 AT Heerlen, The Netherlands
- SPEL Psychologen Putten, 3881 NE Putten, The Netherlands
| | - Annemiek van Dijke
- PsyQ I-Psy Brijder The Netherlands, Leiden University Medical Centre, 2333 ZA Leiden, The Netherlands
| | - Roeslan Leontjevas
- Department of Psychology, Open University of the Netherlands, 6419 AT Heerlen, The Netherlands
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11
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Packard K, Opendak M. Rodent models of early adversity: Impacts on developing social behavior circuitry and clinical implications. Front Behav Neurosci 2022; 16:918862. [PMID: 35990728 PMCID: PMC9385963 DOI: 10.3389/fnbeh.2022.918862] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/08/2022] [Indexed: 11/13/2022] Open
Abstract
Flexible and context-appropriate social functioning is key for survival across species. This flexibility also renders social behavior highly plastic, particularly during early development when attachment to caregiver can provide a template for future social processing. As a result, early caregiving adversity can have unique and lasting impacts on social behavior and even confer vulnerability to psychiatric disorders. However, the neural circuit mechanisms translating experience to outcome remain poorly understood. Here, we consider social behavior scaffolding through the lens of reward and threat processing. We begin by surveying several complementary rodent models of early adversity, which together have highlighted impacts on neural circuits processing social cues. We next explore these circuits underlying perturbed social functioning with focus on dopamine (DA) and its role in regions implicated in social and threat processing such as the prefrontal cortex (PFC), basolateral amygdala (BLA) and the lateral habenula (LHb). Finally, we turn to human populations once more to examine how altered DA signaling and LHb dysfunction may play a role in social anhedonia, a common feature in diagnoses such as schizophrenia and major depressive disorder (MDD). We argue that this translational focus is critical for identifying specific features of adversity that confer heightened vulnerability for clinical outcomes involving social cue processing.
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Affiliation(s)
- Katherine Packard
- Department of Neuroscience, Kennedy Krieger Institute, Baltimore, MD, United States
| | - Maya Opendak
- Department of Neuroscience, Kennedy Krieger Institute, Baltimore, MD, United States
- Solomon H. Snyder Department of Neuroscience, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
- *Correspondence: Maya Opendak
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Sheffler J, Meyer C, Puga F. Multi-sample assessment of stress reactivity as a mediator between childhood adversity and mid- to late-life outcomes. Aging Ment Health 2022; 26:1207-1216. [PMID: 33860705 DOI: 10.1080/13607863.2021.1910787] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVES We examined whether adult stress reactivity accounts for the relationship between early life adversity (ELA) and psychological, physical, and cognitive outcomes. METHODS We examined the relationship between ELA, stress reactivity, psychological well-being, physical health, and cognitive function in two separate datasets - a cross-sectional community sample of older adults (N = 510) aged 60 and older, and waves I-III of the Midlife in the United States (MIDUS) dataset. Age, sex, and income served as covariates in all analyses. Bootstrapped mediation models were used to assess recent stress as a mediator between ELA and mid- to late-life outcomes. RESULTS ELA was significantly associated with adult stress, anxiety, depression, health conditions, and object cognitive assessments. Adult stress partially accounted for the relationships between ELA and depression, anxiety, health conditions, and memory problems. CONCLUSION Our findings demonstrate that ELA may influence increased stress in older age, which confers additional risks for developing depression, anxiety, health problems, and cognitive decline. It is possible that intervening on adult stress may reduce risk for both psychological and physical pathology across the lifespan. Further research is needed to develop targeted interventions for mid and late-life stress to improve overall health as individuals age.
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Affiliation(s)
- Julia Sheffler
- Behavioral Sciences and Social Medicine Department, Florida State University College of Medicine, Tallahassee, FL, USA
| | - Celina Meyer
- Behavioral Sciences and Social Medicine Department, Florida State University College of Medicine, Tallahassee, FL, USA
| | - Frank Puga
- Department of Acute, Chronic and Continuing Care, The University of Alabama at Birmingham, Birmingham, AL, USA
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Adverse childhood experiences and late-life diurnal HPA axis activity: Associations of different childhood adversity types and interaction with timing in a sample of older East Prussian World War II refugees. Psychoneuroendocrinology 2022; 139:105717. [PMID: 35313255 DOI: 10.1016/j.psyneuen.2022.105717] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 02/21/2022] [Accepted: 03/07/2022] [Indexed: 11/21/2022]
Abstract
Adverse childhood experiences (ACEs) have been associated with unfavorable health outcomes throughout the life up to old age. Mechanisms through which ACEs impact later life health are still not entirely clear. There is growing evidence for the idea that alterations in the hypothalamic pituitary adrenal (HPA) axis might cause the effects of ACEs on later health consequences. Only few studies have investigated associations between ACEs and diurnal HPA axis functioning in older adults. Therefore, we investigated the impact of type and timing of ACEs linked to flight of war on diurnal HPA axis activity in a sample of East Prussian World War II refugees aged 74-91 years. We calculated a dichotomous variable according to the (minimum) age at trauma: early ACE (eACE; 0-5 years) and late ACE (lACE; 6-17 years). Multiple linear regression analysis using different ACEs linked to flight of war (war-related trauma, individual experience of violence, neglect) as well as age at trauma and the interactions of ACEs and age at trauma as predictors and three cortisol outcomes (AUCG (area under the curve with respect to the ground), decline (morning to night) and CAR (cortisol awakening response)) was performed. For AUCG, we found a negative association of individual experience of violence only in lACE participants. For decline, a positive association with neglect was observed for the whole study sample. The overall model for CAR was not statistically significant. Our findings support the hypothesis that type as well as timing of ACEs might influence diurnal HPA axis functioning into old age. These findings may contribute to a better understanding of the lifelong influence of ACEs.
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Silva M, Pereira H. The Impact of Life Trauma on Mental Health and Suicidal Behavior: A Study from Portuguese Language Countries. Behav Sci (Basel) 2022; 12:bs12040102. [PMID: 35447674 PMCID: PMC9031010 DOI: 10.3390/bs12040102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/02/2022] [Accepted: 04/08/2022] [Indexed: 02/05/2023] Open
Abstract
Several studies report the incidence of traumatic experiences in community and clinical samples, and substantial research demonstrates the impact of traumatic events on mental health and suicidal behavior, but this area remains unexplored in the Community of Portuguese Language Countries (CPLC). Thus, this study aims to (1) describe traumatic experiences, mental health levels and suicidal behavior among individuals from Portugal, Brazil and African Countries with Portuguese as an Official Language (ACPOL); (2) assess correlations between traumatic experiences and mental health and suicidal behavior; and (3) assess the impact of exposure to a traumatic event on mental health and suicidal behavior. The measurement instruments included a sociodemographic questionnaire, Brief Trauma Questionnaire, Brief Symptoms Inventory-18, and the Portuguese version of the Suicidal Behaviors Questionnaire-Revised. ACPOL participants reported greater impact of war, Portuguese participants reported greater impact of disasters, and Brazilian participants reported greater impact of psychological and sexual abuse, assault, and death of a family member. Brazilian participants showed the worst levels of mental health and suicidal thoughts. Strong correlations were found between traumatic experiences and mental health levels and suicidal behavior. Traumatic experiences contributed to the explanation of mental health levels and probability of committing suicide.
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Affiliation(s)
- Mariana Silva
- Department of Psychology and Education, Faculty of Social and Human Sciences, University of Beira Interior, Pólo IV, 6200-209 Covilhã, Portugal;
| | - Henrique Pereira
- Department of Psychology and Education, Faculty of Social and Human Sciences, University of Beira Interior, Pólo IV, 6200-209 Covilhã, Portugal;
- Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal
- Correspondence:
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Panagou C, MacBeth A. Deconstructing pathways to resilience: A systematic review of associations between psychosocial mechanisms and transdiagnostic adult mental health outcomes in the context of adverse childhood experiences. Clin Psychol Psychother 2022; 29:1626-1654. [PMID: 35266603 PMCID: PMC9790303 DOI: 10.1002/cpp.2732] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 03/02/2022] [Accepted: 03/07/2022] [Indexed: 12/30/2022]
Abstract
Adverse childhood experiences (ACEs) are identified with increased risk of adult mental health difficulties and negative impacts on well-being. However, there is a need to go beyond simple associations and identify candidate mechanisms underpinning the ACEs-mental health relationship. Further methodological heterogeneity points to issues around the operationalization of ACEs and the importance of modelling data using robust research designs. The aim of the current review was to synthesize studies that utilized formal mediation and/or moderation analyses to explore psychological and social variables on the pathway between clearly defined ACEs (as measured by the ACE questionnaire and Childhood Trauma Questionnaire [CTQ]) and common mental health outcomes (depressive, anxiety and post-traumatic stress disorder [PTSD] symptoms) across community samples aged over 18. A total of 31 papers were retrieved for critical appraisal. The majority of the studies explored factors mediating/moderating the link between child adversity and depression and less on anxiety and trauma. Most mechanisms were tested in only single studies, limiting the consistency of evidence. Evidence indicated that the mechanisms underlying associations between ACEs and adult mental health are likely to reflect multiple intervening variables. Further, there are substantial methodological limitations in the extant literature including the proliferation of causal inferences from cross-sectional designs and both measurement and conceptual issues in operationalizing adversity. Consistent transdiagnostic mechanisms relevant to common mental health problems were identified, including perceived social support, emotion regulation and negative cognitive appraisals/beliefs. Further research using longitudinal design is required to delineate the potential contribution of the identified mechanisms.
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Affiliation(s)
- Corinna Panagou
- School of Health in Social ScienceUniversity of EdinburghEdinburghEH8 9AGUK
| | - Angus MacBeth
- School of Health in Social ScienceUniversity of EdinburghEdinburghEH8 9AGUK
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Silva M, Pereira H, Beatriz C. Trauma, Mental Health, and Suicidal Tendencies: Lessons from Portuguese Language Countries. JOURNAL OF LOSS & TRAUMA 2021. [DOI: 10.1080/15325024.2021.2007651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Mariana Silva
- Clinical and Health Psychology, University of Beira Interior, Covilhã, Portugal
| | - Henrique Pereira
- Department of Psychology and Education Researcher at the Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD - Portugal), University of Beira Interior, Covilhã, Portugal
| | - Colleen Beatriz
- Fulbright Scholar at the Department of Psychology and Education, University of Beira Interior, Covilhã, Portugal
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Almeida TC, Guarda R, Cunha O. Positive childhood experiences and adverse experiences: Psychometric properties of the Benevolent Childhood Experiences Scale (BCEs) among the Portuguese population. CHILD ABUSE & NEGLECT 2021; 120:105179. [PMID: 34198123 DOI: 10.1016/j.chiabu.2021.105179] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 05/25/2021] [Accepted: 06/16/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Positive childhood experiences have a positive effect on adulthood, and the absence of positive experiences can be more damaging throughout life than the presence of adversity. Recently, researchers have developed the Benevolent Childhood Experiences Scale (BCEs), an instrument designed to assess positive childhood experiences. OBJECTIVES The present study aims to adapt the BCEs to the Portuguese population and examines its psychometric properties. PARTICIPANTS AND SETTINGS 1886 adults with a mean age of 36.36 years (SD = 13.66) from the community participated in this study. METHODS Participants responded to an online protocol consisting of a sociodemographic questionnaire, the BCEs, and the Childhood Trauma Questionnaire (CTQ). RESULTS Exploratory and confirmatory factor analysis revealed a one-factor structure for the BCEs with a good fit, CFI = 0.94; NFI = 0.92; RMSEA = 0.043 [0.036, 0.050]. Results also indicated satisfactory internal consistency and discriminant validity values. Predictive validity showed that higher BCEs scores predicted fewer adverse experiences in the last 3 years, but only before accounting for adverse childhood experiences. CONCLUSIONS Overall, the results support the assertion that the Portuguese version of the BCEs is a valuable, brief, and psychometrically reliable instrument to measure positive childhood experiences that is suitable for use in Portugal.
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Affiliation(s)
- Telma Catarina Almeida
- Instituto Universitário Egas Moniz, Caparica, Portugal; LabPSI - Laboratório de Psicologia Egas Moniz; CiiEM - Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz, Caparica, Portugal.
| | - Renata Guarda
- Instituto Universitário Egas Moniz, Caparica, Portugal; LabPSI - Laboratório de Psicologia Egas Moniz
| | - Olga Cunha
- Universidade Lusófona, Portugal, Hei-Lab
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Erkoreka L, Zamalloa I, Rodriguez S, Muñoz P, Mendizabal I, Zamalloa MI, Arrue A, Zumarraga M, Gonzalez-Torres MA. Attachment anxiety as mediator of the relationship between childhood trauma and personality dysfunction in borderline personality disorder. Clin Psychol Psychother 2021; 29:501-511. [PMID: 34228846 DOI: 10.1002/cpp.2640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 06/24/2021] [Accepted: 06/25/2021] [Indexed: 11/11/2022]
Abstract
Insecure attachment has been described as mediating the relationship between childhood trauma and dysfunctional personality traits in different mental disorders. Despite the role insecure attachment and childhood trauma have independently demonstrated to play as determinants of borderline personality disorder, less is known about the mediating mechanisms explaining these associations. For the first time, we assessed adult attachment, childhood trauma and dimensional personality pathology in a sample of outpatients with borderline personality disorder and tested whether the association between childhood trauma and personality dysfunction was at least partially attributable to insecure attachment. The results showed that attachment anxiety fully mediated the relationship between specific types of trauma (emotional abuse and physical neglect) and emotional dysregulation. Further, emotional abuse was both directly associated with dissocial behaviour and indirectly via attachment anxiety (partial mediation). Emotional abuse has been described as an essential environmental factor for the development of borderline personality disorder and emotional dysregulation, on its part, as the core feature of the condition. Our results indicate that attachment anxiety explains the link between these central aspects of borderline personality disorder. Our findings are consistent with previous research and current etiological understanding of the condition and provide support for recommending a careful assessment of childhood traumatic experiences and adult attachment style to gain a more comprehensive insight into the symptoms and its heterogeneity. As a secondary aim, we assessed the effect parental mental illness may have in these mediation models, but no significant influence on childhood trauma, attachment or personality was found.
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Affiliation(s)
- Leire Erkoreka
- Department of Psychiatry, Galdakao-Usansolo Hospital, Osakidetza Basque Health Service, Galdakao, Spain.,Department of Neurosciences, University of the Basque Country UPV/EHU, Leioa, Spain.,Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - Iker Zamalloa
- Department of Neurosciences, University of the Basque Country UPV/EHU, Leioa, Spain
| | | | - Pedro Muñoz
- Eating Disorders Unit, Bizkaia Mental Health Network, Osakidetza Basque Health Service, Barakaldo, Spain
| | - Imanol Mendizabal
- Department of Neurosciences, University of the Basque Country UPV/EHU, Leioa, Spain
| | - M Isabel Zamalloa
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,Department of Neurochemical Research, Bizkaia Mental Health Network, Osakidetza Basque Health Service, Barakaldo, Spain
| | - Aurora Arrue
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,Department of Neurochemical Research, Bizkaia Mental Health Network, Osakidetza Basque Health Service, Barakaldo, Spain
| | - Mercedes Zumarraga
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,Department of Neurochemical Research, Bizkaia Mental Health Network, Osakidetza Basque Health Service, Barakaldo, Spain
| | - Miguel Angel Gonzalez-Torres
- Department of Neurosciences, University of the Basque Country UPV/EHU, Leioa, Spain.,Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,Department of Psychiatry, Basurto University Hospital, Osakidetza Basque Health Service, Bilbao, Spain
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Guo R, Sun M, Zhang C, Fan Z, Liu Z, Tao H. The Role of Military Training in Improving Psychological Resilience and Reducing Depression Among College Freshmen. Front Psychiatry 2021; 12:641396. [PMID: 34079481 PMCID: PMC8166047 DOI: 10.3389/fpsyt.2021.641396] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 03/31/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Military training plays an important protective role in enhancing mental health. However, the effects of military training on psychological resilience and depression among college freshmen in China remain unclear. The present study aimed to evaluate changes in psychological resilience and depression through military training among college freshmen, and to investigate associated psychosocial factors including childhood trauma that may influence its effects on psychological resilience. Methods: A prospective and self-comparison study design was employed. College freshmen who received 3 weeks of military training were recruited. Socio-demographic variables were collected and childhood trauma exposure was estimated by the Childhood Trauma Questionnaire (CTQ). The Connor-Davidson Resilience Scale (CD-RISC) and Patient Health Questionnaire (PHQ-9) were used to assess psychological resilience and depression before and after the military-style training. Results: The military training significantly increased the total and subscale scores of CD-RISC (p < 0.001), and decreased the PHQ-9 score (p < 0.001). The proportion of students with clinical depression reduced from 10.5% at baseline to 7.2% after the training (p < 0.001). Improvement of CD-RISC scores was positively affected by male gender and urban area, while negatively affected by older age, and higher baseline scores of PHQ-9 and CTQ. A significant correlation was found between changes in scores of CD-RISC and PHQ-9 through the training (r = -0.238, p < 0.001). Conclusions: Military training may have a positive effect on increasing psychological resilience and reducing depressive symptoms among college freshmen, especially in male students and those from an urban area, while older age, childhood trauma, higher depression levels, and resilience at baseline may weaken, or even mask its positive effect. Follow-up research should be considered for the long-term effects of military-style training.
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Affiliation(s)
- Rui Guo
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China.,National Technology Institute on Mental Disorders, Changsha, China
| | - Meng Sun
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Chi Zhang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Zebin Fan
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China.,National Technology Institute on Mental Disorders, Changsha, China
| | - Zhening Liu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China.,National Technology Institute on Mental Disorders, Changsha, China
| | - Haojuan Tao
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China.,National Technology Institute on Mental Disorders, Changsha, China
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Li ET, Luyten P, Midgley N. Psychological Mediators of the Association Between Childhood Emotional Abuse and Depression: A Systematic Review. Front Psychiatry 2020; 11:559213. [PMID: 33343409 PMCID: PMC7746653 DOI: 10.3389/fpsyt.2020.559213] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 11/04/2020] [Indexed: 12/17/2022] Open
Abstract
Background: A number of existing meta-analyses and narrative reviews have already addressed the relation between childhood adversity and depression, yet none of them has examined the specific link between emotional abuse and depression highlighted by previous research. It is no longer appropriate to regard childhood maltreatment as a unitary concept when considering its effects on subsequent depression; instead, subtypes of childhood maltreatment need to be scrutinized separately. This review addresses this significant gap by critically evaluating empirical studies examining psychological mediators of the relationship between childhood emotional abuse and subsequent depression. Methods: A systematic search of nine electronic databases was conducted to identify eligible studies published in English between January 1980 and January 2020. Given the heterogeneous outcomes of eligible studies and the inconsistent reporting of indirect effects, a narrative synthesis, rather than a quantitative meta-analysis, was conducted. An appraisal of methodological quality was also included. Results: We identified 34 papers, comprising 18,529 adults and 3,434 adolescents, including 888 clinical participants. Our synthesis suggests that studies on mediators in the emotional abuse-depression link have focused on five clusters of intervening variables: early maladaptive schemas, cognitive-personality variables, emotion dysregulation, interpersonal styles, and stressful negative events. Only 11 studies identified the unique contribution of emotional abuse to depression by controlling for other forms of childhood maltreatment. Conclusions: Our findings support several routes with relative consistency (e.g., early maladaptive schemas, hopelessness, negative cognitive styles, brooding rumination, overall emotion dysregulation). Because psychological mediators function as a complex interrelated system, controlling for the interrelation between them is important. The evidence for the purported mediating role of the factors identified in this review should be considered with caution given the relative dearth of large-scale, adequately powered longitudinal studies. This review proposes a comprehensive multilevel theoretical framework as a basis for future research.
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Affiliation(s)
- Elizabeth Tianyu Li
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
- Anna Freud National Centre for Children and Families, London, United Kingdom
| | - Patrick Luyten
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
- Anna Freud National Centre for Children and Families, London, United Kingdom
- Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium
- Child Study Center, School of Medicine, Yale University, New Haven, CT, United States
| | - Nick Midgley
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
- Anna Freud National Centre for Children and Families, London, United Kingdom
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Flores-Flores O, Zevallos-Morales A, Carrión I, Pawer D, Rey L, Checkley W, Hurst JR, Siddharthan T, Parodi JF, Gallo JJ, Pollard SL. "We can't carry the weight of the whole world ": illness experiences among Peruvian older adults with symptoms of depression and anxiety. Int J Ment Health Syst 2020; 14:49. [PMID: 32670400 PMCID: PMC7350592 DOI: 10.1186/s13033-020-00381-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 07/03/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Despite the high levels of depression and anxiety symptoms in old age, the use of mental health services in this population is low. Help-seeking behaviors are shaped by how an individual perceives and experiences their illness. The objective of this study was to characterize the illness experiences of Peruvian older adults with depression and anxiety symptoms in order to lay the foundation for tailored community-based mental health interventions. METHODS In this qualitative study, we conducted in-depth interviews with a purposively selected sample of older adults (≥ 60 years) from peri-urban areas of Lima, Peru. We included individuals with only depressive symptoms (Patient Health Questionnaire-9 ≥ 10), only anxiety symptoms (Beck Anxiety Inventory ≥ 16), with depressive and anxiety symptoms, and older adults who mentioned they had received mental health treatment/care. The interview guide included the following topics: perceptions and experiences about depression and anxiety; perceptions about the relationship between physical chronic diseases and mental health; experiences with mental health professionals and treatments, and coping mechanisms. Data collection was conducted between October 2018 and February 2019. RESULTS We interviewed 38 participants (23 women, 15 men) with a mean age of 67.9 years. Participants' ideas and perceptions of depression and anxiety showed considerable overlap. Participants attributed depression and anxiety mainly to familial and financial problems, loneliness, loss of independence and past traumatic experiences. Coping strategies used by older adults included 'self-reflection and adaptation' to circumstances, 'do your part', and seeking 'emotional support' mainly from non-professionals (relatives, friends, acquaintances, and religion). CONCLUSIONS Illness experiences of depression and anxiety set the pathway for tailored community-based mental health interventions for older adults. Overlapping narratives and perceptions of depression and anxiety suggest that these conditions should be addressed together. Mental health interventions should incorporate addressing areas related to depression and anxiety such as prevention of loss of independence, trauma, and loneliness. Good acceptability of receiving emotional support for non-professionals might offer an opportunity to incorporate them when delivering mental health care to older adults.
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Affiliation(s)
- Oscar Flores-Flores
- Facultad de Medicina Humana, Centro de Investigación del Envejecimiento (CIEN), Universidad de San Martin de Porres, Lima, Peru
- Asociación Benéfica PRISMA, Lima, Peru
| | | | - Ivonne Carrión
- Facultad de Medicina Humana, Universidad de San Martin de Porres, Lima, Peru
| | - Dalia Pawer
- Facultad de Medicina Humana, Universidad de San Martin de Porres, Lima, Peru
| | - Lorena Rey
- Pontificia Universidad Católica del Perú, Lima, Peru
| | - W. Checkley
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD USA
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD USA
- Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, MD USA
| | - J. R. Hurst
- UCL Respiratory, University College London, London, UK
| | - T. Siddharthan
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD USA
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD USA
- Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, MD USA
| | - Jose F. Parodi
- Facultad de Medicina Humana, Centro de Investigación del Envejecimiento (CIEN), Universidad de San Martin de Porres, Lima, Peru
| | - Joseph J. Gallo
- Department of Mental Health, Bloomberg School of Public Health, Baltimore, MD USA
- Department of General Internal Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD USA
| | - Suzanne L. Pollard
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD USA
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD USA
- Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, MD USA
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Junod A, Opendak M, LeDoux JE, Sullivan RM. Development of Threat Expression Following Infant Maltreatment: Infant and Adult Enhancement but Adolescent Attenuation. Front Behav Neurosci 2019; 13:130. [PMID: 31293397 PMCID: PMC6603125 DOI: 10.3389/fnbeh.2019.00130] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 06/03/2019] [Indexed: 12/21/2022] Open
Abstract
Early life maltreatment by the caregiver constitutes a major risk factor for the development of later-life psychopathologies, including fear-related pathologies. Here, we used an animal model of early life maltreatment induced by the Scarcity-Adversity Model of low bedding (LB) where the mother is given insufficient bedding for nest building while rat pups were postnatal days (PN) 8-12. To assess effects of maltreatment on the expression of threat-elicited defensive behaviors, animals underwent odor-shock threat conditioning at three developmental stages: late infancy (PN18), adolescence (PN45) or adulthood (>PN75) and tested the next day with odor only presentations (cue test). Results showed that in typically developing rats, the response to threat increases with maturation, although experience with maltreatment in early infancy produced enhanced responding to threat in infancy and adulthood, but a decrease in maltreated adolescents. To better understand the unique features of this decreased threat responding in adolescence, c-Fos expression was assessed within the amygdala and ventromedial prefrontal cortex (vmPFC) associated with the cued expression of threat learning. Fos counts across amygdala subregions were lower in LB rats compared to controls, while enhanced c-Fos expression was observed in the vmPFC prelimbic cortex (PL). Correlational analysis between freezing behavior and Fos revealed freezing levels were correlated with CeA in controls, although more global correlations were detected in LB-reared rats, including the BA, LA, and CeA. Functional connectivity analysis between brain regions showed that LB reared rats exhibited more diffuse interconnectivity across amygdala subnuclei, compared the more heterogeneous patterns observed in controls. In addition, functional connectivity between the IL and LA switched from positive to negative in abused adolescents. Overall, these results suggest that in adolescence, the unique developmental decrease in fear expression following trauma is associated with distinct changes in regional function and long-range connectivity, reminiscent of pathological brain function. These results suggest that early life maltreatment from the caregiver perturbs the developmental trajectory of threat-elicited behavior. Indeed, it is possible that this form of trauma, where the infant's safety signal or "safe haven" (the caregiver) is actually the source of the threat, produces distinct outcomes across development.
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Affiliation(s)
- Anouchka Junod
- Emotional Brain Institute, Nathan Kline Institute, Orangeburg, NY, United States
- Child and Adolescent Psychiatry, New York University School of Medicine, New York, NY, United States
| | - Maya Opendak
- Emotional Brain Institute, Nathan Kline Institute, Orangeburg, NY, United States
- Child and Adolescent Psychiatry, New York University School of Medicine, New York, NY, United States
| | - Joseph E. LeDoux
- Emotional Brain Institute, Nathan Kline Institute, Orangeburg, NY, United States
- Center for Neural Science, New York University, New York, NY, United States
| | - Regina M. Sullivan
- Emotional Brain Institute, Nathan Kline Institute, Orangeburg, NY, United States
- Child and Adolescent Psychiatry, New York University School of Medicine, New York, NY, United States
- Center for Neural Science, New York University, New York, NY, United States
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